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PubMed2002

Comparison of paste and suspension formulations of omeprazole in the healing of gastric ulcers in racehorses in active training.

OBJECTIVE: To compare effects of a commercially available omeprazole paste and a compounded omeprazole suspension on healing of gastric ulcers in Thoroughbred racehorses in active training. DESIGN: Randomized controlled trial. ANIMALS: 32 horses with gastric ulcers. PROCEDURE: Horses were assigned to 2 groups on the basis of endoscopic gastric ulcer severity. Group-1 horses were treated with omeprazole suspension for 30 days and with omeprazole paste for an additional 30 days. Group-2 horses were treated with omeprazole paste for 30 days and omeprazole suspension for an additional 30 days. Serum omeprazole concentrations were measured in 4 additional healthy horses after administration of a single dose of each formulation. In all instances, omeprazole was administered at a dose of 4 mg/kg (1.8 mg/lb), p.o.. RESULTS: Ulcer severity scores on day 0 were not significantly different between groups. On day 30, ulcer severity score was significantly decreased, compared with day-0 score, in group-2 but not in group-1 horses. On day 60, ulcer severity score was significantly decreased, compared with day-0 and day-30 scores, in group-1 horses. In group-2 horses, ulcer severity score on day 60 was significantly lower than the day-0 score but was not significantly different from the day-30 score. Maximum observed serum omeprazole concentration and area under the concentration-time curve were significantly higher after administration of the paste versus the suspension formulation. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that although administration of the commercially available paste omeprazole formulation was effective in promoting healing of gastric ulcers in these horses, administration of the compounded omeprazole suspension was ineffective.

Animals↗
PubMed2006

Findings from a European survey on current bioethics training activities in hospitals.

While much work has been done on improving undergraduate education in bioethics, particularly in medicine, less has been said about continuing education of health care workers, particularly non-medical and nursing personnel. Hospitals bring together a variety of professional and non-professional groups in the place where clinical dilemmas are daily events, and would seem ideal places to conduct an ongoing bioethics dialogue. Yet evidence that this is being achieved is sparse. The European Hospital (-Based) Bioethics Program (EHBP) brings together both current and aspirant members of the EU as partners in a project that aims to assess the current situation with regard to bioethics education in hospitals, identify shortfalls, and address these. In order to achieve the first objective of the EHBP a survey of the current training activities (focused on activities in hospitals) in clinical bioethics in Europe was carried out. The results are presented in this paper, along with a discussion about the implications for the EHBP to address these issues.

Bioethics↗
PubMed2000

A detailed analysis of theatre training activity in a UK teaching hospital.

We examined the placement of anaesthetists in our department over a 2 yr period. Data were collected from an in-theatre system to provide details of caseload and supervision for 34,856 operations. There was wide variation between anaesthetic sub-specialties with overall supervision levels of 35% of cases for senior house officers (SHOs) and 32% for specialist registrars (SpRs). The consultant data showed the size and areas of teaching reserve in the department. We then examined individual logbooks in order to validate our data, and departmental rotas to put these data into perspective with previous attempts to quantify trainee supervision. Supervision data derived from the rota allocations showed that 86% of SHO lists and 62% of SpR lists were scheduled to be supervised. This study has described our training activity and facilitated departmental changes, as well as highlighting the need for great care in interpreting trainee supervision data acquired from different sources, particularly when comparisons are being made.

Anesthesiology↗
PubMed2000

The effect of contralesional limb activation training and sustained attention training for self-care programmes in unilateral spatial neglect.

PURPOSE: To evaluate the effectiveness of two rehabilitation techniques for unilateral spatial neglect, contra-lesional limb activation and sustained attention training, on impaired activities of daily living. METHODS: Two single case, time-series designs incorporating baseline, intervention and post-intervention phases. RESULTS: Significant improvements were observed in both neuropsychological measures and in the independent performance of everyday activities coincident with the start of training. The benefits were well maintained during the post-training period. CONCLUSIONS: The results support the use of the two techniques in achieving functional goals for unilateral neglect patients.

Journal Article↗
PubMed1998

Quo vadis, my transplant fellow: a discussion of transplant surgery fellowship training activity in the United States and Canada: 1991-1997. Education Committee of the American Society of Transplant Surgeons.

This is a discussion of transplant surgery fellowship training issues that pertain to educational quality guidelines of fellowship programs, the number of fellows being trained, and the individual's fate in securing transplant surgery positions after training. In 1995, the Council of the American Society of Transplant Surgeons (ASTS) revised the academic guidelines to enhance the educational standards of programs seeking ASTS approval as a transplant surgery fellowship training program. The criteria for accrediting training programs in kidney and liver transplant surgery were redefined, and new criteria for pancreas transplant surgery training were developed. Regarding the number of transplant surgery fellows being trained per year, during the period from 1991 to 1997, a total of 327 transplant surgery fellows completed training at ASTS-accredited transplant surgery fellowship training programs. The annual number of transplant surgery fellowship graduates has remained nearly constant at approximately 45 per year. However, the proportion of transplant surgery trainees who are foreign medical graduates has increased annually since 1995. Currently, 49% of the trainees are foreign medical graduates. Regarding the individual's fates in securing transplant surgery positions after training, the proportion of U.S./Canadian medical graduates who received transplant surgery training during the last year but are practicing in surgical disciplines other than transplant surgery appears to be increasing. Before 1996, it was rare for transplant surgery trainees to pursue surgical practice activities that did not include transplantation. Among the current group of 28 U.S./Canadian medical graduates who completed transplant surgery training between January 1997 and July 1997, six did not secure an acceptable position in transplantation. Instead, they are practicing in either general surgery or vascular surgery, or obtaining additional transplant training. These changes in the demographics and dynamics of transplant surgery fellowship training activity provoke important concerns.

Canada↗
PubMed1999

Catchlike-inducing train activation of human muscle during isotonic contractions: burst modulation.

Stimulation trains that exploit the catchlike property [catchlike-inducing trains (CITs)] produce greater forces and rates of rise of force than do constant-frequency trains (CFTs) during isometric contractions and isovelocity movements. This study examined the effect of CITs during isotonic contractions in healthy subjects. Knee extension was electrically elicited against a load of 10% of maximum voluntary isometric contraction. The stimulation intensity was set to produce 20% of maximum voluntary isometric contraction. The muscle was tested before and after fatigue with a 6-pulse CFT and 6-pulse CITs that contained an initial doublet, triplet, or quadruplet. For prefatigue responses, the greatest isotonic performance was produced by CITs with initial doublets. When the muscles were fatigued, triplet CITs were best. CITs produce greater excursion, work, peak power, and average power than do CFTs, because CITs produced more rapid rates of rise of force. Faster rates of rise of force enabled the preload on the muscle to be exceeded earlier during the stimulation train.

Adult↗
PubMed1995

Extravehicular activity training and hardware design consideration.

Preparing astronauts to perform the many complex extravehicular activity (EVA) tasks required to assemble and maintain Space Station will be accomplished through training simulations in a variety of facilities. The adequacy of this training is dependent on a thorough understanding of the task to be performed, the environment in which the task will be performed, high-fidelity training hardware and an awareness of the limitations of each particular training facility. Designing hardware that can be successfully operated, or assembled, by EVA astronauts in an efficient manner, requires an acute understanding of human factors and the capabilities and limitations of the space-suited astronaut. Additionally, the significant effect the microgravity environment has on the crew members' capabilities has to be carefully considered not only for each particular task, but also for all the overhead related to the task and the general overhead associated with EVA. This paper will describe various training methods and facilities that will be used to train EVA astronauts for Space Station assembly and maintenance. User-friendly EVA hardware design considerations and recent EVA flight experience will also be presented.

Astronauts↗
PubMed1998

An analysis of training activities in the use of critical care equipment within hospitals in the United Kingdom.

We investigated how training in the use of electromedical devices in adult and neonatal intensive care departments is organised, designed and delivered. Forty-one departments within two Regional Health Authorities in the United Kingdom returned a detailed questionnaire, from which several nonlinear models were developed using fuzzy logic analysis. The results clearly indicate that training in the use of equipment is a very minor activity, with less than 1% of departmental time spent on providing or receiving such training. Departments that had a higher level of expertise required less assistance from technical personnel. Critical care equipment can be utilised more fully, cost effectively and safely if a formal and regular training programme is implemented.

Adult↗
PubMed1985

A comparison of the effects of child management and planned activities training in five parenting environments.

This study compared the effects of two procedures designed to enhance the extratraining effects of behavioral parent training. Twenty parents of oppositional children were randomly assigned to either a child management training condition or a combined child management plus planned activities condition. A further 10 nonproblem children and their parents served as a social validation group. Observations of both parent and child behavior were conducted in each of five home observation settings (breakfast time, kindy (kindergarten) or school exit, a structured playtime, bathtime, and bedtime). Both training procedures resulted in changes in both child oppositional and parent aversive behavior in all observation settings. In addition, desired positive parenting behaviors also improved in all settings. Treatment effects were maintained in all settings at 3-month follow-up. Comparisons between oppositional children following treatment and children in the social validation group showed that they each displayed similarly low levels of oppositional behavior in all settings. The implications of the results for facilitating generalized changes in behavioral parent training are discussed.

Adult↗
PubMed1991

[Lateral instability of the ankle joint (2). Active training programs can prevent surgery].

One hundred consecutive patients with chronic lateral functional instability of the ankle were treated non-operatively with physiotherapy (active range-of-motion training, strengthening exercises and co-ordination training with a tilt-board). All patients were evaluated functionally with a special rating scale, and radiologically with standardised stress radiographs measuring anterior talar translation (ATT) and talar tilt (TT). Excellent or good functional results were obtained in 49 of the patients, fair or poor in the remainder. The outcome was better in those with painful functional instability or mild mechanical instability, while those with more pronounced mechanical instability required further treatment (i e, reconstructive surgery). Of 10 patients with generalised joint laxity, only fair or poor results were obtained in seven, all of whom had mechanical instability.

Adult↗
PubMedDate not supplied

Exercise training activates large-conductance calcium-activated K(+) channels and enhances nitric oxide production in rat mesenteric artery and thoracic aorta.

Exercise training has reversible beneficial effects on cardiovascular diseases, e.g. hypertension, which may result from a decrease in systemic vascular resistance. The purpose of this study was to investigate possible mechanisms associated with the changes in vascular reactivity in large and small arteries with vasoconstrictors and vasodilators in rats after exercise. Wistar-Kyoto rats were trained for 8 weeks (Ex group) on a treadmill and compared with sedentary counterparts (Sed group). After the measurement of blood pressure and heart rate at 8 weeks, rat mesenteric arteries and thoracic aortas were excised and prepared as rings for this study. In addition, special care was taken not to damage the endothelium of the preparations. Our results showed that exercise training for 8 weeks (1) not only prevented an increase in blood pressure but also caused a fall in heart rate, (2) attenuated the contractions induced by both prostaglandin F(2alpha) (PGF(2alpha)) and high K(+) in the mesenteric artery, but reduced the PGF(2alpha)-induced contraction in the aorta only, (3) enhanced the relaxation elicited by acetylcholine (ACh) in both mesenteric arteries and aortas, and (4) increased nitrate [an indicator of nitric oxide (NO) formation] in plasma. The enhancement of ACh-induced relaxation in the mesenteric arteries in the Ex group was suppressed by pretreatment with N(omega) -nitro-L-arginine methyl ester (L-NAME), tetraethylammonium (TEA; a nonselective inhibitor of K(+) channels) or charybdotoxin [CTX; a selective inhibitor of large-conductance calcium-activated K(+) (BK(Ca)) channels], whereas in the aorta that response was attenuated by TEA or CTX and almost completely abolished by L-NAME. However, with a combination of L-NAME plus CTX in the mesenteric artery, ACh-induced relaxation was completely abolished in the Sed group, but not in the Ex group. These results suggest that in addition to NO, activation of BK(Ca) channels in the vascular beds, at least in part, also contributes to vasodilatation in animals with exercise training.

Acetylcholine↗
PubMed1998

Survey of research activity, training needs, departmental support, and career intentions of junior academic general practitioners.

BACKGROUND: Recent changes in the organization of the National Health Service have created new roles and responsibilities for academic general practice. Previous work on the constraints and opportunities of a career in academic general practice is largely anecdotal and is often based on the views of more senior members of the profession. AIM: To survey the research activity, perceived level of training, support needs, and career intentions of junior academic general practitioners (GPs). METHOD: A postal, validated, semistructured questionnaire was sent to the 121 eligible junior academic GPs in the academic departments of general practice in the United Kingdom and Dublin. Main outcome measures were 'research activity score', as measured by publications in peer-reviewed journals and involvement in research projects, 'training score' devised from 13 skills required for both research and teaching, and perceived level of departmental support assessed by six different support mechanisms. RESULTS: Response rate was 89% (n = 108). Forty-six responders (43%) had no publications. Twenty-five responders (23%) had no principal project. Thirty-nine responders (37%) had a mentor. Research activity appeared to be dependent on sex, having a predominantly research role rather than a full-time teaching role, and a positive perception of academic training (P < 0.05). Increasing departmental 'support scores' and length of time in the department were both significantly associated with more positive perceptions of academic training (P < 0.05). Only 29 (27%) responders wanted to progress to senior positions within academic general practice. CONCLUSION: Training and departmental support and guidance available to junior academics in primary care are perceived as variable and often inadequate. If academic general practice is to thrive, improved academic training is required, such as taught Master's degrees, supervised personal projects or 'apprenticeship' as a co-investigator, and improved methods of departmental support.

Career Choice↗
PubMedDate not supplied

Physician health promotion training activities in primary care: a survey of the military residencies.

BACKGROUND: The central role of primary care physicians in health care management, as well as their influence on patients at the highest risk for life-style related disease, makes adequate training in office and hospital health promotion activities essential. METHODS: A questionnaire adapted from one used nationally was sent to all the military training programs in internal medicine, family practice, pediatrics, and obstetrics-gynecology. The questionnaire addressed areas of content, emphasis, facilities, setting, personnel, techniques, and methods used in teaching, as well as priorities placed on health promotion in general and in specific areas. RESULTS: A response was obtained from all training programs (n = 59). Overall, 85 percent had set aside specific time to teach health promotion topics, and 81 percent had set aside time to teach preventive screening. Health promotion topics were incorporated by 85 percent of the programs, and preventive service topics were included in the core curriculum in 86 percent. In 63 percent of the programs residents were taught about assessment of patient motivation, but behavioral modification, relapse prevention, and self-efficacy skills were taught in less than one half of the programs (47, 37, and 34 percent, respectively). For the most part, programs stressed the traditional teaching techniques, such as discussion and lectures (93 percent and 92 percent, respectively), and rarely applied the more effective (and labor-intensive) methods of case precepting (58 percent), viewing videotaped cases (24 percent), and role-playing (5 percent). Only 41 percent of the programs had patient education materials readily available, but many (65 percent) had modified patient problem lists to include preventive or health promotion topics. Physician or patient reminders were used by only a few programs (35 percent and 17 percent, respectively), and in only 48 percent were the residents trained to use any health-screening or health risk appraisal questionnaire. Programs overwhelmingly relied on their physician staff and residents to do health promotion teaching and made little use of ancillary health care personnel who might be better trained in patient education methods. CONCLUSIONS: Primary care residency programs emphasize teaching health promotion and preventive services but generally have not yet developed the teaching systems to provide residents with skills training in preventive and health promotion services. Programs could enhance the clinical prevention skills of physicians completing residencies by having the physicians focus on the skills needed to teach patients self-efficacy, behavior modification, and health maintenance, by using physician and patient reminders, and by taking advantage of health care personnel trained in health education.

Case Management↗
PubMedDate not supplied

A comparison of traditional handwashing training with active handwashing training in the food handler industry.

The Centers for Disease Control and Prevention (CDC) have stated that poor personal hygiene is the third most commonly reported food preparation practice contributing to foodborne disease and h further claimed that contaminated hands may be the most important means by which enteric viruses are transmitted. The study reported here compared the effectiveness of traditional (lecture/video) training with that of traditional training that provided an added active (hands-on) component for the retention of handwashing procedures two weeks after the initial training. Sixty-six food handlers attending training courses were included in the study. All participants received the same lecture/video presentation. Twenty-two (33 percent) of the participants received an additional interactive training component. All participants were tested by a 20-item written test on the day of training. Two weeks after the training, 25 to 30 percent of participants from each group were retested. Results revealed that the participants involved in the interactive training had statistically significant better test performances both on the day of training and on the two-week retest.

Adult↗
PubMedDate not supplied

Role of physical activity training in attenuation of height loss through aging.

BACKGROUND: Although the genetic contribution to variability in bone mass has been estimated to be as high as 80%, evidence continues to accumulate suggesting that factors such as physical activity can influence bone mass which may avoid compression of the vertebrae leading to slower stature decline with age. OBJECTIVES: This study examines whether regular exercise has the potential of positively affecting the aging process with regard to height loss. METHODS: The height of 957 females and 1,088 males who were 35-55 years of age in 1965 were measured again in 1995. Based on a questionnaire, the subjects were divided into four groups. Group A (80 females, aged 73. 2 +/- 6 years, and 141 males, aged 72.1 +/- 5.7 years) represented subjects who were engaged in moderate vigorous aerobic activity throughout their lives; group B (95 females, aged 73.6 +/- 5.5 years, and 207 males, aged 71.7 +/- 6.1 years) were subjects who started their moderate vigorous aerobic activity around the age of 40 and kept their activity until the present time; group C (362 females, aged 73.2 +/- 5 years, and 390 males, aged 71.1 +/- 6 years) were persons who were active as young adults, but did not continue to exercise, and group D (425 females, aged 72.8 +/- 5.3 years, and 350 males, aged 70.9 +/- 6.1 years) were subjects who had not exercised regularly throughout their lives. RESULTS: All subjects lost height due to aging. However, significant (p < 0.05) differences in rate of height loss were found among the A, B, C, and D groups: for females 3.4 +/- 0.7, 3.5 +/- 0.8, 6.0 +/- 0.5, and 6.5 +/- 0.7 cm, respectively; for males 2.6 +/- 0.5, 3.1 +/- 0.4, 5.3 +/- 0.4, and 5. 5 +/- 0.5 cm, respectively. In addition, the females' height loss rate was significantly (p < 0.05) higher than that of the males in all four activity categories. CONCLUSIONS: These data suggest that lifelong moderate endurance training, especially after the age of 40 years, is associated with attenuation of height loss in both sexes. However, the magnitude of the attenuation is significantly higher in males.

Aged↗
PubMed2005

Venous catheter based mapping of ectopic epicardial activation: training data set selection for statistical estimation.

A source of error in most of the existing catheter cardiac mapping approaches is that they are not capable of acquiring epicardial potentials even though arrhythmic substrates involving epicardial and subepicardial layers account for about 15% of the ventricular tachycardias. In this subgroup of patients, mapping techniques that are limited to the endocardium result in localization errors and failure in subsequent ablation procedures. In addition, catheter-based electrophysiological studies of the epicardium are limited to regions near the coronary vessels or require transthoracic access. We have developed a statistical approach by which to estimate high-resolution maps of epicardial activation from very low-resolution multi-electrode venous catheter measurements. A training set of previously recorded maps is necessary for this technique so that composition of the database becomes an important determinant of accuracy. The specific hypothesis of the study was that estimation accuracy would be best when the training data set matches that of the test beat(s), whereby the matching was according to the site of initiation of the beats. This hypothesis suggests approaches to optimized selection of the training set, three of which we have developed and evaluated. One of these methods, the high-CC refinement method, was able to estimate the earliest activation site of left ventricularly paced maps within an average of 4.67 mm of the true site; in 89% of the cases (a total of 231 cases) the error was smaller than 10 mm. In another method, MHC-Spatial activation, right ventricularly paced maps (239 maps) were estimated with an error of 7.15 mm. The average correlation coefficient between the original and the estimated maps was also very high (0.97), which shows the ability of the training data set refinement methods to estimate the epicardial activation sequence. The results of these tests support the hypothesis and, moreover, suggest that such an approach is feasible for providing accurate reconstruction of complete epicardial activation-time maps in a clinical setting.

Algorithms↗