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PubMed1995

Effects of a one-year high-intensity versus low-intensity resistance training program on bone mineral density in older women.

The purpose of this study was to determine the effects of a 12-month resistance training program, of two different intensities, on bone mineral density (BMD) in healthy, older women. Twenty-six Caucasian women (aged 65-79 years) completed the study. Subjects were randomly assigned to one of three groups: high-intensity (HI; n = 8), low-intensity (LI; n = 7), and control (CON; n = 11). The active groups performed 10 exercises, 3 days/week under supervision. Exercise intensity was maintained at 80% of one-repetition maximum (1-RM) for the HI groups, and at 40% 1-RM for the LI group. The volume of work was maintained constant between the two groups by assigning the LI group twice as many repetitions for each exercise. Maximal muscular strength and BMD of the lumbar spine and total hip were measured at baseline and at 12 months. Strength was evaluated using the 1-RM method, and BMD was determined by dual-energy X-ray absorptiometry. Exercise session attendance was similar for the two groups (81.0% HI; 76.8% LI). Muscular strength improved in the exercisers compared with the CON group (p < or = 0.05). Percentage change in lumbar spine BMD was 0.7 +/- 1.9%, 0.5 +/- 2.4%, and -0.1 +/- 2.3% for the HI, LI, and CON groups, respectively. Percentage change in total hip BMD was 0.8 +/- 2.3% (HI), 1.0 +/- 1.7% (LI), and 0.9 +/- 1.3% (CON). Group differences in BMD change were not significant (p > 0.05). These findings suggest that high-intensity and low-intensity resistance training regimens effectively increase muscular strength, but not lumbar spine or total hip BMD, in healthy, older women.

Absorptiometry, Photon↗
PubMed1992

[Meconium aspiration syndrome in the region of Nord-Pas-de-Calais. Development of a training program for neonatal resuscitation].

In the French region Nord-Pas-de-Calais a Public Health action was undertaken in order to set up a training program for neonatal resuscitation for the maternity-hospitals personnel. The incidence and severity of meconium aspiration among the population of children admitted to the neonatal intensive care unit of Lille University Hospital during two 15 month-periods of time, before and after the training, were compared. The number of neonates who presented with meconium aspiration decreased from 54 during the first period to 9 during the second, i.e. from 7.2 to 1.3% with respect to the total number of hospitalized patients (p less than 0.001). On the contrary, the number of deaths did not decrease significantly. This regression of the meconium aspiration gives evidence for an improved quality of care at birth. Even if training is not the only factor, this evolution gives argument in favour of the efficacy of such actions.

Education, Nursing↗
PubMed1995

Pharmacy residency training programs: a resident's perspective.

As changes are being made in the health care system, the roles and responsibilities of the pharmacist are evolving in direct patient care. The knowledge and skills necessary to succeed in these clinical positions are obtained through postgraduate training through pharmacy practice and specialty residencies and fellowships. Residency candidates are faced with important decisions in choosing which training programs to select and planning the course of the training. This article approaches the questions and decision-making process in residency selection from pharmacy residents' points of view.

Accreditation↗
PubMed2000

Are pediatric emergency medicine training programs adequately preparing graduates for involvement in EMS?

OBJECTIVE: To examine the level of involvement in pre-hospital care for children by faculty and fellows of teaching hospitals with a Pediatric Emergency Medicine (PEM) fellowship. In addition, we hypothesized that a divisional faculty member's involvement as principal investigator (PI) on an EMSC grant would not impact divisional involvement in on or off-line medical direction. METHODS DESIGN: Cross-sectional national survey. PARTICIPANTS: PEM fellowship directors. INTERVENTIONS: Self-administered questionnaire. STATISTICS: Descriptive and Chi-square analysis to study null hypothesis. RESULTS: The response rate to the survey was 62% (53/85). Of the programs responding, 53 % provided on-line pediatric medical direction for pre-hospital providers, 77% were involved with paramedic education other than PALS, and 58% of systems had pediatric specific protocols. In 87 % of the programs, a designated faculty member functioned as an EMSC liaison. A division faculty member was or had been the PI on an EMSC grant in 18 programs (34%). There was no significant difference in the provision of on or off-line medical direction comparing programs with or without involvement in an EMSC grant. Only 34% of the responding program directors felt that the current level of exposure to EMS was adequate for PEM fellow training. CONCLUSIONS: The current level of involvement in EMS of PEM faculty and fellows has significant room for improvement. It does not appear that grant support translates into increased local involvement in EMS. Current PEM fellowship curriculum guidelines for training in EMS are not being met by the majority of responding training programs.

Attitude of Health Personnel↗
PubMed1999

The effect of a modified physical training program in reducing injury and medical discharge rates in Australian Army recruits.

This uncontrolled observational study examined the injury and medical discharge outcomes in 318 female and 1,634 male recruits as a result of changes to the Australian Army recruit physical training program. Changes included cessation of road runs, introduction of 400- to 800-m interval training, reduction in test run distance from 5 to 2.4 km, standardization of route marches, and the introduction of deep-water running. There was a 46.6% reduction in the rate of total injury presentation (chi 2 = 14.31, p = 0.0002) after the change. The annual rate of male medical discharges decreased 40.8% from 81.1/1,000 recruits in 1994/1995 to 47.0/1,000 recruits in 1995/1996 (chi 2 = 26.33, p = 0.0001). Female rates increased 58.3% from 104/1,000 recruits to 164.2/1,000 recruits (chi 2 = 6.09, p = 0.014). The decrease in the male medical discharge rate resulted in an estimated saving of $1,267,805 Australian. Bone scans were reduced by 50%, resulting in an estimated annual saving of $61,539 Australian. The disparity between male and female injury rates is a concern. The merits of mixed-gender physical training should be reviewed in the light of these observations, and the establishment of initial entry fitness standards for recruit training may need to be considered.

Adult↗
PubMed1998

A 10-week strength training program: effect on the motor performance of an unimpaired upper extremity.

OBJECTIVE: Muscle strength training is one of the most common therapy methods in physical therapy programs, and the usual goal of this treatment is to improve muscle strength. Little attention has been paid, however, to the effects of strength training on the other components of motor performance. This study examined the effects of a 10-week strength training program on the motor performance of the hand, including reaction time, speed of movement, tapping speed, and coordination in normal healthy volunteers. DESIGN: Before-after trial. SUBJECTS AND SETTING: Sixteen healthy women volunteers aged 25 to 45 years participated. INTERVENTION: Subjects accomplished a 10-week muscle strength training program of the upper extremities. MAIN OUTCOME MEASURES: Reaction time, speed of movement, tapping speed, and coordination were measured three times on consecutive days, and muscle strength and electromyographic values of the right upper extremity were recorded once before the training period. After the training period, the same measurements were made as before the training. RESULTS: The 10-week strength training decreased choice reaction time by 6% (p < .01) and increased tapping speed by 3% (p < .01) and coordination by 5% (p < .05). Speed of movement increased, but this change was not statistically significant. All the measured isometric muscle strengths and electromyographic activations upon maximum isometric contraction increased. CONCLUSIONS: A 10-week strength training of the upper extremities increased muscle strength and some motor performance functions of the hand, including choice reaction time, tapping speed, and coordination.

Adult↗
PubMed2003

Use of a training program to enhance NICU nurses' cognitive abilities for assessing preterm infant behaviors and offering supportive interventions.

This study tested the use of a developmentally supportive care (DSC) training program in the form of videotaped and personalized instruction to increase nurses' cognitive abilities for assessing preterm infant behavioral signals and offering supportive care. The study used a two-group pre-test post-test quasi-experimental repeated measures design. The participants were 25 NICU nurses, 13 in the intervention group, and 12 in the control group. An instrument developed for the purpose of the study was a video test that measured the effectiveness of the DSC training. The video test questionnaires were administered to the participants twice with an interval of four weeks. ANCOVA controlling the baseline scores was used for data analysis. In general, the results support the hypothesis that nurses' cognitive abilities were enhanced after the DSC training. The increase in nurses' cognitive abilities is the prerequisite for behavioral change, based on the assumptions of Bandura's Social Cognitive Learning Theory (Bandura, 1986). As nurses' cognitive abilities increased, it would be possible that nurse behaviors in taking care of these preterm infants might change. Therefore, the author recommends that in order to improve NICU care quality and the outcomes of preterm infants, the concepts of developmentally supportive care be incorporated into NICU caregiving practice by educating nurses.

Adult↗
PubMed1999

[Management of mental health and primary care. Development and evaluation of a training program based on the PLISSIT approach].

Deficits in current approaches of psychosomatic and psychiatric education for general practitioners are reviewed. A skill-based training was developed in line with the four step counseling approach of the "PLISSIT" approach: The GP helps in first step ("permission") the patient to accept his problem and assesses informations about causing and maintaining factors of his symptomatology. In the second step he should provide information about the disorder and reverse misunderstanding and passivity (Limited Information). The GP's should develop preliminary strategies for change in the third step ("coping strategies", "symptom management", "special suggestions") and preparate the intensive phase of therapy as the last step. First results of the evaluation of the training program are presented demonstrate the effectiveness and acceptance of the education program.

Disease Management↗
PubMed1975

A short-term intensive training program for pediatric nurse practitioners.

A pediatric nurse practitioner course has been described in which 30 nurse trainees spent six seeks in an intensive training program followed by six months of preceptorship with a pediatrician in their own agency. This short but intensive program had advantages of permitting the PNP student to retain her health care agency position during the intensive part of the program and of assuring her a position as a PNP once the course was completed. Evaluation of the students by written and practical examinations indicated that they had made significant gains in their knowledge and understanding of pediatrics and in their ability to evaluate and refer patients and to provide well-child care and maternal counseling.

California↗
PubMed1998

Ecological momentary assessment in a behavioral drinking moderation training program.

We assessed predictors of self-reported excessive drinking (> 5 drinks) in a sample of heavy drinkers. Participants were randomly assigned to moderation training or a waiting-list control condition. They were trained in ecological momentary assessment (EMA) involving self-monitoring of drinking and other variables on a small hand-held computer, the electronic diary (ED). During the 8-week study, participants were compliant in their use of the ED for both random prompts and the entry of data related to specific drinking episodes. Generalized estimating equations were used to fit models involving predictors related to past history of drinking, aspects of the training program, drinking restraint, and episode-specific mood. The models indicated robust predictors of decreased and increased drinking. Our results suggest that EMA is a useful methodology for assessing drinking and related behaviors.

Adult↗
PubMed2001

Prevalence of genital chlamydial infection in young women entering a national job training program, 1990-1997.

OBJECTIVES: This analysis describes trends in the prevalence of genital chlamydial infection in economically disadvantaged young women entering a national job training program. METHODS: We examined chlamydia test data for May 1990 through June 1997 for women aged 16 to 24 years who enrolled in the program. The significance of trends was evaluated with the chi 2 test for trend. RESULTS: Prevalence of chlamydial infection declined 32.9%, from 14.9% in 1990 to 10.0% in 1997 (P < .001). Prevalence decreased significantly in all age groups, racial/ethnic groups, and geographic regions. CONCLUSIONS: The decrease in prevalence of chlamydial infection suggests that prevention activities have reached disadvantaged women across the United States; however, prevalence of chlamydial infection remains high, and enhanced prevention efforts in disadvantaged communities are urgently needed.

Adolescent↗
PubMed2000

Effectiveness of a social skills training program using self/other perspective-taking: a nine-month follow-up.

Using a pre/posttest design, with a nine-month follow-up, a new, "modified" social skills training program, which incorporates the concept of self/other perspective-taking, was evaluated and compared to a traditional social skills program in a sample of 36 children. Students in the modified group showed more short- and long-term improvement in behavior than did those in the traditional social skills training group. Implications for practice and research are discussed.

Child↗
PubMed2004

A time of accelerated change in academic cardiovascular medicine: implications for academic divisions of cardiology and their training programs.

With the vast epidemic of vascular disease predicted to be the leading cause of death and disability by a growing margin over the next 30 years, academic medical centers with cardiology training programs have a special responsibility. Given the dramatic advances of biotechnology in producing highly effective but expensive strategies of prevention and treatment, cardiovascular specialists should assist their academic centers in envisioning the future to prepare trainees for a different environment. Cardiologists of the future must be able to adapt to a societal need for patient-oriented, team-based clinical care and rapidly evolving technology, while maintaining the fundamental skills and knowledge required for individual patient interaction. Academic programs should benchmark their activities to ensure responsible resource allocation so that cardiologists of the future will be trained in an environment stimulating excellence and creativity.

Cardiology↗
PubMed2005

A community-based training program for eating disorders and its contribution to a provincial network of specialized services.

The Ontario Community Outreach Program for Eating Disorders is a pilot training project within the eating disorder programs at the University Health Network--Toronto General Hospital (TGH) and the Hospital for Sick Children. This system provides ongoing training, consultation, and research evaluation in areas ranging from prevention through to tertiary care, in the hopes of increasing the capacity of practitioners to respond to the healthcare pressures of those experiencing eating disorders. A total of 3,315 health care practitioners and educators in Ontario participated in community-based training workshops. A pre-post analysis of participants' self-report evaluations was conducted using chi-square analyses. The findings revealed that there was a statistically significant increase in participants' (a) knowledge of eating disorders and of body image issues and (b) level of comfort to either treat clients with eating disorders or teach a curriculum on body image. The contribution of the training program to the development of a provincial network of specialized eating disorder services, designed to promote the public's access to timely and appropriate care for the full spectrum of eating disorders, are discussed.

Adolescent↗
PubMed1998

The situation of diagnostic radiology training programs and their graduates in 1997.

OBJECTIVE: In light of concerns about the job market, the American College of Radiology studied the employment situation of 1997 graduates from diagnostic radiology training programs and the status and plans of these programs. MATERIALS AND METHODS: In an April-May 1997 survey and in a December 1997 follow-up, the American College of Radiology asked a 50% random sample of diagnostic radiology residency directors about their programs and about the employment situation of their 1997 residency and fellowship graduates. Of those surveyed, 89% responded. We compared these findings with those from a similar 1996 survey. The test of statistical significance was p < or = .05. RESULTS: All diagnostic residency and fellowship graduates who wanted to work were employed within 6 months after graduation. Approximately 95% of graduates had positions that directors believed to reasonably match their training and personal employment goals. Outcomes were similar across all fellowship fields except nuclear medicine, a field in which graduates had greater difficulty finding jobs. The completed plus planned changes in program size will lead to a 13-14% reduction in the annual number of graduates. As in previous years, by late April to mid May 1997, 93% of beginning-year residency slots were filled. However, the percentage of beginning residents who are international medical graduates increased. In 1997, residency program directors were more optimistic about graduates' job prospects than in 1996, and there was a statistically significant increase from 1996 in the proportion of fellowship graduates, according to directors, who had found jobs that fit their goals and training. CONCLUSION: Unemployment continues to be low. The 1997 job market has improved over the 1996 job market, but job prospects in nuclear medicine continue to be more problematic than in other subspecialties.

Employment↗
PubMed1988

The long-term impact of a training program in maxillofacial prosthodontics.

A follow-up survey of trainees in a National Cancer Institute-sponsored program in maxillofacial prosthodontics was conducted. Information about the trainees' current professional activities indicated that the majority work in private practice or a dental school, are primarily involved in clinical work or teaching, and see few cancer patients. Inadequate reimbursement and lack of collaboration with surgeons were cited as barriers to involvement in cancer patient care. It is suggested that barriers to applying training expertise in actual practice settings require emphasis in the planning and curricula of training programs.

Career Choice↗
PubMed1983

Mothers' evaluation of a parent training program completed three and one-half years earlier.

The purpose of the present study was to examine the long term effects of a parent training program. Mothers who completed treatment, a mean of 3.6 yr earlier, were asked to fill out measures that examined parent perceptions of child adjustment and parent satisfaction with treatment. Of the 68 mothers to whom questionnaires were mailed, 34 (50%) returned them while 10 questionnaires were returned with an insufficient address. A comparison of pre-treatment, post-treatment and follow-up child adjustment scores indicated that the mothers perceived their children as significantly better adjusted after treatment and that this effect maintained at follow-up. Generally favorable responses were also reported by mothers on a consumer satisfaction measure.

Adolescent↗