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A mail survey was used to document the surgical methods for repair of cleft lip and palate being taught in Plastic Surgery Training Programs. The survey was completed by Senior Residents representing over 80% of the training programs in the United States. The results demonstrate that variation exists regarding methods and techniques for cleft lip and palate surgery.
The purpose of this study was to determine the effects of a resistive training program on the time course of changes in strength, body mass index, lipids, lipoproteins, and apolipoproteins in sedentary obese women. Sixteen sedentary obese women strength trained 3 times . wk-1 for 12 wk performing three sets of six to eight repetitions per set with sets 1 and 2 at 60-70% of one-repetition maximum. During set 3, the subjects used the greatest weight possible so that failure occurred between six to eight repetitions. Six sedentary obese women served as controls. Blood samples for serum total cholesterol (TC), high-density lipoproteins (HDL-C), low-density lipoproteins (LDL-C), triglycerides (TG), TC/HDL-C ratio, apolipoprotein A-I (apo A-I), and apolipoprotein B-100 (apo B-100) were obtained pre, and after 4, 8, and 12 wk of training and approximately 3-4 d following the last training session. A 3-d dietary record was obtained on all subjects pre and post, and subjects were instructed not to alter their diet. The 12 wk of resistive training did not result in a significant change in body weight, BMI, or total kilocalories consumed per day but did show a mean improvement of 58% in muscular strength (P less than 0.05). The training program did not significantly alter the TC, HDL-C, LDL-C, TG, TC/HDL-C ratio, apo A-I, or apo B-100 levels, which suggests that this increase in strength owing to resistive training in the absence of body weight loss did not alter the lipid profiles in these sedentary obese women.
A comparison of the cardiorespiratory responses obtained using both a longitudinal and cross-sectional evaluation of an endurance training program was made in two groups of 60 young male military personnel. Both groups were initially tested (T1) and then retested 6 months later (T2). At T1, Group I was a sample of personnel not participating in a training program while Group II had undergone a 5-month endurance program (2-4 mile run/day). At T2, Groups I and II had been participating in the program for 6 and 11 months, respectively. Testing consisted of sub-maximal and maximal determinations of VO2, VE and heart rate (HR) using an interrupted treadmill test. VO2 max was 11% greater in Group II compared to Group I at T1 and increased 10% in Group I at T2. Similar results were also seen for HR submax, HR max and VE max. These results show that similar values indicative of an improved level of cardiorespiratory fitness can be obtained using either a cross-sectional or longitudinal design when relatively homogeneous groups are studied.
Properly trained and interested volunteers can perform basic nursing skills in a clinical setting. Staff development educators should 1) assess the needs of the area; 2) assess the skills of the volunteers available to them; 3) construct goals and objectives for a thorough orientation program geared to people with nonmedical backgrounds; 4) select appropriate course content and methods of presentation based on the framework provided by the goals and objectives and on the regulations governing the institution in which the volunteer will work; 5) implement the course; and 6) evaluate the adequacy and thoroughness of the program and the competency of the volunteers trained. The potential service that qualified and adequately trained volunteers could offer in patient care areas that are understaffed in nursing personnel is great. Similar programs can be used to supply needed assistance in facilities with limited nursing personnel.
During a 3-year period, 2650 cases of diagnostic laparoscopy were performed on selected infertility patients in a training program on gynecologic laparoscopy at hospitals in Egypt, the Sudan and Saudi Arabia. All cases were attended by the senior author. Most of the procedures were performed by physicians who either had never performed the procedure or had not had significant experience with it. This report presents the laparoscopic findings, complications and problems encountered. It shows that with emphasis on equipment care and handling, careful patient selection and observation of simple precautions during and after the operation, the procedure can be safely included in the training program of residents in obstetrics and gynecology.
Through support from the California State Department of Health Services, San Diego State University continued a statewide program in family life education, which consisted of: 1) establishment of a statewide advisory committee representative of many diverse points of view; 2) performance of a study of the teaching of family life education in the ninth and 10th grades of public schools in the state, as well as an examination of the present status of training of teachers; 3) provision of consultation and training programs for local school districts, including community support and implementation training, program development consultation teacher training and a limited number of small block grants to improve local family life education program efforts; and 4) preservice education classes to be conducted at teacher preparation campuses in the California State University system. The paper describes some of the findings of the study of the ninth and 10th grades, as well as the details of methodology of all four components of the statewide program.
Twenty-six healthy, untrained females were studied to determine the effects of a low-intensity Nautilus circuit training program on resting systolic and diastolic blood pressure. Thirteen subjects who were in good health with no personal history or family history of cardiovascular disease participated in a six-week training program on the Nautilus circuit (14 exercises) and trained at 30% of maximum. Measurements in blood pressure were made before, during (three times per week) and after the study. Another group of 13 females served as controls. An attempt was made to determine if strength increase (due to circuit training) would have an affect on reducing resting systolic and diastolic blood pressure. The following changes occurred in the treatment group: (1) resting systolic blood pressure dropped significantly (from 113 to 99 mmHg) after training and (2) diastolic blood pressure dropped significantly from (70.9 to 62.0 mmHg) after training. However, there were no differences in these decreases between the exercise and control groups. The investigators concluded that low-intensity, resistive training should not increase blood pressure in white, healthy females, ages 18 to 28 years.
As a response to the growing recognition of the need for improvement in medical instructional practices, a training program on teaching skills for resident physicians in the East Tennessee State University College of Medicine was implemented. The program consisted of 13 weekly, one-hour, small-group sessions attended by 20 residents. The microteaching method was utilized for practicing instructional techniques. Significant gains in teaching performance and in attitude toward participating in a teaching skills program were demonstrated, on the basis of videotaped teaching performances and a written questionnaire, indicating that short training programs can assist physicians in the process of instructional improvement.
In it's worker health and safety training program, the California-Arizona Consortium aims to promote worker action to improve health and safety conditions. To assess action on worker-identified health and safety problems, 278 trainees were interviewed 3-8 months after training. Associations with three outcomes were analyzed: (1) attempted action, (2) problem correction, and (3) trainee participation. Perceived management support was associated with all three outcomes, pointing to its key role in maximizing the impact of training. Odds of attempted action were 2-5 times greater with support than without. Trainees for whom English was not the primary language (mostly Spanish speakers) attempted action as often as English speakers. However, the odds of their correcting problems were half that of the English-speaking workers. It is suggested this was due to a perceived lack of control over organizational resources for change, not simply due to communication barriers.
The cardiac dimensions of male long-distance runners (LDR) and cycle racers (CR) were determined echocardiographically during four different training seasons, i.e., a preparation, a competitive, a slowing-down and a resting season, and were compared with those of control subjects (CS). Left ventricular hypertrophy (LVH) was also assessed from the electrocardiogram. The maximal aerobic performance was determined on a bicycle ergometer. In the athletes, left ventricular mass was significantly greater in all seasons than the values in the CS. This difference resulted from a thicker interventricular septum and left ventricular posterior wall as well as a larger left ventricular internal diameter. The existence of LVH was confirmed by the electrocardiographic findings. No differences were observed between the four different training seasons, despite considerable changes in the training program for weeks to months. The maximal aerobic performance test in LDR showed a significantly higher workload during the competitive than during the preparation season. The CR reached significantly lower values during the resting season than during the other seasons. The results indicate that the possible adaptation of the cardiac dimensions to variations in the heaviness of the training program is relatively slow.
A family-therapy training program, one of three main branches of the "Boston model," is described in detail. Salient features of the program include planned integration of a multiplicity of experiential and cognitive learning modes; grounding in a unified, theoretical framework that is neither eclectic nor limited to a single school of thought; focus on nonpathological process in families; and systematic structuring in terms of specific, articulated, training objectives. The goal-directed design process by which training units are developed is explained.
The present investigation utilized a social skills training program to eliminate physically aggressive behavior in a group of six institutionalized elderly patients. The treatment package consisted of instructions, modeling, role playing and feedback. Dependent measures included confirmed incidents of physically aggressive behavior monitored across an ABAB design with a 5-month follow-up period. Results indicated that physically aggressive behavior can be significantly decreased in a group training setting and subsequently generalized to ward and other socialized behavior. Ancillary aspects of the study include the differential properties associated with physical and verbal aggression, the role of vicarious reinforcement on behavior, and generalization effects.
A questionnaire was sent to all pediatric training programs to evaluate the use of pulmonary function reference standards and the interpretation of pulmonary function test results. Responses were obtained from 107 of 130 institutions, and 94 of these had pulmonary function laboratories available. Of the 94, 60 used one of three reference standards. The primary reason the reference standards were chosen was either unknown or because they came with the spirometer (24), were recommended by another person or were those used in that person's training (34), or were thought to be the best standards available or most applicable to the population to be tested (31). To define abnormality, most used an 80% predicted cutoff for forced vital capacity, forced expiratory volume in 1 second, and forced expiratory flow at 25% to 75% vital capacity. For a change in an individual through time, most used a 10% change for forced vital capacity, forced expiratory volume in 1 second, and forced expiratory flow at 25% to 75% vital capacity. Thirteen used statistical methods to define abnormal individuals and none used statistical methods to define a significant change over time. Although there are a few guidelines for reference standards and interpretations of pulmonary function tests, it appears that most laboratories are not using those guidelines and that further guidelines and education are needed.
There are few specialized programs available to train occupational therapists and physical therapists to treat competently in a neonatal intensive care unit (NICU), yet hospitals are trying to fill such positions, and the need for advanced training is essential. A hospital-based program that provides clinical NICU training to therapists from other hospitals is presented. The program is short-term and highly individualized and emphasizes learning pertinent medical information, nonintrusive evaluation skills, and therapeutic intervention with advanced clinical judgment.
The purpose of this study was to examine the effect of an 18-wk weight-training program on average daily metabolic rate (ADMR). Before the intervention and in weeks 8 and 18 (T0, T8, and T18, respectively) data on body composition, sleeping metabolic rate (SMR), food intake, energy cost of the weight-training program (EEex), and nontraining physical activity (accelerometer) were collected in the exercise group (EXER, n = 18 males). ADMR was determined in a subgroup (EX12, n = 12) by using doubly labeled water. At T0 and T18, data (except ADMR) were also collected in a control group (Con, n = 8). Body mass did not change in EXER or Con. Fat-free mass increased only in EXER with 2.1 +/- 1.2 kg, whereas fat mass decreased in EXER as well as Con (2.0 +/- 1.8 and 1.4 +/- 1.0 kg, respectively). Initial ADMR (12.4 +/- 1.2 MJ/day) increased at T8 (13.5 +/- 1.3 MJ/day, P < 0.001) with no further increase at T18 (13.5 +/- 1.9 MJ/day). SMR did not change in EXER (4.8 +/- 0.5, 4.9 +/- 0.5, 4.8 +/- 0.5 kJ/min) or Con (4.7 +/- 0.4, 4.8 +/- 0.4 kJ/min). Energy intake did not change in EXER (10.1 +/- 1.8, 9.7 +/- 1.8, 9.2 +/- 1.9 MJ/day) or Con (10.2 +/- 2.6, 9.4 +/- 1.8, 10.1 +/- 1.5 MJ/day) and was systematically underreported in EX12 (-21 +/- 14, -28 +/- 18, -34 +/- 14%, P < 0.001). EEex (0.47 +/- 0.20, 0.50 +/- 0.18 MJ/day) could only explain 40% of the increase in ADMR. Nontraining physical activity did not change in both groups. In conclusion, although of modest energy cost, weight-training induces a significant increase in ADMR.
The ability of physician extenders to provide patient care in a variety of settings has been reported widely. Less attention has been paid to training programs, especially those of short duration, for physician extenders. A three-month training program for physician extenders at a large teaching hospital was based on teaching the skills needed to run 39 clinical algorithms. The course content and the methods used to test the students during the three months may prove of value to those preparing similar programs.
The cardiac dimensions of long-distance runners (LDR), cycle racers (CR), and weight lifters (WL) were determined echocardiographically and were compared with those of control subjects (CS). Left ventricular hypertrophy (LVH) was also assessed from the electrocardiogram. Training information was obtained through a questionnaire. The maximal aerobic performance was assessed on a cycle ergometer. Comparison of the cardiac dimensions revealed that left ventricular mass (LVmass) was significantly increased in LDR and CR as compared to CS. This resulted from thickening of the interventricular septum and left ventricular posterior wall as well as from enlargement of the left ventricular internal diameter. The existence of LVH was confirmed by electrocardiographic investigation. Although the left ventricular wall was enlarged in WL, their LVmass was not significantly increased as compared with CS. These results are in agreement with the training program followed. Weight lifters almost exclusively performed strength training, while LDR and CR were mainly involved in endurance training. The LDR and CR reached significantly higher maximal aerobic performance levels than WL. The present results suggest a close relationship between the type of cardiac enlargement and the training program followed by the athletes.
This study evaluated the effects of a new oral hygiene training program on approximal caries in a population of 12-13-year-old Brazilian schoolchildren with a well-established habit of daily toothbrushing with a F dentifrice. Two hundred twenty-two children were randomly allocated into two test groups (I and II) and one control group (III). Group I subjects were trained to establish needs-related oral hygiene habits based on self-diagnosis and a new behavioral principle, the 'linking method', for establishment of habits. The first three visits (20 minutes each) were scheduled at two-day intervals. They were recalled for a monthly check-up during the first 4 months, and then every 3 months for reevaluation of the results based on self-diagnosis. Group II subjects were recalled at the same intervals for detailed oral hygiene instruction on how to clean every tooth surface using dental tape, toothbrush, and fluoride dentifrice. Group I developed significantly fewer (p < 0.001) new approximal manifest (dentin) caries lesions than groups II and III. The mean values (SEM) were 2.3 (0.29), 4.7 (0.59), and 5.3 (0.68), respectively. The conclusions from our study are: In a toothbrushing population using fluoride dentifrices and fluoridated drinking water, the oral hygiene training program with behavioral modification significantly reduced caries incidence on approximal surfaces. Frequent repetition of training in meticulous oral hygiene is almost redundant.