Potentiation: Effect of Ballistic and Heavy Exercise on Vertical Jump Performance.

PubMed

Hester, Garrett M; Pope, Zachary K; Sellers, John H; Thiele, Ryan M; DeFreitas, Jason M

2017-03-01

Hester, GM, Pope, ZK, Sellers, JH, Thiele, RM, and DeFreitas, JM. Potentiation: Effect of ballistic and heavy exercise on vertical jump performance. J Strength Cond Res 31(3): 660-666, 2017-The purpose of this study was to compare the acute effects of heavy and ballistic conditioning protocols on vertical jump performance in resistance-trained men. Fourteen resistance-trained men (mean ± SD: age = 22 ± 2.1 years, body mass = 86.29 ± 9.95 kg, and height = 175.39 ± 9.34 cm) with an average relative full squat of 2.02 ± 0.28 times their body mass participated in this study. In randomized, counterbalanced order, subjects performed two countermovement vertical jumps before and 1, 3, 5, and 10 minutes after either performing 10 rapid jump squats or 5 heavy back squats. The back squat protocol consisted of 5 repetitions at 80% one repetition maximum (1RM), whereas the jump squat protocol consisted of 10 repetitions at 20% 1RM. Peak jump height (in centimeters) using a jump mat, along with power output (in Watts) and velocity (in meters per second) through a linear transducer, was recorded for each time interval. There was no significant condition × time interaction for any of the dependent variables (p = 0.066-0.127). In addition, there was no main effect for condition for any of the dependent variables (p = 0.457-0.899). Neither the ballistic nor heavy protocol used in this study enhanced vertical jump performance at any recovery interval. The use of these protocols in resistance-trained men to produce postactivation potentiation is not recommended.

Standardized patient walkthroughs in the National Drug Abuse Treatment Clinical Trials Network: common challenges to protocol implementation.

PubMed

Fussell, Holly E; Kunkel, Lynn E; McCarty, Dennis; Lewy, Colleen S

2011-09-01

Training research staff to implement clinical trials occurring in community-based addiction treatment programs presents unique challenges. Standardized patient walkthroughs of study procedures may enhance training and protocol implementation. Examine and discuss cross-site and cross-study challenges of participant screening and data collection procedures identified during standardized patient walkthroughs of multi-site clinical trials. Actors portrayed clients and "walked through" study procedures with protocol research staff. The study completed 57 walkthroughs during implementation of 4 clinical trials. Observers and walkthrough participants identified three areas of concern (consent procedures, screening and assessment processes, and protocol implementation) and made suggestions for resolving the concerns. Standardized patient walkthroughs capture issues with study procedures previously unidentified with didactic training or unscripted rehearsals. Clinical trials within the National Drug Abuse Treatment Clinical Trials Network are conducted in addiction treatment centers that vary on multiple dimensions. Based on walkthrough observations, the national protocol team and local site leadership modify standardized operating procedures and resolve cross-site problems prior to recruiting study participants. The standardized patient walkthrough improves consistency across study sites and reduces potential site variation in study outcomes.

IL-6, Antioxidant Capacity and Muscle Damage Markers Following High-Intensity Interval Training Protocols

PubMed Central

2017-01-01

Abstract The aim of this study was to investigate changes of interleukin-6 (IL-6), total antioxidant capacity (TAC) and muscle damage markers (creatine kinase (CK), myoglobin and lactate dehydrogenase (LDH)) in response to three different high-intensity interval training (HIIT) protocols of identical external work. Twelve moderately-trained males participated in the three HIIT trials which consisted of a warm-up, followed by 12 min of 15 s, 30 s or 60 s HIIT sequences with the work/rest ratio 1. The biochemical markers of inflammation, oxidative stress and muscle damage were analysed POST, 3 h and 24 h after the exercise. All HIIT protocols caused an immediate increase in IL-6, TAC, CK, myoglobin and LDH. The most pronounced between-trials differences were found for the POST-exercise changes in IL-6 (Effect size ± 90% confidence interval: 1.51 ± 0.63, 0.84 ± 0.34 and 1.80 ± 0.60 for the 15s/15s, 30s/30s and 60s/60s protocol, respectively) and myoglobin (1.11 ± 0.29, 0.45 ± 0.48 and 1.09 ± 0.22 for the 15s/15s, 30s/30s and 60s/60s protocol, respectively). There were no substantial between-trial differences in other biochemical variables. In conclusion, the 15s/15s and 60s/60s protocols might be preferred to the 30s/30s protocols in order to maximize the training stimulus. PMID:28469752

Pilot study of a robotic protocol to treat shoulder subluxation in patients with chronic stroke

PubMed Central

2013-01-01

Background Shoulder subluxation is a frequent complication of motor impairment after stroke, leading to soft tissue damage, stretching of the joint capsule, rotator cuff injury, and in some cases pain, thus limiting use of the affected extremity beyond weakness. In this pilot study, we determined whether robotic treatment of chronic shoulder subluxation can lead to functional improvement and whether any improvement was robust. Methods 18 patients with chronic stroke (3.9 ± 2.9 years from acute stroke), completed 6 weeks of robotic training using the linear shoulder robot. Training was performed 3 times per week on alternate days. Each session consisted of 3 sets of 320 repetitions of the affected arm, and the robotic protocol alternated between training vertical arm movements, shoulder flexion and extension, in an anti-gravity plane, and training horizontal arm movements, scapular protraction and retraction, in a gravity eliminated plane. Results Training with the linear robot improved shoulder stability, motor power, and resulted in improved functional outcomes that were robust 3 months after training. Conclusion In this uncontrolled pilot study, the robotic protocol effectively treated shoulder subluxation in chronic stroke patients. Treatment of subluxation can lead to improved functional use of the affected arm, likely by increasing motor power in the trained muscles. PMID:23914834

Pilot study of a robotic protocol to treat shoulder subluxation in patients with chronic stroke.

PubMed

Dohle, Carolin I; Rykman, Avrielle; Chang, Johanna; Volpe, Bruce T

2013-08-05

Shoulder subluxation is a frequent complication of motor impairment after stroke, leading to soft tissue damage, stretching of the joint capsule, rotator cuff injury, and in some cases pain, thus limiting use of the affected extremity beyond weakness. In this pilot study, we determined whether robotic treatment of chronic shoulder subluxation can lead to functional improvement and whether any improvement was robust. 18 patients with chronic stroke (3.9 ± 2.9 years from acute stroke), completed 6 weeks of robotic training using the linear shoulder robot. Training was performed 3 times per week on alternate days. Each session consisted of 3 sets of 320 repetitions of the affected arm, and the robotic protocol alternated between training vertical arm movements, shoulder flexion and extension, in an anti-gravity plane, and training horizontal arm movements, scapular protraction and retraction, in a gravity eliminated plane. Training with the linear robot improved shoulder stability, motor power, and resulted in improved functional outcomes that were robust 3 months after training. In this uncontrolled pilot study, the robotic protocol effectively treated shoulder subluxation in chronic stroke patients. Treatment of subluxation can lead to improved functional use of the affected arm, likely by increasing motor power in the trained muscles.

Comparison of Sensorimotor Rhythm (SMR) and Beta Training on Selective Attention and Symptoms in Children with Attention Deficit/Hyperactivity Disorder (ADHD): A Trend Report.

PubMed

Mohammadi, Mohammad Reza; Malmir, Nastaran; Khaleghi, Ali; Aminiorani, Majd

2015-06-01

The aim of this study was to assess and compare the effect of two neurofeedback protocols (SMR/theta and beta/theta) on ADHD symptoms, selective attention and EEG (electroencephalogram) parameters in children with ADHD. The sample consisted of 16 children (9-15 year old: 13 boys; 3 girls) with ADHD-combined type (ADHD-C). All of children used methylphenidate (MPH) during the study. The neurofeedback training consisted of two phases of 15 sessions, each lasting 45 minutes. In the first phase, participants were trained to enhance sensorimotor rhythm (12-15 Hz) and reduce theta activity (4-8 Hz) at C4 and in the second phase; they had to increase beta (15-18 Hz) and reduce theta activity at C3. Assessments consisted of d2 attention endurance test, ADHD rating scale (parent form) at three time periods: before, middle and the end of the training. EEG signals were recorded just before and after the training. Based on parents' reports, inattention after beta/theta training, and hyperactivity/impulsivity were improved after the end of the training. All subscales of d2 test were improved except for the difference between maximum and minimum responses. However, EEG analysis showed no significant differences. Neurofeedback in conjunction with Methylphenidate may cause further improvement in ADHD symptoms reported by parents and selective attention without long-term impact on EEG patterns. However, determining the exact relationship between EEG parameters, neurofeedback protocols and ADHD symptoms remain unclear.

Muscle protein metabolism in neonatal alloxan-administered rats: effects of continuous and intermittent swimming training

PubMed Central

2012-01-01

Background This study aimed to examine the effects of intermittent and continuous swimming training on muscle protein metabolism in neonatal alloxan-administered rats. Methods Wistar rats were used and divided into six groups: sedentary alloxan (SA), sedentary control (SC), continuous trained alloxan (CA), intermittent trained alloxan (IA), continuous trained control (CC) and intermittent trained control (IC). Alloxan (250 mg/kg body weight) was injected into newborn rats at 6 days of age. The continuous training protocol consisted of 12 weeks of swimming training in individual cylinder tanks while supporting a load that was 5% of body weight; uninterrupted swimming for 1 h/day, five days a week. The intermittent training protocol consisted of 12 weeks of swimming training in individual cylinder tanks while supporting a load that was 15% of body weight; 30 s of activity interrupted by 30 s of rest for a total of 20 min/day, five days a week. Results At 28 days, the alloxan animals displayed higher glycemia after glucose overload than the control animals. No differences in insulinemia among the groups were detected. At 120 days, no differences in serum albumin and total protein among the groups were observed. Compared to the other groups, DNA concentrations were higher in the alloxan animals that were subjected to continuous training, whereas the DNA/protein ratio was higher in the alloxan animals that were subjected to intermittent training. Conclusion It was concluded that continuous and intermittent training sessions were effective in altering muscle growth by hyperplasia and hypertrophy, respectively, in alloxan-administered animals. PMID:22309804

Why standard brain-computer interface (BCI) training protocols should be changed: an experimental study

NASA Astrophysics Data System (ADS)

Jeunet, Camille; Jahanpour, Emilie; Lotte, Fabien

2016-06-01

Objective. While promising, electroencephaloraphy based brain-computer interfaces (BCIs) are barely used due to their lack of reliability: 15% to 30% of users are unable to control a BCI. Standard training protocols may be partly responsible as they do not satisfy recommendations from psychology. Our main objective was to determine in practice to what extent standard training protocols impact users’ motor imagery based BCI (MI-BCI) control performance. Approach. We performed two experiments. The first consisted in evaluating the efficiency of a standard BCI training protocol for the acquisition of non-BCI related skills in a BCI-free context, which enabled us to rule out the possible impact of BCIs on the training outcome. Thus, participants (N = 54) were asked to perform simple motor tasks. The second experiment was aimed at measuring the correlations between motor tasks and MI-BCI performance. The ten best and ten worst performers of the first study were recruited for an MI-BCI experiment during which they had to learn to perform two MI tasks. We also assessed users’ spatial ability and pre-training μ rhythm amplitude, as both have been related to MI-BCI performance in the literature. Main results. Around 17% of the participants were unable to learn to perform the motor tasks, which is close to the BCI illiteracy rate. This suggests that standard training protocols are suboptimal for skill teaching. No correlation was found between motor tasks and MI-BCI performance. However, spatial ability played an important role in MI-BCI performance. In addition, once the spatial ability covariable had been controlled for, using an ANCOVA, it appeared that participants who faced difficulty during the first experiment improved during the second while the others did not. Significance. These studies suggest that (1) standard MI-BCI training protocols are suboptimal for skill teaching, (2) spatial ability is confirmed as impacting on MI-BCI performance, and (3) when faced with difficult pre-training, subjects seemed to explore more strategies and therefore learn better.

An Alpha and Theta Intensive and Short Neurofeedback Protocol for Healthy Aging Working-Memory Training

PubMed Central

Reis, Joana; Portugal, Ana Maria; Fernandes, Luís; Afonso, Nuno; Pereira, Mariana; Sousa, Nuno; Dias, Nuno S.

2016-01-01

The present study tested the effects of an intensive and short alpha and theta neurofeedback (NF) protocol in working memory (WM) performance in a healthy elder population and explored the effects of a multimodal approach, by supplementing NF with cognitive tasks. Participants were allocated to four groups: NF (N = 9); neurofeedback supplemented with cognitive training (NFCT) (N = 8); cognitive training (CT) (N = 7) and sham neurofeedback (Sham-NF) (N = 6). The intervention consisted in 30-min sessions for 8 days. The NF group presented post intervention increases of alpha and theta relative power as well as performance in the matrix rotation task. In addition, a successful up training of frontal theta showed positive correlation with an improvement of post-training alpha and a better performance in the matrix rotation task. The results presented herein suggest that an intensive and short NF protocol enables elders to learn alpha and theta self-modulation and already presents moderate improvements in cognition and basal EEG. Also, CT group showed moderate performance gains on the cognitive tasks used during the training sessions but no clear improvements on neurophysiology and behavioral measurements were observed. This study represents a first attempt to study the effects of an intensive and short NF protocol in WM performance of elders. The evidence presented here suggests that an intensive and short NF intervention could be a valid alternative for introduction of older populations to NF methodologies. PMID:27458369

Balance Training Versus Balance Training With STARS in Patients With Chronic Ankle Instability: A Randomized Controlled Trial.

PubMed

Burcal, Christopher J; Trier, Alejandra Y; Wikstrom, Erik A

2017-09-01

Both balance training and selected interventions meant to target sensory structures (STARS) have been shown to be effective at restoring deficits associated with chronic ankle instability (CAI). Clinicians often use multiple treatment modalities in patients with CAI. However, evidence for combined intervention effectiveness in CAI patients remains limited. To determine if augmenting a balance-training protocol with STARS (BTS) results in greater improvements than balance training (BT) alone in those with CAI. Randomized-controlled trial. Research laboratory. 24 CAI participants (age 21.3 ± 2.0 y; height 169.8 ± 12.9 cm; mass 72.5 ± 22.2 kg) were randomized into 2 groups: BT and BTS. Participants completed a 4-week progression-based balance-training protocol consisting of 3 20-min sessions per week. The experimental group also received a 5-min set of STARS treatments consisting of calf stretching, plantar massage, ankle joint mobilizations, and ankle joint traction before each balance-training session. Outcomes included self-assessed disability, Star Excursion Balance Test reach distance, and time-to-boundary calculated from static balance trials. All outcomes were assessed before, and 24-hours and 1-week after protocol completion. Self-assessed disability was also captured 1-month after the intervention. No significant group differences were identified (P > .10). Both groups demonstrated improvements in all outcome categories after the interventions (P < .10), many of which were retained at 1-week posttest (P < .10). Although 90% CIs include zero, effect sizes favor BTS. Similarly, only the BTS group exceeded the minimal detectable change for time-to-boundary outcomes. While statistically no more effective, exceeding minimal detectable change scores and favorable effect sizes suggest that a 4-week progressive BTS program may be more effective at improving self-assessed disability and postural control in CAI patients than balance training in isolation.

The application of walking training in the rehabilitation of patients after coronary artery bypass grafting

PubMed Central

Dylewicz, Piotr

2015-01-01

Walking is regarded as one of the most common and utilitarian activities of everyday life. Rehabilitation programs developed on the basis of this form of activity often constitute the primary method of rehabilitating patients after coronary artery bypass grafting. This paper provides a review of literature concerning various forms of walking training, discussing their impact on the parameters of exercise capacity and verifying the training methods with regard to the current guidelines. Attention is drawn to the diversity of the exercise protocols applied during the early and late stages of rehabilitation and pre-rehabilitation programs including: treadmill walking, walking down the corridor, treadmill walking enriched with virtual reality, and walking as an element of training sessions consisting of many different forms of activities. Exercise protocols were also analyzed in terms of their safety, especially in the case of high-intensity interval training. Despite the variety of the available rehabilitation programs, the training methodology requires constant improvement, particularly in terms of load dosage and the supervision of training sessions. PMID:26702291

Extinction of conditioned opiate withdrawal in rats in a two-chambered place conditioning apparatus

PubMed Central

Myers, Karyn M.; Bechtholt-Gompf, Anita J.; Coleman, Brian R.; Carlezon, William A.

2016-01-01

Conditioned opiate withdrawal contributes to relapse in addicts and can be studied in rats using the opiate withdrawal-induced conditioned place aversion (OW-CPA) paradigm. Attenuation of conditioned withdrawal through extinction may be beneficial in the treatment of addiction. Here we describe a protocol for studying OW-CPA extinction using a two-chambered place conditioning apparatus. Rats are made dependent on morphine through subcutaneous implantation of morphine pellets and then trained to acquire OW-CPA through pairings of one chamber with naloxone-precipitated withdrawal and the other chamber with saline. Extinction training consists of re-exposures to both chambers in the absence of precipitated withdrawal. Rats tested following the completion of training show a decline in avoidance of the formerly naloxone-paired chamber with increasing numbers of extinction training sessions. The protocol takes a minimum of seven days; the exact duration varies with the amount of extinction training, which is determined by the goals of the experiment. PMID:22362157

Home-based bimanual training based on motor learning principles in children with unilateral cerebral palsy and their parents (the COAD-study): rationale and protocols.

PubMed

Schnackers, Marlous; Beckers, Laura; Janssen-Potten, Yvonne; Aarts, Pauline; Rameckers, Eugène; van der Burg, Jan; de Groot, Imelda; Smeets, Rob; Geurts, Sander; Steenbergen, Bert

2018-04-18

Home-based training is considered an important intervention in rehabilitation of children with unilateral cerebral palsy. Despite consensus on the value of home-based upper limb training, no evidence-based best practice exists. Promoting compliance of children to adhere to an intensive program while keeping parental stress levels low is an important challenge when designing home-based training programs. Incorporating implicit motor learning principles emerges to be a promising method to resolve this challenge. Here we describe two protocols for home-based bimanual training programs, one based on implicit motor learning principles and one based on explicit motor learning principles, for children with unilateral spastic cerebral palsy aged 2 through 7 years. Children receive goal-oriented, task-specific bimanual training in their home environment from their parents for 3.5 h/week for 12 weeks according to an individualized program. Parents will be intensively coached by a multidisciplinary team, consisting of a pediatric therapist and remedial educationalist. Both programs consist of a preparation phase (goal setting, introductory meetings with coaching professionals, design of individualized program, instruction of parents, home visit) and home-based training phase (training, video-recordings, registrations, and telecoaching and home visits by the coaching team). The programs contrast with respect to the teaching strategy, i.e. how the parents support their child during training. In both programs parents provide their child with instructions and feedback that focus on the activity (i.e. task-oriented) or the result of the activity (i.e. result-oriented). However, in the explicit program parents are in addition instructed to give exact instructions and feedback on the motor performance of the bimanual activities, whereas in the implicit program the use of both hands and the appropriate motor performance of the activity are elicited via manipulation of the organization of the activities. With the protocols described here, we aim to take a next step in the development of much needed evidence-based home-based training programs for children with unilateral cerebral palsy.

Physiological Responses to On-Court vs Running Interval Training in Competitive Tennis Players

PubMed Central

Fernandez-Fernandez, Jaime; Sanz-Rivas, David; Sanchez-Muñoz, Cristobal; de la Aleja Tellez, Jose Gonzalez; Buchheit, Martin; Mendez-Villanueva, Alberto

2011-01-01

The aim of this study was to compare heart rate (HR), blood lactate (LA) and rate of perceived exertion (RPE) responses to a tennis-specific interval training (i.e., on-court) session with that of a matched-on-time running interval training (i.e., off-court). Eight well-trained, male (n = 4) and female (n = 4) tennis players (mean ± SD; age: 16.4 ± 1.8 years) underwent an incremental test where peak treadmill speed, maximum HR (HRmax) and maximum oxygen uptake (VO2max) were determined. The two interval training protocols (i.e., off- court and on-court) consisted of 4 sets of 120 s of work, interspersed with 90 s rest. Percentage of HRmax (95.9 ± 2.4 vs. 96.1 ± 2.2%; p = 0.79), LA (6.9 ± 2.5 vs. 6.2 ± 2.4 mmol·L-1; p = 0.14) and RPE (16.7 ± 2.1 vs. 16.3 ± 1.8; p = 0.50) responses were similar for off-court and on-court, respectively. The two interval training protocols used in the present study have equivalent physiological responses. Longitudinal studies are still warranted but tennis-specific interval training sessions could represent a time-efficient alternative to off-court (running) interval training for the optimization of the specific cardiorespiratory fitness in tennis players. Key points On-court interval training protocol can be used as an alternative to running interval training Technical/tactical training should be performed under conditions that replicate the physical and technical demands of a competitive match During the competitive season tennis on-court training might be preferred to off-court training PMID:24150630

Graduate Students' Administration and Scoring Errors on the WISC-IV: Reducing Inaccuracies with Training and Experience

ERIC Educational Resources Information Center

Alper, Jaclyn

2012-01-01

A total of 52 Wechsler Intelligence Scale for Children, Fourth Edition (WISC-IV) protocols, administered by graduate students were examined to obtain data on the type and frequency of examiner errors, the impact of errors on resultant test scores as well as improvement rate over the course of two years in training. Findings were consistent with…

Colwater fish in rivers

EPA Science Inventory

A standard sampling protocol to assess the fish assemblages and abundances in large, coldwater rivers is most accurate and precise if consistent gears and levels of effort are used at each site. This requires thorough crew training, quality control audits, and replicate sampling...

Acute Physiological Responses to Strongman Training Compared to Traditional Strength Training.

PubMed

Harris, Nigel K; Woulfe, Colm J; Wood, Matthew R; Dulson, Deborah K; Gluchowski, Ashley K; Keogh, Justin B

2016-05-01

Strongman training (ST) has become an increasingly popular modality, but data on physiological responses are limited. This study sought to determine physiological responses to an ST session compared to a traditional strength exercise training (RST) session. Ten healthy men (23.6 ± 27.5 years, 85.8 ± 10.3 kg) volunteered in a crossover design, where all participants performed an ST session, an RST session, and a resting session within 7 days apart. The ST consisted of sled drag, farmer's walk, 1 arm dumbbell clean and press, and tire flip at loads eliciting approximately 30 seconds of near maximal effort per set. The RST consisted of squat, deadlift, bench press, and power clean, progressing to 75% of 1 repetition maximum. Sessions were equated for approximate total set duration. Blood lactate and salivary testosterone were recorded immediately before and after training sessions. Heart rate, caloric expenditure, and substrate utilization were measured throughout the resting session, both training protocols and for 80 minutes after training sessions. Analyses were conducted to determine differences in physiological responses within and between protocols. No significant changes in testosterone occurred at any time point for either session. Lactate increased significantly immediately after both sessions. Heart rate, caloric expenditure, and substrate utilization were all elevated significantly during ST and RST. Heart rate and fat expenditure were significantly elevated compared to resting in both sessions' recovery periods; calorie and carbohydrate expenditures were not. Compared to RST, ST represents an equivalent physiological stimulus on key parameters indicative of potential training-induced adaptive responses. Such adaptations could conceivably include cardiovascular conditioning.

Effect of rest-pause vs. traditional bench press training on muscle strength, electromyography, and lifting volume in randomized trial protocols.

PubMed

Korak, J Adam; Paquette, Max R; Brooks, Justin; Fuller, Dana K; Coons, John M

2017-09-01

Rest-pause (4-s unloaded rest between repetitions) training effects on one repetition maximum (1 RM), lifting volume, and neural activation via electromyography (EMG) are currently vague in the literature and can benefit strength and conditioning professionals for resistance training programme design. Therefore, this study compared 1 RM, neural activation via (EMG), and volume differences between rest-pause vs. traditional resistance training. Trained males (N = 20) were randomly assigned to either a rest-pause or a traditional training group. Pre- and post-1 RM testing was recorded. Training sessions were completed twice a week for 4 weeks and consisted of four sets of bench press to volitional fatigue at 80% of pre-test 1 RM with a 2-min rest between sets. Total volume completed was recorded on each training day. Neural activation of the pectoralis major was measured on the first and last training days. A two-way repeated-measures ANOVA indicated both groups significantly increased their 1 RMs following the 4-week training protocol (p < .05). However, no significant differences were found in 1 RM and neural activation between the two groups (p > .05). An independent samples t test indicated that total volume lifted was significantly higher for the rest-pause group (56,778 vs. 38,315 lbs; p < .05) throughout the protocol and independently during weeks 2, 3, and 4. While strength and neural activation changes did not differ between groups, both increased 1 RMs and the rest-pause group achieved greater increases in volume than the traditional group. If volume is the focus of training, the rest-pause method should be utilized.

Heart-Rate Recovery After Warm-up in Swimming: A Useful Predictor of Training Heart-Rate Response?

PubMed

Ganzevles, Sander P M; de Haan, Arnold; Beek, Peter J; Daanen, Hein A M; Truijens, Martin J

2017-07-01

For training to be optimal, daily training load has to be adapted to the momentary status of the individual athlete, which is often difficult to establish. Therefore, the current study investigated the predictive value of heart-rate recovery (HRR) during a standardized warm-up for training load. Training load was quantified by the variation in heart rate during standardized training in competitive swimmers. Eight female and 5 male Dutch national-level swimmers participated in the study. They all performed 3 sessions consisting of a 300-m warm-up test and a 10 × 100-m training protocol. Both protocols were swum in front crawl at individually standardized velocities derived from an incremental step test. Velocity was related to 75% and 85% heart-rate reserve (% HR res ) for the warm-up and training, respectively. Relative HRR during the first 60 s after the warm-up (HR Rw-up ) and differences between the actual and intended heart rate for the warm-up and the training (ΔHR w-up and ΔHR tr ) were determined. No significant relationship between HRR w-up and ΔHR tr was found (F 1,37 = 2.96, P = .09, R 2 = .07, SEE = 4.65). There was considerable daily variation in ΔHR tr at a given swimming velocity (73-93% HR res ). ΔHR w-up and ΔHR tr were clearly related (F 1,37 = 74.31, P < .001, R 2 = .67, SEE = 2.78). HRR after a standardized warm-up does not predict heart rate during a directly subsequent and standardized training session. Instead, heart rate during the warm-up protocol seems a promising alternative for coaches to make daily individual-specific adjustments to training programs.

Locomotor, cardiocirculatory and metabolic adaptations to training in Andalusian and Anglo-Arabian horses.

PubMed

Muñoz, A; Santisteban, R; Rubio, M D; Agüera, E I; Escribano, B M; Castejón, F M

1999-02-01

The effects of two training programmes in 20 Andalusian and 12 Anglo-Arabian horses were evaluated by an increasing intensity work test at velocities of 4, 5, 6, 7 and 8 m sec(-1). Heart rate was monitored and blood samples were drawn at rest and after each velocity to analyse packed cell volume, haemoglobin concentration, plasma lactate and potassium levels. Furthermore, the programmes were video-taped and stride length, duration and frequency, stance (restraint and propulsion), swing phase durations and stride vertical component were measured. The training protocol of the Andalusian horses produced significant decreases in the cardiovascular, haematological and metabolic responses to exercise. Locomotory training adaptation consisted of an increased stride frequency and a reduced stride length and vertical stride component. The last variable was the limiting factor of stride length both before and after training in the Andalusian horses. A different training protocol for show-jumping competition in Anglo-Arabian horses failed to show significant differences in the studied parameters to the work test, although an increase in stride length at velocities of over 6 m sec(-1) was observed. Stride vertical component did not have an effect on the physiological response to exercise, either before or after training.

Usefulness and acceptability of a standardised orientation and mobility training for partially-sighted older adults using an identification cane

PubMed Central

2012-01-01

Background Orientation and mobility (O&M) training in using an identification (ID) cane is provided to partially-sighted older adults to facilitate independent functioning and participation in the community. Recently, a protocolised standardised O&M-training in the use of the ID cane was developed in The Netherlands. The purpose of this study is to assess the usefulness and acceptability of both the standardised training and the regular training for participants and O&M-trainers in a randomised controlled trial (NCT00946062). Methods The standardised O&M-training consists of two structured face-to-face sessions and one telephone follow-up, in which, in addition to the regular training, self-management and behavioural change techniques are applied. Questionnaires and interviews were used to collect data on the training’s usefulness, e.g. the population reached, self-reported benefits or achievements, and acceptability, e.g. the performance of the intervention according to protocol and participants’ exposure to and engagement in the training. Results Data was collected from 29 O&M-trainers and 68 participants. Regarding the self-reported benefits, outcomes were comparable for the standardised training and the regular training according the trainers and participants e.g., about 85% of the participants in both groups experienced benefits of the cane and about 70% gained confidence in their capabilities. Participants were actively involved in the standardised training. Nearly 40% of the participants in the standardised training group was not exposed to the training according to protocol regarding the number of sessions scheduled and several intervention elements, such as action planning and contracting. Conclusions The standardised and regular O&M-training showed to be useful and mostly acceptable for the partially-sighted older adults and trainers. Yet, a concern is the deviation from the protocol of the standardised O&M-training by the O&M-trainers regarding distinguishing elements such as action planning. Overall, participants appreciated both trainings and reported benefit. PMID:22681932

Rehabilitation robotics: pilot trial of a spatial extension for MIT-Manus

PubMed Central

Krebs, Hermano I; Ferraro, Mark; Buerger, Stephen P; Newbery, Miranda J; Makiyama, Antonio; Sandmann, Michael; Lynch, Daniel; Volpe, Bruce T; Hogan, Neville

2004-01-01

Background Previous results with the planar robot MIT-MANUS demonstrated positive benefits in trials with over 250 stroke patients. Consistent with motor learning, the positive effects did not generalize to other muscle groups or limb segments. Therefore we are designing a new class of robots to exercise other muscle groups or limb segments. This paper presents basic engineering aspects of a novel robotic module that extends our approach to anti-gravity movements out of the horizontal plane and a pilot study with 10 outpatients. Patients were trained during the initial six-weeks with the planar module (i.e., performance-based training limited to horizontal movements with gravity compensation). This training was followed by six-weeks of robotic therapy that focused on performing vertical arm movements against gravity. The 12-week protocol includes three one-hour robot therapy sessions per week (total 36 robot treatment sessions). Results Pilot study demonstrated that the protocol was safe and well tolerated with no patient presenting any adverse effect. Consistent with our past experience with persons with chronic strokes, there was a statistically significant reduction in tone measurement from admission to discharge of performance-based planar robot therapy and we have not observed increases in muscle tone or spasticity during the anti-gravity training protocol. Pilot results showed also a reduction in shoulder-elbow impairment following planar horizontal training. Furthermore, it suggested an additional reduction in shoulder-elbow impairment following the anti-gravity training. Conclusion Our clinical experiments have focused on a fundamental question of whether task specific robotic training influences brain recovery. To date several studies demonstrate that in mature and damaged nervous systems, nurture indeed has an effect on nature. The improved recovery is most pronounced in the trained limb segments. We have now embarked on experiments that test whether we can continue to influence recovery, long after the acute insult, with a novel class of spatial robotic devices. This pilot results support the pursuit of further clinical trials to test efficacy and the pursuit of optimal therapy following brain injury. PMID:15679916

Rehabilitation robotics: pilot trial of a spatial extension for MIT-Manus.

PubMed

Krebs, Hermano I; Ferraro, Mark; Buerger, Stephen P; Newbery, Miranda J; Makiyama, Antonio; Sandmann, Michael; Lynch, Daniel; Volpe, Bruce T; Hogan, Neville

2004-10-26

BACKGROUND: Previous results with the planar robot MIT-MANUS demonstrated positive benefits in trials with over 250 stroke patients. Consistent with motor learning, the positive effects did not generalize to other muscle groups or limb segments. Therefore we are designing a new class of robots to exercise other muscle groups or limb segments. This paper presents basic engineering aspects of a novel robotic module that extends our approach to anti-gravity movements out of the horizontal plane and a pilot study with 10 outpatients. Patients were trained during the initial six-weeks with the planar module (i.e., performance-based training limited to horizontal movements with gravity compensation). This training was followed by six-weeks of robotic therapy that focused on performing vertical arm movements against gravity. The 12-week protocol includes three one-hour robot therapy sessions per week (total 36 robot treatment sessions). RESULTS: Pilot study demonstrated that the protocol was safe and well tolerated with no patient presenting any adverse effect. Consistent with our past experience with persons with chronic strokes, there was a statistically significant reduction in tone measurement from admission to discharge of performance-based planar robot therapy and we have not observed increases in muscle tone or spasticity during the anti-gravity training protocol. Pilot results showed also a reduction in shoulder-elbow impairment following planar horizontal training. Furthermore, it suggested an additional reduction in shoulder-elbow impairment following the anti-gravity training. CONCLUSION: Our clinical experiments have focused on a fundamental question of whether task specific robotic training influences brain recovery. To date several studies demonstrate that in mature and damaged nervous systems, nurture indeed has an effect on nature. The improved recovery is most pronounced in the trained limb segments. We have now embarked on experiments that test whether we can continue to influence recovery, long after the acute insult, with a novel class of spatial robotic devices. This pilot results support the pursuit of further clinical trials to test efficacy and the pursuit of optimal therapy following brain injury.

Optimizing Equivalence-Based Instruction: Effects of Training Protocols on Equivalence Class Formation

ERIC Educational Resources Information Center

Fienup, Daniel M.; Wright, Nicole A.; Fields, Lanny

2015-01-01

Two experiments evaluated the effects of the simple-to-complex and simultaneous training protocols on the formation of academically relevant equivalence classes. The simple-to-complex protocol intersperses derived relations probes with training baseline relations. The simultaneous protocol conducts all training trials and test trials in separate…

Effects of weight training on cognitive functions in elderly with Alzheimer's disease

PubMed Central

Vital, Thays Martins; Hernández, Salma S. Soleman; Pedroso, Renata Valle; Teixeira, Camila Vieira Ligo; Garuffi, Marcelo; Stein, Angelica Miki; Costa, José Luiz Riani; Stella, Florindo

2012-01-01

Deterioration in cognitive functions is characteristic in Alzheimer's disease (AD) and may be associated with decline in daily living activities with consequent reduced quality of life. Objective To analyze weight training effects on cognitive functions in elderly with AD. Subjects 34 elderly with AD were allocated into two groups: Training Group (TG) and Social Gathering Group (SGG). Methods Global cognitive status was determined using the Mini-Mental State Exam. Specific cognitive functions were measured using the Brief Cognitive Battery, Clock Drawing Test and Verbal Fluency Test. The protocols were performed three times a week, one hour per session. The weight training protocol consisted of three sets of 20 repetitions, with two minutes of rest between sets and exercises. The activities proposed for the SGG were not systematized and aimed at promoting social interaction among patients. The statistical analyses were performed with the U Mann Whitney and Wilcoxon tests for group comparisons. All analyses were considered statistically significant at a p-value of 0.05. Results There were no significant differences associated to the effects of the practice of weight training on cognition in AD patients. Conclusion In this study, no improvement in cognitive functions was evident in elderly with AD who followed a low intensity resistance exercise protocol. Thus, future studies could evaluate the effect of more intense exercise programs. PMID:29213805

The influence of exercise intensity on heat acclimation in trained subjects.

PubMed

Houmard, J A; Costill, D L; Davis, J A; Mitchell, J B; Pascoe, D D; Robergs, R A

1990-10-01

Low-intensity exercise (less than or equal to 50% VO2max) has been demonstrated to produce heat acclimation (HA) in trained subjects. The purpose of this study was to determine whether shorter-duration, moderate-intensity exercise would also result in HA. Nine trained runners performed two 9-d exercise heat-stress protocols. Each protocol consisted of a 90-min heat tolerance test on days 1 (HTT1) and 9 (HTT2). On days 2-8 the subjects exercised at 50% VO2max for 60 min.d-1 (T50) or at 75% VO2max for 30-35 min.d-1 (T75). Final HTT2 heart rate and rectal temperature (Tr) were significantly (P less than 0.001) reduced, as compared to HTT1, with no differences between T50 and T75. Both protocols resulted in significant (P less than 0.05) reductions in HTT2 pre-exercise Tr and total exercising caloric expenditure, both of which are known to contribute to HA. No changes in resting plasma volume, osmolality, protein, post-HTT aldosterone, and exercising sweat rate were observed. These results demonstrate that equal levels of HA were obtained with T50 and T75, which suggests that moderate-intensity, short-duration exercise in the heat can produce HA in trained subjects.

STATIC STRETCHING DOES NOT REDUCE VARIABILITY, JUMP AND SPEED PERFORMANCE.

PubMed

de Oliveira, Fábio Carlos Lucas; Rama, Luís Manuel Pinto Lopes

2016-04-01

Stretching is often part of the warm-up routine prior to athletic participation; however, controversial evidence exists on the effects of stretching on countermovement jump (CMJ) and sprint performance. Additionally, analysis of variability between repeated tasks is useful for monitoring players, to analyze factors that could affect the performance, and to guide clinical decisions for training strategies. The purpose of this study was to examine whether static stretching (SS) prior to CMJ and 20-meter (20-m) sprint would affect performance, and to investigate whether SS affects an athlete's ability to perform these tasks consistently. Twenty-two trained healthy athletes (23.2 ± 5.0 years) attended, randomly, two testing sessions, separated by 48 hours. At session one, all participants underwent 10 minutes of dynamic running warm-up followed by the experimental tasks (three CMJ and three 20-m sprint), whereas five minutes of stretching was added after the warm-up routine at session two. All participants performed the same experimental tasks in both sessions. The stretching protocol consisted of five stretching exercises for each lower limb. The paired-samples t-test revealed no significant differences between the stretching protocol condition and no stretching condition for the 20-m sprint (t(21)=.920; p=.368) and CMJ (t(21)=.709; p=.486). There were no significant differences in trial-by-trial variability on 20-m sprint (t(21)=1.934; p=.067) and CMJ scores (t(21)=.793; p=.437) as result of SS. The SS protocol did not modify jumping and running ability in trained healthy athletes. The SS prior to training or competition may not cause detrimental effects to athletic performance. Level III, Nonrandomized controlled trial.

STATIC STRETCHING DOES NOT REDUCE VARIABILITY, JUMP AND SPEED PERFORMANCE

PubMed Central

Rama, Luís Manuel Pinto Lopes

2016-01-01

Background Stretching is often part of the warm-up routine prior to athletic participation; however, controversial evidence exists on the effects of stretching on countermovement jump (CMJ) and sprint performance. Additionally, analysis of variability between repeated tasks is useful for monitoring players, to analyze factors that could affect the performance, and to guide clinical decisions for training strategies. Purpose The purpose of this study was to examine whether static stretching (SS) prior to CMJ and 20-meter (20-m) sprint would affect performance, and to investigate whether SS affects an athlete's ability to perform these tasks consistently. Methods Twenty-two trained healthy athletes (23.2 ± 5.0 years) attended, randomly, two testing sessions, separated by 48 hours. At session one, all participants underwent 10 minutes of dynamic running warm-up followed by the experimental tasks (three CMJ and three 20-m sprint), whereas five minutes of stretching was added after the warm-up routine at session two. All participants performed the same experimental tasks in both sessions. The stretching protocol consisted of five stretching exercises for each lower limb. Results The paired-samples t-test revealed no significant differences between the stretching protocol condition and no stretching condition for the 20-m sprint (t(21)=.920; p=.368) and CMJ (t(21)=.709; p=.486). There were no significant differences in trial-by-trial variability on 20-m sprint (t(21)=1.934; p=.067) and CMJ scores (t(21)=.793; p=.437) as result of SS. Conclusion The SS protocol did not modify jumping and running ability in trained healthy athletes. The SS prior to training or competition may not cause detrimental effects to athletic performance. Level of evidence Level III, Nonrandomized controlled trial. PMID:27104057

Effects of Different Resistance Training Protocols on Upper-Body Strength and Endurance Development in Children.

ERIC Educational Resources Information Center

Faigenbaum, Avery D.; Loud, Rita LaRosa; O'Connell, Jill; Glover, Scott; O'Connell, Jason; Westcott, Wayne L.

2001-01-01

Examined the effects of four resistance training protocols on upper body strength and muscular endurance development in children. Untrained children trained twice per week for 8 weeks, using general conditioning exercises and different upper-body conditioning protocols. Results indicated that higher-repetition training protocols enhanced…

Cross-training in birds: cold and exercise training produce similar changes in maximal metabolic output, muscle masses and myostatin expression in house sparrows (Passer domesticus)

PubMed Central

Zhang, Yufeng; Eyster, Kathleen; Liu, Jin-Song; Swanson, David L.

2015-01-01

ABSTRACT Maximal metabolic outputs for exercise and thermogenesis in birds presumably influence fitness through effects on flight and shivering performance. Because both summit (Msum, maximum thermoregulatory metabolic rate) and maximum (MMR, maximum exercise metabolic rate) metabolic rates are functions of skeletal muscle activity, correlations between these measurements and their mechanistic underpinnings might occur. To examine whether such correlations occur, we measured the effects of experimental cold and exercise training protocols for 3 weeks on body (Mb) and muscle (Mpec) masses, basal metabolic rate (BMR), Msum, MMR, pectoralis mRNA and protein expression for myostatin, and mRNA expression of TLL-1 and TLL-2 (metalloproteinase activators of myostatin) in house sparrows (Passer domesticus). Both training protocols increased Msum, MMR, Mb and Mpec, but BMR increased with cold training and decreased with exercise training. No significant differences occurred for pectoralis myostatin mRNA expression, but cold and exercise increased the expression of TLL-1 and TLL-2. Pectoralis myostatin protein levels were generally reduced for both training groups. These data clearly demonstrate cross-training effects of cold and exercise in birds, and are consistent with a role for myostatin in increasing pectoralis muscle mass and driving organismal increases in metabolic capacities. PMID:25987736

Effects of quadriceps strength after static and dynamic whole-body vibration exercise.

PubMed

Bush, Jill A; Blog, Gabriel L; Kang, Jie; Faigenbaum, Avery D; Ratamess, Nicholas A

2015-05-01

Numerous studies have shown performance benefits including whole-body vibration (WBV) as a training modality or an acute exercise protocol when used as a component of the resistance training program. Some studies have indicated that performing dynamic exercises as compared with static position exercises while exposed to WBV might be beneficial; however, evidence is lacking. Thus, the purpose of this study was to determine if an acute bout of dynamic versus static squats performed during WBV results in increase in quadriceps force production by means of dynamic isokinetic knee extension and flexion exercise. Nonresistance-trained healthy young men and women (N = 21) of 18-25 years participated in 4 protocols with 2-week rest in-between. Protocol 1 consisted of 5 sets of 10 dynamic squats without vibration; Protocol 2: 5 sets of 30-second static squats without vibration; Protocol 3: 5 sets of 10 dynamic squats with 30-Hz WBV for a total of 2.5 minutes; and Protocol 4: 5 sets of 30-second static squats with 30-Hz WBV for a total of 2.5 minutes. Prestrength tests (1 set of 4 repetitions at 100° · s(-1) for the knee extension exercise) was performed within 5 minutes of starting each protocol, and poststrength testing was performed within 1 minute of completing each protocol. Strength outcomes were analyzed by repeated measures analysis of variance with a significance level set at p ≤ 0.05. A significant decrease in strength was observed after dynamic and static squats without WBV (p = 0.002); an increase in strength after dynamic squats with WBV (p = 0.003); and a decrease in strength after static squats with WBV (p = 0.003). The inclusion of WBV to dynamic resistance exercise can be an added modality to increase strength. Whole-body vibration can have varied effects in altering muscle strength in untrained individuals according to the type of resistance training performed. As a dynamic squat with WBV seems to immediately potentiate neuromuscular functioning, the combination of dynamic exercises and WBV could be used as a potential warm-up procedure before resistance exercise.

A Challenge-Based Approach to Body Weight-Supported Treadmill Training Poststroke: Protocol for a Randomized Controlled Trial.

PubMed

Naidu, Avantika; Brown, David; Roth, Elliot

2018-05-03

Body weight support treadmill training protocols in conjunction with other modalities are commonly used to improve poststroke balance and walking function. However, typical body weight support paradigms tend to use consistently stable balance conditions, often with handrail support and or manual assistance. In this paper, we describe our study protocol, which involved 2 unique body weight support treadmill training paradigms of similar training intensity that integrated dynamic balance challenges to help improve ambulatory function post stroke. The first paradigm emphasized walking without any handrails or manual assistance, that is, hands-free walking, and served as the control group, whereas the second paradigm incorporated practicing 9 essential challenging mobility skills, akin to environmental barriers encountered during community ambulation along with hands-free walking (ie hands-free + challenge walking). We recruited individuals with chronic poststroke hemiparesis and randomized them to either group. Participants trained for 6 weeks on a self-driven, robotic treadmill interface that provided body weight support and a safe gait-training environment. We assessed participants at pre-, mid- and post 6 weeks of intervention-training, with a 6-month follow-up. We hypothesized greater walking improvements in the hands-free + challenge walking group following training because of increased practice opportunity of essential mobility skills along with hands-free walking. We assessed 77 individuals with chronic hemiparesis, and enrolled and randomized 30 individuals poststroke for our study (hands-free group=19 and hands-free + challenge walking group=20) from June 2012 to January 2015. Data collection along with 6-month follow-up continued until January 2016. Our primary outcome measure is change in comfortable walking speed from pre to post intervention for each group. We will also assess feasibility, adherence, postintervention efficacy, and changes in various exploratory secondary outcome measures. Additionally, we will also assess participant responses to a study survey, conducted at the end of training week, to gauge each group's training experiences. Our treadmill training paradigms, and study protocol represent advances in standardized approaches to selecting body weight support levels without the necessity for using handrails or manual assistance, while progressively providing dynamic challenges for improving poststroke ambulatory function during rehabilitation. ClinicalTrials.gov NCT02787759; https://clinicaltrials.gov/ct2/show/NCT02787759 (Archived by Webcite at http://www.webcitation.org/6yJZCrIea). ©Avantika Naidu, David Brown, Elliot Roth. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 03.05.2018.

Pelvic Muscle Rehabilitation: A Standardized Protocol for Pelvic Floor Dysfunction

PubMed Central

Pedraza, Rodrigo; Nieto, Javier; Ibarra, Sergio; Haas, Eric M.

2014-01-01

Introduction. Pelvic floor dysfunction syndromes present with voiding, sexual, and anorectal disturbances, which may be associated with one another, resulting in complex presentation. Thus, an integrated diagnosis and management approach may be required. Pelvic muscle rehabilitation (PMR) is a noninvasive modality involving cognitive reeducation, modification, and retraining of the pelvic floor and associated musculature. We describe our standardized PMR protocol for the management of pelvic floor dysfunction syndromes. Pelvic Muscle Rehabilitation Program. The diagnostic assessment includes electromyography and manometry analyzed in 4 phases: (1) initial baseline phase; (2) rapid contraction phase; (3) tonic contraction and endurance phase; and (4) late baseline phase. This evaluation is performed at the onset of every session. PMR management consists of 6 possible therapeutic modalities, employed depending on the diagnostic evaluation: (1) down-training; (2) accessory muscle isolation; (3) discrimination training; (4) muscle strengthening; (5) endurance training; and (6) electrical stimulation. Eight to ten sessions are performed at one-week intervals with integration of home exercises and lifestyle modifications. Conclusions. The PMR protocol offers a standardized approach to diagnose and manage pelvic floor dysfunction syndromes with potential advantages over traditional biofeedback, involving additional interventions and a continuous pelvic floor assessment with management modifications over the clinical course. PMID:25006337

Protocol for a randomized controlled trial of piano training on cognitive and psychosocial outcomes.

PubMed

Bugos, Jennifer

2018-05-09

Age-related cognitive decline and cognitive impairment represent the fastest growing health epidemic worldwide among those over 60. There is a critical need to identify effective and novel complex cognitive interventions to promote successful aging. Since piano training engages cognitive and bimanual sensorimotor processing, we hypothesize that piano training may serve as an effective cognitive intervention, as it requires sustained attention and engages an executive network that supports generalized cognition and emotional control. Here, I describe the protocol of a randomized controlled trial (RCT) to evaluate the impact of piano training on cognitive performance in adulthood, a period associated with decreased neuroplasticity. In this cluster RCT, healthy older adults (age 60-80) were recruited and screened to control for confounding variables. Eligible participants completed an initial 3-h assessment of standardized cognitive and psychosocial measures. Participants were stratified by age, education, and estimate of intelligence and randomly assigned to one of three groups: piano training, computer brain training, or a no-treatment control group. Computer brain training consisted of progressively difficult auditory cognitive exercises (Brain HQ; Posit Science, 2010). Participants assigned to training groups completed a 16-week program that met twice a week for 90 minutes. Upon program completion and at a 3-month follow-up, training participants and no-treatment controls completed a posttest visit lasting 2.5 hours. © 2018 New York Academy of Sciences.

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.

Implementation of Symptom Protocols for Nurses Providing Telephone‐Based Cancer Symptom Management: A Comparative Case Study

PubMed Central

Green, Esther; Ballantyne, Barbara; Tarasuk, Joy; Skrutkowski, Myriam; Carley, Meg; Chapman, Kim; Kuziemsky, Craig; Kolari, Erin; Sabo, Brenda; Saucier, Andréanne; Shaw, Tara; Tardif, Lucie; Truant, Tracy; Cummings, Greta G.; Howell, Doris

2016-01-01

ABSTRACT Background The pan‐Canadian Oncology Symptom Triage and Remote Support (COSTaRS) team developed 13 evidence‐informed protocols for symptom management. Aim To build an effective and sustainable approach for implementing the COSTaRS protocols for nurses providing telephone‐based symptom support to cancer patients. Methods A comparative case study was guided by the Knowledge to Action Framework. Three cases were created for three Canadian oncology programs that have nurses providing telephone support. Teams of researchers and knowledge users: (a) assessed barriers and facilitators influencing protocol use, (b) adapted protocols for local use, (c) intervened to address barriers, (d) monitored use, and (e) assessed barriers and facilitators influencing sustained use. Analysis was within and across cases. Results At baseline, >85% nurses rated protocols positively but barriers were identified (64‐80% needed training). Patients and families identified similar barriers and thought protocols would enhance consistency among nurses teaching self‐management. Twenty‐two COSTaRS workshops reached 85% to 97% of targeted nurses (N = 119). Nurses felt more confident with symptom management and using the COSTaRS protocols (p < .01). Protocol adaptations addressed barriers (e.g., health records approval, creating pocket versions, distributing with telephone messages). Chart audits revealed that protocols used were documented for 11% to 47% of patient calls. Sustained use requires organizational alignment and ongoing leadership support. Linking Evidence to Action Protocol uptake was similar to trials that have evaluated tailored interventions to improve professional practice by overcoming identified barriers. Collaborating with knowledge users facilitated interpretation of findings, aided protocol adaptation, and supported implementation. Protocol implementation in nursing requires a tailored approach. A multifaceted intervention approach increased nurses’ use of evidence‐informed protocols during telephone calls with patients about symptoms. Training and other interventions improved nurses’ confidence with using COSTaRS protocols and their uptake was evident in some documented telephone calls. Protocols could be adapted for use by patients and nurses globally. PMID:27243574

Effectiveness of supportive supervision on the consistency of integrated community cases management skills of the health extension workers in 113 districts of Ethiopia.

PubMed

Ameha, Agazi; Karim, Ali Mehryar; Erbo, Amano; Ashenafi, Addis; Hailu, Mulu; Hailu, Berhan; Folla, Abebe; Bizuwork, Simret; Betemariam, Wuleta

2014-10-01

Consistency in the adherence to integrated Community Case Management (iCCM) protocols for common childhood illnesses provided by Ethiopia's Health Extension Program (HEP) frontline workers. One approach is to provide regular clinical mentoring to the frontline health workers of the HEP at their health posts (HP) through supportive supervision (SS) following the initial training. To Assess the effectiveness of visits to improve the consistency of iCCM skills (CoS) of the HEWs in 113 districts in Ethiopia. We analyzed data from 3,909 supportive supervision visits between January 2011 and June 2013 in 113 districts in Ethiopia. From case assessment registers, a health post was classified as consistent in managing pneumonia, malaria, or diarrhea cases if the disease classification, treatment, and follow-up of the last two cases managed at the health posts were consistent with the protocol. We used regression models to assess the effects of SS on CoS. All HPs (2,368) received at least one supportive supervision visit, 41% received two, and 15% received more than two. During the observation period, HP management consistency in pneumonia, malaria, and diarrhea increased by 3.0, 2.7 and 4.4-fold, respectively. After controlling for secular trend and other factors, significant dose-response relationships were observed between number of SS visits and CoS indicators. The SS visits following the initial training were effective in improving the CoS.

Non-native Speech Perception Training Using Vowel Subsets: Effects of Vowels in Sets and Order of Training

PubMed Central

Nishi, Kanae; Kewley-Port, Diane

2008-01-01

Purpose Nishi and Kewley-Port (2007) trained Japanese listeners to perceive nine American English monophthongs and showed that a protocol using all nine vowels (fullset) produced better results than the one using only the three more difficult vowels (subset). The present study extended the target population to Koreans and examined whether protocols combining the two stimulus sets would provide more effective training. Method Three groups of five Korean listeners were trained on American English vowels for nine days using one of the three protocols: fullset only, first three days on subset then six days on fullset, or first six days on fullset then three days on subset. Participants' performance was assessed by pre- and post-training tests, as well as by a mid-training test. Results 1) Fullset training was also effective for Koreans; 2) no advantage was found for the two combined protocols over the fullset only protocol, and 3) sustained “non-improvement” was observed for training using one of the combined protocols. Conclusions In using subsets for training American English vowels, care should be taken not only in the selection of subset vowels, but also for the training orders of subsets. PMID:18664694

Development of low-volume, high-intensity, aerobic-type interval training for elderly Japanese men: a feasibility study.

PubMed

Osuka, Yosuke; Matsubara, Muneaki; Hamasaki, Ai; Hiramatsu, Yuji; Ohshima, Hiroshi; Tanaka, Kiyoji

2017-01-01

The purposes of this study were to identify 1) the feasibility of a novel exercise protocol (elderly Japanese male version of high-intensity interval aerobic training: EJ-HIAT) and 2) its preliminary data (%V̇O 2peak , rating of perceived exertion) in comparison with traditional moderate-intensity continuous aerobic training (MICT). Twenty-one sedentary elderly men, aged 60-69 years, performed two exercise protocols: EJ-HIAT, consisting of 3 sets of 2-3-min cycling at 75-85%V̇O 2peak with 1-2-min active rests at 50%V̇O 2peak between sets, and MICT, consisting of 40-min cycling at 65%V̇O 2peak . The completion rate, defined as the rate of participants who 1) did not demand withdrawal, 2) were not interrupted by the tester, and 3) did not change the workload during either exercise protocol, of EJ-HIAT was similar to that of MICT (EJ-HIAT: 100%, MICT: 95.2%). Maximal perceived exertion ratings assessed by Borg scale were also similar between EJ-HIAT and MICT. However, objectively measured maximal intensity assessed by %V̇O 2peak was higher for EJ-HIAT than for MICT (EJ-HIAT: 86.0 ± 5.6%, MICT: 67.1 ± 6.4%). These results suggested that EJ-HIAT has good feasibility and perceived exertion similar to MICT despite having higher objectively measured intensity than MICT. An intervention aimed as identifying the effects of EJ-HIAT on exercise tolerance should be performed in the future. UMIN000021185 (February 26, 2016).

[Peripheral venous catheter use in the emergency department: reducing adverse events in patients and biosafety problems for staff].

PubMed

Tomás Vecina, Santiago; Mozota Duarte, Julián; Ortega Marcos, Miguel; Gracia Ruiz Navarro, María; Borillo, Vicente; San Juan Gago, Leticia; Roqueta Egea, Fermin; Chanovas Borrás, Manuel

2016-01-01

To test a strategy to reduce the rate of adverse events in patients and safety problems for emergency department staff who insert peripheral venous catheters (PVCs). The strategy consisted of training, implementing a protocol, and introducing safety-engineered PVCs. Prospective, multicenter, observational, preauthorization study in patients requiring PVC placement in an emergency department. The study had 2 phases. The first consisted of training, implementing a protocol for using conventional PVCs, and monitoring practice. The second phase introduced safety-engineered PVC sets. The number of adverse events in patients and threats to safety for staff were compared between the 2 phases. A total of 520 patients were included, 180 in the first phase and 340 in the second. We detected breaches in aseptic technique, failure to maintain a sterile field, and improper management of safety equipment and devices. Some practices improved significantly during the second phase. Eighty-six adverse events occurred in the first phase and 52 (15.4%) in the second; the between-phase difference was not statistically significant. The incidence of postinfusion phlebitis was 50% lower in the second phase. Seven splash injuries and 1 accidental puncture occurred with conventional PVCs in the first phase; 2 splash injuries occurred with the safety-engineered PVCs in the second phase (36% decrease, P = .04). Differences were particularly noticeable for short-term PVC placements (P = .02). Combining training, a protocol, and the use of safety-engineered PVC sets offers an effective strategy for improving patient and staff safety.

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

PubMed

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

2014-11-01

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

Cross-training in birds: cold and exercise training produce similar changes in maximal metabolic output, muscle masses and myostatin expression in house sparrows (Passer domesticus).

PubMed

Zhang, Yufeng; Eyster, Kathleen; Liu, Jin-Song; Swanson, David L

2015-07-01

Maximal metabolic outputs for exercise and thermogenesis in birds presumably influence fitness through effects on flight and shivering performance. Because both summit (Msum, maximum thermoregulatory metabolic rate) and maximum (MMR, maximum exercise metabolic rate) metabolic rates are functions of skeletal muscle activity, correlations between these measurements and their mechanistic underpinnings might occur. To examine whether such correlations occur, we measured the effects of experimental cold and exercise training protocols for 3 weeks on body (Mb) and muscle (Mpec) masses, basal metabolic rate (BMR), Msum, MMR, pectoralis mRNA and protein expression for myostatin, and mRNA expression of TLL-1 and TLL-2 (metalloproteinase activators of myostatin) in house sparrows (Passer domesticus). Both training protocols increased Msum, MMR, Mb and Mpec, but BMR increased with cold training and decreased with exercise training. No significant differences occurred for pectoralis myostatin mRNA expression, but cold and exercise increased the expression of TLL-1 and TLL-2. Pectoralis myostatin protein levels were generally reduced for both training groups. These data clearly demonstrate cross-training effects of cold and exercise in birds, and are consistent with a role for myostatin in increasing pectoralis muscle mass and driving organismal increases in metabolic capacities. © 2015. Published by The Company of Biologists Ltd.

Robot-assisted training of the kinesthetic sense: enhancing proprioception after stroke.

PubMed

De Santis, Dalia; Zenzeri, Jacopo; Casadio, Maura; Masia, Lorenzo; Riva, Assunta; Morasso, Pietro; Squeri, Valentina

2014-01-01

Proprioception has a crucial role in promoting or hindering motor learning. In particular, an intact position sense strongly correlates with the chances of recovery after stroke. A great majority of neurological patients present both motor dysfunctions and impairments in kinesthesia, but traditional robot and virtual reality training techniques focus either in recovering motor functions or in assessing proprioceptive deficits. An open challenge is to implement effective and reliable tests and training protocols for proprioception that go beyond the mere position sense evaluation and exploit the intrinsic bidirectionality of the kinesthetic sense, which refers to both sense of position and sense of movement. Modulated haptic interaction has a leading role in promoting sensorimotor integration, and it is a natural way to enhance volitional effort. Therefore, we designed a preliminary clinical study to test a new proprioception-based motor training technique for augmenting kinesthetic awareness via haptic feedback. The feedback was provided by a robotic manipulandum and the test involved seven chronic hemiparetic subjects over 3 weeks. The protocol included evaluation sessions that consisted of a psychometric estimate of the subject's kinesthetic sensation, and training sessions, in which the subject executed planar reaching movements in the absence of vision and under a minimally assistive haptic guidance made by sequences of graded force pulses. The bidirectional haptic interaction between the subject and the robot was optimally adapted to each participant in order to achieve a uniform task difficulty over the workspace. All the subjects consistently improved in the perceptual scores as a consequence of training. Moreover, they could minimize the level of haptic guidance in time. Results suggest that the proposed method is effective in enhancing kinesthetic acuity, but the level of impairment may affect the ability of subjects to retain their improvement in time.

Robot-Assisted Training of the Kinesthetic Sense: Enhancing Proprioception after Stroke

PubMed Central

De Santis, Dalia; Zenzeri, Jacopo; Casadio, Maura; Masia, Lorenzo; Riva, Assunta; Morasso, Pietro; Squeri, Valentina

2015-01-01

Proprioception has a crucial role in promoting or hindering motor learning. In particular, an intact position sense strongly correlates with the chances of recovery after stroke. A great majority of neurological patients present both motor dysfunctions and impairments in kinesthesia, but traditional robot and virtual reality training techniques focus either in recovering motor functions or in assessing proprioceptive deficits. An open challenge is to implement effective and reliable tests and training protocols for proprioception that go beyond the mere position sense evaluation and exploit the intrinsic bidirectionality of the kinesthetic sense, which refers to both sense of position and sense of movement. Modulated haptic interaction has a leading role in promoting sensorimotor integration, and it is a natural way to enhance volitional effort. Therefore, we designed a preliminary clinical study to test a new proprioception-based motor training technique for augmenting kinesthetic awareness via haptic feedback. The feedback was provided by a robotic manipulandum and the test involved seven chronic hemiparetic subjects over 3 weeks. The protocol included evaluation sessions that consisted of a psychometric estimate of the subject’s kinesthetic sensation, and training sessions, in which the subject executed planar reaching movements in the absence of vision and under a minimally assistive haptic guidance made by sequences of graded force pulses. The bidirectional haptic interaction between the subject and the robot was optimally adapted to each participant in order to achieve a uniform task difficulty over the workspace. All the subjects consistently improved in the perceptual scores as a consequence of training. Moreover, they could minimize the level of haptic guidance in time. Results suggest that the proposed method is effective in enhancing kinesthetic acuity, but the level of impairment may affect the ability of subjects to retain their improvement in time. PMID:25601833

Neuroendocrine Responses and Body Composition Changes Following Resistance Training Under Normobaric Hypoxia

PubMed Central

Chycki, Jakub; Gołaś, Artur; Zając, Adam; Fidos-Czuba, Olga; Młynarz, Adrian; Smółka, Wojciech

2016-01-01

Abstract The aim of the present study was to evaluate the effects of a 6 week resistance training protocol under hypoxic conditions (FiO2 = 12.9%, 4000 m) on muscle hypertrophy. The project included 12 resistance trained male subjects, randomly divided into two experimental groups. Group 1 (n = 6; age 21 ± 2.4 years; body height [BH] 178.8 ± 7.3 cm; body mass [BM] 80.6 ± 12.3 kg) and group 2 (n = 6; age 22 ± 1.5 years; BH 177.8 ± 3.7cm; BM 81.1 ± 7.5 kg). Each group performed resistance exercises alternately under normoxic and hypoxic conditions (4000 m) for 6 weeks. All subjects followed a training protocol that comprised two training sessions per week at an exercise intensity of 70% of 1RM; each training session consisted of eight sets of 10 repetitions of the bench press and barbell squat, with 3 min rest periods. The results indicated that strength training in normobaric hypoxia caused a significant increase in BM (p < 0.01) and fat free mass (FFM) (p < 0.05) in both groups. Additionally, a significant increase (p < 0.05) was observed in IGF-1 concentrations at rest after 6 weeks of hypoxic resistance training in both groups. The results of this study allow to conclude that resistance training (6 weeks) under normobaric hypoxic conditions induces greater muscle hypertrophy compared to training in normoxic conditions. PMID:28149414

Acute physiological responses to different circuit training protocols.

PubMed

Monteiro, A G; Alveno, D A; Prado, M; Monteiro, G A; Ugrinowitsch, C; Aoki, M S; Piçarro, I C

2008-12-01

The purpose of present study was to compare the acute physiological responses to a circuit weight training with the responses to a combined circuit training (weight training and treadmill run). The sample consisted of 25 individuals at an average state of training, 10 men and 15 female, between 18 and 35 year old. There were selected 60 second sets of resistance exercises to the circuit weight training (CWT). Whereas in the combined circuit training (CCT), the subjects spent 30 seconds on the same resistance exercises and 30 seconds running on the treadmill. The rest intervals between the sets lasted 15 seconds. The analysis of variance (ANOVA) with 5% significance level was utilized to the statistical analysis of the results. Comparing circuit training protocols, it was noted that CCT elicits a higher relative and absolute VO2 and energy expenditure values than CWT for both genders (P<0.05). Regarding inter-gender comparison, males showed higher absolute and relative VO2 and absolute energy expenditure values for both CWT and CCT than females (P<0.05). Females showed a significant greater %VO2max value for both CWT and CCT. Due to the experimental conditions used to state both circuit training bouts (CWT and CCT), the VO2 rate found was higher than the values reported by previous studies which used heavier weight lift. CCT seems adequate to produce cardiovascular improvements and greater energy expenditure for both men and women, while CWT group classes are sufficient only for unfit women.

The Acute Effect of Upper-Body Complex Training on Power Output of Martial Art Athletes as Measured by the Bench Press Throw Exercise

PubMed Central

Liossis, Loudovikos Dimitrios; Forsyth, Jacky; Liossis, Ceorge; Tsolakis, Charilaos

2013-01-01

The purpose of this study was to examine the acute effect of upper body complex training on power output, as well as to determine the requisite preload intensity and intra-complex recovery interval needed to induce power output increases. Nine amateur-level combat/martial art athletes completed four distinct experimental protocols, which consisted of 5 bench press repetitions at either: 65% of one-repetition maximum (1RM) with a 4 min rest interval; 65% of 1RM with an 8 min rest; 85% of 1RM with a 4 min rest; or 85% of 1RM with an 8 min rest interval, performed on different days. Before (pre-conditioning) and after (post-conditioning) each experimental protocol, three bench press throws at 30% of 1RM were performed. Significant differences in power output pre-post conditioning were observed across all experimental protocols (F=26.489, partial eta2=0.768, p=0.001). Mean power output significantly increased when the preload stimulus of 65% 1RM was matched with 4 min of rest (p=0.001), and when the 85% 1RM preload stimulus was matched with 8 min of rest (p=0.001). Moreover, a statistically significant difference in power output was observed between the four conditioning protocols (F= 21.101, partial eta2=0.913, p=0.001). It was concluded that, in complex training, matching a heavy preload stimulus with a longer rest interval, and a lighter preload stimulus with a shorter rest interval is important for athletes wishing to increase their power production before training or competition. PMID:24511352

Tongue pressure profile training for dysphagia post stroke (TPPT): study protocol for an exploratory randomized controlled trial.

PubMed

Steele, Catriona M; Bayley, Mark A; Péladeau-Pigeon, Melanie; Stokely, Shauna L

2013-05-07

It is estimated that approximately 50% of stroke survivors will experience swallowing difficulty, or dysphagia. The associated sequelae of dysphagia include dehydration, malnutrition, and aspiration pneumonia, all of which have can have serious medical consequences. To improve swallowing safety and efficiency, alternative nutritional intake methods (for example, a feeding tube) or a modified diet texture (such as pureed foods or thickened liquids) may be recommended but these modifications may negatively affect quality of life. An alternative approach to treating dysphagia has emerged over the past few years, targeting stronger lingual muscles through maximal isometric pressure tasks. Although these studies have shown promising results, thin-liquid bolus control continues to be challenging for patients with dysphagia. Previous work investigating lingual pressures when healthy participants swallow has suggested that greater task specificity in lingual exercises may yield improved results with thin liquids. This is a small, exploratory randomized clinical trial being conducted with post-stroke patients 4 to 20 weeks after onset of dysphagia secondary to impaired lingual control. At enrollment, participants are randomly assigned to one of two treatment protocols, either tongue pressure profile training (TPPT) or the control treatment, tongue pressure strength-and-accuracy training (TPSAT). Each treatment protocol consists of 24 sessions of treatment over 8 to 12 weeks with monitoring of tongue pressure as well as a baseline and outcome videofluoroscopic swallowing study. Tongue pressure measures, videofluoroscopic measures, and functional outcome measures will be obtained following training of 60 participants (30 in each condition), to determine whether TPPT yields better outcomes. This study will continue to explore options beyond tube feeding and modified diets for people with neurogenic dysphagia following stroke. Should the novel protocol, TPPT, prove to be more effective than the TPSAT protocol, this may influence standards of care and best practices for patients with dysphagia involving impaired thin-liquid control as a result of stroke. Clinicaltrials.gov http://NCT01370083.

The effects of traditional, superset, and tri-set resistance training structures on perceived intensity and physiological responses.

PubMed

Weakley, Jonathon J S; Till, Kevin; Read, Dale B; Roe, Gregory A B; Darrall-Jones, Joshua; Phibbs, Padraic J; Jones, Ben

2017-09-01

Investigate the acute and short-term (i.e., 24 h) effects of traditional (TRAD), superset (SS), and tri-set (TRI) resistance training protocols on perceptions of intensity and physiological responses. Fourteen male participants completed a familiarisation session and three resistance training protocols (i.e., TRAD, SS, and TRI) in a randomised-crossover design. Rating of perceived exertion, lactate concentration ([Lac]), creatine kinase concentration ([CK]), countermovement jump (CMJ), testosterone, and cortisol concentrations was measured pre, immediately, and 24-h post the resistance training sessions with magnitude-based inferences assessing changes/differences within/between protocols. TRI reported possible to almost certainly greater efficiency and rate of perceived exertion, although session perceived load was very likely lower. SS and TRI had very likely to almost certainly greater lactate responses during the protocols, with changes in [CK] being very likely and likely increased at 24 h, respectively. At 24-h post-training, CMJ variables in the TRAD protocol had returned to baseline; however, SS and TRI were still possibly to likely reduced. Possible increases in testosterone immediately post SS and TRI protocols were reported, with SS showing possible increases at 24-h post-training. TRAD and SS showed almost certain and likely decreases in cortisol immediately post, respectively, with TRAD reporting likely decreases at 24-h post-training. SS and TRI can enhance training efficiency and reduce training time. However, acute and short-term physiological responses differ between protocols. Athletes can utilise SS and TRI resistance training, but may require additional recovery post-training to minimise effects of fatigue.

Cognitive Coping Tool Kit for Psychosis: Development of a Group-Based Curriculum

ERIC Educational Resources Information Center

Goldberg, Joel O.; Wheeler, Heather; Lubinsky, Tobi; Van Exan, Jessica

2007-01-01

This article outlines an 8-week curriculum that was created to help outpatients develop cognitive and behavioral skills for coping with delusions and hallucinations as well as to reduce patients' comorbid subjective levels of distress (e.g., depression, anxiety). The manualized protocol consisted of psychoeducation and training in a variety of CBT…

Shift in responsibilities in diabetes care: the Nurse-Driven Diabetes In-Hospital Treatment protocol (N-DIABIT).

PubMed

Manders, I G; Stoecklein, K; Lubach, C H C; Bijl-Oeldrich, J; Nanayakkara, P W B; Rauwerda, J A; Kramer, M H H; Eekhoff, E M W

2016-06-01

To investigate the feasibility, safety and efficacy of the Nurse-Driven Diabetes In-Hospital Treatment protocol (N-DIABIT), which consists of nurse-driven correctional therapy, in addition to physician-guided basal therapy, and is carried out by trained ward nurses. Data on 210 patients with diabetes consecutively admitted in the 5-month period after the introduction of N-DIABIT (intervention group) were compared with the retrospectively collected data on 200 consecutive patients with diabetes admitted in the 5-month period before N-DIABIT was introduced (control group). Additional per-protocol analyses were performed in patients in whom mean patient-based protocol adherence was ≥ 70% (intervention subgroup, n = 173 vs. control subgroup, n = 196). There was no difference between the intervention and the control group in mean blood glucose levels (8.9 ± 0.1 and 9.1 ± 0.2 mmol/l, respectively; P = 0.38), consecutive hyperglycaemic (blood glucose ≥ 10.0 mmol/l) episodes; P = 0.15), admission duration (P = 0.79), mean number of blood glucose measurements (P = 0.21) and incidence of severe hypoglycaemia (P = 0.29). Per-protocol analyses showed significant reductions in mean blood glucose levels and consecutive hypoglycaemia and hyperglycaemia in the intervention compared with the control group. Implementation of N-DIABIT by trained ward nurses in non-intensive care unit diabetes care is feasible, safe and non-inferior to physician-driven care alone. High protocol adherence was associated with improved glycaemic control. © 2015 Diabetes UK.

Alternative to traditional stretching methods for flexibility enhancement in well-trained combat athletes: local vibration versus whole-body vibration.

PubMed

Kurt, C

2015-09-01

This study aimed to compare the effect of local vibration (LV) and whole body vibration (WBV) on lower body flexibility and to assess whether vibration treatments were more effective than traditionally used static and dynamic stretching methods. Twenty-four well-trained male combat athletes (age: 22.7 ± 3.3 years) performed four exercise protocols - LV (30 Hz, 4 mm), WBV (30 Hz, 4 mm), static stretching (SS), and dynamic stretching (DS) - in four sessions of equal duration 48 hours apart in a randomized, balanced order. During a 15-minute recovery after each protocol, subjects performed the stand and reach test (S&R) at the 15th second and the 2(nd), 4(th), 6(th), 8(th), 10(th) and 15(th) minute. There was a similar change pattern in S&R scores across the 15-minute recovery after each protocol (p = 0.572), remaining significantly elevated throughout the recovery. A significant main protocol effect was found for absolute change in S&R scores relative to baseline (p = 0.015). These changes were statistically greater in LV than WBV and DS. Changes in SS were not significantly different from LV, but were consistently lower than LV with almost moderate effect sizes. After LV, a greater percentage of subjects increased flexibility above the minimum detectable change compared to other protocols. Subjects with high flexibility (n = 12) benefited more from LV compared with other methods (effect size ≥ 0.862). In conclusion, LV was an effective alternative exercise modality to acutely increase lower extremity flexibility for well-trained athletes compared with WBV and traditional stretching exercises.

Repetition Performance And Blood Lactate Responses Adopting Different Recovery Periods Between Training Sessions In Trained Men.

PubMed

Miranda, Humberto; de Freitas Maia, Marianna; Paz, Gabriel Andrade; de Souza, João A A A; Simão, Roberto; de Araújo Farias, Déborah; Willardson, Jeffrey M

2017-02-08

The purpose of this study was to examine the effect of different recovery periods (24h, 48h, and 72h) between repeated resistance training (RT) sessions for the upper body muscles on repetition performance and blood lactate responses in trained men. Sixteen recreationally trained men (age: 26.1 ± 3.1 years; height: 179 ± 4.5 cm; body mass: 82.6 ± 4.0 kg, 4.5 ± 2.2 years of RT experience) participated in this study. Eight-repetition maximum (8-RM) loads were determined for the bench press (BP), 30° incline bench press (BP30), and 45° incline bench press (BP45) exercises. To assess the effects of different recovery periods between repeated training sessions, three protocols were performed in randomized order, including: 24 hours (P24); 48 hours (P48); and 72 hours (P72). Each RT session consisted of performing four repetition maximum sets of BP, BP30, and BP45 with 8-RM loads and 2-minute rest intervals between sets. Blood lactate levels were measured pre-session (PRE), immediately post-session (POST), 3 minutes post-session (P3), and 5 minutes post-session (P5). For the P24 protocol, significant decreases in repetition performance were found between sessions for the BP, BP30, and BP45 exercises, respectively. When considering session 2 only, the total work (repetition x sets) was significantly higher in P48 and P72 versus P24 for the BP30 and BP45 exercises. Blood lactate levels (i.e. POST, P3, and P5) significantly increased for session 2 under the P24 compared to the P48 and P72 protocols, respectively. Therefore, coaches and practitioners who need to accomplish a higher training volume for the upper body muscles should adopt recovery periods longer than 24 hours between sessions that train the same or similar muscle groups.

Acute effect of a complex training protocol of back squats on 30-m sprint times of elite male military athletes

PubMed Central

Ojeda, Álvaro Huerta; Ríos, Luis Chirosa; Barrilao, Rafael Guisado; Serrano, Pablo Cáceres

2016-01-01

[Purpose] The aim of this study was to determine the acute effect temporal of a complex training protocol on 30 meter sprint times. A secondary objective was to evaluate the fatigue indexes of military athletes. [Subjects and Methods] Seven military athletes were the subjects of this study. The variables measured were times in 30-meter sprint, and average power and peak power of squats. The intervention session with complex training consisted of 4 sets of 5 repetitions at 30% 1RM + 4 repetitions at 60% 1RM + 3 repetitions of 30 meters with 120-second rests. For the statistical analysis repeated measures of ANOVA was used, and for the post hoc analysis, student’s t-test was used. [Results] Times in 30 meter sprints showed a significant reduction between the control set and the four experimental sets, but the average power and peak power of squats did not show significant changes. [Conclusion] The results of the study show the acute positive effect of complex training, over time, in 30-meter sprint by military athletes. This effect is due to the post activation potentiation of the lower limbs’ muscles in the 30 meters sprint. PMID:27134353

Acute effect of a complex training protocol of back squats on 30-m sprint times of elite male military athletes.

PubMed

Ojeda, Álvaro Huerta; Ríos, Luis Chirosa; Barrilao, Rafael Guisado; Serrano, Pablo Cáceres

2016-03-01

[Purpose] The aim of this study was to determine the acute effect temporal of a complex training protocol on 30 meter sprint times. A secondary objective was to evaluate the fatigue indexes of military athletes. [Subjects and Methods] Seven military athletes were the subjects of this study. The variables measured were times in 30-meter sprint, and average power and peak power of squats. The intervention session with complex training consisted of 4 sets of 5 repetitions at 30% 1RM + 4 repetitions at 60% 1RM + 3 repetitions of 30 meters with 120-second rests. For the statistical analysis repeated measures of ANOVA was used, and for the post hoc analysis, student's t-test was used. [Results] Times in 30 meter sprints showed a significant reduction between the control set and the four experimental sets, but the average power and peak power of squats did not show significant changes. [Conclusion] The results of the study show the acute positive effect of complex training, over time, in 30-meter sprint by military athletes. This effect is due to the post activation potentiation of the lower limbs' muscles in the 30 meters sprint.

Design and creation of an experimental program of advanced training in reconstructive microsurgery.

PubMed

Lorenzo, Andrés R; Alvarez, Angel; Garcia-Barreiro, Juan; Centeno, Alberto; Lopez, Eduardo; Martelo, Francisco

2006-01-01

In this study, we design an experimental protocol for the purpose of enhancing performance in training in microsurgery. It is based on five free tissue transfer exercises in rat (epigastric cutaneous flap, saphenous fasciocutaneous flap, epigastric neurovascular flap, saphenous muscular flap, and hindlimb replantation), which simulate the principal clinical procedures of reconstructive microsurgery. The first part of the study consists of an anatomical review of the flaps of 5 rats and in the second part we have carried out the free transfer of flaps on 25 rats divided into 5 groups. To differentiate between them, we have created a mathematical function, referred to as difficulty in a microsurgical exercise, which has enabled us to establish a scale of progression for training, ranging form the easiest to the most difficult. As a conclusion, we believe that this protocol is a useful instrument as it allows for a more precise assessment of microsurgical capacity due to enhanced accuracy in the reproduction of global procedures and the fact that the quantification of progress in training is based on clinical monitoring after 7 days. (c) 2006 Wiley-Liss, Inc. Microsurgery, 2006.

Effect of Fatigue Protocols on Lower Limb Neuromuscular Function and Implications for Anterior Cruciate Ligament Injury Prevention Training: A Systematic Review.

PubMed

Barber-Westin, Sue D; Noyes, Frank R

2017-12-01

Approximately two-thirds of anterior cruciate ligament (ACL) tears are sustained during noncontact situations when an athlete is cutting, pivoting, decelerating, or landing from a jump. Some investigators have postulated that fatigue may result in deleterious alterations in lower limb biomechanics during these activities that could increase the risk of noncontact ACL injuries. However, prior studies have noted a wide variation in fatigue protocols, athletic tasks studied, and effects of fatigue on lower limb kinetics and kinematics. First, to determine if fatigue uniformly alters lower limb biomechanics during athletic tasks that are associated with noncontact ACL injuries. Second, to determine if changes should be made in ACL injury prevention training programs to alter the deleterious effects of fatigue on lower limb kinetics and kinematics. Systematic review; Level of evidence, 4. A systematic review of the literature using MEDLINE was performed. Key terms were fatigue, neuromuscular, exercise, hop test, and single-legged function tests. Inclusion criteria were original research studies involving healthy participants, use of a fatigue protocol, study of at least 1 lower limb task that involved landing from a hop or jump or cutting, and analysis of at least 1 biomechanical variable. Thirty-seven studies involving 806 athletes (485 female, 321 male; mean age, 22.7 years) met the inclusion criteria. General fatigue protocols were used in 20 investigations, peripheral protocols were used in 17 studies, and 21 different athletic tasks were studied (13 single-legged, 8 double-legged). There was no consistency among investigations regarding the effects of fatigue on hip, knee, or ankle joint angles and moments or surface electromyography muscle activation patterns. The fatigue protocols typically did not produce statistically significant changes in ground-reaction forces. Published fatigue protocols did not uniformly produce alterations in lower limb neuromuscular factors that heighten the risk of noncontact ACL injuries. Therefore, justification does not currently exist for major changes in ACL injury prevention training programs to account for potential fatigue effects. However, the effect of fatigue related to ACL injuries is worthy of further investigation, including the refinement of protocols and methods of analysis.

Development of a neuromuscular electrical stimulation protocol for sprint training.

PubMed

Russ, David W; Clark, Brian C; Krause, Jodi; Hagerman, Fredrick C

2012-09-01

Sprint training is associated with several beneficial adaptations in skeletal muscle, including an enhancement of sarcoplasmic reticulum (SR) Ca(2+) release. Unfortunately, several patient populations (e.g., the elderly, those with cardiac dysfunction) that might derive great benefit from sprint exercise are unlikely to tolerate it. The purpose of this report was to describe the development of a tolerable neuromuscular electrical stimulation (NMES) protocol that induces skeletal muscle adaptations similar to those observed with sprint training. Our NMES protocol was modeled after a published sprint exercise protocol and used a novel electrode configuration and stimulation sequence to provide adequate training stimulus while maintaining subject tolerance. Nine young, healthy subjects (four men) began and completed the training protocol of the knee extensor muscles. All subjects completed the protocol, with ratings of discomfort far less than those reported in studies of traditional NMES. Training induced significant increases in SR Ca(2+) release and citrate synthase activity (~16% and 32%, respectively), but SR Ca(2+) uptake did not change. The percentage of myosin heavy chain IIx isoform was decreased significantly after training. At the whole muscle level, neither central activation nor maximum voluntary isometric contraction force were significantly altered, although isometric force did exhibit a trend toward an increase (~3%, P = 0.055). Surprisingly, the NMES training produced a significant increase in muscle cross-sectional area (~3%, P = 0.04). It seems that an appropriately designed NMES protocol can mimic many of the benefits of sprint exercise training, with a low overall time commitment and training volume. These findings suggest that NMES has the potential to bring the benefits of sprint exercise to individuals who are unable to tolerate traditional sprint training.

The Rockefeller University Navigation Program: A Structured Multidisciplinary Protocol Development and Educational Program to Advance Translational Research

PubMed Central

Kost, Rhonda G.; Dowd, Kathleen A.; Hurley, Arlene M.; Rainer, Tyler‐Lauren; Coller, Barry S.

2014-01-01

Abstract The development of translational clinical research protocols is complex. To assist investigators, we developed a structured supportive guidance process (Navigation) to expedite protocol development to the standards of good clinical practice (GCP), focusing on research ethics and integrity. Navigation consists of experienced research coordinators leading investigators through a concerted multistep protocol development process from concept initiation to submission of the final protocol. To assess the effectiveness of Navigation, we collect data on the experience of investigators, the intensity of support required for protocol development, IRB review outcomes, and protocol start and completion dates. One hundred forty‐four protocols underwent Navigation and achieved IRB approval since the program began in 2007, including 37 led by trainee investigators, 26 led by MDs, 9 by MD/PhDs, 57 by PhDs, and 12 by investigators with other credentials (e.g., RN, MPH). In every year, more than 50% of Navigated protocols were approved by the IRB within 30 days. For trainees who had more than one protocol navigated, the intensity of Navigation support required decreased over time. Navigation can increase access to translational studies for basic scientists, facilitate GCP training for investigators, and accelerate development and approval of protocols of high ethical and scientific quality. PMID:24405608

Environmental Sound Training in Cochlear Implant Users

PubMed Central

Sheft, Stanley; Kuvadia, Sejal; Gygi, Brian

2015-01-01

Purpose The study investigated the effect of a short computer-based environmental sound training regimen on the perception of environmental sounds and speech in experienced cochlear implant (CI) patients. Method Fourteen CI patients with the average of 5 years of CI experience participated. The protocol consisted of 2 pretests, 1 week apart, followed by 4 environmental sound training sessions conducted on separate days in 1 week, and concluded with 2 posttest sessions, separated by another week without training. Each testing session included an environmental sound test, which consisted of 40 familiar everyday sounds, each represented by 4 different tokens, as well as the Consonant Nucleus Consonant (CNC) word test, and Revised Speech Perception in Noise (SPIN-R) sentence test. Results Environmental sounds scores were lower than for either of the speech tests. Following training, there was a significant average improvement of 15.8 points in environmental sound perception, which persisted 1 week later after training was discontinued. No significant improvements were observed for either speech test. Conclusions The findings demonstrate that environmental sound perception, which remains problematic even for experienced CI patients, can be improved with a home-based computer training regimen. Such computer-based training may thus provide an effective low-cost approach to rehabilitation for CI users, and potentially, other hearing impaired populations. PMID:25633579

Effects of strongman training on salivary testosterone levels in a sample of trained men.

PubMed

Ghigiarelli, Jamie J; Sell, Katie M; Raddock, Jessica M; Taveras, Kurt

2013-03-01

Strongman exercises consist of multi-joint movements that incorporate large muscle mass groups and impose a substantial amount of neuromuscular stress. The purpose of this study was to examine salivary testosterone responses from 2 novel strongman training (ST) protocols in comparison with an established hypertrophic (H) protocol reported to acutely elevate testosterone levels. Sixteen men (24 ± 4.4 years, 181.2 ± 6.8 cm, and 95.3 ± 20.3 kg) volunteered to participate in this study. Subjects completed 3 protocols designed to ensure equal total volume (sets and repetitions), rest period, and intensity between the groups. Exercise sets were performed to failure. Exercise selection and intensity (3 sets × 10 repetitions at 75% 1 repetition maximum) were chosen as they reflected commonly prescribed resistance exercise protocols recognized to elicit a large acute hormonal response. In each of the protocols, subjects were required to perform 3 sets to muscle failure of 5 different exercises (tire flip, chain drag, farmers walk, keg carry, and atlas stone lift) with a 2-minute rest interval between sets and a 3-minute rest interval between exercises. Saliva samples were collected pre-exercise (PRE), immediate postexercise (PST), and 30 minutes postexercise (30PST). Delta scores indicated a significant difference between PRE and PST testosterone level within each group (p ≤ 0.05), with no significant difference between the groups. Testosterone levels spiked 136% (225.23 ± 148.01 pg·ml(-1)) for the H group, 74% (132.04 ± 98.09 pg·ml(-1)) for the ST group, and 54% (122.10 ± 140.67 pg·ml) for the mixed strongman/hypertrophy (XST) group. A significant difference for testosterone level occurred over time (PST to 30PST) for the H group p ≤ 0.05. In conclusion, ST elicits an acute endocrine response similar to a recognized H protocol when equated for duration and exercise intensity.

Muscle performance following an acute bout of plyometric training combined with low or high intensity weight exercise.

PubMed

Beneka, Anastasia G; Malliou, Paraskevi K; Missailidou, Victoria; Chatzinikolaou, Athanasios; Fatouros, Ioannis; Gourgoulis, Vassilios; Georgiadis, Elias

2013-01-01

To determine the time course of performance responses after an acute bout of plyometric exercise combined with high and low intensity weight training, a 3-group (including a control group), repeated-measures design was employed. Changes in performance were monitored through jumping ability by measuring countermovement and squat jumping, and strength performance assessment through isometric and isokinetic testing of knee extensors (at two different velocities). Participants in both experimental groups performed a plyometric protocol consisting of 50 jumps over 50 cm hurdles and 50 drop jumps from a 50 cm plyometric box. Additionally, each group performed two basic weight exercises consisting of leg presses and leg extensions at 90-95% of maximum muscle strength for the high intensity group and 60% of maximum muscle strength for the low intensity group. The results of the study suggest that an acute bout of intense plyometric exercise combined with weight exercise induces time-dependent changes in performance, which are also dependent on the nature of exercise protocol and testing procedures. In conclusion, acute plyometric exercise with weight exercise may induce a substantial decline in jumping performance for as long as 72 hours but not in other forms of muscle strength.

Development of Energy Efficient Clustering Protocol in Wireless Sensor Network Using Neuro-Fuzzy Approach.

PubMed

Julie, E Golden; Selvi, S Tamil

2016-01-01

Wireless sensor networks (WSNs) consist of sensor nodes with limited processing capability and limited nonrechargeable battery power. Energy consumption in WSN is a significant issue in networks for improving network lifetime. It is essential to develop an energy aware clustering protocol in WSN to reduce energy consumption for increasing network lifetime. In this paper, a neuro-fuzzy energy aware clustering scheme (NFEACS) is proposed to form optimum and energy aware clusters. NFEACS consists of two parts: fuzzy subsystem and neural network system that achieved energy efficiency in forming clusters and cluster heads in WSN. NFEACS used neural network that provides effective training set related to energy and received signal strength of all nodes to estimate the expected energy for tentative cluster heads. Sensor nodes with higher energy are trained with center location of base station to select energy aware cluster heads. Fuzzy rule is used in fuzzy logic part that inputs to form clusters. NFEACS is designed for WSN handling mobility of node. The proposed scheme NFEACS is compared with related clustering schemes, cluster-head election mechanism using fuzzy logic, and energy aware fuzzy unequal clustering. The experiment results show that NFEACS performs better than the other related schemes.

Development of Energy Efficient Clustering Protocol in Wireless Sensor Network Using Neuro-Fuzzy Approach

PubMed Central

Julie, E. Golden; Selvi, S. Tamil

2016-01-01

Wireless sensor networks (WSNs) consist of sensor nodes with limited processing capability and limited nonrechargeable battery power. Energy consumption in WSN is a significant issue in networks for improving network lifetime. It is essential to develop an energy aware clustering protocol in WSN to reduce energy consumption for increasing network lifetime. In this paper, a neuro-fuzzy energy aware clustering scheme (NFEACS) is proposed to form optimum and energy aware clusters. NFEACS consists of two parts: fuzzy subsystem and neural network system that achieved energy efficiency in forming clusters and cluster heads in WSN. NFEACS used neural network that provides effective training set related to energy and received signal strength of all nodes to estimate the expected energy for tentative cluster heads. Sensor nodes with higher energy are trained with center location of base station to select energy aware cluster heads. Fuzzy rule is used in fuzzy logic part that inputs to form clusters. NFEACS is designed for WSN handling mobility of node. The proposed scheme NFEACS is compared with related clustering schemes, cluster-head election mechanism using fuzzy logic, and energy aware fuzzy unequal clustering. The experiment results show that NFEACS performs better than the other related schemes. PMID:26881269

Using behavioral skills training and video rehearsal to teach blackjack skills.

PubMed

Speelman, Ryan C; Whiting, Seth W; Dixon, Mark R

2015-09-01

A behavioral skills training procedure that consisted of video instructions, video rehearsal, and video testing was used to teach 4 recreational gamblers a specific skill in playing blackjack (sometimes called card counting). A multiple baseline design was used to evaluate intervention effects on card-counting accuracy and chips won or lost across participants. Before training, no participant counted cards accurately. Each participant completed all phases of the training protocol, counting cards fluently with 100% accuracy during changing speed criterion training exercises. Generalization probes were conducted while participants played blackjack in a mock casino following each training phase. Afterwards, all 4 participants were able to count cards while they played blackjack. In conjunction with count accuracy, total winnings were tracked to determine the monetary advantages associated with counting cards. After losing money during baseline, 3 of 4 participants won a substantial amount of money playing blackjack after the intervention. © Society for the Experimental Analysis of Behavior.

Influence of tilt training on activation of the autonomic nervous system in patients with vasovagal syncope.

PubMed

Gajek, Jacek; Zyśko, Dorota; Halawa, Bogumił; Mazurek, Walentyna

2006-04-01

Tilt training is a new treatment for vasovagal syncope. Its therapeutic efficacy is thought to be the result of the desensitization of cardiopulmonary receptors, but it could be the influence of the tilt training on the activation of the autonomic nervous system as well. The study group consisted of 24 vasovagal patients (17 women and 7 men) aged 32.5 +/- 11.8 years. The diagnostic head-up tilt test was performed according to the Italian protocol with nitroglycerin if necessary. The monitoring head-up tilt test was performed according to the Westminster protocol without provocation, after 1 to 3 months of tilt training. Holter ECG recordings for HRV parameters (time and frequency domain) were obtained from selected 2-min intervals before, during and after the diagnostic and monitoring tilt test. The diagnostic test was positive in the passive phase in 6 and after provocation in 18 patients. During the training period no syncope occurred. Analysing the HRV parameters we demonstrated the following findings: I. mRR decreases immediately after assumption of a vertical position in both tests (diagnostic and monitoring) but in the diagnostic test its further decrease occurs earlier than in the monitoring test; 2. the absolute power of the HF component is greater in the early phase of tilt after tilt training than in the corresponding period in the diagnostic test. After a longer period of tilt training the activation of the sympathetic nervous system in response to the erect position is diminished.

Differences in the Flexibility of Switching Learning Strategies and CREB Phosphorylation Levels in Prefrontal Cortex, Dorsal Striatum and Hippocampus in Two Inbred Strains of Mice

PubMed Central

Cho, Woo-Hyun; Han, Jung-Soo

2016-01-01

Flexibility in using different learning strategies was assessed in two different inbred strains of mice, the C57BL/6 and DBA/2 strains. Mice were trained sequentially in two different Morris water maze protocols that tested their ability to switch their learning strategy to complete a new task after first being trained in a different task. Training consisted either of visible platform trials (cued training) followed by subsequent hidden platform trials (place training) or the reverse sequence (place training followed by cued training). Both strains of mice showed equivalent performance in the type of training (cued or place) that they received first. However, C57BL/6 mice showed significantly better performances than DBA/2 mice following the switch in training protocols, irrespective of the order of training. After completion of the switched training session, levels of cAMP response element-binding protein (CREB) and phosphorylated CREB (pCREB) were measured in the hippocampus, striatum and prefrontal cortex of the mice. Prefrontal cortical and hippocampal pCREB levels differed by strain, with higher levels found in C57BL/6 mice than in DBA/2 mice. No strain differences were observed in the medial or lateral region of the dorsal striatum. These findings indicate that the engagement (i.e., CREB signaling) of relevant neural structures may vary by the specific demands of the learning strategy, and this is closely tied to differences in the flexibility of C57BL/6 and DBA/2 mice to switch their learning strategies when given a new task. PMID:27695401

Effects of two aerobic exercise training protocols on parameters of oxidative stress in the blood and liver of obese rats.

PubMed

Delwing-de Lima, Daniela; Ulbricht, Ariene Sampaio Souza Farias; Werlang-Coelho, Carla; Delwing-Dal Magro, Débora; Joaquim, Victor Hugo Antonio; Salamaia, Eloise Mariani; de Quevedo, Silvana Rodrigues; Desordi, Larissa

2017-12-08

We evaluated the effects of moderate-intensity continuous training (MICT) and high-intensity interval training (HIIT) protocols on the alterations in oxidative stress parameters caused by a high-fat diet (HFD), in the blood and liver of rats. The HFD enhanced thiobarbituric acid reactive substances (TBA-RS) and protein carbonyl content, while reducing total sulfhydryl content and catalase (CAT) and glutathione peroxidase (GSH-Px) activities in the blood. Both training protocols prevented an increase in TBA-RS and protein carbonyl content, and prevented a reduction in CAT. HIIT protocol enhanced SOD activity. In the liver, HFD didn't alter TBA-RS, total sulfhydryl content or SOD, but increased protein carbonyl content and CAT and decreased GSH-Px. The exercise protocols prevented the increase in protein carbonyl content and the MICT protocol prevented an alteration in CAT. In conclusion, HFD elicits oxidative stress in the blood and liver and both protocols prevented most of the alterations in the oxidative stress parameters.

Automating individualized coaching and authentic role-play practice for brief intervention training.

PubMed

Hayes-Roth, B; Saker, R; Amano, K

2010-01-01

Brief intervention helps to reduce alcohol abuse, but there is a need for accessible, cost-effective training of clinicians. This study evaluated STAR Workshop , a web-based training system that automates efficacious techniques for individualized coaching and authentic role-play practice. We compared STAR Workshop to a web-based, self-guided e-book and a no-treatment control, for training the Engage for Change (E4C) brief intervention protocol. Subjects were medical and nursing students. Brief written skill probes tested subjects' performance of individual protocol steps, in different clinical scenarios, at three test times: pre-training, post-training, and post-delay (two weeks). Subjects also did live phone interviews with a standardized patient, post-delay. STAR subjects performed significantly better than both other groups. They showed significantly greater improvement from pre-training probes to post-training and post-delay probes. They scored significantly higher on post-delay phone interviews. STAR Workshop appears to be an accessible, cost-effective approach for training students to use the E4C protocol for brief intervention in alcohol abuse. It may also be useful for training other clinical interviewing protocols.

Amplitude-oriented exercise in Parkinson's disease: a randomized study comparing LSVT-BIG and a short training protocol.

PubMed

Ebersbach, Georg; Grust, Ute; Ebersbach, Almut; Wegner, Brigitte; Gandor, Florin; Kühn, Andrea A

2015-02-01

LSVT-BIG is an exercise for patients with Parkinson's disease (PD) comprising of 16 1-h sessions within 4 weeks. LSVT-BIG was compared with a 2-week short protocol (AOT-SP) consisting of 10 sessions with identical exercises in 42 patients with PD. UPDRS-III-score was reduced by -6.6 in LSVT-BIG and -5.7 in AOT-SP at follow-up after 16 weeks (p < 0.001). Measures of motor performance were equally improved by LSVT-BIG and AOT-SP but high-intensity LSVT-BIG was more effective to obtain patient-perceived benefit.

Instructor Handbook for the Protocol Modules on Classroom Management. Utah Protocol Materials Project.

ERIC Educational Resources Information Center

Langer, Philip; Borg, Walter R.

This handbook is designed to acquaint the teacher educator with the training materials in classroom management prepared by the Utah State University Protocol Training Project. It deals with the protocol materials generally and with each module specifically, and includes the following sections: (a) an introduction to and rationale for protocol…

Investigating the feasibility and acceptability of health psychology-informed obesity training for medical students.

PubMed

Chisholm, Anna; Hart, Jo; Mann, Karen; Perry, Mark; Duthie, Harriet; Rezvani, Leila; Peters, Sarah

2016-01-01

Health psychologists have succeeded in identifying theory-congruent behaviour change techniques (BCTs) to prevent and reduce lifestyle-related illnesses, such as cardiovascular disease, cancers and diabetes. Obesity management discussions between doctors and patients can be challenging and are often avoided. Despite a clear training need, it is unknown how best to tailor BCT research findings to inform obesity-management training for future healthcare professionals. The primary objective of this descriptive study was to gather information on the feasibility and acceptability of delivering and evaluating health psychology-informed obesity training to UK medical students. Medical students (n = 41) attended an obesity management session delivered by GP tutors. Sessions were audio-recorded to enable fidelity checks. Acceptability of training was explored qualitatively. Tutors consistently delivered training according to the intervention protocol; and students and tutors found the training highly acceptable. This psychology-informed training can be delivered successfully by GP tutors and further research is warranted to explore its efficacy.

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.

Protocol for determining bull trout presence

USGS Publications Warehouse

Peterson, James; Dunham, Jason B.; Howell, Philip; Thurow, Russell; Bonar, Scott

2002-01-01

The Western Division of the American Fisheries Society was requested to develop protocols for determining presence/absence and potential habitat suitability for bull trout. The general approach adopted is similar to the process for the marbled murrelet, whereby interim guidelines are initially used, and the protocols are subsequently refined as data are collected. Current data were considered inadequate to precisely identify suitable habitat but could be useful in stratifying sampling units for presence/absence surveys. The presence/absence protocol builds on previous approaches (Hillman and Platts 1993; Bonar et al. 1997), except it uses the variation in observed bull trout densities instead of a minimum threshold density and adjusts for measured differences in sampling efficiency due to gear types and habitat characteristics. The protocol consists of: 1. recommended sample sizes with 80% and 95% detection probabilities for juvenile and resident adult bull trout for day and night snorkeling and electrofishing adjusted for varying habitat characteristics for 50m and 100m sampling units, 2. sampling design considerations, including possible habitat characteristics for stratification, 3. habitat variables to be measured in the sampling units, and 3. guidelines for training sampling crews. Criteria for habitat strata consist of coarse, watershed-scale characteristics (e.g., mean annual air temperature) and fine-scale, reach and habitat-specific features (e.g., water temperature, channel width). The protocols will be revised in the future using data from ongoing presence/absence surveys, additional research on sampling efficiencies, and development of models of habitat/species occurrence.

Protein Supplementation to Augment the Effects of High Intensity Resistance Training in Untrained Middle-Aged Males: The Randomized Controlled PUSH Trial.

PubMed

Wittke, Andreas; von Stengel, Simon; Hettchen, Michael; Fröhlich, Michael; Giessing, Jürgen; Lell, Michael; Scharf, Michael; Bebenek, Michael; Kohl, Matthias; Kemmler, Wolfgang

2017-01-01

High intensity (resistance exercise) training (HIT) defined as a "single set resistance exercise to muscular failure" is an efficient exercise method that allows people with low time budgets to realize an adequate training stimulus. Although there is an ongoing discussion, recent meta-analysis suggests the significant superiority of multiple set (MST) methods for body composition and strength parameters. The aim of this study is to determine whether additional protein supplementation may increase the effect of a HIT-protocol on body composition and strength to an equal MST-level. One hundred and twenty untrained males 30-50 years old were randomly allocated to three groups: (a) HIT, (b) HIT and protein supplementation (HIT&P), and (c) waiting-control (CG) and (after cross-over) high volume/high-intensity-training (HVHIT). HIT was defined as "single set to failure protocol" while HVHIT consistently applied two equal sets. Protein supplementation provided an overall intake of 1.5-1.7 g/kg/d/body mass. Primary study endpoint was lean body mass (LBM). LBM significantly improved in all exercise groups ( p ≤ 0.043); however only HIT&P and HVHIT differ significantly from control ( p ≤ 0.002). HIT diverges significantly from HIT&P ( p = 0.017) and nonsignificantly from HVHIT ( p = 0.059), while no differences were observed for HIT&P versus HVHIT ( p = 0.691). In conclusion, moderate to high protein supplementation significantly increases the effects of a HIT-protocol on LBM in middle-aged untrained males.

101 Labeled Brain Images and a Consistent Human Cortical Labeling Protocol

PubMed Central

Klein, Arno; Tourville, Jason

2012-01-01

We introduce the Mindboggle-101 dataset, the largest and most complete set of free, publicly accessible, manually labeled human brain images. To manually label the macroscopic anatomy in magnetic resonance images of 101 healthy participants, we created a new cortical labeling protocol that relies on robust anatomical landmarks and minimal manual edits after initialization with automated labels. The “Desikan–Killiany–Tourville” (DKT) protocol is intended to improve the ease, consistency, and accuracy of labeling human cortical areas. Given how difficult it is to label brains, the Mindboggle-101 dataset is intended to serve as brain atlases for use in labeling other brains, as a normative dataset to establish morphometric variation in a healthy population for comparison against clinical populations, and contribute to the development, training, testing, and evaluation of automated registration and labeling algorithms. To this end, we also introduce benchmarks for the evaluation of such algorithms by comparing our manual labels with labels automatically generated by probabilistic and multi-atlas registration-based approaches. All data and related software and updated information are available on the http://mindboggle.info/data website. PMID:23227001

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

PubMed Central

2014-01-01

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

Cleft audit protocol for speech (CAPS-A): a comprehensive training package for speech analysis.

PubMed

Sell, D; John, A; Harding-Bell, A; Sweeney, T; Hegarty, F; Freeman, J

2009-01-01

The previous literature has largely focused on speech analysis systems and ignored process issues, such as the nature of adequate speech samples, data acquisition, recording and playback. Although there has been recognition of the need for training on tools used in speech analysis associated with cleft palate, little attention has been paid to this issue. To design, execute, and evaluate a training programme for speech and language therapists on the systematic and reliable use of the Cleft Audit Protocol for Speech-Augmented (CAPS-A), addressing issues of standardized speech samples, data acquisition, recording, playback, and listening guidelines. Thirty-six specialist speech and language therapists undertook the training programme over four days. This consisted of two days' training on the CAPS-A tool followed by a third day, making independent ratings and transcriptions on ten new cases which had been previously recorded during routine audit data collection. This task was repeated on day 4, a minimum of one month later. Ratings were made using the CAPS-A record form with the CAPS-A definition table. An analysis was made of the speech and language therapists' CAPS-A ratings at occasion 1 and occasion 2 and the intra- and inter-rater reliability calculated. Trained therapists showed consistency in individual judgements on specific sections of the tool. Intraclass correlation coefficients were calculated for each section with good agreement on eight of 13 sections. There were only fair levels of agreement on anterior oral cleft speech characteristics, non-cleft errors/immaturities and voice. This was explained, at least in part, by their low prevalence which affects the calculation of the intraclass correlation coefficient statistic. Speech and language therapists benefited from training on the CAPS-A, focusing on specific aspects of speech using definitions of parameters and scalar points, in order to apply the tool systematically and reliably. Ratings are enhanced by ensuring a high degree of attention to the nature of the data, standardizing the speech sample, data acquisition, the listening process together with the use of high-quality recording and playback equipment. In addition, a method is proposed for maintaining listening skills following training as part of an individual's continuing education.

High-intensity body weight training is comparable to combined training in changes in muscle mass, physical performance, inflammatory markers and metabolic health in postmenopausal women at high risk for type 2 diabetes mellitus: A randomized controlled clinical trial.

PubMed

Martins, Fernanda Maria; de Paula Souza, Aletéia; Nunes, Paulo Ricardo Prado; Michelin, Márcia Antoniazi; Murta, Eddie Fernando Candido; Resende, Elisabete Aparecida Mantovani Rodrigues; de Oliveira, Erick Prado; Orsatti, Fábio Lera

2018-07-01

This study compared the effects of 12 weeks of high-intensity interval body weight training (HIBWT) with combined training (COMT; aerobic and resistance exercises on body composition, a 6-minute walk test (6MWT; physical performance), insulin resistance (IR) and inflammatory markers in postmenopausal women (PW) at high risk of type 2 diabetes mellitus (TDM2). In this randomized controlled clinical study, 16 PW at high risk of TDM2 were randomly allocated into two groups: HIBWT (n = 8) and COMT (n = 8). The HIBWT group performed a training protocol (length time ~28 min) consisting of ten sets of 60 s of high intensity exercise interspersed by a recovery period of 60 s of low intensity exercise. The COMT group performed a training protocol (length time ~60 min) consisting of a 30 min walk of moderate intensity following by five resistance exercises. All training sessions were performed in the university gym facility three days a week (no consecutive days) for 12 weeks. All outcomes (body composition, muscle function, and IR and inflammatory markers) were assessed at the baseline and at the end of the study. Both groups increased (P < 0.05) muscle mass index (MMI), 6MWT, and interleukin 1 receptor antagonist and decreased fasting glucose, glycated hemoglobin , Insulin, HOMA-IR, and monocyte chemoattractant protein-1 (trend, P = 0.056). HIBWT effects were indistinguishable (P > 0.05) from the effects of COMT. There was a significant (P < 0.05) interaction of time by the group in muscle strength, indicating that only the COMT increased the muscle strength. This study suggests that changes in HOMA, IL-1ra, 6MWT, and MMI with HITBW are similar when compared to COMT in PW at high risk of TDM2. The patients were part of a 12-week training study (ClinicalTrials.gov Identifier: NCT03200639). Copyright © 2018 Elsevier Inc. All rights reserved.

A technology training protocol for meeting QSEN goals: Focusing on meaningful learning.

PubMed

Luo, Shuhong; Kalman, Melanie

2018-01-01

The purpose of this paper is to describe and discuss how we designed and developed a 12-step technology training protocol. The protocol is meant to improve meaningful learning in technology education so that nursing students are able to meet the informatics requirements of Quality and Safety Education in Nursing competencies. When designing and developing the training protocol, we used a simplified experiential learning model that addressed the core features of meaningful learning: to connect new knowledge with students' prior knowledge and real-world workflow. Before training, we identified students' prior knowledge and workflow tasks. During training, students learned by doing, reflected on their prior computer skills and workflow, designed individualized procedures for integration into their workflow, and practiced the self-designed procedures in real-world settings. The trainer was a facilitator who provided a meaningful learning environment, asked the right questions to guide reflective conversation, and offered scaffoldings at critical moments. This training protocol could significantly improve nurses' competencies in using technologies and increase their desire to adopt new technologies. © 2017 Wiley Periodicals, Inc.

Interactive metronome training for a 9-year-old boy with attention and motor coordination difficulties.

PubMed

Bartscherer, Melinda L; Dole, Robin L

2005-01-01

The purpose of this case report is to describe a new intervention, the Interactive Metronome, for improving timing and coordination. A nine-year-old boy, with difficulties in attention and developmental delay of unspecified origin underwent a seven-week training program with the Interactive Metronome. Before, during, and after training timing, accuracy was assessed with testing procedures consistent with the Interactive Metronome training protocol. Before and after training, his gross and fine motor skills were examined with the Bruininiks-Oseretsky Test of Motor Proficiency (BOTMP). The child exhibited marked change in scores on both timing accuracy and several BOTMP subtests. Additionally his mother relayed anecdotal reports of changes in behavior at home. This child's participation in a new intervention for improving timing and coordination was associated with changes in timing accuracy, gross and fine motor abilities, and parent reported behaviors. These findings warrant further study.

Unipedal Postural Balance and Countermovement Jumps After a Warm-up and Plyometric Training Session: A Randomized Controlled Trial.

PubMed

Romero-Franco, Natalia; Jiménez-Reyes, Pedro

2015-11-01

The purpose of this study was to analyze the immediate effects of a plyometric training protocol on unipedal postural balance and countermovement jumps. In addition, we analyzed the effects of a warm-up on these parameters. Thirty-two amateur male sprinters (24.9 ± 4.1 years; 72.3 ± 10.7 kg; 1.78 ± 0.05 m; 22.6 ± 3.3 kg·m) were randomly sorted into a control group (n = 16) (they did not perform any physical activity) and a plyometric training group (n = 16) (they performed a 15-minute warm-up and a high-intensity plyometric protocol consisting of 10 sets of 15 vertical jumps). Before and after the warm-up, and immediately after and 5 minutes after the plyometric protocol, all athletes indicated the perceived exertion on calf and quad regions on a scale from 0 (no exertion) to 10 (maximum exertion). They also carried out a maximum countermovement jump and a unipedal postural balance test (athletes would remain as still as possible for 15 seconds in a left leg and right leg support stance). Results showed that, in the plyometric group, length and velocity of center-of-pressure movement in right leg support stance increased compared with baseline (p = 0.001 and p = 0.004, respectively) and to the control group (p = 0.035 and p = 0.029, respectively) immediately after the plyometric protocol. In addition, the countermovement jump height decreased right after the plyometric protocol (p < 0.001). The perceived exertion on calf and quad regions increased after the plyometry (p < 0.001). Five minutes later, these parameters remained deteriorated despite a slight recovery (length: p = 0.044; velocity: p = 0.05; countermovement jump height: p < 0.001; local exertion: p < 0.001). Data also showed that countermovement jump height improved after the warm-up (p = 0.021), but unipedal postural balance remained unaltered. As a conclusion, high-intensity plyometric exercises blunt unipedal postural balance and countermovement jump performance. The deterioration lasts at least 5 minutes, which may influence future exercises in the training session. Coaches should plan the training routine according to the immediate effects of plyometry on postural balance and vertical jumps, which play a role in injury prevention and sports performance.

Sprint interval training (SIT) substantially reduces depressive symptoms in major depressive disorder (MDD): A randomized controlled trial.

PubMed

Minghetti, Alice; Faude, Oliver; Hanssen, Henner; Zahner, Lukas; Gerber, Markus; Donath, Lars

2018-07-01

Continuous aerobic exercise training (CAT) is considered a complementary treatment option in patients with major depressive disorder (MDD). Intermittent exercise training protocols, such as sprint interval training (SIT) have gained increasing popularity, but no studies on depressive symptoms following SIT in patients with MDD are available. Fifty-nine in-patients with MDD were randomly assigned to a SIT or CAT group. Medication was counterbalanced in both intervention arms. Both intervention groups received 3 weekly training sessions for 4-weeks (12 sessions in total). SIT comprised 25 bouts of 30 seconds at 80% of maximal power, whereas CAT consisted of 20 minutes of physical activity at 60% of maximal power. The training protocols were isocalorically designed. Maximal bicycle ergometer exercise testing yielded maximal and submaximal physical fitness parameters. The Beck-Depression-Inventory-II (BDI-II) was filled out by the patients before and after the intervention period. BDI-II scores substantially decreased in both groups with an effect size pointing towards a large effect (p < 0.001, η p ² = 0.70) while submaximal (0.07 < d < 0.89) and maximal (0.05 < d < 0.85) fitness variables improved in both groups. Short-term SIT leads to similar results as CAT in patients with MDD and can be regarded as a time-efficient and promising exercise-based treatment strategy. Copyright © 2018 Elsevier B.V. All rights reserved.

Assessment of the ability of wheelchair subjects with spinal cord injury to perform a specific protocol of shoulder training: a pilot study.

PubMed

Merolla, Giovanni; Dellabiancia, Fabio; Filippi, Maria Vittoria; De Santis, Elisa; Alpi, Daniele; Magrini, Paola; Porcellini, Giuseppe

2014-04-01

a regular program of exercises in subjects with spinal cord injury (SCI) can contribute to reduce the risk of upper extremities injuries. in this prospective laboratory study we tested the hypothesis that a training machine developed for able-body users is suitable for a shoulder training protocol in 11 paraplegic subjects with SCI. Overall subjects were assessed with the SCIM III, CS, DASH and standard shoulder examination. We set a protocol of shoulder exercises performed with a training machine. Overall subjects were able to perform the protocol but 2 did not complete the exercises n° 6 and 7. The position of the wheelchair during each exercise was recorded. Wheelchair position/loading level were significantly correlated with the protocol n° 2, 3 and 5 as well as BMI/loading level for the exercises n° 5 and 9 and age/loading level for the exercise n° 7. Clinical scores were neither correlated with loading nor with anthropometric data. FROM THE ANALYSIS OF DATA COLLECTED IN THIS STUDY ARISED THAT: 1) the training machine needs some adjustments for paraplegic subjects, 2) the training protocol was appropriate except for the exercises needing a torso-rotation and 3) the template for wheelchair position may be a valid guide for an optimal paraplegic shoulder training.

Exercise training prevents skeletal muscle damage in an experimental sepsis model

PubMed Central

Coelho, Carla Werlang; Jannig, Paulo R; de Souza, Arlete B; Fronza, Hercilio; Westphal, Glauco A; Petronilho, Fabricia; Constantino, Larissa; Dal-Pizzol, Felipe; Ferreira, Gabriela K; Streck, Emilio E; Silva, Eliezer

2013-01-01

OBJECTIVE: Oxidative stress plays an important role in skeletal muscle damage in sepsis. Aerobic exercise can decrease oxidative stress and enhance antioxidant defenses. Therefore, it was hypothesized that aerobic exercise training before a sepsis stimulus could attenuate skeletal muscle damage by modulating oxidative stress. Thus, the aim of this study was to evaluate the effects of aerobic physical preconditioning on the different mechanisms that are involved in sepsis-induced myopathy. METHODS: Male Wistar rats were randomly assigned to either the untrained or trained group. The exercise training protocol consisted of an eight-week treadmill program. After the training protocol, the animals from both groups were randomly assigned to either a sham group or a cecal ligation and perforation surgery group. Thus, the groups were as follows: sham, cecal ligation and perforation, sham trained, and cecal ligation and perforation trained. Five days after surgery, the animals were euthanized and their soleus and plantaris muscles were harvested. Fiber cross-sectional area, creatine kinase, thiobarbituric acid reactive species, carbonyl, catalase and superoxide dismutase activities were measured. RESULTS: The fiber cross-sectional area was smaller, and the creatine kinase, thiobarbituric acid reactive species and carbonyl levels were higher in both muscles in the cecal ligation and perforation group than in the sham and cecal ligation and perforation trained groups. The muscle superoxide dismutase activity was higher in the cecal ligation and perforation trained group than in the sham and cecal ligation and perforation groups. The muscle catalase activity was lower in the cecal ligation and perforation group than in the sham group. CONCLUSION: In summary, aerobic physical preconditioning prevents atrophy, lipid peroxidation and protein oxidation and improves superoxide dismutase activity in the skeletal muscles of septic rats. PMID:23420166

Standardized training in nurse model travel clinics.

PubMed

Sofarelli, Theresa A; Ricks, Jane H; Anand, Rahul; Hale, Devon C

2011-01-01

International travel plays a significant role in the emergence and redistribution of major human diseases. The importance of travel medicine clinics for preventing morbidity and mortality has been increasingly appreciated, although few studies have thus far examined the management and staff training strategies that result in successful travel-clinic operations. Here, we describe an example of travel-clinic operation and management coordinated through the University of Utah School of Medicine, Division of Infectious Diseases. This program, which involves eight separate clinics distributed statewide, functions both to provide patient consult and care services, as well as medical provider training and continuing medical education (CME). Initial training, the use of standardized forms and protocols, routine chart reviews and monthly continuing education meetings are the distinguishing attributes of this program. An Infectious Disease team consisting of one medical doctor (MD) and a physician assistant (PA) act as consultants to travel nurses who comprise the majority of clinic staff. Eight clinics distributed throughout the state of Utah serve approximately 6,000 travelers a year. Pre-travel medical services are provided by 11 nurses, including 10 registered nurses (RNs) and 1 licensed practical nurse (LPN). This trained nursing staff receives continuing travel medical education and participate in the training of new providers. All nurses have completed a full training program and 7 of the 11 (64%) of clinic nursing staff serve more than 10 patients a week. Quality assurance measures show that approximately 0.5% of charts reviewed contain a vaccine or prescription error which require patient notification for correction. Using an initial training program, standardized patient intake forms, vaccine and prescription protocols, preprinted prescriptions, and regular CME, highly trained nurses at travel clinics are able to provide standardized pre-travel care to international travelers originating from Utah. © 2010 International Society of Travel Medicine.

Perceptual learning of basic visual features remains task specific with Training-Plus-Exposure (TPE) training.

PubMed

Cong, Lin-Juan; Wang, Ru-Jie; Yu, Cong; Zhang, Jun-Yun

2016-01-01

Visual perceptual learning is known to be specific to the trained retinal location, feature, and task. However, location and feature specificity can be eliminated by double-training or TPE training protocols, in which observers receive additional exposure to the transfer location or feature dimension via an irrelevant task besides the primary learning task Here we tested whether these new training protocols could even make learning transfer across different tasks involving discrimination of basic visual features (e.g., orientation and contrast). Observers practiced a near-threshold orientation (or contrast) discrimination task. Following a TPE training protocol, they also received exposure to the transfer task via performing suprathreshold contrast (or orientation) discrimination in alternating blocks of trials in the same sessions. The results showed no evidence for significant learning transfer to the untrained near-threshold contrast (or orientation) discrimination task after discounting the pretest effects and the suprathreshold practice effects. These results thus do not support a hypothetical task-independent component in perceptual learning of basic visual features. They also set the boundary of the new training protocols in their capability to enable learning transfer.

Standardized quality-assessment system to evaluate pressure ulcer care in the nursing home.

PubMed

Bates-Jensen, Barbara M; Cadogan, Mary; Jorge, Jennifer; Schnelle, John F

2003-09-01

To demonstrate reliability and feasibility of a standardized protocol to assess and score quality indicators relevant to pressure ulcer (PU) care processes in nursing homes (NHs). Descriptive. Eight NHs. One hundred ninety-one NH residents for whom the PU Resident Assessment Protocol of the Minimum Data Set was initiated. Nine quality indicators (two related to screening and prevention of PU, two focused on assessment, and five addressing management) were scored using medical record data, direct human observation, and wireless thigh monitor observation data. Feasibility and reliability of medical record, observation, and thigh monitor protocols were determined. The percentage of participants who passed each of the indicators, indicating care consistent with practice guidelines, ranged from 0% to 98% across all indicators. In general, participants in NHs passed fewer indicators and had more problems with medical record accuracy before a PU was detected (screening/prevention indicators) than they did once an ulcer was documented (assessment and management indicators). Reliability of the medical record protocol showed kappa statistics ranging from 0.689 to 1.00 and percentage agreement from 80% to 100%. Direct observation protocols yielded kappa statistics of 0.979 and 0.928. Thigh monitor protocols showed kappa statistics ranging from 0.609 to 0.842. Training was variable, with the observation protocol requiring 1 to 2 hours, medical records requiring joint review of 20 charts with average time to complete the review of 20 minutes, and the thigh monitor data requiring 1 week for training in data preparation and interpretation. The standardized quality assessment system generated scores for nine PU quality indicators with good reliability and provided explicit scoring rules that permit reproducible conclusions about PU care. The focus of the indicators on care processes that are under the control of NH staff made the protocol useful for external survey and internal quality improvement purposes, and the thigh monitor observational technology provided a method for monitoring repositioning care processes that were otherwise difficult to monitor and manage.

Push-pull training reduces foveal sensory eye dominance within the early visual channels

PubMed Central

Xu, Jingping P.; He, Zijiang J.; Ooi, Teng Leng

2011-01-01

A push-pull training protocol is applied to reduce sensory eye dominance in the foveal region. The training protocol consists of cueing the weak eye to force it to become dominant while the strong eye is suppressed when a pair of dichoptic orthogonal grating stimulus is subsequently presented to it (Ooi and He, 1999). We trained with four pairs of dichoptic orthogonal gratings (0°/90°, 90°/0°, 45°/135° and 135°/45° at 3 cpd) to affect the interocular inhibitory interaction tuned to the four trained orientations (0°, 45°, 90° and 135°). After a 10-day training session, we found a significant learning effect (reduced sensory eye dominance) at the trained orientations as well as at two other untrained orientations (22.5° and 67.5°). This suggests that the four pairs of oriented training stimuli are sufficient to produce a learning effect at any other orientation. The nearly complete transfer of the learning effect across orientation is attributed to the fact that the trained and untrained orientations are close enough to fall in the same orientation tuning function of the early visual cortical neurons (~37.5°). Applying the same notion of transfer of learning within the same feature channel, we also found a large transfer effect to an untrained spatial frequency (6 cpd), which is 1 octave higher than the trained spatial frequency (3 cpd). Furthermore, we found that stereopsis is improved, as is the competitive ability between the two eyes, after the push-pull training. Our data analysis suggests that these improvements are correlated with the reduced sensory eye dominance after the training, i.e., due to a more balanced interocular inhibition. We also found that the learning effect (reduced SED and stereo threshold) can be retained for more than a year after the termination of the push-pull training. PMID:21689673

Effects of short-term two weeks low intensity plyometrics combined with dynamic stretching training in improving vertical jump height and agility on trained basketball players.

PubMed

Ramachandran, Selvam; Pradhan, Binita

2014-01-01

Sport specific training in basketball players should focus on vertical jump height and agility in consistent with demands of the sport. Since plyometrics training improves vertical jump height and agility, it can be useful training strategy to improve the performance of basketball players. A convenience sample of thirty professional basketball players were recruited. Following pre-intervention assessment, interventions using plyometrics training and dynamic stretching protocol was administered on the basketball players. The outcome measures were assessed before the intervention and at the end of first and second week. Statistically significant improvements in vertical jump height (31.68 ± 11.64 to 37.57 ± 16.74; P < 0.012) and agility (16.75 ± 2.49 to 16.51 ± 2.80; P <0.00) were observed between pretest--posttest measures and no changes in muscle girth and isometric muscle strength. The study concludes that short term two weeks plyometrics training combined with dynamic stretching as a useful sport specific training strategy to improve vertical jump height and agility on trained basketball players.

The Effects of Training Contingency Awareness During Attention Bias Modification on Learning and Stress Reactivity.

PubMed

Lazarov, Amit; Abend, Rany; Seidner, Shiran; Pine, Daniel S; Bar-Haim, Yair

2017-09-01

Current attention bias modification (ABM) procedures are designed to implicitly train attention away from threatening stimuli with the hope of reducing stress reactivity and anxiety symptoms. However, the mechanisms underlying effective ABM delivery are not well understood, with awareness of the training contingency suggested as one possible factor contributing to ABM efficacy. Here, 45 high-anxious participants were trained to divert attention away from threat in two ABM sessions. They were randomly assigned to one of three training protocols: an implicit protocol, comprising two standard implicit ABM training sessions; an explicit protocol, comprising two sessions with explicit instruction as to the attention training contingency; and an implicit-explicit protocol, in which participants were not informed of the training contingency in the first ABM session and informed of it at the start of the second session. We examined learning processes and stress reactivity following a stress-induction task. Results indicate that relative to implicit instructions, explicit instructions led to stronger learning during the first training session. Following rest, the explicit and implicit groups exhibited consolidation-related improvement in performance, whereas no such improvement was noted for the implicit-explicit group. Finally, although stress reactivity was reduced after training, contingency awareness did not yield a differential effect on stress reactivity measured using both self-reports and skin conductance, within and across sessions. These results suggest that explicit ABM administration leads to greater initial learning during the training protocol while not differing from standard implicit administration in terms of off-line learning and stress reactivity. Copyright © 2017. Published by Elsevier Ltd.

A dyadic protocol for training complex skills: a replication using female participants.

PubMed

Sanchez-Ku, M L; Arthur, W

2000-01-01

The effectiveness and efficiency of the active interlocked modeling (AIM) dyadic protocol in training complex skills has been extensively demonstrated. However, past evaluation studies have all used male participants exclusively. Consequently, the present study investigated the generalizability of the effectiveness and efficiency gains to women. We randomly assigned 108 female participants to either the AIM-dyad condition or a standard individual control training condition. The results supported the robustness and viability of the AIM protocol. Although their overall performance was lower than that obtained for men in previous studies, women trained in the AIM-dyad condition performed as well as those trained in the individual condition. Thus, the efficiency gains associated with the AIM-dyad protocol, which result from the ability to train two people simultaneously to reach the same performance level as a single person with no increase in training time or machine cost, are generalizable to female participants. The applied and basic research implications of the present study are discussed within the context of well-documented male/female differences in the performance of complex psychomotor tasks. For instance, given the number of women entering the workforce and the significant proportion of women in professions previously deemed to be male-dominated (e.g., air navigation), it is reassuring to know that sex differences in task performance do not necessarily imply sex differences in the effectiveness of training protocols.

Effect of strength training on regional hypertrophy of the elbow flexor muscles.

PubMed

Drummond, Marcos D M; Szmuchrowski, Leszek A; Goulart, Karine N O; Couto, Bruno P

2016-10-01

Muscle hypertrophy is the main structural adaptation to strength training. We investigated the chronic effects of strength training on muscle hypertrophy in different regions of the elbow flexor muscles. Eleven untrained men (21.8 ± 1.62 years) underwent magnetic resonance imaging to determine the proximal, medial, distal, and mean cross-sectional areas (CSA) of the elbow flexors. The volunteers completed 12 weeks of strength training. The training protocol consisted of 4 sets of 8-10 maximum repetitions of unilateral elbow flexion. The interval between sets was 120 s. The training frequency was 3 sessions per week. The magnetic resonance images verified the presence of significant and similar hypertrophy in the distal, medial, and proximal portions of the elbow flexor muscles. Muscle hypertrophy may be assessed using only the medial CSA. We should not expect different degrees of hypertrophy among the regions of the elbow flexor muscles. Muscle Nerve 54: 750-755, 2016. © 2016 Wiley Periodicals, Inc.

Translational microsurgery. A new platform for transplantation research.

PubMed

Kobayashi, Eiji; Haga, Junko

2016-03-01

Clinical microsurgery has been introduced in many fields, while experimental microsurgery has the cross-disciplinary features of the sciences and techniques for growth of medicine, pharmacology, veterinary, engineering etc. Training protocol, proposing a new name as Translational Microsurgery, was introduced. Reconstructive skills of hepatic artery in pediatric living donor liver transplantation were summarized. Ex vivo training protocol using artificial blood vessel for surgeons was proposed. Clinical microsurgery requires anastomosis with delicate arteries and limited field of view. Our training protocol revealed that the relation between the score and speed was seen, while not all the surgeons with enough experience got high score. This training led to muster clinical skills and to apply excellent experimental works. Our microsurgical training protocol has been planned from the points of clinical setting. Training for vascular anastomosis led to rodent transplantation models. These models were used for immunology and immunosuppressant research. Microsurgical techniques led to master catheter technique and to inject various drugs or gene vectors.

Intensive Sensorimotor Arm Training Mediated by Therapist or Robot Improves Hemiparesis in Patients With Chronic Stroke

PubMed Central

Volpe, Bruce T.; Lynch, Daniel; Rykman-Berland, Avrielle; Ferraro, Mark; Galgano, Michael; Hogan, Neville; Krebs, Hermano I.

2016-01-01

Investigators have demonstrated that a variety of intensive movement training protocols for persistent upper limb paralysis in patients with chronic stroke (6 months or more after stroke) improve motor outcome. This randomized controlled study determined in patients with upper limb motor impairment after chronic stroke whether movement therapy delivered by a robot or by a therapist using an intensive training protocol was superior. Robotic training (n = 11) and an intensive movement protocol (n = 10) improved the impairment measures of motor outcome significantly and comparably; there were no significant changes in disability measures. Motor gains were maintained at the 3-month evaluation after training. These data contribute to the growing awareness that persistent impairments in those with chronic stroke may not reflect exhausted capacity for improvement. These new protocols, rendered by either therapist or robot, can be standardized, tested, and replicated, and potentially will contribute to rational activity-based programs. PMID:18184932

The effects of two equal-volume training protocols upon strength, body composition and salivary hormones in male rugby union players

PubMed Central

Heke, TOL; Keogh, JWL

2016-01-01

This study examined the effects of two equal-volume resistance-training protocols upon strength, body composition and salivary hormones in male rugby union players. Using a crossover design, 24 male rugby players completed a 4-week full-body (FB) and split-body (SB) training protocol of equal volume during the competitive season. One repetition maximum (1RM) strength, body composition via skinfold measurements and salivary testosterone (T) and cortisol (C) concentrations were assessed pre and post training. The FB and SB protocols improved upper (7.3% and 7.4%) and lower body 1RM strength (7.4% and 5.4%), whilst reducing body fat (-0.9% and -0.4%) and fat mass (-5.7% and -2.1%), respectively (all p ≤ 0.021). The SB protocol elevated T (21%) and C (50%) concentrations with a higher T/C ratio (28%) after FB training (all p ≤ 0.039). The strength changes were similar, but the body composition and hormonal results differed by protocol. Slope testing on the individual responses identified positive associations (p ≤ 0.05) between T and C concentrations and absolute 1RM strength in stronger (squat 1RM = 150.5 kg), but not weaker (squat 1RM = 117.4 kg), men. A short window of training involving FB or SB protocols can improve strength and body composition in rugby players. The similar strength gains highlight training volume as a key adaptive stimulus, although the programme structure (i.e. FB or SB) did influence the body composition and hormonal outcomes. It also appears that 1RM strength is associated with individual hormonal changes and baseline strength. PMID:27274103

The effects of two equal-volume training protocols upon strength, body composition and salivary hormones in male rugby union players.

PubMed

Crewther, B T; Heke, Tol; Keogh, Jwl

2016-06-01

This study examined the effects of two equal-volume resistance-training protocols upon strength, body composition and salivary hormones in male rugby union players. Using a crossover design, 24 male rugby players completed a 4-week full-body (FB) and split-body (SB) training protocol of equal volume during the competitive season. One repetition maximum (1RM) strength, body composition via skinfold measurements and salivary testosterone (T) and cortisol (C) concentrations were assessed pre and post training. The FB and SB protocols improved upper (7.3% and 7.4%) and lower body 1RM strength (7.4% and 5.4%), whilst reducing body fat (-0.9% and -0.4%) and fat mass (-5.7% and -2.1%), respectively (all p ≤ 0.021). The SB protocol elevated T (21%) and C (50%) concentrations with a higher T/C ratio (28%) after FB training (all p ≤ 0.039). The strength changes were similar, but the body composition and hormonal results differed by protocol. Slope testing on the individual responses identified positive associations (p ≤ 0.05) between T and C concentrations and absolute 1RM strength in stronger (squat 1RM = 150.5 kg), but not weaker (squat 1RM = 117.4 kg), men. A short window of training involving FB or SB protocols can improve strength and body composition in rugby players. The similar strength gains highlight training volume as a key adaptive stimulus, although the programme structure (i.e. FB or SB) did influence the body composition and hormonal outcomes. It also appears that 1RM strength is associated with individual hormonal changes and baseline strength.

Novel Combined Training Approach Improves Sleep Quality but Does Not Change Body Composition in Healthy Elderly Women: A Preliminary Study

PubMed Central

Sousa, Thiago Matheus da Silva; Ruberti, Olivia de Moraes; Novais, Tânia Maria Gaspar; Oliveira, Paula de Lourdes Lauande; Almeida, Fabiano de Jesus Furtado; Pulcherio, Janaína Oliveira Bentivi

2017-01-01

The aim of this study was to investigate the effects of a novel combined training protocol on sleep quality and body composition of healthy elderly women. The study sample consisted of 8 sedentary elderly individuals with mean (±SD) of 67 (±8) years of age, 96.0 (±7.8) mg/dL fasting blood glucose, 94.4 (±36.1) mg/dL triglycerides, 179.1 (±22.4) mg/dL total cholesterol, 57.2 (±15.7) mg/dL high-density lipoprotein (HDL), 103.1 (±25.2) mg/dL low-density lipoprotein (LDL), 125.3 (±8.4) mmHg systolic blood pressure, and 72.6 (±10.1) mmHg diastolic blood pressure. The training protocol consisted of resistance training exercises (approximately 18-minute duration) combined with aerobic exercises (approximately 26-minute duration), performed interspersed in the same session, for 8 weeks (3 times a week), with a 24-hour interval rest between each session. Continuous variables were expressed as the mean (±standard deviation) and the paired sample t-test compares baseline with final measurement. The results showed a significant improvement (p = 0.01) in quality of sleep (4.9 ± 1.5 versus 3.8 ± 1.8 for total PSQI index) without body significant improvements in the fat-free mass (59.9 ± 4.0 versus 60.5 ± 4.4; p = 0.20) and fat mass (40.1 ± 4.0 versus 39.5 ± 4.4; p = 0.20) in healthy elderly women. In this sense, the novel combined training proposed may be an effective alternative or adjunct to present therapies aimed at improving the sleep quality in this population. PMID:29062575

The Effects of High Intensity Interval Training vs Steady State Training on Aerobic and Anaerobic Capacity

PubMed Central

Foster, Carl; Farland, Courtney V.; Guidotti, Flavia; Harbin, Michelle; Roberts, Brianna; Schuette, Jeff; Tuuri, Andrew; Doberstein, Scott T.; Porcari, John P.

2015-01-01

High intensity interval training (HIIT) has become an increasingly popular form of exercise due to its potentially large effects on exercise capacity and small time requirement. This study compared the effects of two HIIT protocols vs steady-state training on aerobic and anaerobic capacity following 8-weeks of training. Fifty-five untrained college-aged subjects were randomly assigned to three training groups (3x weekly). Steady-state (n = 19) exercised (cycle ergometer) 20 minutes at 90% of ventilatory threshold (VT). Tabata (n = 21) completed eight intervals of 20s at 170% VO2max/10s rest. Meyer (n = 15) completed 13 sets of 30s (20 min) @ 100% PVO2 max/ 60s recovery, average PO = 90% VT. Each subject did 24 training sessions during 8 weeks. Results: There were significant (p < 0.05) increases in VO2max (+19, +18 and +18%) and PPO (+17, +24 and +14%) for each training group, as well as significant increases in peak (+8, + 9 and +5%) & mean (+4, +7 and +6%) power during Wingate testing, but no significant differences between groups. Measures of the enjoyment of the training program indicated that the Tabata protocol was significantly less enjoyable (p < 0.05) than the steady state and Meyer protocols, and that the enjoyment of all protocols declined (p < 0.05) across the duration of the study. The results suggest that although HIIT protocols are time efficient, they are not superior to conventional exercise training in sedentary young adults. Key points Steady state training equivalent to HIIT in untrained students Mild interval training presents very similar physiologic challenge compared to steady state training HIIT (particularly very high intensity variants were less enjoyable than steady state or mild interval training Enjoyment of training decreases across the course of an 8 week experimental training program PMID:26664271

The Effects of High Intensity Interval Training vs Steady State Training on Aerobic and Anaerobic Capacity.

PubMed

Foster, Carl; Farland, Courtney V; Guidotti, Flavia; Harbin, Michelle; Roberts, Brianna; Schuette, Jeff; Tuuri, Andrew; Doberstein, Scott T; Porcari, John P

2015-12-01

High intensity interval training (HIIT) has become an increasingly popular form of exercise due to its potentially large effects on exercise capacity and small time requirement. This study compared the effects of two HIIT protocols vs steady-state training on aerobic and anaerobic capacity following 8-weeks of training. Fifty-five untrained college-aged subjects were randomly assigned to three training groups (3x weekly). Steady-state (n = 19) exercised (cycle ergometer) 20 minutes at 90% of ventilatory threshold (VT). Tabata (n = 21) completed eight intervals of 20s at 170% VO2max/10s rest. Meyer (n = 15) completed 13 sets of 30s (20 min) @ 100% PVO2 max/ 60s recovery, average PO = 90% VT. Each subject did 24 training sessions during 8 weeks. There were significant (p < 0.05) increases in VO2max (+19, +18 and +18%) and PPO (+17, +24 and +14%) for each training group, as well as significant increases in peak (+8, + 9 and +5%) & mean (+4, +7 and +6%) power during Wingate testing, but no significant differences between groups. Measures of the enjoyment of the training program indicated that the Tabata protocol was significantly less enjoyable (p < 0.05) than the steady state and Meyer protocols, and that the enjoyment of all protocols declined (p < 0.05) across the duration of the study. The results suggest that although HIIT protocols are time efficient, they are not superior to conventional exercise training in sedentary young adults. Key pointsSteady state training equivalent to HIIT in untrained studentsMild interval training presents very similar physiologic challenge compared to steady state trainingHIIT (particularly very high intensity variants were less enjoyable than steady state or mild interval trainingEnjoyment of training decreases across the course of an 8 week experimental training program.

Italian ICF training programs: describing and promoting human functioning and research.

PubMed

Francescutti, Carlo; Fusaro, Guido; Leonardi, Matilde; Martinuzzi, Andrea; Sala, Marina; Russo, Emanuela; Frare, Mara; Pradal, Monica; Zampogna, Daniela; Cosentino, Alessandro; Raggi, Alberto

2009-01-01

Purpose of the article is to report on 5 years of ICF training experiences in Italy aimed at promoting a consistent approach to ICF's field application. More than 7000 persons participated in around 150 training events: almost half were organised by political bodies, at national, regional or local level, directly linked to implementation experiences. Few training events were organised by the school sector, while training commissioned by NGOs represent a relevant area and, in our opinion, constitute the first step towards a full inclusion of persons with disabilities. Central pillars of our training modules are: the inclusion of all ICF components in the description of functional profiles, the need of providing brief theoretical background information before moving to practical aspects and the importance of providing personalised face to face training modules, in contrast to self-administered learning modules, or web-based protocols. On the basis of our experience, we can conclude that training's objectives are generally reached: trainees improved their knowledge of the ICF and its related tools, and are able to begin practical applications in their contexts.

Short-term adaptations following Complex Training in team-sports: A meta-analysis

PubMed Central

Martinez-Rodriguez, Alejandro; Calleja-González, Julio; Alcaraz, Pedro E.

2017-01-01

Objective The purpose of this meta-analysis was to study the short-term adaptations on sprint and vertical jump (VJ) performance following Complex Training (CT) in team-sports. CT is a resistance training method aimed at developing both strength and power, which has a direct effect on sprint and VJ. It consists on alternating heavy resistance training exercises with plyometric/power ones, set for set, on the same workout. Methods A search of electronic databases up to July 2016 (PubMed-MEDLINE, SPORTDiscus, Web of Knowledge) was conducted. Inclusion criteria: 1) at least one CT intervention group; 2) training protocols ≥4-wks; 3) sample of team-sport players; 4) sprint or VJ as an outcome variable. Effect sizes (ES) of each intervention were calculated and subgroup analyses were performed. Results A total of 9 studies (13 CT groups) met the inclusion criteria. Medium effect sizes (ES) (ES = 0.73) were obtained for pre-post improvements in sprint, and small (ES = 0.41) in VJ, following CT. Experimental-groups presented better post-intervention sprint (ES = 1.01) and VJ (ES = 0.63) performance than control-groups. Sprint large ESs were exhibited in younger athletes (<20 years old; ES = 1.13); longer CT interventions (≥6 weeks; ES = 0.95); conditioning activities with intensities ≤85% 1RM (ES = 0.96) and protocols with frequencies of <3 sessions/week (ES = 0.84). Medium ESs were obtained in Division I players (ES = 0.76); training programs >12 total sessions (ES = 0.74). VJ Large ESs in programs with >12 total sessions (ES = 0.81). Medium ESs obtained for under-Division I individuals (ES = 0.56); protocols with intracomplex rest intervals ≥2 min (ES = 0.55); conditioning activities with intensities ≤85% 1RM (ES = 0.64); basketball/volleyball players (ES = 0.55). Small ESs were found for younger athletes (ES = 0.42); interventions ≥6 weeks (ES = 0.45). Conclusions CT interventions have positive medium effects on sprint performance and small effects on VJ in team-sport athletes. This training method is a suitable option to include in the season planning. PMID:28662108

The perceptual learning of time-compressed speech: A comparison of training protocols with different levels of difficulty

PubMed Central

Gabay, Yafit; Karni, Avi; Banai, Karen

2017-01-01

Speech perception can improve substantially with practice (perceptual learning) even in adults. Here we compared the effects of four training protocols that differed in whether and how task difficulty was changed during a training session, in terms of the gains attained and the ability to apply (transfer) these gains to previously un-encountered items (tokens) and to different talkers. Participants trained in judging the semantic plausibility of sentences presented as time-compressed speech and were tested on their ability to reproduce, in writing, the target sentences; trail-by-trial feedback was afforded in all training conditions. In two conditions task difficulty (low or high compression) was kept constant throughout the training session, whereas in the other two conditions task difficulty was changed in an adaptive manner (incrementally from easy to difficult, or using a staircase procedure). Compared to a control group (no training), all four protocols resulted in significant post-training improvement in the ability to reproduce the trained sentences accurately. However, training in the constant-high-compression protocol elicited the smallest gains in deciphering and reproducing trained items and in reproducing novel, untrained, items after training. Overall, these results suggest that training procedures that start off with relatively little signal distortion (“easy” items, not far removed from standard speech) may be advantageous compared to conditions wherein severe distortions are presented to participants from the very beginning of the training session. PMID:28545039

A sustainable model for training teachers to use pivotal response training.

PubMed

Suhrheinrich, Jessica

2015-08-01

The increase in the rate of autism diagnoses has created a growing demand for teachers who are trained to use effective interventions. The train-the-trainer model, which involves training supervisors to train others, may be ideal for providing cost-effective training and ongoing support to teachers. Although research supports interventions, such as pivotal response training, as evidence-based, dissemination to school environments has been problematic. This study assessed the benefits of using the train-the-trainer model to disseminate pivotal response training to school settings. A multiple-baseline design was conducted across three training groups, each consisting of one school staff member (trainer), three special education teachers, and six students. Trainers conducted the teacher-training workshop with high adherence to training protocol and met mastery criteria in their ability to implement pivotal response training, assess implementation of pivotal response training, and provide feedback to teachers. Six of the nine teachers mastered all components of pivotal response training. The remaining three teachers implemented 89% of the pivotal response training components correctly. The majority of trainers and teachers maintained their abilities at follow-up. These results support the use of the train-the-trainer model as an effective method of disseminating evidence-based practices in school settings. © The Author(s) 2014.

Perceptual learning of basic visual features remains task specific with Training-Plus-Exposure (TPE) training

PubMed Central

Cong, Lin-Juan; Wang, Ru-Jie; Yu, Cong; Zhang, Jun-Yun

2016-01-01

Visual perceptual learning is known to be specific to the trained retinal location, feature, and task. However, location and feature specificity can be eliminated by double-training or TPE training protocols, in which observers receive additional exposure to the transfer location or feature dimension via an irrelevant task besides the primary learning task Here we tested whether these new training protocols could even make learning transfer across different tasks involving discrimination of basic visual features (e.g., orientation and contrast). Observers practiced a near-threshold orientation (or contrast) discrimination task. Following a TPE training protocol, they also received exposure to the transfer task via performing suprathreshold contrast (or orientation) discrimination in alternating blocks of trials in the same sessions. The results showed no evidence for significant learning transfer to the untrained near-threshold contrast (or orientation) discrimination task after discounting the pretest effects and the suprathreshold practice effects. These results thus do not support a hypothetical task-independent component in perceptual learning of basic visual features. They also set the boundary of the new training protocols in their capability to enable learning transfer. PMID:26873777

Gradual training of alpacas to the confinement of metabolism pens reduces stress when normal excretion behavior is accommodated.

PubMed

Lund, Kirrin E; Maloney, Shane K; Milton, John T B; Blache, Dominique

2012-01-01

Confinement in metabolism pens may provoke a stress response in alpacas that will reduce the welfare of the animal and jeopardize the validity of scientific results obtained in such pens. In this study, we tested a protocol designed to successfully train alpacas to be held in a specially designed metabolism pen so that the animals' confinement would not jeopardize their welfare. We hypothesized that the alpacas would show fewer behaviors associated with a response to stress as training gradually progressed, and that they would adapt to being in the confinement of the metabolism pen. The training protocol was successful at introducing alpacas to the metabolism pens, and it did reduce the incidence of behavioral responses to stress as the training progressed. The success of the training protocol may be attributed to the progressive nature of the training, the tailoring of the protocol to suit alpacas, and the use of positive reinforcement. This study demonstrated that both animal welfare and the validity of the scientific outcomes could be maximized by the gradual training of experimental animals, thereby minimizing the stress imposed on the animals during experimental procedures.

Rest Interval Required for Power Training With Power Load in the Bench Press Throw Exercise.

PubMed

Hernández Davó, Jose L; Solana, Rafael Sabido; Sarabia Marín, Jose M; Fernández Fernández, Jaime; Moya Ramón, Manuel

2016-05-01

This study aimed to test the influence of various rest interval (RI) durations used between sets on power output performance and physiological and perceptual variables during a strength training session using 40% of the 1 repetition maximum (1RM) in the bench press throw exercise. Thirty-one college students (18 males and 13 females) took part in the study. The experimental protocol consists of 5 sets of 8 repetitions of the bench press throw exercise with a load representing 40% of 1RM. Subjects performed the experimental protocol on 3 different occasions, differing by the RI between sets (1, 2, or 3 minutes). During the sessions, power data (mean power and peak power), physiological (lactate concentration [La]) and perceptual (rating of perceived exertion) variables were measured. In addition, delayed onset muscular soreness was reported 24 and 48 hours after the training session. One-way repeated-measures analysis of variance showed that 1-minute RI entailed higher power decreases and greater increases in values of physiological and perceptual variables compared with both 2- and 3-minute RIs. Nevertheless, no differences were found between 2- and 3-minute RIs. Therefore, this study showed that, when training with 40% of 1RM in the bench press throw exercise, a 2-minute RI between sets can be enough to avoid significant decreases in power output. Consequently, training sessions' duration could be reduced without causing excessive fatigue, allowing additional time to focus on other conditioning priorities.

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.

Neuromodulating Attention and Mind-Wandering Processes with a Single Session Real Time EEG.

PubMed

Gonçalves, Óscar F; Carvalho, Sandra; Mendes, Augusto J; Leite, Jorge; Boggio, Paulo S

2018-06-01

Our minds are continuously alternating between external attention (EA) and mind wandering (MW). An appropriate balance between EA and MW is important for promoting efficient perceptual processing, executive functioning, decision-making, auto-biographical memory, and creativity. There is evidence that EA processes are associated with increased activity in high-frequency EEG bands (e.g., SMR), contrasting with the dominance of low-frequency bands during MW (e.g., Theta). The aim of the present study was to test the effects of two distinct single session real-time EEG (rtEEG) protocols (SMR up-training/Theta down-training-SMR⇑Theta⇓; Theta up-training/SMR down-training-Theta⇑SMR⇓) on EA and MW processes. Thirty healthy volunteers were randomly assigned to one of two rtEEG training protocols (SMR⇑Theta⇓; Theta⇑SMR⇓). Before and after the rtEEG training, participants completed the attention network task (ANT) along with several MW measures. Both training protocols were effective in increasing SMR (SMR⇑Theta⇓) and theta (Theta⇑SMR⇓) amplitudes but not in decreasing the amplitude of down-trained bands. There were no significant effects of the rtEEG training in either EA or MW measures. However, there was a significant positive correlation between post-training SMR increases and the use of deliberate MW (rather than spontaneous) strategies. Additionally, for the Theta⇑SMR⇓ protocol, increase in post-training Theta amplitude was significantly associated with a decreased efficiency in the orientation network.

An Exercise Protocol Designed to control Energy Expenditure and to have a Positive Impact on Maximal Oxygen Consumption for Long-Term Space Missions

NASA Astrophysics Data System (ADS)

Matsuo, Tomoaki; Ohkawara, Kazunori; Seino, Satoshi; Shimojo, Nobutake; Yamada, Shin; Ohshima, Hiroshi; Tanaka, Kiyoji; Mukai, Chiaki

2013-02-01

Maximal oxygen consumption decreases during spaceflight, and astronauts also experience controversial weight loss. Future space missions require a more efficient exercise program to maintain work efficiency and to control increased energy expenditure (EE). We have been developing two types of original exercise training protocols which are better suited to astronauts’ daily routine exercise during long-term spaceflight: sprint interval training (SIT) and high-intensity interval aerobic training (HIAT). In this study, we compared the total EE, including excess post-exercise energy expenditure (EPEE), induced by our interval cycling protocols with the total EE of a traditional, continuous aerobic training (CAT). In the results, while the EPEEs after the SIT and HIAT were greater than after the CAT, the total EE for an entire exercise/rest session with the CAT was the greatest of our three exercise protocols. The SIT and HIAT would be potential protocols to control energy expenditure for long space missions.

The effects of superset configuration on kinetic, kinematic, and perceived exertion in the barbell bench press.

PubMed

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

2017-08-04

Training that is efficient and effective is of great importance to an athlete. One method of improving efficiency is by incorporating supersets into resistance training routines. However, the structuring of supersets is still unexplored. Therefore, the purpose of this study was to assess the effects of agonist-antagonist (A-A), alternate peripheral (A-P), and similar biomechanical (SB) superset configurations on rate of perceived exertion (RPE), kinetic and kinematic changes during the bench press. 10 subjects performed resistance training protocols in a randomized-crossover design, with magnitude-based inferences assessing changes/differences within and between protocols. Changes in RPE were very likely and almost certainly greater in the A-P and SB protocols when compared with the A-A, while all superset protocols had very likely to almost certain reductions in mean velocity and power from baseline. Reductions in mean velocity and power were almost certainly greater in the SB protocol, with differences between the A-A and A-P protocols being unclear. Decreases in peak force were likely and almost certain in the A-A and SB protocols respectively, with changes in A-P being unclear. Differences between these protocols showed likely greater decreases in SB peak forces when compared to A-A, with all other superset comparisons being unclear. This study demonstrates the importance of exercise selection when incorporating supersets into a training routine. It is suggested that the practitioner uses A-A supersets when aiming to improve training efficiency and minimize reductions in kinetic and kinematic output of the agonist musculature while completing the barbell bench press.

Effect of training level and blood flow restriction on thermal parameters: Preliminary study

NASA Astrophysics Data System (ADS)

Sampaio, Lucas; Bezerra, Ewertton; Paladino, Kayo; dos Santos, João Otacílio Libardoni; Priego Quesada, Jose I.; Rossato, Mateus

2016-11-01

Training with blood flow restriction could lead to an effect on skin temperature. Additionally, this effect could be higher in people with lower physical fitness level due to their lower capacity of heat loss. The aim of this preliminary study was therefore to evaluate the effects of training experience on the acute and chronic thermal skin responses after performing exercise with and without blood flow restriction. The study included ten men, of these, five were trained. All subjects performed tests and re-tests for maximum strength (1 repetition maximum) through unilateral leg extensions (right thigh at 45 ± 6.7 kg and left thigh at 45.5 ± 8.1 kg, p > 0.05). The protocol consisted of four sets to concentric failure, with one-minute rest intervals between sets at an intensity corresponding to 40% of 1 RM. There were 7-day intervals between experimental sessions (150 mmHg versus unrestricted flow restriction). The thermal images were made before the protocol (pre), immediately after the end of the series (post), and 24 h afterward (post 24 h). When comparing temperature variation (Δ exercise and Δ 24 h) between groups, it was observed that the trained participants showed a greater drop in temperature 24 h after exercise with 150 mmHg restriction (confidence interval: 95% of Δ 24 h [-0.2 to -0.9 °C]) compared to untrained subjects (p = 0.006 and ES > 1.5, confidence interval: 95% Δ 24 h [-0.1 to 0.6 °C].) In conclusion, this preliminary study showed that training experience interferes with the chronic cutaneous thermal temperature of the anterior thigh when strength training associated with blood flow restriction 150 mmHg was performed.

Initial Outcomes from a Multicenter Study Utilizing the Indego Powered Exoskeleton in Spinal Cord Injury.

PubMed

Tefertiller, Candy; Hays, Kaitlin; Jones, Janell; Jayaraman, Arun; Hartigan, Clare; Bushnik, Tamara; Forrest, Gail F

2018-01-01

Objective: To assess safety and mobility outcomes utilizing the Indego powered exoskeleton in indoor and outdoor walking conditions with individuals previously diagnosed with a spinal cord injury (SCI). Methods: We conducted a multicenter prospective observational cohort study in outpatient clinics associated with 5 rehabilitation hospitals. A convenience sample of nonambulatory individuals with SCI ( N = 32) completed an 8-week training protocol consisting of walking training 3 times per week utilizing the Indego powered exoskeleton in indoor and outdoor conditions. Participants were also trained in donning/doffing the exoskeleton during each session. Safety measures such as adverse events (AEs) were monitored and reported. Time and independence with donning/doffing the exoskeleton as well as walking outcomes to include the 10-meter walk test (10MWT), 6-minute walk test (6MWT), Timed Up & Go test (TUG), and 600-meter walk test were evaluated from midpoint to final evaluations. Results: All 32 participants completed the training protocol with limited device-related AEs, which resulted in no interruption in training. The majority of participants in this trial were able to don and doff the Indego independently. Final walking speed ranged from 0.19 to 0.55 m/s. Final average indoor and outdoor walking speeds among all participants were 0.37 m/s ( SD = 0.08, 0.09, respectively), after 8 weeks of training. Significant ( p < .05) improvements were noted between midpoint and final gait speeds in both indoor and outdoor conditions. Average walking endurance also improved among participants after training. Conclusion: The Indego was shown to be safe for providing upright mobility to 32 individuals with SCIs who were nonambulatory. Improvements in speed and independence were noted with walking in indoor and outdoor conditions as well as with donning/doffing the exoskeleton.

Effects of a Peer Tutor Training Program on Tutors and Tutees with Severe Disabilities in Adapted Physical Education

ERIC Educational Resources Information Center

Vonlintel, Drew James

2015-01-01

This dissertation examines the efficacy of peer tutor training in adapted physical education (APE). A peer tutor evaluation form was created to assess the skills of untrained peer tutors (n = 12). Once skills were assessed, a peer tutor training protocol was created. The protocol was implemented in a peer tutor training program. After peer tutors…

Effects of manipulating the duration and intensity of aerobic training sessions on the physical performance of rats.

PubMed

Teixeira-Coelho, Francisco; Fonseca, Cletiana Gonçalves; Barbosa, Nicolas Henrique Santos; Vaz, Filipe Ferreira; Cordeiro, Letícia Maria de Souza; Coimbra, Cândido Celso; Pires, Washington; Soares, Danusa Dias; Wanner, Samuel Penna

2017-01-01

This study investigated the effects of manipulating the load components of aerobic training sessions on the physical performance of rats. To achieve this purpose, adult male Wistar rats were divided into four groups: an untrained control (CON) group and training groups with a predominant overload in intensity (INT) or duration (DUR) or alternating and similar overloads in intensity and duration (ID). Prior to, during, and after 8 weeks of the control or training protocols, the performance of the rats (evaluated by their workload) was determined during fatiguing, incremental-speed treadmill running. Two additional incremental running tests were performed prior to and at the end of the protocols to measure the peak rate of oxygen consumption (VO2peak). As expected, the rats in the trained groups exhibited increased performance, whereas the untrained rats showed stable performance throughout the 8 weeks. Notably, the performance gain exhibited by the DUR rats reached a plateau after the 4th week. This plateau was not present in the INT or ID rats, which exhibited increased performance at the end of training protocol compared with the DUR rats. None of the training protocols changed the VO2peak values; however, these values were attained at faster speeds, which indicated increased running economy. In conclusion, our findings demonstrate that the training protocols improved the physical performance of rats, likely resulting from enhanced running economy. Furthermore, compared with overload in duration, overload in the intensity of training sessions was more effective at inducing performance improvements across the 8 weeks of the study.

Effects of manipulating the duration and intensity of aerobic training sessions on the physical performance of rats

PubMed Central

Teixeira-Coelho, Francisco; Fonseca, Cletiana Gonçalves; Barbosa, Nicolas Henrique Santos; Vaz, Filipe Ferreira; Cordeiro, Letícia Maria de Souza; Coimbra, Cândido Celso; Pires, Washington; Soares, Danusa Dias

2017-01-01

This study investigated the effects of manipulating the load components of aerobic training sessions on the physical performance of rats. To achieve this purpose, adult male Wistar rats were divided into four groups: an untrained control (CON) group and training groups with a predominant overload in intensity (INT) or duration (DUR) or alternating and similar overloads in intensity and duration (ID). Prior to, during, and after 8 weeks of the control or training protocols, the performance of the rats (evaluated by their workload) was determined during fatiguing, incremental-speed treadmill running. Two additional incremental running tests were performed prior to and at the end of the protocols to measure the peak rate of oxygen consumption (VO2peak). As expected, the rats in the trained groups exhibited increased performance, whereas the untrained rats showed stable performance throughout the 8 weeks. Notably, the performance gain exhibited by the DUR rats reached a plateau after the 4th week. This plateau was not present in the INT or ID rats, which exhibited increased performance at the end of training protocol compared with the DUR rats. None of the training protocols changed the VO2peak values; however, these values were attained at faster speeds, which indicated increased running economy. In conclusion, our findings demonstrate that the training protocols improved the physical performance of rats, likely resulting from enhanced running economy. Furthermore, compared with overload in duration, overload in the intensity of training sessions was more effective at inducing performance improvements across the 8 weeks of the study. PMID:28841706

Effects of exercise training on systo-diastolic ventricular dysfunction in patients with hypertension: an echocardiographic study with tissue velocity and strain imaging evaluation.

PubMed

Leggio, Massimo; Mazza, Andrea; Cruciani, Giancarlo; Sgorbini, Luca; Pugliese, Marco; Bendini, Maria Grazia; Severi, Paolo; Jesi, Anna Patrizia

2014-07-01

There is a lack of detailed data regarding the effect of exercise training in pharmacologically treated hypertensive patients. Therefore, the aim of this study was to evaluate the effects of exercise training on left and right ventricular morphologic and functional parameters by means of conventional echocardiography and sensitive new echocardiographic techniques including tissue Doppler velocity and strain imaging, that were performed in pharmacologically treated hypertensive patients at baseline and at the end of a specific exercise training protocol for primary prevention of cardiovascular disease. We selected 116 pharmacologically treated hypertensive patients who completed the exercise training protocol. All patients underwent a clinical history and examination; transthoracic echocardiography and exercise testing were performed at baseline and at the end of the exercise training protocol. Conventional echocardiography revealed a mild degree of diastolic dysfunction without significant differences or variations from baseline to the end of the exercise training protocol. In contrast, tissue Doppler velocity and strain imaging measurements demonstrated and highlighted the positive influence of exercise training: for both left and right ventricle myocardial early peak diastolic velocities (Em), the ratio of myocardial early-late peak diastolic velocity (Em/Am), myocardial peak systolic velocities (Sm) and peak strain and strain rate values significantly increased at the end of the exercise training protocol, suggesting a relationship between exercise capacity and both left and right ventricular systo-diastolic function. Our study, by means of newer more sensitive echocardiographic techniques, clearly demonstrated the positive impact of exercise training on both left and right ventricular systo-diastolic function, in terms of adjunctive subclinical improvement, in pharmacologically treated hypertensive patients.

Step-up training for colorectal and gastric ESD and the challenge of ESD training in the proximal colon: results from a German Center.

PubMed

Ebigbo, Alanna; Probst, Andreas; Römmele, Christoph; Messmann, Helmut

2018-05-01

The endoscopic submucosal dissection (ESD) of cancerous and precancerous lesions in the gastrointestinal (GI) tract is an effective but difficult-to-learn procedure, especially for Western endoscopists. We developed a step-up training protocol and evaluated its outcome on a single endoscopist using specific performance measures. The training protocol included a 12-month period of 50 observational and supervised ESD cases as well as 24 animal procedures. After completion of the protocol, ESD competency was evaluated in the first 30 independent ESD cases. Majority of lesions were located in the stomach and rectum. Performance measures included R0-resection rate, complication rate and resection speed. R0 resection rate was 93 %, complication rate was 7 % and median resection speed was 6,77 cm 2 /h. 1 case of delayed perforation with subsequent hemicolectomy occurred in the descending colon. The ESD step-up training protocol used in this study on a single endoscopist showed excellent outcomes for lesions in the rectum and stomach. However, ESD training in the upper colon remains a challenge.

Suicide intervention training evaluation: a preliminary report.

PubMed

Tierney, R J

1994-01-01

To date, very little work has been done on evaluating training in suicide intervention. This study developed and piloted a comprehensive method for evaluating suicide intervention training by applying three studies of immediate training effects on (a) suicide intervention abilities, (b) attitudes to suicide and suicide intervention, and (c) knowledge about suicide. The focus of the evaluation was a broadly used 2-day suicide intervention training program. Changes in suicide intervention abilities were measured by the Suicide Intervention Response Inventory (SIRI) and by performance in simulated suicide intervention situations, scored with the Suicide Intervention Protocol (SIP). Subjects consisted of 19 workshop participants in a pre-post condition and 17 participants in a post-test only condition. Results indicated significant increases in skills in suicide intervention situations. No significant effects were noted on the SIRI. Results from the attitudes and knowledge studies were very preliminary. They are reported here so that others may become aware of the methodology being used and the status of evaluation of the target program. Implications for further research are discussed.

Copenhagen study of overweight patients with coronary artery disease undergoing low energy diet or interval training: the randomized CUT-IT trial protocol.

PubMed

Pedersen, Lene Rørholm; Olsen, Rasmus Huan; Frederiksen, Marianne; Astrup, Arne; Chabanova, Elizaveta; Hasbak, Philip; Holst, Jens Juul; Kjær, Andreas; Newman, John W; Walzem, Rosemary; Wisløff, Ulrik; Sajadieh, Ahmad; Haugaard, Steen Bendix; Prescott, Eva

2013-11-19

Coronary artery disease (CAD) is accountable for more than 7 million deaths each year according to the World Health Organization (WHO). In a European population 80% of patients diagnosed with CAD are overweight and 31% are obese. Physical inactivity and overweight are major risk factors in CAD, thus central strategies in secondary prevention are increased physical activity and weight loss. In a randomized controlled trial 70 participants with stable CAD, age 45-75, body mass index 28-40 kg/m2 and no diabetes are randomized (1:1) to 12 weeks of intensive exercise or weight loss both succeeded by a 40-week follow-up. The exercise protocol consist of supervised aerobic interval training (AIT) at 85-90% of VO2peak 3 times weekly for 12 weeks followed by supervised AIT twice weekly for 40 weeks. In the weight loss arm dieticians instruct the participants in a low energy diet (800-1000 kcal/day) for 12 weeks, followed by 40 weeks of weight maintenance combined with supervised AIT twice weekly. The primary endpoint of the study is change in coronary flow reserve after the first 12 weeks' intervention. Secondary endpoints include cardiovascular, metabolic, inflammatory and anthropometric measures. The study will compare the short and long-term effects of a protocol consisting of AIT alone or a rapid weight loss followed by AIT. Additionally, it will provide new insight in mechanisms behind the benefits of exercise and weight loss. We wish to contribute to the creation of effective secondary prevention and sustainable rehabilitation strategies in the large population of overweight and obese patients diagnosed with CAD. ClinicalTrials.gov: NCT01724567.

Enhanced Medical Rehabilitation: Effectiveness of a clinical training model.

PubMed

Bland, Marghuretta D; Birkenmeier, Rebecca L; Barco, Peggy; Lenard, Emily; Lang, Catherine E; Lenze, Eric J

2016-10-14

Patient engagement in medical rehabilitation can be greatly influenced by their provider during therapy sessions. We developed Enhanced Medical Rehabilitation (EMR), a set of provider skills grounded in theories of behavior change. EMR utilizes 18 motivational techniques focused on providing frequent feedback to patients on their effort and progress and linking these to patient goals. To examine the effectiveness of a clinical training protocol for clinicians to do EMR, as measured by clinician adherence. A physical therapist, physical therapist assistant, occupational therapist, and certified occupational therapist assistant were trained in EMR. Training consisted of five formal training sessions and individual and group coaching. Adherence to EMR techniques was measured during two phases: Pre-Training and Maintenance, with an a priori target of 90% adherence by clinicians to each EMR technique. With training and coaching, clinician adherence per therapeutic activity significantly improved in 13 out of 18 items (p < 0.05). The target of 90% adherence was not achieved for many items. Our training and coaching program successfully trained clinicians to promote patient engagement during therapeutic service delivery, although not typically to 90% or greater adherence. Ongoing coaching efforts were necessary to increase adherence.

Stepping in Place While Voluntarily Turning Around Produces a Long-Lasting Posteffect Consisting in Inadvertent Turning While Stepping Eyes Closed

PubMed Central

2016-01-01

Training subjects to step in place on a rotating platform while maintaining a fixed body orientation in space produces a posteffect consisting in inadvertent turning around while stepping in place eyes closed (podokinetic after-rotation, PKAR). We tested the hypothesis that voluntary turning around while stepping in place also produces a posteffect similar to PKAR. Sixteen subjects performed 12 min of voluntary turning while stepping around their vertical axis eyes closed and 12 min of stepping in place eyes open on the center of a platform rotating at 60°/s (pretests). Then, subjects continued stepping in place eyes closed for at least 10 min (posteffect). We recorded the positions of markers fixed to head, shoulder, and feet. The posteffect of voluntary turning shared all features of PKAR. Time decay of angular velocity, stepping cadence, head acceleration, and ratio of angular velocity after to angular velocity before were similar between both protocols. Both postrotations took place inadvertently. The posteffects are possibly dependent on the repeated voluntary contraction of leg and foot intrarotating pelvic muscles that rotate the trunk over the stance foot, a synergy common to both protocols. We propose that stepping in place and voluntary turning can be a scheme ancillary to the rotating platform for training body segment coordination in patients with impairment of turning synergies of various origin. PMID:27635264

Training Organizations in Use of a Modified Stream Visual Assessment Protocol

ERIC Educational Resources Information Center

Obropta, Christopher C.; Yergeau, Steven E.

2011-01-01

The Stream Visual Assessment Protocol (SVAP) was evaluated as a means to increase watershed surveys in New Jersey. Groups were trained in an SVAP modified for New Jersey streams. Participants in three training workshops were surveyed to determine the usefulness of SVAP as a cost-effective method to evaluate watershed health. Many respondents found…

Promoting communication with older adults: protocols for resolving interpersonal conflicts and for enhancing interactions with doctors.

PubMed

Weitzman, Patricia Flynn; Weitzman, Eben A

2003-07-01

In this paper, we review the importance of effective communication in older adulthood, and ideas for promoting it. We focus on theoretical and applied work in two communicative encounters that have particular relevance for older adult health, i.e., interpersonal conflict and visits with a healthcare provider. Little applied work has aimed to adapt training protocols for older adults in these two areas. We will present training protocols we have developed in constructive conflict resolution for older adults, and on enhancing doctor-patient communication. We present these protocols to stimulate ideas on the part of the reader on how to further develop and refine training efforts for older adults in effective communication.

Weight training in youth-growth, maturation, and safety: an evidence-based review.

PubMed

Malina, Robert M

2006-11-01

To review the effects of resistance training programs on pre- and early-pubertal youth in the context of response, potential influence on growth and maturation, and occurrence of injury. Evidence-based review. Twenty-two reports dealing with experimental resistance training protocols, excluding isometric programs, in pre- and early-pubertal youth, were reviewed in the context of subject characteristics, training protocol, responses, and occurrence of injury. Experimental programs most often used isotonic machines and free weights, 2- and 3-day protocols, and 8- and 12-week durations, with significant improvements in muscular strength during childhood and early adolescence. Strength gains were lost during detraining. Experimental resistance training programs did not influence growth in height and weight of pre- and early-adolescent youth, and changes in estimates of body composition were variable and quite small. Only 10 studies systematically monitored injuries, and only three injuries were reported. Estimated injury rates were 0.176, 0.053, and 0.055 per 100 participant-hours in the respective programs. Experimental training protocols with weights and resistance machines and with supervision and low instructor/participant ratios are relatively safe and do not negatively impact growth and maturation of pre- and early-pubertal youth.

The Effect of High Intensity Interval Run Training on Cross-sectional Area of the Vastus Lateralis in Untrained College Students

PubMed Central

ESTES, REBEKAH R.; MALINOWSKI, AMY; PIACENTINI, MEREDITH; THRUSH, DAVID; SALLEY, ERIC; LOSEY, CASSIDY; HAYES, ERIK

2017-01-01

Aerobic cycling has been repeatedly shown to induce hypertrophy in skeletal muscle across a variety of populations, while there has been a lack of investigation into the impact of running upon hypertrophy. An increasingly popular model of aerobic exercise is high-intensity interval training (HIIT); in addition to its positive impact upon cardiovascular health, HIIT may be sufficient for inducing significant muscular hypertrophy. Therefore, the purpose of this investigation was to examine the influence of a high-intensity interval running protocol upon hypertrophy of the vastus lateralis in an untrained, young population. Twelve recreationally active university students (Male: 2; Female: 10; 19.9±0.5 yr.; 169.8±1.9 cm; 63.8±2.3 kg; VO2max: 42.1±1.6 ml•kg−1min−1) completed 24.5±0.6 sessions of high-intensity interval run training over 10 weeks. The protocol consisted of four sets of 4 minutes running at 90–95% HRmax followed by 3 minutes active rest at 70% HRmax. Relative and absolute aerobic capacity increased 5.2±2.2% and 6.0±2.3% respectively as a result of the intervention (p< 0.05). Cross-sectional area (CSA) of the vastus lateralis was measured via panoramic ultrasound imaging pre- and post-intervention. Following the protocol, CSA of the intervention group was 10.6±2.7% greater (p< 0.05), while that of the control group did not change. This is the first data to demonstrate hypertrophy of the vastus lateralis in a young population following a running protocol. These data support the existing body of evidence suggesting aerobic exercise to be an effective mode of improving cardiorespiratory fitness as well as increasing whole muscle size of the quadriceps. PMID:28479954

Cardiac autonomic response following high-intensity running work-to-rest interval manipulation.

PubMed

Cipryan, Lukas; Laursen, Paul B; Plews, Daniel J

2016-10-01

The cardiorespiratory, cardiac autonomic (via heart rate variability (HRV)) and plasma volume responses to varying sequences of high-intensity interval training (HIT) of consistent external work were investigated. Twelve moderately trained males underwent three HIT bouts and one control session. The HIT trials consisted of warm-up, followed by 12 min of 15 s, 30 s or 60 s work:relief HIT sequences at an exercise intensity of 100% of the individual velocity at [Formula: see text]O2max (v[Formula: see text]O2max), interspersed by relief intervals at 60% [Formula: see text]O2max (work/relief ratio = 1). HRV was evaluated via the square root of the mean sum of the squared differences between R-R intervals (rMSSD) before, 1 h, 3 h and 24 h after the exercise. Plasma volume was assessed before, immediately after, and 3 h and 24 h after. There were no substantial between-trial differences in acute cardiorespiratory responses. The rMSSD values remained decreased 1 h after the exercise cessation in all exercise groups. The rMSSD subsequently increased between 1 h and 3 h after exercise, with the most pronounced change in the 15/15 group. There were no relationships between HRV and plasma volume. All HIT protocols resulted in similar cardiorespiratory responses with slightly varying post-exercise HRV responses, with the 30/30 protocol eliciting the least disruption to post-exercise HRV. These post-exercise HRV findings suggest that the 30/30 sequence may be the preferable HIT prescription when the between-training period is limited.

Effects of standard training in the use of closed-circuit televisions in visually impaired adults: design of a training protocol and a randomized controlled trial.

PubMed

Burggraaff, Marloes C; van Nispen, Ruth M A; Melis-Dankers, Bart J M; van Rens, Ger H M B

2010-03-10

Reading problems are frequently reported by visually impaired persons. A closed-circuit television (CCTV) can be helpful to maintain reading ability, however, it is difficult to learn how to use this device. In the Netherlands, an evidence-based rehabilitation program in the use of CCTVs was lacking. Therefore, a standard training protocol needed to be developed and tested in a randomized controlled trial (RCT) to provide an evidence-based training program in the use of this device. To develop a standard training program, information was collected by studying literature, observing training in the use of CCTVs, discussing the content of the training program with professionals and organizing focus and discussion groups. The effectiveness of the program was evaluated in an RCT, to obtain an evidence-based training program. Dutch patients (n = 122) were randomized into a treatment group: normal instructions from the supplier combined with training in the use of CCTVs, or into a control group: instructions from the supplier only. The effect of the training program was evaluated in terms of: change in reading ability (reading speed and reading comprehension), patients' skills to operate the CCTV, perceived (vision-related) quality of life and tasks performed in daily living. The development of the CCTV training protocol and the design of the RCT in the present study may serve as an example to obtain an evidence-based training program. The training program was adjusted to the needs and learning abilities of individual patients, however, for scientific reasons it might have been preferable to standardize the protocol further, in order to gain more comparable results. http://www.trialregister.nl, identifier: NTR1031.

Effects of standard training in the use of closed-circuit televisions in visually impaired adults: design of a training protocol and a randomized controlled trial

PubMed Central

2010-01-01

Background Reading problems are frequently reported by visually impaired persons. A closed-circuit television (CCTV) can be helpful to maintain reading ability, however, it is difficult to learn how to use this device. In the Netherlands, an evidence-based rehabilitation program in the use of CCTVs was lacking. Therefore, a standard training protocol needed to be developed and tested in a randomized controlled trial (RCT) to provide an evidence-based training program in the use of this device. Methods/Design To develop a standard training program, information was collected by studying literature, observing training in the use of CCTVs, discussing the content of the training program with professionals and organizing focus and discussion groups. The effectiveness of the program was evaluated in an RCT, to obtain an evidence-based training program. Dutch patients (n = 122) were randomized into a treatment group: normal instructions from the supplier combined with training in the use of CCTVs, or into a control group: instructions from the supplier only. The effect of the training program was evaluated in terms of: change in reading ability (reading speed and reading comprehension), patients' skills to operate the CCTV, perceived (vision-related) quality of life and tasks performed in daily living. Discussion The development of the CCTV training protocol and the design of the RCT in the present study may serve as an example to obtain an evidence-based training program. The training program was adjusted to the needs and learning abilities of individual patients, however, for scientific reasons it might have been preferable to standardize the protocol further, in order to gain more comparable results. Trial registration http://www.trialregister.nl, identifier: NTR1031 PMID:20219120

Strength and Aerobic Exercises Improve Spatial Memory in Aging Rats Through Stimulating Distinct Neuroplasticity Mechanisms.

PubMed

Vilela, Thais Ceresér; Muller, Alexandre Pastoris; Damiani, Adriani Paganini; Macan, Tamires Pavei; da Silva, Sabrina; Canteiro, Paula Bortoluzzi; de Sena Casagrande, Alisson; Pedroso, Giulia Dos Santos; Nesi, Renata Tiscoski; de Andrade, Vanessa Moraes; de Pinho, Ricardo Aurino

2017-12-01

Aging is associated with impaired cognition and memory and increased susceptibility to neurodegenerative disorders. Physical exercise is neuroprotective; however, the major evidence of this effect involves studies of only aerobic training in young animals. The benefits of other exercise protocols such as strength training in aged animals remains unknown. Here, we investigated the effect of aerobic and strength training on spatial memory and hippocampal plasticity in aging rats. Aging Wistar rats performed aerobic or strength training for 50 min 3 to 4 days/week for 8 weeks. Spatial memory and neurotrophic and glutamatergic signaling in the hippocampus of aged rats were evaluated after aerobic or strength training. Both aerobic and strength training improved cognition during the performance of a spatial memory task. Remarkably, the improvement in spatial memory was accompanied by an increase in synaptic plasticity proteins within the hippocampus after exercise training, with some differences in the intracellular functions of those proteins between the two exercise protocols. Moreover, neurotrophic signaling (CREB, BDNF, and the P75 NTR receptor) increased after training for both exercise protocols, and aerobic exercise specifically increased glutamatergic proteins (NMDA receptor and PSD-95). We also observed a decrease in DNA damage after aerobic training. In contrast, strength training increased levels of PKCα and the proinflammatory factors TNF-α and IL-1β. Overall, our results show that both aerobic and strength training improved spatial memory in aging rats through inducing distinct molecular mechanisms of neuroplasticity. Our findings extend the idea that exercise protocols can be used to improve cognition during aging.

Introducing Clicker Training as a Cognitive Enrichment for Laboratory Mice.

PubMed

Leidinger, Charlotte; Herrmann, Felix; Thöne-Reineke, Christa; Baumgart, Nadine; Baumgart, Jan

2017-03-06

Establishing new refinement strategies in laboratory animal science is a central goal in fulfilling the requirements of Directive 2010/63/EU. Previous research determined a profound impact of gentle handling protocols on the well-being of laboratory mice. By introducing clicker training to the keeping of mice, not only do we promote the amicable treatment of mice, but we also enable them to experience cognitive enrichment. Clicker training is a form of positive reinforcement training using a conditioned secondary reinforcer, the "click" sound of a clicker, which serves as a time bridge between the strengthened behavior and an upcoming reward. The effective implementation of the clicker training protocol with a cohort of 12 BALB/c inbred mice of each sex proved to be uncomplicated. The mice learned rather quickly when challenged with tasks of the clicker training protocol, and almost all trained mice overcame the challenges they were given (100% of female mice and 83% of male mice). This study has identified that clicker training for mice strongly correlates with reduced fear in the mice during human-mice interactions, as shown by reduced anxiety-related behaviors (e.g., defecation, vocalization, and urination) and fewer depression-like behaviors (e.g., floating). By developing a reliable protocol that can be easily integrated into the daily routine of the keeping of laboratory mice, the lifetime experience of welfare in the mice can be improved substantially.

Systematic Evaluation of the Patient-Reported Outcome (PRO) Content of Clinical Trial Protocols

PubMed Central

Kyte, Derek; Duffy, Helen; Fletcher, Benjamin; Gheorghe, Adrian; Mercieca-Bebber, Rebecca; King, Madeleine; Draper, Heather; Ives, Jonathan; Brundage, Michael; Blazeby, Jane; Calvert, Melanie

2014-01-01

Background Qualitative evidence suggests patient-reported outcome (PRO) information is frequently absent from clinical trial protocols, potentially leading to inconsistent PRO data collection and risking bias. Direct evidence regarding PRO trial protocol content is lacking. The aim of this study was to systematically evaluate the PRO-specific content of UK National Institute for Health Research (NIHR) Health Technology Assessment (HTA) programme trial protocols. Methods and Findings We conducted an electronic search of the NIHR HTA programme database (inception to August 2013) for protocols describing a randomised controlled trial including a primary/secondary PRO. Two investigators independently reviewed the content of each protocol, using a specially constructed PRO-specific protocol checklist, alongside the ‘Standard Protocol Items: Recommendations for Interventional Trials’ (SPIRIT) checklist. Disagreements were resolved through discussion with a third investigator. 75 trial protocols were included in the analysis. Protocols included a mean of 32/51 (63%) SPIRIT recommendations (range 16–41, SD 5.62) and 11/33 (33%) PRO-specific items (range 4–18, SD 3.56). Over half (61%) of the PRO items were incomplete. Protocols containing a primary PRO included slightly more PRO checklist items (mean 14/33 (43%)). PRO protocol content was not associated with general protocol completeness; thus, protocols judged as relatively ‘complete’ using SPIRIT were still likely to have omitted a large proportion of PRO checklist items. Conclusions The PRO components of HTA clinical trial protocols require improvement. Information on the PRO rationale/hypothesis, data collection methods, training and management was often absent. This low compliance is unsurprising; evidence shows existing PRO guidance for protocol developers remains difficult to access and lacks consistency. Study findings suggest there are a number of PRO protocol checklist items that are not fully addressed by the current SPIRIT statement. We therefore advocate the development of consensus-based supplementary guidelines, aimed at improving the completeness and quality of PRO content in clinical trial protocols. PMID:25333349

Hippocampus NMDA receptors selectively mediate latent extinction of place learning.

PubMed

Goodman, Jarid; Gabriele, Amanda; Packard, Mark G

2016-09-01

Extinction of maze learning may be achieved with or without the animal performing the previously acquired response. In typical "response extinction," animals are given the opportunity to make the previously acquired approach response toward the goal location of the maze without reinforcement. In "latent extinction," animals are not given the opportunity to make the previously acquired response and instead are confined to the previous goal location without reinforcement. Previous evidence indicates that the effectiveness of these protocols may depend on the type of memory being extinguished. Thus, one aim of the present study was to further examine the effectiveness of response and latent extinction protocols across dorsolateral striatum (DLS)-dependent response learning and hippocampus-dependent place learning tasks. In addition, previous neural inactivation experiments indicate a selective role for the hippocampus in latent extinction, but have not investigated the precise neurotransmitter mechanisms involved. Thus, the present study also examined whether latent extinction of place learning might depend on NMDA receptor activity in the hippocampus. In experiment 1, adult male Long-Evans rats were trained in a response learning task in a water plus-maze, in which animals were reinforced to make a consistent body-turn response to reach an invisible escape platform. Results indicated that response extinction, but not latent extinction, was effective at extinguishing memory in the response learning task. In experiment 2, rats were trained in a place learning task, in which animals were reinforced to approach a consistent spatial location containing the hidden escape platform. In experiment 2, animals also received intra-hippocampal infusions of the NMDA receptor antagonist 2-amino-5-phosphopentanoic acid (AP5; 5.0 or 7.5 ug/0.5 µg) or saline vehicle immediately before response or latent extinction training. Results indicated that both extinction protocols were effective at extinguishing memory in the place learning task. In addition, intra-hippocampal AP5 (7.5 µg) impaired latent extinction, but not response extinction, suggesting that hippocampal NMDA receptors are selectively involved in latent extinction. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Bridging the gap in complementary and alternative medicine research: manualization as a means of promoting standardization and flexibility of treatment in clinical trials of acupuncture.

PubMed

Schnyer, Rosa N; Allen, John J B

2002-10-01

An important methodological challenge encountered in acupuncture clinical research involves the design of treatment protocols that help ensure standardization and replicability while allowing for the necessary flexibility to tailor treatments to each individual. Manualization of protocols used in clinical trials of acupuncture and other traditionally-based complementary and alternative medicine (CAM) systems facilitates the systematic delivery of replicable and standardized, yet individually-tailored treatments. To facilitate high-quality CAM acupuncture research by outlining a method for the systematic design and implementation of protocols used in CAM clinical trials based on the concept of treatment manualization. A series of treatment manuals was developed to systematically articulate the Chinese medical theoretical and clinical framework for a given Western-defined illness, to increase the quality and consistency of treatment, and to standardize the technical aspects of the protocol. In all, three manuals were developed for National Institutes of Health (NIH)-funded clinical trials of acupuncture for depression, spasticity in cerebral palsy, and repetitive stress injury. In Part I, the rationale underlying these manuals and the challenges encountered in creating them are discussed, and qualitative assessments of their utility are provided. In Part II, a methodology to develop treatment manuals for use in clinical trials is detailed, and examples are given. A treatment manual provides a precise way to train and supervise practitioners, enable evaluation of conformity and competence, facilitate the training process, and increase the ability to identify the active therapeutic ingredients in clinical trials of acupuncture.

Mental Fatigue and Physical and Cognitive Performance During a 2-Bout Exercise Test.

PubMed

Vrijkotte, Susan; Meeusen, Romain; Vandervaeren, Cloe; Buyse, Luk; Cutsem, Jeroen van; Pattyn, Nathalie; Roelands, Bart

2018-04-01

The 2-bout exercise protocol has been developed to diagnose nonfunctional overreaching and the "overtraining syndrome." It consists of 2 maximal exercise bouts separated by 4 hours. Mental fatigue negatively influences performance, but the effects of its occurrence during the 2-bout exercise protocol have never been investigated. The aim of this study was to examine whether mental fatigue (induced during the rest period) influences physical and cognitive performance during/after the second exercise bout of the 2-bout exercise protocol. Nine healthy, well-trained male cyclists participated in a single-blind, randomized, placebo-controlled crossover study. The intervention consisted of either 1.5-hour rest (control) or performing a computer-based Stroop task to induce mental fatigue. Cognitive (Eriksen Flanker task), physiological (lactate, maximum heart rate, and maximum wattage), and subjective data (mental fatigue-visual analog scale, Profile of Mood States, and rating of perceived exertion) were gathered. Ratings of fatigue, tension, and mental fatigue were affected in the mental fatigue condition (P < .05). Neither physiological nor cognitive differences were found between conditions. Ratings of mental fatigue were already affected after the first maximum exercise test (P < .05). Neither physical nor cognitive performance was affected by mental fatigue, but subjective ratings did reveal significant differences. It is recommended to exclude mentally challenging tasks during the 2-bout exercise protocol rest period to ascertain unaffected subjective test results. This study should be repeated in athletes diagnosed with nonfunctional overreaching/overtraining syndrome.

Do 6 months of whole-body vibration training improve lean mass and bone mass acquisition of adolescent swimmers?

PubMed

Gómez-Bruton, A; González-Agüero, A; Matute-Llorente, A; Julián, C; Lozano-Berges, G; Gómez-Cabello, A; Casajús, J A; Vicente-Rodríguez, G

2017-12-01

Swimming has little effect on bone mass. Therefore, adolescent swimmers should complement their water training with a short and intense weight-bearing training, aiming to increase their bone acquisition. Forty swimmers performed a six-month whole-body vibration (WBV) training. WBV had no effect on adolescent swimmers' bone mass or lean mass. The aims of the present study were to evaluate the effects of a whole-body vibration (WBV) intervention on bone mineral density (BMD), bone mineral content (BMC) and lean mass (LM) in adolescent swimmers. Forty male and female adolescent swimmers (VIB; mean age 14.2 ± 1.9 years) completed the WBV protocol that consisted of 15 min of training 3 days per week during a 6-month period (ranging from 3.6 to 11.6 g), while 23 swimmers (SWI; mean age 15.0 ± 2.2 years) continued with their regular swimming training alone. VIB were divided into tertiles according to training compliance in order to evaluate if any dose-effect relation existed. BMD, BMC and LM were measured longitudinally by dual energy X-ray at the whole body, lumbar-spine and hip. No group by time interactions and no differences in change percentage were found for BMD, BMC or LM in any of the measured variables. The mean change percentage of the subtotal body (whole body minus the head) for VIB and SWI, respectively, was 2.3 vs. 2.4% for BMD, 5.7 vs 5.7% for BMC and 7.3 vs. 8.0% for lean mass. Moreover, no indication for dose-response was observed. The proposed WBV protocol had no effect on BMD, BMC and LM in adolescent swimmers. Other types of training should be used in this population to improve both bone and lean mass.

Effects of Video Game Training on Behavioral and Electrophysiological Measures of Attention and Memory: Protocol for a Randomized Controlled Trial.

PubMed

Ballesteros, Soledad; Mayas, Julia; Ruiz-Marquez, Eloisa; Prieto, Antonio; Toril, Pilar; Ponce de Leon, Laura; de Ceballos, Maria L; Reales Avilés, José Manuel

2017-01-24

Neuroplasticity-based approaches seem to offer promising ways of maintaining cognitive health in older adults and postponing the onset of cognitive decline symptoms. Although previous research suggests that training can produce transfer effects, this study was designed to overcome some limitations of previous studies by incorporating an active control group and the assessment of training expectations. The main objectives of this study are (1) to evaluate the effects of a randomized computer-based intervention consisting of training older adults with nonaction video games on brain and cognitive functions that decline with age, including attention and spatial working memory, using behavioral measures and electrophysiological recordings (event-related potentials [ERPs]) just after training and after a 6-month no-contact period; (2) to explore whether motivation, engagement, or expectations might account for possible training-related improvements; and (3) to examine whether inflammatory mechanisms assessed with noninvasive measurement of C-reactive protein in saliva impair cognitive training-induced effects. A better understanding of these mechanisms could elucidate pathways that could be targeted in the future by either behavioral or neuropsychological interventions. A single-blinded randomized controlled trial with an experimental group and an active control group, pretest, posttest, and 6-month follow-up repeated measures design is used in this study. A total of 75 cognitively healthy older adults were randomly distributed into experimental and active control groups. Participants in the experimental group received 16 1-hour training sessions with cognitive nonaction video games selected from Lumosity, a commercial brain training package. The active control group received the same number of training sessions with The Sims and SimCity, a simulation strategy game. We have recruited participants, have conducted the training protocol and pretest assessments, and are currently conducting posttest evaluations. The study will conclude in the first semester of 2017. Data analysis will take place during 2017. The primary outcome is transfer of benefit from training to attention and working memory functions and the neural mechanisms underlying possible cognitive improvements. We expect that mental stimulation with video games will improve attention and memory both at the behavioral level and in ERP components promoting brain and mental health and extending independence among elderly people by avoiding the negative personal and economic consequences of long-term care. Clinicaltrials.gov NCT02796508; https://clinicaltrials.gov/ct2/show/NCT02796508 (archived by WebCite at http://www.webcitation.org/6nFeKeFNB). ©Soledad Ballesteros, Julia Mayas, Eloisa Ruiz-Marquez, Antonio Prieto, Pilar Toril, Laura Ponce de Leon, Maria L de Ceballos, José Manuel Reales Avilés. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 24.01.2017.

Building an evidence-base for the training of evidence-based treatments in community settings: Use of an expert-informed approach.

PubMed

Scudder, Ashley; Herschell, Amy D

2015-08-01

In order to make EBTs available to a large number of children and families, developers and expert therapists have used their experience and expertise to train community-based therapists in EBTs. Understanding current training practices of treatment experts may be one method for establishing best practices for training community-based therapists prior to comprehensive empirical examinations of training practices. A qualitative study was conducted using surveys and phone interviews to identify the specific procedures used by treatment experts to train and implement an evidence-based treatment in community settings. Twenty-three doctoral-level, clinical psychologists were identified to participate because of their expertise in conducting and training Parent-Child Interaction Therapy. Semi-structured qualitative interviews were completed by phone, later transcribed verbatim, and analyzed using thematic coding. The de-identified data were coded by two independent qualitative data researchers and then compared for consistency of interpretation. The themes that emerged following the final coding were used to construct a training protocol to be empirically tested. The goal of this paper is to not only understand the current state of training practices for training therapists in a particular EBT, Parent-Child Interaction Therapy, but to illustrate the use of expert opinion as the best available evidence in preparation for empirical evaluation.

The Effects of Sport-Specific Drills Training or High-Intensity Interval Training in Young Tennis Players.

PubMed

Fernandez-Fernandez, Jaime; Sanz, David; Sarabia, Jose Manuel; Moya, Manuel

2017-01-01

To compare the effects of combining high-intensity training (HIT) and sport-specific drill training (MT) versus sportspecific drill training alone (DT) on fitness performance characteristics in young tennis players. Twenty young tennis players (14.8 ± 0.1 y) were assigned to either DT (n = 10) or MT (n = 10) for 8 wk. Tennis drills consisted of two 16- to 22-min on-court exercise sessions separated by 3 min of passive rest, while MT consisted of 1 sport-specific DT session and 1 HIT session, using 16-22 min of runs at intensities (90-95%) related to the velocity obtained in the 30-15 Intermittent Fitness Test (V IFT ) separated by 3 min of passive rest. Pre- and posttests included peak oxygen uptake (VO 2 peak), V IFT , speed (20 m, with 5- and 10-m splits), 505 Agility Test, and countermovement jump (CMJ). There were significant improvements after the training period in VO 2 peak (DT 2.4%, ES = moderate; MT 4.2%, ES = large) and V IFT (DT 2.2%, ES = small; MT 6.3%, ES = large) for both DT and MT, with no differences between training protocols. Results also showed a large increase in the 505 Agility Test after MT, while no changes were reported in the other tests (sprint and CMJ), either for MT or DT. Even though both training programs resulted in significant improvements in aerobic performance, a mixed program combining tennis drills and runs based on the V IFT led to greater gains and should be considered the preferred training method for improving aerobic power in young athletes.

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

PubMed Central

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

2015-01-01

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

Improving fitness of elite handball players: small-sided games vs. high-intensity intermittent training.

PubMed

Iacono, Antonio Dello; Eliakim, Alon; Meckel, Yoav

2015-03-01

The present study was designed to compare the effects of high-intensity intermittent training (HIIT) and small-sided games (SSGs) training on fitness variables of elite handball players. Eighteen highly trained players (mean age ± SD: 25.6 ± 0.5 years) were assigned to either HIIT or SSGs group training protocols twice per week for 8 weeks. The HIIT consisted of 12-24 × 15 seconds of high-intensity runs interspersed by 15 seconds of recovery. The SSGs training consisted of 3 against 3 small-sided handball games. Both training methods were matched for exercise duration and recovery at each training session. Before and after 8-week training, the following fitness variables were assessed-speed: 10- and 20-m sprint time, agility: handball agility specific test (HAST), upper arm strength: 1 repetition maximum (1RM) bench press test, lower limb power: counter-movement jump tests with (CMJarm) and without (CMJ) arm movement, and aerobic fitness (yo-yo intermittent recovery test level 1 [YYIRTL1]). Significant improvement was found in the YYIRTL1 (23.3 and 26.3%, respectively), 10-m sprint (2.3 and 4.1%, respectively) and 20-m sprint (2.1 and 4%, respectively), HAST (1.1 and 2.2%, respectively), 1RM bench press (6.8 and 12.3%, respectively), CMJ (7.4 and 10.8%, respectively), and CMJarm (6.4 and 8.9%, respectively) following training in both groups (p ≤ 0.05 for all). There was a significantly greater improvement in 10- and 20-m sprint, HAST, 1RM, CMJ, and CMJarm following the SSGs training compared with the HIIT (p ≤ 0.05 for all). These results indicated that both HIIT and SSGs are effective training methods for fitness development among elite adult handball players. However, SSGs training may be considered as the preferred training regimen for improving handball-specific fitness variables during the in-season period.

Mindfulness-based resilience training to reduce health risk, stress reactivity, and aggression among law enforcement officers: A feasibility and preliminary efficacy trial.

PubMed

Christopher, Michael S; Hunsinger, Matthew; Goerling, Lt Richard J; Bowen, Sarah; Rogers, Brant S; Gross, Cynthia R; Dapolonia, Eli; Pruessner, Jens C

2018-06-01

The primary objective of this study was to assess feasibility and gather preliminary outcome data on Mindfulness-Based Resilience Training (MBRT) for law enforcement officers. Participants (n = 61) were randomized to either an 8-week MBRT course or a no intervention control group. Self-report and physiological data were collected at baseline, post-training, and three months following intervention completion. Attendance, adherence, post-training participant feedback, and interventionist fidelity to protocol all demonstrated feasibility of MBRT for law enforcement officers. Compared to no intervention controls, MBRT participants experienced greater reductions in salivary cortisol, self-reported aggression, organizational stress, burnout, sleep disturbance, and reported increases in psychological flexibility and non-reactivity at post-training; however, group differences were not maintained at three-month follow-up. This initial randomized trial suggests MBRT is a feasible intervention. Outcome data suggest MBRT targets key physiological, psychological, and health risk factors in law enforcement officers, consistent with the potential to improve officer health and public safety. However, follow-up training or "booster" sessions may be needed to maintain training gains. A fully powered longitudinal randomized trial is warranted. Copyright © 2018 Elsevier B.V. All rights reserved.

Better than sleep: theta neurofeedback training accelerates memory consolidation.

PubMed

Reiner, Miriam; Rozengurt, Roman; Barnea, Anat

2014-01-01

Consistent empirical results showed that both night and day sleep enhanced memory consolidation. In this study we explore processes of consolidation of memory during awake hours. Since theta oscillations have been shown to play a central role in exchange of information, we hypothesized that elevated theta during awake hours will enhance memory consolidation. We used a neurofeedback protocol, to enhance the relative power of theta or beta oscillations. Participants trained on a tapping task, were divided into three groups: neurofeedback theta; neurofeedback beta; control. We found a significant improvement in performance in the theta group, relative to the beta and control groups, immediately after neurofeedback. Performance was further improved after night sleep in all groups, with a significant advantage favoring the theta group. Theta power during training was correlated with the level of improvement, indicating a clear relationship between memory consolidation, and theta neurofeedback. Copyright © 2013 Elsevier B.V. All rights reserved.

Cognitive defusion versus thought distraction: a clinical rationale, training, and experiential exercise in altering psychological impacts of negative self-referential thoughts.

PubMed

Masuda, Akihiko; Feinstein, Amanda B; Wendell, Johanna W; Sheehan, Shawn T

2010-11-01

Using two modes of intervention delivery, the present study compared the effects of a cognitive defusion strategy with a thought distraction strategy on the emotional discomfort and believability of negative self-referential thoughts. One mode of intervention delivery consisted of a clinical rationale and training (i.e., Partial condition). The other mode contained a condition-specific experiential exercise with the negative self-referential thought in addition to the clinical rationale and training (i.e., Full condition). Nonclinical undergraduates were randomly assigned to one of five protocols: Partial-Defusion, Full-Defusion, Partial-Distraction, Full-Distraction, and a distraction-based experimental control task. The Full-Defusion condition reduced the emotional discomfort and believability of negative self-referential thoughts significantly more than other comparison conditions. The positive results of the Full-Defusion condition were also found among participants with elevated depressive symptoms.

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

PubMed

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

2015-01-01

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

Cost-effectiveness of an intensive group training protocol compared to physiotherapy guideline care for sub-acute and chronic low back pain: design of a randomised controlled trial with an economic evaluation. [ISRCTN45641649

PubMed Central

van der Roer, Nicole; van Tulder, Maurits W; Barendse, Johanna M; van Mechelen, Willem; Franken, Willemien K; Ooms, Arjan C; de Vet, Henrica CW

2004-01-01

Background Low back pain is a common disorder in western industrialised countries and the type of treatments for low back pain vary considerably. Methods In a randomised controlled trial the cost-effectiveness and cost-utility of an intensive group training protocol versus physiotherapy guideline care for sub-acute and chronic low back pain patients is evaluated. Patients with back pain for longer than 6 weeks who are referred to physiotherapy care by their general practitioner or medical specialist are included in the study. The intensive group training protocol combines exercise therapy with principles of behavioural therapy ("graded activity") and back school. This training protocol is compared to physiotherapy care according to the recently published Low Back Pain Guidelines of the Royal Dutch College for Physiotherapy. Primary outcome measures are general improvement, pain intensity, functional status, work absenteeism and quality of life. The direct and indirect costs will be assessed using cost diaries. Patients will complete questionnaires at baseline and 6, 13, 26 and 52 weeks after randomisation. Discussion No trials are yet available that have evaluated the effect of an intensive group training protocol including behavioural principles and back school in a primary physiotherapy care setting and no data on cost-effectiveness and cost-utility are available. PMID:15560843

Isometric handgrip training reduces arterial pressure at rest without changes in sympathetic nerve activity

NASA Technical Reports Server (NTRS)

Ray, C. A.; Carrasco, D. I.

2000-01-01

The purpose of this study was to determine whether isometric handgrip (IHG) training reduces arterial pressure and whether reductions in muscle sympathetic nerve activity (MSNA) mediate this drop in arterial pressure. Normotensive subjects were assigned to training (n = 9), sham training (n = 7), or control (n = 8) groups. The training protocol consisted of four 3-min bouts of IHG exercise at 30% of maximal voluntary contraction (MVC) separated by 5-min rest periods. Training was performed four times per week for 5 wk. Subjects' resting arterial pressure and heart rate were measured three times on 3 consecutive days before and after training, with resting MSNA (peroneal nerve) recorded on the third day. Additionally, subjects performed IHG exercise at 30% of MVC to fatigue followed by muscle ischemia. In the trained group, resting diastolic (67 +/- 1 to 62 +/- 1 mmHg) and mean arterial pressure (86 +/- 1 to 82 +/- 1 mmHg) significantly decreased, whereas systolic arterial pressure (116 +/- 3 to 113 +/- 2 mmHg), heart rate (67 +/- 4 to 66 +/- 4 beats/min), and MSNA (14 +/- 2 to 15 +/- 2 bursts/min) did not significantly change following training. MSNA and cardiovascular responses to exercise and postexercise muscle ischemia were unchanged by training. There were no significant changes in any variables for the sham training and control groups. The results indicate that IHG training is an effective nonpharmacological intervention in lowering arterial pressure.

Ensuring Quality in AFRINEST and SATT

PubMed Central

2013-01-01

Background: Three randomized open-label clinical trials [Simplified Antibiotic Therapy Trial (SATT) Bangladesh, SATT Pakistan and African Neonatal Sepsis Trial (AFRINEST)] were developed to test the equivalence of simplified antibiotic regimens compared with the standard regimen of 7 days of parenteral antibiotics. These trials were originally conceived and designed separately; subsequently, significant efforts were made to develop and implement a common protocol and approach. Previous articles in this supplement briefly describe the specific quality control methods used in the individual trials; this article presents additional information about the systematic approaches used to minimize threats to validity and ensure quality across the trials. Methods: A critical component of quality control for AFRINEST and SATT was striving to eliminate variation in clinical assessments and decisions regarding eligibility, enrollment and treatment outcomes. Ensuring appropriate and consistent clinical judgment was accomplished through standardized approaches applied across the trials, including training, assessment of clinical skills and refresher training. Standardized monitoring procedures were also applied across the trials, including routine (day-to-day) internal monitoring of performance and adherence to protocols, systematic external monitoring by funding agencies and external monitoring by experienced, independent trial monitors. A group of independent experts (Technical Steering Committee/Technical Advisory Group) provided regular monitoring and technical oversight for the trials. Conclusions: Harmonization of AFRINEST and SATT have helped to ensure consistency and quality of implementation, both internally and across the trials as a whole, thereby minimizing potential threats to the validity of the trials’ results. PMID:23945575

Development of pre-deployment primary healthcare training for Combat Medical Technicians.

PubMed

Parsons, Iain T; Rawden, M P; Wheatley, R J

2014-09-01

To develop and run a primary healthcare (PHC) refresher package to address the range of clinical presentations to Combat Medical Technicians (CMTs) on deployment and improve their confidence and capability in providing PHC for Op Herrick 18, with particular regard to the first month of deployment. A regimental level, two-and-a-half day refresher package was developed following analysis of PHC conditions most likely to be seen on Op HERRICK 18. It consisted of lectures and skill stations with written and case-based assessment phases to demonstrate effective and safe use of CMT clinical protocols on simulated patients. Internal feedback assessed the CMT's subjective understanding of each individual section. A qualitative questionnaire was used to retrospectively evaluate the package after 1 month of deployment. Immediate feedback showed that the refresher training was well received. Following the first month of deployment, CMTs who had attended the PHC refresher package felt more confident in managing PHC patients and felt they had received training for the majority of PHC conditions witnessed during their deployment in comparison with CMTs who had not. By delivering a training package acceptable to the majority of medics, we have increased the confidence and capability of CMTs in delivering PHC within the context of their protocols and prepared them for their first month of deployment. It suggests that PHC delivery can be improved by such a package and consideration should be given to formalising this into a military training qualification. 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.

Intensive training program for ultrasound diagnosis of adnexal masses: protocol and preliminary results.

PubMed

Alcázar, J L; Díaz, L; Flórez, P; Guerriero, S; Jurado, M

2013-08-01

To assess the feasibility of a specific training program for ultrasound diagnosis of adnexal masses. A 2-month intensive training program was developed. The program protocol consisted of a 1-day intensive theoretical course focused on clinical and sonographic issues related to adnexal masses and ovarian cancer, followed by a 4-week real-time ultrasound training program in a tertiary center (25-30 adnexal masses evaluated per month) and a final 4-week period for offline assessment of three-dimensional (3D) volumes from adnexal masses. In this final period, each trainee evaluated five sets of 100 3D volumes. 3D volumes contained gray-scale and power Doppler information, and the trainee was provided with clinical data for each case (patient age, menopausal status and reported symptoms). 3D volumes were obtained from surgically removed masses that had undergone histological diagnosis or from masses that had been followed up until resolution. After assessment of each set, the trainee's diagnostic performance was calculated (sensitivity and specificity) and each incorrectly classified mass was evaluated with the trainer. The objective was to achieve a sensitivity of > 95% and a specificity of > 90%. Learning curve cumulative summation (LC-CUSUM) graphs were plotted to assess the learning curve for the trainees. One trainer and two trainees with little experience in gynecological ultrasound (one gynecologist and one radiologist) participated in this study. LC-CUSUM graphs showed that competence was achieved after 170 or 185 examinations. The objectives for diagnostic performance were achieved after assessment of the second set of 3D volumes (200 cases) for each trainee. The proposed training program appears to be feasible. High diagnostic performance can be achieved after analysis of 200 cases and maintained thereafter. Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd.

Facilitated versus self-guided training of non-ophthalmologists for grading pre-plus and plus disease using fundus images for retinopathy of prematurity screening

PubMed Central

Raufi, Nikolas N.; Morris, Caleb K.; Freedman, Sharon F.; Wallace, David K.; Prakalapakorn, S. Grace

2016-01-01

Purpose Retinopathy of prematurity (ROP) is an important cause of preventable blindness; barriers to screening necessitate novel approaches. While trained non-ophthalmologists can accurately grade retinal images for ROP, effective training protocols are not established. This study compares the effectiveness of facilitated versus self-guided training of non-ophthalmologists for grading retinal images for pre-plus or plus disease in ROP. Methods Forty-eight undergraduate and graduate students were trained to grade retinal images for the presence of pre-plus or plus disease. Students were randomly assigned to one of two training protocols. Both utilized identical electronic slideshows; one guided by an in-person facilitator, and the other was self-guided. After completing their respective training, students proficient in grading pre-plus and plus disease graded images in a telemedicine screening scenario. Accuracy of grading was compared to the reference standard of clinical examination. Results 83% (40/48) of trained students (91% in the facilitated vs. 77% in the self-guided group, p=0.26) were proficient and qualified to grade the ROP telemedicine screening scenario. Median accuracy for grading normal, pre-plus or plus disease was 69% (70% in the facilitated vs. 68% in the self-guided group, p=0.91). When considering the designation of pre-plus or plus disease by graders as a screening test for detecting plus disease (confirmed on clinical exam), the median sensitivity and specificity of all students was 95% and 64%, respectively. Conclusions Both facilitated- and self-guided teaching protocols yielded similar performance in ROP image grading for pre-plus or plus disease. Self-guided training protocols may be adequate to train non-ophthalmologists to grade retinal images for pre-plus and plus disease with high sensitivity. PMID:27224953

Implementation of online suicide-specific training for VA providers.

PubMed

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

2014-10-01

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

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

PubMed

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

2015-12-01

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

Randomized controlled trial protocol: balance training with rhythmical cues to improve and maintain balance control in Parkinson's disease.

PubMed

Capato, Tamine Teixeira da Costa; Tornai, Juliana; Ávila, Patrícia; Barbosa, Egberto Reis; Piemonte, Maria Elisa Pimentel

2015-09-07

Postural instability is a particularly incapacitating disorder, whose loss of motor independence by Parkinson´s Disease (PD) patients marks a significant stage of disease onset. Evidence suggests that deficits in automatic motor control, sensory integration and attention are associated with the lack of balance in PD. Physiotherapy together with medication play an important role in the treatment of this state, although no consensus has been reached on the best treatment modality. The aim of this randomized controlled trial protocol is to evaluate the effects of balance training with rhythmical (BRT), which is a motor program to improve balance associated with rhythmical auditory cues (RACs). This study is ongoing in the stage 1. A total of 150 PD patients at H&Y stages II-III and asymptomatic for depression and dementia are enrolled in a single-blind randomized study. Randomization is achieved via a computer-generated random-sequence table. All patients should also present a fall history. They will be assigned into one of three groups, and their balance and gait will be assessed before and after 10 training sessions, and after 4 and 30 weeks subsequent to the end of the training. The BRT group will receive a motor program to improve balance associated with RACs, the MT group will perform motor training with the same aims as those in the BRT group but without RACs, and the control group (CG) will be trained only in orientations. The exercise program specific to balance is of 5 weeks' duration with two sessions per week, 45 min each, and consists of general physiotherapy exercises. Each session will be divided into five warm-up minutes-30 min for the main part and 10 min for the cool down. The training progresses and intensifies each week depending on the individual's performance. The subjects should be able to execute 10 repetitions of the exercise sequences correctly to progress to the next movement. This randomized study protocol will evaluate the effects of a motor program designed to improve balance associated with RACs, and will also assess whether balance training leads to activation of balance reactions at the appropriate time. We hypothesize that if this motor program is maintained long-term, it will prevent falls. Clinicaltrials.gov NCT02488265 ; Ethics Committee of the University of São Paulo Faculty of Medicine Clinics Hospital 1.102.464.

Investigating Linguistic Sources of Differential Item Functioning Using Expert Think-Aloud Protocols in Science Achievement Tests

NASA Astrophysics Data System (ADS)

Roth, Wolff-Michael; Oliveri, Maria Elena; Dallie Sandilands, Debra; Lyons-Thomas, Juliette; Ercikan, Kadriye

2013-03-01

Even if national and international assessments are designed to be comparable, subsequent psychometric analyses often reveal differential item functioning (DIF). Central to achieving comparability is to examine the presence of DIF, and if DIF is found, to investigate its sources to ensure differentially functioning items that do not lead to bias. In this study, sources of DIF were examined using think-aloud protocols. The think-aloud protocols of expert reviewers were conducted for comparing the English and French versions of 40 items previously identified as DIF (N = 20) and non-DIF (N = 20). Three highly trained and experienced experts in verifying and accepting/rejecting multi-lingual versions of curriculum and testing materials for government purposes participated in this study. Although there is a considerable amount of agreement in the identification of differentially functioning items, experts do not consistently identify and distinguish DIF and non-DIF items. Our analyses of the think-aloud protocols identified particular linguistic, general pedagogical, content-related, and cognitive factors related to sources of DIF. Implications are provided for the process of arriving at the identification of DIF, prior to the actual administration of tests at national and international levels.

[Theory of Mind in a child with autism: how to train her?].

PubMed

Martín García, María J; Gómez Becerra, Inmaculada; Garro Espín, María J

2012-11-01

Theory of Mind is a metacognitive skill that, in many cases, is deficient in autism. In this paper, we present a clinical study conducted with a child diagnosed with autism, which verifies the effectiveness of a training protocol testing false beliefs, which has been considered to measure the Theory of Mind. Basically, the protocol incorporates a number of verbal prompts (such as emphasizing the elements of the narratives that indicate situational or temporary changes), trains many examples, extending the tests incorporating some games with more familiar objects from the child's daily life, applies differential contingencies to discriminate right from wrong in each child's responses and provides descriptive feedback. The results show that the training protocol achieved the highest level of correct trials and the child generalizes the ability to take the perspective of her natural context.

Acute Effects of Plyometric and Resistance Training on Running Economy in Trained Runners.

PubMed

Marcello, Richard T; Greer, Beau K; Greer, Anna E

2017-09-01

Marcello, RT, Greer, BK, and Greer, AE. Acute effects of plyometric and resistance training on running economy in trained runners. J Strength Cond Res 31(9): 2432-2437, 2017-Results regarding the acute effects of plyometrics and resistance training (PRT) on running economy (RE) are conflicting. Eight male collegiate distance runners (21 ± 1 years, 62.5 ± 7.8 ml·kg·min V[Combining Dot Above]O2 peak) completed V[Combining Dot Above]O2 peak and 1 repetition maximum (1RM) testing. Seven days later, subjects completed a 12 minutes RE test at 60 and 80% V[Combining Dot Above]O2 peak, followed by a PRT protocol or a rested condition of equal duration (CON). The PRT protocol consisted of 3 sets of 5 repetitions at 85% 1RM for barbell squats, Romanian deadlifts, and barbell lunges; the same volume was used for resisted lateral lunges, box jumps, and depth jumps. Subjects completed another RE test immediately after the treatments and 24 hours later. Subjects followed an identical protocol 6 days later with condition assignment reversed. Running economy was determined by both relative V[Combining Dot Above]O2 (ml·kg·min) and energy expenditure (EE) (kcal·min). There was a significant (p ≤ 0.05) between-trial increase in V[Combining Dot Above]O2 (37.1 ± 4.2 ml·kg·min PRT vs. 35.5 ± 3.9 ml·kg·min CON) and EE (11.4 ± 1.3 kcal·min PRT vs. 11.0 ± 1.4 kcal·min CON) immediately after PRT at 60% V[Combining Dot Above]O2 peak, but no significant changes were observed at 80% V[Combining Dot Above]O2 peak. Respiratory exchange ratio was significantly (p ≤ 0.05) reduced 24 hours after PRT (0.93 ± 0.0) as compared to the CON trial (0.96 ± 0.0) at 80% V[Combining Dot Above]O2 peak. Results indicate that high-intensity PRT may acutely impair RE in aerobically trained individuals at a moderate running intensity, but that the attenuation lasts less than 24 hours in duration.

Comparison of responses to two high-intensity intermittent exercise protocols.

PubMed

Gist, Nicholas H; Freese, Eric C; Cureton, Kirk J

2014-11-01

The purpose of this study was to compare peak cardiorespiratory, metabolic, and perceptual responses to acute bouts of sprint interval cycling (SIC) and a high-intensity intermittent calisthenics (HIC) protocol consisting of modified "burpees." Eleven (8 men and 3 women) moderately trained, college-aged participants (age = 21.9 ± 2.1, body mass index = 24.8 ± 1.9, V[Combining Dot Above]O2peak = 54.1 ± 5.4 ml·kg·min) completed 4 testing sessions across 9 days with each session separated by 48-72 hours. Using a protocol of 4 repeated bouts of 30-second "all-out" efforts interspersed with 4-minute active recovery periods, responses to SIC and HIC were classified relative to peak values. Mean values for %V[Combining Dot Above]O2peak and %HRpeak for SIC (80.4 ± 5.3% and 86.8 ± 3.9%) and HIC (77.6 ± 6.9% and 84.6 ± 5.3%) were not significantly different (p > 0.05). Effect sizes (95% confidence interval) calculated for mean differences were: %V[Combining Dot Above]O2peak Cohen's d = 0.51 (0.48-0.53) and %HRpeak Cohen's d = 0.57 (0.55-0.59). A low-volume, high-intensity bout of repeated whole-body calisthenic exercise induced cardiovascular responses that were not significantly different but were ∼1/2SD lower than "all-out" SIC. These results suggest that in addition to the benefit of reduced time commitment, a high-intensity interval protocol of calisthenics elicits vigorous cardiorespiratory and perceptual responses and may confer physiological adaptations and performance improvements similar to those reported for SIC. The potential efficacy of this alternative interval training method provides support for its application by athletes, coaches, and strength and conditioning professionals.

Effect of inspiratory muscle training with load compared with sham training on blood pressure in individuals with hypertension: study protocol of a double-blind randomized clinical trial.

PubMed

Posser, Simone Regina; Callegaro, Carine Cristina; Beltrami-Moreira, Marina; Moreira, Leila Beltrami

2016-08-02

Hypertension is a complex chronic condition characterized by elevated arterial blood pressure. Management of hypertension includes non-pharmacologic strategies, which may include techniques that effectively reduce autonomic sympathetic activity. Respiratory exercises improve autonomic control over cardiovascular system and attenuate muscle metaboreflex. Because of these effects, respiratory exercises may be useful to lower blood pressure in subjects with hypertension. This randomized, double-blind clinical trial will test the efficacy of inspiratory muscle training in reducing blood pressure in adults with essential hypertension. Subjects are randomly allocated to intervention or control groups. Intervention consists of inspiratory muscle training loaded with 40 % of maximum inspiratory pressure, readjusted weekly. Control sham intervention consists of unloaded exercises. Systolic and diastolic blood pressures are co-primary endpoint measures assessed with 24 h ambulatory blood pressure monitoring. Secondary outcome measures include cardiovascular autonomic control, inspiratory muscle metaboreflex, cardiopulmonary capacity, and inspiratory muscle strength and endurance. Previously published work suggests that inspiratory muscle training reduces blood pressure in persons with hypertension, but the effectiveness of this intervention is yet to be established. We propose an adequately sized randomized clinical trial to test this hypothesis rigorously. If an effect is found, this study will allow for the investigation of putative mechanisms to mediate this effect, including autonomic cardiovascular control and metaboreflex. ClinicalTrials.gov NCT02275377 . Registered on 30 September 2014.

Development methodology of the novel Endoscopic stone treatment step 1 (EST s1) training/assessment curriculum.

PubMed

Veneziano, Domenico; Ahmed, Kamran; Van Cleynenbreugel, Ben S E P; Gözen, Ali Serdar; Palou, Joan; Sarica, Kemal; Liatsikos, Evangelos N; Sanguedolce, Francesco; Honeck, Patrick; Alvarez-Maestro, Mario; Papatsoris, Athanasios; Kallidonis, Panagiotis; Greco, Francesco; Breda, Alberto; Somani, Bhaskar

2017-07-10

Background Simulation based technical-skill assessment is a core topic of debate, especially in high-risk environments. After the introduction of the E-BLUS exam for basic laparoscopy, no more technical training/assessment urological protocols have been developed in Europe. Objective We describe the methodology used in the development of the novel Endoscopic Stone Treatment step 1 (EST s1) assessment curriculum. Materials and Methods The "full life cycle curriculum development" template was followed for curriculum development. A CTA was run to define the most important steps and details of RIRS, in accordance with EAU Urolithiasis guidelines. Training tasks were created between April 2015 and September 2015. Tasks and metrics were further analyzed by a consensus meeting with the EULIS board in February 2016. A review, aimed to study available simulators and their accordance with task requirements, was subsequently run in London on March 2016. After initial feedback and further tests, content validity of this protocol was achieved during EUREP 2016. Results The EST s1 curriculum development, took 23 months. 72 participants tested the 5 preliminary tasks during EUREP 2015, with sessions of 45 minutes each. Likert-scale questionnaires were filled-out to score the quality of training. The protocol was modified accordingly and 25 participants tested the 4 tasks during the hands-on training sessions of the ESUT 2016 congress. 134 participants finally participated in the validation study in EUREP 2016. During the same event 10 experts confirmed content validity by filling-out a Likert-scale questionnaire. Conclusion We described a reliable and replicable methodology that can be followed to develop training/assessment protocols for surgical procedures. The expert consensus meetings, strict adherence to guidelines and updated literature search towards an Endourology curriculum allowed correct training and assessment protocol development. It is the first step towards standardized simulation training in Endourology with a potential for worldwide adoption.

Effect of two complex training protocols of back squats in blood indicators of muscular damage in military athletes

PubMed Central

Ojeda, Álvaro Huerta; Ríos, Luis Chirosa; Barrilao, Rafael Guisado; Ríos, Ignacio Chirosa; Serrano, Pablo Cáceres

2016-01-01

[Purpose] The aim of this study was to determine the variations in the blood muscular damage indicators post application of two complex training programs for back squats. [Subjects and Methods] Seven military athletes were the subjects of this study. The study had a quasi-experimental cross-over intra-subject design. Two complex training protocols were applied, and the variables to be measured were cortisol, metabolic creatine kinase, and total creatine kinase. For the statistical analysis, Student’s t-test was used. [Results] Twenty-four hours post effort, a significant decrease in cortisol level was shown for both protocols; however, the metabolic creatine kinase and total creatine kinase levels showed a significant increase. [Conclusion] Both protocols lowered the indicator of main muscular damage in the blood supply (cortisol). This proved that the work weight did not generate significant muscular damage in the 24-hour post-exercise period. PMID:27313356

Effect of two complex training protocols of back squats in blood indicators of muscular damage in military athletes.

PubMed

Ojeda, Álvaro Huerta; Ríos, Luis Chirosa; Barrilao, Rafael Guisado; Ríos, Ignacio Chirosa; Serrano, Pablo Cáceres

2016-05-01

[Purpose] The aim of this study was to determine the variations in the blood muscular damage indicators post application of two complex training programs for back squats. [Subjects and Methods] Seven military athletes were the subjects of this study. The study had a quasi-experimental cross-over intra-subject design. Two complex training protocols were applied, and the variables to be measured were cortisol, metabolic creatine kinase, and total creatine kinase. For the statistical analysis, Student's t-test was used. [Results] Twenty-four hours post effort, a significant decrease in cortisol level was shown for both protocols; however, the metabolic creatine kinase and total creatine kinase levels showed a significant increase. [Conclusion] Both protocols lowered the indicator of main muscular damage in the blood supply (cortisol). This proved that the work weight did not generate significant muscular damage in the 24-hour post-exercise period.

Energy expenditure and EPOC between water-based high-intensity interval training and moderate-intensity continuous training sessions in healthy women.

PubMed

Schaun, Gustavo Zaccaria; Pinto, Stephanie Santana; Praia, Aline Borges de Carvalho; Alberton, Cristine Lima

2018-02-05

The present study compared the energy expenditure (EE) during and after two water aerobics protocols, high-intensity interval training (HIIT) and moderate continuous training (CONT). A crossover randomized design was employed comprising 11 healthy young women. HIIT consisted of eight 20s bouts at 130% of the cadence associated with the maximal oxygen consumption (measured in the aquatic environment) with 10s passive rest. CONT corresponded to 30 min at a heart rate equivalent to 90-95% of the second ventilatory threshold. EE was measured during and 30 min before and after the protocols and excess post-exercise oxygen consumption (EPOC) was calculated. Total EE during session was higher in CONT (227.62 ± 31.69 kcal) compared to HIIT (39.91 ± 4.24 kcal), while EE per minute was greater in HIIT (9.98 ± 1.06 kcal) than in CONT (7.58 ± 1.07 kcal). Post-exercise EE (64.48 ± 3.50 vs. 63.65 ± 10.39 kcal) and EPOC (22.53 ± 4.98 vs.22.10 ± 8.00 kcal) were not different between HIIT and CONT, respectively. Additionally, oxygen uptake had already returned to baseline fifteen minutes post-exercise. These suggest that a water aerobics CONT session results in post-exercise EE and EPOC comparable to HIIT despite the latter supramaximal nature. Still, CONT results in higher total EE.

Effects of a dynamic balance training protocol on podalic support in older women. Pilot Study.

PubMed

Battaglia, Giuseppe; Bellafiore, Marianna; Bianco, Antonino; Paoli, Antonio; Palma, Antonio

2010-01-01

The foot provides the only direct contact with supporting surfaces and therefore plays an important role in all postural tasks. Changes in the musculoskeletal and neurological characteristics of the foot with advancing age can alter plantar loading patterns and postural balance. Several studies have reported that exercise training improves postural performance in elderly individuals. The aim of our study was to investigate the effectiveness of a dynamic balance training protocol performed for 5 weeks on the support surface, percentage distribution of load in both feet, and body balance performance in healthy elderly women. Ten subjects (68.67±5.50 yrs old; 28.17±3.35 BMI) were evaluated with a monopodalic performance test and baropodometric analyses before and after the training period. We found a significant improvement in balance unipedal performance times on left and right foot by 20.18% and 26.23% respectively (p<0.05). The support surface of the right foot significantly increased in response to the training protocol and, in particular, in both forefoot and rearfoot regions (p<0.05). In addition, before the training period, load distribution on the left foot was greater than on the right one; equal load redistribution was measured on both feet in response to exercise (p>0.05). The increased support surface and equal redistribution of body weight on both feet obtained in response to our training protocol may be postural adaptations sufficient to improve static balance in elderly women.

Observer Use of Standardized Observation Protocols in Consequential Observation Systems

ERIC Educational Resources Information Center

Bell, Courtney A.; Yi, Qi; Jones, Nathan D.; Lewis, Jennifer M.; McLeod, Monica; Liu, Shuangshuang

2014-01-01

Evidence from a handful of large-scale studies suggests that although observers can be trained to score reliably using observation protocols, there are concerns related to initial training and calibration activities designed to keep observers scoring accurately over time (e.g., Bell, et al, 2012; BMGF, 2012). Studies offer little insight into how…

Study on Quality of IUD Services Provided by Trained Professionals at Teaching Institutes.

PubMed

Prasad, Noopur; Jain, M L; Meena, B S

2018-06-01

Access the completeness in IUD services provided by trained professionals and find out the weak links. Study was conducted on 100 IUD trained professionals of tertiary care hospital and nursing teaching institute. All were given questionnaire that was duly filled by them. Data obtained were analysed. Protocols of case selection, pre-insertion counselling, insertion process and follow-up were assessed. All the four criteria were assessed on score of ten. Study group could not get ten points under any of the set criteria. Average of 53% case selection, 31.4% pre-insertion counselling, 42.5% insertion protocols and 46.1% follow-up counselling criteria were observed by study group. Highest compliance of protocols was seen among postgraduate students. Although IUD training is given to all medical professionals and IUD facility is available up to subcentres but the study shows that completeness in services is still lacking. Ensuring ideal place for IUD insertion, proper case selection, use of specific instruments for insertion and observance of insertion protocols are very vital for the success of IUD.

The Effects of Individualized Resistance Strength Programs on Knee Muscular Imbalances in Junior Elite Soccer Players

PubMed Central

Śliwowski, Robert; Jadczak, Łukasz; Hejna, Rafał; Wieczorek, Andrzej

2015-01-01

The purpose of this study was to investigate the effects of a resistance training program on the muscular strength of soccer players’ knees that initially presented unilateral and bilateral differences. For this study, a team of 24 male well-trained junior soccer players was divided into two strength program training groups: a Resistance Training Control Group (RTCG) composed of 10 players that did not have muscular imbalances and a Resistance Training Experimental Group (RTEG) composed of 14 players that had muscular imbalances. All players followed a resistance training program for six weeks, two times per week, during the transition period. The program of individualized strength training consisted of two parts. The first part, which was identical in terms of the choice of training loads, was intended for both training groups and contained two series of exercises including upper and lower body exercises. The second part of the program was intended only for RTEG and consisted of two additional series for the groups of muscles that had identified unilateral and bilateral differences. The applied program showed various directions in the isokinetic profile of changes. In the case of RTCG, the adaptations related mainly to the quadriceps muscle (the peak torque (PT) change for the dominant leg was statistically significant (p < 0.05)). There were statistically significant changes in RTEG (p < 0.05) related to PT for the hamstrings in both legs, which in turn resulted in an increase in the conventional hamstring/quadriceps ratio (H/Q). It is interesting that the statistically significant (p < 0.05) changes were noted only for the dominant leg. No statistically significant changes in bilateral differences (BD) were noted in either group. These results indicate that individualized resistance training programs could provide additional benefits to traditional strength training protocols to improve muscular imbalances in post-adolescent soccer players. PMID:26630271

Pressure-flow specificity of inspiratory muscle training.

PubMed

Tzelepis, G E; Vega, D L; Cohen, M E; Fulambarker, A M; Patel, K K; McCool, F D

1994-08-01

The inspiratory muscles (IM) can be trained by having a subject breathe through inspiratory resistive loads or by use of unloaded hyperpnea. These disparate training protocols are characterized by high inspiratory pressure (force) or high inspiratory flow (velocity), respectively. We tested the hypothesis that the posttraining improvements in IM pressure or flow performance are specific to training protocols in a way that is similar to force-velocity specificity of skeletal muscle training. IM training was accomplished in 15 normal subjects by use of three protocols: high inspiratory pressure-no flow (group A, n = 5), low inspiratory pressure-high flow (group B, n = 5), and intermediate inspiratory pressure and flow (group C, n = 5). A control group (n = 4) did no training. Before and after training, we measured esophageal pressure (Pes) and inspiratory flow (VI) during single maximal inspiratory efforts against a range of external resistances including an occluded airway. Efforts originated below relaxation volume (Vrel), and peak Pes and VI were measured at Vrel. Isovolume maximal Pes-VI plots were constructed to assess maximal inspiratory pressure-flow performance. Group A (pressure training) performed 30 maximal static inspiratory maneuvers at Vrel daily, group B (flow training) performed 30 sets of three maximal inspiratory maneuvers with no added external resistance daily, and group C (intermediate training) performed 30 maximal inspiratory efforts on a midrange external resistance (7 mm ID) daily. Subjects trained 5 days/wk for 6 wk. Data analysis included comparison of posttraining Pes-VI slopes among training groups.(ABSTRACT TRUNCATED AT 250 WORDS)

The implementation and evaluation of an evidence-based statewide prehospital pain management protocol developed using the national prehospital evidence-based guideline model process for emergency medical services.

PubMed

Brown, Kathleen M; Hirshon, Jon Mark; Alcorta, Richard; Weik, Tasmeen S; Lawner, Ben; Ho, Shiu; Wright, Joseph L

2014-01-01

In 2008, the National Highway Traffic Safety Administration funded the development of a model process for the development and implementation of evidence-based guidelines (EBGs) for emergency medical services (EMS). We report on the implementation and evaluation of an evidence-based prehospital pain management protocol developed using this model process. An evidence-based protocol for prehospital management of pain resulting from injuries and burns was reviewed by the Protocol Review Committee (PRC) of the Maryland Institute for Emergency Medical Services Systems (MIEMSS). The PRC recommended revisions to the Maryland protocol that reflected recommendations in the EBG: weight-based dosing and repeat dosing of morphine. A training curriculum was developed and implemented using Maryland's online Learning Management System and successfully accessed by 3,941 paramedics and 15,969 BLS providers. Field providers submitted electronic patient care reports to the MIEMSS statewide prehospital database. Inclusion criteria were injured or burned patients transported by Maryland ambulances to Maryland hospitals whose electronic patient care records included data for level of EMS provider training during a 12-month preimplementation period and a 12-month postimplementation period from September 2010 through March 2012. We compared the percentage of patients receiving pain scale assessments and morphine, as well as the dose of morphine administered and the use of naloxone as a rescue medication for opiate use, before and after the protocol change. No differences were seen in the percentage of patients who had a pain score documented or the percent of patients receiving morphine before and after the protocol change, but there was a significant increase in the total dose and dose in mg/kg administered per patient. During the postintervention phase, patients received an 18% higher total morphine dose and a 14.9% greater mg/kg dose. We demonstrated that the implementation of a revised statewide prehospital pain management protocol based on an EBG developed using the National Prehospital Evidence-based Guideline Model Process was associated with an increase in dosing of narcotic pain medication consistent with that recommended by the EBG. No differences were seen in the percentage of patients receiving opiate analgesia or in the documentation of pain scores.

Impact of high- and low-intensity targeted exercise training on the type of substrate utilization in obese boys submitted to a hypocaloric diet.

PubMed

Brandou, F; Savy-Pacaux, A M; Marie, J; Bauloz, M; Maret-Fleuret, I; Borrocoso, S; Mercier, J; Brun, J F

2005-09-01

We assessed the effect of two programs combining a hypocaloric diet with low-intensity (LI) or high-intensity (HI) exercise training, during two months, on substrate utilization at exercise in obese children. Fifteen obese boys participated in a combined program of exercise and caloric restriction-induced weight loss (diet starting two weeks before the training program). The maximal fat oxidation point (Lipox max) was determined to individualize exercise training. Training consisted of cycling at either LI (Lipox max) for seven children or HI (Lipoxmax+40% Lipox max) for eight children. All children exhibited a decrease in weight (LI: -5.2 kg +/- 0.7 (P<0.01), HI: -7 kg +/- 0.7 (P<0.01)). While in the LI group, both fat and CHO oxidation were unchanged after training, HI group oxidize less fat and more CHO after training when exercising at 20% and 30% Wmax th (P = 0.02). While a LI exercise training program maintains (but does not improve) the ability to oxidize fat at exercise, HI training actually shifts towards CHO the balance of substrate oxidation during exercise. Thus, a low intensity training protocol seems to counteract to some extent the decline in lipid oxidation at exercise that occurs after a hypocaloric diet, and is thus likely to be synergistic to diet in the weight lowering strategy.

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.

Optimal timing of pulse onset for language mapping with navigated repetitive transcranial magnetic stimulation.

PubMed

Krieg, Sandro M; Tarapore, Phiroz E; Picht, Thomas; Tanigawa, Noriko; Houde, John; Sollmann, Nico; Meyer, Bernhard; Vajkoczy, Peter; Berger, Mitchel S; Ringel, Florian; Nagarajan, Srikantan

2014-10-15

Within the primary motor cortex, navigated transcranial magnetic stimulation (nTMS) has been shown to yield maps strongly correlated with those generated by direct cortical stimulation (DCS). However, the stimulation parameters for repetitive nTMS (rTMS)-based language mapping are still being refined. For this purpose, the present study compares two rTMS protocols, which differ in the timing of pulse train onset relative to picture presentation onset during object naming. Results were the correlated with DCS language mapping during awake surgery. Thirty-two patients with left-sided perisylvian tumors were examined by rTMS prior to awake surgery. Twenty patients underwent rTMS pulse trains starting at 300 ms after picture presentation onset (delayed TMS), whereas another 12 patients received rTMS pulse trains starting at the picture presentation onset (ONSET TMS). These rTMS results were then evaluated for correlation with intraoperative DCS results as gold standard in terms of differential consistencies in receiver operating characteristics (ROC) statistics. Logistic regression analysis by protocols and brain regions were conducted. Within and around Broca's area, there was no difference in sensitivity (onset TMS: 100%, delayed TMS: 100%), negative predictive value (NPV) (onset TMS: 100%, delayed TMS: 100%), and positive predictive value (PPV) (onset TMS: 55%, delayed TMS: 54%) between the two protocols compared to DCS. However, specificity differed significantly (onset TMS: 67%, delayed TMS: 28%). In contrast, for posterior language regions, such as supramarginal gyrus, angular gyrus, and posterior superior temporal gyrus, early pulse train onset stimulation showed greater specificity (onset TMS: 92%, delayed TMS: 20%), NPV (onset TMS: 92%, delayed TMS: 57%) and PPV (onset TMS: 75%, delayed TMS: 30%) with comparable sensitivity (onset TMS: 75%, delayed TMS: 70%). Logistic regression analysis also confirmed the greater fit of the predictions by rTMS that had the pulse train onset coincident with the picture presentation onset when compared to the delayed stimulation. Analyses of differential disruption patterns of mapped cortical regions were further able to distinguish clusters of cortical regions standardly associated with semantic and pre-vocalization phonological networks proposed in various models of word production. Repetitive nTMS predictions by both protocols correlate well with DCS outcomes especially in Broca's region, particularly with regard to TMS negative predictions. With this study, we have demonstrated that rTMS stimulation onset coincident with picture presentation onset improves the accuracy of preoperative language maps, particularly within posterior language areas. Moreover, immediate and delayed pulse train onsets may have complementary disruption patterns that could differentially capture cortical regions causally necessary for semantic and pre-vocalization phonological networks. Published by Elsevier Inc.

Impact of exercise on fecal and cecal metabolome over aging: a longitudinal study in rats.

PubMed

Deda, Olga; Gika, Helen; Panagoulis, Theodoros; Taitzoglou, Ioannis; Raikos, Nikolaos; Theodoridis, Georgios

2017-01-01

Physical exercise can reduce adverse conditions during aging, while both exercise and aging act as metabolism modifiers. The present study investigates rat fecal and cecal metabolome alterations derived from exercise during rats' lifespan. Groups of rats trained life-long or for a specific period of time were under study. The training protocol consisted of swimming, 15-18 min per day, 3-5 days per week, with load of 4-0% of rat's weight. Fecal samples and cecal extracts were analyzed by targeted and untargeted metabolic profiling methods (GC-MS and LC-MS/MS). Effects of exercise and aging on the rats' fecal and cecal metabolome were observed. Fecal and cecal metabolomics are a promising field to investigate exercise biochemistry and age-related alterations.

Exercise counteracts fatty liver disease in rats fed on fructose-rich diet

PubMed Central

2010-01-01

Background This study aimed to analyze the effects of exercise at the aerobic/anaerobic transition on the markers of non-alcoholic fatty liver disease (NAFLD), insulin sensitivity and the blood chemistry of rats kept on a fructose-rich diet. Methods We separated 48 Wistar rats into two groups according to diet: a control group (balanced diet AIN-93 G) and a fructose-rich diet group (60% fructose). The animals were tested for maximal lactate-steady state (MLSS) in order to identify the aerobic/anaerobic metabolic transition during swimming exercises at 28 and 90 days of age. One third of the animals of each group were submitted to swimming training at an intensity equivalent to the individual MLSS for 1 hours/day, 5 days/week from 28 to 120 days (early protocol). Another third were submitted to the training from 90 to 120 days (late protocol), and the others remained sedentary. The main assays performed included an insulin tolerance test (ITT) and tests of serum alanine aminotransferase [ALT] and aspartate aminotransferase [AST] activities, serum triglyceride concentrations [TG] and liver total lipid concentrations. Results The fructose-fed rats showed decreased insulin sensitivity, and the late-exercise training protocol counteracted this alteration. There was no difference between the groups in levels of serum ALT, whereas AST and liver lipids increased in the fructose-fed sedentary group when compared with the other groups. Serum triglycerides concentrations were higher in the fructose-fed trained groups when compared with the corresponding control group. Conclusions The late-training protocol was effective in restoring insulin sensitivity to acceptable standards. Considering the markers here evaluated, both training protocols were successful in preventing the emergence of non-alcoholic fatty liver status disease. PMID:20946638

An isokinetic training program for reducing falls in a community-dwelling older adult: a case report.

PubMed

Beebe, Justin A; Hines, Roger W; McDaniel, Laura T; Shelden, Brenda L

2013-01-01

With the population older than 65 years, projected to double by the year 2030, falls in older adults are a substantial health concern. Muscle strength deficits are one of the multifactorial components linked to increased fall risk, and decreasing these deficits has been one of the goals of interventions designed to decrease fall risk. These interventions have traditionally focused on improving peak torque; however, recent research suggests that exercise protocols that focus on the rate of torque development (RTD) may be more effective in decreasing fall risk. This case report examines clinical outcomes following implementation of an isokinetic strengthening protocol coupled with a balance program designed to reduce fall risk in a community-dwelling older adult. The individual was a 70-year-old woman with a history of 3 falls over the past 8 months and no related medical etiology who had self-limited her activities because of fear of another fall. She was classified as having substantial risk for future falls because of fall history, increased fear of falling, and below age norms on the Berg Balance Scale (BBS), and the Timed Up and Go (TUG). The treatment program consisted of 12 weeks of high-intensity isokinetic knee extensor training, high challenge dynamic gait and balance activities, and core strengthening. The isokinetic protocol consisted of 4 sets of 10 concentric-only repetitions at speeds of 240°/sec and 300°/sec for a total of 8 work sets. Dynamic gait activities incorporating directional and obstacle drills, and rocker and balance boards were used for balance training activities. Progressive theraband exercises were used for core strengthening. As her home program, the participant was encouraged to return to line dancing twice per week. During the 12-week protocol, the participant completed two 90-minute therapy sessions and two 90-minute dance classes per week. After the 12 weeks of treatment, knee extensor peak torque at 150 ms improved on the right from 67.8 N to 107.1 N (57.9% increase), and on the left from 65.1 N to 97.6 N (49.9% increase). The BBS score improved from 45 to 52; and the TUG improved from 14.0 to 8.6 seconds. Both final scores exceeded fall risk cutoffs (BBS = 48; TUG = 13.5 seconds) and the change score exceeded minimal detectable change (BBS = 7; TUG 5.4 seconds). The treatment program produced improvements in knee extensor peak torque and RTD, but more importantly, the final scores on the clinical outcome measures placed the participant above established fall-risk cutoff scores. Although future research with increased numbers of participants and a control group should be conducted to confirm this study's results, these findings support the use of isokinetic training to reduce fall risk in older adults.

Neurofeedback training improves attention and working memory performance.

PubMed

Wang, Jinn-Rong; Hsieh, Shulan

2013-12-01

The present study aimed to investigate the effectiveness of the frontal-midline theta (fmθ) activity uptraining protocol on attention and working memory performance of older and younger participants. Thirty-two participants were recruited. Participants within each age group were randomly assigned to either the neurofeedback training (fmθ uptraining) group or the sham-neurofeedback training group. There was a significant improvement in orienting scores in the older neurofeedback training group. In addition, there was a significant improvement in conflict scores in both the older and young neurofeedback training groups. However, alerting scores failed to increase. In addition, the fmθ training was found to improve working memory function in the older participants. The results further showed that fmθ training can modulate resting EEG for both neurofeedback groups. Our study demonstrated that fmθ uptraining improved attention and working memory performance and theta activity in the resting state for normal aging adults. In addition, younger participants also benefited from the present protocol in terms of improving their executive function. The current findings contribute to a better understanding of the mechanisms underlying neurofeedback training in cognitive function, and suggest that the fmθ uptraining protocol is an effective intervention program for cognitive aging. Copyright © 2013 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

Stable, Long-Term, Spatial Memory in Young and Aged Rats Achieved with a One Day Morris Water Maze Training Protocol

ERIC Educational Resources Information Center

Barrientos, Ruth M.; Kitt, Meagan M.; D'Angelo, Heather M.; Watkins, Linda R.; Rudy, Jerry W.; Maier, Steven F.

2016-01-01

Here, we present data demonstrating that a 1 d Morris water maze training protocol is effective at producing stable, long-term spatial memory in both young (3 mo old) and aged (24 mo old) F344xBN rats. Four trials in each of four sessions separated by a 2.5 h ISI produced robust selective search for the platform 1 and 4 d after training, in both…

Towards Using Microstate-Neurofeedback for the Treatment of Psychotic Symptoms in Schizophrenia. A Feasibility Study in Healthy Participants.

PubMed

Diaz Hernandez, Laura; Rieger, Kathryn; Baenninger, Anja; Brandeis, Daniel; Koenig, Thomas

2016-03-01

Spontaneous EEG signal can be parsed into sub-second periods of stable functional states (microstates) that assumingly correspond to brief large scale synchronization events. In schizophrenia, a specific class of microstate (class "D") has been found to be shorter than in healthy controls and to be correlated with positive symptoms. To explore potential new treatment options in schizophrenia, we tested in healthy controls if neurofeedback training to self-regulate microstate D presence is feasible and what learning patterns are observed. Twenty subjects underwent EEG-neurofeedback training to up-regulate microstate D presence. The protocol included 20 training sessions, consisting of baseline trials (resting state), regulation trials with auditory feedback contingent on microstate D presence, and a transfer trial. Response to neurofeedback was assessed with mixed effects modelling. All participants increased the percentage of time spent producing microstate D in at least one of the three conditions (p < 0.05). Significant between-subjects across-sessions results showed an increase of 0.42 % of time spent producing microstate D in baseline (reflecting a sustained change in the resting state), 1.93 % of increase during regulation and 1.83 % during transfer. Within-session analysis (performed in baseline and regulation trials only) showed a significant 1.65 % increase in baseline and 0.53 % increase in regulation. These values are in a range that is expected to have an impact upon psychotic experiences. Additionally, we found a negative correlation between alpha power and microstate D contribution during neurofeedback training. Given that microstate D has been related to attentional processes, this result provides further evidence that the training was to some degree specific for the attentional network. We conclude that microstate-neurofeedback training proved feasible in healthy subjects. The implementation of the same protocol in schizophrenia patients may promote skills useful to reduce positive symptoms by means of EEG-neurofeedback.

Pre-exercise β-hydroxy-β-methylbutyrate free-acid supplementation improves work capacity recovery: a randomized, double-blinded, placebo-controlled study.

PubMed

Correia, Ana Luiza Matias; de Lima, Filipe Dinato; Bottaro, Martim; Vieira, Amilton; da Fonseca, Andrew Correa; Lima, Ricardo M

2018-02-08

The purpose of this study was to investigate the effects of a single-dose of β-hydroxy-β-methylbutyrate free acid (HMB-FA) supplementation on muscle recovery after a high-intensity exercise bout. Twenty-three trained young males were randomly assigned to receive either a single-dose supplementation of 3g of HMB-FA (n = 12; age 22.8 ± 3.0 years) or placebo (PLA; n = 11; age 22.9 ± 3.1 years). A muscle damage protocol was applied 60 minutes after supplementation, and consisted of seven sets of 20 drop jumps from a 60-cm box with 2-min rest intervals between sets. Muscle swelling, countermovement jump (CMJ), maximal voluntary isometric torque (MVIT) and work capacity (WC) were measured before, immediately after, 24, 48 and 72 hours after the exercise protocol. Muscle swelling, CMJ and MVIT changed similarly in both groups after the exercise protocol (p < 0.001), but returned to pre-exercise levels after 24 hours in both groups. WC decreased similarly in both groups after the exercise protocol (p < 0.01). For HMB-FA, WC returned to pre-exercise level 24 hours after exercise protocol. However, on PLA, WC did not return to pre-exercise level even 72 hours after the exercise protocol. In summary, a single-dose of HMB-FA supplementation improved WC recovery after a high-intensity exercise bout. However, HMB-FA did not affect the time-course of muscle swelling, MVIT and CMJ recovery.

Importance of Standardized DXA Protocol for Assessing Physique Changes in Athletes.

PubMed

Nana, Alisa; Slater, Gary J; Hopkins, Will G; Halson, Shona L; Martin, David T; West, Nicholas P; Burke, Louise M

2016-06-01

The implications of undertaking DXA scans using best practice protocols (subjects fasted and rested) or a less precise but more practical protocol in assessing chronic changes in body composition following training and a specialized recovery technique were investigated. Twenty-one male cyclists completed an overload training program, in which they were randomized to four sessions per week of either cold water immersion therapy or control groups. Whole-body DXA scans were undertaken with best practice protocol (Best) or random activity protocol (Random) at baseline, after 3 weeks of overload training, and after a 2-week taper. Magnitudes of changes in total, lean and fat mass from baseline-overload, overload-taper and baseline-taper were assessed by standardization (Δmean/SD). The standard deviations of change scores for total and fat-free soft tissue mass (FFST) from Random scans (2-3%) were approximately double those observed in the Best (1-2%), owing to extra random errors associated with Random scans at baseline. There was little difference in change scores for fat mass. The effect of cold water immersion therapy on baseline-taper changes in FFST was possibly harmful (-0.7%; 90% confidence limits ±1.2%) with Best scans but unclear with Random scans (0.9%; ±2.0%). Both protocols gave similar possibly harmful effects of cold water immersion therapy on changes in fat mass (6.9%; ±13.5% and 5.5%; ±14.3%, respectively). An interesting effect of cold water immersion therapy on training-induced changes in body composition might have been missed with a less precise scanning protocol. DXA scans should be undertaken with Best.

High-intensity interval training evokes larger serum BDNF levels compared with intense continuous exercise.

PubMed

Saucedo Marquez, Cinthia Maria; Vanaudenaerde, Bart; Troosters, Thierry; Wenderoth, Nicole

2015-12-15

Exercise can have a positive effect on the brain by activating brain-derived neurotrophic factor (BDNF)-related processes. In healthy humans there appears to be a linear relationship between exercise intensity and the positive short-term effect of acute exercise on BDNF levels (i.e., the highest BDNF levels are reported after high-intensity exercise protocols). Here we performed two experiments to test the effectiveness of two high-intensity exercise protocols, both known to improve cardiovascular health, to determine whether they have a similar efficacy in affecting BDNF levels. Participants performed a continuous exercise (CON) protocol at 70% of maximal work rate and a high-intensity interval-training (HIT) protocol at 90% of maximal work rate for periods of 1 min alternating with 1 min of rest (both protocols lasted 20 min). We observed similar BDNF kinetics in both protocols, with maximal BDNF concentrations being reached toward the end of training (experiment 1). We then showed that both exercise protocols significantly increase BDNF levels compared with a rest condition (CON P = 0.04; HIT P < 0.001), with HIT reaching higher BDNF levels than CON (P = 0.035) (experiment 2). These results suggest that shorter bouts of high intensity exercise are slightly more effective than continuous high-intensity exercise for elevating serum BDNF. Additionally, 73% of the participants preferred the HIT protocol (P = 0.02). Therefore, we suggest that the HIT protocol might represent an effective and preferred intervention for elevating BDNF levels and potentially promoting brain health. Copyright © 2015 the American Physiological Society.

Elbow joint position sense after neuromuscular training with handheld vibration.

PubMed

Tripp, Brady L; Faust, Donald; Jacobs, Patrick

2009-01-01

Clinicians use neuromuscular control exercises to enhance joint position sense (JPS); however, because standardizing such exercises is difficult, validations of their use are limited. To evaluate the acute effects of a neuromuscular training exercise with a handheld vibrating dumbbell on elbow JPS acuity. Crossover study. University athletic training research laboratory. Thirty-one healthy, college-aged volunteers (16 men, 15 women, age = 23 + or - 3 years, height = 173 + or - 8 cm, mass = 76 + or - 14 kg). We measured and trained elbow JPS using an electromagnetic tracking device that provided auditory and visual biofeedback. For JPS testing, participants held a dumbbell and actively identified the target elbow flexion angle (90 degrees ) using the software-generated biofeedback, followed by 3 repositioning trials without feedback. Each neuromuscular training protocol included 3 exercises during which participants held a 2.55-kg dumbbell vibrating at 15, 5, or 0 Hz and used software-generated biofeedback to locate and maintain the target elbow flexion angle for 15 seconds. We calculated absolute (accuracy) and variable (variability) errors using the differences between target and reproduced angles. Training protocols using 15-Hz vibration enhanced accuracy and decreased variability of elbow JPS (P < or = .005), whereas 5-Hz vibration did not affect accuracy (F(1,61) = 2.625, P = .100) but did decrease variability (F(1,61) = 7.250, P = .009). The control condition and 0-Hz training protocol had no effect on accuracy or variability (P > or = .200). Our results suggest these neuromuscular control exercises, which included low-magnitude, low-frequency handheld vibration, may enhance elbow JPS. Future researchers should examine vibration of various durations and frequencies, should include injured participants and functional multijoint and multiplanar measures, and should examine long-term effects of training protocols on JPS and injury.

Balance Training Programs in Athletes – a Systematic Review

PubMed Central

Brachman, Anna; Kamieniarz, Anna; Michalska, Justyna; Pawłowski, Michał; Słomka, Kajetan J.; Juras, Grzegorz

2017-01-01

Abstract It has become almost routine practice to incorporate balance exercises into training programs for athletes from different sports. However, the type of training that is most efficient remains unclear, as well as the frequency, intensity and duration of the exercise that would be most beneficial have not yet been determined. The following review is based on papers that were found through computerized searches of PubMed and SportDiscus from 2000 to 2016. Articles related to balance training, testing, and injury prevention in young healthy athletes were considered. Based on a Boolean search strategy the independent researchers performed a literature review. A total of 2395 articles were evaluated, yet only 50 studies met the inclusion criteria. In most of the reviewed articles, balance training has proven to be an effective tool for the improvement of postural control. It is difficult to establish one model of training that would be appropriate for each sport discipline, including its characteristics and demands. The main aim of this review was to identify a training protocol based on most commonly used interventions that led to improvements in balance. Our choice was specifically established on the assessment of the effects of balance training on postural control and injury prevention as well as balance training methods. The analyses including papers in which training protocols demonstrated positive effects on balance performance suggest that an efficient training protocol should last for 8 weeks, with a frequency of two training sessions per week, and a single training session of 45 min. This standard was established based on 36 reviewed studies. PMID:28828077

Effects of Menstrual Phase-Dependent Resistance Training Frequency on Muscular Hypertrophy and Strength.

PubMed

Sakamaki-Sunaga, Mikako; Min, Seokki; Kamemoto, Kayoko; Okamoto, Takanobu

2016-06-01

The present study investigated how different training frequencies during menstrual phases affect muscle hypertrophy and strength. Fourteen eumenorrheic women performed 3 sets of arm curls (8-15 repetitions) until failure for 12 weeks. Depending on the menstrual cycle phase, each subject trained each arm separately after either a 3- or a 1-d·wk training protocol during the follicular phase (FP-T) and a 3- or 1-d·wk training protocol during the luteal phase (LP-T). Cross-sectional area (CSA), 1 repetition maximum, and maximum voluntary contraction significantly increased 6.2 ± 4.4, 36.4 ± 11.9, and 16.7 ± 5.6%, respectively (p ≤ 0.05 vs. before training), in the FP-T group and 7.8 ± 4.2, 31.8 ± 14.1, and 14.9 ± 12.7%, respectively (p ≤ 0.05 vs. before training), in the LP-T group. Changes in CSA between the FP-T and the LP-T groups significantly and positively correlated (r = 0.54, p ≤ 0.05). There were no major differences among the different training protocols with regard to muscle hypertrophy and strength. Therefore, we suggest that variations in female hormones induced by the menstrual cycle phases do not significantly contribute to muscle hypertrophy and strength gains during 12 weeks of resistance training.

High-intensity interval training versus moderate-intensity steady-state training in UK cardiac rehabilitation programmes (HIIT or MISS UK): study protocol for a multicentre randomised controlled trial and economic evaluation.

PubMed

McGregor, Gordon; Nichols, Simon; Hamborg, Thomas; Bryning, Lucy; Tudor-Edwards, Rhiannon; Markland, David; Mercer, Jenny; Birkett, Stefan; Ennis, Stuart; Powell, Richard; Begg, Brian; Haykowsky, Mark J; Banerjee, Prithwish; Ingle, Lee; Shave, Rob; Backx, Karianne

2016-11-16

Current international guidelines for cardiac rehabilitation (CR) advocate moderate-intensity exercise training (MISS, moderate-intensity steady state). This recommendation predates significant advances in medical therapy for coronary heart disease (CHD) and may not be the most appropriate strategy for the 'modern' patient with CHD. High-intensity interval training (HIIT) appears to be a safe and effective alternative, resulting in greater improvements in peak oxygen uptake (VO 2 peak ). To date, HIIT trials have predominantly been proof-of-concept studies in the laboratory setting and conducted outside the UK. The purpose of this multicentre randomised controlled trial is to compare the effects of HIIT and MISS training in patients with CHD attending UK CR programmes. This pragmatic study will randomly allocate 510 patients with CHD to 8 weeks of twice weekly HIIT or MISS training at 3 centres in the UK. HIIT will consist of 10 high-intensity (85-90% peak power output (PPO)) and 10 low-intensity (20-25% PPO) intervals, each lasting 1 min. MISS training will follow usual care recommendations, adhering to currently accepted UK guidelines (ie, >20 min continuous exercise at 40-70% heart rate reserve). Outcome measures will be assessed at baseline, 8 weeks and 12 months. The primary outcome for the trial will be change in VO 2 peak as determined by maximal cardiopulmonary exercise testing. Secondary measures will assess physiological, psychosocial and economic outcomes. The study protocol V.1.0, dated 1 February 2016, was approved by the NHS Health Research Authority, East Midlands-Leicester South Research Ethics Committee (16/EM/0079). Recruitment will start in August 2016 and will be completed in June 2018. Results will be published in peer-reviewed journals, presented at national and international scientific meetings and are expected to inform future national guidelines for exercise training in UK CR. NCT02784873; pre-results. 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/.

High-intensity interval training versus moderate-intensity steady-state training in UK cardiac rehabilitation programmes (HIIT or MISS UK): study protocol for a multicentre randomised controlled trial and economic evaluation

PubMed Central

McGregor, Gordon; Nichols, Simon; Hamborg, Thomas; Bryning, Lucy; Tudor-Edwards, Rhiannon; Markland, David; Mercer, Jenny; Birkett, Stefan; Ennis, Stuart; Powell, Richard; Begg, Brian; Haykowsky, Mark J; Banerjee, Prithwish; Ingle, Lee; Shave, Rob; Backx, Karianne

2016-01-01

Introduction Current international guidelines for cardiac rehabilitation (CR) advocate moderate-intensity exercise training (MISS, moderate-intensity steady state). This recommendation predates significant advances in medical therapy for coronary heart disease (CHD) and may not be the most appropriate strategy for the ‘modern’ patient with CHD. High-intensity interval training (HIIT) appears to be a safe and effective alternative, resulting in greater improvements in peak oxygen uptake (VO2 peak). To date, HIIT trials have predominantly been proof-of-concept studies in the laboratory setting and conducted outside the UK. The purpose of this multicentre randomised controlled trial is to compare the effects of HIIT and MISS training in patients with CHD attending UK CR programmes. Methods and analysis This pragmatic study will randomly allocate 510 patients with CHD to 8 weeks of twice weekly HIIT or MISS training at 3 centres in the UK. HIIT will consist of 10 high-intensity (85–90% peak power output (PPO)) and 10 low-intensity (20–25% PPO) intervals, each lasting 1 min. MISS training will follow usual care recommendations, adhering to currently accepted UK guidelines (ie, >20 min continuous exercise at 40–70% heart rate reserve). Outcome measures will be assessed at baseline, 8 weeks and 12 months. The primary outcome for the trial will be change in VO2 peak as determined by maximal cardiopulmonary exercise testing. Secondary measures will assess physiological, psychosocial and economic outcomes. Ethics and dissemination The study protocol V.1.0, dated 1 February 2016, was approved by the NHS Health Research Authority, East Midlands—Leicester South Research Ethics Committee (16/EM/0079). Recruitment will start in August 2016 and will be completed in June 2018. Results will be published in peer-reviewed journals, presented at national and international scientific meetings and are expected to inform future national guidelines for exercise training in UK CR. Trial registration number NCT02784873; pre-results. PMID:27852718

A new rapid kindling variant for induction of cortical epileptogenesis in freely moving rats

PubMed Central

Morales, Juan Carlos; Álvarez-Ferradas, Carla; Roncagliolo, Manuel; Fuenzalida, Marco; Wellmann, Mario; Nualart, Francisco Javier; Bonansco, Christian

2014-01-01

Kindling, one of the most used models of experimental epilepsy is based on daily electrical stimulation in several brain structures. Unlike the classic or slow kindling protocols (SK), the rapid kindling types (RK) described until now require continuous stimulation at suprathreshold intensities applied directly to the same brain structure used for subsequent electrophysiological and immunohistochemical studies, usually the hippocampus. However, the cellular changes observed in these rapid protocols, such as astrogliosis and neuronal loss, could be due to experimental manipulation more than to epileptogenesis-related alterations. Here, we developed a new RK protocol in order to generate an improved model of temporal lobe epilepsy (TLE) which allows gradual progression of the epilepsy as well as obtaining an epileptic hippocampus, thus avoiding direct surgical manipulation and electric stimulation over this structure. This new protocol consists of basolateral amygdala (BLA) stimulation with 10 trains of biphasic pulses (10 s; 50 Hz) per day with 20 min-intervals, during 3 consecutive days, using a subconvulsive and subthreshold intensity, which guarantees tissue integrity. The progression of epileptic activity was evaluated in freely moving rats through electroencephalographic (EEG) recordings from cortex and amygdala, accompanied with synchronized video recordings. Moreover, we assessed the effectiveness of RK protocol and the establishment of epilepsy by evaluating cellular alterations of hippocampal slices from kindled rats. RK protocol induced convulsive states similar to SK protocols but in 3 days, with persistently lowered threshold to seizure induction and epileptogenic-dependent cellular changes in amygdala projection areas. We concluded that this novel RK protocol introduces a new variant of the chronic epileptogenesis models in freely moving rats, which is faster, highly reproducible and causes minimum cell damage with respect to that observed in other experimental models of epilepsy. PMID:25100948

A new rapid kindling variant for induction of cortical epileptogenesis in freely moving rats.

PubMed

Morales, Juan Carlos; Alvarez-Ferradas, Carla; Roncagliolo, Manuel; Fuenzalida, Marco; Wellmann, Mario; Nualart, Francisco Javier; Bonansco, Christian

2014-01-01

Kindling, one of the most used models of experimental epilepsy is based on daily electrical stimulation in several brain structures. Unlike the classic or slow kindling protocols (SK), the rapid kindling types (RK) described until now require continuous stimulation at suprathreshold intensities applied directly to the same brain structure used for subsequent electrophysiological and immunohistochemical studies, usually the hippocampus. However, the cellular changes observed in these rapid protocols, such as astrogliosis and neuronal loss, could be due to experimental manipulation more than to epileptogenesis-related alterations. Here, we developed a new RK protocol in order to generate an improved model of temporal lobe epilepsy (TLE) which allows gradual progression of the epilepsy as well as obtaining an epileptic hippocampus, thus avoiding direct surgical manipulation and electric stimulation over this structure. This new protocol consists of basolateral amygdala (BLA) stimulation with 10 trains of biphasic pulses (10 s; 50 Hz) per day with 20 min-intervals, during 3 consecutive days, using a subconvulsive and subthreshold intensity, which guarantees tissue integrity. The progression of epileptic activity was evaluated in freely moving rats through electroencephalographic (EEG) recordings from cortex and amygdala, accompanied with synchronized video recordings. Moreover, we assessed the effectiveness of RK protocol and the establishment of epilepsy by evaluating cellular alterations of hippocampal slices from kindled rats. RK protocol induced convulsive states similar to SK protocols but in 3 days, with persistently lowered threshold to seizure induction and epileptogenic-dependent cellular changes in amygdala projection areas. We concluded that this novel RK protocol introduces a new variant of the chronic epileptogenesis models in freely moving rats, which is faster, highly reproducible and causes minimum cell damage with respect to that observed in other experimental models of epilepsy.

A Randomized Trial Comparing Two Tongue-Pressure Resistance Training Protocols for Post-Stroke Dysphagia.

PubMed

Steele, Catriona M; Bayley, Mark T; Peladeau-Pigeon, Melanie; Nagy, Ahmed; Namasivayam, Ashwini M; Stokely, Shauna L; Wolkin, Talia

2016-06-01

The objective of this study was to compare the outcomes of two tongue resistance training protocols. One protocol ("tongue-pressure profile training") emphasized the pressure-timing patterns that are typically seen in healthy swallows by focusing on gradual pressure release and saliva swallowing tasks. The second protocol ("tongue-pressure strength and accuracy training") emphasized strength and accuracy in tongue-palate pressure generation and did not include swallowing tasks. A prospective, randomized, parallel allocation trial was conducted. Of 26 participants who were screened for eligibility, 14 received up to 24 sessions of treatment. Outcome measures of posterior tongue strength, oral bolus control, penetration-aspiration and vallecular residue were made based on videofluoroscopy analysis by blinded raters. Complete data were available for 11 participants. Significant improvements were seen in tongue strength and post-swallow vallecular residue with thin liquids, regardless of treatment condition. Stage transition duration (a measure of the duration of the bolus presence in the pharynx prior to swallow initiation, which had been chosen to capture impairments in oral bolus control) showed no significant differences. Similarly, significant improvements were not seen in median scores on the penetration-aspiration scale. This trial suggests that tongue strength can be improved with resistance training for individuals with tongue weakness following stroke. We conclude that improved penetration-aspiration does not necessarily accompany improvements in tongue strength; however, tongue-pressure resistance training does appear to be effective for reducing thin liquid vallecular residue.

Effect of long-term exercise training on blood viscosity during endurance exercise at an anaerobic threshold intensity.

PubMed

Adachi, H; Sakurai, S; Tanehata, M; Oshima, S; Taniguchi, K

2000-11-01

Blood viscosity (etaB) is low in athletes, but the effect of exercise training on etaB during endurance exercise at an anaerobic threshold (AT) intensity in non-athletes is not well known, although it is known that exercise training sometimes induces the hyperviscosity syndrome. Fourteen subjects were recruited and divided into 2 groups: those who trained at an AT intensity for 30 min/day, 3 times weekly for 1 year (Group T, n=8), and sedentary subjects (Group C, n=6). The test protocol consisted of a single 30-min treadmill exercise at each individual's AT intensity, which was determined in advance. The etaB, plasma viscosity (etaP), and hematocrit were measured just before and at the end of the treadmill exercise. The subjects were not allowed to drink any water before exercise. In the Group C subjects, the hematocrit and etaP increased significantly and the etaB tended to increase. However, in the Group T subjects, the hematocrit and etaP did not increase and the etaB decreased significantly. These data indicate that long-term exercise training attenuates the increase in blood viscosity during exercise.

The effectiveness of whole-body-vibration training in improving hamstring flexibility in physically active adults.

PubMed

Houston, Megan N; Hodson, Victoria E; Adams, Kelda K E; Hoch, Johanna M

2015-02-01

Hamstring tightness is common among physically active individuals. In addition to limiting range of motion and increasing the risk of muscle strain, hamstring tightness contributes to a variety of orthopedic conditions. Therefore, clinicians continue to identify effective methods to increase flexibility. Although hamstring tightness is typically treated with common stretching techniques such as static stretching and proprioceptive neuromuscular facilitation, it has been suggested that whole-body-vibration (WBV) training may improve hamstring flexibility. Can WBV training, used in isolation or in combination with common stretching protocols or exercise, improve hamstring flexibility in physically active young adults? Summary of Key Findings: Of the included studies, 4 demonstrated statistically significant improvements in hamstring flexibility in the intervention group, and 1 study found minor improvements over time in the intervention group after treatment. Clinical Bottom Line: There is moderate evidence to support the use of WBV training to improve hamstring flexibility in physically active young adults. There is grade B evidence that WBV training improves hamstring flexibility in physically active adults. The Centre of Evidence Based Medicine recommends a grade of B for level 2 evidence with consistent findings.

Physiological, Perceptual, and Affective Responses to Six High-Intensity Interval Training Protocols.

PubMed

Follador, Lucio; Alves, Ragami C; Ferreira, Sandro Dos S; Buzzachera, Cosme F; Andrade, Vinicius F Dos S; Garcia, Erick D S de A; Osiecki, Raul; Barbosa, Sara C; de Oliveira, Letícia M; da Silva, Sergio G

2018-04-01

This study examined the extent to which different high-intensity interval training (HIIT) and sprint interval training (SIT) protocols could influence psychophysiological responses in moderately active young men. Fourteen participants completed, in a randomized order, three cycling protocols (SIT: 4 × 30-second all-out sprints; Tabata: 7 × 20 seconds at 170% ⋮O 2max ; and HIIT: 10 × 60 seconds at 90% HR max ) and three running HIIT protocols (4 × 4 minutes at 90%-95% HR max , 5 × at v⋮O 2max , and 4 × 1,000 meters at a rating of perceived exertion (RPE) of 8, from the OMNI-Walk/Run scale). Oxygen uptake (⋮O 2 ), heart rate, and RPE were recorded during each interval. Affective responses were assessed before and after each trial. The Tabata protocol elicited the highest ⋮O 2 and RPE responses, and the least pleasant session-affect among the cycling trials. The v⋮O 2max elicited the highest ⋮O 2 and RPE responses and the lowest mean session-affect among the running trials. Findings highlight the limited application of SIT and some HIIT protocols to individuals with low fitness levels.

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

PubMed

Berryman, Nicolas; Mujika, Inigo; Bosquet, Laurent

2018-05-29

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

High-impact exercise in rats prior to and during suspension can prevent bone loss

PubMed Central

Yanagihara, G.R.; Paiva, A.G.; Gasparini, G.A.; Macedo, A.P.; Frighetto, P.D.; Volpon, J.B.; Shimano, A.C.

2016-01-01

High-impact exercise has been considered an important method for treating bone loss in osteopenic experimental models. In this study, we investigated the effects of osteopenia caused by inactivity in femora and tibiae of rats subjected to jump training using the rat tail suspension model. Eight-week-old female Wistar rats were divided into five groups (n=10 each group): jump training for 2 weeks before suspension and training during 3 weeks of suspension; jump training for 2 weeks before suspension; jump training only during suspension; suspension without any training; and a control group. The exercise protocol consisted of 20 jumps/day, 5 days/week, with a jump height of 40 cm. The bone mineral density of the femora and tibiae was measured by double energy X-ray absorptiometry and the same bones were evaluated by mechanical tests. Bone microarchitecture was evaluated by scanning electron microscopy. One-way ANOVA was used to compare groups. Significance was determined as P<0.05. Regarding bone mineral density, mechanical properties and bone microarchitecture, the beneficial effects were greater in the bones of animals subjected to pre-suspension training and subsequently to training during suspension, compared with the bones of animals subjected to pre-suspension training or to training during suspension. Our results indicate that a period of high impact exercise prior to tail suspension in rats can prevent the installation of osteopenia if there is also training during the tail suspension. PMID:26840705

High-impact exercise in rats prior to and during suspension can prevent bone loss.

PubMed

Yanagihara, G R; Paiva, A G; Gasparini, G A; Macedo, A P; Frighetto, P D; Volpon, J B; Shimano, A C

2016-03-01

High-impact exercise has been considered an important method for treating bone loss in osteopenic experimental models. In this study, we investigated the effects of osteopenia caused by inactivity in femora and tibiae of rats subjected to jump training using the rat tail suspension model. Eight-week-old female Wistar rats were divided into five groups (n=10 each group): jump training for 2 weeks before suspension and training during 3 weeks of suspension; jump training for 2 weeks before suspension; jump training only during suspension; suspension without any training; and a control group. The exercise protocol consisted of 20 jumps/day, 5 days/week, with a jump height of 40 cm. The bone mineral density of the femora and tibiae was measured by double energy X-ray absorptiometry and the same bones were evaluated by mechanical tests. Bone microarchitecture was evaluated by scanning electron microscopy. One-way ANOVA was used to compare groups. Significance was determined as P<0.05. Regarding bone mineral density, mechanical properties and bone microarchitecture, the beneficial effects were greater in the bones of animals subjected to pre-suspension training and subsequently to training during suspension, compared with the bones of animals subjected to pre-suspension training or to training during suspension. Our results indicate that a period of high impact exercise prior to tail suspension in rats can prevent the installation of osteopenia if there is also training during the tail suspension.

Visual training improves perceptual grouping based on basic stimulus features.

PubMed

Kurylo, Daniel D; Waxman, Richard; Kidron, Rachel; Silverstein, Steven M

2017-10-01

Training on visual tasks improves performance on basic and higher order visual capacities. Such improvement has been linked to changes in connectivity among mediating neurons. We investigated whether training effects occur for perceptual grouping. It was hypothesized that repeated engagement of integration mechanisms would enhance grouping processes. Thirty-six participants underwent 15 sessions of training on a visual discrimination task that required perceptual grouping. Participants viewed 20 × 20 arrays of dots or Gabor patches and indicated whether the array appeared grouped as vertical or horizontal lines. Across trials stimuli became progressively disorganized, contingent upon successful discrimination. Four visual dimensions were examined, in which grouping was based on similarity in luminance, color, orientation, and motion. Psychophysical thresholds of grouping were assessed before and after training. Results indicate that performance in all four dimensions improved with training. Training on a control condition, which paralleled the discrimination task but without a grouping component, produced no improvement. In addition, training on only the luminance and orientation dimensions improved performance for those conditions as well as for grouping by color, on which training had not occurred. However, improvement from partial training did not generalize to motion. Results demonstrate that a training protocol emphasizing stimulus integration enhanced perceptual grouping. Results suggest that neural mechanisms mediating grouping by common luminance and/or orientation contribute to those mediating grouping by color but do not share resources for grouping by common motion. Results are consistent with theories of perceptual learning emphasizing plasticity in early visual processing regions.

Developments in fiber optics for distribution automation

NASA Technical Reports Server (NTRS)

Kirkham, H.; Friend, H.; Jackson, S.; Johnston, A.

1991-01-01

An optical fiber based communications system of unusual design is described. The system consists of a network of optical fibers overlaid on the distribution system. It is configured as a large number of interconnected rings, with some spurs. Protocols for access to and control of the network are described. Because of the way they function, the protocols are collectively called AbNET, in commemoration of the microbiologists' abbreviation Ab for antibody. Optical data links that could be optically powered are described. There are two versions, each of which has a good frequency response and minimal filtering requirements. In one, a conventional FM pulse train is used at the transmitter, and a novel form of phase-locked loop is used as demodulator. In the other, the FM transmitter is replaced with a pulse generator arranged so that the period between pulses represents the modulating signal. Transmitter and receiver designs, including temperature compensation methods, are presented. Experimental results are given.

Basic Microsurgery Training Using the Laboratory Rat (Rattus norvegicus)

DTIC Science & Technology

2018-03-01

all information . Use additional pages if necessary.) PROTOCOL #: FDG20170016A DATE: 1 March 2018 PROTOCOL TITLE: “Basic Microsurgery Training...2018__ RYAN M. DIEPENBROCK, Lt Col, USAF, DC (Date) 3 FDG20170016A Attachments: Attachment 1: Defense Technical Information Center (DTIC) Abstract...Submission Attachment 1 Defense Technical Information Center (DTIC) Abstract Submission Objectives: The purpose of this course is to

Understanding Frame-of-Reference Training Success: A Social Learning Theory Perspective

ERIC Educational Resources Information Center

Sulsky, Lorne M.; Kline, Theresa J. B.

2007-01-01

Employing the social learning theory (SLT) perspective on training, we analysed the effects of alternative frame-of-reference (FOR) training protocols on various criteria of training effectiveness. Undergraduate participants (N = 65) were randomly assigned to one of four FOR training conditions and a control condition. Training effectiveness was…

Design and Evaluation of a Training Protocol for a Photographic Method of Visual Estimation of Fruit and Vegetable Intake among Kindergarten Through Second-Grade Students.

PubMed

Masis, Natalie; McCaffrey, Jennifer; Johnson, Susan L; Chapman-Novakofski, Karen

2017-04-01

To design a replicable training protocol for visual estimation of fruit and vegetable (FV) intake of kindergarten through second-grade students through digital photography of lunch trays that results in reliable data for FV served and consumed. Protocol development through literature and researcher input was followed by 3 laboratory-based trainings of 3 trainees. Lunchroom data collection sessions were done at 2 elementary schools for kindergarten through second-graders. Intraclass correlation coefficients (ICCs) were used. By training 3, ICC was substantial for amount of FV served and consumed (0.86 and 0.95, respectively; P < .05). The ICC was moderate for percentage of fruits consumed (0.67; P = .06). In-school estimates for ICCs were all significant for amounts served at school 1 and percentage of FV consumed at both schools. The protocol resulted in reliable estimation of combined FV served and consumed using digital photography. The ability to estimate FV intake accurately will benefit intervention development and evaluation. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Cardiovascular responses to a high-volume continuous circuit resistance training protocol.

PubMed

Gotshalk, Lincoln A; Berger, Richard A; Kraemer, William J

2004-11-01

The purpose of this investigation was to determine the level of cardiovascular stress elicited by continuous and prolonged circuit resistance training (CRT). Each of the 11 men who volunteered as a subject were tested to determine oxygen consumption and heart rate responses to a submaximal and maximal treadmill protocol and a CRT session consisting of 10 exercises and 10 repetitions at 40% of 1 repetition maximum (1RM) for each station with 4.6 circuits performed. The physiological stress of the CRT in this study was evident by the sustained heart rate of more than 70% of maximum for 16.6 minutes, with the last 12 minutes at more than 80%. Despite the large anaerobic component in CRT, Vo(2) was sustained at 50% or more of maximum for the final 12 minutes. Treadmill running, involving large muscle groups, increased Vo(2) more rapidly than CRT, where alternating larger and smaller muscle groups were used. In addition, at the same Vo(2) heart rate differed significantly between the 2 modes of activity. Heart rate in CRT was higher (at 165) than the heart rate of 150 found during treadmill running at the same 50% Vo(2). Such workouts may be used in a training cycle in classical linear periodization or in a nonlinear program day targeting local muscular endurance under intense cardiorespiratory conditions, which may help individuals develop enhanced toleration of physiological environments where high cardiovascular demands and higher lactate concentrations are present.

Heart rate recovery and heart rate variability are unchanged in patients with coronary artery disease following 12 weeks of high-intensity interval and moderate-intensity endurance exercise training.

PubMed

Currie, Katharine D; Rosen, Lee M; Millar, Philip J; McKelvie, Robert S; MacDonald, Maureen J

2013-06-01

Decreased heart rate variability and attenuated heart rate recovery following exercise are associated with an increased risk of mortality in cardiac patients. This study investigated the effects of 12 weeks of moderate-intensity endurance exercise (END) and a novel low-volume high-intensity interval exercise protocol (HIT) on measures of heart rate recovery and heart rate variability in patients with coronary artery disease (CAD). Fourteen males with CAD participated in 12 weeks of END or HIT training, each consisting of 2 supervised exercise sessions per week. END consisted of 30-50 min of continuous cycling at 60% peak power output (PPO). HIT involved ten 1-min intervals at 88% PPO separated by 1-min intervals at 10% PPO. Heart rate recovery at 1 min and 2 min was measured before and after training (pre- and post-training, respectively) using a submaximal exercise bout. Resting time and spectral and nonlinear domain measures of heart rate variability were calculated. Following 12 weeks of END and HIT, there was no change in heart rate recovery at 1 min (END, 40 ± 12 beats·min(-1) vs. 37 ± 19 beats·min(-1); HIT, 31 ± 8 beats·min(-1) vs. 35 ± 8 beats·min(-1); p ≥ 0.05 for pre- vs. post-training) or 2 min (END, 44 ± 18 beats·min(-1) vs. 43 ± 19 beats·min(-1); HIT, 42 ± 10 beats·min(-1) vs. 50 ± 6 beats·min(-1); p ≥ 0.05 for pre- vs. post-training). All heart rate variability indices were unchanged following END and HIT training. In conclusion, neither END nor HIT exercise programs elicited training-induced improvements in cardiac autonomic function in patients with CAD. The absence of improvements with training may be attributed to the optimal medical management and normative pretraining state of our sample.

[The factors that influence the use of clinical protocols according to the opinion of health center coordinators. The Research Group on the Evaluation and Improvement of Clinical Protocols].

PubMed

Saura-Llamas, J; Saturno Hernández, P J; Gaona Ramón, J M; Romero Román, J R; González Barberá, M

1999-11-15

To find the factors that affect the use of clinical protocols in primary care, in the view of primary care team coordinators, and the reasons why they are little followed, and to bring together suggestions for improvement. An opinion study, through a telephone survey. Primary health care. The health centres in Murcia with protocolized activity: 31 at the start of the project. The coordinators and those in charge of nursing, 62 people in all. After a pilot study, a structured telephone survey was carried out, administered by a trained interviewer who posed two open questions: why do you think that the professionals at your centre do not use the existing protocols more often? and: what suggestions would you make to improve the protocols and have them used more? A specialist company did the field-work in June and July 1996. There was a 98% reply rate. To the first question, coordinators thought that low use could be explained by excess demand and lack of time for consultations (33% of all replies), although they also cited other organisational problems in the centre, defects in protocols and lack of training. Those in charge of nursing gave very similar replies, with excess demand (39%) predominating. To the second question, on increasing the use of protocols, coordinators suggested that the protocols needed to be improved (44.8% of replies), and also cited the need for improvements in organisation and on-going training. Very similar answers came from the nursing side, where 43.5% highlighted the need to improve the protocol documents. The coordinators assumed that the clinical protocols were used little and could be improved. In their view the basic reason for their low use is excessive pressure from the patient-load. The key to using them more is improvement in the protocol documents.

Transfer learning improves supervised image segmentation across imaging protocols.

PubMed

van Opbroek, Annegreet; Ikram, M Arfan; Vernooij, Meike W; de Bruijne, Marleen

2015-05-01

The variation between images obtained with different scanners or different imaging protocols presents a major challenge in automatic segmentation of biomedical images. This variation especially hampers the application of otherwise successful supervised-learning techniques which, in order to perform well, often require a large amount of labeled training data that is exactly representative of the target data. We therefore propose to use transfer learning for image segmentation. Transfer-learning techniques can cope with differences in distributions between training and target data, and therefore may improve performance over supervised learning for segmentation across scanners and scan protocols. We present four transfer classifiers that can train a classification scheme with only a small amount of representative training data, in addition to a larger amount of other training data with slightly different characteristics. The performance of the four transfer classifiers was compared to that of standard supervised classification on two magnetic resonance imaging brain-segmentation tasks with multi-site data: white matter, gray matter, and cerebrospinal fluid segmentation; and white-matter-/MS-lesion segmentation. The experiments showed that when there is only a small amount of representative training data available, transfer learning can greatly outperform common supervised-learning approaches, minimizing classification errors by up to 60%.

Simultaneous brightness contrast of foraging Papilio butterflies

PubMed Central

Kinoshita, Michiyo; Takahashi, Yuki; Arikawa, Kentaro

2012-01-01

This study focuses on the sense of brightness in the foraging Japanese yellow swallowtail butterfly, Papilio xuthus. We presented two red discs of different intensity on a grey background to butterflies, and trained them to select one of the discs. They were successfully trained to select either a high intensity or a low intensity disc. The trained butterflies were tested on their ability to perceive brightness in two different protocols: (i) two orange discs of different intensity presented on the same intensity grey background and (ii) two orange discs of the same intensity separately presented on a grey background that was either higher or lower in intensity than the training background. The butterflies trained to high intensity red selected the orange disc of high intensity in protocol 1, and the disc on the background of low intensity grey in protocol 2. We obtained similar results in another set of experiments with purple discs instead of orange discs. The choices of the butterflies trained to low intensity red were opposite to those just described. Taken together, we conclude that Papilio has the ability to learn brightness and darkness of targets independent of colour, and that they have the so-called simultaneous brightness contrast. PMID:22179808

Different Muscle Action Training Protocols on Quadriceps-Hamstrings Neuromuscular Adaptations.

PubMed

Ruas, Cassio V; Brown, Lee E; Lima, Camila D; Gregory Haff, G; Pinto, Ronei S

2018-05-01

The aim of this study was to compare three specific concentric and eccentric muscle action training protocols on quadriceps-hamstrings neuromuscular adaptations. Forty male volunteers performed 6 weeks of training (two sessions/week) of their dominant and non-dominant legs on an isokinetic dynamometer. They were randomly assigned to one of four groups; concentric quadriceps and concentric hamstrings (CON/CON, n=10), eccentric quadriceps and eccentric hamstrings (ECC/ECC, n=10), concentric quadriceps and eccentric hamstrings (CON/ECC, n=10), or no training (CTRL, n=10). Intensity of training was increased every week by decreasing the angular velocity for concentric and increasing it for eccentric groups in 30°/s increments. Volume of training was increased by adding one set every week. Dominant leg quadriceps and hamstrings muscle thickness, muscle quality, muscle activation, muscle coactivation, and electromechanical delay were tested before and after training. Results revealed that all training groups similarly increased MT of quadriceps and hamstrings compared to control (p<0.05). However, CON/ECC and ECC/ECC training elicited a greater magnitude of change. There were no significant differences between groups for all other neuromuscular variables (p>0.05). These findings suggest that different short-term muscle action isokinetic training protocols elicit similar muscle size increases in hamstrings and quadriceps, but not for other neuromuscular variables. Nevertheless, effect sizes indicate that CON/ECC and ECC/ECC may elicit the greatest magnitude of change in muscle hypertrophy. © Georg Thieme Verlag KG Stuttgart · New York.

Design of the multicenter standardized supervised exercise training intervention for the claudication: exercise vs endoluminal revascularization (CLEVER) study.

PubMed

Bronas, Ulf G; Hirsch, Alan T; Murphy, Timothy; Badenhop, Dalynn; Collins, Tracie C; Ehrman, Jonathan K; Ershow, Abby G; Lewis, Beth; Treat-Jacobson, Diane J; Walsh, M Eileen; Oldenburg, Niki; Regensteiner, Judith G

2009-11-01

The CLaudication: Exercise Vs Endoluminal Revascularization (CLEVER) study is the first randomized, controlled, clinical, multicenter trial that is evaluating a supervised exercise program compared with revascularization procedures to treat claudication. In this report, the methods and dissemination techniques of the supervised exercise training intervention are described. A total of 217 participants are being recruited and randomized to one of three arms: (1) optimal medical care; (2) aortoiliac revascularization with stent; or (3) supervised exercise training. Of the enrolled patients, 84 will receive supervised exercise therapy. Supervised exercise will be administered according to a protocol designed by a central CLEVER exercise training committee based on validated methods previously used in single center randomized control trials. The protocol will be implemented at each site by an exercise committee member using training methods developed and standardized by the exercise training committee. The exercise training committee reviews progress and compliance with the protocol of each participant weekly. In conclusion, a multicenter approach to disseminate the supervised exercise training technique and to evaluate its efficacy, safety and cost-effectiveness for patients with claudication due to peripheral arterial disease (PAD) is being evaluated for the first time in CLEVER. The CLEVER study will further establish the role of supervised exercise training in the treatment of claudication resulting from PAD and provide standardized methods for use of supervised exercise training in future PAD clinical trials as well as in clinical practice.

Assessing the effectiveness of the NICHD investigative interview protocol when interviewing French-speaking alleged victims of child sexual abuse in Quebec.

PubMed

Cyr, Mireille; Lamb, Michael E

2009-05-01

The study was designed to assess the effectiveness of the flexibly structured NICHD Investigative Interview Protocol for child sexual abuse (CSA) investigative interviews by police officers and mental health workers in Quebec. The NICHD Protocol was designed to operationalize "best practice" guidelines and to help forensic interviewers use open-ended prompts to facilitate free recall by alleged victims. A total of 83 interviews with 3- to 13-year-old alleged victims were matched with 83 interviews conducted by the same interviewers before they were trained to use the Protocol. Interviews were matched with respect to the children's ages, children-perpetrator relationships, and the types and frequency of abuse. Coders categorized each of the prompts used to elicit information about the abuse and tabulated the numbers of new forensically relevant details provided in each response. Interviewers used three times as many open-ended prompts in Protocol interviews than in non-Protocol interviews, whereas use of all other types of questions was halved, and the total number of questions asked decreased by 25%. Protocol-guided interviews yielded more details than comparison interviews. The mean number of details per prompt increased from 3 to 5 details when the Protocol was used. Even with young children, interviewers using the Protocol employed more invitations to elicit forensically relevant details. French-speaking investigators using the NICHD Protocol used open-ended prompts rather than focused questions when interviewing alleged victims. In addition, these interviewers needed fewer questions to get relevant information when using the Protocol. A French version of the NICHD Protocol is now available to police officers and social workers who investigate the alleged sexual abuse of young children in French-speaking countries. This French version allowed trained interviewers to increase the use of invitations and reduce the use of more focused and risky questions. When the number of questions was controlled, more central details and more details in total were obtained in Protocol interviews, because the average prompt elicited more detailed answers in Protocol interviews. However, learning to use the NICHD Protocol required extended training and continued feedback sessions to maintain the high quality of interviewing.

Effect of beta and gamma neurofeedback on memory and intelligence in the elderly.

PubMed

Staufenbiel, S M; Brouwer, A-M; Keizer, A W; van Wouwe, N C

2014-01-01

Recent research showed a correlation between cognitive decline and a decrease of EEG gamma activity. In the present double-blind randomized control study, we investigated whether gamma and beta neurofeedback protocols, that have been shown to modulate performance on cognitive control and memory in young adults, also leads to increased brain activity and cognitive performance in elderly. Twenty older adults either performed eight 30-min gamma neurofeedback session or beta neurofeedback session within a period of 21 days. Cognitive performance was determined before and after the training through an IQ and memory task and we added a subjective well-being questionnaire. Both neurofeedback training protocols resulted in a significant increase of the brain activity within each training session, suggesting that the aging brain is still trainable. However, we found no effects on cognitive performance or transfer of the feedback beyond the trainings. We discuss several possible reasons for the lack of training on rest measurements and cognition and ways to improve the feedback protocols for future studies. Copyright © 2013 Elsevier B.V. All rights reserved.

Surgeon Training, Protocol Compliance, and Technical Outcomes From Breast Cancer Sentinel Lymph Node Randomized Trial

PubMed Central

Ashikaga, Takamaru; Harlow, Seth P.; Skelly, Joan M.; Julian, Thomas B.; Brown, Ann M.; Weaver, Donald L.; Wolmark, Norman

2009-01-01

Background The National Surgical Adjuvant Breast and Bowel Project B-32 trial was designed to determine whether sentinel lymph node resection can achieve the same therapeutic outcomes as axillary lymph node resection but with fewer side effects and is one of the most carefully controlled and monitored randomized trials in the field of surgical oncology. We evaluated the relationship of surgeon trial preparation, protocol compliance audit, and technical outcomes. Methods Preparation for this trial included a protocol manual, a site visit with key participants, an intraoperative session with the surgeon, and prerandomization documentation of protocol compliance. Training categories included surgeons who submitted material on five prerandomization surgeries and were trained by a core trainer (category 1) or by a site trainer (category 2). An expedited group (category 3) included surgeons with extensive experience who submitted material on one prerandomization surgery. At completion of training, surgeons could accrue patients. Two hundred twenty-four surgeons enrolled 4994 patients with breast cancer and were audited for 94 specific items in the following four categories: procedural, operative note, pathology report, and data entry. The relationship of training method; protocol compliance performance audit; and the technical outcomes of the sentinel lymph node resection rate, false-negative rate, and number of sentinel lymph nodes removed was determined. All statistical tests were two-sided. Results The overall sentinel lymph node resection success rate was 96.9% (95% confidence interval [CI] = 96.4% to 97.4%), and the overall false-negative rate was 9.5% (95% CI = 7.4% to 12.0%), with no statistical differences between training methods. Overall audit outcomes were excellent in all four categories. For all three training groups combined, a statistically significant positive association was observed between surgeons’ average number of procedural errors and their false-negative rate (ρ = +0.188, P = .021). Conclusions All three training methods resulted in uniform and high overall sentinel lymph node resection rates. Subgroup analyses identified some variation in false-negative rates that were related to audited outcome performance measures. PMID:19704072

Self-organization of human embryonic stem cells on micropatterns

PubMed Central

Deglincerti, Alessia; Etoc, Fred; Guerra, M. Cecilia; Martyn, Iain; Metzger, Jakob; Ruzo, Albert; Simunovic, Mijo; Yoney, Anna; Brivanlou, Ali H.; Siggia, Eric; Warmflash, Aryeh

2018-01-01

Fate allocation in the gastrulating embryo is spatially organized as cells differentiate to specialized cell types depending on their positions with respect to the body axes. There is a need for in vitro protocols that allow the study of spatial organization associated with this developmental transition. While embryoid bodies and organoids can exhibit some spatial organization of differentiated cells, these methods do not yield consistent and fully reproducible results. Here, we describe a micropatterning approach where human embryonic stem cells are confined to disk-shaped, sub-millimeter colonies. After 42 hours of BMP4 stimulation, cells form self-organized differentiation patterns in concentric radial domains, which express specific markers associated with the embryonic germ layers, reminiscent of gastrulating embryos. Our protocol takes 3 days; it uses commercial microfabricated slides (CYTOO), human laminin-521 (LN-521) as extra-cellular matrix coating, and either conditioned or chemically-defined medium (mTeSR). Differentiation patterns within individual colonies can be determined by immunofluorescence and analyzed with cellular resolution. Both the size of the micropattern and the type of medium affect the patterning outcome. The protocol is appropriate for personnel with basic stem cell culture training. This protocol describes a robust platform for quantitative analysis of the mechanisms associated with pattern formation at the onset of gastrulation. PMID:27735934

Method for training honeybees to respond to olfactory stimuli and enhancement of memory retention therein

DOEpatents

McCade, Kirsten J.; Wingo, Robert M.; Haarmann, Timothy K.; Sutherland, Andrew; Gubler, Walter D.

2015-12-15

A specialized conditioning protocol for honeybees that is designed for use within a complex agricultural ecosystem. This method ensures that the conditioned bees will be less likely to exhibit a conditioned response to uninfected plants, a false positive response that would render such a biological sensor unreliable for agricultural decision support. Also described is a superboosting training regime that allows training without the aid of expensive equipment and protocols for training in out in the field. Also described is a memory enhancing cocktail that aids in long term memory retention of a vapor signature. This allows the bees to be used in the field for longer durations and with fewer bees trained overall.

Baclofen facilitates the extinction of methamphetamine-induced conditioned place preference in rats

PubMed Central

Voigt, Robin M.; Herrold, Amy A.; Napier, T. Celeste

2011-01-01

The powerful, long-lasting association between the rewarding effects of a drug and contextual cues associated with drug administration can be studied using conditioned place preference (CPP). The GABAB receptor agonist baclofen facilitates the extinction of morphine-induced CPP in mice. The current study extended this work by determining if baclofen could enhance the extinction of methamphetamine (Meth) CPP. CPP was established using a six day conditioning protocol wherein Meth-pairings were alternated with saline-pairings. Rats were subsequently administered baclofen (2mg/kg i.p. or vehicle) immediately after each daily forced extinction session, which consisted of a saline injection immediately prior to being placed into the previously Meth- or saline-paired chamber. One extinction training cycle, consisted of six once-daily forced extinction sessions, mimicking the alternating procedure established during conditioning, followed by a test for preference (Ext test). CPP persisted for at least four extinction cycles in vehicle-treated rats. In contrast, CPP was inhibited following a single extinction training cycle. These data indicate that Meth-induced CPP was resistant to extinction, but extinction training was rendered effective when the training was combined with baclofen. These findings converge with the prior demonstration of baclofen facilitating the extinction of morphine-induced CPP indicating that GABAB receptor actions are independent of the primary (unconditioned) stimulus (i.e., the opiate or the stimulant) and likely reflect mechanisms engaged by extinction learning processes per se. Thus, baclofen administered in conjunction with extinction training may be of value for addiction therapy regardless of the class of drug being abused. PMID:21463025

Impact of exercise programs among helicopter pilots with transient LBP.

PubMed

Andersen, Knut; Baardsen, Roald; Dalen, Ingvild; Larsen, Jan Petter

2017-06-20

Flight related low back pain (LBP) among helicopter pilots is frequent and may influence flight performance. Prolonged confined sitting during flights seems to weaken lumbar trunk (LT) muscles with associated secondary transient pain. Aim of the study was to investigate if structured training could improve muscular function and thus improve LBP related to flying. 39 helicopter pilots (35 men and 4 women), who reported flying related LBP on at least 1 of 3 missions last month, were allocated to two training programs over a 3-month period. Program A consisted of 10 exercises recommended for general LBP. Program B consisted of 4 exercises designed specifically to improve LT muscular endurance. The pilots were examined before and after the training using questionnaires for pain, function, quality of health and tests of LT muscular endurance as well as ultrasound measurements of the contractility of the lumbar multifidus muscle (LMM). Approximately half of the participants performed the training per-protocol. Participants in this subset group had comparable baseline characteristics as the total study sample. Pre and post analysis of all pilots included, showed participants had marked improvement in endurance and contractility of the LMM following training. Similarly, participants had improvement in function and quality of health. Participants in program B had significant improvement in pain, function and quality of health. This study indicates that participants who performed a three months exercise program had improved muscle endurance at the end of the program. The helicopter pilots also experienced improved function and quality of health. Identifier: NCT01788111 Registration date; February 5th, 2013, verified April 2016.

Ko wai ahau? (Who am I?) How cultural identity issues are experienced by Maori psychiatrists and registrars working with children and adolescents.

PubMed

Elder, Hinemoa

2008-06-01

This paper aimed to investigate narratives regarding the experience of Maori cultural identity of Maori psychiatrists and registrars who have worked with tamariki (children), taiohi (adolescents) and whanau (families). This was a Kaupapa Maori (Maori-centred) qualitative study where a total of five Maori psychiatrists and registrars were interviewed using a semi-structured questionnaire informed by Tikanga Maori (Maori custom and protocol). This paper presents one significant theme, that of "doing the work differently". Within this theme, the perceived 'mismatch' between psychiatric training, seeming to value opacity in clinical sessions, compared to Tikanga Maori aspects of the doctor's identity which values whakawhanaungatanga (connectivity and relationships) was consistently described. This paper has implications for registrar training needs, workforce development, service development and cultural competency.

Improving Suicide Prevention in Dutch Regions by Creating Local Suicide Prevention Action Networks (SUPRANET): A Study Protocol.

PubMed

Gilissen, Renske; De Beurs, Derek; Mokkenstorm, Jan; Mérelle, Saskia; Donker, Gé; Terpstra, Sanne; Derijck, Carla; Franx, Gerdien

2017-03-28

The European Alliance against Depression (EAAD) program is to be introduced in The Netherlands from 2017 onwards. This program to combat suicide consists of interventions on four levels: (1) increasing the awareness of suicide by local media campaigns; (2) training local gatekeepers, such as teachers or police officers; (3) targeting high-risk persons in the community; and (4) training and support of professionals in primary care settings. The implementation starts in seven Dutch pilot regions. Each region is designated as a Suicide Prevention Action NETwork (SUPRANET). This paper describes the SUPRANET program components and the evaluation of its feasibility and impact. The findings will be used to facilitate the national implementation of EAAD in The Netherlands and to add new findings to the existing literature on EAAD.

Improving Suicide Prevention in Dutch Regions by Creating Local Suicide Prevention Action Networks (SUPRANET): A Study Protocol

PubMed Central

Gilissen, Renske; De Beurs, Derek; Mokkenstorm, Jan; Mérelle, Saskia; Donker, Gé; Terpstra, Sanne; Derijck, Carla; Franx, Gerdien

2017-01-01

The European Alliance against Depression (EAAD) program is to be introduced in The Netherlands from 2017 onwards. This program to combat suicide consists of interventions on four levels: (1) increasing the awareness of suicide by local media campaigns; (2) training local gatekeepers, such as teachers or police officers; (3) targeting high-risk persons in the community; and (4) training and support of professionals in primary care settings. The implementation starts in seven Dutch pilot regions. Each region is designated as a Suicide Prevention Action NETwork (SUPRANET). This paper describes the SUPRANET program components and the evaluation of its feasibility and impact. The findings will be used to facilitate the national implementation of EAAD in The Netherlands and to add new findings to the existing literature on EAAD. PMID:28350367

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

PubMed

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

2017-06-01

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

The PULSAR primary care protocol: a stepped-wedge cluster randomized controlled trial to test a training intervention for general practitioners in recovery-oriented practice to optimize personal recovery in adult patients.

PubMed

Enticott, Joanne C; Shawyer, Frances; Brophy, Lisa; Russell, Grant; Fossey, Ellie; Inder, Brett; Mazza, Danielle; Vasi, Shiva; Weller, Penelope June; Wilson-Evered, Elisabeth; Edan, Vrinda; Meadows, Graham

2016-12-20

General practitioners (GPs) in Australia play a central role in the delivery of mental health care. This article describes the PULSAR (Principles Unite Local Services Assisting Recovery) Primary Care protocol, a novel mixed methods evaluation of a training intervention for GPs in recovery-oriented practice. The aim of the intervention is to optimize personal recovery in patients consulting study GPs for mental health issues. The intervention mixed methods design involves a stepped-wedge cluster randomized controlled trial testing the outcomes of training in recovery-oriented practice, together with an embedded qualitative study to identify the contextual enablers and challenges to implementing recovery-oriented practice. The project is conducted in Victoria, Australia between 2013 and 2017. Eighteen general practices and community health centers are randomly allocated to one of two steps (nine months apart) to start an intervention comprising GP training in the delivery of recovery-oriented practice. Data collection consists of cross-sectional surveys collected from patients of participating GPs at baseline, and again at the end of Steps 1 and 2. The primary outcome is improvement in personal recovery using responses to the Questionnaire about the Process of Recovery. Secondary outcomes are improvements in patient-rated measures of personal recovery and wellbeing, and of the recovery-oriented practice they have received, using the INSPIRE questionnaire, the Warwick-Edinburgh Mental Well-being Scale, and the Kessler Psychological Distress Scale. Participant data will be analyzed in the group that the cluster was assigned to at each study time point. Another per-protocol dataset will contain all data time-stamped according to the date of intervention received at each cluster site. Qualitative interviews with GPs and patients at three and nine months post-training will investigate experiences and challenges related to implementing recovery-oriented practice in primary care. Recovery-oriented practice is gaining increasing prominence in mental health service delivery and the outcomes of such an approach within the primary care sector for the first time will be evaluated in this project. If findings are positive, the intervention has the potential to extend recovery-oriented practice to GPs throughout the community. Australian and New Zealand Clinical Trial Registry ( ACTRN12614001312639 ). Registered: 8 August 2014.

Early Weightbearing Protocol in Operative Fixation of Acute Jones Fractures.

PubMed

Waverly, Brett J; Sorensen, Matthew D; Sorensen, Tyler K

The treatment of Jones fractures has been controversial in terms of nonoperative versus operative management, given the high incidence of nonunion secondary to the delicate blood supply to the proximal fifth metatarsal. We report a retrospective review of a patient cohort treated with an early weightbearing protocol after operative intramedullary fixation in acute Jones fractures. Thirty-one consecutive patients with an acute Jones fracture underwent operative fixation with a single intramedullary solid screw. The postoperative protocol consisted of immediate weightbearing in a controlled ankle motion boot for 2 weeks with a gradual transition to regular shoes at 2 weeks postoperative. At 2 weeks, the patients were allowed to perform low-impact activities such as walking, swimming, biking, or elliptical training. Patients were allowed to return to all activities, as tolerated, regardless of radiographic healing, at 6 weeks postoperatively. Serial postoperative radiographs were taken at 2-week intervals to determine radiographic union. Our patient population consisted of 24 males (77.42%) and 7 females (22.58%), with a mean average age of 37.5 ± 12.59 years and mean average body mass index of 25.7 ± 2.32 kg/m 2 . Fracture union was observed in all 31 patients (100%) at a mean average of 5.7 ± 1.47 (range 4 to 10) weeks. Two (6.5%) patients required hardware removal, with one (3.2%) experiencing sural neuritis. This review of patients undergoing early weightbearing after operative fixation of an acute Jones fracture demonstrated a satisfactory incidence of union compared with traditional postoperative protocols at a mean follow-up duration of 18.58 ± 5.66 months. Copyright © 2017 The American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

From Chaos to Content: An Integrated Approach to Government Web Sites

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

Demuth, Nora H.; Knudson, Christa K.

2005-01-03

The web development team of the Environmental Technology Directorate (ETD) at the U.S. Department of Energy’s Pacific Northwest National Laboratory (PNNL) redesigned the ETD website as a database-driven system, powered by the newly designed ETD Common Information System (ETD-CIS). The ETD website was redesigned in response to an analysis that showed the previous ETD websites were inefficient, costly, and lacking in a consistent focus. Redesigned and newly created websites based on a new ETD template provide a consistent image, meet or exceed accessibility standards, and are linked through a common database. The protocols used in developing the ETD website supportmore » integration of further organizational sites and facilitate internal use by staff and training on ETD website development and maintenance. Other PNNL organizations have approached the ETD web development team with an interest in applying the methods established by the ETD system. The ETD system protocol could potentially be used by other DOE laboratories to improve their website efficiency and content focus. “The tools by which we share science information must be as extraordinary as the information itself.[ ]” – DOE Science Director Raymond Orbach« less

The effect of an interactive cycling training on cognitive functioning in older adults with mild dementia: study protocol for a randomized controlled trial.

PubMed

Karssemeijer, E G A; Bossers, W J R; Aaronson, J A; Kessels, R P C; Olde Rikkert, M G M

2017-03-21

To date there is no cure or an effective disease-modifying drug to treat dementia. Available acetylcholine-esterase inhibiting drugs or memantine only produce small benefits on cognitive and behavioural functioning and their clinical relevance remains controversial. Combined cognitive-aerobic interventions are an appealing alternative or add-on to current pharmacological treatments. The primary aim of this study is to investigate the efficacy of a combined cognitive-aerobic training and a single aerobic training compared to an active control group in older adults with mild dementia. We expect to find a beneficial effect on executive functioning in both training regimes, compared to the control intervention, with the largest effect in the combined cognitive-aerobic group. Secondary, intervention effects on cognitive functioning in other domains, physical functioning, physical activity levels, activities of daily living, frailty and quality of life are studied. The design is a single-blind, randomized controlled trial (RCT) with three groups: a combined cognitive-aerobic bicycle training (interactive cycling), a single aerobic bicycle training and a control intervention, which consists of stretching and toning exercises. Older adults with mild dementia follow a 12-week training program consisting of three training sessions of 30-40 min per week. The primary study outcome is objective executive functioning measured with a neuropsychological assessment. Secondary measures are objective cognitive functioning in other domains, physical functioning, physical activity levels, activities of daily living, frailty, mood and quality of life. The three groups are compared at baseline, after 6 and 12 weeks of training, and at 24-week follow-up. This study will provide novel information on the effects of an interactive cycling training on executive function in older adults with mild dementia. Furthermore, since this study has both a combined cognitive-aerobic training and a single aerobic training group the effectiveness of the different components of the intervention can be identified. The results of this study may be used for physical and mental activity recommendations in older adults with dementia. The Netherlands National Trial Register NTR5581 . Registered 14 February 2016.

Strength and Hypertrophy Adaptations Between Low- vs. High-Load Resistance Training: A Systematic Review and Meta-analysis.

PubMed

Schoenfeld, Brad J; Grgic, Jozo; Ogborn, Dan; Krieger, James W

2017-12-01

Schoenfeld, BJ, Grgic, J, Ogborn, D, and Krieger, JW. Strength and hypertrophy adaptations between low- vs. high-load resistance training: a systematic review and meta-analysis. J Strength Cond Res 31(12): 3508-3523, 2017-The purpose of this article was to conduct a systematic review of the current body of literature and a meta-analysis to compare changes in strength and hypertrophy between low- vs. high-load resistance training protocols. Searches of PubMed/MEDLINE, Cochrane Library, and Scopus were conducted for studies that met the following criteria: (a) an experimental trial involving both low-load training [≤60% 1 repetition maximum (1RM)] and high-load training (>60% 1RM); (b) with all sets in the training protocols being performed to momentary muscular failure; (c) at least one method of estimating changes in muscle mass or dynamic, isometric, or isokinetic strength was used; (d) the training protocol lasted for a minimum of 6 weeks; (e) the study involved participants with no known medical conditions or injuries impairing training capacity. A total of 21 studies were ultimately included for analysis. Gains in 1RM strength were significantly greater in favor of high- vs. low-load training, whereas no significant differences were found for isometric strength between conditions. Changes in measures of muscle hypertrophy were similar between conditions. The findings indicate that maximal strength benefits are obtained from the use of heavy loads while muscle hypertrophy can be equally achieved across a spectrum of loading ranges.

Space Fortress game training and executive control in older adults: A pilot intervention

PubMed Central

Stern, Yaakov; Blumen, Helena M.; Rich, Leigh W.; Richards, Alexis; Herzberg, Gray; Gopher, Daniel

2012-01-01

We investigated the feasibility of using the Space Fortress (SF) game, a complex video game originally developed to study complex skill acquisition in young adults, to improve executive control processes in cognitively healthy older adults. The study protocol consisted of 36 one-hour game play sessions over 3 months with cognitive evaluations before and after, and a follow-up evaluation at 6 months. Sixty participants were randomized to one of three conditions: Emphasis Change (EC) – elders were instructed to concentrate on playing the entire game but place particular emphasis on a specific aspect of game play in each particular game; Active Control (AC) – game play with standard instructions; Passive Control (PC) – evaluation sessions without game play. Primary outcome measures were obtained from five tasks, presumably tapping executive control processes. A total of 54 older adults completed the study protocol. One measure of executive control, WAIS-III letter–number sequencing, showed improvement in performance from pre- to post-evaluations in the EC condition, but not in the other two conditions. These initial findings are modest but encouraging. Future SF interventions need to carefully consider increasing the duration and or the intensity of the intervention by providing at-home game training, reducing the motor demands of the game, and selecting appropriate outcome measures. PMID:21988726

Multicenter Cell Processing for Cardiovascular Regenerative Medicine Applications - The Cardiovascular Cell Therapy Research Network (CCTRN) Experience

PubMed Central

Gee, Adrian P.; Richman, Sara; Durett, April; McKenna, David; Traverse, Jay; Henry, Timothy; Fisk, Diann; Pepine, Carl; Bloom, Jeannette; Willerson, James; Prater, Karen; Zhao, David; Koç, Jane Reese; Ellis, Steven; Taylor, Doris; Cogle, Christopher; Moyé, Lemuel; Simari, Robert; Skarlatos, Sonia

2013-01-01

Background Aims Multi-center cellular therapy clinical trials require the establishment and implementation of standardized cell processing protocols and associated quality control mechanisms. The aims here were to develop such an infrastructure in support of the Cardiovascular Cell Therapy Research Network (CCTRN) and to report on the results of processing for the first 60 patients. Methods Standardized cell preparations, consisting of autologous bone marrow mononuclear cells, prepared using the Sepax device were manufactured at each of the five processing facilities that supported the clinical treatment centers. Processing staff underwent centralized training that included proficiency evaluation. Quality was subsequently monitored by a central quality control program that included product evaluation by the CCTRN biorepositories. Results Data from the first 60 procedures demonstrate that uniform products, that met all release criteria, could be manufactured at all five sites within 7 hours of receipt of the bone marrow. Uniformity was facilitated by use of the automated systems (the Sepax for processing and the Endosafe device for endotoxin testing), standardized procedures and centralized quality control. Conclusions Complex multicenter cell therapy and regenerative medicine protocols can, where necessary, successfully utilize local processing facilities once an effective infrastructure is in place to provide training, and quality control. PMID:20524773

Crescent pyramid and drop-set systems do not promote greater strength gains, muscle hypertrophy, and changes on muscle architecture compared with traditional resistance training in well-trained men.

PubMed

Angleri, Vitor; Ugrinowitsch, Carlos; Libardi, Cleiton Augusto

2017-02-01

The aim of this study was to compare the effects of crescent pyramid (CP) and drop-set (DS) systems with traditional resistance training (TRAD) with equalized total training volume (TTV) on maximum dynamic strength (1-RM), muscle cross-sectional area (CSA), pennation angle (PA), and fascicle length (FL). Thirty-two volunteers had their legs randomized in a within-subject design in TRAD (3-5 sets of 6-12 repetitions at 75% 1-RM), CP (3-5 sets of 6-15 repetitions at 65-85% 1-RM), and DS (3-5 sets of ~50-75% 1-RM to muscle failure) protocols. Each leg was trained for 12 weeks. Participants had one leg fixed in the TRAD while the contralateral leg performed either CP or DS to allow for TTV equalization. The CSA increased significantly and similarly for all protocols (TRAD: 7.6%; CP: 7.5%; DS: 7.8%). All protocols showed significant and similar increases in leg press (TRAD = 25.9%; CP = 25.9%; DS = 24.9%) and leg extension 1-RM loads (TRAD = 16.6%; CP = 16.4%; DS = 17.1%). All protocols increased PA (TRAD = 10.6%; CP = 11.0%; DS = 10.3%) and FL (TRAD = 8.9%; CP = 8.9%; DS = 9.1%) similarly. CP and DS systems do not promote greater gains in strength, muscle hypertrophy and changes in muscle architecture compared to traditional resistance training.

Anaerobic threshold employed on exercise training prescription and performance assessment for laboratory rodents: A short review.

PubMed

Abreu, Phablo; Mendes, Sávio Victor Diogenes; Leal-Cardoso, José Henrique; Ceccatto, Vânia Marilande

2016-04-15

Several studies have generated numerous terms in the field of exercise training prescription and performance assessment that often do not match the information previously demonstrated by many other works, generating much debate and resulting in an immense pool of scientific results. Several protocols in exercise training prescription and performance assessment have been proposed for these purposes by many reasons. In the field of exercise science, the protocol must be thoroughly investigated and provide real tools to be reproducible. Many laboratories have been adapting and developing evaluation protocols and testing on physical training of rodents in different experimental conditions. In this context, mice, rats and rabbits are preferentially chosen due to easy manipulation and good response to exercise, and comparable at results obtained with humans in compatible effort intensities. But, the exercise training programs and aerobic-anaerobic transition assessment proposed for animal models vary extensively, depending on the species, gender, age, type of stimulus, type of exercise, type of method and also on the specific objectives of the program. This short review demonstrates the need in offering tools performed by invasive measurement to assess the anaerobic threshold by blood lactate employed on evolution of aerobic-anaerobic parameters of rodents. The objective of this short review was to present and to discuss physical evaluation protocols applications to rodents. The table submitted may give a basis for anaerobic threshold employed on exercise training prescription and performance assessment for laboratory rodents in future research. Copyright © 2016 Elsevier Inc. All rights reserved.

Beware: Recruitment of Muscle Activity by the EEG-Neurofeedback Trainings of High Frequencies

PubMed Central

Paluch, Katarzyna; Jurewicz, Katarzyna; Rogala, Jacek; Krauz, Rafał; Szczypińska, Marta; Mikicin, Mirosław; Wróbel, Andrzej; Kublik, Ewa

2017-01-01

EEG-neurofeedback (NFB) became a very popular method aimed at improving cognitive and behavioral performance. However, the EMG frequency spectrum overlies the higher EEG oscillations and the NFB trainings focusing on these frequencies is hindered by the problem of EMG load in the information fed back to the subjects. In such a complex signal, it is highly probable that the most controllable component will form the basis for operant conditioning. This might cause different effects in the case of various training protocols and therefore needs to be carefully assessed before designing training protocols and algorithms. In the current experiment a group of healthy adults (n = 14) was trained by professional trainers to up-regulate their beta1 (15–22 Hz) band for eight sessions. The control group (n = 18) underwent the same training regime but without rewards for increasing beta. In half of the participants trained to up-regulate beta1 band (n = 7) a systematic increase in tonic EMG activity was identified offline, implying that muscle activity became a foundation for reinforcement in the trainings. The remaining participants did not present any specific increase of the trained beta1 band amplitude. The training was perceived effective by both trainers and the trainees in all groups. These results indicate the necessity of proper control of muscle activity as a requirement for the genuine EEG-NFB training, especially in protocols that do not aim at the participants’ relaxation. The specificity of the information fed back to the participants should be of highest interest to all therapists and researchers, as it might irreversibly alter the results of the training. PMID:28373836

Effects of consensus training on the reliability of auditory perceptual ratings of voice quality.

PubMed

Iwarsson, Jenny; Reinholt Petersen, Niels

2012-05-01

This study investigates the effect of consensus training of listeners on intrarater and interrater reliability and agreement of perceptual voice analysis. The use of such training, including a reference voice sample, could be assumed to make the internal standards held in memory common and more robust, which is of great importance to reduce the variability of auditory perceptual ratings. A prospective design with testing before and after training. Thirteen students of audiologopedics served as listening subjects. The ratings were made using a multidimensional protocol with four-point equal-appearing interval scales. The stimuli consisted of text reading by authentic dysphonic patients. The consensus training for each perceptual voice parameter included (1) definition, (2) underlying physiology, (3) presentation of carefully selected sound examples representing the parameter in three different grades followed by group discussions of perceived characteristics, and (4) practical exercises including imitation to make use of the listeners' proprioception. Intrarater reliability and agreement showed a marked improvement for intermittent aphonia but not for vocal fry. Interrater reliability was high for most parameters before training with a slight increase after training. Interrater agreement showed marked increases for most voice quality parameters as a result of the training. The results support the recommendation of specific consensus training, including use of a reference voice sample material, to calibrate, equalize, and stabilize the internal standards held in memory by the listeners. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Effects of recreational soccer in men with prostate cancer undergoing androgen deprivation therapy: study protocol for the ‘FC Prostate’ randomized controlled trial

PubMed Central

2013-01-01

Background Androgen deprivation therapy (ADT) is a cornerstone in the treatment of advanced prostate cancer. Adverse musculoskeletal and cardiovascular effects of ADT are widely reported and investigations into the potential of exercise to ameliorate the effects of treatment are warranted. The ‘Football Club (FC) Prostate’ study is a randomized trial comparing the effects of soccer training with standard treatment approaches on body composition, cardiovascular function, physical function parameters, glucose tolerance, bone health, and patient-reported outcomes in men undergoing ADT for prostate cancer. Methods/Design Using a single-center randomized controlled design, 80 men with histologically confirmed locally advanced or disseminated prostate cancer undergoing ADT for 6 months or more at The Copenhagen University Hospital will be enrolled on this trial. After baseline assessments eligible participants will be randomly assigned to a soccer training group or a control group receiving usual care. The soccer intervention will consist of 12 weeks of training 2–3 times/week for 45–60 min after which the assessment protocol will be repeated. Soccer training will then continue bi-weekly for an additional 20 weeks at the end of which all measures will be repeated to allow for additional analyses of long-term effects. The primary endpoint is changes in lean body mass from baseline to 12 weeks assessed by dual X-ray absorptiometry scan. Secondary endpoints include changes of cardiovascular, metabolic, and physical function parameters, as well as markers of bone metabolism and patient-reported outcomes. Discussion The FC Prostate trial will assess the safety and efficacy of a novel soccer-training approach to cancer rehabilitation on a number of clinically important health outcomes in men with advanced prostate cancer during ADT. The results may pave the way for innovative, community-based interventions in the approach to treating prostate cancer. Trial registration ClinicalTrials.gov: NCT01711892 PMID:24330570

Video training with peer feedback in real-time consultation: acceptability and feasibility in a general-practice setting.

PubMed

Eeckhout, Thomas; Gerits, Michiel; Bouquillon, Dries; Schoenmakers, Birgitte

2016-08-01

Since many years, teaching and training in communication skills are cornerstones in the medical education curriculum. Although video recording in a real-time consultation is expected to positively contribute to the learning process, research on this topic is scarce. This study will focus on the feasibility and acceptability of video recording during real-time patient encounters performed by general practitioner (GP) trainees. The primary research question addressed the experiences (defined as feasibility and acceptability) of GP trainees in video-recorded vocational training in a general practice. The second research question addressed the appraisal of this training. The procedure of video-recorded training is developed, refined and validated by the Academic Teaching Practice of Leuven since 1974 (Faculty of Medicine of the University of Leuven). The study is set up as a cross-sectional survey without follow-up. Outcome measures were defined as 'feasibility and acceptability' (experiences of trainees) of the video-recorded training and were approached by a structured questionnaire with the opportunity to add free text comments. The studied sample consisted of all first-phase trainees of the GP Master 2011-2012 at the University of Leuven. Almost 70% of the trainees were positive about recording consultations. Nevertheless, over 60% believed that patients felt uncomfortable during the video-recorded encounter. Almost 90% noticed an improvement of own communication skills through the observation and evaluation of. Most students (85%) experienced the logistical issues as major barrier to perform video consultations on a regular base. This study lays the foundation stone for further exploration of the video training in real-time consultations. Both students and teachers on the field acknowledge that the power of imaging is underestimated in the training of communication and vocational skills. The development of supportive material and protocols will lower thresholds. Time investment for teachers could be tempered by bringing up students to peer tutors and by an accurate scheduling of the video training. The development of supportive material and protocols will lower thresholds. Further research should finally focus on long-term efficacy and efficiency in terms of learning outcomes and on the facilitation of the technical process. 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/

Video training with peer feedback in real-time consultation: acceptability and feasibility in a general-practice setting

PubMed Central

Eeckhout, Thomas; Gerits, Michiel; Bouquillon, Dries; Schoenmakers, Birgitte

2016-01-01

Objective Since many years, teaching and training in communication skills are cornerstones in the medical education curriculum. Although video recording in a real-time consultation is expected to positively contribute to the learning process, research on this topic is scarce. This study will focus on the feasibility and acceptability of video recording during real-time patient encounters performed by general practitioner (GP) trainees. Method The primary research question addressed the experiences (defined as feasibility and acceptability) of GP trainees in video-recorded vocational training in a general practice. The second research question addressed the appraisal of this training. The procedure of video-recorded training is developed, refined and validated by the Academic Teaching Practice of Leuven since 1974 (Faculty of Medicine of the University of Leuven). The study is set up as a cross-sectional survey without follow-up. Outcome measures were defined as ‘feasibility and acceptability’ (experiences of trainees) of the video-recorded training and were approached by a structured questionnaire with the opportunity to add free text comments. The studied sample consisted of all first-phase trainees of the GP Master 2011–2012 at the University of Leuven. Results Almost 70% of the trainees were positive about recording consultations. Nevertheless, over 60% believed that patients felt uncomfortable during the video-recorded encounter. Almost 90% noticed an improvement of own communication skills through the observation and evaluation of. Most students (85%) experienced the logistical issues as major barrier to perform video consultations on a regular base. Conclusions This study lays the foundation stone for further exploration of the video training in real-time consultations. Both students and teachers on the field acknowledge that the power of imaging is underestimated in the training of communication and vocational skills. The development of supportive material and protocols will lower thresholds. Practice implications Time investment for teachers could be tempered by bringing up students to peer tutors and by an accurate scheduling of the video training. The development of supportive material and protocols will lower thresholds. Further research should finally focus on long-term efficacy and efficiency in terms of learning outcomes and on the facilitation of the technical process. PMID:26842970

A Five-Year Goal for Training Complexes.

ERIC Educational Resources Information Center

Cohen, Saul B.

The training complex is conceived as a new kind of mechanism within which teachers will be trained with the assistance of protocol and training materials. It is to be operated by a consortium of universities, schools, and other agencies. Each training complex would be the core of an Educational Service District, which would be responsible for…

A Rehabilitation Protocol for Empowering Spatial Orientation in MCI. A Pilot Study.

PubMed

Gadler, Erminia; Grassi, Alessandra; Riva, Giuseppe

2009-01-01

Spatial navigation is among the first cognitive functions to be impaired in Alzheimer's disease [1] and deficit in this domain is detectable earlier in patients with Mild Cognitive Impairment [2]. Since efficacy of cognitive training in persons with MCI was successfully assessed [3], we developed a multitasking training protocol using virtual environments for stimulating attention, perception and visuo-spatial cognition in order to empower spatial orientation in MCI. Two healthy elders were exposed to the training over a period of four weeks and both showed improved performances in attention and orientation after the end of the intervention.

Augmented Reality Mentor for Training Maintenance Procedures: Interim Assessment

DTIC Science & Technology

2014-08-01

USABILITY QUESTIONNAIRE ........................................................ C-1 APPENDIX D: AR MENTOR USABILITY INTERVIEW PROTOCOL...APPENDIX F. INSTRUCTOR INTERVIEW PROTOCOL ......................................... F-1 APPENDIX G: MECHANIC INTERVIEW PROTOCOL...thus freeing up the opportunity for instruction around higher-order problem solving. They may also reduce the burden on peer “ helpers ” who read

28 CFR 115.121 - Evidence protocol and forensic medical examinations.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Office on Violence Against Women publication, “A National Protocol for Sexual Assault Medical Forensic... sexual abuse in its lockups, the agency shall follow a uniform evidence protocol that maximizes the... lockup detainees shall receive basic training regarding how to detect and respond to victims of sexual...

28 CFR 115.121 - Evidence protocol and forensic medical examinations.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Office on Violence Against Women publication, “A National Protocol for Sexual Assault Medical Forensic... sexual abuse in its lockups, the agency shall follow a uniform evidence protocol that maximizes the... lockup detainees shall receive basic training regarding how to detect and respond to victims of sexual...

28 CFR 115.121 - Evidence protocol and forensic medical examinations.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Office on Violence Against Women publication, “A National Protocol for Sexual Assault Medical Forensic... sexual abuse in its lockups, the agency shall follow a uniform evidence protocol that maximizes the... lockup detainees shall receive basic training regarding how to detect and respond to victims of sexual...

Effects of Video Game Training on Behavioral and Electrophysiological Measures of Attention and Memory: Protocol for a Randomized Controlled Trial

PubMed Central

Mayas, Julia; Ruiz-Marquez, Eloisa; Prieto, Antonio; Toril, Pilar; Ponce de Leon, Laura; de Ceballos, Maria L; Reales Avilés, José Manuel

2017-01-01

Background Neuroplasticity-based approaches seem to offer promising ways of maintaining cognitive health in older adults and postponing the onset of cognitive decline symptoms. Although previous research suggests that training can produce transfer effects, this study was designed to overcome some limitations of previous studies by incorporating an active control group and the assessment of training expectations. Objective The main objectives of this study are (1) to evaluate the effects of a randomized computer-based intervention consisting of training older adults with nonaction video games on brain and cognitive functions that decline with age, including attention and spatial working memory, using behavioral measures and electrophysiological recordings (event-related potentials [ERPs]) just after training and after a 6-month no-contact period; (2) to explore whether motivation, engagement, or expectations might account for possible training-related improvements; and (3) to examine whether inflammatory mechanisms assessed with noninvasive measurement of C-reactive protein in saliva impair cognitive training-induced effects. A better understanding of these mechanisms could elucidate pathways that could be targeted in the future by either behavioral or neuropsychological interventions. Methods A single-blinded randomized controlled trial with an experimental group and an active control group, pretest, posttest, and 6-month follow-up repeated measures design is used in this study. A total of 75 cognitively healthy older adults were randomly distributed into experimental and active control groups. Participants in the experimental group received 16 1-hour training sessions with cognitive nonaction video games selected from Lumosity, a commercial brain training package. The active control group received the same number of training sessions with The Sims and SimCity, a simulation strategy game. Results We have recruited participants, have conducted the training protocol and pretest assessments, and are currently conducting posttest evaluations. The study will conclude in the first semester of 2017. Data analysis will take place during 2017. The primary outcome is transfer of benefit from training to attention and working memory functions and the neural mechanisms underlying possible cognitive improvements. Conclusions We expect that mental stimulation with video games will improve attention and memory both at the behavioral level and in ERP components promoting brain and mental health and extending independence among elderly people by avoiding the negative personal and economic consequences of long-term care. Trial Registration Clinicaltrials.gov NCT02796508; https://clinicaltrials.gov/ct2/show/NCT02796508 (archived by WebCite at http://www.webcitation.org/6nFeKeFNB) PMID:28119279

Virtual Auditory Space Training-Induced Changes of Auditory Spatial Processing in Listeners with Normal Hearing.

PubMed

Nisha, Kavassery Venkateswaran; Kumar, Ajith Uppunda

2017-04-01

Localization involves processing of subtle yet highly enriched monaural and binaural spatial cues. Remediation programs aimed at resolving spatial deficits are surprisingly scanty in literature. The present study is designed to explore the changes that occur in the spatial performance of normal-hearing listeners before and after subjecting them to virtual acoustic space (VAS) training paradigm using behavioral and electrophysiological measures. Ten normal-hearing listeners participated in the study, which was conducted in three phases, including a pre-training, training, and post-training phase. At the pre- and post-training phases both behavioral measures of spatial acuity and electrophysiological P300 were administered. The spatial acuity of the participants in the free field and closed field were measured apart from quantifying their binaural processing abilities. The training phase consisted of 5-8 sessions (20 min each) carried out using a hierarchy of graded VAS stimuli. The results obtained from descriptive statistics were indicative of an improvement in all the spatial acuity measures in the post-training phase. Statistically, significant changes were noted in interaural time difference (ITD) and virtual acoustic space identification scores measured in the post-training phase. Effect sizes (r) for all of these measures were substantially large, indicating the clinical relevance of these measures in documenting the impact of training. However, the same was not reflected in P300. The training protocol used in the present study on a preliminary basis proves to be effective in normal-hearing listeners, and its implications can be extended to other clinical population as well.

Elbow Joint Position Sense After Neuromuscular Training With Handheld Vibration

PubMed Central

Tripp, Brady L.; Faust, Donald; Jacobs, Patrick

2009-01-01

Abstract Context: Clinicians use neuromuscular control exercises to enhance joint position sense (JPS); however, because standardizing such exercises is difficult, validations of their use are limited. Objective: To evaluate the acute effects of a neuromuscular training exercise with a handheld vibrating dumbbell on elbow JPS acuity. Design: Crossover study. Setting: University athletic training research laboratory. Patients or Other Participants: Thirty-one healthy, college-aged volunteers (16 men, 15 women, age  =  23 ± 3 years, height  =  173 ± 8 cm, mass  =  76 ± 14 kg). Intervention(s): We measured and trained elbow JPS using an electromagnetic tracking device that provided auditory and visual biofeedback. For JPS testing, participants held a dumbbell and actively identified the target elbow flexion angle (90°) using the software-generated biofeedback, followed by 3 repositioning trials without feedback. Each neuromuscular training protocol included 3 exercises during which participants held a 2.55-kg dumbbell vibrating at 15, 5, or 0 Hz and used software-generated biofeedback to locate and maintain the target elbow flexion angle for 15 seconds. Main Outcome Measure(s): We calculated absolute (accuracy) and variable (variability) errors using the differences between target and reproduced angles. Results: Training protocols using 15-Hz vibration enhanced accuracy and decreased variability of elbow JPS (P ≤ .005), whereas 5-Hz vibration did not affect accuracy (F1,61  =  2.625, P  =  .100) but did decrease variability (F1,61  =  7.250, P  =  .009). The control condition and 0-Hz training protocol had no effect on accuracy or variability (P ≥ .200). Conclusions: Our results suggest these neuromuscular control exercises, which included low-magnitude, low-frequency handheld vibration, may enhance elbow JPS. Future researchers should examine vibration of various durations and frequencies, should include injured participants and functional multijoint and multiplanar measures, and should examine long-term effects of training protocols on JPS and injury. PMID:19911088

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.

Effects of Plyometric and Directional Training on Speed and Jump Performance in Elite Youth Soccer Players.

PubMed

Beato, Marco; Bianchi, Mattia; Coratella, Giuseppe; Merlini, Michele; Drust, Barry

2018-02-01

Beato, M, Bianchi, M, Coratella, G, Merlini, M, and Drust, B. Effects of plyometric and directional training on speed and jump performance in elite youth soccer players. J Strength Cond Res 32(2): 289-296, 2018-Soccer players perform approximately 1,350 activities (every 4-6 seconds), such as accelerations/decelerations and changes of direction (CODs) during matches. It is well established that COD and plyometric training have a positive impact on fitness parameters in football players. This study analyzed the effect of a complex COD and plyometric protocol (CODJ-G) compared with an isolated COD protocol (COD-G) training on elite football players. A randomized pre-post parallel group trial was used in this study. Twenty-one youth players were enrolled in this study (mean ± SD; age 17 ± 0.8 years, mass 70.1 ± 6.4 kg, and height 177.4 ± 6.2 cm). Players were randomized into 2 different groups: CODJ-G (n = 11) and COD-G (n = 10), training frequency of 2 times a week more than 6 weeks. Sprint 10, 30, and 40 m, long jump, triple hop jump, and 505 COD test were considered. Exercise-induced within-group changes in performance for both CODJ-G and COD-G: long jump (effect size [ES] = 0.32 and ES = 0.26, respectively) and sprint 10 m (ES = -0.51 and ES = -0.22, respectively), after 6 weeks of training. Moreover, CODJ-G reported substantially better results (between-group changes) in long jump test (ES = 0.32). In conclusion, this study showed that short-term protocols (CODJ-G and COD-G) are important and able to give meaningful improvements on power and speed parameters in a specific soccer population. CODJ-G showed a larger effect in sprint and jump parameters compared with COD-G after the training protocol. This study offers important implications for designing COD and jumps training in elite soccer.

Improving neuromuscular performance in young basketball players: plyometric vs. technique training.

PubMed

Attene, G; Iuliano, E; Di Cagno, A; Calcagno, G; Moalla, W; Aquino, G; Padulo, J

2015-01-01

The aim of this study was to compare the effects of plyometric training versus basketball technique training on improving neuro-muscular performance. Thirty-six (age 14.9±0.9 years, body height 164.0±7.6 cm, body weight 54.0±8.7 kg, BMI 20.1±2.4 kg·m-2) basketball players girls were randomly allocated to 2 groups: Basketball Plyometric Training (BPT, N.=18) and Basketball Technique Training (BTT, N.=18). The players were tested by two specific tests: counter movement jump (CMJ) and squat jump (SJ) before and after 6 training weeks. The jump height, as dependent variable, showed a different trend as an effect of the different training protocols, in contrast with the current knowledge. Manova did not show significant interactions between the two groups for the height of jumps, while significant differences were found for interaction time × training (P<0.05) and for main effect × time (P<0.001). After training, the BPT group increased significantly CMJ performance by 11.3% (P<0.05), whereas the BTT group increased by 4.6%. Likewise, the BPT group demonstrated a significant greater improvement of jump height than BTT group (an increase of 15.4% vs. 7.5%, P<0.01; respectively). These results suggest that both training protocols proposed in this study improved vertical jump performance. However, a combination of the two protocols, plyometric training and sport-specific-exercises, could be useful to optimize performance by an easy transition from controlled a-specific to sport-specific performance requirements. In conclusion, BPT is a safe and effective method of achieving a favourable neuro-muscular performance than BTT in female basketball players.

Additive Effects of Intermittent Hypobaric Hypoxia and Endurance Training on Bodyweight, Food Intake, and Oxygen Consumption in Rats.

PubMed

Cabrera-Aguilera, Ignacio; Rizo-Roca, David; Marques, Elisa A; Santocildes, Garoa; Pagès, Teresa; Viscor, Gines; Ascensão, António A; Magalhães, José; Torrella, Joan Ramon

2018-06-29

Cabrera-Aguilera, Ignacio, David Rizo-Roca, Elisa A. Marques, Garoa Santocildes, Teresa Pagès, Gines Viscor, António A. Ascensão, José Magalhães, and Joan Ramon Torrella. Additive effects of intermittent hypobaric hypoxia and endurance training on bodyweight, food intake, and oxygen consumption in rats. High Alt Med Biol 00:000-000, 2018.-We used an animal model to elucidate the effects of an intermittent hypobaric hypoxia (IHH) and endurance exercise training (EET) protocol on bodyweight (BW), food and water intake, and oxygen consumption. Twenty-eight young adult male rats were divided into four groups: normoxic sedentary (NS), normoxic exercised (NE), hypoxic sedentary (HS), and hypoxic exercised (HE). Normoxic groups were maintained at an atmospheric pressure equivalent to sea level, whereas the IHH protocol consisted of 5 hours per day for 33 days at a simulated altitude of 6000 m. Exercised groups ran in normobaric conditions on a treadmill for 1 hour/day for 5 weeks at a speed of 25 m/min. At the end of the protocol, both hypoxic groups showed significant decreases in BW from the ninth day of exposure, reaching final 10% (HS) to 14.5% (HE) differences when compared with NS. NE rats also showed a significant weight reduction after the 19th day, with a decrease of 7.4%. The BW of hypoxic animals was related to significant hypophagia elicited by IHH exposure (from 8% to 12%). In contrast, EET had no effect on food ingestion. Total water intake was not affected by hypoxia but was significantly increased by exercise. An analysis of oxygen consumption at rest (mL O 2 /[kg·min]) revealed two findings: a significant decrease in both hypoxic groups after the protocol (HS, 21.7 ± 0.70 vs. 19.1 ± 0.78 and HE, 22.8 ± 0.80 vs. 17.1 ± 0.90) and a significant difference at the end of the protocol between NE (21.3 ± 0.77) and HE (17.1 ± 0.90). These results demonstrate that IHH and EET had an additive effect on BW loss, providing evidence that rats underwent a metabolic adaptation through a reduction in oxygen consumption measured under normoxic conditions. These data suggest that the combination of IHH and EET could serve as an alternative treatment for the management of overweight and obesity.

Acute Effect of Whole-Body Vibration Warm-up on Footspeed Quickness.

PubMed

Donahue, Ryan B; Vingren, Jakob L; Duplanty, Anthony A; Levitt, Danielle E; Luk, Hui-Ying; Kraemer, William J

2016-08-01

Donahue, RB, Vingren, JL, Duplanty, AA, Levitt, DE, Luk, H-Y, and Kraemer, WJ. Acute effect of whole-body vibration warm-up on footspeed quickness. J Strength Cond Res 30(8): 2286-2291, 2016-The warm-up routine preceding a training or athletic event can affect the performance during that event. Whole-body vibration (WBV) can increase muscle performance, and thus the inclusion of WBV to the warm-up routine might provide additional performance improvements. The purpose of this investigation was to examine the acute effect of a WBV warm-up, using a vertical oscillating platform and a more traditional warm-up protocol on feet quickness in physically active men. Twenty healthy and physically active men (18-25 years, 22 ± 3 years, 176.8 ± 6.4 cm, 84.4 ± 11.5 kg, 10.8 ± 1.4% body fat) volunteered for this study. A 2 × 2 factorial design was used to examine the effect of 4 warm-up scenarios (no warm-up, traditional warm-up only, WBV warm-up only, and combined traditional and WBV warm-up) on subsequent 3-second Quick feet count test (QFT) performance. The traditional warm-up consisted of static and dynamic exercises and stretches. The WBV warm-up consisted of 60 seconds of vertical sinusoidal vibration at a frequency of 35 Hz and amplitude of 4 mm on a vibration platform. The WBV protocol significantly (p ≤ 0.0005, η = 0.581) augmented QFT performance (WBV: 37.1 ± 3.4 touches; no-WBV: 35.7 ± 3.4 touches). The results demonstrate that WBV can enhance the performance score on the QFT. The findings of this study suggest that WBV warm-up should be included in warm-up routines preceding training and athletic events which include very fast foot movements.

Healthcare Text Classification System and its Performance Evaluation: A Source of Better Intelligence by Characterizing Healthcare Text.

PubMed

Srivastava, Saurabh Kumar; Singh, Sandeep Kumar; Suri, Jasjit S

2018-04-13

A machine learning (ML)-based text classification system has several classifiers. The performance evaluation (PE) of the ML system is typically driven by the training data size and the partition protocols used. Such systems lead to low accuracy because the text classification systems lack the ability to model the input text data in terms of noise characteristics. This research study proposes a concept of misrepresentation ratio (MRR) on input healthcare text data and models the PE criteria for validating the hypothesis. Further, such a novel system provides a platform to amalgamate several attributes of the ML system such as: data size, classifier type, partitioning protocol and percentage MRR. Our comprehensive data analysis consisted of five types of text data sets (TwitterA, WebKB4, Disease, Reuters (R8), and SMS); five kinds of classifiers (support vector machine with linear kernel (SVM-L), MLP-based neural network, AdaBoost, stochastic gradient descent and decision tree); and five types of training protocols (K2, K4, K5, K10 and JK). Using the decreasing order of MRR, our ML system demonstrates the mean classification accuracies as: 70.13 ± 0.15%, 87.34 ± 0.06%, 93.73 ± 0.03%, 94.45 ± 0.03% and 97.83 ± 0.01%, respectively, using all the classifiers and protocols. The corresponding AUC is 0.98 for SMS data using Multi-Layer Perceptron (MLP) based neural network. All the classifiers, the best accuracy of 91.84 ± 0.04% is shown to be of MLP-based neural network and this is 6% better over previously published. Further we observed that as MRR decreases, the system robustness increases and validated by standard deviations. The overall text system accuracy using all data types, classifiers, protocols is 89%, thereby showing the entire ML system to be novel, robust and unique. The system is also tested for stability and reliability.

SU-G-206-01: A Fully Automated CT Tool to Facilitate Phantom Image QA for Quantitative Imaging in Clinical Trials

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

Wahi-Anwar, M; Lo, P; Kim, H

Purpose: The use of Quantitative Imaging (QI) methods in Clinical Trials requires both verification of adherence to a specified protocol and an assessment of scanner performance under that protocol, which are currently accomplished manually. This work introduces automated phantom identification and image QA measure extraction towards a fully-automated CT phantom QA system to perform these functions and facilitate the use of Quantitative Imaging methods in clinical trials. Methods: This study used a retrospective cohort of CT phantom scans from existing clinical trial protocols - totaling 84 phantoms, across 3 phantom types using various scanners and protocols. The QA system identifiesmore » the input phantom scan through an ensemble of threshold-based classifiers. Each classifier - corresponding to a phantom type - contains a template slice, which is compared to the input scan on a slice-by-slice basis, resulting in slice-wise similarity metric values for each slice compared. Pre-trained thresholds (established from a training set of phantom images matching the template type) are used to filter the similarity distribution, and the slice with the most optimal local mean similarity, with local neighboring slices meeting the threshold requirement, is chosen as the classifier’s matched slice (if it existed). The classifier with the matched slice possessing the most optimal local mean similarity is then chosen as the ensemble’s best matching slice. If the best matching slice exists, image QA algorithm and ROIs corresponding to the matching classifier extracted the image QA measures. Results: Automated phantom identification performed with 84.5% accuracy and 88.8% sensitivity on 84 phantoms. Automated image quality measurements (following standard protocol) on identified water phantoms (n=35) matched user QA decisions with 100% accuracy. Conclusion: We provide a fullyautomated CT phantom QA system consistent with manual QA performance. Further work will include parallel component to automatically verify image acquisition parameters and automated adherence to specifications. Institutional research agreement, Siemens Healthcare; Past recipient, research grant support, Siemens Healthcare; Consultant, Toshiba America Medical Systems; Consultant, Samsung Electronics; NIH Grant support from: U01 CA181156.« less

Effects of Adding an Internet-Based Pain Coping Skills Training Protocol to a Standardized Education and Exercise Program for People With Persistent Hip Pain (HOPE Trial): Randomized Controlled Trial Protocol

PubMed Central

Rini, Christine; Keefe, Francis; French, Simon; Nelligan, Rachel; Kasza, Jessica; Forbes, Andrew; Dobson, Fiona; Haxby Abbott, J.; Dalwood, Andrew; Vicenzino, Bill; Harris, Anthony; Hinman, Rana S.

2015-01-01

Background Persistent hip pain in older people is usually due to hip osteoarthritis (OA), a major cause of pain, disability, and psychological dysfunction. Objective The purpose of this study is to evaluate whether adding an Internet-based pain coping skills training (PCST) protocol to a standardized intervention of education followed by physical therapist–instructed home exercise leads to greater reductions in pain and improvements in function. Design An assessor-, therapist-, and participant-blinded randomized controlled trial will be conducted. Setting The study will be conducted in a community setting. Participants The participants will be 142 people over 50 years of age with self-reported hip pain consistent with hip OA. Intervention Participants will be randomly allocated to: (1) a control group receiving a 24-week standardized intervention comprising an 8-week Internet-based education package followed by 5 individual physical therapy exercise sessions plus home exercises (3 times weekly) or (2) a PCST group receiving an 8-week Internet-based PCST protocol in addition to the control intervention. Measurements Outcomes will be measured at baseline and 8, 24, and 52 weeks, with the primary time point at 24 weeks. Primary outcomes are hip pain on walking and self-reported physical function. Secondary outcomes include health-related quality-of-life, participant-perceived treatment response, self-efficacy for pain management and function, pain coping attempts, pain catastrophizing, and physical activity. Measurements of adherence, adverse events, use of health services, and process measures will be collected at 24 and 52 weeks. Cost-effectiveness will be assessed at 52 weeks. Limitations A self-reported diagnosis of persistent hip pain will be used. Conclusions The findings will help determine whether adding an Internet-based PCST protocol to standardized education and physical therapist–instructed home exercise is more effective than education and exercise alone for persistent hip pain. This study has the potential to guide clinical practice toward innovative modes of psychosocial health care provision. PMID:26023213

Effects of Adding an Internet-Based Pain Coping Skills Training Protocol to a Standardized Education and Exercise Program for People With Persistent Hip Pain (HOPE Trial): Randomized Controlled Trial Protocol.

PubMed

Bennell, Kim L; Rini, Christine; Keefe, Francis; French, Simon; Nelligan, Rachel; Kasza, Jessica; Forbes, Andrew; Dobson, Fiona; Abbott, J Haxby; Dalwood, Andrew; Vicenzino, Bill; Harris, Anthony; Hinman, Rana S

2015-10-01

Persistent hip pain in older people is usually due to hip osteoarthritis (OA), a major cause of pain, disability, and psychological dysfunction. The purpose of this study is to evaluate whether adding an Internet-based pain coping skills training (PCST) protocol to a standardized intervention of education followed by physical therapist-instructed home exercise leads to greater reductions in pain and improvements in function. An assessor-, therapist-, and participant-blinded randomized controlled trial will be conducted. The study will be conducted in a community setting. The participants will be 142 people over 50 years of age with self-reported hip pain consistent with hip OA. Participants will be randomly allocated to: (1) a control group receiving a 24-week standardized intervention comprising an 8-week Internet-based education package followed by 5 individual physical therapy exercise sessions plus home exercises (3 times weekly) or (2) a PCST group receiving an 8-week Internet-based PCST protocol in addition to the control intervention. Outcomes will be measured at baseline and 8, 24, and 52 weeks, with the primary time point at 24 weeks. Primary outcomes are hip pain on walking and self-reported physical function. Secondary outcomes include health-related quality-of-life, participant-perceived treatment response, self-efficacy for pain management and function, pain coping attempts, pain catastrophizing, and physical activity. Measurements of adherence, adverse events, use of health services, and process measures will be collected at 24 and 52 weeks. Cost-effectiveness will be assessed at 52 weeks. A self-reported diagnosis of persistent hip pain will be used. The findings will help determine whether adding an Internet-based PCST protocol to standardized education and physical therapist-instructed home exercise is more effective than education and exercise alone for persistent hip pain. This study has the potential to guide clinical practice toward innovative modes of psychosocial health care provision. © 2015 American Physical Therapy Association.

An in vivo investigative protocol for HDR prostate brachytherapy using urethral and rectal thermoluminescence dosimetry.

PubMed

Toye, Warren; Das, Ram; Kron, Tomas; Franich, Rick; Johnston, Peter; Duchesne, Gillian

2009-05-01

To develop an in vivo dosimetry based investigative action level relevant for a corrective protocol for HDR brachytherapy boost treatment. The dose delivered to points within the urethra and rectum was measured using TLD in vivo dosimetry in 56 patients. Comparisons between the urethral and rectal measurements and TPS calculations showed differences, which are related to the relative position of the implant and TLD trains, and allowed shifts of implant position relative to the prostate to be estimated. Analysis of rectal dose measurements is consistent with implant movement, which was previously only identified with the urethral data. Shift corrected doses were compared with results from the TPS. Comparison of peak doses to the urethra and rectum has been assessed against the proposed corrective protocol to limit overdosing these critical structures. An initial investigative level of 20% difference between measured and TPS peak dose was established, which corresponds to 1/3 of patients which was practical for the caseload. These patients were assessed resulting in corrective action being applied for one patient. Multiple triggering for selective investigative action is outlined. The use of a single in vivo measurement in the first fraction optimizes patient benefit at acceptable cost.

Problem-solving in caregiver-counselling (PLiP Study): study protocol of a cluster randomized pragmatic trial.

PubMed

Pfeiffer, Klaus; Hautzinger, Martin; Patak, Margarete; Grünwald, Julia; Becker, Clemens; Albrecht, Diana

2017-03-06

Despite the positive evaluation of various caregiver interventions over the past 3 decades, only very few intervention protocols have been translated to delivery in service contexts. The purpose of this study is to train care counsellors of statutory long term care insurances in problem-solving and to evaluate this approach as an additional component in the statutory care counselling in Germany. A pragmatic cluster randomized controlled trial in which 38 sites with 58 care counsellors are randomly assigned to provide either routine counselling plus additional problem-solving for caregivers or routine counselling alone. The counsellor training comprises an initial 2-day training, a follow-up day after 4 months, and biweekly supervision contacts with a psychotherapist for 6 months over the phone. The agreed minimum counselling intensity is one initial face-to-face contact including a caregiver assessment and at least one telephone follow-up contact. Caregivers who are positively screened for significant strain in their role are followed up at 3 and 6 months after baseline assessment. Main outcome are caregivers' depressive symptoms. While it is unclear if the expected very low amount of additional counselling time is sufficient to yield any additional effects on caregiver depression, it is also unclear if the additional problem-solving component yields to synergies with routine counselling that is based on information and case management. There are different potential individual and organisational barriers to a consistent intervention delivery like gratification for participation, time for extra work or internal motivation to participate. ( ISRCTN23635523 ).

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

PubMed

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

2017-01-01

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

Spontaneous and training-induced cortical plasticity in MD patients: Hints from lateral masking.

PubMed

Maniglia, Marcello; Soler, Vincent; Cottereau, Benoit; Trotter, Yves

2018-01-08

Macular degeneration (MD) affects central vision and represents the leading cause of visual diseases in elderly population worldwide. As a consequence of central vision loss, MD patients develop a preferred retinal locus (PRL), an eccentric fixation point that replaces the fovea. Here, our aim was to determine whether and to what extent spontaneous plasticity takes place in the cortical regions formerly responding to central vision and whether a visual training based on perceptual learning (PL) can boost this plasticity within the PRL area. Spontaneous and PL-induced cortical plasticity were characterized by using lateral masking, a contrast sensitivity modulation induced by collinear flankers. This configuration is known to be sensitive to neural plasticity and underlies several rehabilitation trainings. Results in a group of 4 MD patients showed that collinear facilitation was similar to what observed in age- and eccentricity-matched controls. However, MD patients exhibited significantly reduced collinear inhibition, a sign of neural plasticity, consistent with the hypothesis of partial cortical reorganization. Three AMD patients from the same group showed a further reduction of inhibition after training, but not controls. This result suggests that PL might further boost neural plasticity, opening promising perspectives for the development of rehabilitation protocols for MD patients.

Examining the Real-Time Effects of Reading-Strategy Training.

ERIC Educational Resources Information Center

Hamman, D.; And Others

A think-aloud protocol study examined changes in real-time cognitive, metacognitive, and motivation processing that may have resulted from reading-strategy training. Eighth-grade students participated in 4 weeks of reading-strategy training during social studies class. Students used their own social studies text during the training. Fourteen…

Australian Recognition Framework Arrangements. Australia's National Training Framework.

ERIC Educational Resources Information Center

Australian National Training Authority, Brisbane.

This document explains the objectives, principles, standards, and protocols of the Australian Recognition Framework (ARF), which is a comprehensive approach to national recognition of vocational education and training (VET) that is based on a quality-assured approach to the registration of training organizations seeking to deliver training, assess…

The Brain Games study: protocol for a randomised controlled trial of computerised cognitive training for preventing mental illness in adolescents with high-risk personality styles.

PubMed

Mewton, Louise; Hodge, Antoinette; Gates, Nicola; Visontay, Rachel; Teesson, Maree

2017-09-25

A broad range of mental disorders are now understood as aberrations of normal adolescent brain development. In both adolescents and adults, executive dysfunction has been implicated across a range of mental illnesses, and enhancing executive functioning may prove to be a useful prevention strategy for adolescents at risk for a range of psychopathology. This study will consist of a double-blind, randomised controlled trial with a 12-month follow-up period. Participants will consist of 200 people aged 16-24 years who are at risk for a range of mental disorders based on personality risk factors, but have not experienced a lifetime mental illness as determined by a structured diagnostic interview. Participants will be randomly allocated to either an intervention group who complete an online cognitive training programme specifically targeting executive functioning ability or a control group who complete an online cognitive training programme that has limited executive functioning training potential. Superiority of the executive functioning training programme compared with the control training programme will be assessed at baseline, post-training and at 3-month, 6-month and 12-month follow-up. All assessments will be conducted online. The primary outcome of the study will be general psychopathology as measured by the Strengths and Difficulties Questionnaire. Secondary outcomes will include executive functioning ability, day-to-day functioning and alcohol consumption. All analyses will be undertaken using mixed-model repeated measures analysis of variance with planned contrasts. Ethics approval has been obtained from the University of New South Wales Human Research Ethics Committee (HC15094). Results of the trial immediately post-treatment and at 12 months follow-up will be submitted for publication in peer-reviewed journals. ACTRN12616000127404; Pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The Brain Games study: protocol for a randomised controlled trial of computerised cognitive training for preventing mental illness in adolescents with high-risk personality styles

PubMed Central

Mewton, Louise; Hodge, Antoinette; Gates, Nicola; Visontay, Rachel; Teesson, Maree

2017-01-01

Introduction A broad range of mental disorders are now understood as aberrations of normal adolescent brain development. In both adolescents and adults, executive dysfunction has been implicated across a range of mental illnesses, and enhancing executive functioning may prove to be a useful prevention strategy for adolescents at risk for a range of psychopathology. Methods and analysis This study will consist of a double-blind, randomised controlled trial with a 12-month follow-up period. Participants will consist of 200 people aged 16–24 years who are at risk for a range of mental disorders based on personality risk factors, but have not experienced a lifetime mental illness as determined by a structured diagnostic interview. Participants will be randomly allocated to either an intervention group who complete an online cognitive training programme specifically targeting executive functioning ability or a control group who complete an online cognitive training programme that has limited executive functioning training potential. Superiority of the executive functioning training programme compared with the control training programme will be assessed at baseline, post-training and at 3-month, 6-month and 12-month follow-up. All assessments will be conducted online. The primary outcome of the study will be general psychopathology as measured by the Strengths and Difficulties Questionnaire. Secondary outcomes will include executive functioning ability, day-to-day functioning and alcohol consumption. All analyses will be undertaken using mixed-model repeated measures analysis of variance with planned contrasts. Ethics and dissemination Ethics approval has been obtained from the University of New South Wales Human Research Ethics Committee (HC15094). Results of the trial immediately post-treatment and at 12 months follow-up will be submitted for publication in peer-reviewed journals. Trial registration number ACTRN12616000127404; Pre-results. PMID:28951415

Initiation and preliminary evaluation of an oncology pharmacy training course for staff pharmacists.

PubMed

Saylor, Matthew S; Blanchette, Lisa M; Smith, Morgan B; Cambron, Katie; Andricopulos, Katie; Brown, M Jay

2016-08-01

There is currently a disparity between oncology pharmacy job openings and PGY2 trained pharmacists completing residency training each year. As a result, pharmacists without specialized training in oncology are filling much needed oncology positions and may need on-the-job oncology training. To improve oncology knowledge among non-PGY2 trained pharmacists working in oncology positions, Novant Health coordinated an Oncology Pharmacy Training Course (OPTC). The primary objective was to assess efficacy of the OPTC through evaluation of post-intervention oncology knowledge. Secondary objectives included efficacy of each lecture, assessment of knowledge improvement in those with and without residency or chemotherapy training, and assessment of satisfaction with the OPTC. This was a prospective, cohort study. All pharmacists expressing interest in the OPTC were included unless PGY2 oncology residency trained or Board-Certified in Oncology Pharmacy (BCOP). Participants were invited to attend twice monthly lectures and were evaluated using questionnaires at baseline, 1, 3, 6, and 12 months. At the 3-month evaluation, 29 pharmacists completed the per-protocol evaluation. Knowledge scores increased from a mean of 29.6% to 52.2% (p < 0.01). Ten participants were chemotherapy trained. Baseline knowledge scores were slightly higher in the chemotherapy-trained than training naïve participants (mean 42.5% vs. 27.4%). Both groups experienced significantly improved knowledge scores at 3 months (mean 59% and 48.1% respectively, p < 0.01). Implementation of a formalized OPTC can improve oncology knowledge among staff pharmacists in a community hospital system. This improvement in knowledge is consistent regardless of baseline chemotherapy training. © The Author(s) 2015.

Exercise training improves sleep pattern and metabolic profile in elderly people in a time-dependent manner

PubMed Central

2011-01-01

Aging and physical inactivity are two factors that favors the development of cardiovascular disease, metabolic syndrome, obesity, diabetes, and sleep dysfunction. In contrast, the adoption a habitual of moderate exercise may present a non-pharmacological treatment alternative for sleep and metabolic disorders. We aimed to assess the effects of moderate exercise training on sleep quality and on the metabolic profile of elderly people with a sedentary lifestyle. Fourteen male sedentary, healthy, elderly volunteers performed moderate training for 60 minutes/day, 3 days/week for 24 wk at a work rate equivalent to the ventilatory aerobic threshold. The environment was kept at a temperature of 23 ± 2°C, with an air humidity 60 ± 5%. Blood and polysomnographs analysis were collected 3 times: at baseline (1 week before training began), 3 and 6 months (after 3 and 6 months of training). Training promoted increasing aerobic capacity (relative VO2, time and velocity to VO2max; p < 0.05), and reduced serum NEFA, and insulin concentrations as well as improved HOMA index (p < 0.05), and increased adiponectin levels (p < 0.05), after 3 months of training when compared with baseline data. The sleep parameters, awake time and REM sleep latency were decreased after 6 months exercise training (p < 0.05) in relation baseline values. Our results demonstrate that the moderate exercise training protocol improves the sleep profile in older people, but the metabolism adaptation does not persist. Suggesting that this population requires training strategy modifications as to ensure consistent alterations regarding metabolism. PMID:21733182

[Development of clinical trial education program for pharmaceutical science students through small group discussion and role-playing using protocol].

PubMed

Imakyure, Osamu; Shuto, Hideki; Nishikawa, Fumi; Hagiwara, Yoshifuka; Inoue, Sachiko; Koyanagi, Taeko; Hirakawa, Masaaki; Kataoka, Yasufumi

2010-08-01

The acquirement of basic knowledge of clinical trials and professional attitude in their practices is a general instructional objective in the Model Core Curriculum for Pharmaceutical Education. Unfortunately, the previous program of clinical trial education was not effective in the acquirement of a professional attitude in their practices. Then, we developed the new clinical trial education program using protocol through small group discussion (SGD) and roll-playing. Our program consists of 7 steps of practical training. In step 1, the students find some problems after presentation of the protocol including case and prescription. In step 2, they analyse the extracted problems and share the information obtained in SGD. In steps 3 and 5, five clinical case scenarios are presented to the students and they discuss which case is suitable for entry to the clinical trial or which case corresponds to the discontinuance criteria in the present designed protocol. In steps 4 and 6, the roll-playing is performed by teachers and students as doctors and clinical research coordinators (CRC) respectively. Further, we conducted a trial practice based on this program for the students. In the student's self-evaluation into five grades, the average score of the skill acquisition level in each step was 3.8-4.7 grade. Our clinical trial education program could be effective in educating the candidates for CRC or clinical pharmacists.

The use of high-fidelity human patient simulation as an evaluative tool in the development of clinical research protocols and procedures.

PubMed

Wright, Melanie C; Taekman, Jeffrey M; Barber, Linda; Hobbs, Gene; Newman, Mark F; Stafford-Smith, Mark

2005-12-01

Errors in clinical research can be costly, in terms of patient safety, data integrity, and data collection. Data inaccuracy in early subjects of a clinical study may be associated with problems in the design of the protocol, procedures, and data collection tools. High-fidelity patient simulation centers provide an ideal environment to apply human-centered design to clinical trial development. A draft of a complex clinical protocol was designed, evaluated and modified using a high-fidelity human patient simulator in the Duke University Human Simulation and Patient Safety Center. The process included walk-throughs, detailed modifications of the protocol and development of procedural aids. Training of monitors and coordinators provided an opportunity for observation of performance that was used to identify further improvements to the protocol. Evaluative steps were used to design the research protocol and procedures. Iterative modifications were made to the protocol and data collection tools. The success in use of human simulation in the preparation of a complex clinical drug trial suggests the benefits of human patient simulation extend beyond training and medical equipment evaluation. Human patient simulation can provide a context for informal expert evaluation of clinical protocol design and for formal "rehearsal" to evaluate the efficacy of procedures and support tools.

SUSTAINED ISOMETRIC SHOULDER CONTRACTION ON MUSCULAR STRENGTH AND ENDURANCE: A RANDOMIZED CLINICAL TRIAL.

PubMed

Myers, Natalie L; Toonstra, Jenny L; Smith, Jacob S; Padgett, Cooper A; Uhl, Tim L

2015-12-01

The Advanced Throwers Ten Exercise Program incorporates sustained isometric contractions in conjunction with dynamic shoulder movements. It has been suggested that incorporating isometric holds may facilitate greater increases in muscular strength and endurance. However, no objective evidence currently exists to support this claim. The purpose of this research was to compare the effects of a sustained muscle contraction resistive training program (Advanced Throwers Ten Program) to a more traditional exercise training protocol to determine if increases in shoulder muscular strength and endurance occur in an otherwise healthy population. It was hypothesized that utilizing a sustained isometric hold during a shoulder scaption exercise from the Advanced Throwers Ten would produce greater increases in shoulder strength and endurance as compared to a traditional training program incorporating a isotonic scapular plane abduction (scaption) exercise. Randomized Clinical Trial. Fifty healthy participants were enrolled in this study, of which 25 were randomized into the traditional training group (age: 26 ± 8, height:172 ± 10 cm, weight: 73 ± 13 kg, Marx Activity Scale: 11 ± 4) and 25 were randomized to the Advanced Throwers Ten group (age: 28 ± 9, height: 169 ± 23 cm, weight: 74 ± 16 kg, Marx Activity Scale: 11 ± 5). No pre-intervention differences existed between the groups (P>0.05). Arm endurance and strength data were collected pre and post intervention using a portable load cell (BTE Evaluator, Hanover, MD). Both within and between group analyses were done in order to investigate average torque (strength) and angular impulse (endurance) changes. The traditional and Advanced Throwers Ten groups both significantly improved torque and angular impulse on both the dominant and non-dominant arms by 10-14%. There were no differences in strength or endurance following the interventions between the two training groups (p>0.75). Both training approaches increased strength and endurance as the muscle loads were consistent between protocols indicating that either approach will have positive effects. Level 2.

Efficacy of a hybrid online training for panic symptoms and agoraphobia: study protocol for a randomized controlled trial.

PubMed

Ebenfeld, Lara; Kleine Stegemann, Stefan; Lehr, Dirk; Ebert, David Daniel; Jazaieri, Hooria; van Ballegooijen, Wouter; Funk, Burkhardt; Riper, Heleen; Berking, Matthias

2014-11-04

Recently, internet-based interventions have been proposed as effective treatments for people with panic disorder (PD). However, little is known about the clinical effects of integrating mobile technology into these interventions. Because users carry their smartphones with them throughout the day, we hypothesize that this technology can be used to significantly support individuals with monitoring and overcoming their PD symptoms. The aim of the present study is to evaluate the efficacy and cost-effectiveness of a newly developed hybrid intervention that combines internet/PC with smartphone delivery to treat the symptoms of PD. The intervention is based on cognitive behavioral therapy and consists of six modules over a total of six weeks. A two-arm randomized controlled trial (RCT) will be conducted to evaluate the effects of a hybrid online training module for PD. Based on a power calculation (d =0.60; 1-β of 80%; α =0.05), 90 participants with mild to moderate panic symptoms with or without agoraphobia (as assessed by the Panic and Agoraphobia Scale) will be recruited from the general population and randomly assigned to either the intervention group or a six-month waitlist control group. The primary outcome measure will be the severity of panic symptoms. Secondary outcomes will include depression, quality of life, and an observer-based rating of panic severity. Furthermore, data regarding acceptance and the usability of the smartphone app will be assessed. Assessments will take place at baseline as well as eight weeks, three months, and six months after randomization. Moreover, a cost-effectiveness analysis will be performed from a societal perspective. Data will be analyzed on an intention-to-treat basis and per protocol. To our knowledge, this RCT is one of the first to examine the efficacy of a hybrid online training for adult PD. This study seeks to contribute to the emerging field of hybrid online training. If the intervention is efficacious, then research on this hybrid online training should be extended. The cost-effectiveness analysis will also indicate whether online training is an economical tool for treating PD among adults. German Clinical Trial Register: DRKS00005223 (registered on 15 August 2013).

Safety and efficacy of cardiac rehabilitation for patients with continuous flow left ventricular assist devices.

PubMed

Marko, Christiane; Danzinger, Georg; Käferbäck, Michael; Lackner, Thomas; Müller, Rudolf; Zimpfer, Daniel; Schima, Heinrich; Moscato, Francesco

2015-11-01

Despite the increasing use of left ventricular assist devices (LVADs) in terminal heart failure, cardiac rehabilitation protocols have not yet been documented in larger LVAD patient cohorts. The aim of this study was to investigate safety and efficacy of exercise training during a rehabilitation programme after post-operative discharge of LVAD patients. Rehabilitation data obtained between 2010-2012 from 41 LVAD patients (mean age 54.8 ± 11.6 years; 20% female) were retrospectively analysed. The exercise protocol consisted of strength exercises for lower limbs, bicycle ergometry, walking and gymnastics. The numbers of training sessions, their duration and intensity as well as adverse events were documented. Spiroergometry was performed at least once and twice in a subgroup of 15 patients (at the beginning and end of rehabilitation). Rehabilitation started 48 ± 38 days post LVAD implantation with an average duration of 32 ± 6 days. An increase in exercise capacity was observed. Duration (19 ± 4 vs 14 ± 2 min, p < 0.001) and intensity of bicycle ergometry increased (module number 6.2 ± 2.8 vs 2.0 ± 1.9, p < 0.001) as well as muscular strength all muscle groups trained (e.g. 33.6 ± 15.2 vs 26.6 ± 11.9 kg at the leg press, p = 0.002). Spiroergometry revealed an increase of maximal oxygen consumption (14.5 ± 5.2 vs 11.3 ± 4.1 ml/min/kg, p = 0.007) in the subgroup that underwent two examinations. In the whole population the average increase was lower (12.81 ± 4.35 ml/min/kg). One training-related adverse event (non-sustained ventricular tachycardia) was observed. Exercise training for LVAD patient as part of a multidisciplinary rehabilitation programme is effective and safe. This warrants the broad application of exercise training after LVAD implantation. © The European Society of Cardiology 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Team Training and Institutional Protocols to Prevent Shoulder Dystocia Complications.

PubMed

Smith, Samuel

2016-12-01

Shoulder dystocia is an obstetrical emergency that may result in significant neonatal complications. It requires rapid recognition and a coordinated response. Standardization of care, teamwork and communication, and clinical simulation are the key components of patient safety programs in obstetrics. Simulation-based team training and institutional protocols for the management of shoulder dystocia are emerging as integral components of many labor and delivery safety initiatives because of their impact on technical skills and team performance.

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.

Effects of Fatigue on Throwing Performance in Experienced Team Handball Players

PubMed Central

Nuño, Alberto; van den Tillaar, Roland; Guisado, Rafael; Martín, Ignacio; Martinez, Isidoro; Chirosa, Luis J.

2016-01-01

Abstract The purpose of this study was to investigate the effect of central and peripheral physiological fatigue on throwing accuracy and ball release velocity in team handball. Twenty male subjects (age 24.7 ± 3.9 yrs, body mass 88.5 ± 5.0 kg, body height 1.86 ± 0.05 m, training experience 12.7 ± 3.8 yrs) from one handball team participated in this study. The participants completed four sets of eight laps of a circuit that consisted of specific team handball drills/exercises, with decreasing recovery times between the laps in each set in order to induce physiological fatigue. Duration of the recovery intervals determined the description of the effort made in each set: “light" (80 s recovery between laps), “moderate" (40 s), “hard" (20 s) and “very hard" (10 s). A heart rate, concentration of lactate in blood and the rate of perceived exertion (RPE) were recorded. Ball velocity and accuracy were measured after each set and they both decreased during a fatigue protocol. However, accuracy only decreased significantly in the end of the protocol, while ball release was already affected after the first round of the protocol. The results substantiate the initial hypothesis and confirm that both throwing accuracy and ball release velocity decrease significantly as physiological fatigue increases. These variables began to decrease when the fatigue quantification values were high or very high. The findings can be used by coaches to develop training programs to teach players how to identify fatigue thresholds and combat the effects of fatigue through decision-making skills at critical game moments. PMID:28031762

A Generic Communication Protocol for Remote Laboratories: an Implementation on e-lab

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

Henriques, Rafael B.; Fernandes, H.; Duarte, Andre S.

2015-07-01

The remote laboratories at IST (Instituto Superior Tecnico), e-lab, serve as a valuable tool for education and training based on remote control technologies. Due to the high number and increase of remotely operated experiments a generic protocol was developed to perform the communication between the software driver and the respective experimental setup in an easier and more unified way. The training in these fields of students and personnel can take advantage of such infrastructure with the purpose of deploying new experiments in a faster way. More than 10 experiments using the generic protocol are available on-line in a 24 xmore » 7 way. (authors)« less

Ability, incentives, and management feedback: organizational change to reduce pressure ulcers in a nursing home.

PubMed

Rosen, Jules; Mittal, Vikas; Degenholtz, Howard; Castle, Nick; Mulsant, Benoit H; Hulland, Shelley; Nace, David; Rubin, Fred

2006-03-01

Quality improvement (QI) processes in nursing homes are highly variable and often ineffective. This study evaluated an innovative QI process to reduce pressure ulcers (PUs) in a nursing home with a high rate of PUs. This was a 48-week, longitudinal study comparing the incidence of PUs during 12-week baseline and intervention and post-intervention periods. Not-for-profit, 136-bed nursing home in urban Western Pennsylvania. All residents and all staff at the nursing home participated in this study. The intervention consisted of 3 components: Ability enhancement, incentivization, and management feedback. To enhance ability, all staff members completed a computer-based interactive video education program on PU prevention and were mandated to use penlights to promote early detection. Incentivization included $75 for each staff member if the desired reduction in PU incidence was achieved. Management feedback provided real-time information of staff"s adherence to the mandated training. Outcome measures consisted of staff's adherence to mandated training and the incidence of new PUs during the baseline period compared to the intervention and post-intervention periods. Management responded to noncompliance with training with both rewards and stepped discipline. Adherence to protocol, as measured by training compliance, was 100%. There was a significant reduction (P < .05) in the incidence of stage 2 or worse PUs during the intervention period. During the post-intervention periods, the effect was lost. An innovative QI initiative resulted in a significant decrease in PUs in 1 facility. This intervention was not sustainable when the 3 components of the QI intervention were no longer actively maintained.

Effect of Low-Level Laser Therapy and Strength Training Protocol on Hand Grip by Dynamometry

PubMed Central

Barbosa, Rafael; Marcolino, Alexandre; Souza, Vitor; Bertolino, Guilherme; Fonseca, Marisa; Guirro, Rinaldo

2017-01-01

Introduction: The purpose of this study was to investigate the effect of low-level laser therapy (LLLT) – 660 nm and 904 nm - before grip strength protocol in healthy subjects. Methods: The study included 45 healthy volunteers with an average age of 22.7 (±1.4) years, subdivided into the following groups, control group: grip strength training associated with placebo LLLT; 660 nm group: LLLT (660 nm, 20 J/cm2, power of 30 mW, and beam area of 0.06 cm2, continuous, energy 1.2 J, and exposure time 40 seconds per point) before grip strength training and 904 nm group: LLLT (904 nm, 10 J/cm2, peak power of 70 W and 0.13 cm2 beam area, with pulsed beam 9.500 Hz and 30 seconds of exposure time per point and emitted energy 1.2 J) before grip strength training. The LLLT was timed to contact 10 points located in the region of the superficial and deep flexor muscles of the fingers, with a total energy of 12.0 J per session. For the strength training protocol, the volunteer exercised their fingers with the dominant hand on a small table, elbow flexed at 90°, forearm in neutral, using a light extension handle. The Oxford protocol was performed during four weeks. The grip strength was assessed using a dynamometer (Jamar™). The data were evaluated by the analysis of variance (ANOVA) statistical method. Results: In the comparison of intragroup evaluation, only the 904 nm group showed a difference compared to the baseline assessment after 4 weeks (P < 0.05), in the final intergroup evaluation, a difference was observed in the comparison between the control and 904 nm groups Conclusion: In conclusion, LLLT (904 nm) applied before resistance training was effective in gaining grip strength when compared to LLLT (660 nm) and isolated strength training after 4 weeks. PMID:29123629

Individualized treadmill and strength training for chronic stroke rehabilitation: effects of imbalance.

PubMed

Al-Jarrah, Muhammed; Shaheen, Samira; Harries, Netta; Kissani, Najib; Molteni, Franco; Bar Haim, Simona

2014-01-01

Stroke survivors often have significant walking limitations and are at high risk for falling. Treadmill training, as a rehabilitation approach in stroke survivors, and its relationship to balance ability has not been widely studied. The main goal of this study was to investigate the effectiveness of an individualized treadmill-strength training protocol on functional outcomes in chronic stroke survivors. Thirty adult participants with chronic stroke were recruited from 1 European and 4 Middle Eastern countries. Each completed 36 sessions of treadmill-strength training. The rehabilitation protocol was individualized according to each patient's cardiovascular fitness. Ten-meter walk test (10MWT), Berg Balance Scale (BBS), and 6-minute walk test (6MWT) were measured before (T0) and after training (T1) and 6 months later (T2). Paired t tests were used to test differences with training (T1 - T0) and retention after training (T2 - T1). Increases in all 3 measures from T0 to T1 were significant. There were no changes in 10MWT and BBS from T1 to T2, but 6MWT tended to increase. Separate analyses for subjects with BBS scores <41 at T0 demonstrated comparatively greater improvements from T0 to T1 than in those with BBS scores ≯40. Those with low scores also significantly increased from T1 to T2 in both walk tests. These findings suggest that a protocol combining treadmill with strength training has beneficial long-term effects on functional walking measures after chronic stroke, especially in patients who initially have low balance ability.

Living high training low induces physiological cardiac hypertrophy accompanied by down-regulation and redistribution of the renin-angiotensin system

PubMed Central

Shi, Wei; Meszaros, J Gary; Zeng, Shao-ju; Sun, Ying-yu; Zuo, Ming-xue

2013-01-01

Aim: Living high training low” (LHTL) is an exercise-training protocol that refers living in hypoxia stress and training at normal level of O2. In this study, we investigated whether LHTL caused physiological heart hypertrophy accompanied by changes of biomarkers in renin-angiotensin system in rats. Methods: Adult male SD rats were randomly assigned into 4 groups, and trained on living low-sedentary (LLS, control), living low-training low (LLTL), living high-sedentary (LHS) and living high-training low (LHTL) protocols, respectively, for 4 weeks. Hematological parameters, hemodynamic measurement, heart hypertrophy and plasma angiotensin II (Ang II) level of the rats were measured. The gene and protein expression of angiotensin-converting enzyme (ACE), angiotensinogen (AGT) and angiotensin II receptor I (AT1) in heart tissue was assessed using RT-PCR and immunohistochemistry, respectively. Results: LLTL, LHS and LHTL significantly improved cardiac function, increased hemoglobin concentration and RBC. At the molecular level, LLTL, LHS and LHTL significantly decreased the expression of ACE, AGT and AT1 genes, but increased the expression of ACE and AT1 proteins in heart tissue. Moreover, ACE and AT1 protein expression was significantly increased in the endocardium, but unchanged in the epicardium. Conclusion: LHTL training protocol suppresses ACE, AGT and AT1 gene expression in heart tissue, but increases ACE and AT1 protein expression specifically in the endocardium, suggesting that the physiological heart hypertrophy induced by LHTL is regulated by region-specific expression of renin-angiotensin system components. PMID:23377552

SU-F-R-06: Traumatic Brachial Plexus Injury Imaging, Developing a Coherent Clinical Protocol From Literature Review Through Practice

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

Wu, D; France, E; Lambert, J

Purpose: Medical Physics teams can now play a critical role to help plan and provide studied approaches for traumatic brachial plexus MR imaging (tbpMRI). This is especially important for coordination with uncommon applications, since it is challenging to select the right modality, parameters, and train technologists on the essential components. For this work, we started with a review of the medical literature, performed crossover/volunteer studies to bring tbpMRI to practice with greater image QC and protocol management. Methods: To the best of our knowledge, we reviewed the known searchable domain for tbpMRI. We found 69 total articles since 2000. Articlesmore » were evaluated with our published protocol for literature management (LIMES3). Two physicists and two radiologists condensed the information from all articles into a knowledgebase. Results: The initial literature demonstrated great heterogeneity, which was a sign that this area needed greater consistency. Despite inconsistency and imprecision, we extracted the most relevant targets using our long-term experience with protocol development in MSK. We ran volunteers on six different magnets of various field strengths with multiple receiver coils, and rebuilt a coherent protocol for tbpMRI. Our radiologists rated LIMES3 work as superior. We have received referrals from the ER and have conducted four patient evaluations. Conclusion: Traumatic brachial plexus MRI has great possible benefits for patients. This work supports the complexity of tbpMRI scanning. As this is rarely performed, it requires a more diligent protocol workflow, coordination of caregivers, and education within multiple clinical departments. Choosing the correct imaging exam can be critical, as patients can have significant neuropathy and/or paralysis. The LIMES3 protocol is well liked at our institution, and forms the cornerstone of understanding for our work. Our literature management led to a better clinical protocol creation despite the diffuse and inconclusive information presented in the existing medical literature.« less

Nonpharmacological treatment of tics in Tourette syndrome adding videotape training to self-hypnosis.

PubMed

Lazarus, Jeffrey E; Klein, Susan K

2010-01-01

This case series examines the practicality of using a standardized method of training children in self-hypnosis (SH) methods to explore its efficiency and short-term efficacy in treating tics in patients with Tourette syndrome. The files of 37 children and adolescents with Tourette syndrome referred for SH training were reviewed, yielding 33 patients for analysis. As part of a protocol for SH training, all viewed a videotape series of a boy undergoing SH training for tic control. Improvement in tic control was abstracted from subjective patient report. Seventy-nine percent of the patients trained in this technique experienced short-term clinical response, defined as control over the average 6-week follow-up period. Of the responders, 46% achieved tic control with SH after only 2 sessions and 96% after 3 visits. One patient required 4 visits. Instruction in SH, aided by the use of videotape training, augments a protocol and probably shortens the time of training in this technique. If SH is made more accessible in this way, it will be a valuable addition to multi-disciplinary management of tic disorders in Tourette syndrome.

Enhancing Communication to Improve Patient Safety and to Increase Patient Satisfaction.

PubMed

Burgener, Audrey M

With the continuous rise of sentinel and adverse events due to ineffective communication, it is time for health care organizations to start implementing a focus on enhancing effective communication in which will, in turn, improve patient safety and experience, boosting the bottom line. This article identifies and discusses different communication protocols that can be used to enhance the consistency of more efficient and effective communication within a health care organization to overall improve patient care and patient satisfaction. The rising importance of patient satisfaction and Hospital Consumer Assessment of Healthcare Providers and Systems scores required by the Centers for Medicare and Medicaid Services are causing a shift in how hospitals evaluate and manage their health care organizations today. Following the situation-background-assessment-recommendation and acknowledge-introduce-duration-explain-thank protocols, as well as proper and effective training and educational programs, enhances more effective communication in health care organizations which improves patient safety and increases patient satisfaction.

Mechanical Analysis of the Acute Effects of a Heavy Resistance Exercise Warm-Up on Agility Performance in Court-Sport Athletes

PubMed Central

Sole, Christopher J.; Moir, Gavin L.; Davis, Shala E.; Witmer, Chad A.

2013-01-01

The purpose of this study was to determine the acute effects of heavy resistance exercise on agility performance in court-sport athletes. Five men (age: 20.6 ± 1.9 years; body mass: 79.36 ± 11.74 kg; body height: 1.93 ± 0.09 m) and five women (age 21.2 ± 2.7 years; body mass: 65.8 ± 10.18 kg; body height 1.77 ± 0.08 m) volunteered to participate in the present study. All subjects were NCAA Division II athletes who currently participated in tennis or basketball and all had previous resistance training experience of at least one year. In a counterbalanced design, agility performance during a 10 m shuttle test was assessed following either a dynamic warm-up (DW) or heavy resistance warm-up (HRW) protocol. The HRW protocol consisted of three sets of squats at 50, 60, and 90% of 1-RM. Agility performance was captured using an eight camera motion analysis system and the mechanical variables of stride length, stride frequency, stance time, flight time, average ground reaction force, as well as agility time were recorded. No significant differences were reported for the HRW and DW protocols for any of the mechanical variables (p>0.05), although there was a trend towards the HRW protocol producing faster agility times compared to the control protocol (p = 0.074). Based on the trend towards a significant effect, as well as individual results it is possible that HRW protocols could be used as an acute method to improve agility performance in some court-sport athletes. PMID:24511350

The Feasibility and Potential Impact of Brain Training Games on Cognitive and Emotional Functioning in Middle-Aged Adults.

PubMed

McLaughlin, Paula M; Curtis, Ashley F; Branscombe-Caird, Laura M; Comrie, Janna K; Murtha, Susan J E

2018-02-01

To investigate whether a commercially available brain training program is feasible to use with a middle-aged population and has a potential impact on cognition and emotional well-being (proof of concept). Fourteen participants (ages 46-55) completed two 6-week training conditions using a crossover (counterbalanced) design: (1) experimental brain training condition and (2) active control "find answers to trivia questions online" condition. A comprehensive neurocognitive battery and a self-report measure of depression and anxiety were administered at baseline (first time point, before training) and after completing each training condition (second time point at 6 weeks, and third time point at 12 weeks). Cognitive composite scores were calculated for participants at each time point. Study completion and protocol adherence demonstrated good feasibility of this brain training protocol in healthy middle-aged adults. Exploratory analyses suggested that brain training was associated with neurocognitive improvements related to executive attention, as well as improvements in mood. Overall, our findings suggest that brain training programs are feasible in middle-aged cohorts. We propose that brain training games may be linked to improvements in executive attention and affect by promoting cognitive self-efficacy in middle-aged adults.

Effects of creatine supplementation along with resistance training on urinary formaldehyde and serum enzymes in wrestlers.

PubMed

Nasseri, Azadeh; Jafari, Afshar

2016-04-01

Formaldehyde is a cytotoxic agent produced from creatine through a metabolic pathway, and in this regard, it has been claimed that creatine supplementation could be cytotoxic. Even though the cytotoxic effects of creatine supplementation have been widely studied, yet little is known about how resistance training can alter these toxic effects. This study aimed to determine the effects of short-term creatine supplementation plus resistance training on the level of urinary formaldehyde and concentrations of serum enzymes in young male wrestlers. In a double-blind design twenty-one subjects were randomized into creatine supplementation (Cr), creatine supplementation plus resistance training (Cr + T) and placebo plus resistance training (Pl + T) groups. Participants ingested creatine (0.3 g/kg/day) or placebo for 7 days. The training protocol consisted of 3 sessions in one week, each session including three sets of 6-9 repetitions at 80-85% of one-repetition maximum for whole-body exercise. Urine and blood samples were collected at baseline and at the end of the supplementation. Creatine supplementation significantly increased the excretion rate of urinary formaldehyde in the Cr and Cr + T groups by 63.4% and 30.4%, respectively (P<0.05), indicating that resistance training could partially lower this rate by 17.7%. No significant differences were detected in the levels of serum enzymes across time and groups (P>0.05). These findings indicate that resistance training may lower the increase of urinary formaldehyde excretion induced by creatine supplementation, suggesting that creatine consumption could be relatively less toxic when combined with resistance training.

Effects of intensity and duration of exercise on muscular responses to training of thoroughbred racehorses.

PubMed

Rivero, José-Luis L; Ruz, Antonio; Martí-Korff, Silvia; Estepa, José-Carlos; Aguilera-Tejero, Escolástico; Werkman, Jutta; Sobotta, Mathias; Lindner, Arno

2007-05-01

This study examined the effects of the intensity and duration of exercise on the nature and magnitude of training adaptations in muscle of adolescent (2-3 yr old) racehorses. Six thoroughbreds that had been pretrained for 2 mo performed six consecutive conditioning programs of varying lactate-guided intensities [velocities eliciting blood lactate concentrations of 2.5 mmol/l (v2.5) and 4 mmol/l (v4), respectively] and durations (5, 15, 25 min). Pre- and posttraining gluteus muscle biopsies were analyzed for myosin heavy chain content, fiber-type composition, fiber size, capillarization, and fiber histochemical oxidative and glycolytic capabilities. Although training adaptations were similar in nature, they varied greatly in magnitude among the different training protocols. Overall, the use of v4 as the exercise intensity for 25 min elicited the most consistent training adaptations in muscle, whereas the minimal training stimulus that evoked any significant change was identified with exercises of 15 min at v2.5. Within this range, muscular adaptations showed significant trends to be proportional to the exercise load of specific training programs. Taken together, these data suggest that muscular adaptations to training in horses occur on a continuum that is based on the exercise intensity and duration of training. The practical implications of this study are that exercises for 15 to 25 min/day at velocities between v2.5 and v4 can improve in the short term (3 wk) the muscular stamina in thoroughbreds. However, exercises of 5-15 min at v4 are necessary to enhance muscular features related to strength (hypertrophy).

The acute effects of heavy back squats on mechanical variables during a series of bilateral hops.

PubMed

Moir, Gavin L; Dale, Jonathan R; Dietrich, Wendy W

2009-07-01

The purpose of the present study was to investigate the acute effects of performing a heavy resistance exercise (HRE) protocol on the mechanical variables during a series of bilateral hops. In a block-randomized design, 10 strength trained men performed an HRE or a control treatment before performing 5 series of bilateral hops separated by 2 minutes of passive recovery. Each series of bilateral hops was performed for 15 seconds on a force platform with the subject hopping at a frequency of 2.0 Hz. From the vertical force trace, the vertical force during the countermovement phase of each hop, the negative displacement during the countermovement phase, and the vertical stiffness were calculated. The HRE treatment consisted of performing parallel back squats with 40, 50, 60, and 80% of each subject's 1-repetition maximum after a series of dynamic stretches. The control treatment consisted of the dynamic stretches only. No significant differences in any of the mechanical variables were reported after the 2 treatments (p > 0.05). There were no significant correlations between the absolute maximal strength values and the percent change in any of the mechanical variables after the 2 treatments. Despite the lack of significant changes reported for the group, there were some notable individual responses. It is possible that increases in vertical stiffness during bilateral hops can be achieved after an HRE protocol in certain individuals. However, practitioners should be aware of the specificity issues and the individual nature of the responses to such protocols.

Myoeletric indices of fatigue adopting different rest intervals during leg press sets.

PubMed

Miranda, Humberto; Maia, Marianna; de Oliveira, Carlos G; Farias, Déborah; da Silva, Jurandir B; Lima, Vicente P; Willardson, Jeffrey M; Paz, Gabriel A

2018-01-01

The purpose of this study was to examine the acute effect of different rest intervals between multiple sets of the 45° angled leg press exercise (LP45) on surface electromyographic (SEMG) spectral and amplitude indices of fatigue. Fifteen recreationally trained females performed three protocols in a randomized crossover design; each consisting of four sets of 10 repetitions with 1 (P1), 3 (P3), or 5 (P5) minute rest intervals between sets. Each set was performed with 70% of the LP45 ten-repetition maximum load. The SEMG data for biceps femoris (BF), vastus lateralis (VL), vastus medialis (VM), and rectus femoris (RF) muscles was then evaluated. The SEMG amplitude change in the time coefficient (CRMS) and spectral fatigue index (Cf5) indicated higher levels of fatigue for all muscles evaluated during the P3 protocol versus the P1 and P5 protocols (p ≤ 0.05), respectively. The RF and VL muscles showed greater fatigue levels by the second and third sets; whereas, greater fatigue was shown in the VM and BF muscles by the fourth set (p ≤ 0.05). A three-minute rest interval between sets might represent a neuromuscular window between a fatigue stated and fully recovered state in the context of neural activation. Moreover, a three minute rest interval between sets might allow for consistent recruitment of high threshold motor units over multiple sets, and thus promote a more effective stimulus for strength gains. Copyright © 2017 Elsevier Ltd. All rights reserved.

Evaluation of a rape protocol: a five year follow-up with nurse managers.

PubMed

Lewis, Carol M; DiNitto, Diana; Nelson, Terri Spahr; Just, Mary Margaret; Campbell-Ruggaard, Julie

2003-01-01

To evaluate the use and effectiveness of a protocol developed for emergency nurses and other medical personnel to use with survivors of sexual assault. The Ohio Department of Health (ODH) Protocol for the Treatment of Adult Sexual Assault Survivors was developed by a multi-disciplinary team in 1991-92 as a written guide to provide comprehensive, standardized, non-judgmental, and equitable treatment for survivors. In 1993, this 118-page manual was sent to all Ohio hospitals. In 1994, a follow-up video and training guide were also delivered. In 1997, Victims Rights Advocacy, a non-profit agency in Ohio, and the Center for Social Work Research at The University of Texas at Austin collaboratively conducted an evaluation of the utilization and effectiveness of this protocol at Ohio hospitals. Emergency departments at Ohio hospitals were asked to complete a mailed survey regarding their policies and procedures for treating sexual assault patients. Telephone calls were made to the hospitals that did not return a survey, and site visits were conducted at 20 hospitals in diverse areas of Ohio. Overall, respondents concurred that hospitals can benefit from using a standardized protocol, such as the ODH Protocol, for treating victims of sexual assault. Survey participants also indicated that training is needed on several topics, especially testifying in court, cultural awareness, and the needs of special populations, such as male, gay, lesbian, and bisexual survivors. In addition, findings indicate that survivors need more follow-up services, and written information about these services should be provided to them. Nurse practitioners can improve the treatment of sexual assault survivors in their communities through a variety of actions, such as gathering information about available protocols and training opportunities for personnel, and becoming familiar with resources that can help victims.

Economic evaluation of an intensive group training protocol compared with usual care physiotherapy in patients with chronic low back pain.

PubMed

van der Roer, Nicole; van Tulder, Maurits; van Mechelen, Willem; de Vet, Henrica

2008-02-15

Economic evaluation from a societal perspective conducted alongside a randomized controlled trial with a follow-up of 52 weeks. To evaluate the cost effectiveness and cost utility of an intensive group training protocol compared with usual care physiotherapy in patients with nonspecific chronic low back pain. The intensive group training protocol combines exercise therapy, back school, and behavioral principles. Two studies found a significant reduction in absenteeism for a graded activity program in occupational health care. This program has not yet been evaluated in a primary care physiotherapy setting. Participating physical therapists in primary care recruited 114 patients with chronic nonspecific low back pain. Eligible patients were randomized to either the protocol group or the guideline group. Outcome measures included functional status (Roland Morris Disability Questionnaire), pain intensity (11-point numerical rating scale), general perceived effect and quality of life (EuroQol-5D). Cost data were measured with cost diaries and included direct and indirect costs related to low back pain. After 52 weeks, the direct health care costs were significantly higher for patients in the protocol group, largely due to the costs of the intervention. The mean difference in total costs amounted to [Euro sign] 233 (95% confidence interval: [Euro sign] -2.185; [Euro sign] 2.764). The cost-effectiveness planes indicated no significant differences in cost effectiveness between the 2 groups. The results of this economic evaluation showed no difference in total costs between the protocol group and the guideline group. The differences in effects were small and not statistically significant. At present, national implementation of the protocol is not recommended.

Crowdsourcing Science to Promote Human Health: New Tools to Promote Sampling of Mosquito Populations by Citizen Scientists

NASA Astrophysics Data System (ADS)

Boger, R. A.; Low, R.; Jaroensutasinee, M.; Jaroensutasinee, K.; Sparrow, E. B.; Costosa, J. I.; Medina, J.; Randolph, G.

2015-12-01

GLOBE in Thailand and GLOBE in Africa independently developed citizen science protocols for collecting and analyzing mosquito larvae. These protocols have been piloted in several workshops and implemented in schools. Data collected have been used for several secondary, undergraduate and graduate student research studies. Over this past year, 2015, these protocols have been synthesized into one protocol that will be made available to the world-wide community through the GLOBE website (www.globe.gov). This new protocol is designed to be flexible in the mosquito species that can be collected and the types of environments sampled (e.g., containers in and around the house, ponds, irrigation ditches in a rice paddy field). Plans are underway to enable web-based data entry and mobile apps for data collection and submission. Once everything is finalized, a GLOBE field campaign will be initiated for citizen scientists to collect meaningful data on where different types of mosquito larvae are found and how the abundance and distribution is changing seasonally. To assist in the standardization of data collection and quality control, training slides are being developed and will be made available in early 2016. This will enable a wider participation of citizen scientists to participate in this effort to collect mosquito data by making it easier to become part of the GLOBE community. As with mosquito larvae, training slides are being created for hydrosphere, biosphere, atmosphere, and pedosphere GLOBE measurement protocols. The development of the mosquito protocol and the training slides are in direct response to the GLOBE community's desire to increase citizen science participation beyond primary and secondary schools, in observing and measuring environmental change.

Randomized clinical trial: the use of SpeechEasy® in stuttering treatment.

PubMed

Ritto, Ana Paula; Juste, Fabiola Staróbole; Stuart, Andrew; Kalinowski, Joseph; de Andrade, Claudia Regina Furquim

2016-11-01

Numerous studies have demonstrated the benefit of devices delivering altered auditory feedback (AAF) as a therapeutic alternative for those who stutter. The effectiveness of a device delivering AAF (SpeechEasy®) was compared with behavioural techniques in the treatment of stuttering in a randomized clinical trial. Two groups of adults who stutter participated: group 1 consisted of 10 men and one woman aged 21-42 years (mean = 30.0). Group 2 consisted of six men and one woman aged 20-50 years (mean = 35.6). Participants in group 1 were fit with a SpeechEasy® device and were not given any additional training (i.e., supplementary fluency enhancing techniques). Participants used the device daily for 6 months. Participants in group 2 received treatment in the form of a 12-week fluency promotion protocol with techniques based on both fluency shaping and stuttering modification. There were no statistically significant differences (p > .05) between groups in participants' stuttered syllables following treatment. That is, both therapeutic protocols achieved approximately 40% reduction in number of stuttered syllables from baseline measures, with no significant relapse after 3 or 6 months post-treatment. The results suggest that the SpeechEasy® device can be a viable option for the treatment of stuttering. © 2016 Royal College of Speech and Language Therapists.

Comparison of traditional and recent approaches in the promotion of balance and strength in older adults.

PubMed

Granacher, Urs; Muehlbauer, Thomas; Zahner, Lukas; Gollhofer, Albert; Kressig, Reto W

2011-05-01

Demographic change in industrialized countries produced an increase in the proportion of elderly people in our society, resulting in specific healthcare challenges. One such challenge is how to effectively deal with the increased risk of sustaining a fall and fall-related injuries in old age. Deficits in postural control and muscle strength represent important intrinsic fall risk factors. Thus, adequate training regimens need to be designed and applied that have the potential to reduce the rate of falling in older adults by countering these factors. Therefore, the purpose of this review is to compare traditional and recent approaches in the promotion of balance and strength in older adults. Traditionally, balance and resistance training programmes proved to be effective in improving balance and strength, and in reducing the number of falls. Yet, it was argued that these training protocols are not specific enough to induce adaptations in neuromuscular capacities that are specifically needed in actual balance-threatening situations (e.g. abilities to recover balance and to produce force explosively). Recent studies indicated that perturbation-based or multitask balance training and power/high-velocity resistance training have the potential to improve these specific capacities because they comply with the principle of training specificity. In fact, there is evidence that these specifically tailored training programmes are more effective in improving balance recovery mechanisms and muscle power than traditional training protocols. A few pilot studies have even shown that these recently designed training protocols have an impact on the reduction of fall incidence rate in older adults. Further research is needed to confirm these results and to elucidate the underlying mechanisms responsible for the adaptive processes.

Dissemination of CBTI to the Non-Sleep Specialist: Protocol Development and Training Issues

PubMed Central

Manber, Rachel; Carney, Colleen; Edinger, Jack; Epstein, Dana; Friedman, Leah; Haynes, Patricia L.; Karlin, Bradley E.; Pigeon, Wilfred; Siebern, Allison T.; Trockel, Mickey

2012-01-01

Strong evidence supports the efficacy of cognitive behavioral therapy for insomnia (CBTI). A significant barrier to wide dissemination of CBTI is the lack of qualified practitioners. We describe challenges and decisions made when developing a CBTI dissemination program in the Veterans Health Administration (VHA). The program targets mental health clinicians from different disciplines (psychiatry, psychology, social work, and nursing) with varying familiarity and experience with general principles of cognitive behavioral therapies (CBT). We explain the scope of training (how much to teach about the science of sleep, comorbid sleep disorders, other medical and mental health comorbidities, and hypnotic-dependent insomnia), discuss adaptation of CBTI to address the unique challenges posed by comorbid insomnia, and describe decisions made about the strategy of training (principles, structure and materials developed/recommended). Among these decisions is the question of how to balance the structure and flexibility of the treatment protocol. We developed a case conceptualization-driven approach and provide a general session-by-session outline. Training licensed therapists who already have many professional obligations required that the training be completed in a relatively short time with minimal disruptions to training participants' routine work responsibilities. These “real-life” constraints shaped the development of this competency-based, yet pragmatic training program. We conclude with a description of preliminary lessons learned from the initial wave of training and propose future directions for research and dissemination. Citation: Manber R; Carney C; Edinger J; Epstein D; Friedman L; Haynes PL; Karlin BE; Pigeon W; Siebern AT; Trockel M. Dissemination of CBTI to the non-sleep specialist: protocol development and training issues. J Clin Sleep Med 2012;8(2):209-218. PMID:22505869

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.

Pivotal Response Training. What Works Clearinghouse Intervention Report

ERIC Educational Resources Information Center

What Works Clearinghouse, 2016

2016-01-01

This intervention report presents findings from a systematic review of "pivotal response training" conducted using the What Works Clearinghouse Procedures and Standards Handbook (version 3.0) and the Children and Students with an Autism Spectrum Disorder review protocol (version 3.0). "Pivotal response training"…

Working Memory Training in ADHD: Controlling for Engagement, Motivation, and Expectancy of Improvement (Pilot Study).

PubMed

Mawjee, Karizma; Woltering, Steven; Lai, Nathan; Gotlieb, Howell; Kronitz, Reena; Tannock, Rosemary

2017-09-01

The aim of this study was to evaluate whether a shortened-length session of CogMed Working Memory Training (CWMT) would be a suitable active control group and evaluate study protocol to aid in design refinements for a larger randomized controlled trial (RCT). Thirty-eight post-secondary students diagnosed with ADHD were randomized into 25 sessions of standard (45 min/session) or shortened (15 min/session) CWMT, or into a waitlist control group. There was no significant difference in completion rate or training index score between the standard- and shortened-length groups indicating that both groups showed improvement and put forth good effort during training. Preliminary findings suggest that shorter training sessions may induce similar levels of engagement, motivation, and expectancy of improvement in participants. We conclude that a larger scale RCT that utilizes shortened-length training as an active control group is warranted, but that a few modifications to the study protocol will be required.

The interactions between hemostasis and resistance training: a review

PubMed Central

Nascimento, Dahan da Cunha; Neto, Frederico Ribeiro; de Santana, Frederico Santos; da Silva, Renato André Sousa; dos Santos-Neto, Leopoldo; Balsamo, Sandor

2012-01-01

Physical inactivity is considered a risk factor for cardiovascular disease and is strongly associated with changes in arterial structure. Regular physical activity and exercise contributes to the prevention of coronary artery disease. Therefore, cardiovascular and resistance training improve hemostatic parameters and promote a less thrombotic blood profile. This review highlights the studies, mechanisms, and outcomes relating to the effectiveness of resistance training on the process of hemostasis. The Pubmed, Scopus, Medline, Scielo, Lilacs, Ibecs, and Cochrane databases were used to locate the original articles. Seventeen studies were found during the research process. Of these, ten articles were excluded. Those protocols using a high volume of training for young adults showed a greater fibrinolytic response, and training protocols with intensities above 80% of 1 maximum repetition showed an increased platelet activity. In subjects with coronary artery disease, just one session of resistance training resulted in improvement in the fibrinolytic system (tissue plasminogen activator) without raising potential thrombotic markers. PMID:22419885

Evaluation of a suicide prevention training curriculum for substance abuse treatment providers based on Treatment Improvement Protocol Number 50 (TIP 50)

PubMed Central

Conner, Kenneth R.; Wood, Jane; Pisani, Anthony R.; Kemp, Janet

2013-01-01

Substance use disorders (SUD) confer risk for suicide yet there are no empirically supported suicide prevention training curricula tailored to SUD treatment providers. We assessed the efficacy of a 2-hour training that featured a suicide prevention training video produced by the Department of Veterans Affairs (VA). The video was based on Treatment Improvement Protocol Number 50, TIP 50, a practical manual to manage suicide risk produced by the Substance Abuse and Mental Health Services Administration (SAMHSA). The training was provided in small groups to 273 SUD treatment providers in 18 states. Results were evaluated using self-report assessments obtained at pre-test, post-test, and 2-month follow-up. Statistically significant changes (p<.001) within subjects were obtained on self-efficacy, knowledge, and frequency of suicide prevention practice behaviors. The positive results together with the brevity of the training and its ease of implementation indicate high potential for widespread adoption and the importance of further study. PMID:22417671

[Change of care model in natural childbirth: Implementation in La Ribera delivery room].

PubMed

Camacho-Morell, F; Romero-Martín, M J

To assess knowledge, wish for inclusion and implementation of normal childbirth care protocols at La Ribera University Hospital, the reason why they are not applied, and to assess the attendance at antepartum training activities. Cross-sectional descriptive study. They were carried out 186 surveys by convenience sampling to pregnant women attending fetal well-being control at hospital between 2014 and 2015. They were collected data about knowledge, wish for inclusion, compliance of protocols and reasons for non-compliance, and attendance at antepartum training activities. Percentages and confidence intervals were calculated. Chi-square test was used to compare categorical variables. They were collected percentages of knowledge (77%, CI95%: 75,5-78,5) and wish for inclusion (84,6%, CI 95% : 82,5-86,7). Protocol compliance ranged from 6% (nitrous oxide administration) to 91% (skin-to-skin contact). The main reasons for non-compliance were due to circumstances of childbirth process (56,3%, CI 95% : 51,1-61,5). Attendance at maternal education classes was 62%, mainly primiparous women (p=0,0001) with medium or high education level (p=0,001). Pregnant women have a high knowledge and wish for inclusion of normal childbirth care protocols. Attendance at antepartum training activities could by improved and the main reason for non-attendance is lack of information. Compliance is good enough in most protocols; when they are not applied is due to childbirth circumstances. Remaining tasks include the introduction of additional protocols and to involve pregnant women in decision-making. Copyright © 2017 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

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

PubMed

Rakovshik, Sarah G; McManus, Freda

2010-07-01

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

Highly Efficient Training, Refinement, and Validation of a Knowledge-based Planning Quality-Control System for Radiation Therapy Clinical Trials

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

Li, Nan; Carmona, Ruben; Sirak, Igor

Purpose: To demonstrate an efficient method for training and validation of a knowledge-based planning (KBP) system as a radiation therapy clinical trial plan quality-control system. Methods and Materials: We analyzed 86 patients with stage IB through IVA cervical cancer treated with intensity modulated radiation therapy at 2 institutions according to the standards of the INTERTECC (International Evaluation of Radiotherapy Technology Effectiveness in Cervical Cancer, National Clinical Trials Network identifier: 01554397) protocol. The protocol used a planning target volume and 2 primary organs at risk: pelvic bone marrow (PBM) and bowel. Secondary organs at risk were rectum and bladder. Initial unfiltered dose-volumemore » histogram (DVH) estimation models were trained using all 86 plans. Refined training sets were created by removing sub-optimal plans from the unfiltered sample, and DVH estimation models… and DVH estimation models were constructed by identifying 30 of 86 plans emphasizing PBM sparing (comparing protocol-specified dosimetric cutpoints V{sub 10} (percentage volume of PBM receiving at least 10 Gy dose) and V{sub 20} (percentage volume of PBM receiving at least 20 Gy dose) with unfiltered predictions) and another 30 of 86 plans emphasizing bowel sparing (comparing V{sub 40} (absolute volume of bowel receiving at least 40 Gy dose) and V{sub 45} (absolute volume of bowel receiving at least 45 Gy dose), 9 in common with the PBM set). To obtain deliverable KBP plans, refined models must inform patient-specific optimization objectives and/or priorities (an auto-planning “routine”). Four candidate routines emphasizing different tradeoffs were composed, and a script was developed to automatically re-plan multiple patients with each routine. After selection of the routine that best met protocol objectives in the 51-patient training sample (KBP{sub FINAL}), protocol-specific DVH metrics and normal tissue complication probability were compared for original versus KBP{sub FINAL} plans across the 35-patient validation set. Paired t tests were used to test differences between planning sets. Results: KBP{sub FINAL} plans outperformed manual planning across the validation set in all protocol-specific DVH cutpoints. The mean normal tissue complication probability for gastrointestinal toxicity was lower for KBP{sub FINAL} versus validation-set plans (48.7% vs 53.8%, P<.001). Similarly, the estimated mean white blood cell count nadir was higher (2.77 vs 2.49 k/mL, P<.001) with KBP{sub FINAL} plans, indicating lowered probability of hematologic toxicity. Conclusions: This work demonstrates that a KBP system can be efficiently trained and refined for use in radiation therapy clinical trials with minimal effort. This patient-specific plan quality control resulted in improvements on protocol-specific dosimetric endpoints.« less

Improvements in tongue strength and pressure-generation precision following a tongue-pressure training protocol in older individuals with dysphagia: three case reports.

PubMed

Yeates, Erin M; Molfenter, Sonja M; Steele, Catriona M

2008-01-01

Dysphagia, or difficulty swallowing, often occurs secondary to conditions such as stroke, head injury or progressive disease, many of which increase in frequency with advancing age. Sarcopenia, the gradual loss of muscle bulk and strength, can place older individuals at greater risk for dysphagia. Data are reported for three older participants in a pilot trial of a tongue-pressure training therapy. During the experimental therapy protocol, participants performed isometric strength exercises for the tongue as well as tongue pressure accuracy tasks. Biofeedback was provided using the Iowa Oral Performance Instrument (IOPI), an instrument that measures tongue pressure. Treatment outcome measures show increased isometric tongue strength, improved tongue pressure generation accuracy, improved bolus control on videofluoroscopy, and improved functional dietary intake by mouth. These preliminary results indicate that, for these three adults with dysphagia, tongue-pressure training was beneficial for improving both instrumental and functional aspects of swallowing. The experimental treatment protocol holds promise as a rehabilitative tool for various dysphagia populations.

Culturally Relevant Human Subjects Protection Training: A Case Study in Community-Engaged Research in the United States.

PubMed

Kue, Jennifer; Szalacha, Laura A; Happ, Mary Beth; Crisp, Abigail L; Menon, Usha

2018-02-01

Non-academic members of research teams, such as community members, can perceive traditional human subjects protection training as lacking in cultural relevance. We present a case exemplar of the development of a human subjects protection training for research staff with limited English proficiency and/or no or limited research experience. Seven modules were adapted for language, cultural examples, etc., from the standard Collaborative Institutional Training Initiative (CITI) human subjects protection training. Non-academic research staff completed a day-long training in human subjects protection (six modules) and our research protocol (one module). We assessed comprehension of content with PowerPoint slides and module quizzes. All participants successfully passed each module quiz with ≥ 80% correct. Questions answered incorrectly were discussed before proceeding to the next module. To meet the increasing demand for collaborative community-engaged research with underserved minority populations, human subjects protection training protocols can be adapted successfully to reflect real-world situations and provide culturally relevant materials to help non-academic research staff better understand the importance and necessity of research ethics.

Affirmative LGBT psychotherapy: Outcomes of a therapist training protocol.

PubMed

Pepping, Christopher A; Lyons, Anthony; Morris, Eric M J

2018-03-01

Lesbian, gay, bisexual, and transgender (LGBT) people seek psychotherapy at high rates, and the importance of providing culturally appropriate and LGBT-affirmative psychotherapy has been widely acknowledged. Despite this, remarkably little research has investigated the effects of therapist training in LGBT-affirmative psychotherapy. Here we examined the effectiveness of a training protocol for LGBT-affirmative psychotherapy with 96 mental health professionals, ranging in therapeutic experience from <1 year to 37 years (M = 6.54 years). Across all outcomes, therapists reported increased knowledge and skills related to working with LGBT clients following the training. Therapists also displayed reductions in homo-negativity and trans-negativity. Therapists' characteristics did not influence the extent to which they benefited from training. Specifically, years of clinical experience, therapist religiosity, and therapist psychological flexibility were unrelated to changes in attitudes, knowledge, and skills. The results of this study clearly suggest that providing training in LGBT-affirmative psychotherapy can enhance therapists' attitudes, knowledge, and skills. Of particular importance is that the benefits associated with such training appear to hold regardless of therapists' characteristics. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

SU-E-E-05: Improving Contouring Precision and Consistency for Physicians-In-Training with Simple Lab Experiments

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

Ma, L; Larson, D A

2015-06-15

Purpose: Target contouring for high-dose treatments such as radiosurgery of brain metastases is highly critical in eliminating marginal failure and reducing complications as shown by recent clinical studies. In order to improve contouring accuracy and practice consistency for the procedure, we introduced a self-assessed physics lab practice for the physicians-in-training. Methods: A set of commercially acquired high-precision PMMA plastic spheres were randomly embedded in a Styrofoam block and then scanned with the CT/MR via the clinical procedural imaging protocol. A group of first-year physicians-in-training (n=6) from either neurosurgery or radiation oncology department were asked to contour the scanned objects (diametermore » ranged from 0.4 cm to 3.8 cm). These user-defined contours were then compared with the ideal contour sets of object shape for self assessments to determine the maximum areas of the observed discrepancies and method of improvements. Results: The largest discrepancies from initial practice were consistently found to be located near the extreme longitudinal portions of the target for all the residents. Discrepancy was especially prominent when contouring small objects < 1.0 cm in diameters. For example, the mean volumes rendered from the initial contour data set differed from the ideal data set by 7.7%±6.6% for the participants (p> 0.23 suggesting agreement cannot be established). However, when incorporating a secondary imaging scan such as reconstructed coronal or sagittal images in a repeat practice, the agreement was dramatically improved yielding p<0.02 in agreement with the reference data set for all the participants. Conclusion: A simple physics lab revealed a common pitfall in contouring small metastatic brain tumors for radiosurgical procedures and provided a systematic tool for physicians-in-training in improving their clinical contouring skills. Dr Ma is current a board member of international stereotactic radiosurgical society.« less

Training professionals' communication and motivation skills to improve spinal cord injury patients' satisfaction and clinical outcomes: Study protocol of the ESPELMA trial.

PubMed

Lusilla-Palacios, Pilar; Castellano-Tejedor, Carmina; Lucrecia-Ramírez-Garcerán; Navarro-Sanchís, José A; Rodríguez-Urrutia, Amanda; Parramon-Puig, Gemma; Valero-Ventura, Sergi; Cuxart-Fina, Ampar

2015-10-01

Acute spinal cord injury leaves patients severely impaired and generates high levels of psychological distress among them and their families, which can cause a less active role in rehabilitation, worse functional recovery, and less perceived satisfaction with the results. Additionally, rehabilitation professionals who deal with this psychological distress could ultimately experience higher stress and more risk of burnout. This article presents the study protocol of the ESPELMA project, aimed to train rehabilitation professionals in the clinical management of acute spinal cord injury-associated psychological distress, and to measure the impact of this training on the patients' perceived satisfaction with treatment. © The Author(s) 2013.

Interactions of cortisol, testosterone, and resistance training: influence of circadian rhythms.

PubMed

Hayes, Lawrence D; Bickerstaff, Gordon F; Baker, Julien S

2010-06-01

Diurnal variation of sports performance usually peaks in the late afternoon, coinciding with increased body temperature. This circadian pattern of performance may be explained by the effect of increased core temperature on peripheral mechanisms, as neural drive does not appear to exhibit nycthemeral variation. This typical diurnal regularity has been reported in a variety of physical activities spanning the energy systems, from Adenosine triphosphate-phosphocreatine (ATP-PC) to anaerobic and aerobic metabolism, and is evident across all muscle contractions (eccentric, isometric, concentric) in a large number of muscle groups. Increased nerve conduction velocity, joint suppleness, increased muscular blood flow, improvements of glycogenolysis and glycolysis, increased environmental temperature, and preferential meteorological conditions may all contribute to diurnal variation in physical performance. However, the diurnal variation in strength performance can be blunted by a repeated-morning resistance training protocol. Optimal adaptations to resistance training (muscle hypertrophy and strength increases) also seem to occur in the late afternoon, which is interesting, since cortisol and, particularly, testosterone (T) concentrations are higher in the morning. T has repeatedly been linked with resistance training adaptation, and higher concentrations appear preferential. This has been determined by suppression of endogenous production and exogenous supplementation. However, the cortisol (C)/T ratio may indicate the catabolic/anabolic environment of an organism due to their roles in protein degradation and protein synthesis, respectively. The morning elevated T level (seen as beneficial to achieve muscle hypertrophy) may be counteracted by the morning elevated C level and, therefore, protein degradation. Although T levels are higher in the morning, an increased resistance exercise-induced T response has been found in the late afternoon, suggesting greater responsiveness of the hypothalamo-pituitary-testicular axis then. Individual responsiveness has also been observed, with some participants experiencing greater hypertrophy and strength increases in response to strength protocols, whereas others respond preferentially to power, hypertrophy, or strength endurance protocols dependent on which protocol elicited the greatest T response. It appears that physical performance is dependent on a number of endogenous time-dependent factors, which may be masked or confounded by exogenous circadian factors. Strength performance without time-of-day-specific training seems to elicit the typical diurnal pattern, as does resistance training adaptations. The implications for this are (a) athletes are advised to coincide training times with performance times, and (b) individuals may experience greater hypertrophy and strength gains when resistance training protocols are designed dependent on individual T response.

The efficacy of prospective memory rehabilitation plus metacognitive skills training for adults with traumatic brain injury: study protocol for a randomized controlled trial.

PubMed

Fleming, Jennifer; Ownsworth, Tamara; Doig, Emmah; Hutton, Lauren; Griffin, Janelle; Kendall, Melissa; Shum, David H K

2017-01-05

Impairment of prospective memory (PM) is common following traumatic brain injury (TBI) and negatively impacts on independent living. Compensatory approaches to PM rehabilitation have been found to minimize the impact of PM impairment in adults with TBI; however, poor self-awareness after TBI poses a major barrier to the generalization of compensatory strategies in daily life. Metacognitive skills training (MST) is a cognitive rehabilitation approach that aims to facilitate the development of self-awareness in adults with TBI. This paper describes the protocol of a study that aims to evaluate the efficacy of a MST approach to compensatory PM rehabilitation for improving everyday PM performance and psychosocial outcomes after TBI. This randomized controlled trial has three treatment groups: compensatory training plus metacognitive skills training (COMP-MST), compensatory training only (COMP), and waitlist control. Participants in the COMP-MST and COMP groups will complete a 6-week intervention consisting of six 2-h weekly training sessions. Each 1.5-h session will involve compensatory strategy training and 0.5 h will incorporate either MST (COMP-MST group) or filler activity as an active control (COMP group). Participants in the waitlist group receive care as usual for 6 weeks, followed by the COMP-MST intervention. Based on the sample size estimate, 90 participants with moderate to severe TBI will be randomized into the three groups using a stratified sampling approach. The primary outcomes include measures of PM performance in everyday life and level of psychosocial reintegration. Secondary outcomes include measures of PM function on psychometric testing, strategy use, self-awareness, and level of support needs following TBI. Blinded assessments will be conducted pre and post intervention, and at 3-month and 6-month follow-ups. This study seeks to determine the efficacy of COMP-MST for improving and maintaining everyday PM performance and level of psychosocial integration in adults with moderate to severe TBI. The findings will advance theoretical understanding of the role of self-awareness in compensatory PM rehabilitation and skills generalization. COMP-MST has the potential to reduce the cost of rehabilitation and lifestyle support following TBI because the intervention could enhance generalization success and lifelong application of PM compensatory strategies. New Zealand Clinical Trials Registry, ACTRN12615000996561 . Registered on 23 September 2015; retrospectively registered 2 months after commencement.

Feasibility of high-intensity interval training and moderate-intensity continuous training in adults with inactive or mildly active Crohn's disease: study protocol for a randomised controlled trial.

PubMed

Tew, Garry A; Carpenter, Roger; Seed, Michael; Anderson, Simon; Langmead, Louise; Fairhurst, Caroline; Bottoms, Lindsay

2017-01-01

Structured exercise training has been proposed as a useful adjunctive therapy for Crohn's disease by improving immune function and psychological health, reducing fatigue and promoting gains in muscle and bone strength. However, the evidence for exercise in Crohn's disease is sparse, with only a handful of small prospective trials [1, 2], with methodological limitations, including the use of non-randomised and non-controlled study designs and small sample sizes. Here, we describe the protocol for a study that aims to assess the feasibility and acceptability of two common types of exercise training-high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT)-in adults with inactive or mildly active Crohn's disease (CD). This is a randomised, controlled, assessor-blinded, feasibility trial with three parallel groups. Forty-five adults with inactive or mildly active Crohn's disease will be randomly assigned 1:1:1 to HIIT, MICT or usual care control. Participants in the HIIT and MICT groups will be invited to undertake three sessions of supervised exercise each week for 12 consecutive weeks. HIIT sessions will consist of ten 1-min intervals of cycling exercise at 90% of peak power output separated by 1 min of active recovery. MICT sessions will involve 30 min of continuous cycling at 35% of peak power output. Participants will be assessed before randomisation and 13 and 26 weeks after randomisation. Feasibility outcomes include rates of recruitment, retention and adherence. Interviews with participants will explore the acceptability of the exercise programmes and study procedures. Clinical/health outcomes include cardiorespiratory fitness, body mass index, resting blood pressure, markers of disease activity (faecal calprotectin and Crohn's Disease Activity Index) and activated T cell cytokine profiles. Study questionnaires include the Inflammatory Bowel Disease Quality of Life Questionnaire, EQ-5D-5L, IBD Fatigue Scale, Hospital and Anxiety Depression Scale, and International Physical Activity Questionnaire. This study will provide useful information on the feasibility and acceptability of supervised exercise training in adults with inactive and mildly active Crohn's disease and will inform the design of a subsequent, adequately powered, multi-centre trial. The trial is registered with the International Standard Randomised Controlled Trial Register (ISRCTN13021107). Date registration assigned was 02/12/2015.

Cognitive training plus a comprehensive psychosocial programme (OPUS) versus the comprehensive psychosocial programme alone for patients with first-episode schizophrenia (the NEUROCOM trial): a study protocol for a centrally randomised, observer-blinded multi-centre clinical trial.

PubMed

Vesterager, Lone; Christensen, Torben Ø; Olsen, Birthe B; Krarup, Gertrud; Forchhammer, Hysse B; Melau, Marianne; Gluud, Christian; Nordentoft, Merete

2011-02-09

Up to 85% of patients with schizophrenia demonstrate cognitive dysfunction in at least one domain. Cognitive dysfunction plays a major role in functional outcome. It is hypothesized that addition of cognitive training to a comprehensive psychosocial programme (OPUS) enhances both cognitive and everyday functional capacity of patients more than the comprehensive psychosocial programme alone. The NEUROCOM trial examines the effect on cognitive functioning and everyday functional capacity of patients with schizophrenia of a 16-week manualised programme of individual cognitive training integrated in a comprehensive psychosocial programme versus the comprehensive psychosocial programme alone. The cognitive training consists of four modules focusing on attention, executive functioning, learning, and memory. Cognitive training involves computer-assisted training tasks as well as practical everyday tasks and calendar training. It takes place twice a week, and every other week the patient and trainer engage in a dialogue on the patient's cognitive difficulties, motivational goals, and progress in competence level. Cognitive training relies on errorless learning principles, scaffolding, and verbalisation in its effort to improve cognitive abilities and teach patients how to apply compensation strategies as well as structured problem solving techniques. At 16-week post-training and at ten-months follow-up, assessments are conducted to investigate immediate outcome and possible long-term effects of cognitive training. We conduct blinded assessments of cognition, everyday functional capacity and associations with the labour market, symptom severity, and self-esteem. Results from four-month and ten-month follow-ups have the potential of reliably providing documentation of the long-term effect of CT for patients with schizophrenia. Clinicaltrials.gov NCT00472862.

The design of scenario-based training from the resilience engineering perspective: a study with grid electricians.

PubMed

Saurin, Tarcisio Abreu; Wachs, Priscila; Righi, Angela Weber; Henriqson, Eder

2014-07-01

Although scenario-based training (SBT) can be an effective means to help workers develop resilience skills, it has not yet been analyzed from the resilience engineering (RE) perspective. This study introduces a five-stage method for designing SBT from the RE view: (a) identification of resilience skills, work constraints and actions for re-designing the socio-technical system; (b) design of template scenarios, allowing the simulation of the work constraints and the use of resilience skills; (c) design of the simulation protocol, which includes briefing, simulation and debriefing; (d) implementation of both scenarios and simulation protocol; and (e) evaluation of the scenarios and simulation protocol. It is reported how the method was applied in an electricity distribution company, in order to train grid electricians. The study was framed as an application of design science research, and five research outputs are discussed: method, constructs, model of the relationships among constructs, instantiations of the method, and theory building. Concerning the last output, the operationalization of the RE perspective on three elements of SBT is presented: identification of training objectives; scenario design; and debriefing. Copyright © 2013 Elsevier Ltd. All rights reserved.

Fast transfer of crossmodal time interval training.

PubMed

Chen, Lihan; Zhou, Xiaolin

2014-06-01

Sub-second time perception is essential for many important sensory and perceptual tasks including speech perception, motion perception, motor coordination, and crossmodal interaction. This study investigates to what extent the ability to discriminate sub-second time intervals acquired in one sensory modality can be transferred to another modality. To this end, we used perceptual classification of visual Ternus display (Ternus in Psychol Forsch 7:81-136, 1926) to implicitly measure participants' interval perception in pre- and posttests and implemented an intra- or crossmodal sub-second interval discrimination training protocol in between the tests. The Ternus display elicited either an "element motion" or a "group motion" percept, depending on the inter-stimulus interval between the two visual frames. The training protocol required participants to explicitly compare the interval length between a pair of visual, auditory, or tactile stimuli with a standard interval or to implicitly perceive the length of visual, auditory, or tactile intervals by completing a non-temporal task (discrimination of auditory pitch or tactile intensity). Results showed that after fast explicit training of interval discrimination (about 15 min), participants improved their ability to categorize the visual apparent motion in Ternus displays, although the training benefits were mild for visual timing training. However, the benefits were absent for implicit interval training protocols. This finding suggests that the timing ability in one modality can be rapidly acquired and used to improve timing-related performance in another modality and that there may exist a central clock for sub-second temporal processing, although modality-specific perceptual properties may constrain the functioning of this clock.

Striatal dopamine depletion in rats produces variable effects on contingency detection: task-related influences.

PubMed

Braun, Stephanie; Hauber, Wolfgang

2012-02-01

Dopamine (DA) depletion of the posterior dorsomedial striatum (pDMS) can impair the capability of rats to detect changes in the causal efficacy of actions. Here we sought to characterize in more detail the effects of pDMS DA depletions on contingency detection as a function of different contingency degradation training protocols. In experiment 1, sham controls and rats with pDMS DA depletions received limited contingency degradation training (4 days) that involved an invariable and high degree of degradation to one of two contingencies controlling instrumental choice behaviour. The results demonstrated that lesioned rats were insensitive to contingency manipulations both during contingency degradation training and in the subsequent extinction test. Experiment 2 further indicated that rats with pDMS DA depletion subjected to extended contingency degradation training (12 days) became sensitive to contingency manipulations during the training phase but not in the subsequent extinction test. In experiment 3, an extended but more complex contingency degradation training protocol (12 days) was used that involved a gradual shift from a low to an intermediate and a high degree of contingency degradation rather than a high and invariable degree of contingency degradation as in experiments 1 and 2. Notably, lesioned rats were sensitive to contingency manipulations both during the contingency degradation training phase and in the subsequent extinction test. Thus, pDMS DA depletions can impair the capability to detect changes in the causal efficacy of actions; however, the occurrence and pattern of impairments depend on the contingency degradation training protocol being used. © 2012 The Authors. European Journal of Neuroscience © 2012 Federation of European Neuroscience Societies and Blackwell Publishing Ltd.

Acute Effects of Back Squats on Countermovement Jump Performance Across Multiple Sets of A Contrast Training Protocol in Resistance-Trained Males.

PubMed

Bauer, Pascal; Sansone, Pierpaolo; Mitter, Benedikt; Makivic, Bojan; Seitz, Laurent B; Tschan, Harald

2018-01-03

The present study was designed to evaluate the voluntary post-activation potentiation (PAP) effects of moderate (MI) or high intensity (HI) back squat exercises on countermovement jump (CMJ) performance across multiple sets of a contrast training protocol. Sixty resistance-trained male subjects (age, 23.3 ± 3.3 y; body mass, 86.0 ± 13.9 kg; parallel back squat 1-repetition maximum [1-RM], 155.2 ± 30.0 kg) participated in a randomized, cross-over study. After familiarization, the subjects visited the laboratory on three separate occasions. They performed a contrast PAP protocol comprising three sets of either MI (6×60% of 1-RM) or HI back squats (4x90% of 1-RM) or 20 s of recovery (CTRL) alternated with seven CMJs that were performed at 15 s, and 1, 3, 5, 7, 9 and 11 min after the back squats or recovery. Jump height and relative peak power output recorded with a force platform during MI and HI conditions were compared to those recorded during control condition to calculate the voluntary PAP effect. CMJ performance was decreased immediately after the squats but increased across all three sets of MI and HI between 3 - 7 minutes post-recovery. However, voluntary PAP effects were small or trivial and no difference between the three sets could be found. These findings demonstrate that practitioners can use MI and HI back squats to potentiate CMJs across a contrast training protocol, but a minimum of 3 min of recovery after the squats is needed to benefit from voluntary PAP.

Breaking bad news in clinical setting - health professionals' experience and perceived competence in Southwestern Nigeria: a cross sectional study.

PubMed

Adebayo, Philip Babatunde; Abayomi, Olukayode; Johnson, Peter O; Oloyede, Taofeeq; Oyelekan, Abimbola A A

2013-01-01

Communication skills are vital in clinical settings because the manner in which bad news is delivered could be a huge determinant of responses to such news; as well as compliance with beneficial treatment option. Information on training, institutional guidelines and protocols for breaking bad news (BBN) is scarce in Nigeria. We assessed the training, experience and perceived competence of BBN among medical personnel in southwestern Nigeria. The study was a cross-sectional descriptive study conducted out among doctors and nurses in two healthcare institutions in southwestern Nigeria using an anonymous questionnaire (adapted from the survey by Horwitz et al.), which focused on the respondents training, awareness of protocols in BBN; and perceived competence (using a Five-Point Likert Scale) in five clinical scenarios. We equally asked the respondents about an instance of BBN they have recently witnessed. A total of 113 of 130 selected (response rate 86.9%) respondents were studied. Eight (7.1%) of the respondents knew of the guidelines on BBN in the hospital in which they work. Twenty-three (20.3%) respondents claimed knowledge of a protocol. The median perceived competence rating was 4 out of 5 in all the clinical scenarios. Twenty-five (22.1%) respondents have had a formal training in BBN and they generally had significant higher perceived competence rating (P = 0.003-0.021). There is poor support from fellow workers during instances of BBN. It appears that the large proportion of the respondents in this study were unconsciously incompetent in BBN in view of the low level of training and little or no knowledge of well known protocols for BBN even though self-rated competence is high. Continuous medical education in communication skills among health personnel in Nigeria is advocated.

Development of robotic mobility for infants: rationale and outcomes.

PubMed

Larin, Hélène M; Dennis, Carole W; Stansfield, Sharon

2012-09-01

To assess the feasibility of a robotic mobility device for infants using alternative control interfaces aimed at promoting early self-initiated mobility, and to assess the effects of a training protocol and robot experience. Observational and pre-post quantitative case studies. Standardised, research laboratory and day-care centres with toys and individuals familiar to infants. Children with and without disabilities, aged 5 months to 3 years. In each study, infants were seated over a Pioneer™ 3-DX mobile robot. Some infants controlled the directional movement of the robot by weight shifting their body on a Nintendo® Wii™ Balance Board (the WeeBot), while others used a modified joystick. Infants participated in five sessions over 2 to 5 weeks. Sessions consisted of administering a 10-minute training protocol preceded and followed by 2 to 3 minutes of free play. One child with motor impairment used a button switch array and a different experimental design. From the videotaped free-play periods, goal-directed behaviours were coded and time in motion was measured. In the training period, a scoring system was developed to measure the infants' driving performance. Preliminary outcomes indicate that infants without disabilities, aged 5 to 10 months, demonstrated significant improvement in driving performance and goal-directed movement using the WeeBot. Infants who used the joystick were less successful on all measures. Results for infants with disabilities using the WeeBot were mixed. Mobile robots offer promise to enhance the development of early self-mobility. Novel types of interfaces, such as the WeeBot, warrant further investigation. Copyright © 2012 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Rehabilitation after a grade III latissimus dorsi tear of a soccer player: A case report.

PubMed

Fysentzou, Christodoulos

2016-11-21

Latissimus dorsi, grade III tendon tears are an uncommon injury. There are very few cases reported in the literature, but most importantly, no cases could be found that relate to soccer. To present a successful, non-operative rehabilitation program for a professional athlete, after a grade III latissimus dorsi tear. A 37 year old healthy, elite professional soccer goalkeeper was injured during a championship game. The athlete fell on his left side with an outstretched and externally rotated upper extremity in order to catch a ball that was going very close to the left pole of his goal-post. After on-field and off-field clinical examinations, the diagnosis was a left latissimus dorsi tendon tear which was later confirmed by MRI as a grade III tear. During the first two weeks, intervention consisted of anti-inflammatory treatment and light therapeutic exercises. As the pain was subsiding and the strength was returning, the treatment shifted to purely strengthening and functional training. Four weeks after the injury, the athlete presented with pain 0/10 in all functional activities and full ROM in both active and passive movements. Before discharge, the athlete underwent a sport specific training program, without any complains, that cleared him to participate in normal training with the rest of the team. Three months after the injury the strength of the player's left shoulder was 5/5 in all movements. The protocol used yielded an accelerated return to sport (soccer) and function compared with other published research after a grade III latissimus dorsi tendon tear. One year later, the goalkeeper was still playing in the same competitive level without any re-injuries or complains, which means that this treatment protocol withstood the test of time.

Predicting binding poses and affinities for protein - ligand complexes in the 2015 D3R Grand Challenge using a physical model with a statistical parameter estimation

NASA Astrophysics Data System (ADS)

Grudinin, Sergei; Kadukova, Maria; Eisenbarth, Andreas; Marillet, Simon; Cazals, Frédéric

2016-09-01

The 2015 D3R Grand Challenge provided an opportunity to test our new model for the binding free energy of small molecules, as well as to assess our protocol to predict binding poses for protein-ligand complexes. Our pose predictions were ranked 3-9 for the HSP90 dataset, depending on the assessment metric. For the MAP4K dataset the ranks are very dispersed and equal to 2-35, depending on the assessment metric, which does not provide any insight into the accuracy of the method. The main success of our pose prediction protocol was the re-scoring stage using the recently developed Convex-PL potential. We make a thorough analysis of our docking predictions made with AutoDock Vina and discuss the effect of the choice of rigid receptor templates, the number of flexible residues in the binding pocket, the binding pocket size, and the benefits of re-scoring. However, the main challenge was to predict experimentally determined binding affinities for two blind test sets. Our affinity prediction model consisted of two terms, a pairwise-additive enthalpy, and a non pairwise-additive entropy. We trained the free parameters of the model with a regularized regression using affinity and structural data from the PDBBind database. Our model performed very well on the training set, however, failed on the two test sets. We explain the drawback and pitfalls of our model, in particular in terms of relative coverage of the test set by the training set and missed dynamical properties from crystal structures, and discuss different routes to improve it.

Acute effects of a resisted dynamic warm-up protocol on jumping performance.

PubMed

Cilli, M; Gelen, E; Yildiz, S; Saglam, T; Camur, Mh

2014-12-01

This study aimed to investigate the kinematic and kinetic changes when resistance is applied in horizontal and vertical directions, produced by using different percentages of body weight, caused by jumping movements during a dynamic warm-up. The group of subjects consisted of 35 voluntary male athletes (19 basketball and 16 volleyball players; age: 23.4 ± 1.4 years, training experience: 9.6 ± 2.7 years; height: 177.2 ± 5.7 cm, body weight: 69.9 ± 6.9 kg) studying Physical Education, who had a jump training background and who were training for 2 hours, on 4 days in a week. A dynamic warm-up protocol containing seven specific resistance movements with specific resistance corresponding to different percentages of body weight (2%, 4%, 6%, 8%, 10%) was applied randomly on non consecutive days. Effects of different warm-up protocols were assessed by pre-/post- exercise changes in jump height in the countermovement jump (CMJ) and the squat jump (SJ) measured using a force platform and changes in hip and knee joint angles at the end of the eccentric phase measured using a video camera. A significant increase in jump height was observed in the dynamic resistance warm-up conducted with different percentages of body weight (p < 0.05). On the other hand, no significant difference in different percentages of body weight states was observed (p > 0.05). In jump movements before and after the warm-up, while no significant difference between the vertical ground reaction forces applied by athletes was observed (p > 0.05), in some cases of resistance, a significant reduction was observed in hip and knee joint angles (p < 0.05). The dynamic resistance warm-up method was found to cause changes in the kinematics of jumping movements, as well as an increase in jump height values. As a result, dynamic warm-up exercises could be applicable in cases of resistance corresponding to 6-10% of body weight applied in horizontal and vertical directions in order to increase the jump performance acutely.

ACUTE EFFECTS OF A RESISTED DYNAMIC WARM-UP PROTOCOL ON JUMPING PERFORMANCE

PubMed Central

Cilli, M; Yildiz, S; Saglam, T; Camur, MH

2014-01-01

This study aimed to investigate the kinematic and kinetic changes when resistance is applied in horizontal and vertical directions, produced by using different percentages of body weight, caused by jumping movements during a dynamic warm-up. The group of subjects consisted of 35 voluntary male athletes (19 basketball and 16 volleyball players; age: 23.4 ± 1.4 years, training experience: 9.6 ± 2.7 years; height: 177.2 ± 5.7 cm, body weight: 69.9 ± 6.9 kg) studying Physical Education, who had a jump training background and who were training for 2 hours, on 4 days in a week. A dynamic warm-up protocol containing seven specific resistance movements with specific resistance corresponding to different percentages of body weight (2%, 4%, 6%, 8%, 10%) was applied randomly on non consecutive days. Effects of different warm-up protocols were assessed by pre-/post- exercise changes in jump height in the countermovement jump (CMJ) and the squat jump (SJ) measured using a force platform and changes in hip and knee joint angles at the end of the eccentric phase measured using a video camera. A significant increase in jump height was observed in the dynamic resistance warm-up conducted with different percentages of body weight (p < 0.05). On the other hand, no significant difference in different percentages of body weight states was observed (p > 0.05). In jump movements before and after the warm-up, while no significant difference between the vertical ground reaction forces applied by athletes was observed (p > 0.05), in some cases of resistance, a significant reduction was observed in hip and knee joint angles (p < 0.05). The dynamic resistance warm-up method was found to cause changes in the kinematics of jumping movements, as well as an increase in jump height values. As a result, dynamic warm-up exercises could be applicable in cases of resistance corresponding to 6-10% of body weight applied in horizontal and vertical directions in order to increase the jump performance acutely. PMID:25435670

Acute hormonal responses in elite junior weightlifters.

PubMed

Kraemer, W J; Fry, A C; Warren, B J; Stone, M H; Fleck, S J; Kearney, J T; Conroy, B P; Maresh, C M; Weseman, C A; Triplett, N T

1992-02-01

To date, no published studies have demonstrated resistance exercise-induced increases in serum testosterone in adolescent males. Furthermore, few data are available on the effects of training experience and lifting performance on acute hormonal responses to weightlifting in young males. Twenty-eight junior elite male Olympic-style weightlifters (17.3 +/- 1.4 yrs) volunteered for the study. An acute weightlifting exercise protocol using moderate to high intensity loads and low volume, characteristic of many weightlifting training sessions, was examined. The exercise protocol was directed toward the training associated with the snatch lift weightlifting exercise. Blood samples were obtained from a superficial arm vein at 7 a.m. (for baseline measurements), and again at pre-exercise, 5 min post-, and 15 min post-exercise time points for determination of serum testosterone, cortisol, growth hormone, plasma beta-endorphin, and whole blood lactate. The exercise protocol elicited significant (p less than or equal to 0.05) increases in each of the hormones and whole blood lactate compared to pre-exercise measures. While not being significantly older, subsequent analysis revealed that subjects with greater than 2 years training experience exhibited significant exercise-induced increases in serum testosterone from pre-exercise to 5 min post-exercise (16.2 +/- 6.2 to 21.4 +/- 7.9 nmol.l-1), while those with less than or equal to 2 years training showed no significant serum testosterone differences. None of the other hormones or whole blood lactate appear to be influenced by training experience.(ABSTRACT TRUNCATED AT 250 WORDS)

Biofeedback assisted control of respiratory sinus arrhythmia as a biobehavioral intervention for depressive symptoms in patients after cardiac surgery: a preliminary study.

PubMed

Patron, Elisabetta; Messerotti Benvenuti, Simone; Favretto, Giuseppe; Valfrè, Carlo; Bonfà, Carlotta; Gasparotto, Renata; Palomba, Daniela

2013-03-01

The current study investigated whether biofeedback training aimed at increasing respiratory sinus arrhythmia (RSA), a measure of cardiac vagal modulation, can reduce depressive symptoms in patients after cardiac surgery. This randomized controlled study enrolled 26 patients after first-time cardiac surgery. The patients were randomly assigned to an RSA-biofeedback group (N = 13) or to a treatment as usual group (N = 13). The biofeedback training consisted of five 45 min sessions designed to increase RSA. The outcome was assessed as changes in RSA and in the Centre for Epidemiologic Studies of Depression (CES-D) values from pre- to post-training. Both groups were comparable for demographic and biomedical characteristics. RSA increased significantly in patients who underwent RSA-biofeedback compared to controls. Moreover, the CES-D scores were reduced significantly from pre- to post-training in the RSA-biofeedback group compared to the controls. Changes in RSA were inversely related to changes in CES-D scores from pre- to post-training. These findings extend the effectiveness of RSA-biofeedback for increasing vagal modulation as well as for reducing depressive symptoms in post-surgical patients. Overall, the current study also suggests that this biobehavioral intervention may add to the efficacy of postoperative risk reduction programs and rehabilitation protocols in cardiac surgery patients.

Modulation of H-Reflex Depression with Paired-Pulse Stimulation in Healthy Active Humans.

PubMed

Oza, Preeti D; Dudley-Javoroski, Shauna; Shields, Richard K

2017-01-01

Depression of the Hoffman reflex (H-reflex) is used to examine spinal control mechanisms during exercise, fatigue, and vibration and in response to training. H-reflex depression protocols frequently use trains of stimuli; this is time-consuming and prevents instantaneous assessment of motor neuronal excitability. The purpose of this study was to determine if paired-pulse H-reflex depression is reproducible and whether paired-pulse stimulation adequately estimates the depression induced by the more traditional ten-pulse train. H-reflexes were elicited via ten-pulse trains at 0.1, 0.2, 1, 2, and 5 Hz in ten neurologically intact individuals on two separate days. We measured the depression elicited by the second pulse (H2) and the mean depression elicited by pulses 2-10 (Hmean). H2 was consistent at all frequencies on both days ( r 2 = 0.97, p < 0.05, and ICC (3,1) = 0.81). H2 did not differ from Hmean ( p > 0.05). The results indicate that paired-pulse H-reflex depression has high between-day reliability and yields depression estimates that are comparable to those obtained via ten-pulse trains. Paired-pulse H-reflex depression may be especially useful for studies that require rapid assessment of motor neuronal excitability, such as during exercise, fatigue, and vibration, or to establish recovery curves following inhibition.

Undulatory physical resistance training program increases maximal strength in elderly type 2 diabetics.

PubMed

Santos, Gilberto Monteiro dos; Montrezol, Fábio Tanil; Pauli, Luciana Santos Souza; Sartori-Cintra, Angélica Rossi; Colantonio, Emilson; Gomes, Ricardo José; Marinho, Rodolfo; Moura, Leandro Pereira de; Pauli, José Rodrigo

2014-01-01

To investigate the effects of a specific protocol of undulatory physical resistance training on maximal strength gains in elderly type 2 diabetics. The study included 48 subjects, aged between 60 and 85 years, of both genders. They were divided into two groups: Untrained Diabetic Elderly (n=19) with those who were not subjected to physical training and Trained Diabetic Elderly (n=29), with those who were subjected to undulatory physical resistance training. The participants were evaluated with several types of resistance training's equipment before and after training protocol, by test of one maximal repetition. The subjects were trained on undulatory resistance three times per week for a period of 16 weeks. The overload used in undulatory resistance training was equivalent to 50% of one maximal repetition and 70% of one maximal repetition, alternating weekly. Statistical analysis revealed significant differences (p<0.05) between pre-test and post-test over a period of 16 weeks. The average gains in strength were 43.20% (knee extension), 65.00% (knee flexion), 27.80% (supine sitting machine), 31.00% (rowing sitting), 43.90% (biceps pulley), and 21.10% (triceps pulley). Undulatory resistance training used with weekly different overloads was effective to provide significant gains in maximum strength in elderly type 2 diabetic individuals.

The Feasibility and Potential Impact of Brain Training Games on Cognitive and Emotional Functioning in Middle-Aged Adults

PubMed Central

Curtis, Ashley F.; Branscombe-Caird, Laura M.; Comrie, Janna K.; Murtha, Susan J.E.

2018-01-01

Abstract Objectives:To investigate whether a commercially available brain training program is feasible to use with a middle-aged population and has a potential impact on cognition and emotional well-being (proof of concept). Method: Fourteen participants (ages 46–55) completed two 6-week training conditions using a crossover (counterbalanced) design: (1) experimental brain training condition and (2) active control “find answers to trivia questions online” condition. A comprehensive neurocognitive battery and a self-report measure of depression and anxiety were administered at baseline (first time point, before training) and after completing each training condition (second time point at 6 weeks, and third time point at 12 weeks). Cognitive composite scores were calculated for participants at each time point. Results: Study completion and protocol adherence demonstrated good feasibility of this brain training protocol in healthy middle-aged adults. Exploratory analyses suggested that brain training was associated with neurocognitive improvements related to executive attention, as well as improvements in mood. Conclusion: Overall, our findings suggest that brain training programs are feasible in middle-aged cohorts. We propose that brain training games may be linked to improvements in executive attention and affect by promoting cognitive self-efficacy in middle-aged adults. PMID:29189046

Chapter 2: Commercial and Industrial Lighting Evaluation Protocol. The Uniform Methods Project: Methods for Determining Energy Efficiency Savings for Specific Measures

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

Kurnik, Charles W; Gowans, Dakers; Telarico, Chad

The Commercial and Industrial Lighting Evaluation Protocol (the protocol) describes methods to account for gross energy savings resulting from the programmatic installation of efficient lighting equipment in large populations of commercial, industrial, and other nonresidential facilities. This protocol does not address savings resulting from changes in codes and standards, or from education and training activities. A separate Uniform Methods Project (UMP) protocol, Chapter 3: Commercial and Industrial Lighting Controls Evaluation Protocol, addresses methods for evaluating savings resulting from lighting control measures such as adding time clocks, tuning energy management system commands, and adding occupancy sensors.

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

PubMed Central

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

2016-01-01

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

Resistance Training Regulates Cardiac Function through Modulation of miRNA-214

PubMed Central

Melo, Stéphano Freitas Soares; Barauna, Valério Garrone; Júnior, Miguel Araújo Carneiro; Bozi, Luiz Henrique Marchesi; Drummond, Lucas Rios; Natali, Antônio José; de Oliveira, Edilamar Menezes

2015-01-01

Aims: To determine the effects of resistance training (RT) on the expression of microRNA (miRNA)-214 and its target in sarcoplasmic reticulum Ca2+-ATPase (SERCA2a), and on the morphological and mechanical properties of isolated left ventricular myocytes. Main methods: Male Wistar rats were divided into two groups (n = 7/group): Control (CO) or trained (TR). The exercise-training protocol consisted of: 4 × 12 bouts, 5×/week during 8 weeks, with 80% of one repetition maximum. Key findings: RT increased the left ventricular myocyte width by 15% and volume by 12%, compared with control animals (p < 0.05). The time to half relaxation and time to peak were 8.4% and 4.4% lower, respectively, in cells from TR group as compared to CO group (p < 0.05). RT decreased miRNA-214 level by 18.5% while its target SERCA2a expression were 18.5% higher (p < 0.05). Significance: Our findings showed that RT increases single left ventricular myocyte dimensions and also leads to faster cell contraction and relaxation. These mechanical adaptations may be related to the augmented expression of SERCA2a which, in turn, may be associated with the epigenetic modification of decreased miRNA-214 expression. PMID:25822872

Pre- versus post-exercise protein intake has similar effects on muscular adaptations.

PubMed

Schoenfeld, Brad Jon; Aragon, Alan; Wilborn, Colin; Urbina, Stacie L; Hayward, Sara E; Krieger, James

2017-01-01

The purpose of this study was to test the anabolic window theory by investigating muscle strength, hypertrophy, and body composition changes in response to an equal dose of protein consumed either immediately pre- versus post-resistance training (RT) in trained men. Subjects were 21 resistance-trained men (>1 year RT experience) recruited from a university population. After baseline testing, participants were randomly assigned to 1 of 2 experimental groups: a group that consumed a supplement containing 25 g protein and 1 g carbohydrate immediately prior to exercise (PRE-SUPP) ( n  = 9) or a group that consumed the same supplement immediately post-exercise (POST-SUPP) ( n  = 12). The RT protocol consisted of three weekly sessions performed on non-consecutive days for 10 weeks. A total-body routine was employed with three sets of 8-12 repetitions for each exercise. Results showed that pre- and post-workout protein consumption had similar effects on all measures studied ( p  > 0.05). These findings refute the contention of a narrow post-exercise anabolic window to maximize the muscular response and instead lends support to the theory that the interval for protein intake may be as wide as several hours or perhaps more after a training bout depending on when the pre-workout meal was consumed.

Measurement of Functional Capacity Requirements of Farmers: IMPLICATIONS FOR A CARDIAC REHABILITATION TRAINING PROGRAM.

PubMed

Jordan, Shannon; Karcher, Justin; Rogers, Rebecca; Kennedy, Kathleen; Lawrence, Anne; Adams, Jenny

2017-03-01

Updated cardiac rehabilitation (CR) and return-to-work guidelines from the American College of Sports Medicine (ACSM) now include specificity of training for industrial athletes (exercise training that involves the muscle groups, movements, and energy systems that these patients use during occupational tasks). However, many CR facilities do not apply this principle, relying instead on the traditional protocol that consists primarily of aerobic exercise. This study was conducted to measure the metabolic cost of typical farming tasks and to compare 2 methods of calculating training intensities. Metabolic data were collected from 28 participants (23 men and 5 women, aged 18 to 57 years) while they loaded 10 hay bales, dug a fence posthole, filled 8 seed hoppers, and shoveled grain. Mean metabolic equivalent levels during these activities were 5.9 to 7.6 and participants reached 60% to 70% of heart rate reserve (HRR). By comparison, their mean resting heart rate + 30 beats per minute (RHR+30, a traditional CR intensity level) represented only 28% of HRR. Participants in the current study performed farming tasks within the ACSM's recommended range of 40% to 80% of HRR, and the results suggest that training at RHR+30 would have been inadequate for helping a farmer return to work after a cardiac event. Using the study tasks as a basis, we described exercises that would be appropriate for the supervised resistance training of farmers in a CR setting.

A simplified protocol for differentiation of electrophysiologically mature neuronal networks from human induced pluripotent stem cells.

PubMed

Gunhanlar, N; Shpak, G; van der Kroeg, M; Gouty-Colomer, L A; Munshi, S T; Lendemeijer, B; Ghazvini, M; Dupont, C; Hoogendijk, W J G; Gribnau, J; de Vrij, F M S; Kushner, S A

2018-05-01

Progress in elucidating the molecular and cellular pathophysiology of neuropsychiatric disorders has been hindered by the limited availability of living human brain tissue. The emergence of induced pluripotent stem cells (iPSCs) has offered a unique alternative strategy using patient-derived functional neuronal networks. However, methods for reliably generating iPSC-derived neurons with mature electrophysiological characteristics have been difficult to develop. Here, we report a simplified differentiation protocol that yields electrophysiologically mature iPSC-derived cortical lineage neuronal networks without the need for astrocyte co-culture or specialized media. This protocol generates a consistent 60:40 ratio of neurons and astrocytes that arise from a common forebrain neural progenitor. Whole-cell patch-clamp recordings of 114 neurons derived from three independent iPSC lines confirmed their electrophysiological maturity, including resting membrane potential (-58.2±1.0 mV), capacitance (49.1±2.9 pF), action potential (AP) threshold (-50.9±0.5 mV) and AP amplitude (66.5±1.3 mV). Nearly 100% of neurons were capable of firing APs, of which 79% had sustained trains of mature APs with minimal accommodation (peak AP frequency: 11.9±0.5 Hz) and 74% exhibited spontaneous synaptic activity (amplitude, 16.03±0.82 pA; frequency, 1.09±0.17 Hz). We expect this protocol to be of broad applicability for implementing iPSC-based neuronal network models of neuropsychiatric disorders.

Global Metabolic Stress of Isoeffort Continuous and High Intensity Interval Aerobic Exercise: A Comparative 1H NMR Metabonomic Study.

PubMed

Zafeiridis, Andreas; Chatziioannou, Anastasia Chrysovalantou; Sarivasiliou, Haralambos; Kyparos, Antonios; Nikolaidis, Michalis G; Vrabas, Ioannis S; Pechlivanis, Alexandros; Zoumpoulakis, Panagiotis; Baskakis, Constantinos; Dipla, Konstantina; Theodoridis, Georgios A

2016-12-02

The overall metabolic/energetic stress that occurs during an acute bout of exercise is proposed to be the main driving force for long-term training adaptations. Continuous and high-intensity interval exercise protocols (HIIE) are currently prescribed to acquire the muscular and metabolic benefits of aerobic training. We applied 1 H NMR-based metabonomics to compare the overall metabolic perturbation and activation of individual bioenergetic pathways of three popular aerobic exercises matched for effort/strain. Nine men performed continuous, long-interval (3 min), and short-interval (30 s) bouts of exercise under isoeffort conditions. Blood was collected before and after exercise. The multivariate PCA and OPLS-DA models showed a distinct separation of pre- and postexercise samples in three protocols. The two models did not discriminate the postexercise overall metabolic profiles of the three exercise types. Analysis focused on muscle bioenergetic pathways revealed an extensive upregulation of carbohydrate-lipid metabolism and the TCA cycle in all three protocols; there were only a few differences among protocols in the postexercise abundance of molecules when long-interval bouts were performed. In conclusion, continuous and HIIE exercise protocols, when performed with similar effort/strain, induce comparable global metabolic response/stress despite their marked differences in work-bout intensities. This study highlights the importance of NMR metabonomics in comprehensive monitoring of metabolic consequences of exercise training in the blood of athletes and exercising individuals.

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

PubMed

Vervuert, I; Coenen, M; Zamhöfer, J

2005-01-01

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

A Protocol for Safe Lithiation Reactions Using Organolithium Reagents

PubMed Central

Gau, Michael R.; Zdilla, Michael J.

2016-01-01

Organolithium reagents are powerful tools in the synthetic chemist's toolbox. However, the extreme pyrophoric nature of the most reactive reagents warrants proper technique, thorough training, and proper personal protective equipment. To aid in the training of researchers using organolithium reagents, a thorough, step-by-step protocol for the safe and effective use of tert-butyllithium on an inert gas line or within a glovebox is described. As a model reaction, preparation of lithium tert-butyl amide by the reaction of tert-butyl amine with one equivalent of tert-butyl lithium is presented. PMID:27911386

Exercise-training protocols for astronauts in microgravity

NASA Technical Reports Server (NTRS)

Greenleaf, J. E.; Bulbulian, R.; Bernauer, E. M.; Haskell, W. L.; Moore, T.

1989-01-01

Based on physical working requirements for astronauts during intra- and extravehicular activity and on the findings from bed-rest studies that utilized exercise training as a countermeasure for the reduction of aerobic power, deterioration of muscular strength and endurance, decrements in mood and cognitive performance, and possibly for bone loss, two exercise protocols are proposed. One assumes that, during microgravity, astronaut exercise physiological functions should be maintained at 100 percent of ground-based levels. The other assumes that maximal aerobic power in flight can be reduced by 10 percent of the ground-based level.

Changing the Antibiotic Prescribing of general practice registrars: the ChAP study protocol for a prospective controlled study of a multimodal educational intervention.

PubMed

van Driel, Mieke L; Morgan, Simon; Tapley, Amanda; McArthur, Lawrie; McElduff, Patrick; Yardley, Lucy; Dallas, Anthea; Deckx, Laura; Mulquiney, Katie; Davis, Joshua S; Davey, Andrew; Henderson, Kim; Little, Paul; Magin, Parker J

2016-06-06

Australian General Practitioners (GPs) are generous prescribers of antibiotics, prompting concerns including increasing antimicrobial resistance in the community. Recent data show that GPs in vocational training have prescribing patterns comparable with the high prescribing rate of their established GP supervisors. Evidence-based guidelines consistently advise that antibiotics are not indicated for uncomplicated upper respiratory tract infections (URTI) and are rarely indicated for acute bronchitis. A number of interventions have been trialled to promote rational antibiotic prescribing by established GPs (with variable effectiveness), but the impact of such interventions in a training setting is unclear. We hypothesise that intervening while early-career GPs are still developing their practice patterns and prescribing habits will result in better adherence to evidence-based guidelines as manifested by lower antibiotic prescribing rates for URTIs and acute bronchitis. The intervention consists of two online modules, a face-to-face workshop for GP trainees, a face-to-face workshop for their supervisors and encouragement for the trainee-supervisor dyad to include a case-based discussion of evidence-based antibiotic prescribing in their weekly one-on-one teaching meetings. We will use a non-randomised, non-equivalent control group design to assess the impact on antibiotic prescribing for acute upper respiratory infections and acute bronchitis by GP trainees in vocational training. Early-career GPs who are still developing their clinical practice and prescribing habits are an underutilized target-group for interventions to curb the growth of antimicrobial resistance in the community. Interventions that are embedded into existing training programs or are linked to continuing professional development have potential to increase the impact of existing interventions at limited additional cost. Australian New Zealand Clinical Trials Registry, ACTRN12614001209684 (registered 17/11/2014).

Training Synesthetic Letter-color Associations by Reading in Color

PubMed Central

Colizoli, Olympia; Murre, Jaap M. J.; Rouw, Romke

2014-01-01

Synesthesia is a rare condition in which a stimulus from one modality automatically and consistently triggers unusual sensations in the same and/or other modalities. A relatively common and well-studied type is grapheme-color synesthesia, defined as the consistent experience of color when viewing, hearing and thinking about letters, words and numbers. We describe our method for investigating to what extent synesthetic associations between letters and colors can be learned by reading in color in nonsynesthetes. Reading in color is a special method for training associations in the sense that the associations are learned implicitly while the reader reads text as he or she normally would and it does not require explicit computer-directed training methods. In this protocol, participants are given specially prepared books to read in which four high-frequency letters are paired with four high-frequency colors. Participants receive unique sets of letter-color pairs based on their pre-existing preferences for colored letters. A modified Stroop task is administered before and after reading in order to test for learned letter-color associations and changes in brain activation. In addition to objective testing, a reading experience questionnaire is administered that is designed to probe for differences in subjective experience. A subset of questions may predict how well an individual learned the associations from reading in color. Importantly, we are not claiming that this method will cause each individual to develop grapheme-color synesthesia, only that it is possible for certain individuals to form letter-color associations by reading in color and these associations are similar in some aspects to those seen in developmental grapheme-color synesthetes. The method is quite flexible and can be used to investigate different aspects and outcomes of training synesthetic associations, including learning-induced changes in brain function and structure. PMID:24638033

Music enhances performance and perceived enjoyment of sprint interval exercise.

PubMed

Stork, Matthew J; Kwan, Matthew Y W; Gibala, Martin J; Martin Ginis, Kathleen A

2015-05-01

Interval exercise training can elicit physiological adaptations similar to those of traditional endurance training, but with reduced time. However, the intense nature of specific protocols, particularly the "all-out" efforts characteristic of sprint interval training (SIT), may be perceived as being aversive. The purpose of this study was to determine whether listening to self-selected music can reduce the potential aversiveness of an acute session of SIT by improving affect, motivation, and enjoyment, and to examine the effects of music on performance. Twenty moderately active adults (22 ± 4 yr) unfamiliar with interval exercise completed an acute session of SIT under two different conditions: music and no music. The exercise consisted of four 30-s "all-out" Wingate Anaerobic Test bouts on a cycle ergometer, separated by 4 min of rest. Peak and mean power output, RPE, affect, task motivation, and perceived enjoyment of the exercise were measured. Mixed-effects models were used to evaluate changes in dependent measures over time and between the two conditions. Peak and mean power over the course of the exercise session were higher in the music condition (coefficient = 49.72 [SE = 13.55] and coefficient = 23.65 [SE = 11.30]; P < 0.05). A significant time by condition effect emerged for peak power (coefficient = -12.31 [SE = 4.95]; P < 0.05). There were no between-condition differences in RPE, affect, or task motivation. Perceived enjoyment increased over time and was consistently higher in the music condition (coefficient = 7.00 [SE = 3.05]; P < 0.05). Music enhances in-task performance and enjoyment of an acute bout of SIT. Listening to music during intense interval exercise may be an effective strategy for facilitating participation in, and adherence to, this form of training.

Acute effects of static and dynamic stretching on jump performance after 15 min of reconditioning shooting phase in basketball players.

PubMed

Annino, Giuseppe; Ruscello, Bruno; Lebone, Pietro; Palazzo, Francesco; Lombardo, Mauro; Padua, Elvira; Verdecchia, Luca; Tancredi, Virginia; Iellamo, Ferdinando

2017-04-01

The aim of this study was to assess the effects of static (SS) and dynamic stretching (DS) on vertical jump performance executed before, immediately after and at the end of the shooting phase (i.e., 15 min later), as to simulate the actual conditions preceding a match, in professional basketball players. Ten elite basketball players (age: 29±6.73 years, height: 194.67±7.75 cm, weight: 91±8.17 kg and BMI 23.8±7.91 kg.m-2) participated to the study. SS and DS protocols were administered during the first training session of the week, 48 hours after the championship match. Stretching protocols consisted in ~7 minutes of general warm-up phase followed by ~8 minutes of SS and DS, performed with a cross-over design., and ~15 minutes of a specific warm-up shooting phase (SP). Vertical jump tests consisted in counter movement jump (CMJ) and CMJ with arm swings (CMJas) and were performed immediately after the end of each stretching phase (preS, postS, postSP). A significant decrease (P=0.05; η2partial=0.29) in jumping tests height occurred in CMJas, when performed after the SS (i.e., PostS). However, no significant differences in jumping performances, occurred after the general warm phase and the specific warm-up shooting phase, between the two stretching protocols. These results would indicate that, overall, stretching routines either dynamic or static, performed before a basketball match are transient and affect only marginally leg muscles performance. Stretching routines, particularly the dynamic ones, may be useful to maintain muscle performance before a competition, provided that this latter begins shortly after.

Work-Based Mentor Training for Pennsylvania's School-to-Work System. Final Report.

ERIC Educational Resources Information Center

Walker, Thomas J.; And Others

Three Pennsylvania universities focused on defining the functional role and identifying the training needs of work-based mentors for Pennsylvania's system of school-to-work transition, in order to design a training protocol. Interviews were conducted with 81 experienced employees concerning their view of the mentoring role and the activities that…

Undulatory physical resistance training program increases maximal strength in elderly type 2 diabetics

PubMed Central

dos Santos, Gilberto Monteiro; Montrezol, Fábio Tanil; Pauli, Luciana Santos Souza; Sartori-Cintra, Angélica Rossi; Colantonio, Emilson; Gomes, Ricardo José; Marinho, Rodolfo; de Moura, Leandro Pereira; Pauli, José Rodrigo

2014-01-01

Objective To investigate the effects of a specific protocol of undulatory physical resistance training on maximal strength gains in elderly type 2 diabetics. Methods The study included 48 subjects, aged between 60 and 85 years, of both genders. They were divided into two groups: Untrained Diabetic Elderly (n=19) with those who were not subjected to physical training and Trained Diabetic Elderly (n=29), with those who were subjected to undulatory physical resistance training. The participants were evaluated with several types of resistance training’s equipment before and after training protocol, by test of one maximal repetition. The subjects were trained on undulatory resistance three times per week for a period of 16 weeks. The overload used in undulatory resistance training was equivalent to 50% of one maximal repetition and 70% of one maximal repetition, alternating weekly. Statistical analysis revealed significant differences (p<0.05) between pre-test and post-test over a period of 16 weeks. Results The average gains in strength were 43.20% (knee extension), 65.00% (knee flexion), 27.80% (supine sitting machine), 31.00% (rowing sitting), 43.90% (biceps pulley), and 21.10% (triceps pulley). Conclusion Undulatory resistance training used with weekly different overloads was effective to provide significant gains in maximum strength in elderly type 2 diabetic individuals. PMID:25628192

The perception-action dynamics of action competency are altered by both physical and observational training.

PubMed

Buchanan, John J; Ramos, Jorge; Robson, Nina

2015-04-01

Action competency is defined as the ability of an individual to self-evaluate their own performance capabilities. The current experiment demonstrated that physical and observational training with a motor skill alters action competency ratings in a similar manner. Using a pre-test and post-test protocol, the results revealed that action competency is constrained prior to training by the intrinsic dynamics of relative phase (ϕ), with in-phase (ϕ = 0°) and anti-phase (ϕ = 180°) patterns receiving higher competency ratings than other relative phase patterns. After 2 days of training, action competency ratings for two trained relative phase patterns, +60° and +120°, increased following physical practice or observational practice. A transfer test revealed that both physical performance ability and action competency ability transferred to the symmetry partners (-60° and -120°) of the two trained relative phase patterns following physical or observational training. The findings also revealed that relative motion direction acts as categorical information that helps to organize action production and facilitate action competency. The results are interpreted based on the coordination dynamics theory of perception-action coupling, and extend this theory by showing that visual perception, action production, and action competency are all constrained in a consistent manner by the dynamics of the order parameter relative phase. As a whole, the findings revealed that relative motion, relative phase, and possibly relative amplitude information are all distinct sources of information that contribute to the emergence of a kinematic understanding of action in the nervous system.

Home-based treadmill training improved seminal quality in adults with type 2 diabetes.

PubMed

Rosety-Rodriguez, M; Rosety, J M; Fornieles, G; Rosety, M A; Diaz, A J; Rosety, I; Rodríguez-Pareja, A; Rosety, M; Ordonez, F J; Elosegui, S

2014-11-01

This was the first study conducted to determine the influence of home-based treadmill training on seminal quality in adults with type 2 diabetes. Sixty sedentary adults with type 2 diabetes volunteered for the current study. Thirty were randomly allocated to the intervention group and performed a a 14-week, home-based, treadmill training program, 3 sessions per week, consisting of a warm-up (10-15min), 40min treadmill exercise at a work intensity of 55-70% of peak heart rate (increasing by 2.5% each two weeks) measured during a maximal treadmill test, and cooling-down (5-10min). The control group included 30, age and BMI matched adults with type 2 diabetes who did not take part in any training program. Seminal quality analysis included semen volume, sperm concentration, motility and normal morphologic features. Furthermore, total antioxidant status (TAS) as well as glutathione peroxidase (GPX) activity were assessed in seminal plasma. This protocol was approved by an Institutional Ethics Committee. The home-based treadmill training significantly increased sperm concentration as well as percentages of total sperm motility and normal spermatozoa. Furthermore, TAS and GPX activity were increased after the completion of the training program. No significant changes in any of the measured variables were found in the control group. Home-based treadmill training improved seminal quality in adults with type 2 diabetes. A secondary finding was that seminal antioxidant defense system was significantly increased after being exercised. Copyright © 2013 AEU. Published by Elsevier Espana. All rights reserved.

CT and MR Protocol Standardization Across a Large Health System: Providing a Consistent Radiologist, Patient, and Referring Provider Experience.

PubMed

Sachs, Peter B; Hunt, Kelly; Mansoubi, Fabien; Borgstede, James

2017-02-01

Building and maintaining a comprehensive yet simple set of standardized protocols for a cross-sectional image can be a daunting task. A single department may have difficulty preventing "protocol creep," which almost inevitably occurs when an organized "playbook" of protocols does not exist and individual radiologists and technologists alter protocols at will and on a case-by-case basis. When multiple departments or groups function in a large health system, the lack of uniformity of protocols can increase exponentially. In 2012, the University of Colorado Hospital formed a large health system (UCHealth) and became a 5-hospital provider network. CT and MR imaging studies are conducted at multiple locations by different radiology groups. To facilitate consistency in ordering, acquisition, and appearance of a given study, regardless of location, we minimized the number of protocols across all scanners and sites of practice with a clinical indication-driven protocol selection and standardization process. Here we review the steps utilized to perform this process improvement task and insure its stability over time. Actions included creation of a standardized protocol template, which allowed for changes in electronic storage and management of protocols, designing a change request form, and formation of a governance structure. We utilized rapid improvement events (1 day for CT, 2 days for MR) and reduced 248 CT protocols into 97 standardized protocols and 168 MR protocols to 66. Additional steps are underway to further standardize output and reporting of imaging interpretation. This will result in an improved, consistent radiologist, patient, and provider experience across the system.

Orientation and mobility training for adults with low vision: a new standardized approach

PubMed Central

Ballemans, Judith; Kempen, Gertrudis IJM

2013-01-01

Background: Orientation and mobility training aims to facilitate independent functioning and participation in the community of people with low vision. Objective: (1) To gain insight into current practice regarding orientation and mobility training, and (2) to develop a theory-driven standardized version of this training to teach people with low vision how to orientate and be safe in terms of mobility. Study of current practice: Insight into current practice and its strengths and weaknesses was obtained via reviewing the literature, observing orientation and mobility training sessions (n = 5) and interviewing Dutch mobility trainers (n = 18). Current practice was mainly characterized by an individual, face-to-face orientation and mobility training session concerning three components: crystallizing client’s needs, providing information and training skills. A weakness was the lack of a (structured) protocol based on evidence or theory. New theory-driven training: A new training protocol comprising two face-to-face sessions and one telephone follow-up was developed. Its content is partly based on the components of current practice, yet techniques from theoretical frameworks (e.g. social-cognitive theory and self-management) are incorporated. Discussion: A standardized, tailor-made orientation and mobility training for using the identification cane is available. The new theory-driven standardized training is generally applicable for teaching the use of every low-vision device. Its acceptability and effectiveness are currently being evaluated in a randomized controlled trial. PMID:22734105

Protocols for Handling Messages Between Simulation Computers

NASA Technical Reports Server (NTRS)

Balcerowski, John P.; Dunnam, Milton

2006-01-01

Practical Simulator Network (PSimNet) is a set of data-communication protocols designed especially for use in handling messages between computers that are engaging cooperatively in real-time or nearly-real-time training simulations. In a typical application, computers that provide individualized training at widely dispersed locations would communicate, by use of PSimNet, with a central host computer that would provide a common computational- simulation environment and common data. Originally intended for use in supporting interfaces between training computers and computers that simulate the responses of spacecraft scientific payloads, PSimNet could be especially well suited for a variety of other applications -- for example, group automobile-driver training in a classroom. Another potential application might lie in networking of automobile-diagnostic computers at repair facilities to a central computer that would compile the expertise of numerous technicians and engineers and act as an expert consulting technician.

Hospital implementation of resuscitation guidelines and review of CPR training programmes: a nationwide study.

PubMed

Schmidt, Anders S; Lauridsen, Kasper G; Adelborg, Kasper; Løfgren, Bo

2016-06-01

This study aimed to investigate cardiopulmonary resuscitation (CPR) guideline implementation and CPR training in hospitals. This nationwide study included mandatory resuscitation protocols from each Danish hospital. Protocols were systematically reviewed for adherence to the European Resuscitation Council (ERC) 2010 guidelines and CPR training in each hospital. Data were included from 45 of 47 hospitals. Adherence to the ERC basic life support (BLS) algorithm was 49%, whereas 63 and 58% of hospitals adhered to the recommended chest compression depth and rate. Adherence to the ERC advanced life support (ALS) algorithm was 81%. Hospital BLS course duration was [median (interquartile range)] 2.3 (1.5-2.5) h, whereas ALS course duration was 4.0 (2.5-8.0) h. Implementation of ERC 2010 guidelines on BLS is limited in Danish hospitals 2 years after guideline publication, whereas the majority of hospitals adhere to the ALS algorithm. CPR training differs among hospitals.

Effect of leg exercise training on vascular volumes during 30 days of 6 deg head-down bed rest

NASA Technical Reports Server (NTRS)

Greenleaf, J. E.; Vernikos, J.; Wade, C. E.; Barnes, P. R.

1992-01-01

In order to investigate the effects of leg exercise training on vascular volumes during 30 d of 6-deg head-down bed rest, plasma and red cell volumes, body density, and water balance were measured in 19 men confined to bed rest (BR). One group had no exercise training (NOE), another near-maximal variable-intensity isotonic exercise (ITE) for 60 min/d, and the third near-maximal intermittent isokinetic exercise (IKE) for 60 min/d. Mean energy costs for the NOE, IKE, and ITE regimens were determined. Body densities within groups and mean urine volumes between groups were unchanged during BR. Changes in red cell volume followed changes in plasma volume. There was close coupling between resting plasma volume and plasma protein and osmotic content. It is argued that the ITE training protocol is better than the IKE protocol for maintaining plasma volume during prolonged exposure to BR.

Effects of Short-Interval and Long-Interval Swimming Protocols on Performance, Aerobic Adaptations, and Technical Parameters: A Training Study.

PubMed

Dalamitros, Athanasios A; Zafeiridis, Andreas S; Toubekis, Argyris G; Tsalis, George A; Pelarigo, Jailton G; Manou, Vasiliki; Kellis, Spiridon

2016-10-01

Dalamitros, AA, Zafeiridis, AS, Toubekis, AG, Tsalis, GA, Pelarigo, JG, Manou, V, and Kellis, S. Effects of short-interval and long-interval swimming protocols on performance, aerobic adaptations, and technical parameters: A training study. J Strength Cond Res 30(10): 2871-2879, 2016-This study compared 2-interval swimming training programs of different work interval durations, matched for total distance and exercise intensity, on swimming performance, aerobic adaptations, and technical parameters. Twenty-four former swimmers were equally divided to short-interval training group (INT50, 12-16 × 50 m with 15 seconds rest), long-interval training group (INT100, 6-8 × 100 m with 30 seconds rest), and a control group (CON). The 2 experimental groups followed the specified swimming training program for 8 weeks. Before and after training, swimming performance, technical parameters, and indices of aerobic adaptations were assessed. ΙΝΤ50 and ΙΝΤ100 improved swimming performance in 100 and 400-m tests and the maximal aerobic speed (p ≤ 0.05); the performance in the 50-m swim did not change. Posttraining V[Combining Dot Above]O2max values were higher compared with pretraining values in both training groups (p ≤ 0.05), whereas peak aerobic power output increased only in INT100 (p ≤ 0.05). The 1-minute heart rate and blood lactate recovery values decreased after training in both groups (p < 0.01). Stroke length increased in 100 and 400-m swimming tests after training in both groups (p ≤ 0.05); no changes were observed in stroke rate after training. Comparisons between groups on posttraining mean values, after adjusting for pretraining values, revealed no significant differences between ΙΝΤ50 and ΙΝΤ100 for all variables; however, all measures were improved vs. the respective values in the CON (p < 0.001-0.05). In conclusion, when matched for distance and exercise intensity, the short-interval (50 m) and long-interval (100 m) protocols confer analogous improvements in swimming performance, in stroke cycle parameters, and in indices of aerobic adaptations after 8 weeks of training.

Prehospital care training in a rapidly developing economy: a multi-institutional study.

PubMed

Vyas, Dinesh; Hollis, Michael; Abraham, Rohit; Rustagi, Neeti; Chandra, Siddharth; Malhotra, Ajai; Rajpurohit, Vikas; Purohit, Harshada; Pal, Ranabir

2016-06-01

The trauma pandemic is one of the leading causes of death worldwide but especially in rapidly developing economies. Perhaps, a common cause of trauma-related mortality in these settings comes from the rapid expansion of motor vehicle ownership without the corresponding expansion of national prehospital training in developed countries. The resulting road traffic injuries often never make it to the hospital in time for effective treatment, resulting in preventable disability and death. The current article examines the development of a medical first responder training program that has the potential to reduce this unnecessary morbidity and mortality. An intensive training workshop has been differentiated into two progressive tiers: acute trauma training (ATT) and broad trauma training (BTT) protocols. These four-hour and two-day protocols, respectively, allow for the mass education of laypersons-such as police officials, fire brigade, and taxi and/or ambulance drivers-who are most likely to interact first with prehospital victims. Over 750 ATT participants and 168 BTT participants were trained across three Indian educational institutions at Jodhpur and Jaipur. Trainees were given didactic and hands-on education in a series of critical trauma topics, in addition to pretraining and post-training self-assessments to rate clinical confidence across curricular topics. Two-sample t-test statistical analyses were performed to compare pretraining and post-training confidence levels. Program development resulted in recruitment of a variety of career backgrounds for enrollment in both our ATT and BTT workshops. The workshops were run by local physicians from a wide spectrum of medical specialties and previously ATT-trained police officials. Statistically significant improvements in clinical confidence across all curricular topics for ATT and BTT protocols were identified (P < 0.0001). In addition, improvement in confidence after BTT training was similar in Jodhpur compared with Jaipur. These results suggest a promising level of reliability and reproducibility across different geographic areas in rapidly developing settings. Program expansion can offer an exponential growth in the training rate of medical first responders, which can help curb the trauma-related mortality in rapidly developing economies. Future directions will include clinical competency assessments and further progressive differentiation into higher tiers of trauma expertise. Published by Elsevier Inc.

Does attention redirection contribute to the effectiveness of attention bias modification on social anxiety?

PubMed

Yao, Nisha; Yu, Hongyu; Qian, Mingyi; Li, Songwei

2015-12-01

Attention bias modification (ABM) is designed to modify threat-related attention bias and thus alleviate anxiety. The current research examined whether consistently directing attention towards targeted goals per se contributes to ABM efficacy. We randomly assigned 68 non-clinical college students with elevated social anxiety to non-valence-specific attend-to-geometrics (AGC), attention modification (AMC), or attention control (ACC) conditions. We assessed subjective, behavioral, and physiological reactivity to a speech task and self-reported social anxiety symptoms. After training, participants in the AMC exhibited an attention avoidance from threat, and those in the AGC responded more rapidly toward targeted geometrics. There was a significant pre- to post-reduction in subjective speech distress across groups, but behavioral and physiological reactivity to speech, as well as self-report social anxiety symptoms, remained unchanged. These results lead to questions concerning effectiveness of ABM training for reducing social anxiety. Further examination of the current ABM protocol is required. Copyright © 2015 Elsevier Ltd. All rights reserved.

Change in functional balance after an exercise program with Nintendo Wii in Latino patients with cerebral palsy: a case series.

PubMed

Gatica-Rojas, Valeska; Cartes-Velásquez, Ricardo; Méndez-Rebolledo, Guillermo; Olave-Godoy, Felipe; Villalobos-Rebolledo, David

2016-08-01

[Purpose] This study aimed to explore the possibility of improving functional balance using an exercise program with Nintendo and the Balance Board peripheral in subjects with cerebral palsy. [Subjects and Methods] This study included 4 male outpatients of a neurological center. All participants received an exercise program based on the use of Nintendo with the Balance Board peripheral. Training consisted of three 25-min sessions per week for 6 weeks. Each session was guided by a physical therapist. Timed up-and-go and one-leg standing tests were conducted before and after the intervention. [Results] All subjects showed significant improvements in the results of the timed up-and-go test. However, there were no significant changes in the results of the one-leg standing test. [Conclusion] The exercise protocol involving Nintendo with the Balance Board peripheral appears to improve functional dynamic balance in patients with cerebral palsy. However, static functional balance does not improve after 6 weeks of training.

[Effects of 12 sessions of high intensity intermittent training and nutrition counseling on body fat in obese and overweight participants].

PubMed

Molina, Catalina; Cifuentes, Gabriela; Martínez, Cristian; Mancilla, Rodrigo; Díaz, Erik

2016-10-01

The search of efficient exercise alternatives to treat obesity is worthwhile. To demonstrate the effect of high intensity intermittent exercise on body fat reduction in overweight and obese subjects. A group of 65 overweight and obese adult subjects (25 men), aged 18-65 years, participated during 12 sessions in a high intensity physical exercise program, 3 days/week. Weight, height and body fat was measured before and after the intervention by bioimpedance. Each session consisted of 1 min stationary cycling exercise at high intensity, followed by 2 min inactive rest. This cycle was repeated 10 times, thus the method is called 1*2*10. There was a significant reduction of body fat of -1.88 ± 2.8 and -3.44 ± 2.7 kg, in women and men, respectively (p < 0.05). The 1*2*10 training protocol lasting 12 weeks in association with nutrition counseling is effective in reducing body fat in overweight persons.

Change in functional balance after an exercise program with Nintendo Wii in Latino patients with cerebral palsy: a case series

PubMed Central

Gatica-Rojas, Valeska; Cartes-Velásquez, Ricardo; Méndez-Rebolledo, Guillermo; Olave-Godoy, Felipe; Villalobos-Rebolledo, David

2016-01-01

[Purpose] This study aimed to explore the possibility of improving functional balance using an exercise program with Nintendo and the Balance Board peripheral in subjects with cerebral palsy. [Subjects and Methods] This study included 4 male outpatients of a neurological center. All participants received an exercise program based on the use of Nintendo with the Balance Board peripheral. Training consisted of three 25-min sessions per week for 6 weeks. Each session was guided by a physical therapist. Timed up-and-go and one-leg standing tests were conducted before and after the intervention. [Results] All subjects showed significant improvements in the results of the timed up-and-go test. However, there were no significant changes in the results of the one-leg standing test. [Conclusion] The exercise protocol involving Nintendo with the Balance Board peripheral appears to improve functional dynamic balance in patients with cerebral palsy. However, static functional balance does not improve after 6 weeks of training. PMID:27630446

Movement towards transdiagnostic psychotherapeutic practices for the affective disorders.

PubMed

Gros, Daniel F; Allan, Nicholas P; Szafranski, Derek D

2016-08-01

Evidence-based cognitive behavioural therapy (CBT) practices were first developed in the 1960s. Over the decades, refinements and alternative symptom foci resulted in the development of several CBT protocols/manuals for each of the many disorders, especially in the affective disorders. Although shown to be effective in highly trained providers, the proliferation of CBT protocols also has shown to demonstrate challenges in dissemination and implementation efforts due to the sheer number of CBT protocols and their related training requirements (eg, 6 months per protocol) and their related cost (eg, over US$2000 each; lost days/hours at work). To address these concerns, newer transdiagnostic CBT protocols have been developed to reduce the number of disorder-specific CBT protocols needed to treat patients with affective disorders. Transdiagnostic treatments are based on the notion that various disorder-specific CBT protocols contain important but overlapping treatment components that can be distilled into a single treatment and therefore address the symptoms and comorbidities across all of the disorders at once. 3 examples of transdiagnostic treatments include group CBT of anxiety, unified protocol for transdiagnostic treatment for emotional disorders and transdiagnostic behaviour therapy. Each transdiagnostic protocol is designed for a different set of disorders, contains a varied amount of CBT treatment components and is tested in different types of samples. However, together, these 3 transdiagnostic psychotherapies represent the future of CBT practice. 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 Viability of Hearing Protection Device Fit-Testing at Navy and Marine Corps Accession Points

PubMed Central

Federman, Jeremy; Duhon, Christon

2016-01-01

Introduction: The viability of hearing protection device (HPD) verification (i.e., fit-testing) on a large scale was investigated to address this gap in a military accession environment. Materials and Methods: Personal Attenuation Ratings (PARs) following self-fitted (SELF-Fit) HPDs were acquired from 320 US Marine Corps training recruits (87.5% male, 12.5% female) across four test protocols (1-, 3-, 5-, and 7- frequency). SELF-Fit failures received follow-up to assess potential causes. Follow-up PARs were acquired (Experimenter fit [EXP-Fit], followed by Subject re-fit [SUB Re-Fit]). EXP-Fit was intended to provide a perception (dubbed “ear canal muscle memory”) of what a correctly fitted HPD should feel like. SUB Re-Fit was completed following EXP-Fit to determine whether a training recruit could duplicate EXP-Fit on her/his own without assistance. Results: A one-way analysis of variance (ANOVA) (N=320) showed that SELF-Fit means differed significantly between protocols (P < 0.001). Post-hoc analyses showed that the 1-freq SELF-Fit mean was significantly lower than all other protocols (P < 0.03) by 5.6 dB or more. No difference was found between the multi-frequency protocols. For recruits who were followed up with EXP-Fit (n=79), across all protocols, a significant (P < 0.001) mean improvement of 25.68 dB (10.99) was found, but PARs did not differ (P = 0.99) between EXP-Fit protocols. For recruits in the 3-freq and 5-freq protocol groups who experienced all three PAR test methods (n=33), PAR methods differed (P < 0.001) but no method by protocol interaction was found (P = 0.46). Post hoc tests showed that both EXP-Fit and SUB Re-Fit had significantly better attenuation than SELF-Fit (P < 0.001), but no difference was found between EXPFit and SUB Re-Fit (P = 0.59). For SELF-Fit, the 1-freq protocol resulted in a 35% pass rate, whereas the 3-, 5-, and 7-freq protocols resulted in >60% pass rates. Results showed that once recruits experienced how HPDs should feel when inserted correctly, they were able to properly replicate the procedure with similar results to the expert fit suggesting “ear canal muscle memory” may be a viable training strategy concomitant with HPD verification. Fit-test duration was also measured to examine the tradeoff between results accuracy and time required to complete each protocol. Discussion: Results from this study showed the critical importance of initial selection and fitting of HPDs followed by verification (i.e., fit-testing) at Navy and Marine Corps accession points. Achieving adequate protection from an HPD is fundamentally dependent on obtaining proper fit of the issued HPD as well as the quality of training recruits receive regarding HPD use. PMID:27991461

The Trainability of Adolescent Soccer Players to Brief Periodized Complex Training.

PubMed

Chatzinikolaou, Athanasios; Michaloglou, Konstantinos; Avloniti, Alexandra; Leontsini, Diamanda; Deli, Chariklia K; Vlachopoulos, Dimitris; Gracia-Marco, Luis; Arsenis, Sotirios; Athanailidis, Ioannis; Draganidis, Dimitrios; Jamurtas, Athanasios Z; Williams, Craig A; Fatouros, Ioannis G

2018-05-01

To investigate the effect of a complex, short-term strength/power training protocol on performance and body composition of elite early adolescent soccer players. Twenty-two players (14-15 y) were randomly assigned to (1) an experimental group (N = 12; participated in a 5-wk training protocol with traditional multijoint power resistance exercises, Olympic-style lifts, plyometric drills, and speed work; 4 times per week) or (2) a control group (N = 10). Strength and power performance (jumping, speed, change of direction, repeated sprint ability, endurance, isokinetic strength of knee flexors and extensors, maximal strength in various lifts, and speed-endurance) were evaluated pretraining and posttraining. Cessation of training for 5 weeks in the control group induced a marked performance deterioration (∼5%-20%). Training not only prevented strength performance deterioration but also increased it (∼2%-30%). Endurance and repeated sprint ability declined to a smaller extent in experimental group compared with control group (15% vs 7.5%). Isometric strength and body composition remained unaltered in both groups. Results demonstrate that (1) young players exhibit a high level of trainability of their strength/power performance (but not endurance) in response to a short-term complex training protocol during early adolescence, (2) Olympic-style lifts are characterized by increased safety in this age group and appear to be highly effective, (3) lifts incorporating a hip thrust result in increased strength of both knee extensors and flexors, (4) cessation of training for only 5 weeks results in marked deterioration of strength/power and endurance performance, and (5) improvement of strength/power performance may be related to neural-based adaptation as body composition remained unaffected.

A study protocol to investigate the management of depression and challenging behaviors associated with dementia in aged care settings.

PubMed

McCabe, Marita P; Mellor, David; Davison, Tanya E; Karantzas, Gery; von Treuer, Kathryn; O'Connor, Daniel W

2013-09-19

The high occurrence and under-treatment of clinical depression and behavioral and psychological symptoms of dementia (BPSD) within aged care settings is concerning, yet training programs aimed at improving the detection and management of these problems have generally been ineffective. This article presents a study protocol to evaluate a training intervention for facility managers/registered nurses working in aged care facilities that focuses on organisational processes and culture as well as knowledge, skills and self-efficacy. A Randomised Control Trial (RCT) will be implemented across 18 aged care facilities (divided into three conditions). Participants will be senior registered nurses and personal care attendants employed in the aged care facility. The first condition will receive the training program (Staff as Change Agents - Enhancing and Sustaining Mental Health in Aged Care), the second condition will receive the training program and clinical support, and the third condition will receive no intervention. Pre-, post-, 6-month and 12-month follow-up measures of staff and residents will be used to demonstrate how upskilling clinical leaders using our transformational training approach, as well as the use of a structured screening, referral and monitoring protocol, can address the mental health needs of older people in residential care. The expected outcome of this study is the validation of an evidence-based training program to improve the management of depression and BPSD among older people in residential care settings by establishing routine practices related to mental health. This relatively brief but highly focussed training package will be readily rolled out to a larger number of residential care facilities at a relatively low cost. Australia and New Zealand Clinical Trials Register (ANZCTR): The Universal Trial Number (UTN) is U1111-1141-0109.

Six Sessions of Sprint Interval Training Improves Running Performance in Trained Athletes.

PubMed

Koral, Jerome; Oranchuk, Dustin J; Herrera, Roberto; Millet, Guillaume Y

2018-03-01

Koral, J, Oranchuk, DJ, Herrera, R, and Millet, GY. Six sessions of sprint interval training improves running performance in trained athletes. J Strength Cond Res 32(3): 617-623, 2018-Sprint interval training (SIT) is gaining popularity with endurance athletes. Various studies have shown that SIT allows for similar or greater endurance, strength, and power performance improvements than traditional endurance training but demands less time and volume. One of the main limitations in SIT research is that most studies were performed in a laboratory using expensive treadmills or ergometers. The aim of this study was to assess the performance effects of a novel short-term and highly accessible training protocol based on maximal shuttle runs in the field (SIT-F). Sixteen (12 male, 4 female) trained trail runners completed a 2-week procedure consisting of 4-7 bouts of 30 seconds at maximal intensity interspersed by 4 minutes of recovery, 3 times a week. Maximal aerobic speed (MAS), time to exhaustion at 90% of MAS before test (Tmax at 90% MAS), and 3,000-m time trial (TT3000m) were evaluated before and after training. Data were analyzed using a paired samples t-test, and Cohen's (d) effect sizes were calculated. Maximal aerobic speed improved by 2.3% (p = 0.01, d = 0.22), whereas peak power (PP) and mean power (MP) increased by 2.4% (p = 0.009, d = 0.33) and 2.8% (p = 0.002, d = 0.41), respectively. TT3000m was 6% shorter (p < 0.001, d = 0.35), whereas Tmax at 90% MAS was 42% longer (p < 0.001, d = 0.74). Sprint interval training in the field significantly improved the 3,000-m run, time to exhaustion, PP, and MP in trained trail runners. Sprint interval training in the field is a time-efficient and cost-free means of improving both endurance and power performance in trained athletes.

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

PubMed

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

2011-06-01

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

Six Sessions of Sprint Interval Training Improves Running Performance in Trained Athletes

PubMed Central

Oranchuk, Dustin J.; Herrera, Roberto; Millet, Guillaume Y.

2018-01-01

Abstract Koral, J, Oranchuk, DJ, Herrera, R, and Millet, GY. Six sessions of sprint interval training improves running performance in trained athletes. J Strength Cond Res 32(3): 617–623, 2018—Sprint interval training (SIT) is gaining popularity with endurance athletes. Various studies have shown that SIT allows for similar or greater endurance, strength, and power performance improvements than traditional endurance training but demands less time and volume. One of the main limitations in SIT research is that most studies were performed in a laboratory using expensive treadmills or ergometers. The aim of this study was to assess the performance effects of a novel short-term and highly accessible training protocol based on maximal shuttle runs in the field (SIT-F). Sixteen (12 male, 4 female) trained trail runners completed a 2-week procedure consisting of 4–7 bouts of 30 seconds at maximal intensity interspersed by 4 minutes of recovery, 3 times a week. Maximal aerobic speed (MAS), time to exhaustion at 90% of MAS before test (Tmax at 90% MAS), and 3,000-m time trial (TT3000m) were evaluated before and after training. Data were analyzed using a paired samples t-test, and Cohen's (d) effect sizes were calculated. Maximal aerobic speed improved by 2.3% (p = 0.01, d = 0.22), whereas peak power (PP) and mean power (MP) increased by 2.4% (p = 0.009, d = 0.33) and 2.8% (p = 0.002, d = 0.41), respectively. TT3000m was 6% shorter (p < 0.001, d = 0.35), whereas Tmax at 90% MAS was 42% longer (p < 0.001, d = 0.74). Sprint interval training in the field significantly improved the 3,000-m run, time to exhaustion, PP, and MP in trained trail runners. Sprint interval training in the field is a time-efficient and cost-free means of improving both endurance and power performance in trained athletes. PMID:29076961

Varied overground walking-task practice versus body-weight-supported treadmill training in ambulatory adults within one year of stroke: a randomized controlled trial protocol.

PubMed

DePaul, Vincent G; Wishart, Laurie R; Richardson, Julie; Lee, Timothy D; Thabane, Lehana

2011-10-21

Although task-oriented training has been shown to improve walking outcomes after stroke, it is not yet clear whether one task-oriented approach is superior to another. The purpose of this study is to compare the effectiveness of the Motor Learning Walking Program (MLWP), a varied overground walking task program consistent with key motor learning principles, to body-weight-supported treadmill training (BWSTT) in community-dwelling, ambulatory, adults within 1 year of stroke. A parallel, randomized controlled trial with stratification by baseline gait speed will be conducted. Allocation will be controlled by a central randomization service and participants will be allocated to the two active intervention groups (1:1) using a permuted block randomization process. Seventy participants will be assigned to one of two 15-session training programs. In MLWP, one physiotherapist will supervise practice of various overground walking tasks. Instructions, feedback, and guidance will be provided in a manner that facilitates self-evaluation and problem solving. In BWSTT, training will emphasize repetition of the normal gait cycle while supported over a treadmill, assisted by up to three physiotherapists. Outcomes will be assessed by a blinded assessor at baseline, post-intervention and at 2-month follow-up. The primary outcome will be post-intervention comfortable gait speed. Secondary outcomes include fast gait speed, walking endurance, balance self-efficacy, participation in community mobility, health-related quality of life, and goal attainment. Groups will be compared using analysis of covariance with baseline gait speed strata as the single covariate. Intention-to-treat analysis will be used. In order to direct clinicians, patients, and other health decision-makers, there is a need for a head-to-head comparison of different approaches to active, task-related walking training after stroke. We hypothesize that outcomes will be optimized through the application of a task-related training program that is consistent with key motor learning principles related to practice, guidance and feedback. ClinicalTrials.gov # NCT00561405.

Varied overground walking-task practice versus body-weight-supported treadmill training in ambulatory adults within one year of stroke: a randomized controlled trial protocol

PubMed Central

2011-01-01

Background Although task-oriented training has been shown to improve walking outcomes after stroke, it is not yet clear whether one task-oriented approach is superior to another. The purpose of this study is to compare the effectiveness of the Motor Learning Walking Program (MLWP), a varied overground walking task program consistent with key motor learning principles, to body-weight-supported treadmill training (BWSTT) in community-dwelling, ambulatory, adults within 1 year of stroke. Methods/Design A parallel, randomized controlled trial with stratification by baseline gait speed will be conducted. Allocation will be controlled by a central randomization service and participants will be allocated to the two active intervention groups (1:1) using a permuted block randomization process. Seventy participants will be assigned to one of two 15-session training programs. In MLWP, one physiotherapist will supervise practice of various overground walking tasks. Instructions, feedback, and guidance will be provided in a manner that facilitates self-evaluation and problem solving. In BWSTT, training will emphasize repetition of the normal gait cycle while supported over a treadmill, assisted by up to three physiotherapists. Outcomes will be assessed by a blinded assessor at baseline, post-intervention and at 2-month follow-up. The primary outcome will be post-intervention comfortable gait speed. Secondary outcomes include fast gait speed, walking endurance, balance self-efficacy, participation in community mobility, health-related quality of life, and goal attainment. Groups will be compared using analysis of covariance with baseline gait speed strata as the single covariate. Intention-to-treat analysis will be used. Discussion In order to direct clinicians, patients, and other health decision-makers, there is a need for a head-to-head comparison of different approaches to active, task-related walking training after stroke. We hypothesize that outcomes will be optimized through the application of a task-related training program that is consistent with key motor learning principles related to practice, guidance and feedback. Trial Registration ClinicalTrials.gov # NCT00561405 PMID:22018267

Orthodontic treatment outcomes obtained by application of a finishing protocol

PubMed Central

Carvajal-Flórez, Alvaro; Barbosa-Lis, Diana María; Zapata-Noreña, Oscar Arturo; Marín-Velásquez, Julissa Andrea; Afanador-Bayona, Sergio Andrés

2016-01-01

ABSTRACT Objective: To evaluate the results of a finishing protocol implemented in patients treated in the Orthodontics graduate program at Universidad de Antioquia. Evaluation was carried out by means of the criteria set by the Objective Grading System (OGS) of the American Board of Orthodontics (ABO). Methods: Cast models and panoramic radiographs of 34 patients were evaluated. The intervention group (IG) consisted of 17 patients (19.88 ± 4.4 years old) treated under a finishing protocol. This protocol included training in finishing, application of a finishing guide, brackets repositioning and patient's follow-up. Results of the IG were compared to a control group of 17 patients (21.88 ± 7.0 years old) selected by stratified randomization without finishing intervention (CG). Results: The scores for both CG and IG were 38.00 ± 9.0 and 31.41 ± 9.6 (p = 0.048), respectively. The score improved significantly in the IG group, mainly regarding marginal ridges (CG: 5.59 ± 2.2; IG: 3.65 ± 1.8) (p = 0.009) and root angulation (CG: 7.59 ± 2.8; IG: 4.88 ± 2.6) (p = 0.007). Criteria that did not improve, but had the highest scores were: alignment (CG: 6.35 ± 2.7; IG: 6.82 ± 2.8) (p = 0.62) and buccolingual inclination (CG: 3.6 ± 5.88; IG: 5.29 ± 3.9) (p = 0.65). Conclusions: Standardization and implementation of a finishing protocol contributed to improve clinical performance in the Orthodontics graduate program, as expressed by occlusal outcomes. Greater emphasis should be given on the finishing phase to achieve lower scores in the ABO grading system. PMID:27275620

Investigating the impact of alliance-focused training on interpersonal process and therapists' capacity for experiential reflection.

PubMed

Safran, Jeremy; Muran, J Christopher; Demaria, Anthony; Boutwell, Catherine; Eubanks-Carter, Catherine; Winston, Arnold

2014-01-01

In this article we present preliminary findings from a research program designed to investigate the value of alliance-focused training (AFT), a supervision approach designed to enhance therapists' ability to work constructively with negative therapeutic process. In the context of a multiple baseline design, all therapists began treating their patients using cognitive therapy and then joined AFT supervision groups at either session 8 or 16 of a 30 session protocol. Study I investigated the impact of AFT on patient and therapist interpersonal process as assessed through the Structural Analysis of Social Behavior (SASB). Study 2 investigated the impact of AFT on therapists' tendency to reflect on their relationships with their patients in an experientially grounded fashion, as assessed via the Experiencing Scale (EXP). Since one of the goals of AFT is to train therapists to use their own emerging feelings as important clues regarding what may be taking place in the therapeutic relationship, we hypothesized that they would show increased levels of EXP after undergoing AFT. The results of both studies 1 and 2 were for the most part consistent with hypotheses. Implications and future research directions are discussed.

Nocturnal sleep enhances working memory training in Parkinson's disease but not Lewy body dementia

PubMed Central

Trotti, Lynn Marie; Wilson, Anthony G.; Greer, Sophia A.; Bliwise, Donald L.

2012-01-01

Working memory is essential to higher order cognition (e.g. fluid intelligence) and to performance of daily activities. Though working memory capacity was traditionally thought to be inflexible, recent studies report that working memory capacity can be trained and that offline processes occurring during sleep may facilitate improvements in working memory performance. We utilized a 48-h in-laboratory protocol consisting of repeated digit span forward (short-term attention measure) and digit span backward (working memory measure) tests and overnight polysomnography to investigate the specific sleep-dependent processes that may facilitate working memory performance improvements in the synucleinopathies. We found that digit span backward performance improved following a nocturnal sleep interval in patients with Parkinson's disease on dopaminergic medication, but not in those not taking dopaminergic medication and not in patients with dementia with Lewy bodies. Furthermore, the improvements in patients with Parkinson's disease on dopaminergic medication were positively correlated with the amount of slow-wave sleep that patients obtained between training sessions and negatively correlated with severity of nocturnal oxygen desaturation. The translational implication is that working memory capacity is potentially modifiable in patients with Parkinson's disease but that sleep disturbances may first need to be corrected. PMID:22907117

Nocturnal sleep enhances working memory training in Parkinson's disease but not Lewy body dementia.

PubMed

Scullin, Michael K; Trotti, Lynn Marie; Wilson, Anthony G; Greer, Sophia A; Bliwise, Donald L

2012-09-01

Working memory is essential to higher order cognition (e.g. fluid intelligence) and to performance of daily activities. Though working memory capacity was traditionally thought to be inflexible, recent studies report that working memory capacity can be trained and that offline processes occurring during sleep may facilitate improvements in working memory performance. We utilized a 48-h in-laboratory protocol consisting of repeated digit span forward (short-term attention measure) and digit span backward (working memory measure) tests and overnight polysomnography to investigate the specific sleep-dependent processes that may facilitate working memory performance improvements in the synucleinopathies. We found that digit span backward performance improved following a nocturnal sleep interval in patients with Parkinson's disease on dopaminergic medication, but not in those not taking dopaminergic medication and not in patients with dementia with Lewy bodies. Furthermore, the improvements in patients with Parkinson's disease on dopaminergic medication were positively correlated with the amount of slow-wave sleep that patients obtained between training sessions and negatively correlated with severity of nocturnal oxygen desaturation. The translational implication is that working memory capacity is potentially modifiable in patients with Parkinson's disease but that sleep disturbances may first need to be corrected.

Generalized Teleportation and Entanglement Recycling

NASA Astrophysics Data System (ADS)

Strelchuk, Sergii; Horodecki, Michał; Oppenheim, Jonathan

2013-01-01

We introduce new teleportation protocols which are generalizations of the original teleportation protocols that use the Pauli group and the port-based teleportation protocols, introduced by Hiroshima and Ishizaka, that use the symmetric permutation group. We derive sufficient conditions for a set of operations, which in general need not form a group, to give rise to a teleportation protocol and provide examples of such schemes. This generalization leads to protocols with novel properties and is needed to push forward new schemes of computation based on them. Port-based teleportation protocols and our generalizations use a large resource state consisting of N singlets to teleport only a single qubit state reliably. We provide two distinct protocols which recycle the resource state to teleport multiple states with error linearly increasing with their number. The first protocol consists of sequentially teleporting qubit states, and the second teleports them in a bulk.

Generalized teleportation and entanglement recycling.

PubMed

Strelchuk, Sergii; Horodecki, Michał; Oppenheim, Jonathan

2013-01-04

We introduce new teleportation protocols which are generalizations of the original teleportation protocols that use the Pauli group and the port-based teleportation protocols, introduced by Hiroshima and Ishizaka, that use the symmetric permutation group. We derive sufficient conditions for a set of operations, which in general need not form a group, to give rise to a teleportation protocol and provide examples of such schemes. This generalization leads to protocols with novel properties and is needed to push forward new schemes of computation based on them. Port-based teleportation protocols and our generalizations use a large resource state consisting of N singlets to teleport only a single qubit state reliably. We provide two distinct protocols which recycle the resource state to teleport multiple states with error linearly increasing with their number. The first protocol consists of sequentially teleporting qubit states, and the second teleports them in a bulk.

A retrospective analysis to determine the effect of independent treatment centres on the case mix for microsurgical training.

PubMed

Barsam, A; Heatley, C J; Sundaram, V; Toma, N M G

2008-05-01

To determine the effect of Independent Sector Treatment Centres (ISTC) on microsurgical training. A novel scoring protocol for stratification of cases suitable for microsurgical training was devised. This scoring protocol was applied to all patients who underwent cataract surgery on a single consultant dedicated training list between September and November 2004. These patients are representative of patients remaining on the waiting list after ISTC selection, that is, the residual case mix. Patients who underwent cataract surgery on the same consultant list in the same period in 2003 were also analysed when there was no ISTC or other waiting list initiative in operation. Data was available for 129 patients. Seventy three patients underwent cataract surgery between September and November 2003 and 56 patients underwent cataract surgery in the same period in 2004. Using the devised scoring protocol, the mean score in the 2003 group was 1.08 +/-1.75 (range, 0.0-10.5) and for the 2004 group the mean score was 2.31 +/-2.65 (range, 0.0-4.5). A Mann-Whitney test showed that there was a statistically significant difference between the scores in the two groups (P=0.0009). With Independent Sector Treatment Centre implementation the percentage of cases suitable only for consultants increased fourfold. The decrease in suitable cases for training as shown in this study is likely to have serious consequences on microsurgical training in the UK. We recommend that the results of this study are considered in any current or future plans for ISTC continuation and expansion.

Adaptation of exercise-induced stress in well-trained healthy young men.

PubMed

JanssenDuijghuijsen, Lonneke M; Keijer, Jaap; Mensink, Marco; Lenaerts, Kaatje; Ridder, Lars; Nierkens, Stefan; Kartaram, Shirley W; Verschuren, Martie C M; Pieters, Raymond H H; Bas, Richard; Witkamp, Renger F; Wichers, Harry J; van Norren, Klaske

2017-01-01

What is the central question of this study? Exercise is known to induce stress-related physiological responses, such as changes in intestinal barrier function. Our aim was to determine the test-retest repeatability of these responses in well-trained individuals. What is the main finding and its importance? Responses to strenuous exercise, as indicated by stress-related markers such as intestinal integrity markers and myokines, showed high test-retest variation. Even in well-trained young men an adapted response is seen after a single repetition after 1 week. This finding has implications for the design of studies aimed at evaluating physiological responses to exercise. Strenuous exercise induces different stress-related physiological changes, potentially including changes in intestinal barrier function. In the Protégé Study (ISRCTN14236739; www.isrctn.com), we determined the test-retest repeatability in responses to exercise in well-trained individuals. Eleven well-trained men (27 ± 4 years old) completed an exercise protocol that consisted of intensive cycling intervals, followed by an overnight fast and an additional 90 min cycling phase at 50% of maximal workload the next morning. The day before (rest), and immediately after the exercise protocol (exercise) a lactulose and rhamnose solution was ingested. Markers of energy metabolism, lactulose-to-rhamnose ratio, several cytokines and potential stress-related markers were measured at rest and during exercise. In addition, untargeted urine metabolite profiles were obtained. The complete procedure (Test) was repeated 1 week later (Retest) to assess repeatability. Metabolic effect parameters with regard to energy metabolism and urine metabolomics were similar for both the Test and Retest period, underlining comparable exercise load. Following exercise, intestinal permeability (1 h plasma lactulose-to-rhamnose ratio) and the serum interleukin-6, interleukin-10, fibroblast growth factor-21 and muscle creatine kinase concentrations were significantly increased compared with rest only during the first test and not when the test was repeated. Responses to strenuous exercise in well-trained young men, as indicated by intestinal markers and myokines, show adaptation in Test-Retest outcome. This might be attributable to a carry-over effect of the defense mechanisms triggered during the Test. This finding has implications for the design of studies aimed at evaluating physiological responses to exercise. © 2016 The Authors. Experimental Physiology © 2016 The Physiological Society.

Interrater and Intrarater Reliability of the Tuck Jump Assessment by Health Professionals of Varied Educational Backgrounds

PubMed Central

Dudley, Lisa A.; Smith, Craig A.; Olson, Brandon K.; Chimera, Nicole J.

2013-01-01

Objective. The Tuck Jump Assessment (TJA), a clinical plyometric assessment, identifies 10 jumping and landing technique flaws. The study objective was to investigate TJA interrater and intrarater reliability with raters of different educational and clinical backgrounds. Methods. 40 participants were video recorded performing the TJA using published protocol and instructions. Five raters of varied educational and clinical backgrounds scored the TJA. Each score of the 10 technique flaws was summed for the total TJA score. Approximately one month later, 3 raters scored the videos again. Intraclass correlation coefficients determined interrater (5 and 3 raters for first and second session, resp.) and intrarater (3 raters) reliability. Results. Interrater reliability with 5 raters was poor (ICC = 0.47; 95% confidence intervals (CI) 0.33–0.62). Interrater reliability between 3 raters who completed 2 scoring sessions improved from 0.52 (95% CI 0.35–0.68) for session one to 0.69 (95% CI 0.55–0.81) for session two. Intrarater reliability was poor to moderate, ranging from 0.44 (95% CI 0.22–0.68) to 0.72 (95% CI 0.55–0.84). Conclusion. Published protocol and training of raters were insufficient to allow consistent TJA scoring. There may be a learned effect with the TJA since interrater reliability improved with repetition. TJA instructions and training should be modified and enhanced before clinical implementation. PMID:26464881

Improvements in tongue strength and pressure-generation precision following a tongue-pressure training protocol in older individuals with dysphagia: Three case reports

PubMed Central

Yeates, Erin M; Molfenter, Sonja M; Steele, Catriona M

2008-01-01

Dysphagia, or difficulty swallowing, often occurs secondary to conditions such as stroke, head injury or progressive disease, many of which increase in frequency with advancing age. Sarcopenia, the gradual loss of muscle bulk and strength, can place older individuals at greater risk for dysphagia. Data are reported for three older participants in a pilot trial of a tongue-pressure training therapy. During the experimental therapy protocol, participants performed isometric strength exercises for the tongue as well as tongue pressure accuracy tasks. Biofeedback was provided using the Iowa Oral Performance Instrument (IOPI), an instrument that measures tongue pressure. Treatment outcome measures show increased isometric tongue strength, improved tongue pressure generation accuracy, improved bolus control on videofluoroscopy, and improved functional dietary intake by mouth. These preliminary results indicate that, for these three adults with dysphagia, tongue-pressure training was beneficial for improving both instrumental and functional aspects of swallowing. The experimental treatment protocol holds promise as a rehabilitative tool for various dysphagia populations. PMID:19281066

Instituting the Updated CPR Protocol: The Team Physician's Role.

ERIC Educational Resources Information Center

Araujo, David

1994-01-01

Summarizes recommendations from the 1992 National Conference on Cardiopulmonary Resuscitation (CPR) and Emergency Cardiac Care. Because team physicians may have to provide basic life support for athletes or spectators, knowing current (CPR) protocol is essential in developing emergency response plans and training personnel. Practice removing…

The Effectiveness of Group Family Training About the Principles of Harm Reduction Approach on Marital Satisfaction of Spouses of Patients Under Methadone Maintenance Treatment.

PubMed

Hojjat, Seyed Kaveh; Rezaei, Mahdi; Hatami, Seyed Esmaeil; Kohestani, Mina; Norozi Khalili, Mina

2017-01-02

One of the most important problems in treatment of drug dependence is the cooperation of the patient's family. Many families do not look at drug dependence as a chronic and relapsing disorder and expect a quick and definite recovery of the disease. These families, including wives, are unfamiliar with the concept of harm reduction as a realistic approach. The aim of this study was to educate the spouses of patients undergoing methadone maintenance treatment (MMT) on the different aspects of harm reduction approach and assess the impact of this training on marital satisfaction and relapse rate. This study was a pretest-posttest study with control group. The sample consisted of 50 MMT patients and their wives in private methadone maintenance treatment clinics in the city of Bojnurd, located in the northeastern region of Iran. The experimental group received eight group training sessions run by a psychiatrist. The content of the training sessions was based on harm reduction programs for families of patients with high-risk behaviors. Two groups are compared in terms of marital satisfaction and relapse rate. A paired t test was used to compare changes before and after the training. The results of this study showed that harm reduction education and efforts for changing wives' views toward MMT are effective in increasing their marital satisfaction. However, the conducted training showed no effect on relapse rate in the six-month follow-up. Regarding the fact that this type of training has not been paid enough attention in the national protocol, the proposed training program of this research can be considered in MMT clinics.

The effects of spaced retrieval training in improving hyperphagia of people living with dementia in residential settings.

PubMed

Hsu, Chia-Ning; Lin, Li-Chan; Wu, Shiao-Chi

2017-10-01

To investigate the effectiveness of spaced retrieval for improving hyperphagia in patients with dementia in residential care settings. Although 10-30% of patients with dementia have hyperphagia, most studies have focused on eating difficulties. Only a few studies have focused on hyperphagia. Various memory problems cause hyperphagia in patients with dementia. Spaced retrieval, a cognitive technique for information learning, can be used as a training method to improve memory loss. Recent studies showed that patients who received the training successfully memorised information learned in the training and correctly applied it to their daily lives. Single-blind experiments were performed. The 97 subjects with dementia were recruited from seven institutions. All research participants were stratified into three groups according to cognitive impairment severity and Hyperphagic Behavior Scale scores and then randomly assigned to the experimental and control groups. The experimental group received a six-week one-by-one spaced retrieval training for hyperphagia behaviour. The control group received routine care. After the intervention, the frequency and severity of hyperphagia in the patients with dementia, and food intake were significantly lower in the experimental group than in the control group. However, body mass index did not significantly differ. Our results suggest that the spaced retrieval training could decrease the frequency and severity of hyperphagia in patients with dementia. The content of this training programme is consistent with the normal manner of eating in daily life and is easy for patients to understand and perform. Therefore, it can be applied in residents' daily lives. This study confirms the efficacy of the spaced retrieval training protocol for hyperphagia in patients with dementia. In future studies, the follow-up duration can be increased to determine the long-term effectiveness of the intervention. © 2016 John Wiley & Sons Ltd.

Neuromuscular Fatigue and Physiological Responses After Five Dynamic Squat Exercise Protocols.

PubMed

Raeder, Christian; Wiewelhove, Thimo; Westphal-Martinez, Marc P; Fernandez-Fernandez, Jaime; de Paula Simola, Rauno A; Kellmann, Michael; Meyer, Tim; Pfeiffer, Mark; Ferrauti, Alexander

2016-04-01

This aimed to analyze neuromuscular, physiological and perceptual responses to a single bout of 5 different dynamic squat exercise protocols. In a randomized and counterbalanced order, 15 male resistance-trained athletes (mean ± SD; age: 23.1 ± 1.9 years, body mass: 77.4 ± 8.0 kg) completed traditional multiple sets (MS: 4 × 6, 85% 1 repetition maximum [RM]), drop sets (DS: 1 × 6, 85% 1RM + 3 drop sets), eccentric overload (EO: 4 × 6, 70% 1RM concentric, 100% 1RM eccentric), flywheel YoYo squat (FW: 4 × 6, all-out), and a plyometric jump protocol (PJ: 4 × 15, all-out). Blood lactate (La), ratings of perceived exertion (RPE), counter movement jump height (CMJ), multiple rebound jump (MRJ) performance, maximal voluntary isometric contraction force, serum creatine kinase (CK) and delayed onset muscle soreness were measured. Immediately post exercise, La was significantly (p < 0.001) higher in FW (mean ± 95% confidence limit; 12.2 ± 0.9 mmol·L) and lower in PJ (3.0 ± 0.8 mmol·L) compared with MS (7.7 ± 1.5 mmol·L), DS (8.5 ± 0.6 mmol·L), and EO (8.2 ± 1.6 mmol·L), accompanied by similar RPE responses. Neuromuscular performance (CMJ, MRJ) significantly remained decreased (p < 0.001) from 0.5 to 48 hours post exercise in all protocols. There was a significant time × protocol interaction (p ≤ 0.05) in MRJ with a significant lower performance in DS, EO, and FW compared with PJ (0.5 hours post exercise), and in EO compared with all other protocols (24 hours post exercise). A significant main time effect with peak values 24 hours post exercise was observed in CK serum concentrations (p < 0.001), but there was no time × protocol interaction. In conclusion, (a) metabolic and perceptual demands were higher in FW and EO compared with MS, DS and PJ, (b) neuromuscular fatigue was consistent up to 48 hours post exercise in all protocols, and (c) EO induced the greatest neuromuscular fatigue.

Determining Specificity of Motor Imagery Training for Upper Limb Improvement in Chronic Stroke Patients: A Training Protocol and Pilot Results

ERIC Educational Resources Information Center

Craje, Celine

2010-01-01

Motor imagery (MI) refers to the mental rehearsal of a movement without actual motor output. MI training has positive effects on upper limb recovery after stroke. However, until now it is unclear whether this effect is specific to the trained task or a more general motor skill improvement. This study was set up to advance our insights into the…

The development of a fear of falling interdisciplinary intervention program

PubMed Central

Gomez, Fernando; Curcio, Carmen-Lucia

2007-01-01

Objective: To describe the development process of a protocol for a fear of falling interdisciplinary intervention program based on the main factors associated with fear of falling. Design/methods: The process of developing a protocol consisted of defining the target population, selecting the initial assessment components, adapting the intervention program based on findings about fear of falling and restriction of activities in this population. Settings: University-affiliated outpatient vertigo, dizziness and falls clinic in coffee-growers zone of Colombian Andes Mountains. Results: An intervention program was developed based on three main falling conceptual models. A medical intervention, based on a biomedical and pathophysiological model, a physiotherapeutic intervention based on a postural control model and a psychological intervention based on a biological-behavioral model. Conclusion: This interdisciplinary fear of falling intervention program developed is based on particular characteristics of target population, with differences in the inclusion criteria and the program intervention components; with emphasis on medical (recurrent falls and dizziness evaluation and management), psychological (cognitive-behavioral therapy) and physiotherapeutic (balance and transfers training) components. PMID:18225468

[Abdominal catastrophe--abdominal wall defect associated with gastrointestinal fistula--strategy of therapy].

PubMed

Chobola, M; Sobotka, L; Ferko, A; Oberreiter, M; Kaska, M; Motycka, V; Páral, J; Mottl, R

2010-11-01

Wound dehiscence complicated by gastrointestinal (GI) fistula to belong ,,abdominal catastrophe". Therapy is prolonged and connected with high morbidity and mortality rate. In the period from October 2006 to July 2009 we performed 12 reconstructive surgical procedures on gastrointestinal tract in patients with abdominal catastrophe. Treatment of 12 consecutive patients (9 men, 3 women) was managed according to a standardize protocol. The protocol consists of treatment of septic complications, optimisation of nutritional state, special wound procedures, diagnosis of gastrointestinal fistulas and GI tract, timing of surgical procedures, reconstruction of GI tract and postoperative care. Reconstructive surgery of GI tract was successful on 11 patients. One patient developed recurrence of early GI fistula. In four patients we let open abdomen to heal per secundam. We observed no deaths after operation. With regard to complex character of therapy of abdominal catastrophe there is a need of multidisciplinary approach. Considering long-lasting and expensive therapy there is logical step to concentrate these patients into special centres which are experienced, equipped and their staff is trained in treatment of such a seriously impaired patients.

An oral health intervention for people with serious mental illness (Three Shires Early Intervention Dental Trial): study protocol for a randomised controlled trial.

PubMed

Jones, Hannah F; Adams, Clive E; Clifton, Andrew; Simpson, Jayne; Tosh, Graeme; Liddle, Peter F; Callaghan, Patrick; Yang, Min; Guo, Boliang; Furtado, Vivek

2013-05-29

Oral health is an important part of general physical health and is essential for self-esteem, self-confidence and overall quality of life. There is a well-established link between mental illness and poor oral health. Oral health problems are not generally well recognized by mental health professionals and many patients experience barriers to treatment. This is the protocol for a pragmatic cluster randomised trial that has been designed to fit within standard care. Dental awareness training for care co-ordinators plus a dental checklist for service users in addition to standard care will be compared with standard care alone for people with mental illness. The checklist consists of questions about service users' current oral health routine and condition. Ten Early Intervention in Psychosis (EIP) teams in Nottinghamshire, Derbyshire and Lincolnshire will be cluster randomised (five to intervention and five to standard care) in blocks accounting for location and size of caseload. The oral health of the service users will be monitored for one year after randomisation. Current Controlled Trials ISRCTN63382258.

European Train Control System: A Case Study in Formal Verification

NASA Astrophysics Data System (ADS)

Platzer, André; Quesel, Jan-David

Complex physical systems have several degrees of freedom. They only work correctly when their control parameters obey corresponding constraints. Based on the informal specification of the European Train Control System (ETCS), we design a controller for its cooperation protocol. For its free parameters, we successively identify constraints that are required to ensure collision freedom. We formally prove the parameter constraints to be sharp by characterizing them equivalently in terms of reachability properties of the hybrid system dynamics. Using our deductive verification tool KeYmaera, we formally verify controllability, safety, liveness, and reactivity properties of the ETCS protocol that entail collision freedom. We prove that the ETCS protocol remains correct even in the presence of perturbation by disturbances in the dynamics. We verify that safety is preserved when a PI controlled speed supervision is used.

Components That Affect the Personal Motivation to Implement Campus Safety Protocols

ERIC Educational Resources Information Center

Burt, Ernest, III

2013-01-01

This study examined components that have an effect on crisis response team members' personal motivation to perform campus safety protocols. The research method for this study was a quantitative design. The variables measured were compensation, experience, training, and communication. The motivation sources for this study included instrumental…

34 CFR 462.3 - What definitions apply?

Code of Federal Regulations, 2012 CFR

2012-07-01

... items across pre- and post-testing. Test administrator means an individual who is trained to administer... instructional time a student needs before post-testing. Violation of these protocols often invalidates the test... defined in the Act. Test means a standardized test, assessment, or instrument that has a formal protocol...

34 CFR 462.3 - What definitions apply?

Code of Federal Regulations, 2010 CFR

2010-07-01

... items across pre- and post-testing. Test administrator means an individual who is trained to administer... instructional time a student needs before post-testing. Violation of these protocols often invalidates the test... defined in the Act. Test means a standardized test, assessment, or instrument that has a formal protocol...

34 CFR 462.3 - What definitions apply?

Code of Federal Regulations, 2011 CFR

2011-07-01

... items across pre- and post-testing. Test administrator means an individual who is trained to administer... instructional time a student needs before post-testing. Violation of these protocols often invalidates the test... defined in the Act. Test means a standardized test, assessment, or instrument that has a formal protocol...

34 CFR 462.3 - What definitions apply?

Code of Federal Regulations, 2014 CFR

2014-07-01

... items across pre- and post-testing. Test administrator means an individual who is trained to administer... instructional time a student needs before post-testing. Violation of these protocols often invalidates the test... defined in the Act. Test means a standardized test, assessment, or instrument that has a formal protocol...

34 CFR 462.3 - What definitions apply?

Code of Federal Regulations, 2013 CFR

2013-07-01

... items across pre- and post-testing. Test administrator means an individual who is trained to administer... instructional time a student needs before post-testing. Violation of these protocols often invalidates the test... defined in the Act. Test means a standardized test, assessment, or instrument that has a formal protocol...

Combined Heat and Power Protocol for Uniform Methods Project | Advanced

Science.gov Websites

Manufacturing Research | NREL Combined Heat and Power Protocol for Uniform Methods Project Combined Heat and Power Protocol for Uniform Methods Project NREL developed a protocol that provides a ; is consistent with the scope and other protocols developed for the Uniform Methods Project (UMP

High-Intensity Interval Exercises' Acute Impact on Heart Rate Variability: Comparison Between Whole-Body and Cycle Ergometer Protocols.

PubMed

Schaun, Gustavo Z; Del Vecchio, Fabrício B

2018-01-01

Schaun, GZ and Del Vecchio, FB. High-intensity interval exercises' acute impact on heart rate variability: comparison between whole-body and cycle ergometer protocols. J Strength Cond Res 32(1): 223-229, 2018-Study aimed to compare the effects of 2 high-intensity interval training (HIIT) protocols on heart rate variability. Twelve young adult males (23.3 ± 3.9 years, 177.8 ± 7.4 cm, 76.9 ± 12.9 kg) volunteered to participate. In a randomized cross-over design, subjects performed 2 HIIT protocols, 1 on a cycle ergometer (Tabata protocol [TBT]; eight 20-second bouts at 170% Pmax interspersed by 10-second rest) and another with whole-body calisthenic exercises (McRae protocol; eight 20-second all-out intervals interspersed by 10-second rest). Heart rate variability outcomes in the time, frequency, and nonlinear domains were assessed on 3 moments: (a) presession; (b) immediately postsession; and (c) 24 hours postsession. Results revealed that RRmean, Ln rMSSD, Ln high frequency (HF), and Ln low frequency (LF) were significantly reduced immediately postsession (p ≤ 0.001) and returned to baseline 24 h after both protocols. In addition, LF/HF ratio was reduced 24 h postsession (p ≤ 0.01) and SD2 was significantly lower immediately postsession only in TBT. Our main finding was that responses from heart rate autonomic control were similar in both protocols, despite different modes of exercise performed. Specifically, exercises resulted in a high parasympathetic inhibition immediately after session with subsequent recovery within 1 day. These results suggest that subjects were already recovered the day after and can help coaches to better program training sessions with such protocols.

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.

Standardizing Care and Parental Training to Improve Training Duration, Referral Frequency, and Length of Stay: Our Quality Improvement Project Experience.

PubMed

Tolomeo, Concettina Tina; Major, Nili E; Szondy, Mary V; Bazzy-Asaad, Alia

At our institution, there is a six bed Pediatric Respiratory Care Unit for technology dependent infants and children with a tracheostomy tube. A lack of consistency in patient care and parent/guardian education prompted our group to critically evaluate the services we provided by revisiting our teaching protocol and instituting a new model of care in the Unit. The aims of this quality improvement (QI) project were to standardize care and skills proficiency training to parents of infants with a tracheostomy tube in preparation for discharge to home. After conducting a current state survey of key unit stakeholders, we initiated a multidisciplinary, QI project to answer the question: 'could a standardized approach to care and training lead to a decrease in parental/guardian training time, a decrease in length of stay, and/or an increase in developmental interventions for infants with tracheostomy tubes'? A convenience sample of infants with a tracheostomy tube admitted to the Pediatric Respiratory Care Unit were included in the study. Descriptive statistics were used to analyze the results. Through this QI approach, we were able to decrease the time required by parents to achieve proficiency in the care of a technology dependent infant, the length of stay for these infants, and increase referral of the infants for developmental assessment. These outcomes have implications for how to approach deficiencies in patient care and make changes that lead to sustained improvements. Copyright © 2016 Elsevier Inc. All rights reserved.

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

PubMed

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

2017-09-18

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

Overcoming nursing barriers to intensive care unit early mobilisation: A quality improvement project.

PubMed

Hunter, Oluwatobi O; George, Elisabeth L; Ren, Dianxu; Morgan, Douglas; Rosenzweig, Margaret; Klinefelter Tuite, Patricia

2017-06-01

To increase adherence with intensive care unit mobility by developing and implementing a mobility training program that addresses nursing barriers to early mobilisation. An intensive care unit mobility training program was developed, implemented and evaluated with a pre-test, immediate post-test and eight-week post-test. Patient mobility was tracked before and after training. A ten bed cardiac intensive care unit. The training program's efficacy was measured by comparing pre-test, immediate post-test and 8-week post-test scores. Patient mobilisation rates before and after training were compared. Protocol compliance was measured in the post training group. Nursing knowledge increased from pre-test to immediate post-test (p<0.0001) and pre-test to 8-week post-test (p<0.0001). Mean test scores decreased by seven points from immediate post-test (80±12) to 8-week post-test (73±14). Fear significantly decreased from pre-test to immediate post-test (p=0.03), but not from pre-test to 8-week post-test (p=0.06) or immediate post-test to 8-week post-test (p=0.46). Post training patient mobility rates increased although not significantly (p=0.07). Post training protocol compliance was 78%. The project successfully increased adherence with intensive care unit mobility and indicates that a training program could improve adoption of early mobility. Copyright © 2016 Elsevier Ltd. All rights reserved.

Oral health care activities performed by caregivers for institutionalized elderly in Barcelona-Spain.

PubMed

Cornejo-Ovalle, Marco; Costa-de-Lima, Kenio; Pérez, Glória; Borrell, Carme; Casals-Peidro, Elías

2013-07-01

To describe the frequency of brushing teeth and cleaning of dentures, performed by caregivers, for institutionalized elderly people. A cross-sectional study in a sample of 196 caregivers of 31 health centers in Barcelona. The dependent variables were frequency of dental brushing and frequency of cleaning of dentures of the elderly by caregivers. The independent variables were characteristics of caregivers and institutions. We performed bivariate and multivariate descriptive analyses. Robust Poisson regression models were fitted to determine factors associated with the dependent variables and to assess the strength of the association. 83% of caregivers were women, 79% worked on more than one shift, 42% worked only out of necessity, 92% were trained to care for elderly persons, 67% were trained in oral hygiene care for the elderly, and 73% recognized the existence of institutional protocols on oral health among residents. The variables explaining the lower frequency of brushing teeth by caregivers for the elderly, adjusted for the workload, were: no training in the care of elderly persons (PRa 1.7 CI95%: 1.6-1.8), not fully agreeing with the importance of oral health care of the elderly (PRa 2.5 CI95%: 1.5-4.1) and not knowing of the existence of oral health protocols (PRa 1.8 CI95% 1.2-2.6). The variables that explain the lower frequency of cleaning dentures, adjusted for the workload, were lack of training in elderly care (PRa 1.7 CI95%: 1.3-1.9) and not knowing of the existence of protocols (PRa 3.7 CI95%: 1.6-8.7). The majority of caregivers perform activities of oral health care for the elderly at least once per day. The frequency of this care depends mainly on whether caregivers are trained to perform these activities, the importance given to oral health, the workload of caregivers and the existence of institutional protocols on oral health of institutionalized elderly persons.

Acute effect of whole body vibration on isometric strength, squat jump, and flexibility in well-trained combat athletes.

PubMed

Kurt, C; Pekünlü, E

2015-06-01

The purpose of this study was to investigate the effect of whole body vibration (WBV) training on maximal strength, squat jump, and flexibility of well-trained combat athletes. Twelve female and 8 male combat athletes (age: 22.8 ± 3.1 years, mass: 65.4 ± 10.7 kg, height: 168.8 ± 8.8 cm, training experience: 11.6 ± 4.7 years, training volume: 9.3 ± 2.8 hours/week) participated in this study. The study consisted of three sessions separated by 48 hours. The first session was conducted for familiarization. In the subsequent two sessions, participants performed WBV or sham intervention in a randomized, balanced order. During WBV intervention, four isometric exercises were performed (26 Hz, 4 mm). During the sham intervention, participants performed the same WBV intervention without vibration treatment (0 Hz, 0 mm). Hand grip, squat jump, trunk flexion, and isometric leg strength tests were performed after each intervention. The results of a two-factor (pre-post[2] × intervention[2]) repeated measures ANOVA revealed a significant interaction (p = 0.018) of pre-post × intervention only for the hand grip test, indicating a significant performance increase of moderate effect (net increase of 2.48%, d = 0.61) after WBV intervention. Squat jump, trunk flexion, and isometric leg strength performances were not affected by WBV. In conclusion, the WBV protocol used in this study potentiated hand grip performance, but did not enhance squat jump, trunk flexion, or isometric leg strength in well-trained combat athletes.

Robotic Assistance for Training Finger Movement Using a Hebbian Model: A Randomized Controlled Trial.

PubMed

Rowe, Justin B; Chan, Vicky; Ingemanson, Morgan L; Cramer, Steven C; Wolbrecht, Eric T; Reinkensmeyer, David J

2017-08-01

Robots that physically assist movement are increasingly used in rehabilitation therapy after stroke, yet some studies suggest robotic assistance discourages effort and reduces motor learning. To determine the therapeutic effects of high and low levels of robotic assistance during finger training. We designed a protocol that varied the amount of robotic assistance while controlling the number, amplitude, and exerted effort of training movements. Participants (n = 30) with a chronic stroke and moderate hemiparesis (average Box and Blocks Test 32 ± 18 and upper extremity Fugl-Meyer score 46 ± 12) actively moved their index and middle fingers to targets to play a musical game similar to GuitarHero 3 h/wk for 3 weeks. The participants were randomized to receive high assistance (causing 82% success at hitting targets) or low assistance (55% success). Participants performed ~8000 movements during 9 training sessions. Both groups improved significantly at the 1-month follow-up on functional and impairment-based motor outcomes, on depression scores, and on self-efficacy of hand function, with no difference between groups in the primary endpoint (change in Box and Blocks). High assistance boosted motivation, as well as secondary motor outcomes (Fugl-Meyer and Lateral Pinch Strength)-particularly for individuals with more severe finger motor deficits. Individuals with impaired finger proprioception at baseline benefited less from the training. Robot-assisted training can promote key psychological outcomes known to modulate motor learning and retention. Furthermore, the therapeutic effectiveness of robotic assistance appears to derive at least in part from proprioceptive stimulation, consistent with a Hebbian plasticity model.

Exercise training, vascular function, and functional capacity in middle-aged subjects.

PubMed

Maiorana, A; O'Driscoll, G; Dembo, L; Goodman, C; Taylor, R; Green, D

2001-12-01

The aim of this study was to investigate the effect of 8 wk of exercise training on functional capacity, muscular strength, body composition, and vascular function in sedentary but healthy subjects by using a randomized, crossover protocol. After familiarization sessions, 19 subjects aged 47 +/- 2 yr (mean +/- SE) undertook a randomized, crossover design study of the effect of 8 wk of supervised circuit training consisting of combined aerobic and resistance exercise. Peak oxygen uptake (.VO(2peak)), sum of 7 maximal voluntary contractions and the sum of 8 skinfolds and 5 segment girths were determined at entry, crossover, and 16 wk. Endothelium-dependent and -independent vascular function were determined by forearm strain-gauge plethysmography and intrabrachial infusions of acetylcholine (ACh) and sodium nitroprusside (SNP) in 16 subjects. Training did not alter ACh or SNP responses. .VO(2peak), (28.6 +/- 1.1 to 32.6 +/- 1.3 mL.kg(-1).min(-1), P < 0.001), exercise test duration (17.4 +/- 1.1 to 22.1 +/- 1.2 min, P < 0.001), and muscular strength (465 +/- 27 to 535 +/- 27 kg, P < 0.001) significantly increased after the exercise program, whereas skinfolds decreased (144 +/- 10 vs 134 +/- 9 mm, P < 0.001). These results suggest that moderate intensity circuit training designed to minimize the involvement of the arms improves functional capacity, body composition, and strength in healthy, middle-aged subjects without significantly influencing upper limb vascular function. This finding contrasts with previous studies in subjects with type 2 diabetes and heart failure that employed an identical training program.

Development of a waste management protocol based on assessment of knowledge and practice of healthcare personnel in surgical departments.

PubMed

Mostafa, Gehan M A; Shazly, Mona M; Sherief, Wafaa I

2009-01-01

Good healthcare waste management in a hospital depends on a dedicated waste management team, good administration, careful planning, sound organization, underpinning legislation, adequate financing, and full participation by trained staff. Hence, waste management protocols must be convenient and sensible. To assess the knowledge and practice related to waste management among doctors, nurses, and housekeepers in the surgical departments at Al-Mansoura University Hospital, and to design and validate a waste management protocol for the health team in these settings. This cross-sectional study was carried out in the eight surgical departments at Al-Mansoura University Hospital. All health care personnel and their assistants were included: 38 doctors, 106 nurses, and 56 housekeepers. Two groups of jury were included for experts' opinions validation of the developed protocol, one from academia (30 members) and the other from service providers (30 members). Data were collected using a self-administered knowledge questionnaire for nurses and doctors, and an interview questionnaire for housekeepers. Observation checklists were used for assessment of performance. The researchers developed the first draft of the waste management protocol according to the results of the analysis of the data collected in the assessment phase. Then, the protocol was presented to the jury group for validation, and then was implemented. Only 27.4% of the nurses, 32.1% of the housekeepers, and 36.8% of the doctors had satisfactory knowledge. Concerning practice, 18.9% of the nurses, 7.1% of the housekeepers, and none of the doctors had adequate practice. Nurses' knowledge score had a statistically significant weak positive correlation with the attendance of training courses (r=0.23, p<0.05). Validation of the developed protocol was done, and the percent of agreement ranged between 60.0% and 96.7% for the service group, and 60.0% and 90.0% for the academia group. The majority of the doctors, nurses, and housekeepers have unsatisfactory knowledge and inadequate practice related to health care waste management. The knowledge among nurses is positively affected by attendance of training programs. Based on the findings, a protocol for healthcare waste management was developed and validated. It is recommended to implement the developed waste management protocol for the surgical departments in the designed hospital, with establishment of waste management audits.

Prospective memory performance of patients with Parkinson's disease depends on shifting aptitude: evidence from cognitive rehabilitation.

PubMed

Costa, Alberto; Peppe, Antonella; Serafini, Francesca; Zabberoni, Silvia; Barban, Francesco; Caltagirone, Carlo; Carlesimo, Giovanni Augusto

2014-08-01

This study investigated the effect of cognitive training aimed at improving shifting ability on Parkinson's disease (PD) patients' performance of prospective memory (PM) tasks. Using a double-blind protocol, 17 PD patients were randomly assigned to two experimental arms. In the first arm (n=9) shifting training was administered, and in the second (placebo) arm (n=8), language and respiratory exercises. Both treatments consisted of 12 sessions executed over 4 weeks. PM and shifting measures (i.e., Trail Making Test and Alternate Fluency Test) were administered at T0 (before treatment) and T1 (immediately after treatment). A mixed analysis of variance was applied to the data. To evaluate the effects of treatment, the key effect was the interaction between Group (experimental vs. placebo) and Time of Assessment (T0 vs. T1). This interaction was significant for the accuracy indices of the PM procedure (p<.05) and for the performance parameters of the shifting tasks (p ≤.05). Tukey's HSD tests showed that in all cases passing from T0 to T1 performance significantly improved in the experimental group (in all cases p ≤.02) but remained unchanged in the placebo group (all p consistently>.10). The performance change passing from T0 to T1 on the Alternate Fluency test and the PM procedure was significantly correlated (p<.05). Results show that the cognitive training significantly improved PD patients' event-based PM performance and suggest that their poor PM functioning might be related to reduced shifting abilities.

Effects of exercise continued until anaerobic threshold on balance performance in male basketball players.

PubMed

Erkmen, Nurtekin; Suveren, Sibel; Göktepe, Ahmet Salim

2012-06-01

The objective of the present study was to determine the effects of exercise continued until the anaerobic threshold on balance performance in basketball players. Twelve male basketball players (age = 20.92 ± 2.81 years, body height = 192.72 ± 7.61 cm, body mass = 88.09 ± 8.41 kg, training experience = 7.17 ± 3.10 years) volunteered to participate in this study. A Kinesthetic Ability Trainer (KAT 2000 stabilometer) was used to measure the balance performance. Balance tests consisted of static tests on dominant, nondominant and double leg stance. The Bruce Protocol was performed by means of a treadmill. The exercise protocol was terminated when the subject passed the anaerobic threshold. After the exercise protocol, balance measurements were immediately repeated. Statistical differences between pre and post-exercise for dominant, nondominant and double leg stance were determined by the paired samples t-test according to the results of the test of normality. The post-exercise balance score on the dominant leg was significantly higher than pre-exercise (t = -2.758, p < 0.05). No differences existed between pre- and post-exercise in the balance scores of the nondominant leg after the exercise protocol (t = 0.428, p > 0.05). A significant difference was found between pre and post-exercise balance scores in the double leg stance (t = -2.354, p < 0.05). The main finding of this study was that an incremental exercise continued until the anaerobic threshold decreased balance performance on the dominant leg in basketball players, but did not alter it in the nondominant leg.

Evaluation of training nurses to perform semi-automated three-dimensional left ventricular ejection fraction using a customised workstation-based training protocol.

PubMed

Guppy-Coles, Kristyan B; Prasad, Sandhir B; Smith, Kym C; Hillier, Samuel; Lo, Ada; Atherton, John J

2015-06-01

We aimed to determine the feasibility of training cardiac nurses to evaluate left ventricular function utilising a semi-automated, workstation-based protocol on three dimensional echocardiography images. Assessment of left ventricular function by nurses is an attractive concept. Recent developments in three dimensional echocardiography coupled with border detection assistance have reduced inter- and intra-observer variability and analysis time. This could allow abbreviated training of nurses to assess cardiac function. A comparative, diagnostic accuracy study evaluating left ventricular ejection fraction assessment utilising a semi-automated, workstation-based protocol performed by echocardiography-naïve nurses on previously acquired three dimensional echocardiography images. Nine cardiac nurses underwent two brief lectures about cardiac anatomy, physiology and three dimensional left ventricular ejection fraction assessment, before a hands-on demonstration in 20 cases. We then selected 50 cases from our three dimensional echocardiography library based on optimal image quality with a broad range of left ventricular ejection fractions, which was quantified by two experienced sonographers and the average used as the comparator for the nurses. Nurses independently measured three dimensional left ventricular ejection fraction using the Auto lvq package with semi-automated border detection. The left ventricular ejection fraction range was 25-72% (70% with a left ventricular ejection fraction <55%). All nurses showed excellent agreement with the sonographers. Minimal intra-observer variability was noted on both short-term (same day) and long-term (>2 weeks later) retest. It is feasible to train nurses to measure left ventricular ejection fraction utilising a semi-automated, workstation-based protocol on previously acquired three dimensional echocardiography images. Further study is needed to determine the feasibility of training nurses to acquire three dimensional echocardiography images on real-world patients to measure left ventricular ejection fraction. Nurse-performed evaluation of left ventricular function could facilitate the broader application of echocardiography to allow cost-effective screening and monitoring for left ventricular dysfunction in high-risk populations. © 2014 John Wiley & Sons Ltd.

Structure of receptive fields in a computational model of area 3b of primary sensory cortex.

PubMed

Detorakis, Georgios Is; Rougier, Nicolas P

2014-01-01

In a previous work, we introduced a computational model of area 3b which is built upon the neural field theory and receives input from a simplified model of the index distal finger pad populated by a random set of touch receptors (Merkell cells). This model has been shown to be able to self-organize following the random stimulation of the finger pad model and to cope, to some extent, with cortical or skin lesions. The main hypothesis of the model is that learning of skin representations occurs at the thalamo-cortical level while cortico-cortical connections serve a stereotyped competition mechanism that shapes the receptive fields. To further assess this hypothesis and the validity of the model, we reproduced in this article the exact experimental protocol of DiCarlo et al. that has been used to examine the structure of receptive fields in area 3b of the primary somatosensory cortex. Using the same analysis toolset, the model yields consistent results, having most of the receptive fields to contain a single region of excitation and one to several regions of inhibition. We further proceeded our study using a dynamic competition that deeply influences the formation of the receptive fields. We hypothesized this dynamic competition to correspond to some form of somatosensory attention that may help to precisely shape the receptive fields. To test this hypothesis, we designed a protocol where an arbitrary region of interest is delineated on the index distal finger pad and we either (1) instructed explicitly the model to attend to this region (simulating an attentional signal) (2) preferentially trained the model on this region or (3) combined the two aforementioned protocols simultaneously. Results tend to confirm that dynamic competition leads to shrunken receptive fields and its joint interaction with intensive training promotes a massive receptive fields migration and shrinkage.

The Neurogenesis Actuator and NR2B/NMDA Receptor Antagonist Ro25-6981 Consistently Improves Spatial Memory Retraining Via Brain Region-Specific Gene Expression.

PubMed

Gruden, Marina A; Ratmirov, Alexander M; Storozheva, Zinaida I; Solovieva, Olga A; Sherstnev, Vladimir V; Sewell, Robert D E

2018-05-22

NR2B-containing NMDA (NR2B/NMDA) receptors are important in controlling neurogenesis and are involved in generating spatial memory. Ro25-6981 is a selective antagonist at these receptors and actuates neurogenesis and spatial memory. Inter-structural neuroanatomical profiles of gene expression regulating adult neurogenesis and neuroapoptosis require examination in the context of memory retrieval and reversal learning. The aim was to investigate spatial memory retrieval and reversal learning in relation to gene expression-linked neurogenetic processes following blockade of NR2B/NMDA receptors by Ro25-6981. Rats were trained in Morris water maze (MWM) platform location for 5 days. Ro25-6981 was administered (protocol days 6-7) followed by retraining (days 15-18 or 29-32). Platform location was tested (on days 19 or 33) then post-mortem brain tissue sampling (on days 20 or 34). The expression of three genes known to regulate cell proliferation (S100a6), differentiation (Ascl1), and apoptosis (Casp-3) were concomitantly evaluated in the hippocampus, prefrontal cortex, and cerebellum in relation to the MWM performance protocol. Following initial training, Ro25-6981 enhanced visuospatial memory retrieval performance during further retraining (protocol days 29-32) but did not influence visuospatial reversal learning (day 33). Hippocampal Ascl1 and Casp-3 expressions were correspondingly increased and decreased while cerebellar S100a6 and Casp-3 activities were decreased and increased respectively 27 days after Ro25-6981 treatment. Chronological analysis indicated a possible involvement of new mature neurons in the reconfiguration of memory processes. This was attended by behavioral/gene correlations which revealed direct links between spatial memory retrieval enhancement and modified gene activity induced by NR2B/NMDA receptor blockade and upregulation.

Evaluation of a Web-Based Training in Smoking Cessation Counseling Targeting U.S. Eye-Care Professionals

ERIC Educational Resources Information Center

Asfar, Taghrid; Lee, David J.; Lam, Byron L.; Murchison, Ann P.; Mayro, Eileen L.; Owsley, Cynthia; McGwin, Gerald; Gower, Emily W.; Friedman, David S.; Saaddine, Jinan

2018-01-01

Background: Smoking causes blindness-related diseases. Eye-care providers are uniquely positioned to help their patients quit smoking. Aims: Using a pre-/postevaluation design, this study evaluated a web-based training in smoking cessation counseling targeting eye-care providers. Method: The training was developed based on the 3A1R protocol:…

Individual Differences in Executive Functioning Predict Preschoolers' Improvement from Theory-of-Mind Training

ERIC Educational Resources Information Center

Benson, Jeannette E.; Sabbagh, Mark A.; Carlson, Stephanie M.; Zelazo, Philip David

2013-01-01

Twenty-four 3.5-year-old children who initially showed poor performance on false-belief tasks participated in a training protocol designed to promote performance on these tasks. Our aim was to determine whether the extent to which children benefited from training was predicted by their performance on a battery of executive functioning tasks.…

Program to study optimal protocol for cardiovascular and muscular efficiency. [physical fitness training for manned space flight

NASA Technical Reports Server (NTRS)

Olree, H. D.

1974-01-01

Training programs necessary for the development of optimal strength during prolonged manned space flight were examined, and exercises performed on the Super Mini Gym Skylab 2 were compared with similar exercises on the Universal Gym and calisthenics. Cardiopulmonary gains were found negligible but all training groups exhibited good gains in strength.

Alternatives in Aural Rehabilitation: Provider Training of Nonaudiologists in the Delivery of Hearing-Aid Supportive Services to Older Persons with Hearing Loss.

ERIC Educational Resources Information Center

Patterson, Karen; Dancer, Jess

1987-01-01

Describes program in which American Speech-Language-Hearing Association certified audiologists train protocol providers to assist older hearing-aid users in adjusting to using hearing aids on a daily basis. Training emphasizes empathy, effective communication skills, knowledge of the interaction of aging and hearing loss, phases outlined in…

Evaluation of a Crisis-Preparedness Training Program for the Faculty of a Private Elementary School

ERIC Educational Resources Information Center

Boyle, Marybeth N.

2010-01-01

The purpose of this study was to determine the effectiveness of a training program for the faculty of a private elementary school on executing the protocols, roles, and responsibilities defined in the institution's crisis-management plan. A formal training program for the faculty had not been developed, and administrators had no measure by which…

Determination of Minimum Training Sample Size for Microarray-Based Cancer Outcome Prediction–An Empirical Assessment

PubMed Central

Cheng, Ningtao; Wu, Leihong; Cheng, Yiyu

2013-01-01

The promise of microarray technology in providing prediction classifiers for cancer outcome estimation has been confirmed by a number of demonstrable successes. However, the reliability of prediction results relies heavily on the accuracy of statistical parameters involved in classifiers. It cannot be reliably estimated with only a small number of training samples. Therefore, it is of vital importance to determine the minimum number of training samples and to ensure the clinical value of microarrays in cancer outcome prediction. We evaluated the impact of training sample size on model performance extensively based on 3 large-scale cancer microarray datasets provided by the second phase of MicroArray Quality Control project (MAQC-II). An SSNR-based (scale of signal-to-noise ratio) protocol was proposed in this study for minimum training sample size determination. External validation results based on another 3 cancer datasets confirmed that the SSNR-based approach could not only determine the minimum number of training samples efficiently, but also provide a valuable strategy for estimating the underlying performance of classifiers in advance. Once translated into clinical routine applications, the SSNR-based protocol would provide great convenience in microarray-based cancer outcome prediction in improving classifier reliability. PMID:23861920

Training community practitioners in a research intervention: practice examples at the intersection of cancer, Western science, and native Hawaiian healing.

PubMed

Ka'opua, Lana Sue I

2003-01-01

This practice paper describes the preintervention training component of a feasibility study exploring the use of ho'oponopono, an indigenous Hawaiian healing practice, for enhancing psychosocial adaptation to breast cancer among Native Hawaiian women. Practitioners' adherence to research protocols and competence in intervention delivery are both regarded as essential to obtaining valid results in tests of intervention feasibility and efficacy; thus, training in this study dually focused on fortification of adherence and enhancing competence among those recruited to deliver the ho'oponopono intervention. A manual-based training, using adult pedagogical strategies infused with Native Hawaiian cultural practices, was delivered to community practitioners. Effects of the training on practitioners' knowledge and skills were evaluated through multiple methods. Knowledge significantly increased between pre- and post-intervention assessment. However, knowledge application for some practitioners was hindered by skill deficits, stylistic differences, and cultural conflict. Ongoing attention to competence and adherence is indicated. In-service training may bolster competence; however, practitioners may have difficulty in adhering to protocols for different reasons, and individualized clinical supervision and cultural consultation may be helpful in some situations.

The effectiveness of combining inspiratory muscle training with manual therapy and a therapeutic exercise program on maximum inspiratory pressure in adults with asthma: a randomized clinical trial.

PubMed

López-de-Uralde-Villanueva, Ibai; Candelas-Fernández, Pablo; de-Diego-Cano, Beatriz; Mínguez-Calzada, Orcález; Del Corral, Tamara

2018-06-01

The objective of this study was to evaluate whether the addition of manual therapy and therapeutic exercise protocol to inspiratory muscle training was more effective in improving maximum inspiratory pressure than inspiratory muscle training in isolation. This is a single-blinded, randomized controlled trial. In total, 43 patients with asthma were included in this study. The patients were allocated into one of the two groups: (1) inspiratory muscle training ( n = 21; 20-minute session) or (2) inspiratory muscle training (20-minute session) combined with a program of manual therapy (15-minute session) and therapeutic exercise (15-minute session; n = 22). All participants received 12 sessions, two days/week, for six weeks and performed the domiciliary exercises protocol. The main measures such as maximum inspiratory pressure, spirometric measures, forward head posture, and thoracic kyphosis were recorded at baseline and after the treatment. For the per-protocol analysis, between-group differences at post-intervention were observed in maximum inspiratory pressure (19.77 cmH 2 O (11.49-28.04), P < .05; F = 22.436; P < .001; η 2 p  = 0.371) and forward head posture (-1.25 cm (-2.32 to -0.19), P < .05; F = 5.662; P = .022; η 2 p  = 0.13). The intention-to-treat analysis showed the same pattern of findings. The inspiratory muscle training combined with a manual therapy and therapeutic exercise program is more effective than its application in isolation for producing short-term maximum inspiratory pressure and forward head posture improvements in patients with asthma.

A Murine Model of Robotic Training to Evaluate Skeletal Muscle Recovery after Injury.

PubMed

Lai, Stefano; Panarese, Alessandro; Lawrence, Ross; Boninger, Michael L; Micera, Silvestro; Ambrosio, Fabrisia

2017-04-01

In vivo studies have suggested that motor exercise can improve muscle regeneration after injury. Nevertheless, preclinical investigations still lack reliable tools to monitor motor performance over time and to deliver optimal training protocols to maximize force recovery. Here, we evaluated the utility of a murine robotic platform (i) to detect early impairment and longitudinal recovery after acute skeletal muscle injury and (ii) to administer varying intensity training protocols to enhance forelimb motor performance. A custom-designed robotic platform was used to train mice to perform a forelimb retraction task. After an acute injury to bilateral biceps brachii muscles, animals performed a daily training protocol in the platform at high (HL) or low (LL) loading levels over the course of 3 wk. Control animals were not trained (NT). Motor performance was assessed by quantifying force, time, submovement count, and number of movement attempts to accomplish the task. Myofiber number and cross-sectional area at the injury site were quantified histologically. Two days after injury, significant differences in the time, submovement count, number of movement attempts, and exerted force were observed in all mice, as compared with baseline values. Interestingly, the recovery time of muscle force production differed significantly between intervention groups, with HL group showing a significantly accelerated recovery. Three weeks after injury, all groups showed motor performance comparable with baseline values. Accordingly, there were no differences in the number of myofibers or average cross-sectional area among groups after 3 wk. Our findings demonstrate the utility of our custom-designed robotic device for the quantitative assessment of skeletal muscle function in preclinical murine studies. Moreover, we demonstrate that this device may be used to apply varying levels of resistance longitudinally as a means manipulate physiological muscle responses.

A New On-Line Diagnosis Protocol for the SPIDER Family of Byzantine Fault Tolerant Architectures

NASA Technical Reports Server (NTRS)

Geser, Alfons; Miner, Paul S.

2004-01-01

This paper presents the formal verification of a new protocol for online distributed diagnosis for the SPIDER family of architectures. An instance of the Scalable Processor-Independent Design for Electromagnetic Resilience (SPIDER) architecture consists of a collection of processing elements communicating over a Reliable Optical Bus (ROBUS). The ROBUS is a specialized fault-tolerant device that guarantees Interactive Consistency, Distributed Diagnosis (Group Membership), and Synchronization in the presence of a bounded number of physical faults. Formal verification of the original SPIDER diagnosis protocol provided a detailed understanding that led to the discovery of a significantly more efficient protocol. The original protocol was adapted from the formally verified protocol used in the MAFT architecture. It required O(N) message exchanges per defendant to correctly diagnose failures in a system with N nodes. The new protocol achieves the same diagnostic fidelity, but only requires O(1) exchanges per defendant. This paper presents this new diagnosis protocol and a formal proof of its correctness using PVS.

Basic Microsurgery Training Using the Laboratory Rat (Rattus norvegicus)

DTIC Science & Technology

2017-03-23

CHANGES: Have there been any personnel/staffing changes (PI/CI/ AI /TC/lnstructor) since the last IACUC approval of protocol, or annual review? _X_ Yes No If...Include Name, Protocol function - PI/CI/ AI /TC/lnstructor, IACUC approval -Yes/No) Maj Ryan Diepenbrock (PI) IACUC Approval Yes 18Jun 15 DELETIONS...Include Name, Protocol function - PI/CI/ AI /TC/lnstructor, Effective date of deletion) Lt Col Jean Luc Niel (PI) June 2015 Col Bradley Turner (Al)July

Enhancing creative cognition with a rapid right-parietal neurofeedback procedure.

PubMed

Agnoli, Sergio; Zanon, Marco; Mastria, Serena; Avenanti, Alessio; Corazza, Giovanni Emanuele

2018-02-14

The present article describes an innovative neurofeedback training (NFT) procedure aimed at increasing creative cognition through the enhancement of specific brain activities previously associated with divergent thinking. We designed and tested two NFT protocols based on training alpha and beta EEG oscillations selectively measured over the right parietal region. A total of 80 participants were involved, 40 in the alpha NFT protocol and 40 in the beta NFT protocol. The NFT loop was closed on a video stream that would advance only when oscillation power exceeded a normalized threshold. The total duration of the protocol was two hours in a single day, hence its classification as rapid. Changes in ideational fluency and originality, measured with a divergent thinking task, were compared between participants receiving real video feedback and participants receiving sham feedback. We controlled for individual differences in creative achievement level. Results showed that the protocols were effective at enhancing alpha and beta activities in the targeted area. Differences between the two protocols emerged in their effectiveness at promoting divergent thinking. While no significant changes in originality resulted from the rapid alpha NFT, increases in both originality and fluency emerged as a consequence of the rapid beta NFT. These results were particularly evident in participants starting with a low creative achievement level. Possible interpretations and future directions are proposed and discussed. Copyright © 2018 Elsevier Ltd. All rights reserved.

SU-F-R-11: Designing Quality and Safety Informatics Through Implementation of a CT Radiation Dose Monitoring Program

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

Wilson, JM; Samei, E; Departments of Physics, Electrical and Computer Engineering, and Biomedical Engineering, and Medical Physics Graduate Program, Duke University, Durham, NC

2016-06-15

Purpose: Recent legislative and accreditation requirements have driven rapid development and implementation of CT radiation dose monitoring solutions. Institutions must determine how to improve quality, safety, and consistency of their clinical performance. The purpose of this work was to design a strategy and meaningful characterization of results from an in-house, clinically-deployed dose monitoring solution. Methods: A dose monitoring platform was designed by our imaging physics group that focused on extracting protocol parameters, dose metrics, and patient demographics and size. Compared to most commercial solutions, which focus on individual exam alerts and global thresholds, the program sought to characterize overall consistencymore » and targeted thresholds based on eight analytic interrogations. Those were based on explicit questions related to protocol application, national benchmarks, protocol and size-specific dose targets, operational consistency, outliers, temporal trends, intra-system variability, and consistent use of electronic protocols. Using historical data since the start of 2013, 95% and 99% intervals were used to establish yellow and amber parameterized dose alert thresholds, respectively, as a function of protocol, scanner, and size. Results: Quarterly reports have been generated for three hospitals for 3 quarters of 2015 totaling 27880, 28502, 30631 exams, respectively. Four adult and two pediatric protocols were higher than external institutional benchmarks. Four protocol dose levels were being inconsistently applied as a function of patient size. For the three hospitals, the minimum and maximum amber outlier percentages were [1.53%,2.28%], [0.76%,1.8%], [0.94%,1.17%], respectively. Compared with the electronic protocols, 10 protocols were found to be used with some inconsistency. Conclusion: Dose monitoring can satisfy requirements with global alert thresholds and patient dose records, but the real value is in optimizing patient-specific protocols, balancing image quality trade-offs that dose-reduction strategies promise, and improving the performance and consistency of a clinical operation. Data plots that capture patient demographics and scanner performance demonstrate that value.« less

Cerebellar Insulin/IGF-1 signaling in diabetic rats: Effects of exercise training.

PubMed

Borges, Mariana Eiras; Ribeiro, Alessandra Mussi; Pauli, José Rodrigo; Arantes, Luciana Mendonça; Luciano, Eliete; de Moura, Leandro Pereira; de Almeida Leme, José Alexandre Curiacos; Medeiros, Alessandra; Bertolini, Natália Oliveira; Sibuya, Clarice Yoshiko; Gomes, Ricardo José

2017-02-03

The Diabetes Mellitus (DM) is a chronic disease associated with loss of brain regions such as the cerebellum, increasing the risk of developing neurodegenerative diseases such as Parkinson's disease (PD). In the brain of diabetic and PD organisms the insulin/IGF-1 signaling is altered. Exercise training is an effective intervention for the prevention of neurodegerative diseases since it release neurotrophic factors and regulating insulin/IGF-1 signaling in the brain. This study aimed to evaluate the proteins involved in the insulin/IGF-1 pathway in the cerebellum of diabetic rats subjected to exercise training protocol. Wistar rats were distributed in four groups: sedentary control (SC), trained control (TC), sedentary diabetic (SD) and trained diabetic (TD). Diabetes was induced by Alloxan (ALX) (32mg/kgb.w.). The training program consisted in swimming 5days/week, 1h/day, during 6 weeks, supporting an overload corresponding to 90% of the anaerobic threshold. At the end, cerebellum was extracted to determinate the protein expression of GSK-3β, IRβ and IGF-1R and the phosphorylation of β-amyloid, Tau, ERK1+ERK2 by Western Blot analysis. All dependent variables were analyzed by one-way analysis of variance with significance level of 5%. Diabetes causes hyperglycemia in both diabetic groups; however, in TD, there was a reduction in hyperglycemia compared to SD. Diabetes increased Tau and β-amyloid phosphorylation in both SD and TD groups. Furthermore, aerobic exercise increased ERK1+ERK2 expression in TC. The data showed that in cerebellum of diabetic rats induced by alloxan there are some proteins expression like Parkinson cerebellum increased, and the exercise training was not able to modulate the expression of these proteins. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Subliminal attention bias modification training in socially anxious individuals.

PubMed

Maoz, Keren; Abend, Rany; Fox, Nathan A; Pine, Daniel S; Bar-Haim, Yair

2013-01-01

Anxious individuals demonstrate threat-related attention biases both when threat stimuli are presented within conscious awareness and when presented below awareness threshold. Nevertheless, attention bias modification (ABM) research has rarely utilized sub-awareness protocols in an attempt to modify attention patterns and reduce anxiety. Exploring the potential of subliminal ABM is of interest, as it may target attention processes related to anxiety that are distinct from those engaged by supraliminal ABM. Here we examined the effect of a subliminal ABM training protocol on levels of social anxiety and stress vulnerability. Fifty-one socially anxious students were randomly assigned to either ABM or placebo condition, and completed a pre-training assessment, four training sessions, a social stressor task, and a post-training assessment. Results indicate that the subliminal ABM used here did not induce detectable changes in threat-related attention from pre- to post-training as measured by two independent attention tasks. Furthermore, the ABM and placebo groups did not differ on either self-reported social anxiety post-training or state anxiety following stress induction. Post-hoc auxiliary analyses suggest that ABM may be associated with smaller elevations in state anxiety during the stressor task only for participants who demonstrate attention bias toward threat at baseline. Implications and future research directions are discussed.

Subliminal attention bias modification training in socially anxious individuals

PubMed Central

Maoz, Keren; Abend, Rany; Fox, Nathan A.; Pine, Daniel S.; Bar-Haim, Yair

2013-01-01

Anxious individuals demonstrate threat-related attention biases both when threat stimuli are presented within conscious awareness and when presented below awareness threshold. Nevertheless, attention bias modification (ABM) research has rarely utilized sub-awareness protocols in an attempt to modify attention patterns and reduce anxiety. Exploring the potential of subliminal ABM is of interest, as it may target attention processes related to anxiety that are distinct from those engaged by supraliminal ABM. Here we examined the effect of a subliminal ABM training protocol on levels of social anxiety and stress vulnerability. Fifty-one socially anxious students were randomly assigned to either ABM or placebo condition, and completed a pre-training assessment, four training sessions, a social stressor task, and a post-training assessment. Results indicate that the subliminal ABM used here did not induce detectable changes in threat-related attention from pre- to post-training as measured by two independent attention tasks. Furthermore, the ABM and placebo groups did not differ on either self-reported social anxiety post-training or state anxiety following stress induction. Post-hoc auxiliary analyses suggest that ABM may be associated with smaller elevations in state anxiety during the stressor task only for participants who demonstrate attention bias toward threat at baseline. Implications and future research directions are discussed. PMID:23888138

Multisensory perceptual learning is dependent upon task difficulty.

PubMed

De Niear, Matthew A; Koo, Bonhwang; Wallace, Mark T

2016-11-01

There has been a growing interest in developing behavioral tasks to enhance temporal acuity as recent findings have demonstrated changes in temporal processing in a number of clinical conditions. Prior research has demonstrated that perceptual training can enhance temporal acuity both within and across different sensory modalities. Although certain forms of unisensory perceptual learning have been shown to be dependent upon task difficulty, this relationship has not been explored for multisensory learning. The present study sought to determine the effects of task difficulty on multisensory perceptual learning. Prior to and following a single training session, participants completed a simultaneity judgment (SJ) task, which required them to judge whether a visual stimulus (flash) and auditory stimulus (beep) presented in synchrony or at various stimulus onset asynchronies (SOAs) occurred synchronously or asynchronously. During the training session, participants completed the same SJ task but received feedback regarding the accuracy of their responses. Participants were randomly assigned to one of three levels of difficulty during training: easy, moderate, and hard, which were distinguished based on the SOAs used during training. We report that only the most difficult (i.e., hard) training protocol enhanced temporal acuity. We conclude that perceptual training protocols for enhancing multisensory temporal acuity may be optimized by employing audiovisual stimuli for which it is difficult to discriminate temporal synchrony from asynchrony.

Whole-body strength training with Huber Motion Lab and traditional strength training in cardiac rehabilitation: A randomized controlled study.

PubMed

Guiraud, Thibaut; Labrunée, Marc; Besnier, Florent; Sénard, Jean-Michel; Pillard, Fabien; Rivière, Daniel; Richard, Lisa; Laroche, Davy; Sanguignol, Frédéric; Pathak, Atul; Gayda, Mathieu; Gremeaux, Vincent

2017-01-01

Isometric strengthening has been rarely studied in patients with coronary heart disease (CHD), mainly because of possible potential side effects and lack of appropriate and reliable devices. We aimed to compare 2 different modes of resistance training, an isometric mode with the Huber Motion Lab (HML) and traditional strength training (TST), in CHD patients undergoing a cardiac rehabilitation program. We randomly assigned 50 patients to HML or TST. Patients underwent complete blinded evaluation before and after the rehabilitation program, including testing for cardiopulmonary exercise, maximal isometric voluntary contraction, endothelial function and body composition. After 4 weeks of training (16 sessions), the groups did not differ in body composition, anthropometric characteristics, or endothelial function. With HML, peak power output (P=0.035), maximal heart rate (P<0.01) and gain of force measured in the chest press position (P<0.02) were greater after versus before training. Both protocols appeared to be well tolerated, safe and feasible for these CHD patients. A training protocol involving 6s phases of isometric contractions with 10s of passive recovery on an HML device could be safely implemented in rehabilitation programs for patients with CHD and improve functional outcomes. Copyright © 2016. Published by Elsevier Masson SAS.

Overview of the Exploration Exercise Device Validation Study Plans

NASA Technical Reports Server (NTRS)

DeWitt, J. K.; Swan, B. G.

2018-01-01

The NASA has determined that a multi-functional exercise device will be developed for use as an exercise device during exploration missions. The device will allow for full body resistance and metabolic exercise necessary to minimize physiological losses during space flight and to maintain fitness necessary to perform critical mission tasks. Prior to implementation as an exercise device on an Exploration vehicle, there will be verification and validation testing completed to determine device efficacy at providing the necessary training stimuli to achieve desired goals. Because the exploration device will be new device that has yet be specified, specific Verification and Validation (V&V) protocols have yet to be developed. Upon delivery of an exploration exercise device training unit, stakeholders throughout NASA will develop V&V plans that include ground-based testing and testing on the International Space Station (ISS). Stakeholders will develop test protocols that include success criterion for the device. Ground tests will occur at NASA Johnson Space Station prior to flight testing. The intents of the ground tests are to allow crew, spaceflight medicine, science, engineering, Astronaut Strength, Conditioning, and Reconditioning staff, and others to gain experience in the best utilization of the device. The goal is to obtain an evidence base for recommending use of the device on the ISS. The developed protocol will be created to achieve multiple objectives, including determining if the device provides an adequate training stimulus for 5th - 95th percentile males and females, allows for exercise modalities that protect functional capability, and is robust and can withstand extensive human use. Although protocols are yet to be determined, current expectations include use of the device by test subjects and current crew in order to obtain quantitative and qualitative feedback. Information obtained during the ground tests may be used to influence device modifications during design iterations. Assuming successful ground tests, the device will be installed on the ISS for testing during space flight. Spaceflight testing is envisioned to include an activation and checkout (ACO) phase and a V&V phase. During the ACO phase, 1-2 crewmembers will exercise with the device to ensure proper function. ACO is expected to last multiple months because of the many modes and methods of exercise that need to be assessed. However, the goal is to complete the ACO as quickly as possible. Once successful ACO occurs, the crew will be free to use the device for normal exercise pending concurrence from stakeholders. V&V tests on the ISS will ideally consist of crew using the device for all of their exercise for an entire mission. Exercise prescriptions will be supplied that replicate expected prescriptions during exploration missions. Crew that are not enrolled in the V&V studies would be also free to use the device as their schedule permits. As experience is gained by users, exercise protocols could change. The intent of all V&V testing is to ensure that all have thorough understanding of experience at optimizing device capability

Chapter 3: Commercial and Industrial Lighting Controls Evaluation Protocol. The Uniform Methods Project: Methods for Determining Energy Efficiency Savings for Specific Measures

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

Kurnik, Charles W.; Carlson, Stephen

This Commercial and Industrial Lighting Controls Evaluation Protocol (the protocol) describes methods to account for energy savings resulting from programmatic installation of lighting control equipment in large populations of commercial, industrial, government, institutional, and other nonresidential facilities. This protocol does not address savings resulting from changes in codes and standards, or from education and training activities. When lighting controls are installed in conjunction with a lighting retrofit project, the lighting control savings must be calculated parametrically with the lighting retrofit project so savings are not double counted.

A rater training protocol to assess team performance.

PubMed

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

2015-01-01

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

An Assessment Protocol for Selective Mutism: Analogue Assessment Using Parents as Facilitators.

ERIC Educational Resources Information Center

Schill, Melissa T.; And Others

1996-01-01

Assesses protocol for conducting a functional analysis of maintaining variables for children with selective mutism. A parent was trained in and later applied various behavior strategies designed to increase speech in an eight-year-old girl with selective mutism. Parent and child ratings of treatment were positive. Presents implications for future…

SU-F-P-04: Implementation of Dose Monitoring Software: Successes and Pitfalls

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

Och, J

2016-06-15

Purpose: to successfully install a dose monitoring software (DMS) application to assist in CT protocol and dose management. Methods: Upon selecting the DMS, we began our implementation of the application. A working group composed of Medical Physics, Radiology Administration, Information Technology, and CT technologists was formed. On-site training in the application was supplied by the vendor. The decision was made to apply the process for all the CT protocols on all platforms at all facilities. Protocols were painstakingly mapped to the correct masters, and the system went ‘live’. Results: We are routinely using DMS as a tool in our Clinicalmore » Performance CT QA program. It is useful in determining the effectiveness of revisions to existing protocols, and establishing performance baselines for new units. However, the implementation was not without difficulty. We identified several pitfalls and obstacles which frustrated progress. Including: Training deficiencies, Nomenclature problems, Communication, DICOM variability. Conclusion: Dose monitoring software can be a potent tool for QA. However, implementation of the program can be problematic and requires planning, organization and commitment.« less

Adaptive enhancement of learning protocol in hippocampal cultured networks grown on multielectrode arrays

PubMed Central

Pimashkin, Alexey; Gladkov, Arseniy; Mukhina, Irina; Kazantsev, Victor

2013-01-01

Learning in neuronal networks can be investigated using dissociated cultures on multielectrode arrays supplied with appropriate closed-loop stimulation. It was shown in previous studies that weakly respondent neurons on the electrodes can be trained to increase their evoked spiking rate within a predefined time window after the stimulus. Such neurons can be associated with weak synaptic connections in nearby culture network. The stimulation leads to the increase in the connectivity and in the response. However, it was not possible to perform the learning protocol for the neurons on electrodes with relatively strong synaptic inputs and responding at higher rates. We proposed an adaptive closed-loop stimulation protocol capable to achieve learning even for the highly respondent electrodes. It means that the culture network can reorganize appropriately its synaptic connectivity to generate a desired response. We introduced an adaptive reinforcement condition accounting for the response variability in control stimulation. It significantly enhanced the learning protocol to a large number of responding electrodes independently on its base response level. We also found that learning effect preserved after 4–6 h after training. PMID:23745105

Validity and usefulness of the Line Drill test for adolescent basketball players: a Bayesian multilevel analysis.

PubMed

Carvalho, Humberto M; Gonçalves, Carlos E; Grosgeorge, Bernard; Paes, Roberto R

2017-01-01

The study examined the validity of the Line Drill test (LD) in male adolescent basketball players (10-15 years). Sensitiveness of the LD to changes in performance across a training and competition season (4 months) was also considered. Age, maturation, body size and LD were measured (n = 57). Sensitiveness of the LD was examined pre- and post-competitive season in a sub-sample (n = 44). The time at each of the four shuttle sprints of the LD (i.e. four stages) was modelled with Bayesian multilevel models. We observed very large correlation of performance at stage 4 (full LD protocol) with stage 3, but lower correlations with the early LD stages. Players' performance by somatic maturity differed substantially only when considering full LD protocol performance. Substantial improvements in all stages of the protocol were observed across the 4-month competitive season. The LD protocol should be shortened by the last full court shuttle sprint, remaining sensitive to training exposure, and independent of maturity status and body size.

Effects of specified performance criterion and performance feedback on staff behavior: a component analysis.

PubMed

Hardesty, Samantha L; Hagopian, Louis P; McIvor, Melissa M; Wagner, Leaora L; Sigurdsson, Sigurdur O; Bowman, Lynn G

2014-09-01

The present study isolated the effects of frequently used staff training intervention components to increase communication between direct care staff and clinicians working on an inpatient behavioral unit. Written "protocol review" quizzes developed by clinicians were designed to assess knowledge about a patient's behavioral protocols. Direct care staff completed these at the beginning of each day and evening shift. Clinicians were required to score and discuss these protocol reviews with direct care staff for at least 75% of shifts over a 2-week period. During baseline, only 21% of clinicians met this requirement. Completing and scoring of protocol reviews did not improve following additional in-service training (M = 15%) or following an intervention aimed at decreasing response effort combined with prompting (M = 28%). After implementing an intervention involving specified performance criterion and performance feedback, 86% of clinicians reached the established goal. Results of a component analysis suggested that the presentation of both the specified performance criterion and supporting contingencies was necessary to maintain acceptable levels of performance. © The Author(s) 2014.

Supplemental intermittent-day heat training and the lactate threshold.

PubMed

Gollan, Stuart; Chalmers, Samuel; Alderton, Stephen; Norton, Kevin

2017-04-01

Heat acclimation over consecutive days has been shown to improve aerobic-based performance. Recently, it has been suggested that heat training can improve performance in a temperate environment. However, due to the multifactorial training demands of athletes, consecutive-day heat training may not be suitable. The current study aimed to investigate the effect of brief (8×30min) intermittent (every 3-4 days) supplemental heat training on the second lactate threshold point (LT 2 ) in temperate and hot conditions. 21 participants undertook eight intermittent-day mixed-intensity treadmill exercise training sessions in hot (30°C; 50% relative humidity [RH]) or temperate (18°C; 30% RH) conditions. A pre- and post-incremental exercise test occurred in temperate (18°C; 30% RH) and hot conditions (30°C; 50% RH) to determine the change in LT 2 . The heat training protocol did not improve LT 2 in temperate (Effect Size [ES]±90 confidence interval=0.10±0.16) or hot (ES=0.26±0.26) conditions. The primary finding was that although the intervention group had a change greater than the SWC, no statistically significant improvements were observed following an intermittent eight day supplemental heat training protocol comparable to a control group training only in temperate conditions. This is likely due to the brief length of each heat training session and/or the long duration between each heat exposure. Copyright © 2017 Elsevier Ltd. All rights reserved.

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

PubMed

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

2014-06-26

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

Motion sickness adaptation to Coriolis-inducing head movements in a sustained G flight simulator.

PubMed

Newman, Michael C; McCarthy, Geoffrey W; Glaser, Scott T; Bonato, Frederick; Bubka, Andrea

2013-02-01

Technological advances have allowed centrifuges to become more than physiological testing and training devices; sustained G, fully interactive flight simulation is now possible. However, head movements under G can result in vestibular stimulation that can lead to motion sickness (MS) symptoms that are potentially distracting, nauseogenic, and unpleasant. In the current study an MS adaptation protocol was tested for head movements under +Gz. Experienced pilots made 14 predetermined head movements in a sustained G flight simulator (at 3 +Gz) on 5 consecutive days and 17 d after training. Symptoms were measured after each head turn using a subjective 0-10 MS scale. The Simulator Sickness Questionnaire (SSQ) was also administered before and after each daily training session. After five daily training sessions, normalized mean MS scores were 58% lower than on Day 1. Mean total, nausea, and disorientation SSQ scores were 55%, 52%, and 78% lower, respectively. During retesting 17 d after training, nearly all scores indicated 90-100% retention of training benefits. The reduction of unpleasant effects associated with sustained G flight simulation using an adaptation training protocol may enhance the effectiveness of simulation. Practical use of sustained G simulators is also likely to be interspersed with other types of ground and in-flight training. Hence, it would be undesirable and unpleasant for trainees to lose adaptation benefits after a short gap in centrifuge use. However, current results suggest that training gaps in excess of 2 wk may be permissible with almost no loss of adaptation training benefits.

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

PubMed Central

2014-01-01

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

Lower limb strength training in children with cerebral palsy – a randomized controlled trial protocol for functional strength training based on progressive resistance exercise principles

PubMed Central

Scholtes, Vanessa A; Dallmeijer, Annet J; Rameckers, Eugene A; Verschuren, Olaf; Tempelaars, Els; Hensen, Maartje; Becher, Jules G

2008-01-01

Background Until recently, strength training in children with cerebral palsy (CP) was considered to be inappropriate, because it could lead to increased spasticity or abnormal movement patterns. However, the results of recent studies suggest that progressive strength training can lead to increased strength and improved function, but low methodological quality and incomplete reporting on the training protocols hampers adequate interpretation of the results. This paper describes the design and training protocol of a randomized controlled trial to assess the effects of a school-based progressive functional strength training program for children with CP. Methods/Results Fifty-one children with Gross Motor Function Classification Systems levels I to III, aged of 6 to 13 years, were recruited. Using stratified randomization, each child was assigned to an intervention group (strength training) or a control group (usual care). The strength training was given in groups of 4–5 children, 3 times a week, for a period of 12 weeks. Each training session focussed on four exercises out of a 5-exercise circuit. The training load was gradually increased based on the child's maximum level of strength, as determined by the 8 Repetition Maximum (8 RM). To evaluate the effectiveness of the training, all children were evaluated before, during, directly after, and 6 weeks after the intervention period. Primary outcomes in this study were gross motor function (measured with the Gross Motor Function Measure and functional muscle strength tests) and walking ability (measured with the 10-meter, the 1-minute and the timed stair test). Secondary outcomes were lower limb muscle strength (measured with a 6 RM test, isometric strength tests, and a sprint capacity test), mobility (measured with a mobility questionnaire), and sport activities (measured with the Children's Assessment of Participation and Enjoyment). Spasticity and range of motion were assessed to evaluate any adverse events. Conclusion Randomized clinical trials are considered to present the highest level of evidence. Nevertheless, it is of utmost importance to report on the design, the applied evaluation methods, and all elements of the intervention, to ensure adequate interpretation of the results and to facilitate implementation of the intervention in clinical practice if the results are positive. Trial Registration Trial Register NTR1403 PMID:18842125

Physician communication in the operating room.

PubMed

Kirschbaum, Kristin A; Rask, John P; Fortner, Sally A; Kulesher, Robert; Nelson, Michael T; Yen, Tony; Brennan, Matthew

2015-01-01

In this study, communication research was conducted with multidisciplinary groups of operating-room physicians. Theoretical frameworks from intercultural communication and rhetoric were used to (a) measure latent cultural communication variables and (b) conduct communication training with the physicians. A six-step protocol guided the research with teams of physicians from different surgical specialties: anesthesiologists, general surgeons, and obstetrician-gynecologists (n = 85). Latent cultural communication variables were measured by surveys administered to physicians before and after completion of the protocol. The centerpiece of the 2-hour research protocol was an instructional session that informed the surgical physicians about rhetorical choices that support participatory communication. Post-training results demonstrated scores increased on communication variables that contribute to collaborative communication and teamwork among the physicians. This study expands health communication research through application of combined intercultural and rhetorical frameworks, and establishes new ways communication theory can contribute to medical education.

A general protocol for creating high-throughput screening assays for reaction yield and enantiomeric excess applied to hydrobenzoin

PubMed Central

Shabbir, Shagufta H.; Regan, Clinton J.; Anslyn, Eric V.

2009-01-01

A general approach to high-throughput screening of enantiomeric excess (ee) and concentration was developed by using indicator displacement assays (IDAs), and the protocol was then applied to the vicinal diol hydrobenzoin. The method involves the sequential utilization of what we define herein as screening, training, and analysis plates. Several enantioselective boronic acid-based receptors were screened by using 96-well plates, both for their ability to discriminate the enantiomers of hydrobenzoin and to find their optimal pairing with indicators resulting in the largest optical responses. The best receptor/indicator combination was then used to train an artificial neural network to determine concentration and ee. To prove the practicality of the developed protocol, analysis plates were created containing true unknown samples of hydrobenzoin generated by established Sharpless asymmetric dihydroxylation reactions, and the best ligand was correctly identified. PMID:19332790

Molecular recognition and self-assembly special feature: A general protocol for creating high-throughput screening assays for reaction yield and enantiomeric excess applied to hydrobenzoin.

PubMed

Shabbir, Shagufta H; Regan, Clinton J; Anslyn, Eric V

2009-06-30

A general approach to high-throughput screening of enantiomeric excess (ee) and concentration was developed by using indicator displacement assays (IDAs), and the protocol was then applied to the vicinal diol hydrobenzoin. The method involves the sequential utilization of what we define herein as screening, training, and analysis plates. Several enantioselective boronic acid-based receptors were screened by using 96-well plates, both for their ability to discriminate the enantiomers of hydrobenzoin and to find their optimal pairing with indicators resulting in the largest optical responses. The best receptor/indicator combination was then used to train an artificial neural network to determine concentration and ee. To prove the practicality of the developed protocol, analysis plates were created containing true unknown samples of hydrobenzoin generated by established Sharpless asymmetric dihydroxylation reactions, and the best ligand was correctly identified.

A novel conceptual framework for balance training in Parkinson’s disease-study protocol for a randomised controlled trial

PubMed Central

2012-01-01

Background There is increasing scientific knowledge about the interaction between physiological (musculoskeletal, neuromuscular, cognitive and sensory) systems and their influence on balance and walking impairments in Parkinson’s disease. We have developed a new conceptual framework for balance training, emphasising specific components of balance control related to Parkinson’s disease symptoms by using highly challenging, progressive and varying training conditions. The primary aim of this proposed randomised controlled trial will be to investigate the short-term and long-term effects of a 10-week balance training regime in elderly with Parkinson’s disease. Methods/Design Eighty participants with mild to moderate idiopathic Parkinson’s disease will be recruited and randomly allocated to an intervention group receiving balance training or a control group whose participants will continue to receive their usual care. The intervention will consist of a 10-week group training regime (1-hour training, three times per week), which will be led by two physiotherapists to ensure training progression and safety. The conceptual framework will be applied by addressing specific balance components (sensory integration, anticipatory postural adjustments, motor agility, stability limits) through varying training conditions and structured progression. Assessment will be conducted through a multi-dimensional battery of outcomes, prior to and immediately after the 10-week intervention, and at 9 and 15 months’ follow-up after entering the study. Primary outcome measures will be balance performance (assessed using the Mini Balance Evaluation Systems Test), change in gait velocity (m/s) between single and dual task walking, and fear of falling (evaluated using the Fall Efficacy Scale International). Discussion This study has the potential to provide new insight and knowledge of the effects of specific, varied and challenging balance training on a wide health spectrum in elderly with PD. If found to be effective, this pragmatic approach with translation of theory into practice, can be implemented in existing outpatient care. Trial registration NCT01417598 PMID:23017069

Meaning and challenges in the practice of multiple therapeutic massage modalities: a combined methods study.

PubMed

Porcino, Antony J; Boon, Heather S; Page, Stacey A; Verhoef, Marja J

2011-09-20

Therapeutic massage and bodywork (TMB) practitioners are predominantly trained in programs that are not uniformly standardized, and in variable combinations of therapies. To date no studies have explored this variability in training and how this affects clinical practice. Combined methods, consisting of a quantitative, population-based survey and qualitative interviews with practitioners trained in multiple therapies, were used to explore the training and practice of TMB practitioners in Alberta, Canada. Of the 5242 distributed surveys, 791 were returned (15.1%). Practitioners were predominantly female (91.7%), worked in a range of environments, primarily private (44.4%) and home clinics (35.4%), and were not significantly different from other surveyed massage therapist populations. Seventy-seven distinct TMB therapies were identified. Most practitioners were trained in two or more therapies (94.4%), with a median of 8 and range of 40 therapies. Training programs varied widely in number and type of TMB components, training length, or both. Nineteen interviews were conducted. Participants described highly variable training backgrounds, resulting in practitioners learning unique combinations of therapy techniques. All practitioners reported providing individualized patient treatment based on a responsive feedback process throughout practice that they described as being critical to appropriately address the needs of patients. They also felt that research treatment protocols were different from clinical practice because researchers do not usually sufficiently acknowledge the individualized nature of TMB care provision. The training received, the number of therapies trained in, and the practice descriptors of TMB practitioners are all highly variable. In addition, clinical experience and continuing education may further alter or enhance treatment techniques. Practitioners individualize each patient's treatment through a highly adaptive process. Therefore, treatment provision is likely unique to each practitioner. These results may be of interest to researchers considering similar practice issues in other professions. The use of a combined-methods design effectively captured this complexity of TMB practice. TMB research needs to consider research approaches that can capture or adapt to the individualized nature of practice.

Feasibility, safety, and efficacy of aerobic training in pretreated patients with metastatic breast cancer: A randomized controlled trial.

PubMed

Scott, Jessica M; Iyengar, Neil M; Nilsen, Tormod S; Michalski, Meghan; Thomas, Samantha M; Herndon, James; Sasso, John; Yu, Anthony; Chandarlapaty, Sarat; Dang, Chau T; Comen, Elizabeth A; Dickler, Maura N; Peppercorn, Jeffrey M; Jones, Lee W

2018-04-06

The investigation of exercise training in metastatic breast cancer has received minimal attention. This study determined the feasibility and safety of aerobic training in metastatic breast cancer. Sixty-five women (age, 21-80 years) with metastatic (stage IV) breast cancer (57% were receiving chemotherapy, and >40% had ≥ 2 lines of prior therapy) were allocated to an aerobic training group (n = 33) or a stretching group (n = 32). Aerobic training consisted of 36 supervised treadmill walking sessions delivered thrice weekly between 55% and 80% of peak oxygen consumption (VO 2peak ) for 12 consecutive weeks. Stretching was matched to aerobic training with respect to location, frequency, duration, and intervention length. The primary endpoint was aerobic training feasibility, which was a priori defined as the lost to follow-up (LTF) rate (<20%) and attendance (≥70%). Secondary endpoints were safety, objective outcomes (VO 2peak and functional capacity), and patient-reported outcomes (PROs; quality of life). One of the 33 patients (3%) receiving aerobic training was LTF, whereas the mean attendance rate was 63% ± 30%. The rates of permanent discontinuation and dose modification were 27% and 49%, respectively. Intention-to-treat analyses indicated improvements in PROs, which favored the attention control group (P values > .05). Per protocol analyses indicated that 14 of 33 patients (42%) receiving aerobic training had acceptable tolerability (relative dose intensity ≥ 70%), and this led to improvements in VO 2peak and functional capacity (P values < .05). Aerobic training at the dose and schedule tested is safe but not feasible for a significant proportion of patients with metastatic breast cancer. The acceptable feasibility and promising benefit for select patients warrant further evaluation in a dose-finding phase 1/2 study. Cancer 2018. © 2018 American Cancer Society. © 2018 American Cancer Society.

Optimization of 64-MDCT urography: effect of dual-phase imaging with furosemide on collecting system opacification and radiation dose.

PubMed

Portnoy, Orith; Guranda, Larisa; Apter, Sara; Eiss, David; Amitai, Marianne Michal; Konen, Eli

2011-11-01

The purpose of this study was to compare opacification of the urinary collecting system and radiation dose associated with three-phase 64-MDCT urographic protocols and those associated with a split-bolus dual-phase protocol including furosemide. Images from 150 CT urographic examinations performed with three scanning protocols were retrospectively evaluated. Group A consisted of 50 sequentially registered patients who underwent a three-phase protocol with saline infusion. Group B consisted of 50 sequentially registered patients who underwent a reduced-radiation three-phase protocol with saline. Group C consisted of 50 sequentially registered patients who underwent a dual-phase split-bolus protocol that included a low-dose furosemide injection. Opacification of the urinary collecting system was evaluated with segmental binary scoring. Contrast artifacts were evaluated, and radiation doses were recorded. Results were compared by analysis of variance. A significant reduction in mean effective radiation dose was found between groups A and B (p < 0.001) and between groups B and C (p < 0.001), resulting in 65% reduction between groups A and C (p < 0.001). This reduction did not significantly affect opacification score in any of the 12 urinary segments (p = 0.079). In addition, dense contrast artifacts overlying the renal parenchyma observed with the three-phase protocols (groups A and B) were avoided with the dual-phase protocol (group C) (p < 0.001). A dual-phase protocol with furosemide injection is the preferable technique for CT urography. In comparison with commonly used three-phase protocols, the dual-phase protocol significantly reduces radiation exposure dose without reduction in image quality.

Assessment of Self-Contamination During Removal of Personal Protective Equipment for Ebola Patient Care.

PubMed

Casanova, Lisa M; Teal, Lisa J; Sickbert-Bennett, Emily E; Anderson, Deverick J; Sexton, Daniel J; Rutala, William A; Weber, David J

2016-10-01

OBJECTIVE Ebola virus disease (EVD) places healthcare personnel (HCP) at high risk for infection during patient care, and personal protective equipment (PPE) is critical. Protocols for EVD PPE doffing have not been validated for prevention of viral self-contamination. Using surrogate viruses (non-enveloped MS2 and enveloped Φ6), we assessed self-contamination of skin and clothes when trained HCP doffed EVD PPE using a standardized protocol. METHODS A total of 15 HCP donned EVD PPE for this study. Virus was applied to PPE, and a trained monitor guided them through the doffing protocol. Of the 15 participants, 10 used alcohol-based hand rub (ABHR) for glove and hand hygiene and 5 used hypochlorite for glove hygiene and ABHR for hand hygiene. Inner gloves, hands, face, and scrubs were sampled after doffing. RESULTS After doffing, MS2 virus was detected on the inner glove worn on the dominant hand for 8 of 15 participants, on the non-dominant inner glove for 6 of 15 participants, and on scrubs for 2 of 15 participants. All MS2 on inner gloves was observed when ABHR was used for glove hygiene; none was observed when hypochlorite was used. When using hypochlorite for glove hygiene, 1 participant had MS2 on hands, and 1 had MS2 on scrubs. CONCLUSIONS A structured doffing protocol using a trained monitor and ABHR protects against enveloped virus self-contamination. Non-enveloped virus (MS2) contamination was detected on inner gloves, possibly due to higher resistance to ABHR. Doffing protocols protective against all viruses need to incorporate highly effective glove and hand hygiene agents. Infect Control Hosp Epidemiol 2016;1-6.

Diffusion Tensor Imaging and Resting-State Functional MRI-Scanning in 5- and 6-Year-Old Children: Training Protocol and Motion Assessment

PubMed Central

Theys, Catherine; Wouters, Jan; Ghesquière, Pol

2014-01-01

Advanced Magnetic Resonance Imaging (MRI) techniques such as Diffusion Tensor Imaging (DTI) and resting-state functional MRI (rfMRI) are widely used to study structural and functional neural connectivity. However, as these techniques are highly sensitive to motion artifacts and require a considerable amount of time for image acquisition, successful acquisition of these images can be challenging to complete with certain populations. This is especially true for young children. This paper describes a new approach termed the ‘submarine protocol’, designed to prepare 5- and 6-year-old children for advanced MRI scanning. The submarine protocol aims to ensure that successful scans can be acquired in a time- and resource-efficient manner, without the need for sedation. This manuscript outlines the protocol and details its outcomes, as measured through the number of children who completed the scanning procedure and analysis of the degree of motion present in the acquired images. Seventy-six children aged between 5.8 and 6.9 years were trained using the submarine protocol and subsequently underwent DTI and rfMRI scanning. After completing the submarine protocol, 75 of the 76 children (99%) completed their DTI-scan and 72 children (95%) completed the full 35-minute scan session. Results of diffusion data, acquired in 75 children, showed that the motion in 60 of the scans (80%) did not exceed the threshold for excessive motion. In the rfMRI scans, this was the case for 62 of the 71 scans (87%). When placed in the context of previous studies, the motion data of the 5- and 6-year-old children reported here were as good as, or better than those previously reported for groups of older children (i.e., 8-year-olds). Overall, this study shows that the submarine protocol can be used successfully to acquire DTI and rfMRI scans in 5 and 6-year-old children, without the need for sedation or lengthy training procedures. PMID:24718364

Dissemination of CBTI to the non-sleep specialist: protocol development and training issues.

PubMed

Manber, Rachel; Carney, Colleen; Edinger, Jack; Epstein, Dana; Friedman, Leah; Haynes, Patricia L; Karlin, Bradley E; Pigeon, Wilfred; Siebern, Allison T; Trockel, Mickey

2012-04-15

Strong evidence supports the efficacy of cognitive behavioral therapy for insomnia (CBTI). A significant barrier to wide dissemination of CBTI is the lack of qualified practitioners. We describe challenges and decisions made when developing a CBTI dissemination program in the Veterans Health Administration (VHA). The program targets mental health clinicians from different disciplines (psychiatry, psychology, social work, and nursing) with varying familiarity and experience with general principles of cognitive behavioral therapies (CBT). We explain the scope of training (how much to teach about the science of sleep, comorbid sleep disorders, other medical and mental health comorbidities, and hypnotic-dependent insomnia), discuss adaptation of CBTI to address the unique challenges posed by comorbid insomnia, and describe decisions made about the strategy of training (principles, structure and materials developed/recommended). Among these decisions is the question of how to balance the structure and flexibility of the treatment protocol. We developed a case conceptualization-driven approach and provide a general session-by-session outline. Training licensed therapists who already have many professional obligations required that the training be completed in a relatively short time with minimal disruptions to training participants' routine work responsibilities. These "real-life" constraints shaped the development of this competency-based, yet pragmatic training program. We conclude with a description of preliminary lessons learned from the initial wave of training and propose future directions for research and dissemination.

Training response inhibition to reduce food consumption: Mechanisms, stimulus specificity and appropriate training protocols.

PubMed

Adams, Rachel C; Lawrence, Natalia S; Verbruggen, Frederick; Chambers, Christopher D

2017-02-01

Training individuals to inhibit their responses towards unhealthy foods has been shown to reduce food intake relative to a control group. Here we aimed to further explore these effects by investigating the role of stimulus devaluation, training protocol, and choice of control group. Restrained eaters received either inhibition or control training using a modified version of either the stop-signal or go/no-go task. Following training we measured implicit attitudes towards food (Study 1) and food consumption (Studies 1 and 2). In Study 1 we used a modified stop-signal training task with increased demands on top-down control (using a tracking procedure and feedback to maintain competition between the stop and go processes). With this task, we found no evidence for an effect of training on implicit attitudes or food consumption, with Bayesian inferential analyses revealing substantial evidence for the null hypothesis. In Study 2 we removed the feedback in the stop-signal training to increase the rate of successful inhibition and revealed a significant effect of both stop-signal and go/no-go training on food intake (compared to double-response and go training, respectively) with a greater difference in consumption in the go/no-go task, compared with the stop-signal task. However, results from an additional passive control group suggest that training effects could be partly caused by increased consumption in the go control group whereas evidence for reduced consumption in the inhibition groups was inconclusive. Our findings therefore support evidence that inhibition training tasks with higher rates of inhibition accuracy are more effective, but prompt caution for interpreting the efficacy of laboratory-based inhibition training as an intervention for behaviour change. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Effects of beta-adrenergic blockade on training-induced structural adaptations in rat left ventricle.

PubMed

Thomas, D P; McCormick, K M; Jenkins, R R

1988-01-01

The study was designed to evaluate the effects of eight weeks of exercise training or training-beta-adrenergic blockade combination on gross and microscopic alterations of rat cardiac muscle and microvascular bed. Rats were randomly assigned to either sedentary control (C), trained (T), metoprolol-trained (MT), or propranolol-trained (PT) groups. The training protocol involved treadmill running for 8 weeks at 0.5 ms-1, 20% grade. Earlier experiments by us showed this training protocol to be effective in producing significant changes in selected skeletal muscle enzyme activities in all trained groups. In the current study an absolute reduction in left ventricular (LV) weight was observed in the PT compared to the C group (0.91 +/- 0.02 vs. 1.04 +/- 0.04 g, P less than 0.05). LV weight in the T and MT groups was no different from C so that LV to BW ratio (mg.g-1) was significantly increased (P less than 0.05) due to a similar reduction in body weight (BW) in all three training groups. Morphometric analysis of LV myocardium revealed no significant differences in myocyte mean cross-sectional area (micron 2) in any of the groups (289 +/- 16-C, 332 +/- 20-T, 281 +/- 44-MT, and 273 +/- 12-PT). Capillary density independently calculated by light and electron microscopy was unchanged by training or training-beta-blockade combination. It was concluded that training of sufficient intensity and duration to produce skeletal muscle enzyme adaptations does not necessarily produce myocyte hypertrophy or alter LV capillarity. Additionally functioning beta-adrenergic receptors appear to play a role in both the central and peripheral adaptations to endurance exercise training.

Fibre-Specific Responses to Endurance and Low Volume High Intensity Interval Training: Striking Similarities in Acute and Chronic Adaptation

PubMed Central

Scribbans, Trisha D.; Edgett, Brittany A.; Vorobej, Kira; Mitchell, Andrew S.; Joanisse, Sophie D.; Matusiak, Jennifer B. L.; Parise, Gianni; Quadrilatero, Joe; Gurd, Brendon J.

2014-01-01

The current study involved the completion of two distinct experiments. Experiment 1 compared fibre specific and whole muscle responses to acute bouts of either low-volume high-intensity interval training (LV-HIT) or moderate-intensity continuous endurance exercise (END) in a randomized crossover design. Experiment 2 examined the impact of a six-week training intervention (END or LV-HIT; 4 days/week), on whole body and skeletal muscle fibre specific markers of aerobic and anaerobic capacity. Six recreationally active men (Age: 20.7±3.8 yrs; VO2peak: 51.9±5.1 mL/kg/min) reported to the lab on two separate occasions for experiment 1. Following a muscle biopsy taken in a fasted state, participants completed an acute bout of each exercise protocol (LV-HIT: 8, 20-second intervals at ∼170% of VO2peak separated by 10 seconds of rest; END: 30 minutes at ∼65% of VO2peak), immediately followed by a muscle biopsy. Glycogen content of type I and IIA fibres was significantly (p<0.05) reduced, while p-ACC was significantly increased (p<0.05) following both protocols. Nineteen recreationally active males (n = 16) and females (n = 3) were VO2peak-matched and assigned to either the LV-HIT (n = 10; 21±2 yrs) or END (n = 9; 20.7±3.8 yrs) group for experiment 2. After 6 weeks, both training protocols induced comparable increases in aerobic capacity (END: Pre: 48.3±6.0, Mid: 51.8±6.0, Post: 55.0±6.3 mL/kg/min LV-HIT: Pre: 47.9±8.1, Mid: 50.4±7.4, Post: 54.7±7.6 mL/kg/min), fibre-type specific oxidative and glycolytic capacity, glycogen and IMTG stores, and whole-muscle capillary density. Interestingly, only LV-HIT induced greater improvements in anaerobic performance and estimated whole-muscle glycolytic capacity. These results suggest that 30 minutes of END exercise at ∼65% VO2peak or 4 minutes of LV-HIT at ∼170% VO2peak induce comparable changes in the intra-myocellular environment (glycogen content and signaling activation); correspondingly, training-induced adaptations resulting for these protocols, and other HIT and END protocols are strikingly similar. PMID:24901767

Moving Triadic Gaze Intervention Into Practice: Measuring Clinician Attitude and Implementation Fidelity

PubMed Central

Olswang, Lesley B.; Greenslade, Kathryn; Pinder, Gay Lloyd; Dowden, Patricia; Madden, Jodi

2017-01-01

Purpose This research investigated a first step in implementing the dynamic assessment (DA) component of Triadic Gaze Intervention (Olswang, Feuerstein, Pinder, & Dowden, 2013; Olswang et al., 2014), an evidence-based protocol for teaching early signals of communication to young children with physical disabilities. Clinician attitudes about adopting external evidence into practice and implementation fidelity in DA protocol delivery were examined following training. Method Seven early intervention clinicians from multiple disciplines were trained to deliver the four essential elements of the DA protocol: (a) provide communication opportunity, (b) recognize child's potentially communicative signal, (c) shape child's signal toward triadic gaze, and (d) reinforce with play. Clinician attitude regarding adopting evidence into practice was measured at baseline and follow-up, with the Evidence-Based Practice Attitude Scale (Aarons, 2004). Implementation fidelity in delivering the protocol was measured for adherence (accuracy) and competence (quality) during trial implementation. Results Clinicians' attitudes about trying new evidence that at first was perceived as incongruent with their practice improved over the course of the research. Clinicians demonstrated strong adherence to the DA protocol; however, competence varied across clinicians and appeared related to child performance. Conclusions The results provided insight into moving Triadic Gaze Intervention into practice and yielded valuable information regarding the implementation process, with implications for future research. PMID:28525577

Feedback Specificity, Information Processing, and Transfer of Training

ERIC Educational Resources Information Center

Goodman, Jodi S.; Wood, Robert E.; Chen, Zheng

2011-01-01

This study examines the effects of feedback specificity on transfer of training and the mechanisms through which feedback can enhance or inhibit transfer. We used concurrent verbal protocol methodology to elicit and operationalize the explicit information processing activities used by 48 trainees performing the Furniture Factory computer…

Training Tools for Translators and Interpreters

ERIC Educational Resources Information Center

Al-Qinai, Jamal

2010-01-01

The present paper reviews the traditional methodologies of translator training and proposes an eclectic multi-componential approach that involves a set of interdisciplinary skills with the ultimate objective of meeting market demand. Courses on translation for specific purposes (TSP) and think-aloud protocols (TAP) along with self-monitoring and…

Assessment of Healthcare Worker Protocol Deviations and Self-Contamination During Personal Protective Equipment Donning and Doffing.

PubMed

Kwon, Jennie H; Burnham, Carey-Ann D; Reske, Kimberly A; Liang, Stephen Y; Hink, Tiffany; Wallace, Meghan A; Shupe, Angela; Seiler, Sondra; Cass, Candice; Fraser, Victoria J; Dubberke, Erik R

2017-09-01

OBJECTIVE To evaluate healthcare worker (HCW) risk of self-contamination when donning and doffing personal protective equipment (PPE) using fluorescence and MS2 bacteriophage. DESIGN Prospective pilot study. SETTING Tertiary-care hospital. PARTICIPANTS A total of 36 HCWs were included in this study: 18 donned/doffed contact precaution (CP) PPE and 18 donned/doffed Ebola virus disease (EVD) PPE. INTERVENTIONS HCWs donned PPE according to standard protocols. Fluorescent liquid and MS2 bacteriophage were applied to HCWs. HCWs then doffed their PPE. After doffing, HCWs were scanned for fluorescence and swabbed for MS2. MS2 detection was performed using reverse transcriptase PCR. The donning and doffing processes were videotaped, and protocol deviations were recorded. RESULTS Overall, 27% of EVD PPE HCWs and 50% of CP PPE HCWs made ≥1 protocol deviation while donning, and 100% of EVD PPE HCWs and 67% of CP PPE HCWs made ≥1 protocol deviation while doffing (P=.02). The median number of doffing protocol deviations among EVD PPE HCWs was 4, versus 1 among CP PPE HCWs. Also, 15 EVD PPE protocol deviations were committed by doffing assistants and/or trained observers. Fluorescence was detected on 8 EVD PPE HCWs (44%) and 5 CP PPE HCWs (28%), most commonly on hands. MS2 was recovered from 2 EVD PPE HCWs (11%) and 3 CP PPE HCWs (17%). CONCLUSIONS Protocol deviations were common during both EVD and CP PPE doffing, and some deviations during EVD PPE doffing were committed by the HCW doffing assistant and/or the trained observer. Self-contamination was common. PPE donning/doffing are complex and deserve additional study. Infect Control Hosp Epidemiol 2017;38:1077-1083.

Training-induced improvements in postural control are accompanied by alterations in cerebellar white matter in brain injured patients.

PubMed

Drijkoningen, David; Caeyenberghs, Karen; Leunissen, Inge; Vander Linden, Catharine; Leemans, Alexander; Sunaert, Stefan; Duysens, Jacques; Swinnen, Stephan P

2015-01-01

We investigated whether balance control in young TBI patients can be promoted by an 8-week balance training program and whether this is associated with neuroplastic alterations in brain structure. The cerebellum and cerebellar peduncles were selected as regions of interest because of their importance in postural control as well as their vulnerability to brain injury. Young patients with moderate to severe TBI and typically developing (TD) subjects participated in balance training using PC-based portable balancers with storage of training data and real-time visual feedback. An additional control group of TD subjects did not attend balance training. Mean diffusivity and fractional anisotropy were determined with diffusion MRI scans and were acquired before, during (4 weeks) and at completion of training (8 weeks) together with balance assessments on the EquiTest® System (NeuroCom) which included the Sensory Organization Test, Rhythmic Weight Shift and Limits of Stability protocols. Following training, TBI patients showed significant improvements on all EquiTest protocols, as well as a significant increase in mean diffusivity in the inferior cerebellar peduncle. Moreover, in both training groups, diffusion metrics in the cerebellum and/or cerebellar peduncles at baseline were predictive of the amount of performance increase after training. Finally, amount of training-induced improvement on the Rhythmic Weight Shift test in TBI patients was positively correlated with amount of change in fractional anisotropy in the inferior cerebellar peduncle. This suggests that training-induced plastic changes in balance control are associated with alterations in the cerebellar white matter microstructure in TBI patients.

Training-induced improvements in postural control are accompanied by alterations in cerebellar white matter in brain injured patients

PubMed Central

Drijkoningen, David; Caeyenberghs, Karen; Leunissen, Inge; Vander Linden, Catharine; Leemans, Alexander; Sunaert, Stefan; Duysens, Jacques; Swinnen, Stephan P.

2014-01-01

We investigated whether balance control in young TBI patients can be promoted by an 8-week balance training program and whether this is associated with neuroplastic alterations in brain structure. The cerebellum and cerebellar peduncles were selected as regions of interest because of their importance in postural control as well as their vulnerability to brain injury. Young patients with moderate to severe TBI and typically developing (TD) subjects participated in balance training using PC-based portable balancers with storage of training data and real-time visual feedback. An additional control group of TD subjects did not attend balance training. Mean diffusivity and fractional anisotropy were determined with diffusion MRI scans and were acquired before, during (4 weeks) and at completion of training (8 weeks) together with balance assessments on the EquiTest® System (NeuroCom) which included the Sensory Organization Test, Rhythmic Weight Shift and Limits of Stability protocols. Following training, TBI patients showed significant improvements on all EquiTest protocols, as well as a significant increase in mean diffusivity in the inferior cerebellar peduncle. Moreover, in both training groups, diffusion metrics in the cerebellum and/or cerebellar peduncles at baseline were predictive of the amount of performance increase after training. Finally, amount of training-induced improvement on the Rhythmic Weight Shift test in TBI patients was positively correlated with amount of change in fractional anisotropy in the inferior cerebellar peduncle. This suggests that training-induced plastic changes in balance control are associated with alterations in the cerebellar white matter microstructure in TBI patients. PMID:25610786

κ-opioid receptor is involved in the cardioprotection induced by exercise training

PubMed Central

Li, Juan; Tian, Fei; Feng, Na; Fan, Rong; Jia, Min; Guo, Haitao; Cheng, Liang; Liu, Jincheng; Chen, Wensheng; Pei, Jianming

2017-01-01

The present study was designed to test the hypothesis that exercise training elicited a cardioprotective effect against ischemia and reperfusion (I/R) via the κ-opioid receptor (κ-OR)-mediated signaling pathway. Rats were randomly divided into four groups: the control group, the moderate intensity exercise (ME) group, the high intensity exercise (HE) group, and the acute exercise (AE) group. For the exercise training protocols, the rats were subjected to one week of adaptive treadmill training, while from the second week, the ME and HE groups were subjected to eight weeks of exercise training, and the AE group was subjected to three days of adaptive treadmill training and one day of vigorous exercise. After these protocols, the three exercise training groups were divided into different treatment groups, and the rats were subjected to 30 min of ischemia and 120 min of reperfusion. Changes in infarct size and serum cTnT (cardiac troponin T) caused by I/R were reduced by exercise training. Moreover, cardiac dysfunction caused by I/R was also alleviated by exercise training. These effects of exercise training were reversed by nor-BNI (a selective κ-OR antagonist), Compound C (a selective AMPK inhibitor), Akt inhibitor and L-NAME (a non-selective eNOS inhibitor). Expression of κ-OR and phosphorylation of AMPK, Akt and eNOS were significantly increased in the ME, HE and AE groups. These findings demonstrated that the cardioprotective effect of exercise training is possibly mediated by the κ-OR-AMPK-Akt-eNOS signaling pathway. PMID:28301473

Clinical Space Medicine Products as Developed by the Medical Operations Support Team (MOST)

NASA Technical Reports Server (NTRS)

Polk, James D.; Doerr, Harold K.; Hurst, Victor W., IV; Schmid, Josef

2007-01-01

Medical Operations Support Team (MOST) is introducing/integrating teaching practices associated with high fidelity human patient simulation into the NASA culture, in particular, into medical training sessions and medical procedure evaluations. Current/Future Products iclude: a) Development of Sub-optimal Airway Protocols for the International Space Station (ISS) using the ILMA; b) Clinical Core Competency Training for NASA Flight Surgeons (FS); c) Post-Soyuz Landing Clinical Training for NASA FS; d) Experimental Integrated Training for Astronaut Crew Medical Officers and NASA FS; and e) Private Clinical Refresher Training.

An extended protocol for usability validation of medical devices: Research design and reference model.

PubMed

Schmettow, Martin; Schnittker, Raphaela; Schraagen, Jan Maarten

2017-05-01

This paper proposes and demonstrates an extended protocol for usability validation testing of medical devices. A review of currently used methods for the usability evaluation of medical devices revealed two main shortcomings. Firstly, the lack of methods to closely trace the interaction sequences and derive performance measures. Secondly, a prevailing focus on cross-sectional validation studies, ignoring the issues of learnability and training. The U.S. Federal Drug and Food Administration's recent proposal for a validation testing protocol for medical devices is then extended to address these shortcomings: (1) a novel process measure 'normative path deviations' is introduced that is useful for both quantitative and qualitative usability studies and (2) a longitudinal, completely within-subject study design is presented that assesses learnability, training effects and allows analysis of diversity of users. A reference regression model is introduced to analyze data from this and similar studies, drawing upon generalized linear mixed-effects models and a Bayesian estimation approach. The extended protocol is implemented and demonstrated in a study comparing a novel syringe infusion pump prototype to an existing design with a sample of 25 healthcare professionals. Strong performance differences between designs were observed with a variety of usability measures, as well as varying training-on-the-job effects. We discuss our findings with regard to validation testing guidelines, reflect on the extensions and discuss the perspectives they add to the validation process. Copyright © 2017 Elsevier Inc. All rights reserved.

Fasting: a major limitation for resistance exercise training effects in rodents

PubMed Central

das Neves, W.; de Oliveira, L.F.; da Silva, R.P.; Alves, C.R.R.; Lancha, A.H.

2017-01-01

Protocols that mimic resistance exercise training (RET) in rodents present several limitations, one of them being the electrical stimulus, which is beyond the physiological context observed in humans. Recently, our group developed a conditioning system device that does not use electric shock to stimulate rats, but includes fasting periods before each RET session. The current study was designed to test whether cumulative fasting periods have some influence on skeletal muscle mass and function. Three sets of male Wistar rats were used in the current study. The first set of rats was submitted to a RET protocol without food restriction. However, rats were not able to perform exercise properly. The second and third sets were then randomly assigned into three experimental groups: 1) untrained control rats, 2) untrained rats submitted to fasting periods, and 3) rats submitted to RET including fasting periods before each RET session. While the second set of rats performed a short RET protocol (i.e., an adaptation protocol for 3 weeks), the third set of rats performed a longer RET protocol including overload (i.e., 8 weeks). After the short-term protocol, cumulative fasting periods promoted loss of weight (P<0.001). After the longer RET protocol, no difference was observed for body mass, extensor digitorum longus (EDL) morphology or skeletal muscle function (P>0.05 for all). Despite no effects on EDL mass, soleus muscle displayed significant atrophy in the fasting experimental groups (P<0.01). Altogether, these data indicate that fasting is a major limitation for RET in rats. PMID:29185588

Fasting: a major limitation for resistance exercise training effects in rodents.

PubMed

das Neves, W; de Oliveira, L F; da Silva, R P; Alves, C R R; Lancha, A H

2017-11-17

Protocols that mimic resistance exercise training (RET) in rodents present several limitations, one of them being the electrical stimulus, which is beyond the physiological context observed in humans. Recently, our group developed a conditioning system device that does not use electric shock to stimulate rats, but includes fasting periods before each RET session. The current study was designed to test whether cumulative fasting periods have some influence on skeletal muscle mass and function. Three sets of male Wistar rats were used in the current study. The first set of rats was submitted to a RET protocol without food restriction. However, rats were not able to perform exercise properly. The second and third sets were then randomly assigned into three experimental groups: 1) untrained control rats, 2) untrained rats submitted to fasting periods, and 3) rats submitted to RET including fasting periods before each RET session. While the second set of rats performed a short RET protocol (i.e., an adaptation protocol for 3 weeks), the third set of rats performed a longer RET protocol including overload (i.e., 8 weeks). After the short-term protocol, cumulative fasting periods promoted loss of weight (P<0.001). After the longer RET protocol, no difference was observed for body mass, extensor digitorum longus (EDL) morphology or skeletal muscle function (P>0.05 for all). Despite no effects on EDL mass, soleus muscle displayed significant atrophy in the fasting experimental groups (P<0.01). Altogether, these data indicate that fasting is a major limitation for RET in rats.

Effect of tendon vibration during wide-pulse neuromuscular electrical stimulation (NMES) on muscle force production in people with spinal cord injury (SCI).

PubMed

Bochkezanian, Vanesa; Newton, Robert U; Trajano, Gabriel S; Vieira, Amilton; Pulverenti, Timothy S; Blazevich, Anthony J

2018-02-13

Neuromuscular electrical stimulation (NMES) is commonly used in skeletal muscles in people with spinal cord injury (SCI) with the aim of increasing muscle recruitment and thus muscle force production. NMES has been conventionally used in clinical practice as functional electrical stimulation (FES), using low levels of evoked force that cannot optimally stimulate muscular strength and mass improvements, and thus trigger musculoskeletal changes in paralysed muscles. The use of high intensity intermittent NMES training using wide-pulse width and moderate-intensity as a strength training tool could be a promising method to increase muscle force production in people with SCI. However, this type of protocol has not been clinically adopted because it may generate rapid muscle fatigue and thus prevent the performance of repeated high-intensity muscular contractions in paralysed muscles. Moreover, superimposing patellar tendon vibration onto the wide-pulse width NMES has been shown to elicit further increases in impulse or, at least, reduce the rate of fatigue in repeated contractions in able-bodied populations, but there is a lack of evidence to support this argument in people with SCI. Nine people with SCI received two NMES protocols with and without superimposing patellar tendon vibration on different days (i.e. STIM and STIM+vib), which consisted of repeated 30 Hz trains of 58 wide-pulse width (1000 μs) symmetric biphasic pulses (0.033-s inter-pulse interval; 2 s stimulation train; 2-s inter-train interval) being delivered to the dominant quadriceps femoris. Starting torque was 20% of maximal doublet-twitch torque and stimulations continued until torque declined to 50% of the starting torque. Total knee extensor impulse was calculated as the primary outcome variable. Total knee extensor impulse increased in four subjects when patellar tendon vibration was imposed (59.2 ± 15.8%) but decreased in five subjects (- 31.3 ± 25.7%). However, there were no statistically significant differences between these sub-groups or between conditions when the data were pooled. Based on the present results there is insufficient evidence to conclude that patellar tendon vibration provides a clear benefit to muscle force production or delays muscle fatigue during wide-pulse width, moderate-intensity NMES in people with SCI. ACTRN12618000022268 . Date: 11/01/2018. Retrospectively registered.

Does Practice Make Perfect? Role of Training and Feedback in Improving Scientists' Presentation Skills

NASA Astrophysics Data System (ADS)

Tankersley, R. A.; Bourexis, P.; Kaser, J. S.

2011-12-01

Within the research and academic communities there is a growing interest in improving the communication skills of scientists, especially their ability to communicate the substance and importance of their research to general audiences. To address this need, we developed an intensive, two-day workshop [Presentation Boot Camp (PBC)] that focuses on presenting scientific concepts and research findings more effectively to both scientific/technical audiences and the general public. Through a series of interactive sessions, participants receive training in planning and preparing presentations that communicate messages more clearly and effectively and that have a lasting impact on the audience. Topics include: knowing and identifying the needs of the audience, highlighting big ideas and take-home messages, designing effective visuals, decoding complex concepts with diagrams, and displaying data in meaningful ways. PBC attendees also receive training in the use and application of the Presentation Skills Protocol (PSP) and associated rubric for evaluating the effectiveness of scientific presentations. The PSP was originally developed as part of a NSF Graduate Teaching Fellows in K-12 Education Program (GK-12) to assess and track the impact of the GK-12 experience on the communication skills of Graduate Teaching Fellows. The PSP focuses on eleven presentation skill sets, including organization, accuracy, relevance, message, language, equity, delivery, technology, use of time, questions, and presence. The associated rubric operationally defines each of the skill sets at three categorical levels of competence: (1) proficient, (2) developing, and (3) needs attention. The PSP may be used to (1) provide scientists with regular and consistent feedback on the quality and effectiveness of their classroom and research presentations and (2) design professional development activities and training programs that target specific presentation skills. However, our evaluation results indicate that use of the PSP alone does not guarantee communication growth or competence. To achieve significant gains in presentation skills, a three pronged approach is required: (1) formal training in best-practices and techniques for preparing and delivering presentations (e.g., Presentation Boot Camp), (2) frequent opportunities to practice and hone presentation skills (e.g., presentations at professional meetings, informal science centers, and K-12 classrooms), and (3) regular, individualized and structured feedback (e.g., Presentations Skill Protocol).

Acute intermittent hypoxia and rehabilitative training following cervical spinal injury alters neuronal hypoxia- and plasticity-associated protein expression.

PubMed

Hassan, Atiq; Arnold, Breanna M; Caine, Sally; Toosi, Behzad M; Verge, Valerie M K; Muir, Gillian D

2018-01-01

One of the most promising approaches to improve recovery after spinal cord injury (SCI) is the augmentation of spontaneously occurring plasticity in uninjured neural pathways. Acute intermittent hypoxia (AIH, brief exposures to reduced O2 levels alternating with normal O2 levels) initiates plasticity in respiratory systems and has been shown to improve recovery in respiratory and non-respiratory spinal systems after SCI in experimental animals and humans. Although the mechanism by which AIH elicits its effects after SCI are not well understood, AIH is known to alter protein expression in spinal neurons in uninjured animals. Here, we examine hypoxia- and plasticity-related protein expression using immunofluorescence in spinal neurons in SCI rats that were treated with AIH combined with motor training, a protocol which has been demonstrated to improve recovery of forelimb function in this lesion model. Specifically, we assessed protein expression in spinal neurons from animals with incomplete cervical SCI which were exposed to AIH treatment + motor training either for 1 or 7 days. AIH treatment consisted of 10 episodes of AIH: (5 min 11% O2: 5 min 21% O2) for 7 days beginning at 4 weeks post-SCI. Both 1 or 7 days of AIH treatment + motor training resulted in significantly increased expression of the transcription factor hypoxia-inducible factor-1α (HIF-1α) relative to normoxia-treated controls, in neurons both proximal (cervical) and remote (lumbar) to the SCI. All other markers examined were significantly elevated in the 7 day AIH + motor training group only, at both cervical and lumbar levels. These markers included vascular endothelial growth factor (VEGF), brain-derived neurotrophic factor (BDNF), and phosphorylated and nonphosphorylated forms of the BDNF receptor tropomyosin-related kinase B (TrkB). In summary, AIH induces plasticity at the cellular level after SCI by altering the expression of major plasticity- and hypoxia-related proteins at spinal regions proximal and remote to the SCI. These changes occur under the same AIH protocol which resulted in recovery of limb function in this animal model. Thus AIH, which induces plasticity in spinal circuitry, could also be an effective therapy to restore motor function after nervous system injury.

A Linguistic Feature Comparison of the Verbal Protocols of Good and Poor Readers on Standardized Measures of Reading Comprehension.

ERIC Educational Resources Information Center

Kavale, Kenneth A.

Sixteen sixth-grade students participated in a study of the reasoning strategies employed by good and poor readers. Students, trained in applying introspective procedures, completed instruments that measured verbal reasoning, determining cause and effect, reading for inference, and determining main idea. Protocols obtained during five consecutive…

Effect of an Incontinence Training Program on Nursing Home Staff's Knowledge, Attitudes, and Behavior.

ERIC Educational Resources Information Center

Campbell, Emily B; And Others

1991-01-01

Nursing staff (n=166) in four nursing homes participated in quasi-experimental study to measure knowledge and attitudes about urinary incontinence and compliance with toileting protocols. Intervention group (n=96) showed slight increase in knowledge; their attitudes remained positive over four testing times. Compliance with protocol was only 72…

Interactive computer simulations of knee-replacement surgery.

PubMed

Gunther, Stephen B; Soto, Gabriel E; Colman, William W

2002-07-01

Current surgical training programs in the United States are based on an apprenticeship model. This model is outdated because it does not provide conceptual scaffolding, promote collaborative learning, or offer constructive reinforcement. Our objective was to create a more useful approach by preparing students and residents for operative cases using interactive computer simulations of surgery. Total-knee-replacement surgery (TKR) is an ideal procedure to model on the computer because there is a systematic protocol for the procedure. Also, this protocol is difficult to learn by the apprenticeship model because of the multiple instruments that must be used in a specific order. We designed an interactive computer tutorial to teach medical students and residents how to perform knee-replacement surgery. We also aimed to reinforce the specific protocol of the operative procedure. Our final goal was to provide immediate, constructive feedback. We created a computer tutorial by generating three-dimensional wire-frame models of the surgical instruments. Next, we applied a surface to the wire-frame models using three-dimensional modeling. Finally, the three-dimensional models were animated to simulate the motions of an actual TKR. The tutorial is a step-by-step tutorial that teaches and tests the correct sequence of steps in a TKR. The student or resident must select the correct instruments in the correct order. The learner is encouraged to learn the stepwise surgical protocol through repetitive use of the computer simulation. Constructive feedback is acquired through a grading system, which rates the student's or resident's ability to perform the task in the correct order. The grading system also accounts for the time required to perform the simulated procedure. We evaluated the efficacy of this teaching technique by testing medical students who learned by the computer simulation and those who learned by reading the surgical protocol manual. Both groups then performed TKR on manufactured bone models using real instruments. Their technique was graded with the standard protocol. The students who learned on the computer simulation performed the task in a shorter time and with fewer errors than the control group. They were also more engaged in the learning process. Surgical training programs generally lack a consistent approach to preoperative education related to surgical procedures. This interactive computer tutorial has allowed us to make a quantum leap in medical student and resident teaching in our orthopedic department because the students actually participate in the entire process. Our technique provides a linear, sequential method of skill acquisition and direct feedback, which is ideally suited for learning stepwise surgical protocols. Since our initial evaluation has shown the efficacy of this program, we have implemented this teaching tool into our orthopedic curriculum. Our plans for future work with this simulator include modeling procedures involving other anatomic areas of interest, such as the hip and shoulder.

Therapist Training on Cognitive Behavior Therapy for Anxiety Disorders Using Internet-Based Technologies.

PubMed

Kobak, Kenneth A; Wolitzky-Taylor, Kate; Craske, Michelle G; Rose, Raphael D

2017-04-01

This study investigated a technology-enhanced training protocol to facilitate dissemination of therapist training on cognitive behavior therapy (CBT) for anxiety disorders. Seventy community clinicians received an online tutorial followed by live remote observation of clinical skills via videoconference. Impact of training on patient outcomes was also assessed. Training resulted in a significant increase in both trainee knowledge of CBT concepts and techniques and therapist competence in applying these skills. Patients treated by trainees following training had significant reductions in anxiety and depression. Ratings of user satisfaction were high. Results provide support for the use of these technologies for therapist training in CBT.

Therapist Training on Cognitive Behavior Therapy for Anxiety Disorders Using Internet-Based Technologies

PubMed Central

Kobak, Kenneth A.; Wolitzky-Taylor, Kate; Craske, Michelle G.; Rose, Raphael D.

2016-01-01

This study investigated a technology-enhanced training protocol to facilitate dissemination of therapist training on cognitive behavior therapy (CBT) for anxiety disorders. Seventy community clinicians received an online tutorial followed by live remote observation of clinical skills via videoconference. Impact of training on patient outcomes was also assessed. Training resulted in a significant increase in both trainee knowledge of CBT concepts and techniques and therapist competence in applying these skills. Patients treated by trainees following training had significant reductions in anxiety and depression. Ratings of user satisfaction were high. Results provide support for the use of these technologies for therapist training in CBT. PMID:28435174

The effects of whole-body vibration in isolation or combined with strength training in female athletes.

PubMed

Preatoni, Ezio; Colombo, Alessandro; Verga, Monica; Galvani, Christel; Faina, Marcello; Rodano, Renato; Preatoni, Ennio; Cardinale, Marco

2012-09-01

The aims of this study were to assess the behavior of a vibrating platform under different conditions and to compare the effects of an 8-week periodized training program with whole-body vibration (WBV) alone or in combination with conventional strength training (ST). Vibrating frequencies, displacements, and peak accelerations were tested through a piezoelectric accelerometer under different conditions of load and subjects' position. Eighteen national-level female athletes were assigned to 1 of 3 different groups performing WBV, conventional ST, or a combination of the 2 (WBV + ST). Isometric maximal voluntary contraction, dynamic maximal concentric force, and vertical jump tests were performed before and after the conditioning program. Vibrating displacements and maximum accelerations measured on the device were not always consistent with their expected values calculated from the display and manufacturers' information (sinusoidal waveforms). The WBV alone or in combination with low-intensity resistance exercise did not seem to induce significant enhancements in force and power when compared with ST. It appears that WBV cannot substitute parts of ST loading in a cohort of young female athletes. However, vibration effects might be limited by the behavior of the commercial platforms as the one used in the study. More studies are needed to analyze the performances of devices and the effectiveness of protocols.

Neuropsychological benefits of computer-assisted cognitive rehabilitation (using FORAMENRehab program) in children with mild traumatic brain injury or partial epilepsy: A pilot study.

PubMed

Kaldoja, Mari-Liis; Saard, Marianne; Lange, Kirsi; Raud, Triin; Teeveer, Ott-Kaarel; Kolk, Anneli

2015-01-01

The number of children with different cognitive difficulties is constantly increasing. Still, too few evidence-based pediatric neurocognitive rehabilitation programs exist. The main aim of the study was to assess the efficiency and usability of computer-assisted FORAMENRehab program for training specific components of attention in children with mild traumatic brain injury (mTBI) and partial epilepsy (PE). The second aim was to specify short- and long-term effects of the intervention. Eight children between the ages of 9-12 years with attention impairment (3 with PE and 5 with mTBI) and 18 healthy controls participated. FORAMENRehab Attention software, adapted by the authors, was used for intervention. Strict intervention protocol consisting of patients completing 10 sessions over a 6-week-period to train four components of attention (sustaining, focusing, dividing, tracking) was designed and applied. Follow-up assessments were conducted after the end of the last training and 1.63 years later. After the intervention patients' sustained and complex attention improved. Long-term follow-up revealed continuing positive rehabilitation effects. 100% compliance suggested that the used method is attractive for children. These preliminary results of the pilot study give reason to presume that the method is effective in attention impairment remediation. However, more thorough research is needed.

Evaluating intervention fidelity: an example from a high-intensity interval training study.

PubMed

Taylor, Kathryn L; Weston, Matthew; Batterham, Alan M

2015-01-01

Intervention fidelity refers to the degree to which an experimental manipulation has been implemented as intended, but simple, robust methods for quantifying fidelity have not been well documented. Therefore, we aim to illustrate a rigorous quantitative evaluation of intervention fidelity, using data collected during a high-intensity interval training intervention. Single-group measurement study. Seventeen adolescents (mean age ± standard deviation [SD] 14.0 ± 0.3 years) attended a 10-week high-intensity interval training intervention, comprising two exercise sessions per week. Sessions consisted of 4-7 45-s maximal effort repetitions, interspersed with 90-s rest. We collected heart rate data at 5-s intervals and recorded the peak heart rate for each repetition. The high-intensity exercise criterion was ≥ 90% of individual maximal heart rate. For each participant, we calculated the proportion of total exercise repetitions exceeding this threshold. A linear mixed model was applied to properly separate the variability in peak heart rate between- and within-subjects. Results are presented both as intention to treat (including missed sessions) and per protocol (only participants with 100% attendance; n=8). For intention to treat, the median (interquartile range) proportion of repetitions meeting the high-intensity criterion was 58% (42% to 68%). The mean peak heart rate was 85% of maximal, with a between-subject SD of 7.8 (95% confidence interval 5.4 to 11.3) percentage points and a within-subject SD of 15.1 (14.6 to 15.6) percentage points. For the per protocol analysis, the median proportion of high-intensity repetitions was 68% (47% to 86%). The mean peak heart rate was 91% of maximal, with between- and within-subject SDs of 3.1 (-1.3 to 4.6) and 3.4 (3.2 to 3.6) percentage points, respectively. Synthesising information on exercise session attendance and compliance (exercise intensity) quantifies the intervention dose and informs evaluations of treatment fidelity.

An Effective Oral Motor Intervention Protocol for Infants and Toddlers with Low Muscle Tone.

ERIC Educational Resources Information Center

Kumin, Libby; Von Hagel, Kimberly Chapman; Bahr, Diane Chapman

2001-01-01

Parents were trained to provide infants (n=4) with low muscle tone secondary to Down Syndrome with a home intervention oral motor training program. Four case studies indicate that all four children demonstrated improved oral motor function for eating, drinking, and speaking. (Contains references.) (DB)

Special Operations Forces Language and Culture Needs Assessment: Cultural Awarenes and Knowledge Training

DTIC Science & Technology

2010-11-01

hours. Training must incorporate language, culture, norms, customs, etiquette , religion, etc as to how not offend the local ethnicities.” SOF Leader...consensus. The frequency of occurrence for each theme is presented in this report. Analysis of the focus group data followed the same protocol , except

Adaptations to Speed Endurance Training in Highly Trained Soccer Players.

PubMed

Nyberg, Michael; Fiorenza, Matteo; Lund, Anders; Christensen, Magnus; Rømer, Tue; Piil, Peter; Hostrup, Morten; Christensen, Peter M; Holbek, Simon; Ravnholt, Thomas; Gunnarsson, Thomas P; Bangsbo, Jens

2016-07-01

The present study examined whether a period of additional speed endurance training would improve intense intermittent exercise performance in highly trained soccer players during the season and whether the training changed aerobic metabolism and the level of oxidative enzymes in type I and type II muscle fibers. During the last 9 wk of the season, 13 semiprofessional soccer players performed additional speed endurance training sessions consisting of two to three sets of 8-10 repetitions of 30-m sprints with 10 s of passive recovery (SET). Before and after SET, subjects completed a double-step exercise protocol that included transitions from standing to moderate-intensity running (~75% HRmax), followed by transitions from moderate- to high-intensity running (~90% HRmax) in which pulmonary oxygen uptake (V˙O2) was determined. In addition, the yo-yo intermittent recovery test level 1 was performed, and a muscle biopsy was obtained at rest. The yo-yo intermittent recovery test level 1 performance was 11.6% ± 6.4% (mean ± SD) better (2803 ± 330 vs 3127 ± 383 m, P < 0.05) after SET compared with before SET. In the transition from standing to moderate-intensity running, phase II pulmonary V˙O2 kinetics was 11.4% ± 16.5% faster (P < 0.05), and the running economy at this intensity was 2.3% ± 3.0% better (P < 0.05). These improvements were apparent despite the content of muscle proteins regulating oxidative metabolism (3-hydroxyacyl CoA dehydrogenase, COX IV, and OXPHOS), and capillarization was reduced (P < 0.05). The content of 3-hydroxyacyl CoA dehydrogenase and citrate synthase in type I and type II fibers did not change. In highly trained soccer players, additional speed endurance training is associated with an improved ability to perform repeated high-intensity work. To what extent the training-induced changes in V˙O2 kinetics and mechanical efficiency in type I fibers caused the improvement in performance warrants further investigation.

Comparison of greenhouse gas offset quantification protocols for nitrogen management in dryland wheat cropping systems in the Pacific Northwest

USDA-ARS?s Scientific Manuscript database

In the carbon market, greenhouse gas (GHG) offset protocols need to ensure that emission reductions are of high quality, quantifiable and real. However, lack of consistency across protocols for quantifying emission reductions compromise the credibility of offsets generated. Thus, protocol quantifica...

Time Synchronization Prototype, Server Upgrade Procedure Support and Remote Software Development

NASA Technical Reports Server (NTRS)

Sanders, Shania R.

2014-01-01

Networks are roadways of communication that connect devices. Like all roadways, there are rules and regulations that govern whatever (information in this case) travels along them. One type of rule that is commonly used is called a protocol. More specifically, a protocol is a standard that specifies how data should be transmitted over a network. The project outlined in this document seeks to implement one protocol in particular, Precision Time Protocol, within the Kennedy Ground Control Subsystem network at Kennedy Space Center. This document also summarizes work completed for server upgrades, remote software developer training and how all three assignments demonstrated the importance of accountability and security.

Effects of low-volume high-intensity interval training in a community setting: a pilot study.

PubMed

Reljic, Dejan; Wittmann, Felix; Fischer, Joachim E

2018-06-01

High-intensity interval training (HIIT) is emerging as an effective and time-efficient exercise strategy for health promotion. However, most HIIT studies are conducted in laboratory settings and evidence regarding the efficacy of time-efficient "low-volume" HIIT is based mainly on demanding "all-out" protocols. Thus, the aim of this pilot study was to assess the feasibility and efficacy of two low-volume (≤ 30 min time-effort/week), non-all-out HIIT protocols, performed 2 ×/week over 8 weeks in a community-based fitness centre. Thirty-four sedentary men and women were randomised to either 2 × 4-min HIIT (2 × 4-HIIT) or 5 × 1-min HIIT (5 × 1-HIIT) at 85-95% maximal heart rate (HR max ), or an active control group performing moderate-intensity continuous training (MICT, 76 min/week) at 65-75% HR max . The exercise protocols were well tolerated and no adverse events occurred. 2 × 4-HIIT and 5 × 1-HIIT exhibited lower dropout rates (17 and 8 vs. 30%) than MICT. All training modes improved VO 2max (2 × 4-HIIT: + 20%, P < 0.01; 5 × 1-HIIT: + 27%, P < 0.001; MICT: + 16%, P < 0.05), but the HIIT protocols required 60% less time commitment. Both HIIT protocols and MICT had positive impact on cholesterol profiles. Only 5 × 1-HIIT significantly improved waist circumference (P < 0.05) and subjective work ability (P < 0.05). The present study indicates that low-volume HIIT can be feasibly implemented in a community-based setting. Moreover, our data suggest that practical (non-all-out) HIIT that requires as little as 30 min/week, either performed as 2 × 4-HIIT or 5 × 1-HIIT, may induce significant improvements in VO 2max and cardiometabolic risk markers.

A competency framework for colonoscopy training derived from cognitive task analysis techniques and expert review.

PubMed

Zupanc, Christine M; Burgess-Limerick, Robin; Hill, Andrew; Riek, Stephan; Wallis, Guy M; Plooy, Annaliese M; Horswill, Mark S; Watson, Marcus O; Hewett, David G

2015-12-01

Colonoscopy is a difficult cognitive-perceptual-motor task. Designing an appropriate instructional program for such a task requires an understanding of the knowledge, skills and attitudes underpinning the competency required to perform the task. Cognitive task analysis techniques provide an empirical means of deriving this information. Video recording and a think-aloud protocol were conducted while 20 experienced endoscopists performed colonoscopy procedures. "Cued-recall" interviews were also carried out post-procedure with nine of the endoscopists. Analysis of the resulting transcripts employed the constant comparative coding method within a grounded theory framework. The resulting draft competency framework was modified after review during semi-structured interviews conducted with six expert endoscopists. The proposed colonoscopy competency framework consists of twenty-seven skill, knowledge and attitude components, grouped into six categories (clinical knowledge; colonoscope handling; situation awareness; heuristics and strategies; clinical reasoning; and intra- and inter-personal). The colonoscopy competency framework provides a principled basis for the design of a training program, and for the design of formative assessment to gauge progress towards attaining the knowledge, skills and attitudes underpinning the achievement of colonoscopy competence.

Joint power generation differentiates young and adult sprinters during the transition from block start into acceleration: a cross-sectional study.

PubMed

Debaere, Sofie; Vanwanseele, Benedicte; Delecluse, Christophe; Aerenhouts, Dirk; Hagman, Friso; Jonkers, Ilse

2017-11-01

The aim of this study was to investigate differences in joint power generation between well-trained adult athletes and young sprinters from block clearance to initial contact of second stance. Eleven under 16 (U16) and 18 under 18 (U18) promising sprinters executed an explosive start action. Fourteen well-trained adult sprinters completed the exact same protocol. All athletes were equipped with 74 spherical reflective markers, while an opto-electronic motion analysis system consisting of 12 infrared cameras (250 Hz, MX3, Vicon, Oxford Metrics, UK) and 2 Kistler force plates (1,000 Hz) was used to collect the three-dimensional marker trajectories and ground reaction forces (Nexus, Vicon). Three-dimensional kinematics, kinetics, and power were calculated (Opensim) and time normalised from the first action after gunshot until initial contact of second stance after block clearance. This study showed that adult athletes rely on higher knee power generation during the first stance to induce longer step length and therefore higher velocity. In younger athletes, power generation of hip was more dominant.

[Passive tactile stimulation and its clinical and neurophysiological repercussions (P300) in blind children with symptoms of attention deficit disorder].

PubMed

Serrano-Marugán, Isabel; Herrera, Begoña; Romero, Sara; Nogales, Ramón; Poch-Broto, Joaquín; Quintero, Javier; Ortiz, Tomás

2014-02-24

Tactile stimulation is key for the posterior brain re-organization activity and attention processes, however the impact of tactile stimulation on attention deficit disorder (ADD) in blind children remains unexplored. We carried out a study with children having or not ADD (four per group). The subjects have been exposed during six months to tactile stimulation protocol consisting in two daily sessions (morning and afternoon sessions) of 30 minutes each. We have measured the ability to detect an infrequent tactile stimulus, reaction time, latency of P300, sources of brain activity, and ADD clinical symptoms, before and after tactile training. Passive tactile stimulation significantly improves ADD clinical symptoms, particularly attention, behavior and self-control of involuntary movements and tics. In addition, tactile stimulation changes the pattern of brain activity in ADD blind children inducing activity in frontal and occipital areas, which could be associated to a compensation of the attention deficit. Passive tactile stimulation training may improve ADD clinical symptoms and can reorganize the pattern of brain activity in blind ADD children.

Motor imagery: lessons learned in movement science might be applicable for spaceflight

PubMed Central

Bock, Otmar; Schott, Nadja; Papaxanthis, Charalambos

2015-01-01

Before participating in a space mission, astronauts undergo parabolic-flight and underwater training to facilitate their subsequent adaptation to weightlessness. Unfortunately, similar training methods can’t be used to prepare re-adaptation to planetary gravity. Here, we propose a quick, simple and inexpensive approach that could be used to prepare astronauts both for the absence and for the renewed presence of gravity. This approach is based on motor imagery (MI), a process in which actions are produced in working memory without any overt output. Training protocols based on MI have repeatedly been shown to modify brain circuitry and to improve motor performance in healthy young adults, healthy seniors and stroke victims, and are routinely used to optimize performance of elite athletes. We propose to use similar protocols preflight, to prepare for weightlessness, and late inflight, to prepare for landing. PMID:26042004

The effects of training by virtual reality or gym ball on pelvic floor muscle strength in postmenopausal women: a randomized controlled trial.

PubMed

Martinho, Natalia M; Silva, Valéria R; Marques, Joseane; Carvalho, Leonardo C; Iunes, Denise H; Botelho, Simone

2016-03-22

To evaluate the effectiveness of abdominopelvic training by virtual reality compared to pelvic floor muscle training (PFMT) using a gym ball (a previously tested and efficient protocol) on postmenopausal women's pelvic floor muscle (PFM) strength. A randomized controlled trial was conducted with 60 postmenopausal women, randomly allocated into two groups: Abdominopelvic training by virtual reality - APT_VR (n=30) and PFMT using a gym ball - PFMT_GB (n=30). Both types of training were supervised by the same physical therapist, during 10 sessions each, for 30 minutes. The participants' PFM strength was evaluated by digital palpation and vaginal dynamometry, considering three different parameters: maximum strength, average strength and endurance. An intention-to-treat approach was used to analyze the participants according to original groups. No significant between-group differences were observed in most analyzed parameters. The outcome endurance was higher in the APT_VR group (p=0.003; effect size=0.89; mean difference=1.37; 95% CI=0.46 to 2.28). Both protocols have improved the overall PFM strength, suggesting that both are equally beneficial and can be used in clinical practice. Muscle endurance was higher in patients who trained using virtual reality.

The effects of training by virtual reality or gym ball on pelvic floor muscle strength in postmenopausal women: a randomized controlled trial

PubMed Central

Martinho, Natalia M.; Silva, Valéria R.; Marques, Joseane; Carvalho, Leonardo C.; Iunes, Denise H.; Botelho, Simone

2016-01-01

ABSTRACT Objective To evaluate the effectiveness of abdominopelvic training by virtual reality compared to pelvic floor muscle training (PFMT) using a gym ball (a previously tested and efficient protocol) on postmenopausal women’s pelvic floor muscle (PFM) strength. Method A randomized controlled trial was conducted with 60 postmenopausal women, randomly allocated into two groups: Abdominopelvic training by virtual reality – APT_VR (n=30) and PFMT using a gym ball – PFMT_GB (n=30). Both types of training were supervised by the same physical therapist, during 10 sessions each, for 30 minutes. The participants’ PFM strength was evaluated by digital palpation and vaginal dynamometry, considering three different parameters: maximum strength, average strength and endurance. An intention-to-treat approach was used to analyze the participants according to original groups. Results No significant between-group differences were observed in most analyzed parameters. The outcome endurance was higher in the APT_VR group (p=0.003; effect size=0.89; mean difference=1.37; 95% CI=0.46 to 2.28). Conclusion Both protocols have improved the overall PFM strength, suggesting that both are equally beneficial and can be used in clinical practice. Muscle endurance was higher in patients who trained using virtual reality. PMID:27437716

The effects of respiratory muscle training on peak cough flow in patients with Parkinson's disease: a randomized controlled study.

PubMed

Reyes, Alvaro; Castillo, Adrián; Castillo, Javiera; Cornejo, Isabel

2018-05-01

To compare the effects of an inspiratory versus and expiratory muscle-training program on voluntary and reflex peak cough flow in patients with Parkinson disease. A randomized controlled study. Home-based training program. In all, 40 participants with diagnosis of Parkinson's disease were initially recruited in the study and randomly allocated to three study groups. Of them, 31 participants completed the study protocol (control group, n = 10; inspiratory training group, n = 11; and expiratory training group, n = 10) Intervention: The inspiratory and expiratory group performed a home-based inspiratory and expiratory muscle-training program, respectively (five sets of five repetitions). Both groups trained six times a week for two months using a progressively increased resistance. The control group performed expiratory muscle training using the same protocol and a fixed resistance. Spirometric indices, maximum inspiratory pressure, maximum expiratory pressure, and peak cough flow during voluntary and reflex cough were assessed before and at two months after training. The magnitude of increase in maximum expiratory pressure ( d = 1.40) and voluntary peak cough flow ( d = 0.89) was greater for the expiratory muscle-training group in comparison to the control group. Reflex peak cough flow had a moderate effect ( d = 0.27) in the expiratory group in comparison to the control group. Slow vital capacity ( d = 0.13) and forced vital capacity ( d = 0.02) had trivial effects in the expiratory versus the control group. Two months of expiratory muscle-training program was more beneficial than inspiratory muscle-training program for improving maximum expiratory pressure and voluntary peak cough flow in patients with Parkinson's disease.

[Systematic review about eccentric training in chronic achilles tendinopathy].

PubMed

Krämer, R; Lorenzen, J; Vogt, P M; Knobloch, K

2010-12-01

Throughout the recent decade, eccentric training has become a widely accepted therapy option in the conservative treatment of chronic Achilles tendinopathy. Nevertheless, current recommendations are missing regarding dosage and duration of eccentric training as well as standardized training protocols. Is eccentric training as a conservative treatment in chronic Achilles tendinopathy of beneficial effect versus other conservative treatments? According to the current scientific data, is it possible to recommend dosages and duration of training time of eccentric training? Systematic review of the current scientific literature on eccentric training as a conservative treatment in chronic Achilles tendinopathy according to the PRISMA-guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). National library of Medicine (NLM) between the years 1950 and 2010. Prospective randomised controlled trials (RCT). 8 RCTs included 416 subjects with a median number of 42 subjects and a range of 17 to 116 subjects per trial. Median follow-up duration was 12 weeks with a range from 12 to 54 weeks. 124 papers met the eligibility criteria in the NLM, whereas only eight randomised controlled trials were included in this review after screening titles, abstracts and full texts. All included trials demonstrated an improvement in pain after performing equivalent training protocols of eccentric training in chronic Achilles tendinopathy. A pooled statistical evaluation of the included trials could not be performed due to different study designs as well as limited documentation of subjects' compliance. In spite of different compliance, effects of eccentric training in conservative treatment of chronic mid-portion-Achilles tendinopathy are promising. Because of the heterogeneous outcome variables (ordinal scale, VAS, FAOS, AOFAS, VISA-A) and the methodological limitations of the trials, no definite recommendation can be published concerning dosage and duration of eccentric training in chronic Achilles tendinopathy. © Georg Thieme Verlag KG Stuttgart · New York.