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PubMed1990

Reference equations used to predict pulmonary function. Survey at institutions with respiratory disease training programs in the United States and Canada.

Adult respiratory disease training programs in the United States and Canada were surveyed to determine which reference equations were used to predict normal pulmonary function and how ethnic differences were approached. Replies from 139 of the 180 (77.2 percent) institutions surveyed were received and evaluated. Surprisingly few studies account for most of the equations in use: three studies account for 85 percent of the spirometric equations, two for 83 percent of the lung volume equations and five for 84 percent of the diffusing capacity equations. Although there are no definite data, the form of many of the replies suggests that equipment default settings may influence the selection process. Of those responding to the ethnic difference question, 53 percent of institutions applied no correction for ethnic differences. There was no consistent pattern to the method of correction among those who did.

Canada↗
PubMed1997

Survey of the cross-cultural content of U.S. psychiatry residency training programs.

To establish the extent of cross-cultural content contained in the 224 psychiatric residency training programs, the Directors of Residency Training were surveyed by mail. Thirty-seven percent (N = 83) of Directors responded; 92% (N = 76) had cross-cultural content, 99% (N = 82) had opportunities to work with minority patients, and 77% (N = 64) had supervision by some minority faculty. Responding programs reported a need for teaching videotapes (85%, N = 71), cross-cultural references (78%, N = 65), academic psychiatrists familiar with different cultural groups (76%, N = 63), and cross-cultural supervision (75%, N = 62).

Cultural Diversity↗
PubMed1995

Interobserver and interequipment variability of echo-Doppler examination of the portal vein: effect of a cooperative training program.

The aim of this study was to assess the interobserver, interequipment, and time-dependent variabilities of echo-Doppler measurements of portal blood flow velocity (PBV), portal vein diameters (PVDs) and their derived parameters, portal blood flow (PBF), and congestion index (CI) in cirrhotic patients. The influence of a cooperative training program of the operators on the reproductibility of the results was also investigated. The echo-Doppler parameters were independently measured in 15 patients by four skilled operators, using four echo-Doppler machines (Acuson, ATL, Hitachi-Esaote, Toshiba. Eight of the 15 patients were restudied after 15 days by the same operators using only one machine. Significantly different values of PBV, PBF, and CI were obtained. PBV variance was equipment-related (32%) and operator-related in a smaller portion (5%). No systematic effect related to the time of investigation was found. After training to define a precise protocol, new measurements were performed by four operators on 8 different patients. No significant differences were found among the operators for any of the parameters and the 95% confidence limits (CL) and coefficients of variation (CV) of PBV showed a marked decrease (CL from +/- 26.4% to +/- 15.6%). These results indicate that (1) a significant systematic variability exists between Doppler measurements with different equipment; (2) there is no significant time-dependent systematic variability of Doppler measurements; and (3) a cooperative training program reduces the interobserver variability for direct measurements, such as PBV.

Analysis of Variance↗
PubMed2003

The effects of the 1997 Balanced Budget Act on family practice residency training programs.

BACKGROUND AND OBJECTIVES: This study assessed the impact of the Balanced Budget Act (BBA) of 1997 on family practice residency training programs in the United States. METHODS: We surveyed 453 active family practice residency programs, asking about program closures and new program starts (including rural training tracks), changes in the number of residents and faculty, and curriculum changes. Programs were classified according to their urban or rural location, university or community hospital setting, and rural and/or urban underserved mission emphasis. RESULTS: A total of 435 (96%) of the programs responded. Overall, the impact of the BBA was relatively small. In 1998 and 1999, nationwide, there were 11 program closures, a net decrease of only 82 residents, and a net increase of 52 faculty across program settings and mission emphasis. The rate of family practice residency program closures increased from an average of 3.0 per year between 1988-1997 to 4.8 per year in the 4 years following passage of the BBA. CONCLUSIONS: The 1997 BBA did not have an immediate significant negative impact on family practice residency programs. However, there is a worrisome increase in the rate of family practice residency closures since 1997. A mechanism needs to be established to monitor all primary care program closures to give an early warning should this trend continue.

Budgets↗
PubMed2001

Effects on physical performance and pain from three dynamic training programs for women with work-related trapezius myalgia.

To compare training programs for women with trapezius myalgia regarding physical performance and pain, 102 women were randomized to strength, endurance, co-ordination and non-training groups. Before and after the intervention, static strength and dynamic muscular endurance in shoulder muscles were measured on a Cybex II dynamometer. Muscle activity in shoulder muscles was monitored via surface EMG. The signal amplitude ratio between the active and passive phase of repeated contractions indicated the ability to relax. Pain at present, pain in general and pain at worst were measured on visual analogue scales. After training, within group comparisons showed that the training groups rated less pain, and in the strength training group ratings of pain at worst differed from the non-training group. Using the non-training group as a reference, static strength increased in the strength and endurance training groups and muscular endurance in all training groups. The study indicates that regular exercises with strength, endurance or co-ordination training of neck/shoulder muscles might alleviate pain for women with work-related trapezius myalgia.

Adult↗
PubMed1988

Carotid endarterectomy in a general surgical training program.

Concern regarding the quality of surgical treatment performed within resident training programs and the need for direct, active involvement of the attending surgeon have been issues of interest to surgeons and the public. To provide specialized training in the diagnosis and treatment of vascular disease, vascular surgical fellowships have been established. In institutions with established vascular fellowships, one may question whether general surgical residents or vascular surgical fellows should perform carotid endarterectomies. The majority of carotid reconstructive procedures are performed at our institution by the chief general surgical resident under direct supervision. We elected to review our experience with surgical treatment of the carotid artery in an effort to examine the safety of this practice. The record of all patients who underwent carotid endarterectomy or reconstruction from April 1980 to July 1984 were reviewed. One hundred and twenty-nine patients who underwent 153 reconstructions of the carotid artery constituted the study group. The indication for operation was symptomatic carotid atheromatous disease in 96 and asymptomatic disease in 57. Ninety-three per cent of the procedures were performed by the chief general surgical resident under the supervision of one attending surgeon. Although the incidence of associated systemic problems (hypertension, diabetes and coronary artery disease) was significant in the study group, postoperative cardiovascular and cranial nerve and central neurologic deficits were 1.3 per cent, respectively, with no operative mortality. At our institution, the performance of carotid endarterectomy under close supervision provides an excellent context in which the resident in training may learn precise and careful dissection of the tissue and arterial repair. The need for formal vascular surgical fellowships to develop proficiency in judgment, technique and management of vascular disease is not questioned. However, as a learning experience for the general surgical resident, we believe this practice is both safe and effective, and a high standard of patient care is not compromised.

Carotid Arteries↗
PubMed1990

Anthropometry and knee exertion injuries incurred in a physical training program.

Factors causing predisposition to knee exertion injuries were sought by means of a questionnaire and detailed anthropometric measurements in 39 Finnish Army conscripts picked from a random sample of 56 army conscripts. The subjects consisted of two groups of 18- to 23-year-old conscripts; Group A comprised 29 subjects without knee exertion injuries and Group B 10 subjects who had experienced knee exertion injuries during the physical training program of the first eight weeks of military service. In Group A the physical activity level preceding the military service was somewhat higher than in Group B. In Group B the skeletal dimensions were longer and the body fat percentage was higher than in Group A. We conclude that big size of the subjects predisposed to knee exertion injuries during the training program.

Adolescent↗
PubMed1985

Clinical training program for staff pharmacists.

This study describes the development and evaluation of a clinical training program in the areas of pharmacokinetics and infectious diseases for staff pharmacists in a decentralized unit dose drug distribution system. Five staff pharmacists were trained and three other pharmacists served as controls. The teaching sessions consisted of eight 1-hour lectures per group of two to three pharmacists. The lectures were supplemented by handouts, reading assignments, and practical assignments. There was a significant improvement in posttest scores of the trained pharmacists when compared to their pretest scores and from the scores of the control pharmacists. In the Seattle VA Medical Center pharmacy, this program was shown to be successful, and a similar program can be used to train staff pharmacists in other clinical areas of interest.

Cross Infection↗
PubMed2000

A multifaceted mental health training program in reducing burnout among occupational social workers.

This article looks at ways of reducing stress through a multifaceted training program involving the acquisition of mental health knowledge and skills and experiential training in a group of occupational social workers. The training group of 13 occupational workers was compared to a group of occupational social workers not attending the program. Post-training revealed statistically significant increases in professional self-efficacy associated with awareness of psychological and psychopathological issues and professional social support. Reduction in cognitive weariness and listlessness associated with burnout was also found. Gaining competence in mental health issues relating to the occupational setting coupled with emotional sharing helped to reduce professional burnout.

Adaptation, Psychological↗
PubMed2000

The effects of different training programs on the trapezius muscle of women with work-related neck and shoulder myalgia.

The aim of this study was to examine the effects of training on the structural characteristics of the trapezius muscle in women with work-related trapezius myalgia. Muscle biopsies were taken before and after 10 weeks of three different training programs (strength, endurance and coordination). Enzyme-immunohistochemical analysis was performed to assess muscle fibre types, fibre area, capillary supply and cytochrome c oxidase (COX) activity. There was an increase in the proportion of type IIA fibres in strength trained group (P < 0.05). Strength training elicited a preferential increase in the area of type II fibres (P < 0.05); both strength and endurance programs induced an increase in the number of capillaries around type I and IIA muscle fibres. Finally, all training programs induced a decrease in the proportion of COX-negative fibres. In conclusion, the trapezius muscle of women with neck and shoulder myalgia is characterised by a great potential of adaptation to physical exercise over a period of 10 weeks. The significant changes in the number of capillaries and the specific changes induced by training at the level of muscle fibres might well explain the improvement of muscle function.

Adult↗
PubMed1990

A laboratory medicine residency training program that includes clinical consultation and research.

We describe a laboratory medicine residency training program that includes ongoing interaction with both clinical laboratories and clinical services as well as significant research experience. Laboratory medicine residents serve as on-call consultants in the interpretation of test results, design of testing strategies, and assurance of test quality. The consultative on-call beeper system was evaluated and is presented as an effective method of clinical pathology training that is well accepted by the clinical staff. The research component of the residency program is also described. Together, these components provide training in real-time clinical problem solving and prepare residents for the changing technological environment of the clinical laboratory. At the completion of the residency, the majority of the residents are qualified laboratory subspecialists and are also capable of running an independent research program.

Chemistry, Clinical↗
PubMed2000

An interdisciplinary training program in nutrition sciences and cancer.

To address the shortage of health care professionals trained in the nutritional aspects of cancer prevention, the University of Alabama at Birmingham in 1988 initiated the Cancer Prevention and Control Training Program (CPCTP), with R25 grant support from the NIH/NCI. The CPCTP has enrolled 11 predoctoral and 12 postdoctoral trainees, of whom 18 have completed training and five remain in the program. The curriculum and other program elements are described, and the trainees' academic achievements and ultimate careers are reported. The CPCTP has become a significant resource for training cancer nutrition professionals.

Curriculum↗
PubMed1997

Evaluation of a training program for persons with SCI paraplegia using the Parastep 1 ambulation system: part 4. Effect on physical self-concept and depression.

OBJECTIVE: To determine whether persons with spinal cord injury (SCI) paraplegia who participated in an electrical stimulation walking program experienced changes in measures of physical self-concept and depression. DESIGN: Before-after trial. SETTING: Human SCI applied research laboratory. PARTICIPANTS: Volunteer sample of 12 men and 3 women with SCI paraplegia, mean age 28.75 +/- 6.6yrs and mean duration of injury 3.8 +/- 3.2yrs. INTERVENTION: Thirty-two FNS ambulation training sessions using a commercially available system (Parastep 1). The hybrid system consists of a microprocessor-controlled stimulator and a modified walking frame with finger-operated switches that permit the user to control the stimulation parameters and activate the stepping. OUTCOME MEASURES: The Tennessee Self-Concept Scale (TSCS) and the Beck Depression Inventory (BDI) were administered before and after training. Only the Physical Self subscale of the TSCS was analyzed. After training, individual interviews were performed to assess participants' subjective reactions to the training program. RESULTS: A repeated measures analysis of variance indicated that desired directional and statistically significant changes occurred on the Physical Self subscale of the TSCS (F(1,14) = 8.54, p < .011) and on the BDI (F(1,14) = 5.42, p < .035). CONCLUSIONS: Subsequent to the ambulation training program there were statistically significant increases in physical self-concept scores and decreases in depression scores.

Adult↗
PubMed2001

Effects of a circuit weight training program on the body images of college students.

OBJECTIVE: The present investigation examined the extent to which participation in a 6-week circuit-weight training program produced changes in participants' body images relative to a matched control group. METHOD: The weight trainers consisted of 39 college students (27 women and 12 men). The control group of 39 individuals did not weight-train currently or within the past year. All participants were pre- and posttested on the Multidimensional Body Self-Relations Questionnaire, the Social Physique Anxiety Scale, and the Physical Self-Efficacy Scale. Weight trainers were also pre- and posttested on muscular strength and assessed on their motives for exercise. RESULTS: The program successfully increased upper- and lower-body strength. In contrast to the comparison group, weight trainers had a significantly improved evaluation of their appearance, greater body satisfaction, reduced social physique anxiety, and enhanced physical self-efficacy. Outcomes were unrelated to the extent of concurrent aerobic exercise and largely unrelated to exercise motives. DISCUSSION: Even a relatively brief weight training program can produce improvements in multiple aspects of body image. Further research should investigate weight training as an adjunct to psychosocial treatments of body dissatisfaction.

Adolescent↗
PubMed1993

Work hours of residents in seven anesthesiology training programs.

Medical educators and credentialing organizations recently have called attention to the long hours that some house staff are required to spend in the hospital during training. To determine the average duration of in-hospital work hours of anesthesiology residents, 148 residents at seven, university-affiliated training programs kept daily logs of their activities for one week. Residents in clinical anesthesia years 1, 2, and 3 spent an average of 66, 65, and 64 hours per week, respectively, in the hospital with a range of 43 to 104 hours per week. Although there was not a difference in in-hospital work time among years of training, there was a statistical difference between two of the seven programs studied. The largest portion of the in-hospital time was devoted to patient care activities in the operating room. Residents had time for educational activities, conferences, and reading while in the hospital. The overall work hours of the residents in the anesthesiology training programs included in this survey appeared to be within current guidelines.

Anesthesiology↗
PubMed1988

A three-year follow-up of older adult participants in a memory-skills training program.

This study examined the long-term effects of participation in a self-taught memory training program. In all, 27 memory training and 13 nontraining participants were assessed at approximately 3-year follow-ups. Assessment of these groups prior to the introduction of training had revealed nonsignificant differences in memory performance but marked differences in level of memory complaints, with training participants evidencing higher levels of complaints. The current assessment again demonstrated overall nonsignificant differences in memory performance but significant differences in memory complaints between the two groups. More specifically, the training group evidenced significant decreases in memory performance over the 3-year interval, but no significant changes in memory complaints were observed for either group. Thus, memory training appeared to have little long-term effect on memory functioning. Future research should explore long-term maintenance strategies in memory training with older adults.

Aged↗
PubMed1992

Recruiting interns and residents to an osteopathic medical training program.

As more graduates of colleges of osteopathic medicine enroll in allopathic training programs and specialty programs, medical directors of osteopathic medical institutions are faced with the challenge of maintaining a well-trained housestaff. More important, perhaps, this exodus threatens the very core of osteopathic medicine, namely, its ability to produce well-trained primary care physicians. A recruitment plan used at the Chicago College of Osteopathic Medicine and its affiliates is presented here. The plan emphasizes the importance of trainee involvement in their own education as well as the use of residents in recruiting interns and specialty residents.

Advertising↗