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PubMed1997

Effects of a training program on resting plasma 2-hydroxycatecholestrogen levels in eumenorrheic women.

Catecholestrogens (CE) represent a major metabolic pathway in estrogen metabolism. Previous information on CE and training is limited to two cross-sectional studies that did not involve standardized training. Our purpose, by means of a prospective design, was to evaluate the effects of a brief, exhaustive training program on resting plasma concentrations of 2-hydroxy CE. The experimental design spanned two menstrual cycles; a control cycle and a training cycle. The subjects were nine previously untrained, eumenorrheic women [body fat: 24.8 +/- 1.0 (SE) %]. Data were collected during the follicular (FPh) and the luteal phases (LPh). Posttraining FPh and LPh tests were held the day after the last day of a 5-day period of training on a cycle ergometer. Total 2-hydroxyestrogens (2-OHE) averaged 200 +/- 29 pg/ml during the FPh and 420 +/- 54 pg/ml during the LPh (P < 0.05). Levels of total 2-methoxyestrogens (2-MeOE) were 237 +/- 32 pg/ml during the FPh and 339 +/- 26 pg/ml during the LPh (P < 0.05). After training, although the plasma levels of 2-OHE significantly decreased (21%; P < 0.05) during the LPh, the actual CE formation (as estimated from the 2-OHE-to-total estrogens ratio) increased (+ 29%; P < 0.05). CE activity, as expressed by the 2-MeOE-to-2-OHE ratio, showed significantly higher values in both phases (FPh, + 14%; LPh, + 13%; P < 0.05). At the same time, resting levels of norepinephrine (NE) were increased by 42% (P < 0.05). CE strongly inhibit biological decomposition of NE by catechol-O-methyltransferase (COMT). Results of the present study suggest that, in response to training, CE are increasingly competing with the enzyme COMT, thus preventing premature NE deactivation.

Adult↗
PubMed1982

A study of geriatric training programs in the United States.

Training physicians in geriatrics is essential to improving health care for the elderly. The study reported here provides a detailed analysis of geriatric education at the undergraduate, graduate, and fellowship levels. The number of programs for medical students and residents has increased but is still relatively few; most are elective, and they are of variable quality. Both the number of fellowship programs (36) and positions (87) and the current number of yearly graduates (40) are quite small. Few of these programs have been thoroughly evaluated. Data are presented on the type of training sites, educational activities, and clinical interaction at different levels of training. Overall, the nursing home is most frequently used as a training site, and trainees have contact with many care providers. Information of this kind may be of value to those planning or conducting geriatric programs. The results suggest that there is a persistent need for high quality programs at all levels of educational continuum and that such efforts should be evaluated to ensure and improve quality.

Aged↗
PubMed2000

The situation of radiation oncology practice training programs and their graduates in 1998.

PURPOSE: To keep the profession apprised of current trends in the job market, the American College of Radiology (ACR) studied the employment situation of 1998 radiation oncology graduates and the status and plans of radiation oncology training programs in the United States. METHODS AND MATERIALS: In April-May 1998, and again in a December 1998-January 1999 follow-up, the ACR surveyed all radiation oncology residency directors in the U.S. about the employment situation of their 1998 residency and fellowship graduates as well as changes in their programs. Eighty-five percent (71/84) of those surveyed responded. We compare current findings with similar 1997 and earlier surveys and report statistically significant differences (p < or = 0.05). RESULTS: By 6 months after graduation, there were no graduating residents or fellows who had not secured a position, although the status of two was unknown. At that time, about 93% of all graduates had secured positions that directors said reasonably matched graduates' training and personal goals. Program directors reported that accomplished and planned changes in their programs will reduce the annual number of residency graduates by about one-fifth since 1993. However, the number of beginning residency positions offered in 1998 was 149, up from 116 in 1997 and only a few percent below the 1993 level. By the December 1998-January 1999 follow-up, fill rates for offered training positions were 94% for residencies and 80% for fellowships, figures that are similar to those reported for past years. Directors' perceptions of the job market are much more positive. For example, only 11% of residency directors viewed the market as more difficult this year than typical of recent years, as against 48% in 1997 and 82% in 1996. CONCLUSION: Unemployment continues to be low, and another, "softer" indicator, the job market perceptions of residency program directors, continues to improve. Possibly as a result, plans for program reductions are evaporating.

Employment↗
PubMedDate not supplied

Evaluation of a re-training program for older drivers.

BACKGROUND: Some older drivers may have a higher crash risk than others. Because many of these drivers have not received formal driving training, we evaluated the effectiveness of a re-training program for older drivers as it is currently being offered. Specifically, we examined if older drivers who received the training would have better scores on a driving evaluation than drivers who did not receive the training. METHODS: We used a randomized controlled trial. Participants first took part in on-road driving evaluations (possible scores ranged from 0 to 100), after which they were block randomized into training (treatment) or waiting (control) groups based on the driving evaluation results, age, and sex. Individuals in the treatment group attended driver re-training sessions, and were tested once more with the on-road test. Those in the control group completed their second driving evaluation and were then offered the re-training sessions. The second evaluations took place approximately two months after the first evaluations. RESULTS: Sixty-five participants completed two driving evaluations. Despite the overall improvement in driving scores (3.73, SD = 6.87, p = 0.001), we found no statistically significant difference between the control and treatment groups. The mean improvement for the control group was 3.46 (SD=6.72) compared to 4.02 (SD=7.11) for the treatment group (p = 0.747). Drivers' age was related to overall driving scores (r = -0.55, p = 0.001) but not changes between the first and second evaluations (r = 0.01, p = 0.955). INTERPRETATION: Although we have not demonstrated a statistically significant impact of the intervention, the overall increase suggests that an initial driving evaluation may underestimate the actual driving ability of many older drivers. Furthermore, although older drivers may have lower driving scores initially, they have the ability to improve on these scores. These findings should encourage us to explore diverse approaches to improve driving safety.

Accident Prevention↗
PubMed2006

A group parent-training program: a novel approach for eating disorder management.

OBJECTIVE: To describe the rationale, development, and preliminary acceptability of a Group Parent Training Program (GPT) as an alternative approach for the treatment of adolescent eating disorders. METHOD: Sixteen families participated in a 16-session group treatment. After four months, parents were administered a treatment satisfaction questionnaire. RESULTS: Parent response to the intervention was positive. All parents indicated GPT was essential for the management of their child, improved general parenting skills, improved their own self-care, and decreased the burden they experienced as a result of managing their child's illness. DISCUSSION: Given the magnitude of task demands placed on a family for the management of adolescent eating disorders, there is the need for the development of effective intervention strategies that ease the stress of illness management for parents. Preliminary satisfaction data from GPT are promising and argue for a more systematic test of this intervention.

Adolescent↗
PubMed1989

The long-term effectiveness and clinical significance of three cost-effective training programs for families with conduct-problem children.

We evaluated the long-term effectiveness of three cost-effective parent training programs for conduct-problem children. One year posttreatment, 93.1% of families (94 mothers and 60 fathers) were assessed on the basis of teacher and parent reports and home observations. Results indicated that all the significant improvement reported immediately posttreatment were maintained one year later. Moreover, approximately two thirds of the entire sample showed "clinically significant" improvements. There were very few differences between the three treatment conditions except for the "consumer satisfaction" measure indicating that the treatment combining group discussion and video-tape modeling was superior to treatments without both components.

Behavior Therapy↗
PubMed2004

Effectiveness of a multidisciplinary occupational training program for chronic low back pain: a prospective cohort study.

OBJECTIVE: To evaluate the effectiveness of a 12-wk multidisciplinary occupational training program for patients with chronic low back pain and to identify prognostic factors for treatment success. DESIGN: A total of 51 participants were evaluated at baseline, at discharge, and at 1 yr after conclusion of the program. The evaluation included a physical examination and assessment of functional disability, psychological factors, and coping styles. The main target of the program is full work resumption. The central outcome measures therefore are three variables on return to work. RESULTS: Analysis of variance for repeated measures revealed significant beneficial changes during the program for all measures except for several coping-style variables. The acquired level of maximum oxygen uptake, trunk flexibility, functional disability, and catastrophizing were maintained at 1-yr follow-up. At 1-yr follow-up, >60% of the participants had fully returned to work, which is an increase of >40% compared with baseline. Regression analyses showed that sex, age, the baseline values of reinterpretation of pain sensations, and functional disability and changes in trunk flexibility scores during the program are important prognostic factors for complete return to work. CONCLUSIONS: Based on the current findings, the program seems to be efficacious in the short term. Future attention must be directed toward maintaining these results, although work resumption rates improved considerably 1 yr after conclusion of the program.

Abdominal Muscles↗
PubMed1997

The employment market for 1996 diagnostic radiology and radiation oncology graduates: training program directors' point of view.

OBJECTIVE: In light of concerns about the job market, we describe the employment situation for 1996 graduates and the status and plans of training programs. MATERIALS AND METHODS: In April-May 1996, and in a December follow-up, we surveyed all radiation oncology residency directors and a 50% random sample of diagnostic radiology residency directors about the employment situation of their 1996 residency and fellowship graduates and about their programs. One hundred percent of those surveyed responded. We compared findings with similar 1995 surveys. Differences were assessed with t tests, with a p value less than or equal to .05 as the test of significance. RESULTS: Unemployment 6 months after graduation was 0.8% for diagnostic fellows and less for other categories. Approximately 91% of graduates had positions that reasonably matched their training and personal employment goals. Our survey showed that programs have reduced beginning residency slots by 6% in diagnostic radiology and 4% in radiation oncology over the last 3 years. Program directors plan additional reductions of 3% and 29%, respectively, for total reductions in diagnostic radiology of 9% and in radiation oncology of 33%. Many observers were dismayed because of the low percentage of available slots that filled in the 1996 National Resident Matching Program. However, as in previous years, by late April to mid May 1996, more than 92% of beginning-year residency slots were filled. CONCLUSION: Unemployment continues to be low. "Soft" indicators such as the percentage of graduates with unsuitable positions show no deterioration. However, if major surpluses of diagnostic radiologists or radiation oncologists are pending, both the reductions in program size and the failure to fill all available slots are, to date, too minor to offer significant relief. Given the small size of actual reductions so far, the reported plans for large reductions of radiation oncologists seem questionable.

Data Collection↗
PubMed2005

Reducing unmet needs: a prevocational medical training program in public health medicine and primary health care in remote Australia.

OBJECTIVES: To describe the development and implementation of a prevocational medical training program in public health medicine and primary health care in remote Australia and to evaluate the program's adherence to adult learning principles. METHODS: Reports, funding applications and other relevant material relating to the program were reviewed to document learning objectives, and teaching and program implementation strategies. RESULTS: The 24-week program employs two prevocational medical practitioners each year and comprises four weeks at Fremantle Hospital's sexual health clinic followed by 20 weeks in the Kimberley. Curriculum objectives include clinical and public health aspects of sexually transmitted infection management, immunisation, clinical audit and quality improvement, primary health care in remote Aboriginal communities, oral and written presentation skills and working as part of an interdisciplinary team. Teaching strategies used were in accordance with adult learning principles. CONCLUSIONS: Prevocational medical training in public health medicine and primary health care in remote Australia is achievable and reduces current gaps in prevocational medical education.

Adult↗
PubMed1990

National Study of Internal Medicine Manpower: XVII. Changes in the characteristics of internal medicine residents and their training programs, 1988-1989.

The National Study of Internal Medicine Manpower (NaSimm) has been surveying program directors of internal medicine about their programs and residents for 13 years. The 1988-1989 survey results, when compared with the results for 1987-1988, show an increase in both the number of residency positions offered in internal medicine and the number of residents in internal medicine programs. Although the proportion of graduates from U.S. medical schools who choose internal medicine is not changing (34%), the proportion of U.S. medical school graduates who continue training in internal medicine after their first year is decreasing. The composition of the residents in internal medicine by medical school graduated is also changing. Almost 25% of the first-year residents (R1s) in internal medicine are now graduates of foreign medical schools (FMGs) compared with 14% in 1976. The proportion of first-year female residents in internal medicine has increased to 30%, whereas the proportion of both first-year blacks and Hispanics has remained constant at 5% each. In nearly 25% (109 of 440) of the residency programs, more than 50% of the R1s are FMGs. Hispanics, Asians, and blacks were found to be over-represented in the programs training larger proportions of FMGs. This over-representation is attributable, in part, to the fact that Hispanics and Asians may be FMGs. Training issues of concern to program directors continue to be the provision of ambulatory and primary care experiences and the scheduling of nights on call. The survey results show that many residency program directors have reported a reduction in the number of nights on call and an increase in the amount of time residents spend in ambulatory training.

Ethnicity↗
PubMed1998

The effects of a physical training program on patients with osteoarthritis of the knees.

OBJECTIVE: To investigate physical function in patients with severe osteoarthritis (OA) of the knees during and after a general physical training program. DESIGN: Randomized control trial, blinded observer, follow-up at 3 months and 1 year. SETTING: Outpatient clinic. PATIENTS: Consecutive sample of 25 patients (3 men, 22 women) with OA of the knees according to the criteria of the American College of Rheumatology (ACR). Two patients (8%) failed to complete the study. There were no withdrawals for adverse effects. INTERVENTION: Twelve patients received training in groups of 6, twice a week for 3 months. Training focused on general fitness, balance, coordination, stretching, and lower extremity muscle strength, and included a daily home exercise program. MAIN OUTCOME MEASURES: Muscle strength across the knee (extension and flexion), Algofunctional Index (AFI), pain (0 to 10 point scale), walking speed, clinical findings. RESULTS: Patients participated in 96 of 96 assessments (100%) and in 218 of 280 training sessions (77.9%). From baseline to 3 months, isokinetic quadriceps strength (30 degrees/sec) improved 20% (confidence interval [CI] 2alpha = .05, 8% to 50%) in the least affected leg; isometric strength improved 21%. By 1 year, AFI had decreased 3.8 points (CI2alpha = .05, 1.0 to 7.0), pain had decreased 2.0 points (CI2alpha = 05, 0.0 to 4.0), and walking speed had increased 13% (CI2alpha = .05, 4% to 23%). There was an increase in the frequency of palpable joint effusions (p < .01) on the most affected side. Frequency of crepitus decreased on the least affected side (p < .01). CONCLUSIONS: General physical training appears to be beneficial to patients with OA of the knee. As shown by the high compliance and low dropout frequency, such a program is feasible even in patients with severe OA of the knee.

Aged↗
PubMed1995

Materials, methods and results of the Norplant training program.

Norplant subdermal implants for contraception were introduced into UK clinical practice in October 1993. Use of Norplant requires providers to learn additional skills. A training program designed to give providers to opportunity to obtain these skills was designed and implemented through the co-operation of Hoechst Roussel, JHPIEGO and members of the UK medical profession. Uptake of training for Norplant provision has been widespread and Norplant has been established as a realistic contraceptive choice for women in the UK. Introduction of Norplant in the UK has raised many issues that go beyond clinical considerations.

Contraception↗
PubMed1997

Percutaneous endoscopic gastrostomy tube placement in a surgical training program.

BACKGROUND: This study examines the patterns of use of percutaneous endoscopic gastrostomy (PEG) and primary open gastrostomy (Gtube) performed in a residency training program in surgery. METHODS: A retrospective cohort study that assesses the indications and outcomes of 317 PEGs and 75 isolated Gtubes used for gastric access between 1987 and 1997. RESULTS: The demographics and risk factors of the patients receiving Gtube and PEG were comparable. The mean number of PEGs performed per resident is currently 13 per year (mean 5 over 10 years) with a 97% PEG success rate; an 88% success rate is demonstrated for placement of jejunal extensions. CONCLUSIONS: PEGs are generally preferable to Gtubes as primary procedures. Surgical residents should become competent in PEG placement by performing adequate numbers of procedures with fully trained staff.

Adult↗
PubMed2002

A Nationwide Learning-Style Assessment of Undergraduate Athletic Training Students in CAAHEP-Accredited Athletic Training Programs.

OBJECTIVE: To identify the learning styles and preferred environmental characteristics of undergraduate athletic training students in Commission on Accreditation of Allied Health Education Programs (CAAHEP)-accredited athletic training education programs and to determine if learning-style differences existed among geographic regions of the country. DESIGN AND SETTING: Fifty CAAHEP-accredited athletic training programs were randomly selected in proportion to the number of programs in each geographic region. Ten students from each school were selected to complete the Kolb Learning Style Inventory (LSI) and the Productivity Environmental Preference Survey (PEPS). SUBJECTS: A total of 193 undergraduate athletic training students (84 men, 109 women) with a mean age of 22.3 +/- 2.8 years completed the PEPS, while 188 students completed the LSI. MEASUREMENTS: We used chi-square analyses to determine if differences existed in learning-style type and if these differences were based on geographic location. We calculated analysis of variance to determine if there were any geographic differences in the mean overall combination scores of the LSI. Descriptive statistics were used to evaluate the PEPS. RESULTS: The overall return rate was 38%. The chi-square analyses revealed no significant difference in learning-style type for athletic training students, regardless of the geographic region. The LSI yielded a relatively even distribution of learning styles: 29.3% of the students were accommodators, 19.7% were divergers, 21.8% were convergers, and 29.3% were assimilators. The overall mean combination scores were 4.9 (abstract-concrete) and 4.9 (active-reflective), and analysis of variance indicated no significant difference in the mean combination scores among the geographic regions. The PEPS revealed that undergraduate athletic training students demonstrated a strong preference for learning in the afternoon. CONCLUSIONS: Undergraduate athletic training students demonstrated great diversity in learning style. Educators must strongly consider this diversity and incorporate teaching methods that will benefit all types of learners.

Journal Article↗
PubMed1966

Observations on a medical teacher training program.

An increasing interest in educational science as applied to medical education is apparent in the past decade. Recently, a six-week teacher training program was held at the Center for the Study of Medical Education at the University of Illinois. Fifteen medical faculty members, including five Canadians, participated. During this period there was an opportunity to engage in discussions and independent study of several aspects of medical education, using the personnel from the Center's four major divisions as resource people. Training in educational science is important for all teachers, and a centre to provide this type of instruction should be available in Canada.

Canada↗
PubMed1984

Education in geriatrics in physical medicine residency training programs.

The number of aged persons in the United States is rising steadily. Rehabilitation medicine is becoming increasingly involved in providing the care necessary to keep aging individuals in good health so that the onset of late life disability can be delayed and social independence be maintained for as long as possible. For this reason, education in geriatric rehabilitation must become an essential part of training programs for residents in physical medicine and rehabilitation. The curriculum of these programs must be broad based and must include many of the general aspects of geriatric medicine even though they may relate only peripherally to rehabilitation. One faculty member should be charged with the responsibility of organizing the educational program. He should maintain liaison with faculty members of other departments who have expertise in the problems of the aging. Some of the teaching can be done by lectures and seminars but much of it should be carried out in clinical settings such as in-patient facilities, out-patient departments, home health services and day-care programs. Nursing homes might offer suitable training facilities provided that adequate supervision and teaching are available. Every effort should be made to overcome prejudices that may exist with regard to the care and rehabilitation of a geriatric population.

Aged↗
PubMed2004

Effect of an 8-week combined weights and plyometrics training program on golf drive performance.

The purpose of this study was to determine the effect of a combined weights and plyometrics program on golf drive performance. Eleven male golfers' full golf swing was analyzed for club head speed (CS) and driving distance (DD) before and after an 8-week training program. The control group (n = 5) continued their normal training, while the experimental group (n = 6) performed 2 sessions per week of weight training and plyometrics. Controls showed no significant (p > or = 0.05) changes, while experimental subjects showed a significant increase (p < or = 0.05) in CS and DD. The changes in golf drive performance were attributed to an increase in muscular force and an improvement in the sequential acceleration of body parts contributing to a greater final velocity being applied to the ball. It was concluded that specific combined weights and plyometrics training can help increase CS and DD in club golfers.

Adult↗