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PubMed2003

Incorporating sexual orientation into MFT training programs: infusion and inclusion.

Many authors have questioned the preparedness of family therapists to deal with sexual minority clients. Even though the Commission on Accreditation for Marriage and Family Therapy Education (COAMFTE) has called for the integration of sexual orientation into the curriculum of marriage and family therapy training programs, the subject continues to be marginalized. The purpose of this article is to encourage trainers to examine their programs' curricula for evidence of heterosexist bias and introduce ways that they might integrate issues related to same-sex affectional and sexual orientations into their programs via the classroom and the clinic.

Education↗
PubMed2004

Assessment of immunological parameters following a qigong training program.

BACKGROUND: Qigong is a type of Chinese psychosomatic exercise that integrates meditation, slow physical movements, and breathing, and to which numerous physical as well as mental benefits have been classically ascribed. The aim of the present study was to analyze the effects of a qigong program on various immunological parameters. MATERIAL/METHODS: 29 naive subjects participated in the study, of whom 16 were allocated to the experimental group and the rest to the control group. The experimental subjects underwent a qigong training program, conducted by a qualified instructor, consisting of half an hour of daily practice for one month. The day before the experiment commenced and the day after it finished, blood samples were drawn from all subjects for the quantification of immunological parameters (leukocytes, immunoglobulins, and complement). As statistical analysis, analysis of covariance (ANCOVA) was carried out. RESULTS: Statistically significant differences were found between the control and experimental groups, with the experimental group showing lower numbers of total leukocytes and eosinophils, number and percentage of monocytes, as well as complement C3 concentration. In addition, a similar result with a trend towards significance was observed in the number of eosinophils. CONCLUSIONS: These findings demonstrate that after one month of practicing qigong, significant immunological changes occurred between the experimental and control groups, with a consistently lower and broadly significant profile of these measures within the qigong practitioner group.

Adolescent↗
PubMedDate not supplied

The effects of a theory-based training program on nurses' self-efficacy and behavior for smoking cessation counseling.

BACKGROUND: Cigarette smoking continues to put Americans at risk for serious health consequences and early death. Nurses play an important role in disseminating smoking cessation interventions to patients in the hospital. However, nurses are not prepared for smoking cessation counseling. METHOD: A quasi-experimental design was used. Fifteen nurses participated in the Clinical Practice Guideline "5 A's" brief intervention training program, completing a survey during three time periods. RESULTS: There were several statistically significant changes in the dependent variables for self-efficacy and behavior for smoking cessation counseling. CONCLUSION: Results of this study support further research and theory-based training for nurses.

Adult↗
PubMed2003

The savvy caregiver program: developing and testing a transportable dementia family caregiver training program.

PURPOSE: This article reports on the development and field testing of the Savvy Caregiver Program, the transformation of a successful, academic-based caregiver psychoeducational program into a self-contained program that can be adopted in other locations. DESIGN AND METHODS: Program development began with a prototype of a 12-hr course with the aims of introducing family caregivers to the caregiving role, providing them with the knowledge, skills, and attitudes needed to carry out that role, and alerting them to self-care issues. Results from initial field trials dictated a substantial revision of the workshop materials. The next version was field tested in multiple sites in southern rural Minnesota, Colorado, and Alaska. In this expanded testing, participants evaluated the program, and cross-group comparisons were conducted by use of well-established caregiver well-being scales. RESULTS: Virtually all respondents reported increased skill, knowledge, and confidence, and all would recommend the program to others. A preintervention versus postintervention analysis indicates that caregivers' reaction to the overall behavior of the persons for whom they provide care (i.e., "total reaction"), their self-reported burden, and their beliefs about caregiving (emotional enmeshment) changed significantly in directions indicating better caregiver well-being. IMPLICATIONS: Results suggest that it is feasible to translate a research-based caregiver intervention into a packaged program that can be adopted in other settings without the direct involvement of the program initiators.

Caregivers↗
PubMed1994

The efficacy of an ACLS training program for resuscitation from cardiac arrest in a rural community.

STUDY OBJECTIVE: To determine whether an advanced cardiac life support (ACLS) course in a rural hospital will improve resuscitation success from cardiac arrest. DESIGN: A retrospective case review of all patients in cardiac arrest during a 13-month period before and after the institution of an ACLS training program. SETTING: Emergency department of a 42-bed rural, community hospital in a community with no prehospital advanced life support or early defibrillation. PARTICIPANTS: All patients in cardiac arrest were entered into the data base. Twenty-nine patients were included in the pre-ACLS period and 35 in the post-ACLS period. There were no significant differences in age, gender, initial rhythm, comorbid diseases, witnessed versus unwitnessed arrest, or total arrest time in the patients in the pre-ACLS period compared with those in the post-ACLS period. INTERVENTION: ACLS provider training. MAIN RESULTS: Patients in cardiac arrest who had ventricular fibrillation/tachycardia as their initial rhythm had significant improvement in resuscitation success compared with patients in ventricular fibrillation/tachycardia in the pre-ACLS period (six of 15 versus none of nine, P < .05). Out-of-hospital cardiac arrest resuscitation was more successful in the post-ACLS period than in the pre-ACLS period (five of 30 versus none of 25, P < .05). Overall, seven of 35 patients (20%) were resuscitated successfully in the post-ACLS period, with two patients surviving to hospital discharge. This was not significantly different than the two of 29 patients (7%) resuscitated in the pre-ACLS period, with one patient surviving to discharge. CONCLUSION: The institution of an ACLS-provider course in a rural community hospital was associated with improvement in initial resuscitation for patients with ventricular fibrillation/tachycardia and out-of-hospital arrest.

Cardiopulmonary Resuscitation↗
PubMed1992

An in-house training program for hospital-based medical transcriptionists.

Because of the demand for accountability and the necessity that the medical transcription department function as a revenue-generating entity within the hospital structure. HIM professionals are rejecting inadequate solutions and looking for long-term improvements in medical transcription quality and productivity. It has been our experience that many hospitals and clinics are opting to train in-house. This is a cost-effective solution which can quickly provide a return on investment if managed properly. Many HIM professionals choose this solution because it ultimately affords the highest level of control in areas of quality assurance and turnaround time. It is also seen as a long-term solution to continuing staffing shortages, particularly in areas where medical transcription courses offered by local educational facilities are inadequate or nonexistent. Thus, strategic planning to guarantee both quality medical transcription and revenue-generating levels of productivity may involve implementation of an in-house training program. Such a solution will undoubtedly factor into balancing the equation of supply and demand as it pertains to medical transcription staffing in the future.

Centralized Hospital Services↗
PubMed1979

[Methodology of parent group therapy (experiences with a social training program for parents of children and adolescents requiring psychotherapy)].

An analysis is made of the socio-psychological status of parents and their problems with regard to intrafamiliar social behavior, and then the aims of parent groups are defined. This is followed by a critical assessment of such methods as information groups, conventional training groups and dynamic group psychotherapy, all of which are unsuitable for this population. Then follows a discussion of the experience gained and results achieved, with a social training program for parents of children needing psychotherapy, where the disturbance in the child is an expression of family-neurotic disturbances. The accent is on the formation of motivations, sensitization to emotional signals, self-experience, feedback exercises and the mastering of partner-oriented conflict management behavior. The aim is to resolve neurotic family arrangements, so that the child is no more needed as a carrier of symptoms. The new attitudes and conflict management behavior should also be available in genuine educational situations. During the third phase of the program of exercises which consists of three parts, concrete problem situations are dealt within psychodramatic manner. As a conclusion special requirements for leading such groups are discussed with a view to therapists treating parents and children at the same time.

Adolescent↗
PubMed1977

Perceived exertion of absolute work during a military physical training program.

The purpose of this study was to compare the rating of perceived exertion (PRE) and heart rate (HR) in two groups of 60 military personnel who differed in their level of fitness as determined by maximal oxygen uptake (VO2 max). At an initial testing period (T1), Group I represented a sample of personnel not participating in a training program while Group II had engaged in an endurance program (2--4 mile run/day) for 5 months. Six months later (T2), Groups I and II were retested after having participated in the program for 6 and 11 months, respectively. RPE and HR were measured at the end of each min of a 6 min run at an absolute workload of 6 mph, 0% grade on the treadmill. At T1, Group II had a significantly lower HR at each min of work but no difference existed in RPE between groups at any time during the run. At T2, both groups showed a significant decrease in HR and RPE during each min when compared lobgitudinally. The data suggest that the perception of the intensity of absolute work does not differ in groups differing in their level of fitness when studied cross-sectionally. However, significant reductions in perceived exertion occur following physical training.

Adult↗
PubMed1998

Russian family practice training program: a single step on a long journey.

BACKGROUND AND OBJECTIVES: Since 1992, when the Russian government recognized family practice as a medical specialty, efforts have begun to progress from the idea stage to the delivery of patient care via family practice methods. We describe an educational effort to help teach Russian physicians family practice skills. METHODS: Five young Russian physicians were selected from an initial pool of 15 candidates on the basis of standardized testing, English language skills, and their potential to teach future Russian family physicians. Clinical, teaching, and business curricula were developed and used during the 6-month training period for the five selected physicians. Trainees were evaluated by mentors' and preceptors' written evaluations and by the American Board of Family Practice In-training Examination before, during, and at completion of the training. Subsequently, a fully equipped family practice office was opened in St Petersburg to serve as an on-site training facility. RESULTS: The trainees' self-perceived knowledge in community medicine, geriatrics, medical decision making, patient education, behavioral science, preventive medicine, and general family practice topics improved over the course of training. The composite scores on the in-training examinations improved from baseline (30 versus 308). Preceptors noted the greatest improvements in the use of clinical instruments, proficiency in physical exams, accessing medical information, and formulating differential diagnoses. The St Petersburg family practice office opened on October 1, 1996. The trainees now participate in the care of patients in this office and teach a new class of family medicine interns. CONCLUSION: The training program we describe has allowed Russian physicians to acquire new skills and knowledge that they can use and adapt to training future Russian family physicians.

Curriculum↗
PubMed2006

Survey of the patients with cleft lip and palate in China who were funded for surgery by the Smile Train Program from 2000 to 2002.

BACKGROUND: Cleft lip (CL) and cleft palate (CP) are two of the most frequent congenital malformations. Many epidemiologic studies on this deformity have been conducted worldwide, often producing inconsistent results. This study assessed epidemiology and some genetic aspects of cleft lip and palate in a Chinese sample from the Smile Train Program and to compare with other methodologically sound surveys. METHODS: The general information, family history, classification of cleft and associated malformations of 8000 CL and CP surgery patients were analyzed. RESULTS: Of the 8000 cases, 7812 had complete data. The distribution of cleft types is 17.04% with CP, 23.39% with CL and 59.58% with cleft lip and palate (CLP). Unilateral clefts were more common than bilateral, with unilateral to bilateral ratios being 10.4:1 for CL, and 3.42:1 for CLP. The overall male:female ratio was 2.01:1. Left sided defects were more common than right sided regardless of sex, 1.90:1 for CL and 1.96:1 for CLP. CLP and CL were more common in males than in females with sex ratios (SR) of 2.88:1 and 1.85:1 respectively, whereas CP was more common in females with SR of 0.76:1. Associated malformations (2.89%), involved 29 CP cases, 41 CL and 156 CLP. The frequency of associated malformations in CLP (3.35%) was higher than CL (2.24%) and CP (2.22%) (P < 0.05). Patients with CP or CLP were born less often in the winter than in the summer (P < 0.05). A history of family members having clefts occurred in 6.84% of patients. The proportion of CLP cases (7.56%) was significantly higher than that of CL cases (5.64%) (P < 0.05). CONCLUSIONS: The different types of clefts appeared in the highest proportion in CLP and lowest proportion in CP. Males are more common with CL and CLP and less common with CP. These characteristics are the same as those of other Chinese surveys but different from some European reports.

China↗
PubMed1995

Diagnostic laparoscopy: a 5-year experience in a hepatology training program.

Diagnostic laparoscopy continues to have a role in the evaluation and diagnosis of acute and chronic liver diseases, primary and metastatic liver tumors, and peritoneal diseases. We retrospectively reviewed the records of 1794 diagnostic laparoscopies performed at our institution from 1987 to 1992 to identify the indications, results, and safety of this procedure in our training program. A definitive diagnosis was made in 91% of cases with biopsy performed in 93%. Chronic liver disease was evaluated in 890 patients, and a diagnosis was made in 98%. Four hundred thirty-seven patients were evaluated for suspected primary or metastatic carcinoma, and a diagnosis was made in 85%. Ascites was evaluated in 73 patients, and a diagnosis was made in 82%. One-hundred sixty-four patients were evaluated for abnormal liver function tests, and a diagnosis was made in 91%. HIV-related liver function test abnormalities were evaluated in 67 patients, and a diagnosis was made in 81%. One hundred sixty-three patients underwent diagnostic laparoscopy for the evaluation of hepatomegaly, splenomegaly, unexplained portal hypertension, fever of unknown origin, and cholestasis, and a diagnosis was made in 74% of cases. Eight major complications (including abdominal viscus perforation, hemobilia, splenic laceration, bleeding) and thirty-one minor complications were seen. Our findings confirm that diagnostic laparoscopy is a safe and valuable procedure in the evaluation of chronic liver disease.

Chronic Disease↗
PubMed2001

Changes in tumor necrosis factor-alpha system and insulin sensitivity during an exercise training program in obese women with normal and impaired glucose tolerance.

OBJECTIVE: Tumor necrosis factor-alpha (TNFalpha) plays an important role in the pathogenesis of insulin resistance and type 2 diabetes. Plasma levels of the soluble (s) fractions of TNFalpha receptors, especially sTNFR2, are good indicators of TNFalpha system activation in obesity. The aim of the present study was to assess the effect of exercise training on the TNFalpha system and to evaluate the relationship with changes in insulin sensitivity. DESIGN AND METHODS: Sixteen obese women (body mass index (BMI)>27.8 kg/m(2)), 8 with normal (NGT) and 8 with impaired glucose tolerance (IGT), participated in an exercise training program which lasted for 12 weeks and included exercise performed on a bicycle ergometer at an individual intensity of 70% maximal heart rate, for 30 min, 5 days a week. Anthropometrical measurements and blood biochemical analyses were performed, and plasma TNFalpha, sTNFR1 and sTNFR2 levels were assessed. Insulin sensitivity was evaluated using the hyperinsulinemic euglycemic clamp technique (insulin infusion: 50 mU x kg(-1)xh(-1)). RESULTS: At baseline, despite similar anthropometrical parameters, IGT subjects were markedly more insulin resistant and had higher TNFalpha and sTNFR2 concentrations. Exercise training increased insulin sensitivity and decreased TNFalpha and sTNFR2 levels, while sTNFR1 remained unchanged. The decrease in sTNFR2 was significantly related to the increase in insulin sensitivity; that relationship remained significant after adjustment for the concurrent changes in BMI, waist circumference, percentage of body fat, plasma glucose, insulin and free fatty acids. CONCLUSIONS: Regular physical exercise decreases TNFalpha system activity and that decrease may be responsible for the concurrent increase in insulin sensitivity.

Adult↗
PubMed1991

Nutrition training in graduate medical (residency) education: a survey of selected training programs.

Because limited information exists about nutrition training of residents, we studied the teaching practices of nationally recognized nutrition programs. Two hundred thirty-eight nutrition educators and 787 residency-program directors identified 160 institutions with strong nutrition training. The 23 highest-ranked programs were surveyed and 7 were visited. The results showed that 1) clinically active physician-nutritionist role models are the key elements in teaching residents clinical nutrition; 2) multidisciplinary nutrition support teams are valuable learning resources unless they function primarily as technical support services; 3) nutrition elective rotations, although highly effective, are taken by a minority of residents; 4) the nutrition curriculum should include practical learning materials and conferences; and 5) a research environment is important to attract qualified physician-nutritionist role models. A major deficit is teaching nutritionally based approaches to disease prevention in the ambulatory setting. Finally, a shortage of nutrition-oriented physician role models is probably the major constraint in teaching nutrition to residents.

Curriculum↗
PubMed1986

National survey of dermatologists and residency training program directors on dermatology's role in treating sexually transmitted diseases.

Sexually transmitted diseases have increased in both prevalence and public concern over recent years; however, current treatment of sexually transmitted diseases remains fragmented among several specialty groups. In this study, dermatologists, who historically were the leaders in the treatment of sexually transmitted disease, were surveyed to assess their training, practice activity, and attitudes toward sexually transmitted disease. An overwhelming majority of dermatologists and training program directors stated that most sexually transmitted diseases should be treated primarily by dermatologists. Factors that restricted dermatologists' involvement in sexually transmitted diseases included inadequate public awareness of dermatology's role in treating these diseases, the limited number of direct patient visits, and limited physician referrals. This study indicates that dermatologists want to increase their role in sexually transmitted disease and favor making the public aware of their interest and ability.

Dermatology↗
PubMed1999

Human-dog interactions in a guide-dog training program.

We analyzed dyadic interactions between 12 neutered dogs (6 females and 6 males) and 44 humans (20 women, 14 men, and 10 girls) who were unfamiliar with each other. We also examined the effect of sex differences in dogs and humans as well as age differences in humans on human-dog interactions in a guide-dog training program. Female dogs more actively regulated their distance from humans than male dogs. Dogs made contact with women more frequently than with men, and men made contact with dogs more frequently than women. Girls initiated interactions with dogs more frequently than women; girls formed reciprocal interactions with dogs less frequently than women.

Adolescent↗
PubMedDate not supplied

Assessing the ACGME Competencies in Psychiatry Training programs.

In 2000, the Accreditation Council of Graduate Medical Education (ACGME) laid out a definition of competence that included six specific areas of focus: patient care (including clinical reasoning), medical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism, and systems-based practice. The ACGME's intention was to mandate increasingly reliable and valid assessment measures to be used by all training programs over the next decade, with the goal of providing "more credible, accurate, reliable and useful educational outcome data." In this article, the authors will review definitions of competency according to the new ACGME standards and examine the assessment tools currently available, including global evaluations, 360-degree evaluations, checklists, standardized examinations and direct observations. The authors will provide an overview of critical considerations in different assessment methods, including timing, psychometric properties, benchmarks, and feedback. Finally, the authors will discuss the relevant literature concerning the strengths and weaknesses of these various assessment tools. Throughout, the authors will comment on the applicability of the literature on assessment to the field of psychiatry and consider directions for competency assessment within and beyond psychiatric training. Following the paper is an annotated bibliography of the literature for those wishing to explore this topic more deeply and a list of web-based resources that may be used by those wishing to access available instruments.

Accreditation↗