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PubMed1997

Evaluation of diarrhoea management of health professionals trained at the Diarrhoea Training Unit of Rawalpindi General Hospital.

To promote the use of oral rehydration therapy (ORT), a training programme was launched by The Pakistan National Programme for Control of Diarrhoeal Disease (CDD) by establishing the Diarrhoea Training Units (DTUs). Physicians trained at DTU were designated to establish functioning oral rehydration therapy (ORT) corners at their health centres and train health workers in delivery of facilities on standard diarrhoea case management. The study was designed to evaluate the functioning of ORT corners three years after their establishment. The study revealed that ORT corners have failed to achieve the main objectives of DTU programme. Twenty-four out of 49 ORT corners were non-functional after three years of their establishment, mainly due to frequent transfers of trained staff. In 22 ORT corners evaluated, performance of health professionals was far from satisfactory, 19 out of 22 doctors were found to have inadequate performance in diarrhoea management and only 3 out of 7 LHVs performed adequately. LHVs could not consistently deliver health education messages to mothers. There seems to be a lack of interest and willingness to participate actively, as more than 50% of both doctors and LHVs did not consider ORT work as their job. We conclude that the ultimate objectives of improved and appropriate diarrhoea case management through ORT corners have not been achieved.

Antidiarrheals↗

PubMed1997

Is interruption in residency training associated with a change in in-training examination scores?

BACKGROUND: Many military physicians interrupt their training to serve in the position of general medical officer (GMO) after completing their first year of postgraduate medical education. This study compares American Board of Family Practice In-training Examination (ITE) scores of military family practice residents who received continuous training (CFP residents) with those who did GMO tours (GMO residents). METHODS: Historical cohorts of CFP and GMO residents from Army and Navy family practice residencies were compared. The dependent measures were their ITE scores in each year of training. Paired data were analyzed using the Student's test. RESULTS: There were no significant differences in composite or clinical problem set scores between GMO and CFP resident groups. Power to detect a true difference between the groups was 74. CONCLUSIONS: Interruption in residency training is not associated with a significant change in the returning resident's ITE scores.

Achievement↗

PubMed1998

[European Program for Intervention Epidemiology Training (EPIET): a training epidemiologic intervention in Europe].

The European programme for interventional epidemiology training (EPIET) offers a two year practical training in European national institutes mandated for the surveillance and control of communicable diseases. The training, closely supervised by senior epidemiologists, allows each EPIET fellow to learn while serving and conducting tasks devoted to intervention epidemiologists (surveillance, investigation, research, aid to decision making, and communication with the public, the media, the health authorities and the scientific community). The programme is equally funded by the European Commission, the 15 member states, Norway and the World Health Organisation. This training, derived from the North American and British experiences offers a practical complement to knowledge acquired from European universities. EPIET fellows, their supervisors and colleagues from training institutes have rapidly formed a network of intervention epidemiologists necessary for conducting and coordinating the surveillance of communicable diseases in Europe.

Communicable Diseases↗

PubMed1983

Staff training through collaboration: the training resources center.

As fiscal resources for mental health programs dwindle, it is becoming increasingly important to preserve non-direct-service priorities such as staff development. The West Virginia Training Resources Center, a collaborative program operated by the West Virginia Department of Health and the West Virginia University department of behavioral medicine and psychiatry, addresses problems of staff training in the state mental health service system. The authors discuss the development of the center and its functions as provider of training programs, sponsor of statewide training conferences, and clearinghouse of information and expertise. They also discuss problems stemming from the increased need for continuing education for paraprofessionals, the use of outside consultants, and the relationship between academia and the health service sector.

Community Mental Health Centers↗

PubMed1982

Square-wave endurance exercise test (SWEET) for training and assessment in trained and untrained subjects. II. Blood gases and acid-base balance.

In order to obtain information about physiological and homeostasic responses at the maximal Intensity of Endurance of the 45 min "Square-Wave Endurance Exercise Test" (MIE45), three arterial blood samples were taken: (a) at rest; (b) at the 45th min of the SWEET; (c) after 15 min of recovery, to measure paO2, paCO2, [H+], [Hb], and [lactate] in 14 normal male subjects: four trained (T) six well trained (WT) and four others untrained (U). Total mechanical work (TMW) corresponding to MIE45 was significantly higher (mean +/- SEM) respectively in WT (9.22 +/- 0.65 kJ . kg-1, p less than 0.001), than in T (7.17 +/- 0.18 kJ . kg-1, p less than 0.01) and U subjects (4.44 +/- 0.36, p less than 0.001). Because of this the lactate level, which rose significantly during exercise, differed between U and WT subjects (p less than 0.05). In spite of the exhaustive character of the MIE45, [H+] and paO2 remained within the range of normal values. These results suggest that trained and untrained subjects can be trained with the exhausting MIE45 exercise while maintaining a constant [H+] and paO2 at the 45th min of exercise.

Acid-Base Equilibrium↗

PubMed2000

Neuromuscular adaptation during prolonged strength training, detraining and re-strength-training in middle-aged and elderly people.

Effects of a 24-week strength training performed twice weekly (24 ST) (combined with explosive exercises) followed by either a 3-week detraining (3 DT) and a 21-week re-strength-training (21 RST) (experiment A) or by a 24-week detraining (24 DT) (experiment B) on neural activation of the agonist and antagonist leg extensors, muscle cross-sectional area (CSA) of the quadriceps femoris, maximal isometric and one repetition maximum (1-RM) strength and jumping (J) and walking (W) performances were examined. A group of middle-aged (M, 37-44 years, n = 12) and elderly (E, 62-77, n = 10) and another group of M (35-45, n = 7) and E (63-78, n = 7) served as subjects. In experiment A, the 1-RM increased substantially during 24 ST in M (27%, P<0.001) and E (29%, P<0.001) and in experiment B in M (29%, P<0.001) and E (23%, P<0.01). During 21 RST the 1-RM was increased by 5% at week 48 (P<0.01) in M and 3% at week 41 in E (n.s., but P<0.05 at week 34). In experiment A the integrated electromyogram (IEMG) of the vastus muscles in the 1-RM increased during 24 ST in both M (P<0.05) and E (P<0.001) and during 21 RST in M for the right (P<0.05) and in E for both legs (P<0.05). The biceps femoris co-activation during the 1-RM leg extension decreased during the first 8-week training in M (from 29+/-5% to 25+/-3%, n.s.) and especially in E (from 41+/-11% to 32+/-9%, P<0.05). The CSA increased by 7% in M (P<0.05) and by 7% in E (P<0.001), and by 7% (n.s.) in M and by 3% in E (n.s.) during 24 ST periods. Increases of 18% (P<0.001) and 12% (P<0.05) in M and 22% (P<0.001) and 26% (P<0.05) in E occurred in J. W speed increased (P<0.05) in both age groups. The only decrease during 3 DT was in maximal isometric force in M by 6% (P<0.05) and by 4% (n.s.) in E. During 24 DT the CSA decreased in both age groups (P<0.01), the 1-RM decreased by 6% (P<0.05) in M and by 4% (P<0.05) in E and isometric force by 12% (P<0.001) in M and by 9% (P<0.05) in E, respectively, while J and W remained unaltered. The strength gains were accompanied by increased maximal voluntary neural activation of the agonists in both age groups with reduced antagonist co-activation in the elderly during the initial training phases. Neural adaptation seemed to play a greater role than muscle hypertrophy. Short-term detraining led to only minor changes, while prolonged detraining resulted in muscle atrophy and decreased voluntary strength, but explosive jumping and walking actions in both age groups appeared to remain elevated for quite a long time by compensatory types of physical activities when performed on a regular basis.

Adaptation, Physiological↗

PubMed2002

Phonetogram changes for trained singers over a nine-month period of vocal training.

Professional vocalists encounter demands requiring voluntary control of phonation, while utilizing a considerable range of frequency and intensity. These quantifiable acoustic events can be measured and represented in a phonetogram. Previous research has compared the phonetograms of trained and untrained voices and found significant differences between these groups. This study was designed to assess the effects of vocal training for singers over a period of nine months. Phonetogram contour changes were examined, with the primary focus on expansion of frequency range and/or intensity control. Twenty-one first-year, master's level, vocal music students, who were engaged in an intensive vocal performance curriculum, participated in this study. Following nine months of vocal training, significant differences were revealed in the subjects' mean frequency range and minimum vocal intensity across frequency levels. There was no significant difference for the mean maximum vocal intensity across frequency levels following vocal training.

Adult↗

PubMedDate not supplied

Aerobic exercise adaptations in trained adolescent runners following a season of cross-country training.

Adaptations in aerobic exercise responses as well as the relationship between aerobic exercise responses and running performance were examined in a group of previously trained adolescent runners (n = 9; 15.9 +/- 1.0 years) over the course of a competitive cross-country season. Running economy (RE), submaximal blood lactate concentration [BLa] and VO2max were assessed before and immediately after the season. Five-km race time improved (P < 0.05) from 18.68 +/- 1.10 min at the beginning of the season to 18.16 +/- 1.11 min at the end of the season. Significant increases were observed in peak VO2 (61.6 +/- 3.5 to 65.3 +/- 2.9 mL x kg(-1) x min(-1)) and graded exercise test time (11.32 +/- 1.56 to 12.22 +/- 0.79 min). There was a tendency for RE (P = 0.051) to worsen slightly and for [BLa] (P = 0. 057) to decline as a result of training. At the beginning of the season submaximal [BLa] at 14 km x hr(-1) (r = 0.86) and graded exercise test time (r = -0.87) were significantly related to 5-km time. At the end of the season, RE (r = 0.78) and [BLa] (r = 0.77) at 14 km x hr(-1) and graded exercise test time (r = -0.69) were significantly related to race time. In this well-trained group of runners, further training during the cross-country season increased peak VO2 and improved race time. Submaximal [BLa] and graded exercise test time appear to be the most robust predictors of performance, while RE became a significant predictor of race time at the end of the season.

Adaptation, Physiological↗

PubMedDate not supplied

Suicide prevention training after traumatic brain injury: evaluation of a staff training workshop.

OBJECTIVES: To evaluate a suicide prevention training workshop for staff working in the field of traumatic brain injury (TBI) and to develop new measures for evaluation of similar training in the future. DESIGN: A prospective controlled pre- and posttest evaluation with a 6-month follow-up. SUBJECTS: Multidisciplinary TBI rehabilitation and disability staff from the state of Victoria attending the workshop (n=50) and an equivalent control group (n=28) recruited from New South Wales. SETTING: A statewide training workshop was held at a major rehabilitation center in Melbourne. OUTCOME MEASURES: Three designed measures including an objective knowledge test, a self-assessment inventory of knowledge/skills and an attitudinal inventory. RESULTS: Participants recorded statistically significant increases in their scores comparing the pre- to postworkshop evaluations. Many of these gains were maintained at the 6-month follow-up evaluation. In contrast, the control group had scores equivalent to those of workshop participants on the pretest evaluations but recorded no similar increase at follow-up. Factor analysis found that the knowledge and skills self-assessment inventory had 2 factors, each having good internal reliability. CONCLUSION: The current workshop has proved effective in increasing staff knowledge and skills in the assessment and management of people with TBI exhibiting suicidal behaviors. Finally, the initial development of a knowledge and skills self-assessment measure shows promise, providing a resource for the ongoing evaluation of suicide prevention training in the TBI field.

Adult↗

PubMed1997

Postgraduate training. Policy paper prepared by the Subcommittee on Postgraduate training: Permanent Working Group of European Junior Hospital Doctors.

The Permanent Working Group of European Junior Hospital Doctors (PWG) represents the interests, in international matters, of trainees from 23 member states. The PWG recognizes the importance of postgraduate training (PGT) in the maintenance of high quality health care delivery, and in this paper presents its current policy on PGT. This replaces its policy previously published in Medical Education 1989, 23, 339-47. The paper examines the context within which PGT occurs, and calls for an urgent review of its provision and funding. Basic principles, such as PGT existing within a continuum of medical education and the application of a quality assurance-based model, underpin the development of later sections on the structure, process and outcomes of PGT. These recommend the establishment of structured training programmes which should incorporate modern educational practice in the provision and monitoring of PGT. Emphasis is placed on the opportunities for training in the clinical setting and the utilization of a range of educational techniques. Evaluation and guidance by and of clinical supervisors and designated trainers is linked with the responsibilities of the trainee, and is placed within the context of a system of accountability, thus closing the quality assurance cycle. It is recommended that the views of the consumers of PGT, the trainees, are more fully considered in the development of training programmes. Finally, the potential for further harmonization is considered, with cautious advances being proposed.

Attitude↗

PubMed2000

Short-term training: when do repeated bouts of resistance exercise become training?

Chronic resistance training induces increases in muscle fibre cross-sectional area (CSA), otherwise known as hypertrophy. This is due to an increased volume percentage of myofibrillarproteins within a given fibre. The exact time-course for muscle fibre hypertrophy is not well-documented but appears to require at least 6-7 weeks of regular resistive training at reasonably high intensity before increases in fibre CSA are deemed significant. Proposed training-induced changes in neural drive are hypothesized to increase strength due to increased synchrony of motor unit firing, reducedant agonist muscle activity, and/or a reduction in any bilateral strength deficit. Nonetheless, increases in muscle protein synthesis were observed following an isolated bout of resistance exercise. In addition, muscle balance was positive, following resistance exercise when amino acids were infused/ingested. This showed that protein accretion occurred during the postexercise period. The implications of this hypothesis for training-induced increases in strength are discussed.

Adaptation, Physiological↗

PubMed1992

Endurance training amplifies the pulsatile release of growth hormone: effects of training intensity.

The effects of intensity of run training on the pulsatile release of growth hormone (GH) were investigated in 21 eumenorrheic untrained women. The O2 consumption (VO2) at the lactate threshold (LT); fixed blood lactate concentrations (FBLC) of 2.0, 2.5, and 4.0 mM; peak VO2; maximal VO2; body composition; and pulsatile release of GH were measured. Subjects in both the at-lactate threshold (/LT, n = 9) and above-lactate threshold (greater than LT, n = 7) training groups increased VO2 at LT and FBLC of 2.0, 2.5, and 4.0 mM and VO2max after 1 yr of run training. However, the increase observed in the greater than LT group was greater than that in the /LT group (P less than 0.05). No change was observed for the control group (n = 5). No among- or within-group differences were observed for body weight, although trends for reductions in percent body fat (P less than 0.06) and fat weight (P less than 0.15) were observed in the greater than LT group, and both training groups significantly increased fat-free weight (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1994

PMN cell counts and phagocytic activity of highly trained athletes depend on training period.

We tested the hypothesis that polymorphonuclear leukocyte (PMN) cell counts and phagocytic activity determined by latex ingestion and superoxide anion production are influenced by different training periods. We investigated long-distance runners before and up to 24 h after a graded exercise test to exhaustion during moderate training (MT) and intense training (IT) and compared them with untrained (control) subjects. Cell counts and phagocytic activity at rest and after exercise did not differ significantly between MT and control. On the contrary, IT showed a significant (P < or = 0.05) decrease in PMN cell count at rest (2.55 +/- 0.3 cells/nl) compared with MT (3.63 +/- 0.2 cells/nl) and control (3.41 +/- 0.8 cells/nl). Furthermore, phagocytic activity was significantly reduced (P < or = 0.05) in IT at rest and after exercise compared with MT and control. A strong inverse correlation (r = -0.75; P < or = 0.01) between epinephrine and superoxide anion production was found. These results provide evidence that the phagocytic activity depends on the training period and indicate impaired PMN functions during IT, which might lead to increased susceptibility to infection.

Adult↗

PubMed1999

Flexible specialist training compared with full-time training.

The educational and training quality of flexible training posts compared very well and in some instances was better than that obtained in full-time training. The hours of work were fewer, but as a proportion not as small as is sometimes recognized by the Colleges and is comparable with many full-time training programmes in other European Union countries.

Curriculum↗

PubMed2005

Evaluation of a standardized physical training program for basic combat training.

A control group (CG, n = 1,138) that implemented a traditional Basic Combat Training (BCT) physical training (PT) program was compared to an evaluation group (EG, n = 829) that implemented a PT program newly designed for BCT. The Army Physical Fitness Test (APFT) was taken at various points in the PT program, and injuries were obtained from a medical surveillance system. After 9 weeks of training, the proportion failing the APFT was lower in the EG than in the CG (1.7 vs. 3.3%, p = 0.03). After adjustment for initial fitness levels, age, and body mass index, the relative risk of an injury in the CG was 1.6 (95% confidence interval [CI] =1.2-2.0) and 1.5 (95% CI = 1.2-1.8) times higher than in the EG for men and women, respectively. The newly designed PT program resulted in higher fitness test pass rates and lower injury rates compared to a traditional BCT physical training program.

Adaptation, Physiological↗

PubMed2006

Short-term plyometric training improves running economy in highly trained middle and long distance runners.

Fifteen highly trained distance runners VO(2)max 71.1 +/- 6.0 ml.min(-1).kg(-1), mean +/- SD) were randomly assigned to a plyometric training (PLY; n = 7) or control (CON; n = 8) group. In addition to their normal training, the PLY group undertook 3 x 30 minutes PLY sessions per week for 9 weeks. Running economy (RE) was assessed during 3 x 4 minute treadmill runs (14, 16, and 18 km.h(-1)), followed by an incremental test to measure VO(2)max. Muscle power characteristics were assessed on a portable, unidirectional ground reaction force plate. Compared with CON, PLY improved RE at 18 km.h(-1) (4.1%, p = 0.02), but not at 14 or 16 km.h(-1). This was accompanied by trends for increased average power during a 5-jump plyometric test (15%, p = 0.11), a shorter time to reach maximal dynamic strength during a strength quality assessment test (14%, p = 0.09), and a lower VO(2)-speed slope (14%, p = 0.12) after 9 weeks of PLY. There were no significant differences in cardiorespiratory measures or VO(2)max as a result of PLY. In a group of highly-trained distance runners, 9 weeks of PLY improved RE, with likely mechanisms residing in the muscle, or alternatively by improving running mechanics.

Adult↗

PubMed2001

Interval training for performance: a scientific and empirical practice. Special recommendations for middle- and long-distance running. Part II: anaerobic interval training.

Studies of anaerobic interval training can be divided into 2 categories. The first category (the older studies) examined interval training at a fixed work-rate. They measured the time limit or the number of repetitions the individual was able to sustain for different pause durations. The intensities used in these studies were not maximal but were at about 130 to 160% of maximal oxygen uptake (VO2max). Moreover, they used work periods of 10 to 15 seconds interrupted by short rest intervals (15 to 40 seconds). The second category (the more recent studies) asked the participants to repeat maximal bouts with different pause durations (30 seconds to 4 to 5 minutes). These studies examined the changes in maximal dynamic power during successive exercise periods and characterised the associated metabolic changes in muscle. Using short-interval training, it seems to be very difficult to elicit exclusively anaerobic metabolism. However, these studies have clearly demonstrated that the contribution of glycogenolysis to the total energy demand was considerably less than that if work of a similar intensity was performed continuously. However, the latter studies used exercise intensities that cannot be described as maximal. This is the main characteristic of the second category of interval training performed above the minimal velocity associated with VO2max determined in an incremental test (vVO2max). Many studies on the long term physiological effect of supramaximal intermittent exercise have demonstrated an improvement in VO2max or running economy.

Adult↗

PubMed1985

Physical training and personality factors as predictors of marathon time and training injury.

On the basis of surveys completed by 105 male participants in a popular marathon, a multiple regression analysis was conducted to identify the variables contributing significantly to the prediction of final time. Overall prediction was successful, with R = .896, and training pace was the most important factor in the equation, speedier workouts being associated with faster marathon times. Final time was also related positively to best 10-km race time in the previous 12 mo. and repression-sensitization (faster runners being more sensitized), and negatively to maximum number of training miles in a single week, number of previous marathons completed, and number of days of training lost through illness or injury. Contrary to expectations, locus of control was not related to final time. Only 27% of the runners had lost training time through injury, but a discriminant analysis showed that, compared to those who had avoided this problem, the injured were younger, rested less, ran less in the week prior to the marathon, ran a slightly longer long run but ran it earlier before the race, and ran fewer runs of 20 miles or more. It is suggested that researchers should study the repression-sensitization variable and investigate injury in runners preparing for a marathon.

Anxiety↗