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PubMed2004

Diabetes self-management training program in a community clinic improves patient outcomes at modest cost.

Stringent glycemic control reduces complications and health care costs for people with diabetes. This study assessed the effectiveness of a diabetes self-management training (DSMT) program at a community clinic. Education and a glucometer were provided to 70 people with type 2 diabetes in a 4-hour class, followed by individual dietitian consults and monthly support meetings. Most participants were Hispanic or African American with mean age of 49+/-10 years and mean body mass index of 34+/-9. Body weight, glycosylated hemoglobin (A1C), medications, and follow-up attendance were monitored. After 2 to 12 months of program participation, mean A1C improved from 9.7+/-2.4% to 8.2+/-2.0% (P<.001); 61% experienced positive medication outcomes. The cost of community clinic DSMT was approximately $280 per person per year, $185 for each point reduction in A1C. This study indicated that community clinic DSMT can improve glycemic control at modest cost.

Black People↗
PubMed1987

Otosclerosis surgery in a resident training program.

Controversy exists regarding the appropriateness of offering all residents training in stapes surgery due to dwindling case loads in residency programs nationally. A recent study indicated poorer results for stapes surgery performed by residents than results obtained by practicing otologists. One hundred consecutive stapedectomies performed by residents over a three-year period at our institution were reviewed retrospectively, with the objective of determining whether these results should be generalized.

Adult↗
PubMed2006

Peer-mediated social skills training program for young children with high-functioning autism.

One of the most prevailing characteristics of children with autism is their deficit in social communication skills. The purpose of this study was to evaluate the effectiveness of a peer-mediated social skills training (SST) program combined with video feedback, positive reinforcement and token system in increasing social communication skills in young children with high-functioning autism. Four boys with high-functioning autism, ages 6-7 years, participated in the study. The social skills training, lasting 12 weeks, targeted six communication skills, selected after parent interviews and behavioral observation during a pre-training assessment period. One SST session was conducted each week, each session lasted 90min and had six structured activities. The training effectiveness was evaluated through direct observation of a structured interaction period, using an observational coding system. Improvement was observed in three out of four children, although individual differences among children were seen for changes in two global scales as well as subscales. These results suggest that the social skills training was effective in improving social communication skills for some children with high-functioning autism. Clinical and research implications and future directions for social skills training as well as this study's limitations are discussed.

Autistic Disorder↗
PubMed1990

[Rehabilitation following reconstruction of the anterior cruciate ligament. The effect of a 6-week training program].

Operations on the anterior cruciate ligament (ACL) represents a great challenge to the therapeutic team. Apart from early mobilisation, increasing attention must be paid to long-term after-care. Nineteen patients receiving reconstruction of the ACL underwent 6 weeks of training an average of 7.6 months after the procedure. At the start and end of the program, a dynamometric test (Dynamatik), and a function test, modified by Noyes, comprising a one-leg standing jump and hopping on one leg for six meters, were performed. Dynamometry revealed a clearly greater improvement in knee extension in the operated leg as compared with the non-operated leg, while the function tests revealed an improvement only in the operated leg. Correlation studies revealed no relationship between knee extension and function tests. For this reason, in addition to muscular strength, both training programs and after-care should take account also of the functional components of human locomotion, and should be carried out for a number of years.

Adolescent↗
PubMed2006

An advanced specialty training program in anesthesiology: a special educational fellowship designed to return community anesthesiologists to clinical practice.

We describe a program for community anesthesiologists designed to evaluate clinical skills and provide additional training in the latest technologies in anesthesiology. This educational program was established for previously trained anesthesiologists who require additional training for either remedial purposes or because of a prolonged absence from practice. All enrollees had an active, unrestricted California medical license and malpractice insurance. Approximately half of the participants had been in active practice at the time of enrollment; the remainder had been away from practice from 1 to 9 yr. The first 24 graduates of the fellowship spent an average of 9 wk (range, 3-24 wk) in the program to meet their individualized goals. Graduates were surveyed an average of 15 mo after completion of the fellowship. All respondents indicated that they would enroll in the program again; 80% indicated they learned new technical skills, 73% stated that the fellowship introduced them to a greater variety of drugs, and 50% indicated that the fellowship changed their approach to patient care. This program may serve as a model for any discipline of medicine and is particularly relevant for those with a substantial component of technical skills expected of its practitioners.

Adult↗
PubMed1998

Evaluation of an AIDS training program for traditional healers in the Central African Republic.

Training designed to improve AIDS knowledge, attitude, and practice was delivered to 96 traditional healers in the Central African Republic. The training (17 to 36 hours) was conducted by traditional healers with the assistance of staff from the Ministry of Health. Training included the following topics: prevention of HIV transmission during traditional practice; diagnosis, treatment, and prevention of sexually transmitted diseases; condom promotion; AIDS education at the community level; psychosocial support for people with AIDS; and promotion of a positive image for traditional healers. The evaluation of the training consisted of a prospective assessment of knowledge and attitude immediately prior to and after training. These assessments were conducted using structured interviews. Improvement in knowledge and/or attitudes was observed in all areas assessed except for prevention of HIV transmission during traditional practice. We concluded that AIDS training can be successfully delivered to traditional healers.

Acquired Immunodeficiency Syndrome↗
PubMed1999

[Training program for rehabilitation of patients with internal diseases].

Physical training for patients with internal diseases differs in many points to the physical activity recommended for health maintenance. Cardiac patients are usually limited by symptoms (angina, ECG abnormalities, anaerobic threshold) therefore the intensity of the training (monitored by heart rate or ECG) must be setted by an ergometer exercise testing. Patients with obliterative peripheral artery disease may surpass the local anaerobic threshold during interval-type loads. Blood pressure limits the training intensity of the hypertensive patients if not an organ lesion. COPD patients use the rest periods of an interval training for expectoration and for restitution of their blood gas values. In insulin dependent diabetes the vascular complications can be avoided by a proper insulin regime, training and diet. Day-to-day training by an even energy need acts like the insulin therefore it must be carefully dosed. In NIDDM also the carbohydrate metabolism can improve significantly. In anxiety and depression the training and the social milieu offers a physiological trigger for the improvement. Other rehabilitative interactions (psychology, dietetics, behavioral modalities etc.) are built up in the basis of exercise training.

Cardiac Rehabilitation↗
PubMed1980

Survey of training programs in clinical neuropsychology.

Reported the results of a survey of the membership of the International Neuropsychology Society with regard to patterns of training in clinical neuropsychology. Considerable variations in pre- and postdoctoral training and internship programs were found.

Education, Medical, Graduate↗
PubMed2006

Survey of training programs' means for promoting neurology and attracting trainees.

OBJECTIVE: To determine neurology training opportunities available to medical students and to define factors that influence program choice. METHODS: All neurology residency program directors and a random sample of residents were surveyed. Resident questions related to application, interview, and training experience. Directors' questions focused on ways their department generated interest in clinical neurosciences. RESULTS: Medical schools introduce students to clinical neurology primarily through required clerkships. Contact time averages less than 4 weeks and emphasizes inpatient encounters. Preceptorships with neurology faculty do not exist at almost 40% of schools and only 14% have neuroscience tracks. Nearly all residency applicants matched their first or second choice. The majority declined at least one interview and 39% failed to rank at least one site they visited. When choosing where to apply, the programs' reputation and geographic considerations were paramount. When making a rank list, interactions with faculty and residents at interview were most important. Residents generally reported satisfaction with their programs and attribute morale to supportive relationships with faculty and residents. CONCLUSIONS: Neurology programs may be able to enhance students' impression of neurology through changes in their clinical experience and development of venues for more meaningful relationships with faculty. Attention to the residents' personal needs may increase the likelihood of matching the best available candidates and ensuring their satisfaction.

Data Collection↗
PubMed1997

The SMARTT (Sunnybrook Memory Assessment Research Treatment and Training) Program: planning for dementia care.

Dementia is being recognized as a major public health challenge. Caring for those with dementia poses a unique problem for family and health care providers in community and institutional settings. This article describes the development of the Sunnybrook Memory Assessment Research Treatment and Training (SMARTT) Program at an academic health science centre. This program serves as a model for an integrated health system to meet the needs of dementia patients and their families.

Academic Medical Centers↗
PubMed1996

Effects of a long-term training program of increasing intensity on the immune function of indoor Olympic cyclists.

We have studied, on blood samples, the level of immunocompetence (concentration of immune cells, phagocytic process of polymorphonuclear neutrophils, proliferative response of lymphocytes to mitogens), the ascorbic acid content of such immunocompetent cells and the "stress hormone" status (cortisol, ACTH and beta-endorphin) of 10 cyclists, members of the Spanish Indoor Olympic Team and participants in the Olympic Games of Barcelona '92. The study was performed twice during their training for such an event: during the third year of the program (February, 1991) and immediately before the Games (June, 1992). As regards the phagocytic process of neutrophils, we studied the different steps of this process: adherence to endothelium, directed mobility or chemotaxis, ingestion of latex beads and superoxide anion production measured by the nitroblue tetrazolium (NBT) reduction test. We observed a statistically significant increase in chemotaxis and NBT reduction activity just before the Games as compared to the third year of the program, whereas variations were not found in the other parameters. The values of the proliferative capacity of lymphocytes were slightly higher in June '92 than in February '91, but no statistically significant differences were found. The ascorbic acid content decreased strikingly (especially in lymphocytes) immediately before the Games. Regarding the stress hormones and neuropeptides (cortisol, ACTH and beta-endorphin), we observed an increase in serum ACTH and beta-endorphin levels in the last determination (June '92) in comparison to the first one (February '91). These results suggest that, at the end of a long-term training program. no immunosuppression occurs, although an important increase in the concentration of stress hormones (ACTH and beta-endorphin) is found. This is probably caused by the psychological stress associated to the participation in such an important event as the Olympic Games.

Adrenocorticotropic Hormone↗