Years Of Training Research Articles

Adoption Behaviour of Khasi Mandarin Growers Tribal Farmers in Arunachal Pradesh

East Siang district of Arunachal Pradesh in the North Eastern Region has tremendous potentiality for commercial cultivation of Khasi Mandarin. Despite of rich soil and favourable agro-climatic conditions, full potentialities in terms of production and productivity could not be realised by the growers. The study highlights correlates of adoption of improved practices of Khasi Mandarin and the associated problems of adoption of improved practices by the farmers. The overall level of adoption from the fi ndings revealed that majority (64.17%) of the respondents had medium level of adoption which was followed by low adoption level (25.00%). However, only 10.83 per cent were found to be in high level of adoption category. Total land holding, area under mandarin orchard, total annual income, extension contact, training exposure, management orientation and risk bearing ability had positive and signifi cant correlation with the level of adoption. Age, family size, occupation of the family, farming experience and farm labour availability exhibited a non-signifi cant relationship with the level of adoption. All the variables were found to contribute 42.9 per cent of total variation in adoption (R2=0.429) with extension contact, management orientation and risk bearing ability having signifi cant contribution to this variation.

Physiological and Somatic Principal Components Determining VO2max in the Annual Training Cycle of Endurance Athletes.

The purpose of the study was to assess the impact of training on the physiological variables achieved during the test effort in the macrocycle of road cyclists and their use in the maximal oxygen uptake (VO2max) prediction at individual training stages in the VO2max test. Nine well-trained male cyclists (age 25.6 ± 5.2 years and body weight 72.4 ± 7.35 kg) participated in the study and each phase of the macrocycle was followed by a time to exhaustion test (TTE) on the bicycle ergometer. The research showed that training loads significantly influence the maximum power (PPO), ventilation (VE) in the preparatory period (T1), time of the test (TTmax) at the start of the competition period (T2), percentage of body fat in total body weight (%FAT) and skeletal muscle mass (MMS) during the competition period (T3). Of the 16 variables taken for the analysis of the principal components (PC), the regression model determined one principal variable responsible for VO2max in the training macrocycle of cyclists, the relative value of maximum power (PPORV) and the accompanying variables in individual periods: breathing frequency (BF), delta blood lactate concentration (ΔLA), body fat (FAT) and MMS. Determining PC influencing the exercise capacity can be crucial in achieving the intended goals by athletes. Monitoring these indicators can help protect the health of professional athletes and provide guidelines in the training process, stimulate the body properly while protecting against overtraining.

Women's health for a primary care workforce.

Primary care training should include competencies to provide reproductive health services. In the United Sates, primary care is often provided by general internal medicine physicians. Longitudinal training experiences for internal medicine residents in women's health increase knowledge, skills and retention in careers in women's health, but very little literature describes their implementation. The purpose of this paper is to describe the implementation and evaluation of a 2-year women's health training pathway in Internal Medicine. Using the Context, Input, Process, Product (CIPP) model, we describe the salient features of a complex, longitudinal educational intervention at the development, planning and evaluation stages within a large academic medical centre. In 2019, we conducted interviews with the pathway participants (N = 6) in the first 3years of the programme and used the CIPP framework and Kirkpatrick's Model as an a priori codebook for analysis. Participants reported high fidelity and that the training was relevant and appropriate to meet their needs. Practicing clinicians similarly reported that training was relevant and useful and met desired goals for knowledge and integrated approaches to care. Trainees reported unexpected benefits of identity formation and a community of practice. These results suggest that longitudinal training pathways are an effective way to train Internal Medicine residents to provide comprehensive care to women. This study has broader applications for health professions education, providing a model for implementation and evaluation of complex educational interventions in large organisations. Future research should focus on dissemination to train a workforce prepared to offer evidence-based care to women throughout their lifespan.

Emergent Surgical Airway Skills: Time to Re-evaluate the Competencies.

IntroductionOne of the most challenging scenarios an anesthesia provider can face is treating a can't intubate can't ventilate (CICV) patient. The incidence of CICV is estimated to be around one in 10,000 cases. According to the American Society of Anesthesiology Closed Claims Study, adverse respiratory events are the most common type of injury, with difficult intubation and ventilation contributing to the majority of these cases. The objective of this non-interventional quality improvement project was to evaluate the prior training, exposure, and self-reported confidence in handling the CICV scenario among anesthesia providers at Henry Ford Hospital in Detroit, MI.MethodsAn online questionnaire was distributed via email to all residents, certified registered nurse anesthetists (CRNAs), and attending anesthesiologists in March 2021. The email contained a link to an online questionnaire via Microsoft Forms (Microsoft Corporation, Redmond, WA). Univariate group comparisons were carried out between the respondents’ role (attending, CRNA, or resident), as well as between the number of years that the respondents were in practice (< 5 years, 5-10 years, > 10 years).ResultsOut of the total 170 anesthesia providers, 119 participated in the study where 54 (45%) were attendings, 44 (37%) were residents, and 21 (18%) were CRNAs. The majority (75%) did not know the surgical airway kit location, and 87% had not performed the surgical airway procedure before. The vast majority (96.7%) recommended simulation training compared to online training or lecture series, and just over 50% recommended annual training frequency. When looking at the differences in responses based on years of experience as an anesthesia provider, the majority of those with > 10 years in practice knew how to perform the surgical airway technique while respondents with < 5 years did not know how to perform the technique, and 50% of those with five to 10 years experience knew how to perform the surgical airway procedure for a CICV scenario.ConclusionAlthough there were many significant differences observed between the various provider roles and years in practice, surprisingly, the responses revealed both a lack of experience and confidence in performing the surgical airway procedure in all provider roles. These findings highlight a need for better emergency airway teaching and training. These findings will be used to guide the design and implementation of improved surgical airway training for residents, CRNAs, and attending anesthesiologists with the goal of better preparedness for handling a CICV scenario.

Ensure that Title IX advisors receive adequate training, preparation

All participants in the formal Title IX resolution process are required to receive annual training, save for the hearing advisor, according to the May 2020 Title IX regulations. For any parties that don't already have a hearing advisor, the institution must appoint them one.

Психологические и организационноправовые аспекты использования полиграфа с целью оценки надежности кандидатов для службы в силовых структурах

The article presents results of the study of organizational, legal and applied aspects of the use of polygraph by polygraph examiners of security, defense and law enforcement agencies (n=89) for the evaluation of reliability of candidates to service. The authors identify such challenging organizational, legal and applied aspects as: exceeding the permitted load on a polygraph examiner, lack of time for a high-quality pre-test conversation, the pressure of third parties on a polygraph examiner and the absence of any clear criteria in the determination of separate factors of risk of socially dangerous behavior. Moreover, the majority of polygraph examiners noted that there is a need for annual advanced training. Following the results of this study, the authors give practical recommendations on the identifi ed aspects.

Patients Access to Medicines - A Critical Review of the Healthcare System in Kenya.

Access to affordable, safe, effective, and quality-assured medicines by a patient is important for good health outcomes. Unfortunately, there is sparse literature published on the pharmaceutical enablers that may increase the sale of a substandard and falsified (SF) medicine to a patient in Kenya. The review highlights some of the factors that may facilitate the entry of SF medicines into the legitimate pharmaceutical supply chain and discusses their impact on patient access to medicines. Lack of essential medicines in public health facilities is an important factor that may contribute to increased demand for medicine-related out-of-pocket expenses from private health facilities, thus a likelihood for a patient purchasing SF medicine from unlicensed and illegal medicine outlets or unregulated websites. The need to increase medicine availability in the public sector by the Ministry of Health (MOH) is emphasized in addition to the strengthening of public procurement to cushion it from corruption and mismanagement. In addition, the MOH should promote local pharmaceutical manufacturing and implement a medicine pricing containment policy to avoid abuse and prevent overexploitation of patients, increase medicine price transparency, and reduce pharmaceutical supply chain distortion. Recommended regulatory reviews include accreditation of unlicensed illegal medicine outlets to facilitate accountability, regulatory oversight, and active surveillance. The national post-market surveillance regulatory capacity should be strengthened to improve rational medicine use. A 3-year diploma course should be replaced with a shorter 1- or 2-year pharmaceutical support staff training not eligible to superintend a pharmacy. The recommended legislative review includes a mandatory clause to enforce generic prescribing and the implementation of generic substitution by health workers. Unethical manipulative pharmaceutical marketing practices should carry stiffer penalties to deter malpractice. Future research areas include investigation of medicine prescribing and dispensing practices, medicine consumption studies, medicine price differences within different health sub-sectors, and between licensed pharmacies and unlicensed illegal medicine outlets.

What Gets Measured Matters: Introducing a Culture Change Tracking Tool to Capture Person-Centered Care and Quality of Life Progress for QAPI Initiatives

Altarum’s Center for Eldercare Improvement has developed a tool to track progress within a 3-year comprehensive culture change training and implementation initiative in 6 Michigan nursing homes. The Systems Change Tracking Tool https://altarum.org/sites/default/files/uploaded-related-files/Altarum-systems-change-tracking-tool.pdf) based on the Holistic Approach to Transformational Change (HATCh) model, has 6 domains: Care Practices, Workplace Practices, Environment, Family/Community/Activities, Leadership and Stakeholders.

Effectiveness of The Wikipedia Collaboration of Dental Schools' Training Programme: a new Paradigm for Teaching and Learning of Evidence-Based Dentistry.

The Wikipedia Collaboration of Dental Schools (WCODS) is a student-led initiative that aims to publish high quality scientific, evidence-based dental content on the Wikipedia online encyclopaedia by equipping its members to use research, critical appraisal and writing skills to create accurate content. In 2019, the Collaboration launched a standardised training programme developed by Wikimedia-trained committee members, academic dental school staff and the Cochrane Oral Health global community. To evaluate the effectiveness of this training programme in ensuring WCODS editors follow the processes underpinning Evidence-Based Dentistry (EBD). A cohort of dental students and staff (n=136) from six dental schools in the UK and Malaysia took part in a standardised and structured training programme at the annual WCODS training meeting. Participants' abilities and their perceived levels of confidence in carrying out critical analysis of the literature were measured using pre- and post-training surveys, and competency assessments. Participants' skills in conducting literature searches, critical appraisal of the findings and creating and editing a Wikipedia page improved after training. The training programme provided participants with the skill set and confidence to apply best practice to create and edit Wikipedia entries. This Collaboration intends to recruit more contributors to improve global oral health literacy using the free online Wikipedia encyclopaedia.

Perceptions and Motivation Regarding Performing Research in Physicians Specializing in Care for Older Adults Involved in a Mandatory Evidence-Based Medicine Training Study: A Mixed-Methods Study

PurposeEvidence underpinning treatment of older persons with complex conditions is often sparse, and involving more early career physicians committed to optimizing care for older adults may help increase a relevant evidence base. We examined perception of and motivation to conduct research in physicians (residents) specializing in care of older adults.Subjects and MethodsResidents of an academic medical centre in the Netherlands enrolled in a 3-year training programme. The programme includes a mandatory evidence-based medicine (EBM) training study on pain and discomfort in cognitively impaired nursing home patients, in which residents perform their research over the 3-year duration of the programme. We employed a mixed-methods design with survey and qualitative interviews (December 2019–April 2020). The survey included validated scales with agreement response options rated 1–7. Qualitative interviews were underpinned by interpretative phenomenological analysis.ResultsOf 38 invited residents, 23 (15 females) participated. The mean score on perceptions of research was 4.1 (SD 0.8); on intrinsic motivation 4.8 (SD 1.0); on extrinsic motivation 4.3, with a higher SD of 1.4. Eight interviews also showed diversity in the extent to which residents felt equipped to conduct the mandatory EBM training study, and research more generally, which was related to previous experiences performing research. The residents generally did not anticipate conducting research themselves despite recognizing the benefits of training in research.ConclusionPerceptions and motivation of the residents specializing in care of older people to conduct research, although considered relevant to their practice, were not very positive. The study results in recommendations to motivate physicians in geriatrics training to conduct research, eg through personalized boosting of self-efficacy. This is crucial to motivate future physicians to contribute to research relevant to older people in more ways than just delivering data for research conceived by (non-clinical) researchers.

Editors’ Note and Prologue

Editors’ Note and Prologue

Maternal-fetal medicine fellows’ perception and comfort with obstetrical ultrasound and prenatal diagnosis

Ultrasound training is a vital component of maternal-fetal medicine fellowships in the United States. Of the 18 months of core clinical training, the American Board of Obstetrics and Gynecology currently requires a minimum of 3 months to be dedicated to ultrasound to be eligible for board certification. However, the experience and degree of hands-on training differ among the fellowship programs and have not been reassessed for nearly a decade. To assess regional heterogeneity in the ultrasound training experience during maternal-fetal medicine fellowship in the United States. A survey was distributed to postgraduate year (PGY)-6 maternal-fetal medicine fellows registered to attend an annual ultrasound training course before the conference (n=114). For programs with >1 fellow attending (n=39), only 1 of them completed the survey to represent the program. The questions included demographics of the program, ultrasound training structure, the fellows' self-perception of ultrasound capabilities, research, mentorship, and technical aspects of sonography. Seventy two postgraduate year 6 fellows with a wide geographic distribution as follows completed the survey (96% response rate): 10 (14%) from the West, 16 (22%) from the Midwest, 17 (24%) from the South, and 29 (40%) from the Northeast. Respondents undergoing training in the South were less likely to report feeling comfortable performing nuchal translucency and detailed anatomic surveys than those from other regions (nuchal translucency: P=.046; anatomy: P=.011). Most of the respondents reported feeling comfortable performing growth (78%) and umbilical artery Doppler (58%) and feeling uncomfortable with three-dimensional ultrasound, neurosonography, and fetal echocardiography. Respondents in the Northeast were more likely to report feeling comfortable performing chorionic villus sampling (P=.001). There was no difference among fellowship programs in the presence or absence of ultrasound curriculum, bedside teaching, ultrasound-focused research mentorship, or months of ultrasound training. Despite the standardization of ultrasound training structure across the United States, there remains regional heterogeneity in fellow self-reported comfort with specific ultrasound techniques and chorionic villus sampling at a midpoint in their fellowship training. The maternal-fetal medicine attending involvement at the bedside did not affect the fellow self-reported comfort with ultrasound surveys. This study highlights the need for further optimization of maternal-fetal medicine fellowship ultrasound training, especially in advanced sonography and diagnostic procedures.

The 3rd ESTRO-EFOMP core curriculum for medical physics experts in radiotherapy

PurposeTo update the 2011 ESTRO-EFOMP core curriculum (CC) for education and training of medical physics experts (MPE)s working in radiotherapy (RT), in line with recent EU guidelines, and to provide a framework for European countries to develop their own curriculum. Material and methodsSince September 2019, 27 European MPEs representing ESTRO, EFOMP and National Societies, with expertise covering all subfields of RT physics, have revised the CC for recent advances in RT. The ESTRO and EFOMP Education Councils, all European National Societies and international stakeholders have been involved in the revision process. ResultsA 4-year training period has been proposed, with a total of 240 ECTS (European Credit Transfer and Accumulation System).Training entrance levels have been defined ensuring the necessary physics and mathematics background. The concept of competency-based education has been reinforced by introducing the CanMEDS role framework. The updated CC includes (ablative) stereotactic-, MR-guided- and adaptive RT, particle therapy, advanced automation, complex quantitative data analysis (big data/artificial intelligence), use of biological images, and personalized treatments. Due to the continuously increasing RT complexity, more emphasis has been given to quality management. Clear requirements for a research project ensure a proper preparation of MPE residents for their central role in science and innovation in RT. ConclusionThis updated, 3rd edition of the CC provides an MPE training framework for safe and effective practice of modern RT, while acknowledging the significant efforts needed in some countries to reach this level. The CC can contribute to further harmonization of MPE training in Europe.

Improving technical and non-technical skills of emergency medicine residents through a program based on high-fidelity simulation.

We evaluated the effectiveness of a training program with high-fidelity simulation (HFS) to improve technical (TS) and non-technical skills (NTS) of residents in Emergency Medicine. We conducted a 2-year training program for the management of a critical patient based on HFS (6 sessions for every year, four teams who performed 4 scenarios per session). At the beginning of the training program, all participants received a presentation of Crisis Resource Management (CRM) principles. Each session covered a different topic in Emergency Medicine Curriculum. TSs were measured as the proportion of completed tasks in the following areas: airway, breathing, circulation, disability and exposure (ABCDE) assessment and management, completion of anamnesis based on AMPLE (allergy, medications, previous illness, last meal and event) scheme, diagnostic and therapeutic assessment. NTSs were rated by the Clinical Teamwork Scale (CTS). Scores' values and the percentage of correctly performed actions were presented as median with interquartile range. Friedmann non-parametric test was employed to evaluate the trend of TS and NTS over the following sessions. Among the TS, the assessment and management of ABCDE and completion of therapeutic tasks improved (all p < 0.05). The completion of diagnostic tasks (p = 0.050) tended toward significant improvement. The overall CTS score (first session 61 ± 17, last session 84 ± 16, p < 0.001) as well as Communication (first 13.7 ± 3.6, last 18.7 ± 3.5, p < 0.001), Situational Awareness (first 5.3 ± 1.8, last 6.4 ± 1.4, p = 0.012) and Role Responsibility subscores (first 9.7 ± 2.8, last 12.1 ± 3.7, p < 0.001) increased through the following sessions. Therefore, HFS has proven to be an effective instrument to improve TS and NTS among Emergency Medicine residents.

A Needs Assessment of Ohio Farmers’ Self-Reported Health Behaviors

ABSTRACT The study purpose was a needs assessment, to identify and quantify health behavior risk-factors of Ohio farmers in sleep, mental health, fruit/vegetable serving frequency, physical activity, tobacco, alcohol and illicit drug use, and weight status. Guided by the RE-AIM implementation framework, the research question was What behavioral choices pose health risk factors for Ohio farmers? This cross-sectional, quantitative, descriptive study used Qualtrics’ hyperlinks, QR codes, or paper-and-pencil surveys to collect data on seven focused health behaviors. The survey combined valid and reliable public domain questionnaires. The target audience included Ohio farmers representing various commodities. Extension educators at the county, regional, and state level provided access and data collection during their existing community-based programs and annual pesticide training sessions. The survey has been opened from January 20, 2020 to December 5, 2020 with modified recruitment during COVID. A convenience sample of 505 farmers participated. The majority self-identified as male, married, white, non-Latino, and worked full-time. The most frequent commodity was field crops. Most farmers reported 7-to-8 h of sleep, but the MOS SLP6 subscale indicated 89.5% of the farmers reported a score greater than 51. The two PHQ-2 questions showed 9.6% of the farmers scored >3, indicating a likely major depression disorder. Fruit and vegetable serving frequency appeared less than dietary recommendations. Time spent in physical activity did not meet guidelines. Almost 80% of the farmers said they did not use tobacco; the most common choice was chews and snuffs. Audit-C showed 31.4% of the men and 27.7% of the women can be categorized as hazardous drinkers. Illicit drug use was reported by 3.7%. Most farmers were obese or overweight. Male respondents were 83.5% overweight or obese; females 70.8% were overweight or obese. Males ages 55–64 years were mostly likely to be obese (58%) followed by males ages 35–44 years (46%). Results were compared to Ohio’s Behavioral Risk Factor Surveillance System. These data will assist county Extension educators in identifying health prevention programming important for farm populations, utilizing community resources and services. While the findings of Ohio farmers may not be generalizable to other state farming communities, this survey and lessons learned can serve as a model for other Extension assessments.

Sports Injuries Among Players of The Polish National Team in Amputee Football in The Annual Training Cycle.

The aim of the study was to determine the frequency, type and origin of the occurrence of injuries in amputee football. The studied group comprised all members of the Polish national amputee football team (n = 25). During the 9-month observation period, 13 players incurred 22 injuries. The incidence proportion was 48.0 per 100 athletes (95% Cl, 28.4-67.6) and the incidence rate was 5.73 per 1000 athlete-days (95% Cl, 3.33-8.12). The study showed that 32.8% of the injuries were to the thigh, 13.6% to the ankle, and 9.1% to the knee. The obtained results indicate that amputee football players rather frequently incur play-related injuries, but a single athlete incurs relatively few of them, with the lower limb being most commonly injured.

Skills and competencies that a new ENT specialty trainee year 3 should possess: a live Delphi study.

The aim of this study was to develop a novel live Delphi method to obtain a consensus on the skills and competencies that a new ENT registrar (specialty trainee level 3) should possess. Developing a clear outcome set for core surgical trainees is important so that this phase of training can be directed at specific aims. Attendees at the North of England meeting participated in this Delphi exercise. Participants comprised a range of ENT professionals from medical student to consultant surgeons. The main outcome measure of consensus was defined prior to the study as the median response value: strongly agree or more for positive consensus and strongly disagree or less for negative consensus. This study identified multiple areas that reached consensus relating to elective and operative skills and demonstrated agreement in areas relating to ENT specific and allied specialty experience. This study has highlighted a novel method for shaping surgical curricula.

Integrating Authentic Research Into the Emory-Tibet Science Initiative

We are at a historic point in which scientists and Tibetan monastics are working together to investigate ancient questions of mind and matter, and to serve the best interests of humanity. To facilitate this collaboration, His Holiness the Dalai Lama supported the development of the Emory University-Tibet Science Initiative (ETSI), which reflects the first major change in the Tibetan monastic curriculum in six centuries. Over the course of a 6-year long curriculum, Tibetan monastics living in India have the opportunity to study science with experts in various disciplines. In 2019, ETSI graduated its first cohort of monastic students from a 6-year “implementation phase,” and now has entered the “sustainability phase.” A goal of the sustainability phase is to broaden the scope of ETSI and begin training monastics through research. The present paper provides an overview of a 3-year Research Training Program being developed for the sustainability phase. We first overview a pilot program that informed feasibility and potential structure for a broader Research Training Program at the monasteries and monastic universities in India. Next, we discuss the conceptual framework for the Research Training Program and four learning objectives that we hope to attain. We then discuss the specifics of the course design for the proposed 3-year research training curriculum, through which our goal is to transition from a more guided training experience to a less guided experience. Finally, we discuss challenges and opportunities that we expect to encounter in developing and implementing the program.

Effects of Music Training on the Auditory Working Memory of Chinese-Speaking School-Aged Children: A Longitudinal Intervention Study.

Music expertise is known to be beneficial for cognitive function and development. In this study, we conducted 1-year music training for school children (n = 123; 7–11 years of age before training) in China. The children were assigned to music or second-language after-class training groups. A passive control group was included. We aimed to investigate whether music training could facilitate working memory (WM) development compared to second-language training and no training. Before and after the training, auditory WM was measured via a digit span (DS) task, together with the vocabulary and block tests of the Wechsler Intelligence Scale for Child IV (WISC-IV). The results of the DS task revealed superior development in the music group compared to the other groups. However, further analysis of DS forward and backward tasks indicated that the performance of the three training/non-training groups only differed significantly in DS backward scores, but not in the DS forward scores. We conclude that music training may benefit the central executive system of WM, as reflected by the DS backward task.

Green Training and its Impact on the Sustainability of the Health Organization

The main objective of this research is to build a sustainable health organization and to develop sustainability business through green training. To achieve this objective, the researchers surveyed the opinions of a number of employees who work at Najaf Health Directorate headquarter. The research community is (250) employees. The sample of the study is (155) analyzable valid responses. The researcher analyzed the data collected using tests and statistical methods powered by the (SPSS v.24) program. The study adopted one main hypothesis and three subhypotheses, which are the influence relationship among the variables of research. The hypotheses are to review the sustainability dimensions of the health organization, and the extent to which green training affect these dimensions. Finally, the research came up with a set of conclusions, the most important being that sustainability in the health organization is inevitable and not voluntary actions to engage the community's concerns and environmental concerns, as the lack of sustainability of the health organization means transforming it from an organization that tries to relieve the burden and pain of members of society to a bomb timethreatening ecological health. The recommendations touch the needs of the Directorate. The most important recommendation is to increase the number of the green training programs in a way that promotes the sustainability of the health organization. In addition, the research recommends adopting this concept (the green training) in the annual training plans.