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Behavioral vision training for myopia: stimulus specificity of training effects.

The present study assessed transfer of visual training effects for myopia using two different training stimuli and a single subject A-B-C-A design. A male student volunteer, with lens prescription of -3.0 D (left) and -2.0 D (right), served as the subject. During baseline (10 sessions), visual acuity was assessed by two behavioral acuity tests. One test consisted of 50 line drawings of common objects as testing stimuli and the other test had 50 Chinese characters. A procedure including stimulus fading and reinforcement (positive verbal feedback) was used to train the subject to identify either pictorial stimuli or Chinese characters presented from a distance. Training was effective in improving performance on both behavioral acuity tests during the training phases and follow-up but the change was more pronounced on the specific stimuli being used for training. Refractive errors assessed on a weekly basis showed no change in the physiology of both eyes. These results suggest that effects of visual training only partially transferred to untrained stimuli.

Adult↗

In vivo versus simulation training: an interactional analysis of range and type of training exemplars.

We analyzed the role of the range of variation in training exemplars as a contextual variable influencing the effects of in vivo versus simulation training in producing generalized responding. Four mentally retarded adults received single case instruction, followed by general case instruction, on washing machine and dryer use; one task was taught using actual appliances (in vivo) and the other using simulation. In vivo and simulation training were counterbalanced across the two tasks for the 2 subject pairs, using a within-subjects Latin square design. With both paradigms, more errors were made after single case than after general case instruction during probe sessions with untrained washing machines and dryers. These results suggest that generalization errors were affected by the range of training exemplars and not by the use of simulated versus natural training stimuli. Although both general case simulation and general case in vivo training facilitated generalized performance of laundry skills, an analysis of training time and costs indicated that the former approach was more efficient. The study illustrates a methodology for studying complex interactions and guiding decisions on the optimal use of instructional alternatives.

Activities of Daily Living↗

EMG biofeedback training, relaxation training, and placebo for the relief of chronic back pain.

24 patients with chronic low back pain were randomly assigned to three treatment conditions: EMG biofeedback, relaxation training, and a placebo condition. Patients were seen for eight sessions and were evaluated before Session 1 and after Session 8. Eight analyses of covariance which were adjusted for age and pretest scores were computed on the final scores to find which variables could detect significant difference between treatments. Age was included as a covariate because the differences in age between conditions were significant. Four variables with significant and nearly significant differences were chosen for analysis. The second set of analyses identified the nature of the differences among the three conditions. These included a priori planned comparisons among conditions, and paired t tests. Relaxation-trained subjects were significantly superior to subjects in the placebo condition, in decreasing pain during the function test, increasing relaxation, and decreasing Upper Trapezius EMG. They were superior to EMG Biofeedback training in increasing reported activity. Both Relaxation and EMG trained subjects were able to reduce Upper Trapezius EMG by Session 8. Relaxation-trained subjects showed significant change on eight of the 14 possible comparisons for each treatment condition. EMG biofeedback training showed significant favorable results in only one condition; the placebo condition showed no significant results. Relaxation training gave better results in reducing EMG and pain, and in increasing relaxation and activity than either EMG biofeedback alone or a placebo condition.

Back Pain↗

A Nationwide Learning-Style Assessment of Undergraduate Athletic Training Students in CAAHEP-Accredited Athletic Training Programs.

OBJECTIVE: To identify the learning styles and preferred environmental characteristics of undergraduate athletic training students in Commission on Accreditation of Allied Health Education Programs (CAAHEP)-accredited athletic training education programs and to determine if learning-style differences existed among geographic regions of the country. DESIGN AND SETTING: Fifty CAAHEP-accredited athletic training programs were randomly selected in proportion to the number of programs in each geographic region. Ten students from each school were selected to complete the Kolb Learning Style Inventory (LSI) and the Productivity Environmental Preference Survey (PEPS). SUBJECTS: A total of 193 undergraduate athletic training students (84 men, 109 women) with a mean age of 22.3 +/- 2.8 years completed the PEPS, while 188 students completed the LSI. MEASUREMENTS: We used chi-square analyses to determine if differences existed in learning-style type and if these differences were based on geographic location. We calculated analysis of variance to determine if there were any geographic differences in the mean overall combination scores of the LSI. Descriptive statistics were used to evaluate the PEPS. RESULTS: The overall return rate was 38%. The chi-square analyses revealed no significant difference in learning-style type for athletic training students, regardless of the geographic region. The LSI yielded a relatively even distribution of learning styles: 29.3% of the students were accommodators, 19.7% were divergers, 21.8% were convergers, and 29.3% were assimilators. The overall mean combination scores were 4.9 (abstract-concrete) and 4.9 (active-reflective), and analysis of variance indicated no significant difference in the mean combination scores among the geographic regions. The PEPS revealed that undergraduate athletic training students demonstrated a strong preference for learning in the afternoon. CONCLUSIONS: Undergraduate athletic training students demonstrated great diversity in learning style. Educators must strongly consider this diversity and incorporate teaching methods that will benefit all types of learners.

Journal Article↗

[The clinical laboratory training after the graduate in local training hospital setting].

As clinical training has become a compulsory element of the training of physicians, all doctors are now required to undergo training in basic abilities of diagnosis and treatment. Clinical training has become possible in local medical organizations as well as university hospitals and large hospitals. There are full-time clinical pathologists in the laboratory staff of large hospitals, but they have little time for clinical trainees in the present educational system in the field of clinical laboratory. In mid-size and small hospitals, there is no clinical pathologist at the central diagnostic and treatment division, and clinical laboratory technicians are expected to play roles of trainers. It is important for the training administrator to prepare an environment in which clinical trainees can learn the selection of examinations, execution of examinations, interpretation of results, and actual handling of patients and, particularly in the execution of examinations, to cooperate with the director of the examination division and see that trainees can learn the necessary skills that they must acquire. The training administrator must also formulate a program to help clinical trainees to develop the abilities necessary for them to function as a member of team care. Such a program must not only be effective for the training of physicians but also contribute to the development of laboratory technicians and to improvements in the quality of medical care that is provided.

Clinical Laboratory Techniques↗

Effects of residency training in family medicine v. internship training on professional attitudes and practice patterns.

OBJECTIVES: To determine whether the professional attitudes and practice patterns of physicians with residency training in family medicine differ from those of generalists with internship training. DESIGN: Mail survey conducted in 1985-86. SETTING: Province of Quebec. PARTICIPANTS: A stratified random sample of French-speaking family and general practitioners who graduated after 1972 (325 physicians with residency training and 304 with internship training) (response rate 82%). MAIN RESULTS: Physicians with residency training were 3 years younger on average than those with internship training, were more likely to be female (38% v. 18%, p less than 0.001) and were more likely to work on a salaried basis in CLSCs (public community health centres) (36% v. 14%, p less than 0.001). Even after these confounding factors were controlled for, physicians with residency training seemed to be more sensitive to the psychosocial aspects of patient care and tended to attach more importance to informing patients about useful materials and resources concerning their health problems. They were not, however, more likely to value health counselling or integrate it in medical practice. CONCLUSION: Our findings provide some evidence that the new requirement that physicians complete a residency in family medicine to obtain medical licensure in general practice in Quebec may foster a more patient-centred approach to health care.

Adult↗

[Postgraduate neurology training in new clinical training system].

Postgraduate neurology training in new clinical training system in Oita University Hospital was presented. Clinical intern training for first 2 years are performed according to programs proposed by Clinical Training Institute for Interns in Oita University Hospital. This program includes neurology for at least 1 month. Interns will get in clinical management for common and main neurological disorders such as convulsion, unconsciousness, stroke, Parkinson disease and intractable neurological disorders in addition to standard medical skills. Neurology resident training for specialist begins after clinical intern training and is performed in own program proposed by our department. However, the level of educational and training quality is not always high, because of the lack of teaching staff, and insufficient curriculums without rotation system to neuropathology and neuroradiology. To improve this educational program, we need to alter own well-established postgraduate educational programs. The quality of programs must to be approved by Japanese Society of Neurology.

Internship and Residency↗

Change of place, change of pace, change of status: rural community training for junior doctors, does it influence choices of training and career?

INTRODUCTION: The Rural and Remote Area Placement Program (RRAPP) began in April 2000 to provide a rural community practice training term for junior doctors and to increase the opportunities for junior doctors to experience training outside the hospital setting. Recent research into the community-based training and experience for junior doctors in Australia suggests that such experience contributes to their decision-making about future training and career. METHODS: A structured national survey was undertaken of all 107 junior doctors who had participated in RRAPP prior to October 2003 and included semi-structured interviews of 54 participants from prior to October 2002. RESULTS: Data indicated that rural and community experience influenced the choice of further rural and general practice training and also provided a useful setting for junior doctors to reflect on, and confirm, future training plans. This study provided evidence of the positive influence of RRAPP on the career choices of junior doctors, with greater than 70% of participants confirming RRAPP's influence on their plans. This study also provided insight into the process of these career decisions. Decision-making was precipitated by taking junior doctors 'outside their comfort zone' of the tertiary hospital and providing a different perspective on both the present and the future. CONCLUSION: In addition to the contrast in setting and the expansion of knowledge about rural community practice, RRAPP junior doctors identified the change of place, the change of pace, and the change of status as instrumental in their decision-making about future training and careers.

Journal Article↗

[General practitioners' training in psychiatry and prescription of psychotropic drugs. 2. Attitudes of physicians to training in psychotherapy and the extent of their prescriptions].

The object of this investigation was to describe and analyse differences in psychiatric training and attitudes to and employment of psychotropic drugs among general practitioners with and without training in psychotherapy, respectively. The investigation was carried out as a multicentre questionnaire investigation in the County of Aarhus with participation of 192 out of 215 (89%) doctors who were invited. Thirty-nine of the participating general practitioners (20%) had participated in a supervised course in psychoanalytically orientated psychotherapy. Doctors who were trained in psychotherapy had more rarely had appointments in psychiatric departments than other doctors. Doctors trained in psychotherapy prescribed fewer benzodiazepines than other doctors (p less than 0.05) and there was psychotherapy chose psychotherapy more frequently (p = 0.02) and more rarely tendency to a lower total prescription of psychotropic drugs. Doctors trained in a psychotropic drugs (p = 0.004) than doctors without this training as treatment for patients with psychosocial conflicts and they more rarely chose psychotropic drugs to supplement psychotherapy (p less than 0.0001). It is concluded that one of the ways of reducing the massive use of psychotropic drugs in Denmark is to improve general practitioners' training in psychotherapy.

Anti-Anxiety Agents↗

Comparison of standards in training and non-training practices.

The in-practice component of vocational training should take place in practices working to high clinical and teaching standards. By means of a survey of its members, the Severn Faculty of the Royal College of General Practitioners was able to compare training practices with the criteria of the Joint Committee on Postgraduate Training for General Practice, and with non-training practices. The training practices fell short of the criteria in a few areas, but the differences between the training and non-training practices were extensive. Progress towards achieving the standards set by the criteria should be monitored, and the criteria themselves should be made more precise.

Education, Medical, Graduate↗

Primary health care nurse training in Kwazulu. An evaluation of diagnostic flow charts versus a conventional training method.

Diagnostic flow charts have been adapted for the training of primary health care (PHC) nurses in a rural area of South Africa. We designed a randomized controlled trial to assess whether nurses' clinical competence differed if they were trained using flow charts or using conventional patient-centered teaching. Although clinical competence improved during the training programme, this improvement did not differ significantly according to which of the two training methods was used. The nurses in this trial had considerable earlier experience and some training in primary care. Before the trial they had a high level of clinical competence and may already have developed their own diagnostic strategies. We therefore cannot make inferences from our study about whether or not flow charts will be a valuable addition in PHC. Flow charts need to be adapted to take into account where, by whom, and for what purpose they will be used. They must then be tested to ensure that they only rarely result in incorrect diagnosis and treatment. A decision on the use of flow charts in the training of PHC nurses should be based on further educational trials and long-term follow-up of trained health workers. Nurses should participate in educational trials at the start of their careers in PHC. The additional value of flow charts in the auditing of competence and assessment of educational needs should also be explored.

Ambulatory Care Facilities↗

Further increase in high density lipoprotein in trained males after enhanced training.

Eight well-trained males were studied before, during and after 6 months of a progressively increased amount of endurance training in order to elucidate the effects on the apoproteins and apolipoproteins. Initially high HDL-cholesterol levels were revealed (1.62 +/- 0.15 mmol X 1(-1), mean +/- SE.). After a transient but not significant, slight decline at the onset of the increased training program (1.57 +/- 0.06 mmol X 1(-1] HDL-cholesterol increased gradually to the end of the training period (1.92 +/- 0.12 mmol X 1(-1). There was an increased aerobic capacity as judged by maximal oxygen uptake and by lactate concentration during standardized submaximal work. However, at the end of the training period, a levelling off in maximal oxygen uptake was revealed, while HDL-cholesterol was still increasing. The present data demonstrate that HDL can be influenced by training at all levels of aerobic capacity.

Adult↗

Effects of aerobic exercise training and relaxation training on cardiovascular activity during psychological stress.

Students who reported experiencing a high number of stressful life events were randomly assigned to: (a) an aerobic training condition, (b) a relaxation training condition, or (c) a no treatment control condition. Immediately before and after the 11 week training/control period, subjects' aerobic fitness and cardiovascular responses to acute psychological stress were assessed. Results indicated that: (1) subjects in the aerobic training condition showed significantly greater improvements in aerobic fitness than subjects in the other conditions, and (2) the subjects in the aerobic training condition showed significantly greater reductions in heart rate during all phases of the stress than subjects in the other conditions. Post-training differences between aerobic and control conditions during the moderate psychological stress were as great as 17 b.p.m. These results provide evidence for the utility of aerobic training for reducing cardiovascular activity during psychological stress, and they are consistent with earlier findings linking fitness to less illness following stress, reductions in depression and enhanced recovery in cardiac patients.

Adaptation, Psychological↗

Manipulating high-intensity interval training: effects on VO2max, the lactate threshold and 3000 m running performance in moderately trained males.

The aim of this study was to compare the effects of two high-intensity interval training (HIT) programmes on maximal oxygen uptake (.VO(2max)), the lactate threshold (LT) and 3000 m running performance in moderately trained male runners. .VO(2max), the running speed associated with .VO(2max) (V.VO(2max)), the time for which V.VO(2max) can be maintained (T(max)), the running speed at LT (v(LT)) and 3000 m running time (3000 mTT) were determined before and following three different training programmes performed for 10 weeks. Following the pre-test, 17 moderately trained male runners (V O(2max)=51.6+/-2.7ml kg(-1)min(-1)) were divided into training groups based on their 3000 mTT (Group 1, G(1), N=6, 8 x 60% of T(max) at V.VO(2max), 1:1 work:recovery ratio; Group 2, G(2), N=6, 12 x 30s at 130% V.VO(2max), 4.5 min recovery; control group, G(CON), N=5, 60 min at 75% V.VO(2max)). G(1) and G(2) performed two HIT sessions and two 60 min recovery run sessions (75% V.VO(2max)) each week. Control subjects performed four 60 min recovery run sessions (75% V.VO(2max)) each week. In G(1), significant improvements (p<0.05) following HIT were found in .VO(2max) (+9.1%), V.VO(2max) (+6.4%), T(max) (5%), v(LT) (+11.7%) and 3000 mTT (-7.3%). In G(2), significant improvements (p<0.05) following HIT were found in .VO(2max) (+6.2%), V.VO(2max)(+7.8%), T(max) (+32%) and 3000 mTT (-3.4%), but not in v(LT) (+4.7%; p=0.07). No significant changes in these variables were found in G(CON). The present study has shown that 3000 m running performance, .VO(2max), V.VO(2max), T(max) and v(LT) can be significantly enhanced using different HIT programmes in moderately trained runners, but that changes in performance and physiological variables may be more profound using prolonged HIT at intensities of V.VO(2max) with interval durations of 60% T(max).

Adult↗

Erythropoiesis and performance after two weeks of living high and training low in well trained triathletes.

The purpose of our study was to evaluate hematologic acclimatization during 2 weeks of intensive normoxic training with regeneration at moderate altitude (living high-training low, LHTL) and its effects on sea-level performance in well trained athletes compared to another group of equally trained athletes under control conditions (living low - training low, CONTROL). Twenty-one triathletes were ascribed either to LHTL (n = 11; age: 23.0 +/- 4.3 yrs; VO 2 max: 62.5 +/- 9.7 [ml x min -1 x kg -1]) living at 1956 m of altitude or to CONTROL (n = 10; age: 18.7 +/- 5.6 yrs; VO 2 max: 60.5 +/- 6.7 ml x min -1 x kg -1) living at 800 m. Both groups performed an equal training schedule at 800 m. VO 2 max, endurance performance, erythropoietin in serum, hemoglobin mass (Hb tot, CO-rebreathing method) and hematological quantities were measured. A tendency to improved performance in LHTL after the camp was not significant (p < 0.07). Erythropoietin concentration increased temporarily in LHTL (Delta 14.3 +/- 8.7 mU x ml -1; p < 0.012). Hb tot remained unchanged in LHTL whereas was slightly decreased from 12.5 +/- 1.3 to 11.9 +/- 1.3g x kg -1 in CONTROL (p < 0.01). As the reticulocyte number tended to higher values in LHTL than in CONTROL, it seems that a moderate stimulation of erythropoiesis during regeneration at altitude served as a compensation for an exercise-induced destruction of red cells.

Acclimatization↗

Immune system alteration in response to increased physical training during a five day soccer training camp.

Leukocyte and monocyte subpopulations were investigated in ten elite male soccer players before and after a 5-day training camp. It was hypothesized that with increased training intensity and duration, the immune system would show signs of depression. Blood samples were taken at rest before and after the training camp and cell surface antigens were investigated by four-colour flow cytometry. After five days of intensified training, there was a significant decrease in the number of T helper, T cytotoxic and B cells, the expression of CD11 b on leukocytes increased and the NK cell population did not change significantly. It is concluded that after a period of intensified training, soccer players may experience decreased T and B cell numbers in circulation, possibly affecting their capability to activate the immune system and resist infections. However, in contrast to the acute decrease in the number of circulating NK cells commonly observed after physical exercise, no change in this cell population was observed at rest after a period of intensified physical training. Exercise-induced immunological changes were highly differentiated between different leukocyte subpopulations.

Adult↗

Interval training program optimization in highly trained endurance cyclists.

PURPOSE: The purpose of this study was to examine the influence of three different high-intensity interval training (HIT) regimens on endurance performance in highly trained endurance athletes. METHODS: Before, and after 2 and 4 wk of training, 38 cyclists and triathletes (mean +/- SD; age = 25 +/- 6 yr; mass = 75 +/- 7 kg; VO(2peak) = 64.5 +/- 5.2 mL x kg(-1) min(-1)) performed: 1) a progressive cycle test to measure peak oxygen consumption (VO(2peak)) and peak aerobic power output (PPO), 2) a time to exhaustion test (T(max)) at their VO(2peak) power output (P(max)), as well as 3) a 40-km time-trial (TT(40)). Subjects were matched and assigned to one of four training groups (G(2), N = 8, 8 x 60% T(max) at P(max), 1:2 work:recovery ratio; G(2), N = 9, 8 x 60% T(max) at P(max), recovery at 65% HR(max); G(3), N = 10, 12 x 30 s at 175% PPO, 4.5-min recovery; G(CON), N = 11). In addition to G(1), G(2), and G(3) performing HIT twice per week, all athletes maintained their regular low-intensity training throughout the experimental period. RESULTS: All HIT groups improved TT(40) performance (+4.4 to +5.8%) and PPO (+3.0 to +6.2%) significantly more than G(CON) (-0.9 to +1.1%; P < 0.05). Furthermore, G(1) (+5.4%) and G(2) (+8.1%) improved their VO(2peak) significantly more than G(CON) (+1.0%; P < 0.05). CONCLUSION: The present study has shown that when HIT incorporates P(max) as the interval intensity and 60% of T(max) as the interval duration, already highly trained cyclists can significantly improve their 40-km time trial performance. Moreover, the present data confirm prior research, in that repeated supramaximal HIT can significantly improve 40-km time trial performance.

Adult↗

Taking training seriously: a policy statement on public health training by the Joint Council of Governmental Public Health Agencies.

Continuing education and on-the-job training in public health has suffered serious neglect over the past years. As a result, many state and local public health entities have failed to keep step with emerging challenges facing the public's health--challenges that require new and innovative approaches to prevention and treatment. In this article, the Joint Council of Governmental Public Health Agencies seeks to affirm the importance of public health training by examining barriers to training; identifying areas in which training should be emphasized; providing examples of successful training programs; and recommending ways in which public health leaders can revitalize training programs.

Education, Continuing↗