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PubMed2002

Sources of Information on Postgraduate Medical Training Programs--2002 update.

This is the biennial update listing directories, journal articles, Web sites, and general books that aid the librarian, house officer, or medical student in finding information on medical residency and fellowship programs. The World Wide Web continues to surpass print resources as the most current and complete source of information about postgraduate training programs and specialties. The Web has become a marketing tool for hospitals seeking to recruit the best and brightest for their residency and fellowship programs.

Education, Medical↗
PubMed2000

A genetic study of dehydroepiandrosterone sulfate measured before and after a 20-week endurance exercise training program: the HERITAGE Family Study.

Familial aggregation and possible major gene effects were evaluated for the baseline serum dehydroepiandrosterone sulfate (DHEAS) level and the change in DHEAS in response to a 20-week exercise training program in a sample of 481 individuals from 99 Caucasian families who were sedentary at baseline and who participated in the HERITAGE Family Study. Baseline DHEAS levels were not normally distributed, and were therefore logarithmically transformed and adjusted for the effects of age and sex prior to genetic analysis. The DHEAS response to training was computed as the simple difference, post-training minus baseline, and was adjusted for the baseline DHEAS level, age, and sex. Maximal (genetic and familial environmental) heritabilities (using a familial correlation model) reached 58% and 30% for the baseline and the response to training, respectively. Our estimate for the baseline is generally in agreement with previous reports, suggesting that the magnitude of the familial effect underlying this phenotype in these sedentary families is similar to that in the general population. However, segregation analysis showed no evidence for a multifactorial familial component in data for either the baseline or the response to training. Rather, a major additive gene controlling the baseline was found. For the response to training in the complete sample, transmission of the major effect from parents to offspring was ambiguous, but in a subset of 56 "responsive" families (with at least 1 family member whose response to training was greater than 1 standard deviation) this major effect was Mendelian in nature. The putative major genes accounted for 50% and 33% of the variance for the baseline and the response to training, respectively. The novel finding in this study is that the baseline DHEAS level and the change in DHEAS in response to training may be influenced by major gene effects.

Adult↗
PubMed2006

Balance training program is highly effective in improving functional status and reducing the risk of falls in elderly women with osteoporosis: a randomized controlled trial.

INTRODUCTION: The purpose of this study was to investigate the effect of a 12-month Balance Training Program on balance, mobility and falling frequency in women with osteoporosis. METHODS: Sixty-six consecutive elderly women were selected from the Osteometabolic Disease Outpatient Clinic and randomized into 2 groups: the 'Intervention', submitted for balance training; and the 'Control', without intervention. Balance, mobility and falling frequency were evaluated before and at the end of the trial, using the Berg Balance Scale (BBS), the Clinical Test Sensory Interaction Balance (CTSIB) and the Timed "Up & Go" Test (TUGT). Intervention used techniques to improve balance consisting of a 1-hour session each week and a home-based exercise program. RESULTS: Sixty women completed the study and were analyzed. The BBS difference was significant higher in the Intervention group compared to Control (5.5 +/- 5.67 vs -0.5 +/- 4.88 score, p<0.001). Similarly, the number of patients in the Intervention group presented improvement in two conditions of CTSIB compared to Control (eyes closed and unstable surface condition: 13 vs one patient, p < 0.001 and eyes open, visual conflict and unstable surface condition: 12 vs one patient, p<0.001). Additionally, the differences between the TUGT were reduced in the Intervention group compared to Control (-3.65 +/- 3.61 vs 2.27 +/- 7.18 seconds, p< 0.001). Notably, this improvement was paralleled by a reduction in the number of falls/patient in the Intervention group compared to Control (-0.77 +/- 1.76 vs 0.33 +/- 0.96, p=0.018). CONCLUSION: This longitudinal prospective study demonstrated that an intervention using balance training is effective in improving functional and static balance, mobility and falling frequency in elderly women with osteoporosis.

Accidental Falls↗
PubMed2002

Psychotherapy of attention deficit hyperactivity disorder in adults--a pilot study using a structured skills training program.

In clinical practice many adult patients with attention deficit hyperactivity disorder (ADHD) ask for an additional psychotherapeutic intervention besides the medical therapy. In this paper we present a structured skill training program particularly tailored for adult patients with ADHD. The program is based on the principles of cognitive-behavioral treatment for borderline personality disorder developed by M. Linehan. It was modified to suit the special needs of adult patients with ADHD. In this exploratory pilot study we tested this program in a group setting. The following elements were presented: neurobiology of ADHD, mindfulness, chaos and control, behavior analysis, emotion regulation, depression, medication in ADHD, impulse control, stress management, dependency, ADHD in relationship and self respect. In an open study design patients were assessed clinically using psychometric scales (Attention Deficit Hyperactivity Disorder Checklist according to DSM-IV, 16 items of the SCL-90-R, Beck-Depression Inventory, visual analogue scale) prior to and following group therapy. This treatment resulted in positive outcomes in that patients improved on all psychometric scales.

Adult↗
PubMed2001

The benefits and limitations of a physical training program in patients with inflammatory myositis.

The clinical features of inflammatory myositis are determined by the severity and extent of muscle weakness and systemic manifestations. The benefits and limitations of physical training programs and rehabilitation strategies depend on the clinical phase of the disease and analysis of underlying impairments responsible for functional limitations in the patient. Patients with early stage disease and severe weakness will be treated differently than patients who have responded to medication and are improving. Not all patients will respond to medications; their therapy programs will have different requirements. This article reviews available data on the physiologic responses to exercise in patients with inflammatory muscle diseases. New data support more aggressive approaches to progressive strengthening exercises for patients with inflammatory myositis.

Activities of Daily Living↗
PubMed2002

Training program in suicide prevention for psychiatric nursing personnel enhance attitudes to attempted suicide patients.

Attitudes of psychiatric nursing personnel towards patients who had attempted suicide were examined before and after a training program in psychiatric suicide prevention. The attitudinal changes were measured by a newly constructed scale, the understanding of suicide attempt patients scale (USP-scale), and responses to three brief clinical vignettes. General understanding and willingness to nurse, as measured by the USP-scale, increased significantly, and the suicide risk of patients described in case vignettes was estimated more accurately after the program. The results suggest that it may be possible to enhance attitudes to attempted suicide patients among psychiatric nursing personnel.

Adult↗
PubMed1993

Education and training programs for expatriate and Saudi nurses at KKESH.

The purpose of this second article in a series of "Ophthalmic nursing in Saudi Arabia: A western expatriate's perspective" is to acquaint readers with the education and training programs for the expatriate nursing staff and Saudi nurses at the King Khaled Eye Specialist Hospital (KKESH) in Riyadh, Saudi Arabia.

Hospitals, Special↗
PubMed2004

Evaluation of a training program to prepare community health representatives to promote breast and cervix cancer screening among native american women.

BACKGROUND: Native American women have very poor 5-year breast and cervix cancer survival rates compared to other US population groups. We evaluated a training program that prepares community health representatives (CHRs) to promote prevention and early detection of these diseases. Two questions guided the evaluation: (1) Are CHRs an appropriate focus of training? and (2) Does training empower CHRs and, indirectly, their facilities to educate about breast and cervix cancer, promote screening, and teach breast self-exam skills to American Indian and Alaska Native women? METHODS: Twenty CHRs (3 Indian Health Service regions, 9 separate employers) responded to a telephone survey consisting of Likert scale and multiple option and short-answer questions. Analysis relied on descriptive statistics and measures of central tendency. RESULTS: By tenure, cultural and community membership, and ability to adapt to audience needs and setting demands, CHRs make appropriate training recipients. Training improves skills and their use and appears to increase employers' reliance on CHRs for screening promotion and education about cancer. Posttraining, more women hear and heed the screening message. CONCLUSIONS: CHRs are an appropriate focus of training. Training leads to increased screening-related activities and should be continued and expanded.

Breast Neoplasms↗
PubMedDate not supplied

Interpersonal communications skills for dental hygiene students: a pilot training program.

PURPOSE: The educational preparation of most oral health professionals specifically has not addressed professional-patient interaction skills. The purpose of this pilot research project was to determine if the Carkhuff model of communication skills training would improve the interpersonal communication skills of junior dental hygiene students. METHODS: The pilot training program was designed to assess and improve interpersonal communication skills using an experimental pretest-posttest design. In Spring 1990, twenty-four baccalaureate dental hygiene students were randomly divided into experimental and control groups. The experimental group completed twenty (20) hours of interpersonal skills training based on Carkhuff's Human Resources Development Model. Video demonstrations, patient simulations, and role modeling were used to enhance learning and retention. Data were collected using three instruments: 1. "Acting" patient video interviews were evaluated by three independent raters to assess change in skilled behaviors. 2. A self-report instrument and a scenario/response option questionnaire were completed to examine change in knowledge of communication skills. 3. A self-report emotional empathy score determined the effects of training on the dimension of empathy. These instruments were administered pretraining, post-training, and one year later to assess differences in behavior, knowledge, and empathy due to the training and maturation. Data analysis included a two-way analysis of variance with repeated measures, frequency distributions, means, standard deviations, and Chronbach's coefficient alpha. A Mann Whitney U-test also was calculated to examine the differences in the distribution of the change scores over time. RESULTS: Post-train results demonstrated significant differences in knowledge but not in behavior. One-year retention scores showed a significant improvement (p<.01) in both knowledge and behavior by the experimental group when compared to the control group. Empathic responsiveness was not related to the training since both groups progressed modestly but at different rates over the 15-month project. CONCLUSIONS: It is important that dental hygiene practitioners have the requisite interpersonal skills to facilitate the partnership between each patient and client in attaining and maintaining optimal oral health. The results of this pilot study support the recommendation that interpersonal communication skills training become an integral part of the dental hygiene curriculum. However, further studies on this aspect of education should be completed in order to verify the results of this study and provide further support for changes in the education and socialization process of dental hygiene professionals.

Analysis of Variance↗
PubMed2005

Effects of a short-term dynamic balance training program in healthy older women.

PURPOSE: Aging is associated with deterioration of the physiologic systems controlling balance. Consequently, a multitude of intervention trials has appeared in the last 2 decades attempting to improve control of balance. Effective programs often require substantial and frequent time commitments, expensive and specialized equipment, professional assistance, and clinical settings. This investigation reports the effects of a simple, short-term balance training program on dynamic balance in healthy older women. METHODS: Subjects included 11 healthy women (75.6+/-6.4 years) who participated in biweekly, 15-minute balance training sessions for 5 weeks, and 10 age-matched women (71.2+/-9.1 years) who served as controls. Balance training involved medial-lateral and anterior-posterior movements and bilateral partial squats while standing on semi-compressible foam roller-devices. Dynamic balance was quantified using functional reach in the forward, left, and right directions, and a lower extremity reach test. RESULTS: Significant increases were observed in the balance trained group: 25% in functional reach right (P=0.014) and left (P<0.001) and 16% in lower extremity reach (P=0.001). No change was noted in the control group. CONCLUSIONS: Improvements in dynamic balance can be realized following 5 weeks of dynamic balance training using this novel, simplistic, and short-term protocol.

Aged↗
PubMed2003

Improvement of family carers' knowledge, skills and attitudes in caring for older people following the implementation of a Family Carers' Training Program in the community in Indonesia.

The purpose of this study was to examine family carers' knowledge, skills and attitudes in caring for older people following the implementation of a Family Carers' Training Program (FCTP). Family carers (n = 240) from two villages in Indonesia were randomly selected. All participants were surveyed by questionnaires and their care behaviour observed at baseline, three and six months. Findings indicated significant increases in knowledge, skills and attitudes in the intervention group over six months compared to those of the control group. Hence, the FCTP demonstrated a positive effect on family carers' capabilities and attitudes in caring for older people living in the community in the study setting.

Aged↗
PubMed1999

Use of simple measures of physical activity to predict stress fractures in young men undergoing a rigorous physical training program.

Among a population of randomly selected US Marine Corps recruits at Marine Corps Recruit Depot, San Diego, California, the authors developed a screening tool to identify individuals at high risk for lower extremity stress fracture when beginning a rigorous physical training program. The screening tool was developed among 1,286 recruits, then tested and refined among 1,078 additional recruits. The refined algorithm, consisting of five physical activity questions and a 1.5-mi (2.4-km) run time, revealed that 21.6% of "high risk" subjects suffered more than three times as many stress fractures as "low risk" subjects. These data suggest that risk of stress fracture during rigorous physical training is increased by poor physical fitness and low levels of physical activity prior to their entry into the program.

Adolescent↗
PubMed2004

MD-PhD students in a major training program show strong interest in becoming surgeon-scientists.

A wide spectrum of individuals have discussed the importance of promoting research in orthopaedics and of developing clinician-scientists (physicians who also do significant research) in the field. Although orthopaedic research may benefit from recruitment of MD-PhD students as clinician-scientists, it is unclear to what extent MD-PhD students are interested in pursuing research and surgical specialties concurrently. To better understand their professional goals, all MD-PhD students enrolled in our institution's training program were invited to complete an online questionnaire concerning training satisfaction and future career goals. Twenty-four percent of respondents (57.5% response rate of 167 recruits) reported a primary clinical interest in a surgical field (3% interest in orthopaedics); interest was strongest late in training. The majority of surgical MD-PhD students, like nonsurgical students, were planning to make research a significant part of their careers. In addition, students identified the importance of factors such as family issues and faculty role models in determining their clinical interests. The study data indicate that MD-PhD students have strong interests in becoming surgical clinician-scientists. They also suggested that active recruitment (especially early in training) that is responsive to the personal and professional needs of students has the potential to increase the number of clinician-scientists in orthopaedics.

Adult↗
PubMed1999

Evaluation of a preclinical, educational and skills-training program to improve students' use of blood and body fluid precautions: one-year follow-up.

BACKGROUND: Little is known about long-term improvements in medical students' knowledge, attitudes, and use of blood and body fluid precautions following preclinical training. METHODS: We evaluated an educational and skills-training program emphasizing double gloving for high-risk surgical procedures. Baseline surveys measuring knowledge, attitudes, and readiness to use specific precautions were completed by second-year (experimental) students before skills training and by third-year students (control) after their first clinical year. Follow-up surveys were completed 1 year later. Use of double gloves and protective eyewear during surgery clerkships was observed at baseline and follow-up. RESULTS: Of 149 students returning both surveys, the experimental group (n = 91) showed improvements in attitudes toward double gloving (P = 0.038) and use of double gloves during surgery at follow-up (relative risk = 1.95, 95% confidence interval = 1.06, 3.59). They expressed better attitudes toward (P = 0.003) and greater readiness to use (P = 0. 020) double gloves compared with controls at follow-up. They expressed better attitudes toward (P = 0.002) and greater readiness to use (P = 0.001) double gloves compared with controls when each had completed their first clinical year. CONCLUSION: The intervention was associated with improved attitudes toward and use of double gloves during surgery. The experimental group also expressed better attitudes and readiness to use double gloves compared with controls at follow-up.

Blood-Borne Pathogens↗
PubMed2003

Women in surgical residency training programs.

BACKGROUND: Increasing numbers of women are entering surgical fields. The purpose of this study was to assess whether orthopaedic surgery is significantly different from other surgical fields in the recruitment of women to training programs. METHODS: We analyzed data from the American Association of Medical Colleges as reported in annual issues on medical education in the Journal of the American Medical Association for the years 1970 to 2001, excluding 1975. Using linear regression models, we analyzed two factors: changes in the percentage of women within orthopaedic residencies (i.e., the ratio of men to women) and changes in the percentage of all female residents who choose to enter orthopaedics compared with other types of surgical residencies. RESULTS: The percentage of women in the entering classes of medical school has increased from 11.1% in 1970 to 47.8% in 2001, while the percentage of women in orthopaedics has increased from 0.6% in 1970 to 9.0% in 2001. Orthopaedic residencies have the lowest percentage of women compared with all other primary surgical specialties. Only thoracic surgery, a field entered secondarily after the completion of general surgical training, has a lower percentage. The increases in the percentage of women in orthopaedics over the past thirty years have been significantly lower than those in every other primary surgical field (including general surgery, obstetrics and gynecology, ophthalmology, otolaryngology, and urology), except neurosurgery, and are markedly different from the percentages of women in the entering classes of medical school. The percentage of all female residents who choose an orthopaedic residency is 0.6%, a number that has not changed over the past twenty years. CONCLUSIONS: Orthopaedic surgery has not had the same success in recruiting female trainees that other surgical fields have had. Furthermore, there appears to be a leveling of the recruitment rate over the past two decades, indicating that the higher numbers of women entering medicine will not be sufficient to improve gender representation in orthopaedic surgery training.

Adult↗
PubMedDate not supplied

Would you believe that during the 1990s, applications to pediatric dental training programs more than doubled?

A review of application to (and enrollment in) pediatric dental programs indicates increasing dental student graduate interest (particularly by female graduates) in this specialty. Except for black student representation, enrollment in pediatric dentistry training programs increasingly represents the ethnic and racial distribution of the general population.

Black or African American↗
PubMed2004

Mission statements: what do they tell us about family medicine training programs?

OBJECTIVES: Family medicine is the second largest medical specialty in the United States; yet, some argue that it is struggling to define itself. This study examined mission, vision, and goal statements of family medicine residency programs as a means of gaining insight into the current definition of the discipline. METHODS: Mission statements were obtained from the Internet sites of family medicine residency programs or requested directly from programs when the mission statements were not available on the Internet. The content of the mission statements was analyzed for the presence of eight categories of family medicine values that were identified through a literature review. RESULTS: We obtained mission statements from 296 of 472 (63%) residency programs. No significant relationships were found between program characteristics and the number or types of values found in the mission statements. The following three categories of family medicine values were named in at least 70% of mission statements: (1). community issues, (2). academic mission, and (3). quality health care. In contrast, the words "family" and "research" were mentioned by only one third of programs. CONCLUSIONS: Community-oriented care was mentioned more often than family-centered care. Despite the mention of academic missions by many training programs, most lacked a stated interest in research development. Although quality health care was named in the majority of mission statements, keeping current with technology was not. These findings contribute unique information that may be useful in the evolving definition and discussion of family medicine.

Community Health Services↗
PubMed2005

The effects of physical therapists' guidance on improvement in a strength-training program for the frail elderly.

Elderly participants experiencing difficulty in chair rising and with a maximum knee-extensor torque below 87.5 N . m were randomized to different versions of a strength-training program for the knee-extensors: to a high-guidance group (HG; two group sessions supervised by a physical therapist and one unsupervised home session per week, n = 17), a medium-guidance group (MG; one supervised group session and two unsupervised home sessions per week, n = 16), or a control group (C; no exercise, n = 16). Maximal isometric knee strength increased more in HG than in C (p = .03) and with increasing guidance (p = .03). The effect was mainly the result of participants with low initial strength. Walking speed increased more for HG than for C (p = .02) and than for MG (p = .06). No statistically significant improvements were seen on other functional tests. In summary, the study shows a trend toward better results with more supervision, but more and larger studies are needed to confirm this.

Aged↗