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[Relationship between illness, rehabilitation and work (ZERA)--an training program for medical-vocational rehabilitation of the mentally ill].

A training programme for rehabilitation of people with mental illness is presented, designed particularly for schizophrenic patients who need occupational rehabilitation. The training goal is to connect aspects of the schizophrenic disorder with vocational issues. It is aimed at supporting the participants in developing a realistic and appropriate vocational perspective in line with their illness related restrictions and current vocational possibilities, seeking to find out the individual's optimal ability to take stress so as to avoid over- or understimulation in vocational respects. The ZERA training has been developed for implementation in different medical and vocational rehabilitation settings for persons with mental illness. An initial control-group study was carried out to evaluate the effectiveness of this group training approach, and preliminary results have revealed changes in the experimental group in accordance with the objectives of the training and encourage further research.

Adult↗

Evaluation of a sexually transmitted diseases training program.

To determine whether attendance at a sexually transmitted disease (STD) training course produces an immediate and/or sustained gain in knowledge and to assess whether practitioners who might benefit most from such training could be identified easily, 55 practitioners were given one or more standardized written examinations before, immediately after, and four to 15 months after attendance at one of eight intensive one- or two-week training sessions. All practitioners (nine physicians and 46 physician extenders) increased their clinical knowledge of STDs, and most retained this knowledge over a four- to 15-month follow-up period (P less than 0.001). Practitioners with the lowest scores before the course had the least professional training, graduated from professional schools prior to 1965, had less than two years of work experience in STDs, and examined the fewest patients per day (P = 0.028). A lower precourse score was predictive of significant improvement on the postcourse test (P less than 0.001). Our results show that attendance at an STD training course produces both an immediate and a sustained gain in knowledge and indicates that precourse test scores and practitioner characteristics can be useful in identification of practitioners most in need of and most likely to benefit from STD clinical training.

Clinical Competence↗

Effects of a draft-loaded interval-training program on skeletal muscle in the horse.

Five Standardbred trotters were trained on a treadmill 3 times/wk for 12 wk by intervals of draft-loaded exercise. The draft load was 34 kp and the velocity approximately 7 m/s. Muscle biopsies were taken from the gluteus medius and longissimus muscles before training and after 2, 4, 8, and 12 wk of training and from the brachiocephalicus muscle before and after training. Both the percentage and the area of type IIa fibers increased and the percentage of type IIb fibers decreased in the gluteus medius muscle during the first 2 wk of training, and then no further significant difference was noted. The percentage of type I fibers increased in the brachiocephalicus muscle, and the area of type IIb fibers increased in the longissimus muscle. The citrate synthase activity increased in the gluteus muscle only, and the increase was seen during the first 2 wk. No significant differences were seen in 3-hydroxy-acyl-CoA dehydrogenase and lactate dehydrogenase activities in the muscles during the entire training period. Less glycogen was utilized in the gluteus muscle and less blood lactate accumulated when the horses performed an unloaded submaximal exercise test after compared with before training. It can be concluded that rapid changes are induced in the gluteus medius muscle when horses are trained pulling a light-draft resistance at a submaximal trotting speed.

3-Hydroxyacyl CoA Dehydrogenases↗

Fine needle aspiration of palpable breast masses with immediate cytologic interpretation in an OB/GYN residency training program: a preliminary report.

Increasing emphasis has been placed on the training of obstetrics and gynecology residents in the evaluation of patients with breast disease. In the past, one had to refer to the surgery, radiology, or pathology literature to obtain current information on fine needle aspiration. With the present mandate to include breast disease in the academic curricula of obstetrics and gynecology residency training, the Department of Obstetrics and Gynecology, Tripler Army Medical Center, initiated training in breast evaluation. This preliminary report describes the Tripler Obstetrics and Gynecology Department Breast Evaluation Clinic and presents the findings of the first 40 patients.

Adult↗

Effects of exercise training program on functional capacity and quality of life in patients with peripheral arterial occlusive disease. Evaluation of a pilot project.

BACKGROUND: In patients with peripheral arterial occlusive disease (PAOD) stage II, exercise training seems to be important to reduce symptoms and improve functional capacity. We evaluated the effects of an out-patient treatment program on walking distance (standardized treadmill testing), training exercise capacity, and disease specific quality of life (PAVK-86 questionnaire). METHODS AND RESULTS: Thirty-one patients aged 70 +/- 2 with intermittent claudicatio in stage IIa/IIb according to Fontaine (n = 18/13) underwent a supervised 12 week exercise training and education outpatient program. During course of intervention, patients demonstrated improvements in pain-free training walking distance (p < 0.001) and repetitions of tiptoe standing (p < 0.05). In standardized treadmill testing, pain-free walking distance was improved by 182% (129 +/- 19 m-->364 +/- 53 m; p < 0.001), and maximum walking distance by 76% (311 +/- 42 m-->546 +/- 63 m; p < 0.01). Before training, mean subscale scores of the PAVK-86 demonstrated distinct impairments concerning pain and functional status. After 12 weeks of intervention, with exception of the subscale complaints, all dimensions of quality of life assessed have improved significantly. The highest effect size was observed for the subscales pain, mood, and functional status. Improvement in the subscale anxiety and pain-free walking distance (treadmill test) correlated significantly (r = 0.46) as well as improvement in the subscale mood and maximum walking distance (r = 0.45). CONCLUSION: In patients with PAOD stage II considerable effects on functional capacity and important dimensions of quality of life can be achieved by a short exercise and education program.

Aged↗

Training in pediatric critical care medicine: A survey of pediatric residency training programs.

BACKGROUND: After completing their critical care rotations, pediatric residents are expected to have acquired skills in the resuscitation of critically ill newborns and children. Recent Accreditation Council on Graduate Medical Education (ACGME) guidelines have limited the time devoted to critical care training during pediatric residency. We sought to determine how individual programs have structured their critical care training experience in light of these changes. MATERIALS AND METHODS: A questionnaire was mailed to each pediatric residency program listed in the 1996-1997 Graduate Medical Education Directory. Information was obtained regarding the structure of critical care training. Data were analyzed using descriptive techniques, one-way analysis of variance with Scheffé post hoc test, and Fisher exact test as appropriate. RESULTS: Data were received from 149 programs (71% response rate). Most programs were in compliance with ACGME standards regarding the number of months devoted to neonatal intensive care, pediatric intensive care, and emergency medicine. There were no significant differences in the total number of rotations in either the neonatal intensive care unit (NICU) or the pediatric intensive care unit (PICU) when the programs were stratified by size. There were no significant differences in the percentage of programs requiring night call in either the NICU or the PICU during off-service months. However, small programs (< 25 residents) required significantly fewer rotations in emergency medicine (P < 0.001). Most programs complemented the critical care experience by offering additional rotations and advanced life support training. CONCLUSIONS: Pediatric residency programs have structured their critical care rotations in a similar fashion in accordance with ACGME guidelines. The success in meeting the stated objectives, as measured by the ability of graduating residents to stabilize critically ill children, is not known and will require further study.

Child↗

An analysis of the American Cancer Society Clinical Research Training program.

BACKGROUND: In 1996 the American Cancer Society initiated a Clinical Research Training Grant for junior investigators. This was a 3-year mentored grant for preclinical and clinical research training. Two hundred four individuals applied from 103 institutions, and 25% were funded. METHODS: This report is an initial assessment of the impact of the program on future career development. Both the funded and unfunded groups were queried regarding prior research experience, publications, and academic status. RESULTS AND CONCLUSIONS: Although small differences were seen between the funded and unfunded groups, the major finding was that those applicants with prior research and publication experience were more likely to get funded, but both groups were highly motivated to seek an academic career.

American Cancer Society↗

A pilot community program: training adult retardates for private enterprise.

This paper describes a community-based program for placing low-level retardates with no prior work experience or job training into work positions in private business and industry compatible with their needs and abilities. This paper also reports on the various problems and solutions encountered in the attempt to match the needs of employers, who experience rapid turnover and motivation problems of employees in routine work tasks, with the needs of low-level, nonworking, adult retardates who show potential for these types of jobs.

Journal Article↗

Developing empathy in nurses: an inservice training program.

The purpose of this study was to determine whether inservice communication training enhanced the empathic skills of 263 nurses employed at Hacettepe University Hospital. Data were collected using a nurse information form, participants' satisfaction form, and the Empathic Communication Skill B (ECS-B) form developed by Dökmen [Dökmen, U. (1988). A new measurement model of the empathy and developing empathy by using psychodrama. Journal of Education Faculty of Ankara University, 21, 155-190]. The ECS-B was used as both a preintervention and a postintervention measure. The data were expressed as means, percentages, and standard deviations, and were analyzed using Pearson's chi-square test and repeated-measures analysis of variance. The posttest scores of nurses increased from 155.6 to 180.5, and training played a role in enhancing nurses' empathic skills with regard to all variables (P < .05). However, a more comprehensive and continuous training should be planned, and its impact on behavior and patient outcomes should be investigated.

Adult↗

The efficacy of a compact psychoeducational group training program for married couples.

There is a lack of psychoeducational programs for married couples who, although subjectively concerned about their marriages, do not seek marital therapy. In this study, the efficacy of a cognitive-behavioral program delivered on a weekend by 2 trainers for groups of 4 couples was investigated. Couples (n = 67) were recruited by newspaper announcements, then randomly assigned to the intervention program or a waiting-list control group. The program consisted of communication and problem-solving training, couples' discussions to clarify their relationship expectations, and exercises to enhance their sensual or sexual relationship. At postassessment, intervention couples emitted more positive verbal and nonverbal communication behaviors during a conflict discussion task than did control couples, who reported significantly more relationship problem areas and displayed more negative communication behaviors. At the 1-year follow-up, intervention couples reported fewer problem areas in comparison with preassessment.

Adult↗

The effects of a 10-week, periodized, off-season resistance-training program and creatine supplementation among collegiate football players.

The periodized resistance-training model has not been well documented in the literature. Further research is needed to determine if periodized resistance training in conjunction with creatine supplementation can cause changes in strength, performance, total body weight, girth, and lean muscle mass. Therefore, the purpose of this investigation was to determine the effects of periodized resistance training in conjunction with low-dose (LD) and high-dose (HD) creatine supplementation on strength, body composition, and anaerobic muscular endurance. Subjects were divided into 3 groups: LD, HD, and placebo (P). Testing took place pre-, mid-, and postsupplementation for the following: weight, body composition (fat-free mass and fat mass), 1 repetition maximum squat, and anaerobic muscular endurance testing. Results revealed no significant differences in either creatine group when compared with the P group. However, significant differences were noted over time. These data suggest that 10 weeks of periodized resistance training was effective for causing changes in strength, body composition, and anaerobic muscular endurance.

Adolescent↗

An evidence-based virtual reality training program for novice laparoscopic surgeons.

OBJECTIVE: To develop an evidence-based virtual reality laparoscopic training curriculum for novice laparoscopic surgeons to achieve a proficient level of skill prior to participating in live cases. SUMMARY BACKGROUND DATA: Technical skills for laparoscopic surgery must be acquired within a competency-based curriculum that begins in the surgical skills laboratory. Implementation of this program necessitates the definition of the validity, learning curves and proficiency criteria on the training tool. METHODS: The study recruited 40 surgeons, classified into experienced (performed >100 laparoscopic cholecystectomies) or novice groups (<10 laparoscopic cholecystectomies). Ten novices and 10 experienced surgeons were tested on basic tasks, and 11 novices and 9 experienced surgeons on a procedural module for dissection of Calot triangle. Performance of the 2 groups was assessed using time, error, and economy of movement parameters. RESULTS: All basic tasks demonstrated construct validity (Mann-Whitney U test, P < 0.05), and learning curves for novices plateaued at a median of 7 repetitions (Friedman's test, P < 0.05). Expert surgeons demonstrated a learning rate at a median of 2 repetitions (P < 0.05). Performance on the dissection module demonstrated significant differences between experts and novices (P < 0.002); learning curves for novice subjects plateaued at the fourth repetition (P < 0.05). Expert benchmark criteria were defined for validated parameters on each task. CONCLUSION: A competency-based training curriculum for novice laparoscopic surgeons has been defined. This can serve to ensure that junior trainees have acquired prerequisite levels of skill prior to entering the operating room, and put them directly into practice.

Benchmarking↗