Years Of Training Research Articles

Age and Training-Related Changes on Body Composition and Fitness in Male Amateur Cyclists.

Master athletes are considered as a model of healthy aging because they can limit the age-related decline of physiological abilities compared to sedentary individuals. The main objective of this study is to analyze age-related changes and annual training on body composition (BC) and cardiorespiratory fitness (CRF) parameters. The participants in this retrospective cross-sectional study were 176 male cyclists, aged 40–60 years. BC was evaluated through anthropometric measurements and CRF was determined by an incremental cycle ergometer test to exhaustion. A comparative study between age groups was carried out through a one-way ANOVA test and the associations between the variables were assessed by Spearman’s correlation coefficients and multiple regression analysis to estimate the performance. Training was generally associated with a decrease in both body weight and body fat (p < 0.05). A decrease in resting heart rate was observed as a vagal effect of kilometers cycled per year (p < 0.05). Kilometers cycled per year were associated with an increase in peak power output, which was larger in the master 40 group (p < 0.05) with a non-significant upward in VO2max (p > 0.05). In the performance prediction model, the included variables explained 52% of the variance. In summary, the changes induced by age were minimal in BC and negligible in CRF, whereas HR decreased with age. Training load was generally associated with a decrease in body weight, BMI and body fat percentage that was particularly notable in the abdominal skin folds. A decrease in HRrest was observed as a vagal effect due to kilometers cycled per year, and age did not seem to have a significant effect. The annual cycling kilometers were associated with to high PPO that is greater in the M40 group and a non-significant upward trend in VO2max.

Monitoring Blinks And Eyelid Twitches In Horses To Assess Stress During The Samples Collection Process

ABSTRACT To assess stress in horses, a method of monitoring eye blinks (full and half) and eyelid twitches while collecting saliva and blood samples before and after annual intensive police training was carried out. This noninvasive monitoring method was used to determine whether blood collection, which is considered invasive, is more stressful for horses than saliva collection. We discovered no significant difference in stress related manifestations between saliva sampling and blood collection in our study. In both cases, sampling (blood and saliva) reduced the number of full and half eye blinks. Based on our hypothesis, we expected a statistically significant changes in the number of eye blinks and eyelid twitches as the number of potential stressors increased (in our case, we considered police training and sampling). Saliva cortisol levels, on the other hand, revealed that police training for horses was not stressful. The method of measuring eye blinks and eyelid twitches appears to be an appropriate alternative method for monitoring stress factors in horses.

Longitudinal Reliability of Milestones-Based Learning Trajectories in Family Medicine Residents

Longitudinal Milestones data reported to the Accreditation Council for Graduate Medical Education (ACGME) can be used to measure the developmental and educational progression of learners. Learning trajectories illustrate the pattern and rate at which learners acquire competencies toward unsupervised practice. To investigate the reliability of learning trajectories and patterns of learning progression that can support meaningful intervention and remediation for residents. This national retrospective cohort study included Milestones data from residents in family medicine, representing 6 semi-annual reporting periods from July 2016 to June 2019. Longitudinal formative assessment using the Milestones assessment system reported to the ACGME. To estimate longitudinal consistency, growth rate reliability (GRR) and growth curve reliability (GCR) for 22 subcompetencies in the ACGME family medicine Milestones were used, incorporating clustering effects at the program level. Latent class growth curve models were used to examine longitudinal learning trajectories. This study included Milestones ratings from 3872 residents in 514 programs. The Milestones reporting system reliably differentiated individual longitudinal patterns for formative purposes (mean [SD] GRR, 0.63 [0.03]); there was also evidence of precision for model-based rates of change (mean [SD] GCR, 0.91 [0.02]). Milestones ratings increased significantly across training years and reporting periods (mean [SD] of 0.55 [0.04] Milestones units per reporting period; P < .001); patterns of developmental progress varied by subcompetency. There were 3 or 4 distinct patterns of learning trajectories for each of the 22 subcompetencies. For example, for the professionalism subcompetency, residents were classified to 4 groups of learning trajectories; during the 3-year family medicine training period, trajectories diverged further after postgraduate year (PGY) 1, indicating a potential remediation point between the end of PGY 1 and the beginning of PGY 2 for struggling learners, who represented 16% of learners (620 residents). Similar inferences for learning trajectories were found for practice-based learning and improvement, systems-based practice, and interpersonal and communication skills. Subcompetencies in medical knowledge and patient care demonstrated more consistent patterns of upward growth. These findings suggest that the Milestones reporting system provides reliable longitudinal data for individualized tracking of progress in all subcompetencies. Learning trajectories with supporting reliability evidence could be used to understand residents' developmental progress and tailored for individualized learning plans and remediation.

Postural balance and running technique: is there a relationship? Review article

Purpose: to determine the existence of a relationship between the development of muscles responsible for postural balance in a person and running efficiency.Research methods. A literature search was carried out using data from Scopus, Web of Science Core Collection and Pub Med. 40 sources were selected for analysis. Preference was given to works published in publications with a Q1 - Q2 rating.Results. Different sports have different requirements for a person's postural stability. The postural balance is of the greatest importance for the representatives of football, hockey, basketball. Running is the basis of many sports. Therefore, the study of postural balance during running loads is the basis for understanding the mechanisms of maintaining dynamic balance. There is currently research showing that jogging alone improves postural balance. It has also been shown that strengthening the muscles responsible for the postural balance of a person increases the stability of walking and running. The dynamic and static postural balance is influenced by aerobic fatigue, as well as accumulated fatigue in the annual training cycle of athletes. Deterioration of the work of the muscles responsible for the postural balance of a person can lead to injuries, diseases, and also limit the achievement of high sports results in running.Conclusions. This is one of the first studies of postural balance in running. In the work, data will be obtained on the positive influence of the development of postural balance (with the use of exercises for strengthening muscles - local stabilizers, balance exercises) on the running technique and the functional state of runners.

A Study on Communication Behaviour of Extension Personnel of Prakasam District of Andhra Pradesh

Successful communication is the main job of an extension worker. He cannot expect change among farmers unless he is able to communicate effectively to them. This entails the extension personal to have thorough understanding of communication process. This study will be helpful in identifying important variables of extension personnel affecting their communication process. Prakasam District of Andhra Pradesh was selected by purposive random sampling. The study was conducted in 7 mandal's which were selected randomly. Respondents were Agricultural officers, agricultural extension officers, village agricultural assistants and village horticultural assistants. The total sample size for the study were 120 extension personnel. majority of the respondents were female, young aged, having high educational status, with low annual income, job experience and training exposure. Perceived work load was high, medium level of job satisfaction and low level of Innovativeness and medium level of achievement motivation and medium level of communication behaviour was observed. The findings of overall communication behaviour of extension personnel indicate that there is need to increase the communication behaviour from medium to high through suitable training programs on latest Communication technologies and communication skills, providing needed literature.

PERFORMANCE MANAGEMENT STRATEGIES AND EMPLOYEE PRODUCTIVITY IN THE MINISTRY OF WATER AND IRRIGATION IN NAIROBI CITY COUNTY, KENYA

Purpose: The purpose of this study was to establish the effects of performance management strategies to employee productivity in the Ministry of Water and Irrigation in Nairobi City County, Kenya.&#x0D; Methodology: The study adopted a descriptive research design and Maslow’s hierarchy of needs, Herzberg’s two factors and expectancy theory for its theoretical framework. The target population was 200 employees drawn from middle level and lower level cadres in the Ministry of Water and Irrigation. A sample of 133 employees was issued with the questionnaires. Stratified and simple random sampling techniques were used to identify respondents. Primary data was collected using semi-structured questionnaires administered by the researcher. Descriptive statistic like mean, standard deviation frequencies, tables and charts were used to analyze quantitative data using Statistical Package for Social Sciences (SPSS), while open-ended questions were analyzed using content analysis.&#x0D; Results: The findings showed that performance management strategies affect employee productivity but at different levels. Remuneration is the leading factor that negatively influences employee productivity within the scope area. It was also noted that the promotion process affects the Ministry of Water and Irrigation negatively because it is not based on merit. However, both training and physical work environment facilitate improved productivity among the employees. This shows that performance management strategies positively and negatively affect the overall employee productivity in the Ministry of Water and Irrigation.&#x0D; Recommendations: The study recommends that, through the Public Service Commission and Salaries and Remuneration Commission, the government of Kenya introduce measures in areas of remuneration and training that will motivate workers in this ministry. Draft new guidelines for salary review based on the present living standards. The ministry should ensure that all workers are entitled to transport to and from work, mortgage facilities, and other benefits. All salaries be harmonized across the public sector.&#x0D; The promotion policies and guidelines that are already in place be followed when promoting employees. Adoption of a proper appraisal system and that all the promotions are based on merit but not influence, corruption or seniority. The Ministry takes note of the annual training plans and implementing them to the latter.

Traits of the current traditional pathway cardiothoracic surgery training pool: Results of a cross-sectional study

ObjectiveAs new paradigms for cardiothoracic surgery training emerged in recent years, the traditional 2- or 3-year pathway has persisted as an option for trainees completing general surgery residencies. Although the applicant pool for 6-year integrated cardiothoracic surgery training programs has been superficially explored, little data exist characterizing those applicants to the traditional cardiothoracic surgery training pathway and the influence of 6-year integrated expansion on the traditional applicant pool. MethodsWe reviewed materials from candidates applying to a single 2-year cardiothoracic surgery training program between 2015 and 2020. Descriptive and comparative analyses of multiple characteristics were performed over the years of the study. ResultsDuring the years 2015 through 2020, we received 571 applications, accounting for 72% of the total National Residency Matching Program applicant pool. We saw no significant trends in numbers of peer-reviewed publications or presentations. There was a minimal year-to-year increase in number of first-authored posters, 2.04 in 2015 to 2.13 in 2020 (P = .008). Online publications, book chapters, and other publications were stable throughout the study period. Applicants consistently provided an average of 3.6 letters of recommendation, 1.9 from cardiothoracic surgery faculty. Mean in-service score percentiles were stable at the 54th percentile, whereas US Medical Licensing Examination scores increased. ConclusionsDespite expansion of the 6-year integrated pathway to cardiothoracic surgery, we have seen no substantial year-to-year changes in attributes of traditional applicants. Our findings suggest that the cardiothoracic surgery applicant pool continues to be composed of a stable group of highly productive trainees. Future initiatives in candidate selection should emphasize interview strategies to highlight aspects of grit, emotional intelligence, and team dynamics.

Advanced training in industry education

The experience of the Federal Agency for Railway Transport (Roszheldor) conducting annual training courses for the heads of educational institutions of secondary vocational education and heads of state universities of railways supervising their work, organized by the Training and Methodological Center for Education in Railway Transport, considered. The main issues and problems that were discussed from September 13 to 16, 2021 at the courses “Improving the quality of secondary vocational education in the field of railway transport: prospects and ways of development”, held on the basis of the Emperor Alexander I St. Petersburg State Transport University.The topical issues, the study of which is devoted to the event: the results of the work of educational institutions of secondary vocational education of Roszheldor; interaction of educational organizations of Roszheldor with the main employer — JSC Russian Railways; educational and methodological support of basic professional educational programs of secondary vocational education; new organizational and methodological mechanisms in the system of secondary vocational education through Federal educational and methodological association; introduction of technological innovations into secondary vocational education in railway transport through professional skill con-tests; WorldSkills championships; informational, organizational, scientific and methodological resources for solving problems of training mid-level specialists for railway transport.

Panevėžio Raimundo Sargūno sporto gimnazijos baidarininkų rengimas metiniu ciklu, jų fizinių ir funkcinių galių kaita

The training of athletes in an annual cycle is a complex pedagogical process, during which various structural, physiological, mental and adaptive processes take place in athlete‘s body. The modern stage of the development of kayak sport is characterized by the active search and introduction of an increasing number of new methodological tools that increase the effectiveness of the pedagogical impact. However, continuous progress in athletic performance is not possible without a steady increase in the capacity of the body‘s functional systems and physical performance, which are achieved by properly organizing the training process. However, scientific works on the training of young kayakers is not yet sufficient. The structure of training process of sports gymnasium students, combining sports with science, has not been studied in detail. The aim of the work is to analyze the preparation of kayakers studying at sports gymnasium in the annual training cycle, and the change of physical and functional powers of their body. A study of eight kayakers of Panevėžys R. Sargūnas Sports Gymnasium during the annual training cycle was organized in the Sports Research Laboratory of the Vytautas Magnus University Education Academy. The age of the subjects was 16–18 years. During the 2019–2020 training cycle, kayakers‘ survey was conducted 3 times: at the beginning of the preparatory period (November), at the end of the preparatory period (March) and during the competition period (June). The training of the athletes took place according to the athletes‘ training program approved by Panevėžys R. Sargūnas Sports Gymnasium. The physical activity performed by the athletes was recorded in the coaches‘ worksheets and in the athletes‘ diaries. Laboratory studies were performed to evaluate the efficacy of individual mesocycles. Subjects were tested according to a kayakers’ research program. [...]

Defining Essential Topics and Procedures for Korean Family Medicine Residency Training

BackgroundThis study aims to create a comprehensive list of essential topics and procedural skills for family medicine residency training in Korea.MethodsThree e-mailed surveys were conducted. The first and second surveys were sent to all board-certified family physicians in the Korean Academy of Family Medicine (KAFM) database via e-mail. Participants were asked to rate each of the topics (117 in survey 1, 36 in survey 2) and procedures (65 in survey 1, 19 in survey 2) based on how necessary it was to teach it and personal experience of utilizing it in clinical practice. Agreement rates of the responses were calculated and then sent to the 32 KAFM board members in survey 3. Opinions on potential cut-off points to divide the items into three categories and the minimum achievement requirements needed to graduate for each category were solicited.ResultsOf 6,588 physicians, 256 responded to the first survey (3.89% response rate), 209 out of 6,669 to the second survey (3.13%), and 100% responded to the third survey. The final list included 153 topics and 81 procedures, which were organized into three categories: mandatory, recommended, and optional (112/38/3, 27/33/21). For each category of topics and procedures, the minimum requirement for 3-year residency training was set at 90%/60%/30% and 80%/60%/30%, respectively.ConclusionThis national survey was the first investigation to define essential topics and procedures for residency training in Korean family medicine. The lists obtained represent the opinions of Korean family physicians and are expected to aid in the improvement of family medicine training programs in the new competency-based curriculum.

Analyzing Safety Culture in Sri Lankan Industrial Chemical Laboratories

BackgroundA laboratory where chemicals are handled can be considered a hazardous environment, and hence, prudent practices should be strictly enforced. If not, deadly accidents and incidents could occur due to a lack of safety practices and poor safety culture. The purpose of this study is to analyze the existing safety culture and propose potential recommendations to enhance the level of safety education in the chemical laboratories in the Western Province of Sri Lanka. MethodsA survey questionnaire was administered among the laboratory supervisors of the chemical laboratories in the Western Province of Sri Lanka in 2019. ResultsEven though 80 surveys were distributed among prospective participants, only 46 surveys were submitted, which is 58% of the response rate. Most of the individuals who participated in the survey were females below 35 years old, and approximately 96% of the participants had at least one year of working experience in the same laboratory setting. The majority considered safety as an important factor that requires further improvements with third-party safety inspections; however, 54% of the respondents mentioned that those inspections were conducted by the employees from their laboratory. ConclusionFrom the study, it has been discovered that employees have knowledge of safety culture to a certain extent. A significant percentage (83%) of participants believed that further safety measures are required for a safer laboratory. However, the study revealed that the attitudes of some employees should be changed to have a better safety culture. Hence the authors would like to suggest having annual training sessions and well-formulated safety policies to improve the safety culture.

46th Annual Conference of the German Neuropaediatric Society (GNP) and 17th GNP Training Course Academy

After the long break in 2020 due to the pandemic we were pleased to once again offer not only a professional exchange on the latest developments in child neurology but also social networking opportunities at this year's Annual GNP Conference in Salzburg from 5 to November 7, 2021. In early 2020 we were eagerly putting the finishing touches on the planned 46th Annual GNP Conference in Dornbirn, when the developments of the pandemic forced us to cancel the meeting. According to the motto “Turning the crisis into an opportunity”, the 46th Annual GNP Conference and GNP Training Course Academy were therefore also designed as hybrid events to avoid having to completely cancel everything again in these uncertain times.

The Relationship Between Body Compositions of Taekwondo Practitioners Aged 14-16 and Their Aerobic Endurance

Background: Taekwondo (TKD) is a combat sport practiced by millions of children, young people and adults around the world.1 It is an Olympic sports branch with many complex features and constant interaction between two opponents in the competitions, where attack-contact techniques are applied quickly, attacking techniques are strong2,3 but also have good flexibility. Aim: This study has been carried out to identify the relationship between body composition of taekwondo practitioners aged 14-16 who regularly practice taekwondo, and their aerobic endurance. Methods: A total of 33 registered taekwondo practitioners (17 male, 16 female) participated to this study on a voluntary basis. The age, height, weight, and body mass index of all the athletes who took part in the study are 14.96±0.80 years, 162.59±11.59 cm, 50.97±7.51 kg and 19.14±2.39 kg/m² respectively. The group who participated to the study practice taekwondo two days a week, for 2 hours each, for a period of 1.5 years. The aerobic endurance of taekwondo athletes was measured by 20-meter-long Shuttle Run Test. In order to measure the body composition values of the athletes, measurements of skinfold thickness (biceps, triceps, subscapula, subrailiac) were carried out. In calculating the body density, the formula of Durning-Womersley was used; and in calculating the body fat percentage, the formula of Siri was employed. Data was evaluated by SPSS 22.0. The normality distribution of the data obtained at the end of the study was evaluated by Kolmogorov-Smirnov test and it was observed that the data was in line with normal distribution. Following the normalcy assessment, the relationship between body compositions and aerobic endurances was determined by Pearson Correlation analysis. Results: It is possible to say that the body composition values of taekwondo practitioners aged 14-16 have positive and negative impact on their aerobic endurance. It is observed that as the values 20-meter Shuttle Run test increases, fat percentage of athletes decreases. Conclusion: It is concluded that the findings obtained from the research results support the literature, and that body composition and aerobic capacity are important as performance criteria in many studies. It is thought that it may be beneficial for the athletes to perform aerobic endurance exercises during the annual training periods to perform the necessary practices to optimize their body composition and improve their aerobic capacity. Keywords: Taekwondo, Body Composition, Aerobic Endurance

46th Annual Conference of the German Neuropediatric Society (GNP) and 17th GNP Training Course Academy.

After the long break in 2020 due to the pandemic, we are pleased to once again offer not only a professional exchange on the latest developments in child neurology but also social networking opportunities at this year's Annual German Neuropediatric Society (GNP) Conference in Salzburg from November 5 to 7, 2021. In early 2020, we were eagerly putting the finishing touches on the planned 46th Annual GNP Conference in Dornbirn, when the developments of the pandemic forced us to cancel the meeting. Over the last year, we all had to show a lot of flexibility in our everyday lives, and we learned to appreciate the possibilities of virtual participation. According to the motto “Turning the crisis into an opportunity,” the 46th Annual GNP Conference and 17th GNP Training Course Academy were therefore also designed as hybrid events to avoid having to completely cancel everything again in these uncertain times. In Salzburg, the three main tracks of the scientific program will be livestreamed so that the planned topics can reach a large virtual audience. Moving the originally planned venue from Dornbirn to Salzburg is to help create an incentive for attending in person. Unfortunately, the GNP's popular “Skills Lab” with its practical training has fallen victim to the pandemic again this year due to the necessary safety concept.

EP.TU.1068Developing a Major Trauma Nursing Education Framework in Manchester

Abstract Aims The opening of the Major Trauma Ward (MTW) at Manchester University Hospitals NHS Trust represents a key milestone for managing major adult trauma within the Greater Manchester conurbation. We present an overview of the development of a novel Major Trauma Nursing Education Framework incorporating both the induction and continuing professional development of trauma nurses. Methods The MTW nursing skillset combines elements from acute surgical specialities and rehabilitation medicine. A framework for education was constructed from the Adult Nursing Competencies for the Major Trauma Patient (National Major Trauma Nursing Group) and the Trauma Intermediate Life Support curriculum. An induction programme was developed with a Competencies Workbook for an interim period including external courses for band 5 (Nurse Trauma and Critical Care course) and senior nurses (ALS and Neonatal, Adult and Paediatric Safe Transfer and Retrieval Course). An annual training programme will renew these competencies. Results Feedback from the first cohort for the induction programme has been positive, particularly with the third of nurses who did not feel confident managing trauma patients prior to induction (Wilcoxin-signed rank test, p = 0.00116). Free text comments ranged from the completeness of the topics covered to the delivery methods of the curriculum and how to work effectively within the wider multidisciplinary team. Conclusions The development of a formal Major Trauma Nursing Education Framework is necessary for a modern trauma workforce. Feedback has so far been positive. Continual audit of the framework will be necessary to ensure and improve the quality of delivery of education.

SP2.2.16Hospital compound level endoscopy training quality performance: scoping the spectrum

Abstract Aims This study aimed to assess the quality of endoscopy training in a single UK Statutory Educational Body (SEB), related to individual hospitals,compared with the Joint Advisory Group on Gastrointestinal Endoscopy Training (JETS) certification standards. Methods Training procedures numbering 28,928 recorded by 211 consecutive cross-specialty trainee endoscopists registered with JETS in18 hospitals during 2019were analysed. Data included trainer and trainee numbers, training list frequency, procedures, Direct Observation of Procedural Skills (DOPS) completion and Key Performance Indicators (KPI). Results Annual median training procedures per hospital were 1395 (interquartile range (IQR) 465-2365). Median (IQR) trainers and trainees per unit were 11 (6-18) and 12 (7-16) respectively (ratio 0.8 (0.7-1.3)). Annual training list frequency per trainee was 13 (10-17), 35.0% short of JAG standard (n = 20, p = 0.001, effect size -0.56), and median points per adjusted training list were 11 (5-18). Median DOPS completion per trainee and trainer were 3 (1-6) and 4 (1-7) respectively; completing 0.2 DOPS (0.1-0.4) per list and amounting to 6 (2-12) per 200 procedures: less than half of the JAG standard (p &amp;lt; 0.001, -0.61). Median KPI for OGD: J Manoeuvre 94% (90-96), D2 intubation was 93% (91-96); and for Colonoscopy: Caecal intubation 82% (72-90), and Polyp Detection Rate 25% (18-34). Compound hospital training quality score varied 3-fold, the highest performing hospital scoring 26; compared to the poorest performing scoring 9: median 17 (14-20). Conclusion Important variation in endoscopy unit performance were apparent with compound hospital training quality varying almost 3-fold. Trainees, Training Programme Directors alike, should be aware of such data when planning educational programmes to focus, optimise the quality of endoscopic training.

Training of employers and employees in workplace health promotion in Bulgaria – 7-year experience

Abstract Issue Health of working population is a question of present interest because of a number of reasons: aging workforce, globalization of the labour market, new and increasing risks at working environment etc. Workplace Health Promotion (WHP) become increasingly relevant field of action for public health improvement all over the world. According to the Bulgarian legislation annual trainings on health and safety at work are obligatory for employers and employees. Description By this paper 7-year experience in training of employers and employees in WHP was shared. Generally, 9 employers/organizations and 120 employees in three focus groups were included in the training. Questions of the project are: a) how to enhance employers' capability to plan and put into practice health promotion programs; b) how to increase employees' interest for active participation in these programs. Training have been conducted both at workplace and at special meetings outside of work environment, organized by Occupational Health Service in collaboration with health promotion experts of Medical University - Pleven. Results At the beginning (2014), about 2/3 of participants distrust of the proposed approaches. To adapt the training to needs of the audience, a study on the barriers and difficulties in carrying out health promotion activities at workplace was made. Participants were also asked about aspects of WHP that they interested in. During the following meetings (every year from 2014 until now), interest to the WHP and approaches of its implementation have been increasing. Participants improved their activity in discussions, interactive approaches for teaching and training get preferable. Lessons Lack of knowledge about health promotion concept and its principles predispose to distrust of its potential for public health improvement. Positive attitude to the concept could be established by increasing knowledge and skills in this area and by providing examples of good practices and results. Key messages Workplace Health Promotion become increasingly relevant field of action because of aging workforce and new occupational hazards, but there are some barriers and difficulties in its implementation. Annual training of employers and employees in Workplace health promotion improve the capability for implementation of the concept and for utilization its potential for better health of working people.

The Influence of Endurance Training on the Lipid Profile, Body Mass Composition and Cardiovascular Efficiency in Middle-Aged Cross-Country Skiers.

Monitoring the training of amateur long-distance cross-country skiers (XCS) can help athletes’ achieve a higher exercise capacity and protect their health. The aim of this study was to assess body composition changes and lipid profiles in middle-aged amateur long-distance XCS after four months of training, including specialized roller ski training. The results of the time-to-exhaustion (TTE) test and blood tests and changes in body composition were analyzed with basic descriptive statistics: the paired Wilcoxon test was used to compare the results (initial and final). Spearman’s rank correlation coefficient (R) was used to assess the influence of various variables on maximum oxygen uptake (VO2max). The findings show that training of amateur long-distance XCS improved maximal oxygen uptake (p = 0.008) and had a positive effect on fat reduction, measured in percentages (p = 0.038) and in kilograms (p = 0.023), but did not change blood lipids or other parameters. Further research could focus on other aspects of the annual training cycle: the competition period, and women in a larger group of athletes. Training with roller skis and a cross-country skiing training machine (a specialized machine for strengthening the arms and upper body) can support health and prevent obesity, overweight, and cardiovascular disease.

A Mixed-Methods Exploration of the Developmental Trajectory of Autonomous Motivation in Graduate Medical Learners.

Self-determination theory (SDT), when applied to curricular construction, emphasizes curiosity, self-awareness, and resilience. Physicians need these qualities to face the challenges of clinical practice. SDT offers a lens for medical educators to track learner development toward sustainable, rewarding careers. This study describes the changes observed in learner communications about feelings of competence, relatedness, and autonomy across a 3-year family medicine training program designed to develop activated, lifelong learners. This retrospective, mixed-methods case study uses a phenomenological approach to explore how 51 learners described their experiences at various intervals in residency training. Data collected from 2009 to 2015 from resident focus groups, competency assessment meetings, and faculty assessment reports inform a 3-stage analysis process to determine learner motivation levels along the SDT continuum. Aggregated qualitative and quantitative data show residents' progression from introjection (controlled motivation) in PGY1, to identification (autonomous motivation) in PGY2, and integration (autonomous) by the end of PGY3. The examination of a single learner's data set reveals an advanced motivation level in PGY1 (identification), followed by a period of retrograde in PGY2 (introjection), then rebounding in PGY3 (identification), which illustrates how motivation level can be affected by external competency requirements and challenges related to career transitions. The examination of self-motivation in medical learners has implications for curriculum development, assessment, teaching and self-directed learning, and resilience training. Learner awareness of intrinsic motivation, and the curriculum designed around it, can better prepare residents for challenges during residency and help them flourish in twenty-first-century medicine.

The effects of obstetric emergency team training on patient outcome: A systematic review and meta‐analysis

Little is known about the optimal simulation-based team training in obstetric emergencies. We aimed to review how simulation-based team training affects patient outcomes in obstetric emergencies. Search Strategy: MEDLINE, Embase, Cochrane Library, and Cochrane Central Register of Controlled Trials were searched up to and including May 15, 2021. randomized controlled trials (RCTs) and cohort studies on obstetric teams in high-resource settings comparing the effect of simulation-based obstetric emergency team training with no training on the risk of Apgar scores less than 7 at 5min, neonatal hypoxic ischemic encephalopathy, severe postpartum hemorrhage, blood transfusion of four or more units, and delay of emergency cesarean section by more than 30min. The included studies were assessed using PRISMA, EPCO, and GRADE. We found 21 studies, four RCTs and 17 cohort studies, evaluating patient outcomes after obstetric team training compared with no training. Annual obstetric emergency team training may reduce brachial plexus injury (six cohort studies: odds ratio [OR] 0.47, 95% CI 0.33-0.68; one RCT: OR 1.30, 95 CI% 0.39-4.33, low certainty evidence) and suggest a positive effect; but it was not significant on Apgar score below 7 at 5min (three cohort studies: OR 0.77, 95% CI 0.51-1.19; two RCT: OR 0.87, 95% CI 0.72-1.05, moderate certainty evidence). The effect was unclear for hypoxic ischemic encephalopathy, umbilical prolapse, decision to birth interval in emergency cesarean section, and for severe postpartum hemorrhage. Studies with in situ multi-professional simulation-based training demonstrated the best effect. Emerging evidence suggests an effect of obstetric team training on obstetric outcomes, but conflicting results call for controlled trials targeted to identify the optimal methodology for effective team training.