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PubMedDate not supplied

Sexuality training for psychiatry residents: a national survey of training directors.

The current status of training in human sexuality is relevant to all health care professionals. The purpose of the current study was to determine the extent of sexuality training offered in psychiatric residency programs. The training directors of psychiatry residencies were surveyed with regard to the number of expert faculty in sexuality training as well as resident exposure to seven related curricular areas. Of the 69 respondents, the majority reported expert faculty in sexual dysfunctions, sex therapy, therapy with gay/lesbian patients, and HIV/AIDS. For each sexuality topic, approximately 80% of programs reported curricula offerings through either didactics or clinical rotations. For didactics, most topics were presented in the context of a broader course. With the exception of HIV/AIDS, it was rare for programs to offer a clinical rotation involving sexuality issues. In conclusion, the majority of training programs in psychiatry provide curriculum offerings in sexuality training, primarily through didactic education. Results are discussed with regard to comparison to training in professional psychology and the need for assessment of sexuality training in health care professions generally.

Curriculum↗

PubMed1983

Effect of pairing scanning training with block design training in the remediation of perceptual problems in left hemiplegics.

Twenty-seven left hemiplegics were divided into three groups of nine, matched for age, education, degree of left neglect, and time since onset of stroke. Subjects were pretested and, following the training, posttested on the WAIS Performance subtests, the WRAT Reading subtest, a letter cancellation task, an address-copying task, and a face-counting task. Subjects received 1 hour of occupational therapy (OT) each day for 20 successive days as follows: Group I received 1 hour of routine OT; Group II received 20 minutes of routine OT, 20 minutes of cancellation training, and 20 minutes of visual scanning training; Group III received 20 minutes of block design training, 20 minutes of cancellation training, and 20 minutes of visual scanning training. Groups II and III improved on measures of visual scanning, reading, and writing to a significantly greater extent than did Group I, and Group III improved to a significantly greater extent than did Group II. Few differences among the groups were seen on measures of psychometric intelligence and face counting. The results, for the most part, supported previous findings and, furthermore, indicated that block design training enhances the effect of visual scanning training techniques in the remediation of perceptual problems in left hemiplegics.

Aged↗

PubMed2002

Effects of inspiratory muscle training on time-trial performance in trained cyclists.

We evaluated the effects of specific inspiratory muscle training on simulated time-trial performance in trained cyclists. Using a double-blind, placebo-controlled design, 16 male cyclists (VO2max = 64 +/- 2 ml x kg(-1) x min(-1); mean +/- s(x)) were assigned at random to either an experimental (pressure-threshold inspiratory muscle training) or sham-training control (placebo) group. Pulmonary function, maximum dynamic inspiratory muscle function and the physiological and perceptual responses to maximal incremental cycling were assessed. Simulated time-trial performance (20 and 40 km) was quantified as the time to complete pre-set amounts of work. Pulmonary function was unchanged after the intervention, but dynamic inspiratory muscle function improved in the inspiratory muscle training group (P < or = 0.05). After the intervention, the inspiratory muscle training group experienced a reduction in the perception of respiratory and peripheral effort (Borg CR10: 16 +/- 4% and 18 +/- 4% respectively; compared with placebo, P < or = 0.01) and completed the simulated 20 and 40 km time-trials faster than the placebo group [66 +/- 30 and 115 +/- 38 s (3.8 +/- 1.7% and 4.6 +/- 1.9%) faster respectively; P = 0.025 and 0.009]. These results support evidence that specific inspiratory muscle training attenuates the perceptual response to maximal incremental exercise. Furthermore, they provide evidence of performance enhancements in competitive cyclists after inspiratory muscle training.

Adult↗

PubMed2006

Whole-body vibration training compared with resistance training: effect on spasticity, muscle strength and motor performance in adults with cerebral palsy.

OBJECTIVE: The aim of this study was to evaluate the effect on spasticity, muscle strength and motor performance after 8 weeks of whole-body vibration training compared with resistance training in adults with cerebral palsy. METHODS: Fourteen persons with spastic diplegia (21-41 years) were randomized to intervention with either whole-body vibration training (n=7) or resistance training (n=7). Pre- and post-training measures of spasticity using the modified Ashworth scale, muscle strength using isokinetic dynamometry, walking ability using Six-Minute Walk Test, balance using Timed Up and Go test and gross motor performance using Gross Motor Function Measure were performed. RESULTS: Spasticity decreased in knee extensors in the whole-body vibration group. Muscle strength increased in the resistance training group at the velocity 30 degrees /s and in both groups at 90 degrees /s. Six-Minute Walk Test and Timed Up and Go test did not change significantly. Gross Motor Function Measure increased in the whole-body vibration group. CONCLUSION: These data suggest that an 8-week intervention of whole-body vibration training or resistance training can increase muscle strength, without negative effect on spasticity, in adults with cerebral palsy.

Adult↗

PubMed2002

Aerobic training in the 'oldest old': the effect of 24 weeks of training.

OBJECTIVE: to determine the effects of aerobic training on the maximal aerobic power of healthy, very elderly people. DESIGN: a 12-week control period followed by 24 weeks of progressive, weight bearing, aerobic training. SUBJECTS: 26 men and women aged 79 to 91 years conforming to pre-determined health criteria. METHODS: we took measurements before and after a 12 week control period and following 24 weeks of training. These were maximal aerobic power (VO(2)max), heart rate at an oxygen consumption of 10 ml x kg(-1) x min(-1) (HR at VO(2)10), resting heart rate, isometric knee extensor strength, isometric elbow flexor strength and lower limb extensor power. MAIN RESULTS: pre-control values of VO(2)max for the women and men were 14.1 (SD 2.79) and 22.0 (5.12) ml.kg(-1).min(-1) respectively. There was no significant change in the VO(2)max of either group over the control period. After training, there was a 15% increase in the VO(2)max of the women (P<0.01) but no change was observed in the men. In the women, there was no significant change in HR at VO(2)10 over the control period but a 14% decrease (P<0.01) after training. In the men there was a 7% (P<0.05) increase in HR at VO(2)10 over the control period and a 5% (P<0.05) decrease after training. No effect of training was seen on isometric knee extensor strength, isometric elbow flexor strength or lower limb extensor power of either group. CONCLUSION: progressive aerobic training can increase the maximal aerobic power of very elderly women. A 15% increase in VO(2)max may prevent many elderly women from crossing functionally important thresholds, thereby helping to maintain independence.

Aged↗

PubMed2005

Generalization to atypical antipsychotic drugs depends on training dose in rats trained to discriminate 1.25 mg/kg clozapine versus 5.0 mg/kg clozapine versus vehicle in a three-choice drug discrimination task.

The prototypical atypical antipsychotic drug (APD) clozapine (CLZ) elicits a discriminative cue that appears to be similar to the stimulus properties elicited by atypical, but not typical, antipsychotic drugs in two-choice drug discrimination procedures. However, the ability of CLZ to generalize to atypical APDs depends on the training dose, since several atypical APDs (e.g. sertindole, risperidone) do not substitute for a 5.0 mg/kg CLZ training dose in rats, but do so for a 1.25 mg/kg CLZ training dose. Yet, a 1.25 mg/kg CLZ discriminative stimulus has not generalized to all atypical APDs either (e.g. quetiapine); thus, both 1.25 mg/kg and 5.0 mg/kg CLZ discriminative stimuli may be necessary to provide a better screen for atypical APDs. The present study sought to determine whether a three-choice 1.25 mg/kg CLZ versus 5.0 mg/kg CLZ versus vehicle drug discrimination task in rats might better distinguish atypical from typical APDs. Adult male Sprague-Dawley rats were trained in this three-choice drug discrimination task with a fixed ratio 30 reinforcement schedule for food. Clozapine produced full substitution (>or=80% condition-appropriate responding) for both the 1.25 mg/kg CLZ dose (ED50=0.09 mg/kg) and the 5.0 mg/kg CLZ dose (ED50=2.71 mg/kg). The atypical APD olanzapine produced full substitution for the 5.0 mg/kg CLZ dose, but not for the 1.25 mg/kg CLZ dose (ED50=1.55 mg/kg). In contrast, the atypical APD quetiapine produced full substitution for the 1.25 mg/kg CLZ dose (ED50=0.13 mg/kg), but not for the 5.0 mg/kg CLZ dose. Similarly, the atypical APD sertindole produced full substitution for only the 1.25 mg/kg CLZ dose (ED50=0.94 mg/kg). Risperidone, another atypical APD, produced partial substitution (>or=60% and <or=80% condition-appropriate responding) for the 1.25 mg/kg CLZ dose, and failed to substitute for the 5.0 mg/kg CLZ dose. The atypical APD ziprasidone and the typical APDs haloperidol and chlorpromazine failed to substitute for either CLZ training dose. These results demonstrated that the 1.25 mg/kg CLZ training dose provides partial or full stimulus generalization to more atypical APDs than does the 5.0 mg/kg CLZ training dose. Full substitution by olanzapine for only the 5.0 mg/kg CLZ dose suggests that this higher training dose is also important for screening atypical APDs.

Animals↗

PubMed2003

Resistance training and insulin action in humans: effects of de-training.

Aerobic endurance training increases insulin action in skeletal muscle, but the effect of resistance training has not been well described. Controversy exists about whether the effect of resistance training is merely due to an increase in muscle mass. We studied the effect of cessation of resistance training in young, healthy subjects by taking muscle biopsies and measuring insulin-mediated whole body and leg glucose uptake rates after 90 days of heavy resistance training (T) and again after 90 days of de-training (dT). Data on leg glucose uptake were expressed relative to accurate measures of leg muscle mass by MRI scanning. Muscle strength (239 +/- 43 vs. 208 +/- 33 N m), quadriceps area (8463 +/- 453 vs. 7763 +/- 329 mm2) and glycogen content (458 +/- 22 vs. 400 +/- 26 mmol (kg dry weight muscle)(-1)) decreased, while myosin heavy chain isoform IIX increased 4-fold in dT vs. T, respectively (all P < 0.05). GLUT4 mRNA levels and enzyme activities and mRNA levels of glycolytic, lipolytic and glyconeogenic enzymes did not change with de-training. Likewise, capillary density did not change. Whole body glucose uptake decreased 11 % and leg glucose uptake decreased from 75 +/- 11 (T) to 50 +/- 6 (dT) nmol min(-1) (mm muscle)(-2) (P < 0.05) at maximal insulin, the latter decrease being due to decreased arterio-femoral venous glucose extraction. The decrease was mainly due to reduced non-oxidative glucose disposal. We have thus shown that 90 days after the termination of heavy resistance training, insulin-mediated glucose uptake rates per unit of skeletal muscle have decreased significantly.

Adult↗

PubMed2005

Effects of training period on haemorheological variables in regularly trained footballers.

OBJECTIVE: To investigate the effects of one football training period on haemorheological variables in regularly trained footballers. METHOD: Ten subjects were randomly selected from the reserve team of a football club in the Turkish Premier League. During the last week of the football season, one day before a standard training session and two days after the previous league match, venous blood samples were taken (pre-exercise). After 90 minutes of standard training, further blood samples were taken (post-exercise). Blood lactate, blood viscosity, plasma fibrinogen, blood clotting time, acid-base variables, and plasma Na+, K+, and Ca2+ were determined. RESULTS: Haemoglobin, packed cell volume, and mean corpuscular volume were all significantly decreased, whereas white blood cells and platelets were both increased after training. Blood viscosity decreased but the reduction was not significant. Blood lactate, plasma glucose, and Na+ content were significantly increased, but standard bicarbonate, actual bicarbonate, and Ca2+ were significantly decreased. Blood clotting time had shortened significantly after training. Blood viscosity was inversely correlated with plasma glucose concentration (r = -0.48 and p = 0.032). CONCLUSIONS: The results show that blood viscosity tends to decrease as the result of this type of training. This is due to a reduction in packed cell volume and mean corpuscular volume. The increased blood lactate does not have an adverse effect on the blood viscosity of these subjects because protective mechanisms develop with regular training throughout the season.

Adolescent↗

PubMed2003

Effectiveness of dynamic muscle training, relaxation training, or ordinary activity for chronic neck pain: randomised controlled trial.

OBJECTIVE: To determine the effectiveness of dynamic muscle training and relaxation training for chronic neck pain. DESIGN: Randomised controlled trial. SETTING: Five occupational healthcare centres, Tampere, Finland. PARTICIPANTS: 393 female office workers (mean age 45 years) with chronic non-specific neck pain randomly assigned to 12 weeks of dynamic muscle training (n = 135) or relaxation training (n = 128), plus one week of reinforcement training six months after baseline; or ordinary activity (control group; n = 130). MAIN OUTCOME MEASURE: Change in intensity of neck pain at three, six, and 12 months. RESULTS: No significant difference was found in neck pain between the groups at follow up. However, the range of motion for cervical rotation and lateral flexion increased more in the training groups than in the control group. CONCLUSIONS: Dynamic muscle training and relaxation training do not lead to better improvements in neck pain compared with ordinary activity.

Algorithms↗

PubMed1999

Human skeletal muscle HSP70 response to training in highly trained rowers.

Previous studies have demonstrated exercise-induced heat shock protein 70 (HSP70) in animals. The purpose of this study was to investigate human skeletal muscle HSP70 response to rowing training. Ten male rowers trained for 4 wk with different forms, durations, and intensities of exercise. Biopsy was performed in the right musculus vastus lateralis before training and at the end of each week. HSP70 in 5 microg of total protein from the muscle sample was determined by using Western blot and immunodetection with chemiluminescence technique, by means of laser densitometer referring to a series of known standard HSP70. Compared with pretraining (100%), HSP70 increased during training (181, 405, 456, and 363% from the first to fourth training week, respectively) with the maximum HSP70 production at the end of second training week. Thus HSP70 is induced in highly trained human muscle by long-term training.

Adolescent↗

PubMed2003

Effect of heavy increase in training stress on the plasma leptin concentration in highly trained male rowers.

AIM: To characterize the effects of a heavy increase in training stress followed by a reduced stress on fasting plasma leptin levels in highly trained male rowers. METHODS: 12 rowers underwent a 3-week period of maximally increased training stress followed by a 2-week tapering period. RESULTS: A mean 22% increase in training stress caused a significant decrease (by 8%) in the leptin concentrations. A further increase in training stress by 25% significantly reduced leptin further by 35%. A 1st tapering week, during which the training stress was rapidly reduced by approximately 50%, significantly increased the plasma leptin concentrations by 29%. Plasma leptin was significantly increased further (by 4%) during the 2nd tapering week. CONCLUSION: Leptin is sensitive to pronounced changes in training stress in highly trained male rowers.

Adult↗

PubMedDate not supplied

Training in tobacco treatments in psychiatry: a national survey of psychiatry residency training directors.

OBJECTIVE: Nicotine dependence is the most prevalent substance abuse disorder among adult psychiatric patients and is a leading cause of death and disability. This study examines training in tobacco treatment in psychiatry residency programs across the United States. METHOD: The authors recruited training directors to complete a survey of their program's curriculum related to tobacco treatment, attitudes related to treating tobacco in psychiatry, and perceptions of residents' skills for addressing nicotine dependence in psychiatric patients. RESULTS: Respondents were representative of the national pool. Half of the programs provided training in tobacco treatments for a median duration of 1 hour. Content areas covered varied greatly. Programs with tobacco-related training expressed more favorable attitudes toward addressing tobacco in psychiatry and were more likely to report confidence in their residents' skills for treating nicotine dependence. Programs without tobacco training reported a lack of faculty expertise on tobacco treatments. Most training directors reported moderate to high interest in evaluating a model tobacco curriculum for psychiatry and stated they would dedicate an average of 4 hours of curriculum time. CONCLUSIONS: The findings demonstrate the need for and interest in a model tobacco treatment curriculum for psychiatry residency training. Training psychiatrists offers the potential of delivering treatment to one of the largest remaining groups of smokers: patients with mental disorders.

Adult↗

PubMed2004

Evaluation of an inter-professional workshop to develop a psychosocial assessment and child-centred communication training programme for paediatricians in training.

BACKGROUND: The quality of psychosocial assessment of children in consultations varies widely. One reason for this difference is the variability in effective mental health and communication training at undergraduate and post-qualification levels. In recognition of this problem, the Royal College of Paediatrics and Child Health in the United Kingdom have developed the Child in Mind Project that aims to meet this deficit in medical training. This paper describes the evaluation of a workshop that explored the experiences and expectations of health care professionals in the development of a training programme for doctors. METHODS: The one-day inter-professional workshop was attended by 63 participants who were invited to complete evaluation forms before and immediately after the workshop. RESULTS: The results showed that the workshop was partially successful in providing an opportunity for an inter-professional group to exchange ideas and influence the development of a significant project. Exploring the content and process of the proposed training programme and the opportunity for participants to share experiences of effective practice were valued. Participants identified that the current culture within many health care settings would be an obstacle to successful implementation of a training programme. Working within existing training structures will be essential. Areas for improvement in the workshop included clearer statement of goals at the outset and a more suitable environment for the numbers of participants. CONCLUSIONS: The participants made a valuable contribution to the development of the training programme identifying specific challenges. Inter-professional collaborations are likely to result in more deliverable and relevant training programmes. Continued consultation with potential users of the programme - both trainers and trainees will be essential.

Adolescent↗

PubMed2002

Training symmetry of weight distribution after stroke: a randomized controlled pilot study comparing task-related reach, Bobath and feedback training approaches.

OBJECTIVE: To determine (1) the most effective of three treatment approaches to retrain seated weight distribution long-term after stroke and (2) whether improvements could be generalized to weight distribution in standing. SETTING: Inpatient rehabilitation unit. DESIGN: Forty asymmetrical acute stroke subjects were randomly allocated to one of four groups in this pilot study. Changes in weight distribution were compared between the 10 subjects of each of three treatment groups (task-specific reach, Bobath, or Balance Performance Monitor [BPM] feedback training) and a no specific treatment control group. One week of measurement only was followed by two weeks of daily training sessions with the treatment to which the subject was randomly allocated. Measurements were performed using the BPM daily before treatment sessions, two weeks after cessation of treatment and 12 weeks post study. Weight distribution was calculated in terms of mean balance (percentage of total body weight) or the mean of 300 balance points over a 30-s data run. RESULTS: In the short term, the Bobath approach was the most effective treatment for retraining sitting symmetry after stroke (p = 0.004). Training with the BPM and no training were also significant (p = 0.038 and p = 0.035 respectively) and task-specific reach training failed to reach significance (p = 0.26). At 12 weeks post study 83% of the BPM training group, 38% of the task-specific reach group, 29% of the Bobath group and 0% of the untrained group were found to be distributing their weight to both sides. Some generalization of symmetry training in sitting to standing was noted in the BPM training group which appeared to persist long term. CONCLUSIONS: Results should be treated with caution due to the small group sizes. However, these preliminary findings suggest that it might be possible to restore postural symmetry in sitting in the early stages of rehabilitation with therapy that focuses on creating an awareness of body position.

Aged↗

PubMed2002

Physical training for intermittent claudication: a comparison of structured rehabilitation versus home-based training.

In a non-randomized, open-label study results after a structured institution-based peripheral arterial occlusive disease (PAD) rehabilitation program were compared with the results of training at home. Three groups were compared: group 1 (n = 19) PAD rehabilitation; group 2 (n = 19) PAD rehabilitation + clopidogrel 75 mg once daily; group 3 (n = 21) home-based training. The training period was 3 months for all groups, which was followed by a 3-month observation phase (without prescribed training). The rehabilitation program consisted of 3 training hours per week. Background variables, demographics, and baseline claudication distances were comparable between groups. After 3 months of training the absolute claudication distances (ACD) improved by 82.7%, 131.4%, and 5.4% for groups 1, 2 and 3. The initial claudication distances (ICD) changed by 163.8%, 200.6%, and 44.4%, respectively. All changes, except the ACD result for group 3, were statistically significant (p < or = 0.05). Structured training groups (1 and 2) performed significantly better than group 3 (p < or = 0.05). When results from groups 1 and 2 were pooled, ACDs changed from 493.3 +/- 218.1 to 1026.0 +/- 468.9 m, delta 546.0 +/- 378.8 m [95% CI 417.8-674.2 ml; p < or = 0.05. ICDs improved from 175.3 +/- 110.8 m to 493.1 +/- 326.7 m, delta 320.8 +/- 315.9 m [95% CI 213.9-427.7 m]; p < or = 0.05. The difference between the pooled mean results of the structured training groups and the results of group 3 amounted to 474.3 m [95% CI 270.2-678.4 m] and 242.4 m [95% CI 99.0-385.7 m], for ACD and ICD, respectively. Structured, supervised PAD rehabilitation is a highly efficacious treatment for intermittent claudication and may be regarded as the present gold standard among conservative treatment options.

Aged↗

PubMed2001

Self-reported training needs and training issues of advisors to self-advocacy groups for people with mental retardation.

My purpose in this paper is to describe the self-reported training needs and training information of advisors to self-advocacy groups for people with mental retardation. A telephone survey was administered to 118 advisors randomly selected, resulting in 90 completed surveys and a response rate of 76%. Major findings are reported in training topics, preferred training formats, hours and frequency of training, how training needs change, and differences in training needs based on advisor demographic data. The results can be used by individuals and groups to help better support the self-advocacy movement by assisting self-advocacy groups to better prepare and train individuals to be successful and useful advisors.

Adult↗

PubMed2000

Training of pediatricians in care of physical disabilities in children with special health needs: results of a two-state survey of practicing pediatricians and national resident training programs.

OBJECTIVE: One goal of the American Academy of Pediatrics' Future of Pediatric Education II Project is to establish guidelines in training physicians to care for children with special health care needs (CWSN). Assessment of current practices in prescribing therapies and devices is necessary to meet this goal. Although much has been written about CWSN, there is a paucity of literature describing pediatricians' preparedness in prescribing such therapies and devices to children with physical disabilities. In an effort to assess physician preparedness, we surveyed pediatric residents nationwide and practicing pediatricians from 2 states, 1 urban and 1 rural. METHODS. A questionnaire aimed at identifying areas of concern regarding preparedness of physicians in practice and in training was prepared and mailed to prospective participants in Ohio and Mississippi. After follow-up mailings to nonresponders, approximately 59% responded. Summary statistics were reported as proportions with 95% confidence intervals. RESULTS: Among those polled, >70% reported no training in prescribing certain durable medical equipment and over 50% reported no training in prescribing certain therapies. In addition, at least 20% reported no training in treating some of the more common childhood physical disabilities. Nearly three fourths of the respondents indicated that they did not believe that they were adequately prepared to take an active role in prescribing therapies and durable medical equipment. Fewer respondents believed that they should be the sole providers of these therapies and durable medical equipment. CONCLUSIONS: The results of the survey indicate a lack of specific training and physician confidence in prescribing therapies and devices to CWSN, establishing the necessity of expanding training programs to better ensure quality health care for special needs children. Although additional ongoing research is necessary to fully evaluate the preparedness of physicians in caring for CWSN, this survey does help to identify areas of physician training that require improvement to provide quality health care for CWSN.

Child↗

PubMed1997

Influence of strength training on sprint running performance. Current findings and implications for training.

Today, it is generally accepted that sprint performance, like endurance performance, can improve considerably with training. Strength training, especially, plays a key role in this process. Sprint performance will be viewed multidimensionally as an initial acceleration phase (0 to 10 m), a phase of maximum running speed (36 to 100 m) and a transition phase in between. Immediately following the start action, the powerful extensions of the hip, knee and ankle joints are the main accelerators of body mass. However, the hamstrings, the m. adductor magnus and the m. gluteus maximus are considered to make the most important contribution in producing the highest levels of speed. Different training methods are proposed to improve the power output of these muscles. Some of them aim for hypertrophy and others for specific adaptations of the nervous system. This includes general (hypertrophy and neuronal activation), velocity specific (speed-strength) and movement specific (sprint associated exercises) strength training. In developing training strategies, the coach has to keep in mind that strength, power and speed are inherently related to one another, because they are all the output of the same functional systems. As heavy resistance training results in a fibre type IIb into fibre type IIa conversion, the coach has to aim for an optimal balance between sprint specific and nonspecific training components. To achieve this they must take into consideration the specific strength training demands of each individual, based on performance capacity in each specific phase of the sprint.

Acceleration↗