Completion Of Training Program Research Articles

Pelvic floor muscle training for female stress urinary incontinence: Five years outcomes.

To evaluate the clinical status, lower urinary tract symptoms (LUTS) and quality of life (QOL) 5 years after completion of a pelvic floor muscle training (PFMT) program for female stress urinary incontinence (SUI). Two hundred and eight consecutive women who underwent a guided PFMT program as first-line management of SUI were invited to participate in a questionnaire-based outcome study 5 years after treatment. Primary outcome measures comprised of adherence to PFMT, interim surgery for SUI, and patients' self-assessment of LUTS and QOL. One hundred and thirty-two (63%) women completed all questionnaires, 55 of whom (41.7%, mean age 52.1 ± 10.8) reported adherence to PFMT, 75 (56.8%, mean age 49.8 ± 10.8) discontinued training, and two (1.5%) underwent surgery. Further analysis of the 76 non-responders revealed six more patients who underwent surgery. Thus, overall, eight patients (3.8% of the original cohort) underwent surgery within 5 years after completion of the training program. Except for those who underwent surgery, almost all women reported SUI, however their ICIQ-UI scores for frequency and amount of leakage were low (2.2 ± 0.9, 1.18 ± 1.04, respectively) and I-QOL score was high (96.2 ± 13.6). All investigated parameters and domains, in each of the three questionnaires and among all women, consistently demonstrated low severity of LUTS and relatively high continence-associated QOL. There were no statistically significant differences in favor of adherence to PFMT. Although relatively high rates of 5-year adherence to training were demonstrated among our patients, this adherence was not associated with superior treatment outcomes. Further studies are needed to establish the long-term efficacy of PFMT for SUI. Neurourol. Urodynam. 36:132-135, 2017. © 2015 Wiley Periodicals, Inc.

Relationships between clinician-level attributes and fidelity-consistent and fidelity-inconsistent modifications to an evidence-based psychotherapy.

BackgroundClinicians often modify evidence-based psychotherapies (EBPs) when delivering them in routine care settings. There has been little study of factors associated with or implications of modifications to EBP protocols. This paper differentiates between fidelity-consistent and fidelity-inconsistent modifications and it examines the potential influence of two clinician characteristics, training outcomes, and attitudes toward EBPs on fidelity-consistent and fidelity-inconsistent modifications of cognitive behavioral therapy in a sample of clinicians who had been trained to deliver these treatments for children or adults.MethodsSurvey and coded interview data collected 2 years after completion of training programs in cognitive behavioral therapy were used to examine associations between successful or unsuccessful completion of training, clinician attitudes, and modifications. Modifications endorsed by clinicians were categorized as fidelity-consistent or fidelity-inconsistent and entered as outcomes into separate regression models, with training success and attitudes entered as independent variables.ResultsSuccessful completion of a training program was associated with subsequent fidelity-inconsistent modifications but not fidelity-consistent modifications. Therapists who reported greater openness to using EBPs prior to training reported more fidelity-consistent modifications at follow-up, and those who reported greater willingness to adopt EBPs if they found them appealing were more likely to make fidelity-inconsistent modifications.ConclusionsImplications of these findings for training, implementation, EBP sustainment, and future studies are discussed. Research on contextual and protocol-related factors that may impact decisions to modify EBPs will be an important future direction of study to complement to this research.

Low cost tube thoracostomy model for training in resource poor settings

sites and includes an HMS faculty member as a Rwanda-based research advisor and technical support. Research capacity building activities have been prioritized. District-based research trainings develop skills to both produce research and integrate research findings into practice. To develop research leadership, students are supported to complete MPhil/PhD degrees at UR-SPH. To bridge the mentorship gap due to a large student body and small faculty at UR-SPH, these students are co-supervised by UR-SPH and HMS faculty. Outcomes & Evaluation: The following outcomes have been observed. 1) Increased interest in research: 103 PIH/Rwanda, RMoH and UR-SPH colleagues have completed training programs since 2012 and demand for training far exceeds capacity (only 2550% of applicants accepted into trainings). 2) Increased research productivity: The number of publications highlighting PIH/ Rwanda-supported programs has increased from 1-5 peer-reviewed publications per year from 2006-2012 to 10 publications in 2013 and 15 publications published/accepted/submitted as of September 2014 (published/accepted/submitted as of September 2014). 3) Increased Rwandan leadership in research: The first Rwandan-led manuscript describing a PIH/Rwanda-supported program was published in 2013, and, in 2014, 67% (of 15) were first-authored by a Rwandan. 4) Increased link of research to policy: Current research is led or advised by RMoH and PIH/Rwanda program leads, better linking results to program implementation/policy. Going Forward: This work will continue to leverage the institutional strengths of PIH/R and HMS and partnerships with RMoH and UR-SPH. Fostering inclusive research, with clear guidelines, technical support and trainings, remains a priority. However, flexible funding for in-country infrastructure, mentorship and fieldbased training programs is essential for continued growth. Funding: This work is funded by HMS DGHSM, PIH and the Doris Duke Charitable Foundation. Abstract #: 02ETC035

NMC wants to remove time limits for completion of training programmes

NMC wants to remove time limits for completion of training programmes

The 2014 ACR Commission on Human Resources Workforce Survey

The ACR Commission on Human Resources conducts an annual electronic survey during the first quarter of the year to better understand the present workforce scenario for radiologists and allied health professionals. The Practice of Radiology Environment Database is used to identify group leaders who are asked to complete an electronic survey developed by the Commission on Human Resources. The survey asked 1,936 group leaders or their designates to report the number of radiologists currently employed or supervised, the number hired in 2013, and the number they plan to hire in 2014 and 2017. The leaders were asked to report the subspecialty area that was used as the main reason for hiring each physician. The 22% response rate corresponds to 35% of all practicing radiologists in the United States. The2014 survey demonstrated that 78% of the workforce is male and 22% is female and that 87% of theworkforce works full time. Fifty-three percent of the current workforce is in private practice and 47% invarying forms of employment. The current workforce consists of 18% general radiologists and 82% subspecialists. In 2013, 1,069 radiologists were hired. In 2014, 1,114 job opportunities are projected, and 1,131 estimated jobs are forecast for2017. Job opportunities for radiologists in 2014 remain similar to those in 2013 and close to the numbers of residents completing training programs in diagnostic radiology. Job opportunities remain available but may not necessarily be in the subspecialty, geographic area, or type of practice an individual most desires.

Do dropouts with longer training exposure benefit from training programs? Korean evidence employing methods for continuous treatments

Failure of participants to complete training programs is pervasive in existing active labor market programs, both in developed and developing countries. From a policy perspective, it is of interest to know if dropouts benefit from the time they spend in training since these programs require considerable resources. We shed light on this issue by estimating the average employment effects of different lengths of exposure by dropouts in a Korean job training program, and contrasting it to the ones by program completers. To do this, we employ methods to estimate effects from continuous treatments using the generalized propensity score, under the assumption that selection into different lengths of exposure is based on a rich set of observed covariates. We find that dropouts with longer exposures exhibit higher employment probabilities one year after receiving training, but only after surpassing a threshold of exposure of about 12–15 weeks. In contrast, program completers exhibit higher returns from their time of exposure to the program than dropouts, but these tend to decline for longer program durations.

The Blueprint for building psychology into a health care profession: Retaining our foundation in science while expanding breadth of training.

The Blueprint for Health Service Psychology Education and Training represents an important step in defining as a health profession. Although we face many challenges in positioning our profession prominently within the emerging health care system, two issues highlighted in this article are paramount. First, it is important for to retain its emphasis on training health service psychologists (HSPs) to conduct research, not just to consume research, a feature of our profession that distinguishes us from all other health professions. Second, programs that train HSPs need to revise their curricula to assure that graduates possess the competencies needed to function within the health care system, particularly those involving interdisciplinary functioning and exposure to knowledge bases of other health disciplines. In highlighting this broader set of competencies required for effective practice as HSPs, the Blueprint provides a framework for positioning as a health care profession. Descartes (1641/1903) was wrong. Unfortunately, it took us over 350 years to learn this, and in the meantime, we managed to create a health care system in which medical and psychological disorders are diagnosed using different nomenclatures, paid for and managed differentially by health insurance payers, and in which behavioral health care providers are trained in educational programs that rarely interact with members from other health care professions. Recognizing the dysfunction created by the Cartesian separation of mind and body, the American Psychological Asso- ciation (APA) voted overwhelmingly in 2001 to redefine psychol- ogy as a health profession by adopting the mission of advancing psychology as a science and profession and as a means of pro- moting health (emphasis added) and human welfare (Anderson, 2003). Expanding as a health profession continues to be a unifying goal of the APA and is currently one of its three strategic initiatives. Although well over a decade has passed since clarified its vision as being a health profession, very little change has occurred in training health service psychologists (HSPs) to assure they have the essential competencies to function in the modern health care environment. In my view, we continue to squabble among ourselves regarding the best methods for training psychologists who desire to become HSPs, we license those who complete training programs of questionable quality, and we get paid poorly for working with some of the most challenging pa- tients who seek health care. Although our field owns a vision of becoming a health profession, the pathway to achieve it has not always been clear. With the Blueprint for Health Service Psychol- ogy Education and Training (Blueprint), (Health Service Psychol- ogy Education Collaborative (HSPEC), 2013), we now have the floor plans for moving our profession into a prominent role in our nation's emerging health care system. Even the casual reader will observe that as renovation of our profession occurs using the Blueprint, significant modification to what HSPs do and how they are trained needs to occur. Although there are many features of the Blueprint that warrant attention, I would like to concentrate on two of them: (a) the importance of conducting research versus con- suming science, and (b) the need to break down the boundaries that have kept isolated from all of the other health profes- sions.

The Pro12Ala Polymorphism of the Peroxisome Proliferator-Activated Receptor Gamma Gene Modifies the Association of Physical Activity and Body Mass Changes in Polish Women.

Peroxisome proliferator-activated receptor γ is a key regulator of adipogenesis, responsible for fatty acid storage and maintaining energy balance in the human body. Studies on the functional importance of the PPARG Pro12Ala polymorphic variants indicated that the observed alleles may influence body mass measurements; however, obtained results were inconsistent. We have decided to check if body mass changes observed in physically active participants will be modulated by the PPARG Pro12Ala genotype. The genotype distribution of the PPARG Pro12Ala allele was examined in a group of 201 Polish women measured for selected body mass variables before and after the completion of a 12-week training program. The results of our experiment suggest that PPARG genotype can modulate training-induced body mass measurements changes: after completion of the training program, Pro12/Pro12 homozygotes were characterised by a greater decrease of body fat mass measurements in comparison with 12Ala allele carriers. These results indicate that the PPARG 12Ala variant may impair the training-induced positive effects on body mass measurements; however, the detailed mechanism of such interaction remained unclear and observed correlation between PPARG genotype and body mass differential effects should be interpreted with caution.

"Training Engagement Theory: A Multilevel, Temporal Perspective on the Effectiveness of Training"

Training engagement theory depicts the temporal sequence of events at multiple levels of analysis that contribute to training effectiveness. The temporal nature of the theory advocates for examining the processes that occur from before training is conceptualized until after the completion of training programs. As such, training engagement theory proposes a sequence model of the independent and joint effects of establishing training goals, prioritizing those goals, and persisting during goal striving on training effectiveness. Moreover, the theory is multilevel such that each phase of the goal striving process is conceptualized from the organizational, between-person, and within-person levels of analysis. Together the temporal and multilevel nature of training engagement theory provides a broad account of how factors at various levels in the organizational hierarchy influence one another and contribute to the success or failure of organizational training programs. We also propose two critical extensions of current conceptualizations of training effectiveness by adding attrition as an additional indicator of training effectiveness and by clarifying how indicators of training effectiveness—including course satisfaction, attrition, learning performance, and training transfer —may be operationalized differently at various levels in the organization. Finally, we offer testable multilevel propositions derived from training engagement theory to spur future research.

The Vacancies and Preferability of Emergency Medicine Training in Recent Years in Turkey

Objective: Department of Emergency Medicine was founded for the first time in the world in 1970 at Cincinnati University and in Turkey in 1993 at Do- kuz Eylul and Firat Universities. The emergency medicine specialists increased in number rapidly in Turkey by starting-up the training programs in the train- ing and research hospitals of the Health Ministry for the first time in 2006; and participation of the doctors' complete training program for the first time in 2011. We wanted the determine the preferability of the emergency medicine residency program and its completion rate. Material and Methods: The vacancies, preferability rate and completion rate of the residency programs of emergency medicine, family medicine, internal medicine, cardiology and neurosurgery were investigated with this study. The data was derived from the web sites of the Student Selection and Placement Center and the assignment lot lists of the Health Ministry. Results: From 2007 to 2012, 2586 of 2767 emergency medicine vacancies were set. The minimum base -point was 53.03 and the maximum was 55.46 in the examination for specialty training in medicine (TUS). The preferability of emergency medicine was lower than internal medicine and cardiology but similar to neurosurgery and family medicine. The completion of the residency in emergency medicine was 66.1%. Conclusion: In spite of the increase in the number of emergency medicine specialists with the participation of the training and research hospitals, the completion rate of the residency programs were lower than other depart- ments. The completion rates could be increased by improving the job condi- tions of the emergency physicians. (JAEM 2013; 12: 180-4)

The July Phenomenon Revisited

Each July, teaching hospitals experience an influx of new residents and fellows who recently have graduated from medical school or completed residency training programs. During this period, teaching hospitals also assign new positions of responsibility to existing residents and fellows. Medical education is a core mission of teaching hospitals, and, in these hospitals, interns, residents, and fellows play major roles in patient care. This recurrent cycle in which care is delivered by less experienced physicians in the initial month of the academic year has led to the often expressed conventional wisdom of “not to get sick in July.”1 Article see p 2754 In addition to the lore surrounding July admissions to teaching hospitals, previous studies have shown that physician experience is an important determinant of outcomes for a wide range of medical conditions and procedures.2–5 Moreover, literature from economics and other fields has shown that employee turnover can adversely affect organizational productivity.6,7 Given that teaching hospitals face both inexperienced physicians as well as high turnover early in the academic year, it is reasonable to be concerned about the potential for lower quality care around that time. Based on these concerns, a number of studies over the past 25 years have compared patient outcomes in teaching hospitals during July and later months of the academic year. Indeed, a recent systematic review by Young et al6 identified 39 studies that examined care delivered in a wide range of clinical settings, including inpatient medical and surgical wards, intensive care units, operating rooms, and emergency rooms. Of these 39 studies, 27 (69%) evaluated hospital mortality, and of these 27 studies, only 6 (22%) found higher mortality among patients who received care in July or the early months of the academic year associated with housestaff turnover. However, …

Psychological Skills Training of an Elite Wheelchair Water-Skiing Athlete: A Single-Case Study

This study presents a complete psychological skills training (PST) program with a wheelchair athlete and examines the program effectiveness using a mixed-method approach. After initial testing, the athlete followed a two-month program of self-confidence building, motivational, visualization/relaxation, and injury management techniques. Quantitative and qualitative methods were used to examine the impacts on performance and psychological abilities. The triangulated results suggest that the PST program was perceived as effective by the athlete in terms of his sporting performances and mental skills. The characteristics and implications of a PST program with this wheelchair athlete are discussed, as well as the study limitations and the perspectives for future research.

CDP-choline (ceraxon) treatment with hypoxia in the newborn infant

CDP-choline (ceraxon) treatment with hypoxia in the newborn infant

Editorial introductions

Current Opinion in Critical Care was launched in 1995. It is one of a successful series of review journals whose unique format is designed to provide a systematic and critical assessment of the literature as presented in the many primary journals. The field of critical care is divided into 13 sections that are reviewed once a year. Each section is assigned a Section Editor, a leading authority in the area, who identifies the most important topics at that time. Here we are pleased to introduce the journal's Editor and Section Editor for this issue. EDITOR-IN-CHIEF Jean-Louis VincentJean-Louis VincentDr Vincent is Professor of intensive care at the University of Brussels, Belgium, and Head of the Department of Intensive Care at the Erasme University Hospital in Brussels, Belgium. He earned his medical degree from the Universite Libre de Bruxelles, Belgium, with magna cum laude, with a specialty in Internal Medicine and Intensive Care Medicine. His training included two years of fellowship in critical care medicine at the University of Southern California, USA with Prof. Max Harry Weil. Dr Vincent has signed more than 700 original articles, more than 280 book chapters and review articles, and around 800 original abstracts. He has edited 86 books including 63 in his own series Update in Intensive Care and Emergency Medicine and Yearbook in Intensive Care and Emergency Medicine published by Springer-Verlag (Heidelberg, Berlin, New York). He is co-editor of the Textbook of Critical Care (Elsevier Saunders, 5th Edition). He has also written a French Manual of Intensive Care and Emergency Medicine (Springer, France), and is the co-editor of the series Le point sur… (Springer, France). Dr Vincent is the editor-in-chief of Critical Care, Current Opinion in Critical Care, and ICU Management. He is member of the Editorial Boards of about 30 journals including Critical Care Medicine (senior editor), PLoS Medicine, Lancet Infectious Diseases, Intensive Care Medicine, Chest, Shock, and Journal of Critical Care. Dr Vincent is presently Secretary General of the World Federation of Societies of Intensive and Critical Care Medicine. He is a Past-President of the European Society of Intensive Care Medicine and the European Shock Society, and the Past-Chairman of the International Sepsis Forum. For 31 years he has organized an International Symposium on Intensive Care and Emergency Medicine which is held every March in Brussels. This symposium, which gathers 5,000 participants, has become one of the largest meetings in the field. He received the Foundation André Loicq award in 1986, the Foundation De Kerckheer award in 2000, the Distinguished Investigator award of the Society of Critical Care Medicine in 2001 and the College Medalist Award of the American College of Chest Physicians in 2003. He was the Recipient of the "Society Medal” (lifetime award) of the European Society of Intensive Care Medicine in 2009 and he received “ Prix Scientifique Joseph Maison-Sciences biomédicales cliniques” (scientific award of the FRS-FNRS) in 2010. SECTION EDITOR Arthur P. WheelerArthur P. WheelerArthur Wheeler is a Professor in the Division of Allergy, Pulmonary and Critical Care Medicine at Vanderbilt University, USA, and serves as the Director of the Vanderbilt ICU. He is a graduate of the University Of Maryland School Of Medicine, USA, then completed training programs in Internal Medicine, Pulmonary Disease and Critical Care at Vanderbilt University. Dr Wheeler's research interest in severe sepsis, acute lung injury and thromboembolic disease has resulted in more than 100 publications. He is also the co-author of a successful textbook of Critical Care Medicine now in its fourth edition. He has delivered hundreds of national and international lectures and is the recipient of numerous teaching awards. Most recently Dr Wheeler has been developing and testing the effectiveness of alternative care delivery models in critical care including the use of nurse practitioners.

Physical Activity Levels, Lesson Context, and Teacher Behaviours in Elementary Physical Education Classes Taught by Paraeducators

In the USA some states permit the use of paraeducators to teach elementary physical education. These paraeducators are typically poorly trained and have little experience in the subject matter. There have been few studies examining the potential effects of professional development with paraeducators. The purpose of this study was to determine the physical activity levels, lessons context, and teacher behaviors of paraeducators who had received varied amounts of professional development training. A total of 18 paraprofessionals from a potential sample of 54 were randomly selected to be observed teaching physical education using the System for Observing Fitness Instruction Time (SOFIT). ANOVA results indicated no significant differences by years of teacher training in each SOFIT category. Overall, children spent the majority of time in class standing (42.8%) and were only moderately-to-vigorously active for 32.1% of the class time, well below the national recommendation of 50% of class time. These results demonstrate that professional development is not enough to prepare paraeducators to teach elementary physical education. Only licensed and qualified teachers who complete professional training programs should be hired to teach in schools.

Are you interested in becoming a European Spirometry Trainer?

Following a survey conducted in 2008 by ERS on national spirometry training programmes and availability of training in 14 European countries, results conf irmed the clear lack of training opportunities in many countries, with most training taking place on the job. In an effort to address a clear lack of training [1] and studies within the literature confirming under-utilisation of spirometers [2] and misdiagnosis based on inaccurate results [3], an ERS educational Task Force was formed in 2008 as part of the HERMES project family. The primary aim of the project was to set educational standards for the training and certification of spirometry at a European level with the ultimate goal of improving patient care and quality of life for respiratory disease patients. Three years on, the task force has successfully published a complete spirometry training programme and guidelines for certification [4, 5 …

P-1311 - Neurocognitive deficit correction in patients with schizophrenia

Neurocognitive deficits in patients with schizophrenia is a major health and social problem of modern psychiatry. To study the influence of neurocognitive training as well as long-term use of psychopharmacological drugs with serotoninergic mechanism of action (serdolect, fluvoxamine). 4 groups of patients diagnosed with paranoid schizophrenia were formed with stable therapeutic remission. The first group of patients received serdolect as monotherapy in middle doses, the second group received fluvoxamine in combination with conventional antipsychotics as the treatment of cover in middle doses, the third - took place at the complex of neurocognitive training in combination with conventional antipsychotics as the treatment of cover in middle doses, the comparison group received only conventional antipsychotics. Study design: Initial evaluation of patients was carried out at the first call, prior to the neurocognitive training. Follow-up study was conducted one month after completion of training programs and the final examination, after a year. According to the survey indicated an increase in all indicators (the difference with the control group ranged from 3% to 26%), the maximum improvement falls on visual memory, and minimal attention to the function. The neurocognitive training showed itself as an effective method of correcting neurocognitive deficits. Using drugs with serotoninergic mechanism showed significant improvement in neurocognitive profile of schizophrenia patients.

Cross-border co-operation and education in digital investigations: A European perspective

Co-operation and education are fundamental issues when dealing with national and international organizations involved in digital forensic investigations. Although these two aspects are often separately handled, they are strictly connected. On the one hand, different agencies can leverage on co-operation for the training of their investigators while, on the other hand, co-operation is possible only if an adequate level of education on digital forensic matters is reached. In this paper, the concrete outcome of a complete training program that involved several European antitrust agencies is reported (named EAT_FIT, European Antitrust Training in Forensic IT). We sum up the activities and the techniques that are generally used in antitrust investigations, and we outline the rationales used to set up such a training course. Assessment data collected both during and after the training highlight the needs and the difficulties faced by the digital forensic practitioners working in the field.

P01-431 - Rehabilitation aspects in neurocognitive treatment

Neurocognitive deficits in schizophrenia patients is a major health and social problem of modern psychiatry nowadays.ObjectiveTo study the influence of neurocognitive training on higher cortical functions in schizophrenia patients and to evaluate their effectiveness in the treatment of schizophrenia.Material and methodsWe formed groups of patients diagnosed with paranoid schizophrenia undergoing treatment in the departments of rehabilitation and day hospital. All patients received adequate pharmacotherapy with atypical neuroleptics. Patients of the main group additionally participated in the training of cognitive deficits. Patients included in the comparison group received only pharmacotherapy.MethodsClinical (advanced clinical psychopathological interview), paraclinical (psychological study of neurocognitive deficits in a battery of standard tests, the study of social functioning of patients - the scale of PSP).Study designInitial evaluation of patients was carried out at the first call, prior to the neurocognitive training. Follow-up study was conducted one month after completion of training programs and the final examination, after a year. In the comparison group surveys were conducted with the similar frequency.ResultsAfter training the cognitive processes in schizophrenia patients were obtained by increasing the tempo of the performance, improving concentration, improving the adequacy of long-term thinking and memory have been identified trend towards an increase in operational short-term memory.ConclusionThe neurocognitive training showed itself as an effective method of correcting neurocognitive deficits. Inclusion of these trainings in the rehabilitation program helps to reduce the term of the patients stay in hospital and rapid integration into society.

Do Dropouts Benefit from Training Programs? Korean Evidence Employing Methods for Continuous Treatments

Failure of participants to complete training programs is pervasive in existing active labor market programs both in developed and developing countries. The proportion of dropouts in prototypical programs ranges from 10 to 50 percent of all participants. From a policy perspective, it is of interest to know if dropouts benefit from the time they spend in training since these programs require considerable resources. We shed light on this issue by estimating the average employment effects of different lengths of exposure to a program by dropouts in a Korean job training program. To do this, we employ parametric and semiparametric methods to estimate effects from continuous treatments using the generalized propensity score, under the assumption that selection into different lengths of exposure is based on a rich set of observed covariates. We find that participants who drop out later – thereby having longer exposures – exhibit higher employment probabilities one year after receiving training, and that marginal effects of additional exposure to training are initially fairly small, but increase sharply past a certain threshold of exposure. One implication of these results is that this and similar programs could benefit from providing incentives for participants to stay longer in the program.