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At least 577 records · Page 32Linked to original sources

PubMed2002

Inspiratory muscle fatigue in trained cyclists: effects of inspiratory muscle training.

PURPOSE: This study evaluated the influence of simulated 20- and 40-km time trials upon postexercise inspiratory muscle function of trained competitive cyclists. In addition, we examined the influence of specific inspiratory muscle training (IMT) upon the responses observed. METHODS: Using a double-blind placebo-controlled design, 16 male cyclists (mean +/- SEM VO2max 64 +/- 2 mL.kg-1.min-1) were assigned randomly to either an experimental (IMT) or sham-training control (placebo) group. Maximum static and dynamic inspiratory muscle function was assessed immediately pre- and <2, 10, and 30 min post-simulated 20- and 40-km time trials before and after 6-wk of IMT or sham-IMT. RESULTS: Maximum inspiratory mouth pressure (P0) measured within 2 min of completing the 20- and 40-km time trial rides was reduced by 18% and 13%, respectively, and remained below preexercise values at 30 min. The 20- and 40-km time trials induced a reduction in inspiratory flow rate at 30% P0 by 14% and 6% in the IMT group versus 13% and 7% for the placebo group, and also remained below preexercise values at 30 min. There was also a significant slowing of inspiratory muscle relaxation rate postexercise; these trends were almost completely reversed by 30 min postexercise. Significant improvements in 20- and 40-km time trial performance were seen (3.8 +/- 1.7% and 4.6 +/- 1.9%, respectively; P < 0.05) and postexercise reductions in muscle function were attenuated with IMT. CONCLUSION: These data support existing evidence that there is significant global inspiratory muscle fatigue after sustained heavy endurance exercise. Furthermore, the present study provides new evidence that performance enhancements observed after IMT are accompanied by a decrease in inspiratory muscle fatigue.

Adult↗

PubMed2005

Locomotor training and virtual reality-based balance training for an individual with multiple sclerosis: a case report.

BACKGROUND AND PURPOSE: Impaired walking ability, balance, and fatigue are common problems for people with multiple sclerosis (MS). The purpose of this case report is to describe the use of plan of care that included locomotor training using both a body weight support (BWS) with a treadmill (TM) and overground walking as well as a virtual reality (VR)-based balance intervention to improve walking ability, balance, and endurance for an individual with MS. CASE DESCRIPTION: The client was a 48-year-old female with a 10-year history of MS. Her main goals were to improve walking ability, balance, and endurance. She presented with impaired gait, balance, motor function, and increased fatigue. Locomotor training using a BWS/TM system and overground and VR-based balance interventions were implemented 2 days a week for 12 weeks. OUTCOMES: The client demonstrated improvements in gait speed, gait endurance, and balance postintervention and maintained the improvements at a 2-month follow up. DISCUSSION: This case report is the first to report on the use of locomotor training with BWS/TM system and overground and VR-based balance interventions for a client with MS. The plan of care was formulated based on the patient's goals and the available literature on the use of the interventions with other patients with neurologic conditions to provide an intervention that was task-oriented, skilled, and intensive.

Female↗

PubMed2006

Simulation training for a mass casualty incident: two-year experience at the Army Trauma Training Center.

BACKGROUND: Civilian and military mass casualty incidents (MCI) are an unfortunate reality in the 21st century, but there are few situational training exercises (STX) to prepare for them. To fill this gap, we developed a MCI STX for U.S. Army Forward Surgical Teams (FST) in conjunction with the U.S. Army Trauma Training Center. METHODS: After a standardized briefing, each FST has 60 minutes to unpack, setup, and organize a standard equipment cache into an emergency room, operating room, and intensive care unit. In an adjacent room, five anesthetized swine are prepared with standardized, combat-relevant injuries. The number and acuity of the total casualties are unknown to the FST and arrive in waves and without warning. A realistic combat environment is simulated by creating resource limitations, power outages, security breaches, and other stressors. The STX concludes when all casualties have died or are successfully treated. FSTs complete a teamwork self-assessment card, while staff and FST surgeons evaluate organization, resource allocation, communication, treatment, and overall performance. Feedback from each FST can be incorporated into an updated design for the next STX. RESULTS: From 2003-2005, 16 FSTs have completed the STX. All FSTs have had collapses in situational triage, primary/ secondary surveys, and/or ATLS principles (basic ABCs), resulting in approximately 20% preventable deaths. CONCLUSIONS: We concluded (1) a MCI can overwhelm even combat- experienced FSTs; (2) adherence to basic principles of emergency trauma care by all FST members is essential to effectively and efficiently respond to this MCI; (3) by prospectively identifying deficiencies, future military or civilian performance during an actual MCI may be improved; and (4) this MCI STX could provide a template for similar programs to develop, train, and evaluate civilian surgical disaster response teams.

Animals↗

PubMed1991

Vocational trainees' views of their undergraduate endodontic training and their vocational training experience.

By means of a questionnaire, the views of recently qualified graduates, who were participating in vocational training schemes, on their undergraduate endodontic training and postqualification experience were examined. On the basis of these finding suggestions are made as to what changes are necessary in their undergraduate training and how their skills can be further improved after qualification.

Education, Dental↗

PubMed1995

A skin cancer training programme: evaluation of a postgraduate training for family doctors.

This study aimed to evaluate the effectiveness of a postgraduate skin cancer training programme in improving family doctors' levels of knowledge and clinical practice. Forty-one of 59 family doctors (69% consent) who enrolled in the training programme agreed to participate in its evaluation. Approximately half of the doctors were allocated to the 'intervention' group, and the others were in the 'waiting-list' control group. Pre- and post-test data were collected to assess changes in doctors' knowledge, perceived confidence and clinical practice. The training programme involved three sessions, including an information/education session, a practical session at the local Melanoma Unit, and a practical surgical procedures session. There were significant improvements in the proportion of (i) accurate diagnoses, which were made when lesions were presented on colour slides with an accompanying case history; (ii) lesions presented on colour slides in which the correct management of the lesion was identified; and (iii) doctors who felt very or extremely confident in their ability to advise patients on screening frequency, to advise patients on the signs of skin cancer, and to decide whether changes in lesions were malignant. The only improvement observed in the doctors' clinical practice was a significant increase from pre- to post-test in the proportion of pathology request forms on which a diagnosis of the specimen was attempted by doctors in the intervention group compared to those in the control group. The results of this study indicate that whilst significant improvements in knowledge are achievable through postgraduate programmes, clinical practice is much more difficult to change.

Australia↗

PubMed1993

Pediatric and MCH training in Japan: JICA training program in the National Children's Hospital.

The experience of the training program for overseas doctors in the National Children's Hospital during 8 years is described. The program was supported by the Japan International Cooperation Agency (JICA) and the objectives of the training course are to provide doctors from developing countries with a better understanding of diagnosis and treatment as specialized pediatricians and pediatric surgeons and to introduce recent medical techniques and equipment for child care. From 1984 to 1993, 37 doctors from 22 developing countries of Asia, Middle and South America and Africa have attended this program. There were 22 pediatricians, 14 pediatric surgeons and one dentist. The outline of this group training program and problems with the course are discussed.

Child↗

PubMedDate not supplied

A comparison of frontal electromyographic biofeedback training, trapezius electromyographic biofeedback training, and progressive muscle relaxation therapy in the treatment of tension headache.

This study is the first systematic examination of a trapezius EMG biofeedback training regimen with tension headache sufferers. It evaluated the differential effects of three psychophysiological treatments for tension headache: (1) a standard 12-session frontal EMG biofeedback training regimen (n = 8), (2) a 12-session upper trapezius EMG biofeedback training regimen (n = 10), and (3) a standard seven-session progressive muscle relaxation therapy regimen (n = 8). Posttreatment assessment at 3 months following cessation of treatment revealed clinically significant decreases in overall headache activity (50% or greater) in 50% of subjects in the frontal biofeedback group, 100% in the trapezius biofeedback group, and 37.5% in the relaxation therapy group. Chi-squared analyses indicated that the trapezius biofeedback group was more effective in obtaining significant clinical improvement than the frontal biofeedback and relaxation therapy groups (which did not differ from each other). The three treatments did not differ on secondary measures of headache improvement (number of headache-free days, peak headache activity, and medication index). Implications for the psychophysiological treatment of tension headache, as well as future research directions, are discussed.

Adult↗

PubMed2003

Training of residents for their role as flight physicians: a survey of emergency medicine training programs.

OBJECTIVE: To determine the number of emergency medicine (EM) residency programs in which residents serve as helicopter emergency medical services (HEMS) crew, the extent of training provided for this role, and how HEMS residents are evaluated. METHODS: Accredited EM residency programs were contacted by telephone to determine which programs had residents serving as HEMS physicians. A self-administered survey was then mailed to the medical directors of the HEMS programs. Descriptive statistics were determined for each question. RESULTS: Surveys were returned by 18 of the 20 residency programs (90%) where residents served as HEMS physicians. In the majority (94%), residents work with one other crew member, typically a nurse or paramedic. The amount of flight hours for a resident ranged from 25 to 500. The number of flights ranged from five to 225. The amount of HEMS training was highly variable. Four programs (22%) did not require any orientation flights with patients; 12 (67%) did not require any proficiency testing; direct attending supervision was rare (6%); and written feedback occurred in only 28% of programs. CONCLUSIONS: The training of residents for their role as flight physicians is highly variable, considering the amount of air transport time they perform. Direct faculty supervision, proficiency testing, and written feedback are rarely utilized.

Air Ambulances↗

PubMed1987

Advanced training for ambulance crews: implications from 403 consecutive patients with cardiac arrest managed by crews with simple training.

Sixty seven ambulance staff in Nottinghamshire completed a simple extended training programme in managing cardiac arrest and using a defibrillator. This enabled around one third of the ambulance emergency shifts to be manned by such a crew, with a defibrillator as part of their standard equipment. Forty four of 403 consecutive patients who suffered cardiac arrest in the community were managed by these crews and survived to leave hospital. The training programme does not include endotracheal intubation, intravenous infusion, or drug administration. The new official advanced training course for ambulance crews, which includes these skills, is inappropriate in its methods and may delay widespread introduction of emergency ambulances equipped with defibrillators.

Adolescent↗

PubMed1998

Postprandial lipemia in endurance-trained people during a short interruption to training.

This study examined changes in postprandial lipemia in endurance-trained people during a short interruption to training. Nine men and one woman (ages 18-55 yr) undertook fat tolerance tests after 15 h, 60 h, and 6.5 days without exercise. The test meal (1.2 g fat, 1.1 g carbohydrate, 66 kJ/kg body mass) was consumed after a 12-h fast. Postprandial lipemia increased rapidly with detraining (area under plasma triacylglycerol vs. time curve: 8.42 +/- 1.40, 11. 35 +/- 1.38, and 11.97 mM x 6 h at 15 h, 60 h and 6.5 days, respectively). In the fasted state, plasma triacylglycerol concentration (0.85 +/- 0.15, 1.09 +/- 0.12, and 1.10 +/- 0.11 mM at 15 h, 60 h and 6.5 days, respectively) and the ratio of total cholesterol to high-density-lipoprotein cholesterol increased with detraining. Values were significantly higher at 60 h and 6.5 days than values at 15 h ( P < 0.05) for each of these three variables. The serum insulin response was higher ( P < 0.05) at 6.5 days than at 15 h (81.6 +/- 11.3, 87.6 +/- 11.4, and 94.5 +/- 9.4 microIU/ml x 6 h at 15 h, 60 h, and 6.5 days, respectively). Frequent exercise is needed to maintain a low level of postprandial lipemia and insulinemia in trained people.

Adolescent↗

PubMed2003

Effects of live high, train low hypoxic exposure on lactate metabolism in trained humans.

We determined the effect of 20 nights of live high, train low (LHTL) hypoxic exposure on lactate kinetics, monocarboxylate lactate transporter proteins (MCT1 and MCT4), and muscle in vitro buffering capacity (betam) in 29 well-trained cyclists and triathletes. Subjects were divided into one of three groups: 20 consecutive nights of hypoxic exposure (LHTLc), 20 nights of intermittent hypoxic exposure [four 5-night blocks of hypoxia, each interspersed with 2 nights of normoxia (LHTLi)], or control (Con). Rates of lactate appearance (Ra), disappearance (Rd), and oxidation (Rox) were determined from a primed, continuous infusion of l-[U-14C]lactic acid tracer during 90 min of steady-state exercise [60 min at 65% peak O2 uptake (VO(2 peak)) followed by 30 min at 85% VO(2 peak)]. A resting muscle biopsy was taken before and after 20 nights of LHTL for the determination of betam and MCT1 and MCT4 protein abundance. Ra during the first 60 min of exercise was not different between groups. During the last 25 min of exercise at 85% VO(2 peak), Ra was higher compared with exercise at 65% of VO(2 peak) and was decreased in LHTLc (P < 0.05) compared with the other groups. Rd followed a similar pattern to Ra. Although Rox was significantly increased during exercise at 85% compared with 65% of VO(2 peak), there were no differences between the three groups or across trials. There was no effect of hypoxic exposure on betam or MCT1 and MCT4 protein abundance. We conclude that 20 consecutive nights of hypoxia exposure decreased whole body Ra during intense exercise in well-trained athletes. However, muscle markers of lactate metabolism and pH regulation were unchanged by the LHTL intervention.

Acid-Base Equilibrium↗

PubMed2002

Decoding neural spike trains: calculating the probability that a spike train and an external signal are related.

Experimental and clinical applications of extracellular recordings of spiking cell activity frequently are used to relate the activity of a cell to externally measurable signals such as surface potentials, sensory stimuli, or movement measurements. When the external signal is time-varying, correlation methods have traditionally been used to quantify the degree of relation with the neural firing. However, in some circumstances correlation methods can give misleading results. A new algorithm is described that estimates the extent to which a spike train is related to a continuous time-varying signal. The technique calculates the probability of generating a spike train with Poisson statistics if the time-varying signal determines the Poisson rate. This is accomplished by successive division of the signal and the spike train into halves and recursive calculation of the probability of each half-signal. The performance of the new algorithm is compared with the performance of correlation methods on simulated data.

Action Potentials↗

PubMed1983

Educational objectives in psychiatric residency training: a survey of training directors and residents.

The authors surveyed 200 physicians completing their psychiatric residencies on the importance and achievement of 124 core training objectives. One hundred thirty (65%) of the residents and all 23 of the training directors of the programs selected responded. As a group, residents viewed a substantial number of the objectives as less important, and less well accomplished, than did their training directors. The discordantly rated objectives fell in several basic areas of psychiatric competence, such as the management of schizophrenia and drug side effects. Certain objectives were rated at a lower level of accomplishment by residents from smaller programs. Possible factors accounting for these differences are briefly considered.

Curriculum↗

PubMed1992

Training directors' opinions about the psychiatry resident in-training examination (PRITE).

OBJECTIVE: The American College of Psychiatrists conducted research to validate the content outline of the Psychiatry Resident In-Training Examination (PRITE) and to assess what residency training directors think about the examination. METHOD: A mail survey was sent to the 218 psychiatry residency training directors who subscribe to the PRITE. RESULTS: The survey response rate was 70%. A majority of the respondents indicated agreement with the relative emphasis given to each content area in the PRITE (range = 52%-80% agreement). Eighty-one percent of the respondents were strongly in favor of continuing the practice of releasing the examination and the correct responses each year after the examinations have been scored. The majority of the respondents use results on the PRITE for individual resident evaluation and program evaluation (90% and 94%, respectively). Very few respondents use the PRITE results as the sole measure for assessing residents' cognitive competence or use it for marketing their residency programs. CONCLUSIONS: The survey provided strong support for the content areas covered in the PRITE and their relative emphases. The current practice of releasing PRITE items and answers (a main difference between the PRITE and the certification examination of the American Board of Psychiatry and Neurology) was well supported by the survey results. The stated purpose of the PRITE, to provide educationally useful feedback for individuals and groups in the form of comparisons with peers in specific areas of knowledge, was supported by a large majority of the respondents.

Attitude of Health Personnel↗

PubMed1996

Training physicians and health care providers to accurately read coronary arteriograms. A training program.

UNLABELLED: Patterns in visual interpretation of coronary arteriograms (CAs) frequently cause incorrect assessment of percent diameter stenosis (%DS). These errors result in overestimating the results of angioplasty as well as of the number of arteries significantly affected by coronary artery (CAD) disease. METHODS: Forty-one physicians, nurses, and students participated in the standardization of 45 Kodachromes (39 arteries, 6 phantoms) and 5 photographic reproductions. Eleven of the 41 participated in a three-part training program designed to eliminate errors and improve accuracy of interpreting %DS from CAs. RESULTS: Improvement in reading %DS was seen in 69% of CAs with statistical (P < or = 0.05) improvement in one third of these cases, whose narrowings ranged from 4% to 84%DS. Variability of reporting was reduced in 26% of the cases. Skewing, representing an overestimation of "severe" disease and underestimation of "less severe" disease, was reduced with statistical improvement (P < or = 0.05) in reported %DS noted after training. Similar improvement was seen with phantoms but not in photographic images where the arterial edges were outlined. CONCLUSION: The outcomes of clinical management, invasive and interventional (mechanical, thrombolytic) procedures, as well as research studies depend in part upon the accuracy of reading %DS from CAs. Most studies to date have completed using extremely unreliable estimates of %DS with resultant problems in data interpretation. The use of this standardized training program has led to significant improvement in accurately assessing CAD.

Cardiology↗

PubMed1990

Training primary care health workers in mental health care: evaluation of attitudes towards mental illness before and after training.

One hundred and fifty primary care paramedical health workers who underwent a short term training in mental health care were evaluated to understand their attitudes towards mental health before, and immediately after, the training course. The trainees showed a significant change in attitudes in the desirable direction towards different mental health problems. Baseline attitude of health workers was not related to age, sex, level of education or duration of their professional service. However, health workers with low baseline attitude scores registered a significantly higher gain. Item analysis revealed that 10 of the 35 items of the attitude questionnaire failed to reveal significant post training changes.

Adult↗

PubMedDate not supplied

Who benefits from training in linguistic awareness in the first grade, and what components show training effects?

Who among first graders benefit from training in linguistic awareness, and what components of the linguistic awareness are most amenable to training effects? At the beginning of Grade 1 prospective at-risk readers (26 out of 117) were identified on the basis of very low phonological awareness. In the autumn term, they received practice in linguistic awareness. When compared to controls individually matched controls on phonological awareness, listening comprehension, and WISC-R scores, the intervention group showed a more rapid building-up of phonological awareness, especially phoneme-blending ability, as well as superiority in word recognition, spelling, and listening comprehension, which were sustained until the end of Grade 1. Reading comprehension could not be compared because 8 of the 26 controls did not read fluently enough to be tested. The half of the control group with cognitive delays, receiving normal special education instruction, performed consistently worse than their matched pairs in the intervention group. The latter group showed development of phonological awareness, decoding, and spelling equal to that of the cognitively nearly average intervention group and their matched pairs in the control group, who received no additional support. These three groups, originally defined as at-risk readers, performed at the level of other preschool nonreaders at the end of Grade 1. In sum, the children with cognitive delays benefitted from training in linguistic awareness. The results underscore the importance of phoneme synthesis skills in beginning reading and spelling, at least with regular languages.

Awareness↗

PubMed1995

Individual social skills training and co-worker training for supported employees with dual sensory impairment. Two case examples.

Two case studies examined the efficacy of two social enhancement procedures--individual social skills training (SST) and co-worker intervention for two employees with dual sensory impairment who were working in competitive employment settings but who were socially isolated from contact with their nondisabled co-workers. A variety of measures, including direct behavioral observations and social validation ratings, examined social interaction and the formation of social networks in the workplace. Results showed that the number and duration of social interactions improved with each of the social enhancement programs. Social validation data and anecdotal reports indicated that the employees with disabilities became more socially competent, interactive, and included in the social network of the workplace. Interestingly, SST followed by co-worker training resulted in greater increases in social responding as compared to co-worker training followed by SST.

Adult↗