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PubMed2002

Resistance training and cardiac hypertrophy: unravelling the training effect.

Resistance training (RT) is a popular method of conditioning to enhance sport performance as well as an effective form of exercise to attenuate the age-mediated decline in muscle strength and mass. Although the benefits of RT on skeletal muscle morphology and function are well established, its effect on left ventricular (LV) morphology remains equivocal. Some investigations have found that RT is associated with an obligatory increase in LV wall thickness and mass with minimal alteration in LV internal cavity dimension, an effect called concentric hypertrophy. However, others report that short- (<5 years) to long-term (>18 years) RT does not alter LV morphology, arguing that concentric hypertrophy is not an obligatory adaptation secondary to this form of exertion. This disparity between studies on whether RT consistently results in cardiac hypertrophy could be caused by: (i) acute cardiopulmonary mechanisms that minimise the increase in transmural pressure (i.e. ventricular pressure minus intrathoracic pressure) and LV wall stress during exercise; (ii) the underlying use of anabolic steroids by the athletes; or (iii) the specific type of RT performed. We propose that when LV geometry is altered after RT, the pattern is usually concentric hypertrophy in Olympic weightlifters. However, the pattern of eccentric hypertrophy (increased LV mass secondary to an increase in diastolic internal cavity dimension and wall thickness) is not uncommon in bodybuilders. Of particular interest, nearly 40% of all RT athletes have normal LV geometry, and these athletes are typically powerlifters. RT athletes who use anabolic steroids have been shown to have significantly higher LV mass compared with drug-free sport-matched athletes. This brief review will sort out some of the factors that may affect the acute and chronic outcome of RT on LV morphology. In addition, a conceptual framework is offered to help explain why cardiac hypertrophy is not always found in RT athletes.

Adaptation, Physiological↗

PubMed1975

[Respiratory autogenic training (RAT) in the psychosomatic training of physicians].

The Author, after having described the nature of the relationship between the physician and the patient and the various possibilities that are available for their communication and the obstacles that hinder it, specifically analyzes the different phases that are necessary for the physician's psychological formation and the possibilities that the "respiratory autogenic training", practiced in a group, can offer to the expierence of the Baliant groups.

Autogenic Training↗

PubMedDate not supplied

Train-the-trainer for hospital-wide safety training.

This article describes a hospital-wide safety program that was developed using the train-the-trainer model. Education specialists worked with hospital safety experts to develop a program that met Joint Commission on Accreditation of Healthcare Organization standards, improved the quality and safety of the hospital environment, and strengthened interdepartmental relationships. A variety of outcome measures, including quality assurance indicators, was used to evaluate the program.

Humans↗

PubMed1977

Athletic endurance training - advantage for space flight?: The significance of physical fitness for selection and training of spacelab crews.

While intensive physical exercise has been part of the conditioning of astronauts and consmonauts for spaceflights, its benefits have been questioned. After reviewing the pertinent literature, it is concluded that the morphological and functional changes obtained with athletic endurance training are rather specific and of no general advantage for the tolerance to space stresses. Particularly during gravitational loads, in the relaxed subject, these changes allow a more pronounced shift of fluid into the lower extremities, with the possible consequence of a reduced tolerance. This unfavourable response, obviously, is accentuated through immersion and weightlessness. The aerobic work capacity is also more impaired in athletes. Based on these conclusions, recommendations for crews and passengers of future Spacelab missions are given with respect to selection and pre-and in-flight physical exercise.

Acceleration↗

PubMed2002

Training for prescriptions vs. prescriptions for training: where are we now? Where should we be? How do we get there?

The proposal that state legislatures should grant prescription privileges to psychologists is examined critically, with particular attention to the proposal's implications for the future education and training of clinical psychologists. First, the current status of clinical psychology is described. Then, an alternative to the prescription privilege proposal is presented; this alternative prescribes a scientific approach to clinical psychology. Finally, a plan for achieving this alternative is outlined.

Attitude of Health Personnel↗

PubMed2005

Participants' opinions of laparoscopic training devices after a basic laparoscopic training course.

BACKGROUND: Basic laparoscopic skills are initially best taught and practiced in an inanimate setting. Various devices are used to aid in this education of laparoscopic skills. These devices range from simple box trainers to sophisticated virtual reality trainers. This investigation tested the hypothesis that participants would prefer one trainer to another trainer. METHODS: Preclinical medical students volunteered for this study. All underwent a porcine laboratory. The students were then divided into 3 groups by method of training: group A--a virtual reality trainer (MIST-VR), group B--an inanimate box trainer (LTS 2000), and group C--both trainers. Each group participated in 10 laboratories with the assigned trainer(s). After completion of the laboratories, all students underwent a similar porcine laboratory. During this laboratory, opinions of each trainer and specific tasks were ascertained from each student. RESULTS: No statistical difference was seen between groups A and B when asked if their specific trainer helped their skills, was realistic, helped in the animal laboratory, and was interesting. When group C was asked the same questions about each trainer, no statistical difference was seen except that 47% thought the MIST-VR was not realistic as opposed to 0% who thought the LTS 2000 was not realistic (P <.003). The level of difficulty of each task correlated with how much the specific task helped in development of skills for both trainers (P <.0001). In group C, 89% of the participants thought the LTS 2000 helped more that the MIST-VR and 56% thought the LTS 2000 was more interesting than the MIST-VR. In addition, 83% of students in group C chose LTS 2000 when asked to pick only one trainer. CONCLUSIONS: While virtual reality trainers may have some advantages, most participants feel that inanimate box trainers help more, are more interesting, and should be chosen over virtual reality trainers if only one trainer is allowed. Further studies need to investigate if the opinions affect participants' utilization of these trainers.

Clinical Competence↗

PubMed2006

Training-induced plasticity in older adults: effects of training on hemispheric asymmetry.

The extent to which cortical plasticity is retained in old age remains an understudied question, despite large social and scientific implications of such a result. Neuroimaging research reports individual differences in age-related activation, thereby educing speculation that some degree of plasticity may remain throughout life. We conducted a randomized longitudinal dual-task training study to investigate if performance improvements (a) change the magnitude or pattern of fMRI activation, thereby suggesting some plasticity retention in old age and (b) result in a reduction in asymmetry and an increase in age differences in fMRI activation as a compensatory model of performance-related activation predicts. Performance improvements were correlated with an increase in hemispheric asymmetry and a reduction in age differences in ventral and dorsal prefrontal activation. These results provide evidence for plasticity in old age and are discussed in relation to an alternative argument for the role of reduced asymmetry in performance improvements.

Adaptation, Physiological↗

PubMed1999

Attention fixation training: training people to form cognitive maps help to control symptoms of panic disorder with agoraphobia.

Nine individuals diagnosed with panic with agoraphobia received three elements of Attentional Fixation Training (AFT): Directed attention to the external environment, directed topographical synthesis, and directed orientation in space-time to control characteristics of panic. They then walked a standard 2.5 km route and practiced these elements upon entering one of the five panic-inducing situations: (a) walking alone near a busy street with the examiner following at 20 m, (b) walking alone near a busy street with the examiner out of client's visual field, (c) shopping with the examiner present, (d) traveling on a bus alone, and (e) shopping alone. Heart rate was monitored in each of these five situations. Except for the case of using public transport, heart rate activity decreased to a considerable extent during AFT practice suggesting AFT elements provided a good way to control symptoms of panic in vivo. Results were discussed within the confines of a model suggesting that an attentional deficit, which produces a spatial disorientation disorder that maintains both panic and agoraphobia, can efficiently be overcome by means of all three AFT tools.

Adult↗

PubMed2006

[Surgical training with simulators in training centers].

The development of new endoscopic procedures and minimally-invasive surgical interventions has led the methodology used to date to be questioned. Greater demand for safety by patients, the growth of the health budget and the reduced time available for training have led to the proliferation of centers with accredited personnel in which the knowledge and surgical skills necessary for the controlled incorporation of these techniques can be acquired. Simulators are available for the learning of both digestive endoscopy and laparoscopic techniques. These simulators are more or less dynamic, virtual, with viscera or mixed; even live animals can be used. Thus, the various techniques can be incorporated into clinical practice safely and effectively and at a reasonable cost. Simulators also allow evaluation and follow-up of the skills acquired.

Education↗

PubMed2000

Attitudes of trained Swedish lay rescuers toward CPR performance in an emergency. A survey of 1012 recently trained CPR rescuers.

59 years old. Only 1% had attended the course because of their own or a relative's cardiac disease. Ninety-four per cent believed there was a minor to major risk of serious disease transmission while performing CPR. When predicting their willingness to perform CPR in six scenarios, 17% would not start CPR on a young drug addict, 7% would not perform CPR on an unkempt man, while 97% were sure about starting CPR on a relative and 91% on a known person. In four of six scenarios, respondents from rural areas were significantly more positive than respondents from metropolitan areas about starting CPR. In conclusion, readiness to perform CPR on a known person is high among trained CPR rescuers, while hesitation about performing CPR on a stranger is evident. Respondents from rural areas are more frequently positive about starting CPR than those from metropolitan areas.

Adult↗

PubMed2003

Obstetric anaesthesia training in the Wessex region before and after introduction of Calman training.

We canvassed the opinions of anaesthetic trainees by questionnaire in 1995 and 1998, before and after the introduction of Calman training in which the registrar and senior registrar grades were replaced by the specialist registrar grade. We received replies from 106 trainees in 1995 (90%) and 115 (92%) in 1998. The survey results demonstrate that the total experience in obstetric anaesthesia gained by trainees has not decreased. Experience of regional techniques (epidural, spinal and combined spinal-epidural) increased, but the proportion of senior trainees who had performed fewer than 20 general anaesthetics for caesarean section rose from 0/23 in 1995 to 4/33 (12%). In 1998, the majority of senior trainees had experience of general anaesthesia for fetal distress, severe preeclampsia, eclampsia and massive obstetric haemorrhage. Only a minority had experienced failed intubation or a total spinal. In 1995, 5/21 (24%) of senior house officers agreed or strongly agreed that they were on call before they felt confident about dealing with common problems. The proportion was still 4/23 (17%) in 1998.

Journal Article↗

PubMed1975

Influence of psychiatric training, medical qualification, and paramedical training on the rating of abnormal behaviour.

The psychiatric ratings, using the In-Patient Multi-dimensional Psychiatric Scale, of (1) a group of over 200 psychiatrists from the British Isles, (2) third year psychology students, (3) trainee sister tutors, (4) general practitioners attending a postgraduate course in psychiatry, and (5) a group of new registrars at the Maudsley Hospital, were compared. The first hypothesis, that, whereas the non-psychiatrists would rate similar levels of symptoms, the psychiatrists would tend to rate lower than other professional groups, was upheld. The second, that the pattern or profile of symptoms as shown by the IMPS syndromes would differ little between the groups, was also upheld. The third hypothesis, that because of their special training in the recognition of synptoms, psychiatrists would tend to show greater intra-group agreement on the levels of symptoms that the other groups, was not upheld. Some possible reasons for the findings are discussed. The importance for a screening schedule, designed to be used by non-psychiatrists for the detection of psychiatric illness, of the finding that non-psychiatrists rate higher levels of symptoms than psychiatrists, is also discussed.

Adult↗

PubMed2000

Resonant frequency biofeedback training to increase cardiac variability: rationale and manual for training.

Heart rate and blood pressure, as well as other physiological systems, among healthy people, show a complex pattern of variability, characterized by multifrequency oscillations. There is evidence that these oscillations reflect the activity of homeostatic reflexes. Biofeedback training to increase the amplitude of respiratory sinus arrhythmia (RSA) maximally increases the amplitude of heart rate oscillations only at approximately 0.1 Hz. To perform this task people slow their breathing to this rate to a point where resonance occurs between respiratory-induced oscillations (RSA) and oscillations that naturally occur at this rate, probably triggered in part by baroreflex activity. We hypothesize that this type of biofeedback exercises the baroreflexes, and renders them more efficient. A manual is presented for carrying out this method. Supporting data are provided in Lehrer, Smetankin, and Potapova (2000) in this issue.

Arrhythmia, Sinus↗

PubMed2002

Blood Glucose Awareness Training in Dutch Type 1 diabetes patients. Short-term evaluation of individual and group training.

AIMS: The aims of the present study were: (i) to evaluate the effects of a Dutch translation and adaptation of Blood Glucose Awareness Training (BGAT-III) on blood glucose (bg) perception, glycaemic control, and decisions not to drive or to raise the bg during hypoglycaemia; (ii) to compare the effects of individual and group BGAT. METHODS: Fifty-nine patients with Type 1 diabetes participated in BGAT in either a group or an individual setting. Before and after BGAT, 39 (66%) of them completed 30-70 measurements on a hand-held computer (hhc). During every measurement, they estimated their bg, indicated whether they would drive or raise their bg on the basis of their estimation, and then measured their bg. RESULTS: Individual and group BGAT did not have significantly different effects (P = 0.35-0.98). Overall, BGAT did not significantly affect bg perception (P = 0.11-0.65). Before BGAT patients recognized a mean of 32% of their hypoglycaemic episodes, after BGAT a mean of 39% (P = 0.12). After BGAT, patients more often decided not to drive when their bg was low (P = 0.03). They tended to decide more often to raise their bg during hypoglycaemia (P = 0.09). CONCLUSIONS: The effects of BGAT were smaller than expected. Possible reasons for this negative outcome may be the adapted version of BGAT (shorter in duration), a lack of statistical power, or a difference between American and European samples in their reaction to BGAT.

Adult↗

PubMed1995

Effects of exercise training in the elderly: impact of progressive- resistance training on skeletal muscle and whole-body protein metabolism.

The declines in functional capacity and muscle function with advancing age are well-documented. In addition, it appears that the age-related changes in body composition have profound effects on functional capacity and nutrient requirements. The overwhelming evidence presented in the present review suggests that the loss of muscle strength and function observed with advancing age is reversible even in the frail elderly. Along with the profound functional improvement in older individuals in response to progressive-resistance training, several studies have reported increases in resting energy expenditure and increased requirements for dietary protein. Exercise programmes designed to improve muscle strength be recommended for older individuals as an effective countermeasure to the sarcopenia of old age.

Aged↗

PubMed1999

Enhancing Training Efficiency and Effectiveness Through the Use of Dyad Training.

The authors examined the effect of inserting observation practice and undirected dialog into the rest interval between practice trials on the learning of a complex task (stabilometer). Training protocols in which learners practice in pairs (dyads) result in increases in learning efficiency, but the critical issue is the effect on learning effectiveness. Three groups of participants (n = 12 in each group) practiced maintaining their balance on a stabilometer. One group practiced individually, and the other 2 groups practiced in dyads in which 1 performer practiced the task while the other observed. In the dyad-alternate condition, participants alternated between physical, observational, and dialog practice on each trial, whereas in the dyad-control condition, subjects completed all trials on 1 form of practice (either physical or observational practice) before engaging in the other form. The results indicated that the dyad-alternate group initially performed more poorly but quickly overtook the individual group, and the performance advantage of the dyad-alternate group was maintained on the delayed retention test. When the different forms of practice were performed consecutively, as in the dyad-control group, acquisition and retention performance was generally poorer than when they were alternated. Those results suggest that one can combine the benefits of physical practice, observation, and dialog between learners in an interactive way to produce an effective and efficient learning protocol.

Journal Article↗

PubMed1991

The Joint Education and Training Committee of the BOHS, IOH and BEBOH--a discussion on the future of occupational hygiene education and training in the U.K.

This paper begins by drawing a clear distinction between the principles of occupational hygiene, which may be used by many occupational safety and health practitioners, and the profession of occupational hygiene. A new definition of occupational hygiene, which focuses on the objective of promoting health by intervention in the workplace, is proposed. Occupational hygiene professionals should be able to carry out a wide range of activities allied to this objective, from recognizing factors which may affect workers' health to setting priorities for risk management. A description of the competence of a professional hygienist, based on a document produced by the World Health Organization, is presented. The interaction between the various occupational safety and health practitioners is explored and the increasing interaction between the different skill groups recognized. The changing pattern of hazards in the workplace and the changing role of the hygienist are also discussed. In particular, the necessity for hygienists to develop management skills is highlighted. The paper concludes that occupational hygiene education and training must reflect the changing hazards in the workplace and the current approaches to the management of the risks.

Clinical Competence↗

PubMed1999

Effective presentation of radiation safety training--risk communication: an important function of radiation safety training.

Implementing an effective radiation safety program requires good communication with workers. The process begins with radiation safety. Before workers take a position involving radiation exposures, they should understand the possible health risks and what to do to keep their risks ALARA. The goal is for workers to achieve a balanced perspective on radiation health risks in order to avoid either undue fear or undue complacency about radiation. Workers should have enough understanding of radiation risks to decide to acceptor not accept-or not accept the risk of radiation as a condition of employment. Furthermore, the decision to accept radiation risk for the benefits of employment should be based on informed consent. Workers with a good understanding of radiation health risks will strive to minimize not only their own radiation exposure but also those of their work group. Normally radiation safety training to achieve worker understanding is focused primarily on the technology of radiation. However, understanding is more than a matter of good technical information. What one chooses to understand is also impacted by perceptions of radiation risks.

Adult↗