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Effect of aerobic exercise training on mtDNA deletion in soleus muscle of trained and untrained Wistar rats.

BACKGROUND: According to the theory of mitochondrial aging, oxidative stress plays a major role in aging and age related degenerative diseases. Since oxygen consumption and reactive oxygen species rate increase during aerobic exercise, we hypothesised that heavy aerobic training could lead to enhanced mitochondrial DNA (mtDNA) deletion in postmitotic tissues, leading in turn to premature aging and degenerative diseases. METHODS: Sixty adult male 2 month old Wistar14848 rats were divided into six equal groups. Two groups were trained for 3 months by running on a treadmill (5 days/week, incline 6 degrees; group 1: 40 m/min, 20 min/day; group 2: 20 m/min, 40 min/day), while two sedentary groups participated in aerobic exercise only at the end of the study (incline 6 degrees; group 3: 40 m/min; group 4: 20 m/min). To control for physical and physiological parameters, two groups of untrained animals were killed at the beginning (group 6) and end (group 5) of the study. Expand long PCR was used to investigate mtDNA deletion in soleus muscle and a sequencing method was used to confirm the mtDNA deletion break point. RESULTS: Our results did not show any mtDNA deletion in untrained rats or in those that underwent moderate training (group 2) We only found mtDNA deletion (4.6 kb) in the soleus muscle of heavily trained rats (group 1). CONCLUSIONS: These results demonstrate that one session of aerobic exercise does not cause mtDNA deletion in skeletal muscle. The difference in results between heavy and moderate aerobic training may be due to low work rate or up-regulation of inducible antioxidant systems in moderate training.

Adaptation, Physiological↗

Professional and medical outcomes for French train drivers after "person under train" accidents: three year follow up study.

AIMS: To investigate psychiatric disorders, somatic health, and professional effects in French train drivers having experienced a "person under train" accident, and somatic health and professional effects. METHODS: A total of 202 train drivers were evaluated several times: immediately after the event, three months later, and one, two, and three years later. These drivers were compared with 186 train drivers not exposed to that psychotraumatic shock. The evaluations relied primarily on the GHQ-28 and MINI questionnaires. RESULTS: In the exposed group, at the first evaluation, the prevalence of post-traumatic stress was 4%; scores > or =5 on the GHQ-28 were significantly higher than in the non-exposed group (32% versus 6%), for both the overall result and three sub-scores (somatic symptoms, anxiety and sleep, and psychosocial functioning). All these differences disappeared within a year. Vulnerability factors concerned prior traumas, acute and lasting life events, and the particular occupational situation where the driver is not accompanied but drives the train away alone in the aftermath of the accident. Over 95% of subjects had no short, medium, or long term impairment of their occupational fitness. CONCLUSIONS: Most of the psycho-behavioural disorders were observed in the immediate aftermath of the accident and disappeared within a year. The driver's occupational future does not seem to be affected by the "person under train" accident. Consideration of a traumatic accident as a job related risk and close psychological support of drivers after an accident probably increase the subject's ability to recover from the event.

Accidents, Occupational↗

Effect of endurance training on lipid metabolism in women: a potential role for PPARalpha in the metabolic response to training.

Endurance training increases fatty acid oxidation (FAO) and skeletal muscle oxidative capacity. However, the source of the additional fat and the mechanisms for increasing FAO capacity in muscle are not clear. We measured whole body and regional lipolytic activity and whole body and plasma FAO in six lean women during 90 min of bicycling exercise (50% pretraining peak O(2) consumption) before and after 12 wk of endurance training. We also assessed skeletal muscle content of peroxisome proliferator-activated receptor-alpha (PPARalpha) and its target proteins that regulate FAO [medium-chain and very long chain acyl-CoA dehydrogenase (MCAD and VLCAD)]. Despite a 25% increase in whole body FAO during exercise after training (P < 0.05), training did not alter regional adipose tissue lipolysis (abdominal: 0.56 +/- 0.26 and 0.57 +/- 0.10 micromol x 100 g(-1) x min(-1); femoral: 0.13 +/- 0.07 and 0.09 +/- 0.02 micromol x 100 g(-1) x min(-1)), whole body palmitate rate of appearance in plasma (168 +/- 18 and 150 +/- 25 micromol/min), and plasma FAO (554 +/- 61 and 601 +/- 45 micromol/min). However, training doubled the levels of muscle PPARalpha, MCAD, and VLCAD. We conclude that training increases the use of nonplasma fatty acids and may enhance skeletal muscle oxidative capacity by PPARalpha regulation of gene expression.

Acyl-CoA Dehydrogenase↗

Formal training in women's issues in psychiatry: a survey of psychiatry residency training directors.

OBJECTIVE: The authors describe the availability of formal residency training opportunities in women's issues in psychiatry and explore the potential relationships between the availability of training and characteristics of residency programs. METHOD: The authors surveyed psychiatry residency training directors to identify program characteristics and training opportunities. RESULTS: Certain didactic subjects were available in greater than 80% of residencies. Clinical training opportunities were less available and often not required. CONCLUSIONS: Selected didactic training in gender issues is commonly available in a majority of residencies. Nevertheless, general clinical instruction and didactic instruction in several important topics are less available.

Adult↗

Pastoral counseling training: training goals in a changing environment.

Pastoral counseling training is redefining itself in a changing environment. Theological education and ordination and church relatedness once was the crucible that shaped pastoral counselors. Today that formation process is being redefined as an increasing number of non-theologically trained students who are not seeking ordination come to increasingly fewer pastoral counseling training programs for formation in integrating spirituality and psychotherapy. This article outlines a statement of who an ideal intern would be in one pastoral counseling training program, lists fourteen goals of the training program along with the method of achievement, and who in the training program is responsible to see that the goals are accomplished.

Achievement↗

Inspiratory muscle training in chronic airflow limitation: comparison of two different training loads with a threshold device.

The usefulness of inspiratory muscle training (IMT) in chronic airflow limitation (CAL) patients is a controversial issue, mainly due to differences in the training load. To further evaluate this aspect, we studied the effect of the magnitude of the load using a threshold pressure trainer. Ten CAL patients (5 males, 5 females) 67 +/- 2 yrs (mean +/- SEM) and forced expiratory volume in one second (FEV1) 36 +/- 2% pred, were trained for 30 min a day using a load of 30% of their maximal inspiratory mouth pressure (PImax) (Group 1). Another 10 CAL patients (5 males, 5 females), 73 +/- 2 yrs and FEV1 37 +/- 2% pred), were trained using only 12% of their PImax (Group 2). Training was assessed by PImax, inspiratory muscle power output (IMPO), sustainable inspiratory pressure (SIP), maximal inspiratory flow rate (VImax), pattern of breathing during loaded breathing, Mahler's dyspnoea score, and the 6 min walking distance (6MWD). After 5 weeks of training, Group 1 exhibited significant increments in: PImax (34 +/- 11%); IMPO (92 +/- 16%); SIP (36 +/- 9%); and VImax (34 +/- 13%). Dyspnoea was also reduced, and the 6MWD increased by 48 +/- 22 m. We observed no significant changes in Group 2. During loaded breathing, Group 1 showed a significant increment in tidal volume (VT) and mean inspiratory flow (VT/TI), and a reduction in inspiratory time (TI). In Group 2, VT and VT/TI also increased significantly, but the breathing frequency increased with a reduction of expiratory time.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

Inter-rater reliability of formally trained and self-trained raters using the Edmonton Functional Assessment Tool.

The primary objective of this study was to determine the inter-rater reliability of the revised version of the Edmonton Functional Assessment Tool (EFAT-2). A second objective was to determine whether both formally trained and self-trained therapists had an acceptable level of inter-rater reliability. The EFAT-2 was administered to consenting palliative care patients by one of two independent physical therapist rater pairs; one pair self-trained (R1, R2) and the other formally trained (R3, R4). The intraclass correlation [ICC (1,1)] for R1, R2 was 0.97 [95% confidence interval (CI) 0.94-0.99] and for R3, R4 was 0.95 (95% CI 0.90-0.98). The standard error of measurement was 1.09 and 1.44, respectively. The Kappa statistic for the rater pairs on individual EFAT items ranged from 0.17 to 0.96. The results suggest that both formally trained and self-trained therapists obtain an acceptable level of inter-rater reliability when using the EFAT-2.

Aged↗

Incorporating a developmental perspective in doctoral training: survey of clinical child psychology training programs and introduction to the special section.

Examined the degree to which clinical child programs incorporate and integrate developmental theory into their training, and introduced the contributions of 6 leaders in the field to this special section. Fifty-one clinical child doctoral programs responded to the survey. Results indicate that 3 types of training programs are operating: (a) child emphasis (n = 7), which do not have a formal clinical child training program but do have a faculty member who has child research interests; (b) clinical child (n = 37), which have a group of faculty members with specific child research and clinical interests and a formalized program of study; and (c) developmental-clinical programs (n = 7), which are similar to clinical child programs but require a substantive amount of developmental psychology course work and endorse a developmental psychopathology perspective. Findings reveal that clinical child programs have become increasingly differentiated and specialized over the past 20 years, but, with the exception of developmental-clinical programs, most programs are still neglecting to incorporate developmental theory into training. This issue, as well as concerns about the future direction of clinical child doctoral training is addressed in this special section on the Importance of Incorporating Developmental Theory Into Clinical Child Training.

Child↗

Cancer research training: the Southwest Oncology Group young investigator training program (YITP).

BACKGROUND: Recognizing the growing need for an infusion of new investigators into the cancer researchers, and realizing that well-trained cancer researchers are a dying breed, the Southwest Oncology Group (SWOG) initiated the Young Investigator Training Program (YITP) in 1999, supported by the Hope Foundation. The first author was one of four applicants accepted in 2004 and is reporting on this experience. METHODS: After a rigorous and competitive application process, four physicians beginning their career in Hematology-Oncology are chosen each year. Each investigator would have submitted an original research concept. Each class receives intensive training in statistical principles, data collection and analysis, critical decision making, and protocol development guidelines. Each investigator spends 4 days at the SWOG operations office in San Antonio, Texas, and 4 days at the statistical center in Seattle, Washington. RESULTS: As part of the training course, each investigator will design a clinical protocol that will be reviewed by the appropriate disease committees within SWOG. Once approved, it will be submitted to the National Cancer Institute for further review. The four investigators will receive a certificate at the successful completion of the training course and will be recognized at the group meeting. With the class of 2004, 31 investigators will have joined the ranks of seasoned researchers. Fifteen protocols have been introduced and activated at institutions across the United States. Four other protocols are in various stages of the development and approval process. CONCLUSION: The Hope Foundation sponsored SWOG YITP is a unique opportunity. It allows participants to acquire a thorough understanding of the conduct of cancer clinical trials through SWOG. Large institutions are urged to continue sponsoring similar programs. This will build an infrastructure of well-trained cancer researchers to foster and continue the progress achieved in cancer research.

Clinical Trials as Topic↗

Tilt training for recurrent neurocardiogenic syncope: effectiveness, patient compliance, and scheduling the frequency of training sessions.

Unsatisfactory results obtained with medical therapy and dual-chamber pacing for prevention of recurrent neurocardiogenic syncope necessitated the development of new treatment modalities. Tilt-training, a novel treatment for recurrent neurocardiogenic syncope based on exercise sessions with prolonged upright posture (either on a tilt-table or standing on foot against a wall), was shown to be effective in preventing the recurrence of neurocardiogenic syncope. The purpose of this study was to demonstrate the long-term beneficial effects of a transient tilt training program lasting 2 months. Thirty-two patients with recurrent neurocardiogenic syncope (mean number of syncope episodes in the last 6 months was 3.4 +/- 2.3) constituted the study group. All of the patients were tilt test positive. The patients were taught a tilt training program with 2 phases (in-hospital training with repeated tilt procedures until 3 consecutive negative results were obtained and home exercises with standing against a wall) and home exercises lasted a maximum of 2 months. After this training program, the patients received no treatment and were followed for the recurrence of syncope. At the end of the follow-up period (376 +/- 45 days), 81% of the patients were free of recurrent syncope. This study revealed that similar successful results can also be obtained with a transient tilt training program as a first line treatment strategy. Less interference with the daily activities of the patients is the major advantage of this strategy. The ease of performance and high effectiveness rate will most likely result in more frequent utilization of this treatment modality.

Adult↗

Toward a training model for Rorschach scoring revisited: a follow-up study on a training system for interscorer agreement.

A standardized method for training in Rorschach scoring using the Perceptanalytic system showed high interscorer reliability in a classroom setting by 1984. To assess whether this model for training would continue to yield stronger interscorer agreement with continued use in vivo data from classroom training were gathered over a six-year follow-up period (1985-1991). For the subjects, 167 students in a graduate clinical psychology training program, results indicated the system produces high interscorer agreement at both Level I (relatively clear and simple responses) and Level II (very complex or pathological responses). Over-all percent of agreement for 54,329 combined coding and summarizing operations attained a M of 90% (SD = 6.0%). Sufficiently high interscorer reliability in Rorschach scoring can be attained in a classroom setting to support the use of the Perceptanalytic method for training doctoral students. Further research on training systems for the Rorschach as well as some speculative heuristic hypotheses about the nature of the learning process for Rorschach scoring are suggested.

Adult↗

Change in self-efficacy following a single strength training session predicts sedentary older adults' subsequent motivation to join a strength training program.

PURPOSE: To determine whether performance accomplishment and perceived exertion predict change in self-efficacy following a single strength training session and whether change in self-efficacy predicts subsequent motivation to join a strength training program. METHODS: Fifty-nine sedentary older adults participated in a single strength training session at a seniors' exercise center, completed measures of perceived exertion and self-efficacy, and received a voucher for a free fitness consultation. RESULTS: Regression analyses indicated that perceived exertion predicted change in self-efficacy. In turn, greater change in self-efficacy was associated with a greater likelihood of using the voucher for a fitness consultation. DISCUSSION: Sedentary older adults can be motivated toward joining a strength training program after an initial strength training session that required low exertion. Practitioners could increase strength training initiation by providing such experiences.

Aged↗

Acute Performance, Mechanical and Thermal Effects of Isometric Conditioning Versus Standardized Volleyball Pre-Training Activation in Highly Trained Male Players.

This study compared acute performance, neuromuscular, and thermal responses to a maximal isometric conditioning activity (ICA) versus a standardized volleyball pre-training activation (VPA) in highly trained male volleyball players, and to explore putative mechanisms underpinning post-activation performance enhancement (PAPE) considering training load. In a randomized crossover, 14 men (27 &#xb1; 3 y) completed two sessions: VPA (mobility/plyometric drills; 9 min), and ICA comprising 3&#xd7;5&#xd7;3-s maximal isometric back-squat contractions (knee angle 120&#xb0;; 3-min inter-set rest). Countermovement jump (CMJ) height (primary), relative peak power (PP), RSImod, and contraction time (CT) were recorded pre and 3, 6, 9, and 12 min post. Rectus femoris muscle viscoelastic properties and skin surface temperature (SST) were assessed at matched time points. Analyses used repeated-measures ANOVA, responder analysis, correlations, and regression. Period&#xd7;Sequence interactions favored ICA for CMJ and PP when delivered in Period 2 (lower training volume): &#x2206;CMJ was higher under ICA versus VPA (p = 0.005, d = 1.20); PP likewise greater (p = 0.026, &#x3b7;p2 = 0.35). ICA yielded more beneficial responders than VPA (9/14 vs 1/14; McNemar exact p = 0.021). In Period 2, reductions in rectus femoris muscle stiffness independently predicted CMJ gains (&#x3b2;_std = -0.495, p = 0.005), whereas SST changes did not (p = 0.974). RSImod and CT showed no differences. A brief, high-effort isometric squat protocol was associated with superior acute improvements in jump performance compared with a standard volleyball warm-up, but this advantage emerged specifically when the preceding training volume was reduced (Period 2), suggesting that residual fatigue from training may reduce the effects of PAPE. Gains align with neuro-mechanical rather than thermal mechanisms, supporting ICA as a practical, equipment-minimal priming strategy for elite volleyball.

Humans↗

[Exercise training in chronic obstructive pulmonary disease. Comparative study of aerobic training of lower limbs vs. combination with upper limbs].

A prospective, randomized and controlled study has been performed in 28 patients with severe COPD. A group of 14 has been trained with their lower limbs (LL), while another similar group of 14 patients was also trained with their upper limbs (UL). Results showed improvement in both groups in the endurance test for LL, dyspnea scale, efficiency and muscular working capacity. A considerable improvement was observed in the oxygen uptake at the anerobic threshold (VO2AT) which suggests a training effect, expressed through an improvement in exercise tolerance. Only the group who trained UL showed a remarkable improvement in the dyspnea scale, endurance test and maximal static mouth pressure, showing a better intrinsic working capacity and participation of the UL muscles producing those manoeuvres. At the end of training, quality of life was significantly increased and the hospitalization rate was lower in both groups. According to these findings, it is suggested that patients with severe COPD included in training programmes add UL exercises to the LL usually carried out.

Adult↗

[Training quality and quality training].

There is a growing need for all organizations to carry out in-house training based on concrete strategies to be able to face the risks involved in the working context. The area that is most in need of this training is the building sector as it has always been penalized by the poor qualification and cultural levels of its operators, which are among the lowest in the working world. The need to determine in-house training which meets this requirement calls for a particularly effective practical and methodological approach. To achieve this aim, not only is it important that the training programme and the trainers fulfil the requirements of the Legislator, but they must also aim at both improving the technical quality and increasing the qualifications and cultural growth of the human resources. The purpose of this contribution is to advance a correct methodological approach aimed at training quality and quality training.

Education↗

Surgical training posts in Northern Ireland: assessment by surgeons in training.

Northern Ireland has one of the largest surgical training programmes in the United Kingdom. The surgical trainees' assessment of the quality of training provided has been collated prospectively since 1983, and provides a useful insight into the strengths and weaknesses of the programme, as well as the training value of individual posts. The overall quality of clinical training in surgery was considered to be well above average, but some registrars felt that supervision of operative surgery could be improved. Clinical research was considered to be of average quality in the teaching hospitals but below average in district general hospitals. In the current climate of restriction of the number of training posts in general surgery, the views of the trainees should not be neglected in assessing which posts are best suited for training.

Education, Medical, Continuing↗

Variation in lengths of training among residents enrolled in pediatrics and internal medicine training programs.

Data were gathered in 1987 from 180 pediatrics and 302 internal medicine residency training programs about (1) the length of vacation provided their residents, (2) time allowed them for absence from work for reasons other than vacation, (3) how many of them during the previous three years had been required to extend their training to make up absences from work, and (4) whether a system was in place to cover their unexpected absences from work. All these variables affect the duration--but not necessarily the quality--of training that residents actually experience. The data show that these variables demonstrated wide ranges that depended on the postgraduate year of training, the discipline, the program size, and the program type (university, university-affiliated, freestanding, or military). The Accreditation Council for Graduate Medical Education, training program directors, and the American Board of Pediatrics and the American Board of Internal Medicine each need to consider these variables in making their respective decisions about accrediting training programs, verifying the clinical competence of trainees, and certifying program graduates.

Accreditation↗

Pediatric resident training in telephone management: a survey of training programs in the United States.

Although practicing pediatricians spend a major portion of each day in the management of acute illness via telephone, information concerning instructional programs in telephone management is scanty. A 34-item questionnaire was mailed to the 242 program directors of US training programs to obtain information on how telephone calls are handled in pediatric training programs and how pediatric house officers are trained in telephone management. Fifty-five percent of programs have a formalized system for handling telephone calls. One half of programs have a policy on who can answer telephone calls; 11% stated that only physicians are permitted to handle calls. Residents handle an average of 19 calls per day (39% of the total calls received). Only 51% of programs document any telephone calls and only 19% document all calls. Despite the volume of calls handled by pediatric residents, only 45% of training programs offer specific training in telephone management. The most common instructional method is lecturing. Less than one third of programs have a review system or periodically audit telephone calls. Programs that offer resident training in telephone management are significantly more likely to have a system for handling calls, to document calls, and to have a review system.

Acute Disease↗