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PubMed1985

Post-training brain catecholamine levels: lack of response to water-motivated training.

Rats were trained in a one-trial appetitive task using water motivation. Brain catecholamine and metabolite levels were assessed in samples collected 10 min after training. There was no evidence that brain NE levels were modified by training, although catecholamine levels increased when the animals were placed in a novel environment. These results differ from those obtained after avoidance training where the extent of a post-training decrease in brain norepinephrine predicts later retention performance.

3,4-Dihydroxyphenylacetic Acid↗

PubMed1999

Radiation oncology training in the United States: report from the Radiation Oncology Resident Training Working Group organized by the Society of Chairman of Academic Radiation Oncology Programs (SCAROP).

PURPOSE: In response to the major changes occurring in healthcare, medical education, and cancer research, SCAROP addressed issues related to post-graduate education that could enhance existing programs and complement the present system. METHODS AND MATERIALS: SCAROP brought together a Working Group with a broad range of representatives organized in subcommittees to address: training, curriculum, and model building. RESULTS: The Working Group emphasized the importance of training physicians with the necessary clinical, scientific, and analytical skills, and the need to provide expert radiation oncology services to patients throughout the United States. Opportunities currently exist for graduates in academic medicine, although there may be limited time and financial resources available to support academic pursuits. CONCLUSIONS: In the face of diminishing resources for training and education and the increased scope of knowledge required, a number of models for resident training are considered that can provide flexibility to complement the present system. This report is intended to initiate dialogue among the organizations responsible for radiation oncology resident education so that resident training can continually evolve to meet the needs of cancer patients and take advantage of opportunities for progress through innovative cancer care and research.

Curriculum↗

PubMed1999

Mnemonic training in older adults: effects of age, length of training, and type of cognitive pretraining.

OBJECTIVES: To improve performance with mnemonic techniques for remembering words and proper names. DESIGN: For word recall, a 2 x 2 factorial in which type of pretraining and length of training were between-subjects manipulations. For proper name recall, a two-group design in which type of pretraining was manipulated between subjects. SETTING: Community. PARTICIPANTS: 268 community-dwelling adults over the age of 55 years who wished to improve their memory. MEASUREMENTS: Recall of words and proper names both before and after training in mnemonics. INTERVENTION: Participants received a 2-week training course on two mnemonic techniques, the method of loci for words and a name association technique for proper names. RESULTS: There was no effect of the pretraining manipulation on proper name recall. For word recall, however, a multiple regression that included age indicated that the older-old participants benefited more from a combination of comprehensive pretraining and extended mnemonic training than did the younger-old. CONCLUSIONS: Increased training time coupled with a comprehensive pretraining regimen can improve the performance of the older-old in using mnemonics; this improved performance cannot be attributed solely to enhanced knowledge of the mnemonic.

Age Factors↗

PubMed2000

Goal-directed fantasy does not explain the training effect of the Carleton Skills Training Package.

Two treatments to enhance the hypnotic responsiveness of subjects who pretested as low in hypnotic susceptibility were compared. Subjects in one modification treatment (n = 20) received the Carleton Skills Training Package (CSTP). Those in a second modification treatment (n = 20) were administered a partial training that did not include information about imaginal strategies. The authors of the CSTP assume that goal-directed fantasies underlie subjects' feelings of involuntariness, so teaching imaginal strategies is the primary agent of subjective changes after the training. Controls (n = 20) received no treatment. Both training packages enhanced behavioral and subjective response to an equivalent degree. Control subjects' performances were stable across tests. Modest increases in hypnotizability scores following training were related neither to enhancing goal-directed fantasies nor to use of imagery. Other mechanisms, possibly compliance, may underlie the CSTP effect.

Adult↗

PubMed2004

The Yorkshire Modular Training Programme: a model for structured training and quality assurance in obstetrics and gynaecology.

Recent changes in postgraduate education have highlighted the need for structured training to ensure quality in training and optimize patient care. In Yorkshire, a "modular" approach to postgraduate education in obstetrics and gynaecology has been adopted through the Yorkshire Modular Training Programme (YMTP). The curriculum for trainees is divided into "modules" organized over five years. This provides a comprehensive educational package covering all aspects of obstetrics and gynaecology for trainees in the specialty. The YMTP provides a framework for region-wide integration and ownership of responsibility for teaching and training. It also provides quality assurance in education throughout the region and provides an "educational continuum" in which the different modules work together to meet the educational requirements of the trainees. It also aims to integrate "training" and "education" for the trainees. This paper describes the organization of the programme including its educational principles. It discusses its strengths and weaknesses. It provides a useful framework for postgraduate education that could be used by other regions.

Curriculum↗

PubMed2002

A comparison of traditional prosthetic training versus proprioceptive neuromuscular facilitation resistive gait training with trans-femoral amputees.

Reports in the rehabilitation literature suggest that patients with trans-femoral amputation ambulate well after suitable prosthetic treatment. The effects of exercise protocols on function, however, have not been documented in this population. This study was conducted to compare the outcome of traditional and proprioceptive neuromuscular facilitation (PNF) techniques on weight bearing and gait. Fifty unilateral trans-femoral amputees who were attending for their first prosthesis, participated in this study. Amputees were randomly assigned into groups receiving the traditional training or PNF. Traditional treatment was consisted of weight-shifting, balancing, stool-stepping and gait exercises. In the other group the same activities were given by PNF. Amputees were trained 30 minutes daily, for a total of 10 treatments. Pre- and post-training assessment included weight bearing measurements by using two bathroom scales and time-distance characteristics of gait from footprints. A statistically significant difference was found in all parameters within the groups due to pre- and post-training evaluation data (p<0.05), but more obvious improvement was observed in the group who received PNF (p<0.05). The results of the study suggest that the prosthetic training based on proprioceptive feedback was more effective to improve weight bearing and gait when compared with a traditional programme.

Adult↗

PubMed2002

Block-training in group psychotherapy in the Baltic States: Experiences from three years of training.

Since March 1995, the Institute of Group Analysis, Norway has been responsible for a block-training programme in group psychotherapy in Vilnius, Lithuania. Training takes place in English during five weekends per year, with participants from all three Baltic countries. There are three levels: one year basic course, two years advanced course and two years qualifying course. Elements in the training are self-experience in small and large groups, supervision and theory discussions. The plan is to educate local staff, who can then train colleagues on an independent basis. Evaluations show a high degree of satisfaction with the different elements of the course, and an initial honeymoon attitude has given way to a more realistic realization of what is required of a personal and professional commitment. Experiences from the first three years of training are presented.

Baltic States↗

PubMedDate not supplied

Structured research training in residency training programs. The impact on the level of resident research activity.

A survey was conducted to construct a profile of structured resident research training and experience in physiatric residency training programs. Resident research activity was quantified, and factors that may influence the level of resident research activity were examined. Questionnaires were sent to all 72 residency training program directors, of which 87% responded. To construct the profile of structured training and experience in research that currently exists, descriptive analyses were applied to the survey responses. Resident research activity was quantified according to projects per resident per year over the last 3 yr. Resident research activity was assigned to level I activity (> or = 0.25 projects/resident/year) or level II activity (< 0.25 projects/resident/year). This point of discrimination was chosen because it represents one project per resident per 4-yr graduate medical education cycle. Nonparametric, univariate analyses were used to evaluate the impact of each characteristic in the research training profile on resident research activity. The following characteristics were found to be statistically significant (P < 0.05): (1) the use of mentors outside of the physical medicine and rehabilitation department; (2) the provision of guidelines to residents for choosing a mentor; (3) the provision of responsibility guidelines to mentors; (4) the presence of a classroom curriculum. Mentorship outside of the department, however, had a negative impact on resident research activity, although the other three characteristics had positive impacts. A multivariate analysis using stepwise logistic regression was applied to further determine the capacity of each characteristic to predict independently the level of resident research activity. Only one characteristic simultaneously and independently remained significant (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance↗

PubMed1997

Gay and lesbian issues in child and adolescent psychiatry training as reported by training directors.

OBJECTIVE: Although increased evidence of disproportionate psychosocial risk and other health problems encountered by lesbian, gay male, and bisexual (LGB) youths has emerged, no study has described how the topic of homosexuality is addressed within child and adolescent residency psychiatry training. METHOD: Residency training directors in U.S. child and adolescent psychiatry programs were asked questions about instruction on the topic of homosexuality and the care of LGB patients, the department's view of whether homosexuality represents a pathological condition, the director's awareness of LGB colleagues and residents, and the director's opinion of LGB residents' disclosure of their homosexuality to their patients and patients' families. Asking similar questions facilitated a comparison of survey results with those of an earlier study of general psychiatry training directors. RESULTS: The reported departmental attitudes about whether homosexuality represents a pathological condition were essentially equivalent in general and child programs. Child and adolescent training directors were, however, less likely to have a favorable view of disclosure of sexual orientation to patients, less likely to know LGB residents or faculty, and less likely to report LGB residents an asset to their departments. CONCLUSIONS: The prediction that the majority of child and adolescent training programs would reflect a heightened awareness of the vulnerability of LGB youths was not confirmed.

Adolescent↗

PubMed2006

The complementary Erlangen active simulator for interventional endoscopy training is superior to solely clinical education in endoscopic hemostasis--the French training project: a prospective trial.

BACKGROUND: The Erlangen Active Simulator for Interventional Endoscopy (EASIE) using ex-vivo porcine organs was introduced in 1997. The present study should analyze whether repeated EASIE simulator training in endoscopic hemostasis led to superior performance compared with a traditionally educated group. The results were compared with a similar project in New York. METHODS: Thirty-five French GI fellows were enrolled. Baseline skills evaluation was performed in four disciplines (manual skills, injection/coagulation, clip application and variceal ligation) using the compactEASIE-simulator equipped with an upper gastrointestinal organ package for bleeding simulation. The same, translated evaluation forms (from the prior New York project) were used. Subsequently, fellows were randomized into group A (n=17, only clinical education) and group B (n=18, additional three simulator trainings). Group B was trained the next day and after 4 and 7 months by experts of the French Society of Gastrointestinal Endoscopy. Both groups performed routine and emergency endoscopies at their home hospitals during the study period. Both groups were re-evaluated blindly after 9 months. RESULTS: The learning curve for group B showed a significant improvement in all disciplines (P<0.004) whereas group A improved significantly in only two of four disciplines at blinded final evaluation (manual skills P=0.02, injection/coagulation P=0.013). The direct comparison of groups B and A at blinded final evaluation showed significantly superior ratings for group B in all disciplines (P<0.006) and significantly shorter performance times in two disciplines (P=0.016 each). The comparison with the similar 'New York project' revealed that preexisting differences in skills were adjusted by the training. CONCLUSION: Complementary trainings (three workshops in 7 months) in endoscopic hemostasis using the compactEASIE improved skills compared with a solely clinical education. The results of the 'New York project' were confirmed and benefits were independent from the medical educational system.

Animals↗

PubMed1997

Primary care consultation skills training: implementing a new training programme for senior house officers in an accident and emergency department.

Senior house officers (SHOs) in Accident and Emergency (A&E) departments see many patients who present with primary care problems. Until now, most SHOs have lacked postgraduate training in primary care skills to enable them to meet these patients' needs effectively. This paper describes an innovative training programme that has been developing at King's College Hospital, London. It identifies a new opportunity for general practitioners to contribute to the postgraduate medical education of hospital junior medical staff. The training programme was designed to give A&E SHOs protected time in which to reflect on strengths and weaknesses in relation to primary care consultations and learn from their experiences. Its aim was to improve the assessment and management of patients, and to encourage a problem solving approach within the A&E setting. The programme, established in 1992, was developed through collaboration between the departments of A&E Medicine and General Practice and Primary Care. Evaluation has been a central theme in its development, and has been used to ensure that the training meets the needs of each individual set of SHOs and of the department. It has been used in establishing agreement about the training's value and benefits. The authors discuss some of the methodological difficulties encountered in evaluating this type of educational initiative.

Clinical Competence↗

PubMed2005

Shoulder dystocia training using a new birth training mannequin.

Shoulder dystocia 'skill drills' are a requirement for the Maternity CNST standards. However, there is, as yet, no evidence that training in the management of shoulder dystocia improves outcome. We developed a mannequin for training and investigated its effectiveness. The management of shoulder dystocia improved following training with the mannequin. There was a reduction in the head-to-body delivery duration, and the maximum applied delivery force, following training; however, these did not reach statistical significance. After training no subject applied a delivery force of greater than 100 N, a level above which fetal injury has been shown to occur.

Clinical Competence↗

PubMed1985

Training non-psychologists in the treatment of sexual dysfunction with special reference to the training of marriage guidance counsellors.

This paper describes a study in which marriage guidance counsellors were trained in the treatment of sexual difficulties. This study is discussed in the wider context of the literature concerned with training issues in the treatment of sexual function problems. The results of the training programme give clear evidence that non-professionals can be trained to produce results similar to those of a professional and it is argued that issues discussed in the literature concerning the training of professionals in the treatment of sexual difficulties are also applicable to non-professionals.

Counseling↗

PubMed2005

Vitamin D receptor FokI genotype influences bone mineral density response to strength training, but not aerobic training.

To determine the influence of the vitamin D receptor (VDR) gene FokI and BsmI genotype on bone mineral density response to two exercise training modalities, 206 healthy men and women (50-81 years old) were studied before and after approximately 5-6 months of either aerobic exercise training (AT) or strength training (ST). A totla of 123 subjects completed AT (51 men, 72 women) and 83 subjects completed ST (40 men, 43 women). DNA was extracted from blood samples of all subjects and genotyping was performed at the VDR FokI and BsmI locus to determine its association to training response. Total body, greater trochanter and femoral neck bone mineral density (BMD) were measured before and after both training programmes using dual-energy X-ray absorptiometry. VDR BsmI genotype was not significantly related to BMD at baseline or after ST or AT. However, VDR FokI genotype was significantly related to ST- but not AT-induced changes in femoral neck BMD (P < 0.05). The heterozygotes (Ff) in the ST group approached a significantly greater increase in femoral neck BMD (P = 0.058) compared to f homozygotes. There were no significant genotype relationships in the AT group. These data indicate that VDR FokI genotype may influence femoral neck BMD response to ST, but not AT.

Absorptiometry, Photon↗

PubMed2003

Effects of creatine on body composition and strength gains after 4 weeks of resistance training in previously nonresistance-trained humans.

This study examined the effects of Cr supplementation on muscle strength in conjunction with resistance training in nonresistance-trained males utilizing strategies previously reported in the literature to help optimize muscle CR uptake. Nineteen nonresistance-trained males underwent 4 weeks of resistance training (3 days x week(-1)) while assigned to Cr (20 g x d(-1) Cr + 140 g x d(-1) glucose) for 7 days (loading), followed by 5 g x d(-1) Cr + 35 g x d(-1) glucose for 21 days (maintenance; n = 9) or placebo (160 g x d(-1) glucose [loading] followed by 40 g x d(-1) [maintenance; n = 10]). In subjects classified as "responders" to Cr on the basis of body mass changes (n = 7), the magnitude of change in 180 degrees x s(-1) isokinetic (p = .029) and isometric (p = .036) force was greater compared to the placebo group. A positive correlation was found between changes in body mass and 180 degrees x s(-1) isokinetic (loading: r = 0.68, p = .04; maintenance: r = 0.70, p = .037) and isometric (loading: r = 0.82, p < .01) force. Estimated Cr uptake was also positively correlated with changes in isometric force (r = 0.71, p = .033). These results indicate that Cr supplementation can increase muscle strength (allied with 4 weeks of strength training) but only in subjects whose estimated Cr uptake and body mass are significantly increased; the greater the Cr uptake and associated body mass changes, the greater the performance gains.

Adult↗

PubMed2004

Comparison of water turnover rates in young swimmers in training and age-matched non-training individuals.

Total body water (TBW) and water turnover rates (WTR) of 8 competitive swimmers (SW) and 6 age-matched non-training individuals (CON) were determined using deuterium oxide dilution and elimination. During the 7-day study, individuals in the SW group trained 9 times, swimming on average 42.4 km, while the CON group did no regular exercise. Water temperature in the swimming pool was between 26 and 29 degrees C during training sessions. Body mass at the beginning and end of the study period remained essentially the same in the SW (67.8+/- 6.3 kg) and CON (61.1 +/- 8.5 kg) groups. Mean +/- SD TBW of the SW (38.7+/- 5.6 L) was similar to that of the CON (37.5 +/- 8.0 L). Mean WTR was faster in the SW (54 +/- 18 ml x kg x day(- 1) than the CON (28+/- 21 ml x kg x day(-1)). Mean daily urine output was similar in the SW (14 +/- 5 ml x kg x day(-1)) and CON (14+/- 3 ml x kg x day(-1)). Calculated non-renal daily water loss was faster in the SW (41 +/- 21 ml x kg x day(-1)) than the CON (13 +/- 20 ml x kg x day(-1)). This study demonstrates that WTR are faster in young swimmers who exercise strenuously in cool water than in non-training individuals and that the difference was due to the approximately 3-times greater non-renal water losses that the exercising group incurred. This suggests that exercise-induced increases in sweat rates are a major factor in water loss in swimmers training in cool water.

Adolescent↗

PubMed2005

Exercise training and inspiratory muscle training in patients with bronchiectasis.

BACKGROUND: Bronchiectasis is a chronic suppurative lung disease often characterised by airflow obstruction and hyperinflation, and leading to decreased exercise tolerance and reduced health status. The role of pulmonary rehabilitation (PR) and inspiratory muscle training (IMT) has not been investigated in this group of patients. METHODS: Thirty two patients with idiopathic bronchiectasis were randomly allocated to one of three groups: PR plus sham IMT (PR-SHAM), PR plus targeted IMT (PR-IMT), or control. All patients (except the control group) underwent an 8 week training programme of either PR or PR plus targeted IMT. Exercise training during PR was performed three times weekly at 80% of the peak heart rate. IMT was performed at home for 15 minutes twice daily over the 8 week period. RESULTS: PR-SHAM and PR-IMT resulted in significant increases in the incremental shuttle walking test of 96.7 metres (95% confidence interval (CI) 59.6 to 133.7) and 124.5 metres (95% CI 63.2 to 185.9), respectively, and in endurance exercise capacity of 174.9% (95% CI 34.7 to 426.1) and 205.7% (95% CI 31.6 to 310.6). There were no statistically significant differences in the improvements in exercise between the two groups. Significant improvements in inspiratory muscle strength were also observed both in the PR-IMT group (21.4 cm H2O increase, 95% CI 9.3 to 33.4; p = 0.008) and the PR-SHAM group (12.0 cm H2O increase, 95% CI 1.1 to 22.9; p = 0.04), the magnitude of which were also similar (p = 0.220). Improvements in exercise capacity were maintained in the PR-IMT group 3 months after training, but not in the PR-SHAM group. CONCLUSION: PR is effective in improving exercise tolerance in bronchiectasis but there is no additional advantage of simultaneous IMT. IMT may, however, be important in the longevity of the training effects.

Breathing Exercises↗

PubMed2000

Exercise and training in women, Part I: Influence of gender on exercise and training responses.

Exercise and training responses in women are briefly reviewed. Part I of the paper considers the influence of gender on such responses. The average woman has a smaller inherent aerobic power and less muscular strength than a man, reflecting sociocultural influences, physical size, body composition, and hormonal milieu. Nevertheless, the best-trained women can out-perform sedentary men. The handicap of the average woman is offset by a lighter body mass and a tendency to metabolize fat rather than carbohydrate during exercise. A lack of anabolic hormones may limit training increases of muscle bulk in the female. A low initial fitness may enhance the scope for training tolerance, but it also limits tolerance of conditioning. Nevertheless, women seem less vulnerable than men to exercise-induced sudden death and overtraining. Part II of the review considers the influence of the menstrual cycle and pregnancy upon exercise and training responses. Physical activity programmes for young women should take account of possible pregnancy. Potential dangers to the foetus include an excessive rise of core body temperature, a decrease of maternal blood sugar, and foetal hypoxia. Nevertheless, regular moderate exercise generally has a favourable impact upon pregnancy outcomes.

Cardiovascular Physiological Phenomena↗