Component Of Training Research Articles

INDIVIDUAL STRENGTH CHANGES FOLLOWING A VERY BRIEF INTERVENTION ON NATIONAL STRENGTH TRAINING GUIDELINES IN ADULTS AGED 50 - 75 YEARS

BACKGROUND There is little evidence that the public or healthcare practitioners are aware of and implementing the strength training component of the United Kingdom’s (UK) Chief Medical Officers’ physical activity guidelines in practice. Our study aimed to objectively measure strength following a very brief intervention with the strength component to determine if this practice could increase muscle strength. METHODS This was a mixed method, one-arm, pre-post six-month study. Thirty adults aged 50-75 years had hand grip (upper) isometric strength and ankle plantarflexion (lower) isometric strength measured. The average of two trials on the dominant limb were recorded. Participants were provided a physical copy of the guidelines and were asked to follow the strength recommendations. The very brief intervention (five minutes) included information on why and how to follow the strength guidelines, example exercises, along with a proven behaviour change technique (providing a journal to record training sessions). Strength was tested after six-months. RESULTS The group average indicated that there was no change in upper or lower body strength from baseline. However, when data were viewed individually, upper body strength was gained in 21 of 30 participants and lost in 9 (range: -4.5 to +6 kg). 42% of participants gained more than 2 kg in hand strength after six-months. Lower body strength was gained in 15 participants and lost in 15 (range: -12.4 to +8.65 kg). 43% of participants lost more than 2 kg. Qualitatively participants took the opportunity to ‘procure some new weights’ as they found their weights at home ‘too easy.’ Participants had a new-found realisation that ‘strength training is vital to muscle strength.’ Some mentioned that ‘strength training is now part of my life.’ On the other hand, other participants wanted more, noting that ‘there should be more publicity, information about [strength training] to the general public’ and found it unnecessarily ‘hard to find [follow up information] online.’ CONCLUSIONS In the movement to make ‘every contact count,’ a very brief intervention has been shown to raise awareness and change strength training behaviour. Healthcare practitioners should focus on lower body exercise examples alongside progression techniques to avoid rapid loss in lower body strength. Public health stakeholders need to work together to provide easily accessible strength training resources.

How sport specialization age and training components influence the achievements of elite athletes

Early specialization in sports for young elite athletes was undertaken for a variety of positive reasons, but it also can lead to increased vulnerability to injury, burnout, limited skill development, and negative effects on mental well-being as a result of intense training from a young age. The purpose of this study was to determine the relationship between age of sport specialization and training components to the achievements. This was a correlational survey and a cross-sectional approach to elite athletes in the city of Bandung. The sample for this study consisted of 84 high-level athletes who competed in 27 different sports and were eligible for athlete incentives from the government. Athletes were surveyed using a questionnaire to answer questions about their debut age, training frequency, duration, intensity, and highest championship achievement. The results of bivariate analysis showed that age, gender, age of specialization, duration of exercise, and intensity of exercise were not related to sports achievement. Based on the results of statistical analysis, it was known that the frequency of exercise was significantly correlated with sports achievement. Compared to athletes who train less than five times per week, athletes who train more than five times per week were found to have higher performance. Future possible research will assist in identifying the success factors of young athletes who begin sports specialisation at a young age.

Digital literacy within Master of Pharmacy curricula in the United Kingdom: a mixed-method study

Abstract Introduction As digital health technologies (DHTs) like electronic health records (EHRs), computerised clinical decision support (CCDS), and telehealth become integral to healthcare delivery, there is an increasing demand for digitally literate healthcare professionals, including pharmacists. The General Pharmaceutical Council (GPhC) has emphasised digital competencies in the United Kingdom’s (UK’s) Master of Pharmacy (MPharm) curriculum. The Health Education England (HEE) and the Topol review further emphasises this point, indicating the pressing need for a digitally ready healthcare workforce.[1,2] However, despite these efforts, evidence suggests that digital literacy remains underrepresented in undergraduate pharmacy training. Aim To explore the current and planned inclusion of digital literacy education in the MPharm curricula of UK pharmacy schools. Methods A two-phase study was conducted. Phase 1: we undertook a content analysis of curricula from all GPhC-accredited UK pharmacy schools (n=30) in April 2022. Curriculum materials were procured either directly from schools’ websites or via formal correspondence. The analytical approach was based on a preceding systematic scoping review and further refined through an inductive open coding methodology. Phase 2: a structured 14-item quantitative survey, informed by the HEE Digital Capabilities Framework for the Pharmacy Workforce, was emailed to academic representatives across all UK pharmacy institutions, soliciting data on digital literacy, pedagogical methodologies, and envisaged curriculum trajectories. Results Documents for the content analysis were obtained from 46.7% (14/30) of the UK pharmacy schools. Of these, 71.4% (10/14) included components of digital literacy education or training. We identified themes relating to digital literacy education including: the theoretical understanding of health informatics, applied informatics, information technology skills and the newly emerging field of DHTs including artificial intelligence, pharmacogenomics, and personalised therapies. A total of 53.3% (16/30) schools responded to the survey. Most schools who participated in the survey stated that they had integrated digital literacy into their curricula, with only one exception; alignment with the HEE framework varied. Digital literacy was typically integrated within other teaching sessions, taught through self-learning using online resources (66.7%; 12/18). EHRs and remote counselling were primary focus areas (94.4%; 17/18). Challenges in digital literacy education include expertise shortage (68.4%; 13/19), insufficient support from pharmacy organisations (68.4%; 13/19), and limited time (52.6%; 10/19). Conclusion Although the review of the MPharm curricula revealed evidence of UK pharmacy schools incorporating digital literacy, we identified gaps in training and education relating to the variability in topics across schools, misalignment with the HEE framework, and educators’ concerns about the adequacy of current digital literacy provisions. It is important to acknowledge that our study’s low response rate might introduce sample bias, including schools more proactive in teaching digital literacy, and may not be representative of the broader educational context. The observed gaps underscore the need for collaboration with professional bodies and industry experts to enhance training with the aim of ensuring that future pharmacists are prepared and competent to practice in the digital age.

Leadership development in genetic counseling graduate programs.

Leadership is emerging as an important component of health professional training. This study aimed to characterize current leadership development in accredited genetic counseling programs. Semi-structured interviews with program leadership were conducted to explore their program's leadership curricula and their perspectives on the meaning of leadership and its place in genetic counseling training. Eleven interviews were conducted and focused on seven categories related to study goals. Using the Framework Method, themes were generated within the predefined categories. Categories and themes included Defining Leadership (Positional vs Non-positional, Beliefs about Leadership, Role of Leadership in the Field of Genetic Counseling), Leadership Curricula Origin and Delivery (Course-based and Longitudinal, Explicit vs. Implicit, Origin of Material), Role of Faculty and Students (Role of Faculty, Expectations for Students and Qualities of Students), Skills, Evaluation, Priority (Potential for Improvement, Barriers and Facilitators), and Standards (Current Incorporation, Potential Incorporation). All programs had some form of leadership development, but many participants lacked a personal or program definition of leadership. Leadership development varied in curricula and delivery, but most were longitudinal and faculty-driven, with communication, teaching, advocacy, and collaboration as commonly taught skills. However, leadership development opportunities were rarely labeled as such, and participants identified labeling current leadership development as the top area for improvement. Labeling leadership development could improve assessment of current efforts and the ability to address gaps in leadership curricula. This would lay the foundation for necessary intentional leadership development, in turn helping us better advocate for our patients and the profession.

Fostering Empathy: Nurturing Compassionate Healers through Innovative Teaching and Insightful Assessment in Medical Education

Abstract: The significance of empathy in the realm of medical education cannot be undermined, as once a student embarks on their journey to serve and heal mankind, cultivating empathetic skills becomes an indispensable part of their training. Empathy plays a significant role in healthcare delivery in the domains of patient outcomes and doctor-patient relationships. This article provides a brief review of empathy education and assessment techniques in the field of medicine. Upon realizing the merits that can be attributed to empathy, it is of paramount importance that medical students must be trained in empathy to transform them into patient-centered healthcare professionals. Only training medical students in empathy will not serve the purpose, and we must complement the training component with assessment. In conclusion, empathy is one of the key components of compassionate and patient-centered medical care. This calls for the need to train and assess medical students during their training period to improve their empathetic abilities and support the process of producing competent and compassionate future medical doctors.

Comparative analysis of indicators of physical fitness of freestyle wrestlers at the stage of initial training

The sufficient level of general physical fitness of freestyle wrestlers allows them to form the foundation of versatile and proportional development of the physiological systems and organs of children and adolescents. To properly build the educational and training process, it is necessary to regularly and timely control and analyze the general physical, special physical, and psychophysiological fitness of wrestlers. This requires improving the system of sports training in freestyle wrestling through scientific substantiation of more effective methods of improving the athlete's preparedness. Solving this problem is possible only after enriching existing and developing new training programs for wrestlers. The research and practical experience of leading specialists is aimed at modernizing and improving the training process of highly qualified athletes, while the problem of improving the physical and special training of athletes at the initial stages remains relevant today and requires in-depth study.
 The purpose of the study was to determine the indicators of general physical fitness of young wrestlers at the stage of initial training during training according to the generally accepted program and when the coach involves additional functional sets of exercises.
 The research was conducted among children 8-10 years old engaged in freestyle wrestling in groups of primary training: the I-group of children trained according to a standard generally accepted training program, the II-group athletes trained according to the coach’s author’s methodology, which included additional performance of functional sets of exercises for improvement of both general and special physical training using a large number of exercises, games and game tasks of varying coordination complexity.
 In the work, a comparative analysis of the indicators of physical fitness of young wrestlers of both groups of initial training, obtained as a result of control standards, was carried out. The nature of positive changes in these indicators during control tests among wrestlers of the II group was determined. According to the results of the experiment, it can be stated that the training effect should be aimed at improving all components of physical and technical training.

Competencies for proficiency in basic point-of-care ultrasound in anesthesiology: national expert recommendations using Delphi methodology.

Point-of-care ultrasound (POCUS) allows for rapid bedside assessment and guidance of patient care. Recently, POCUS was included as a mandatory component of Canadian anesthesiology training; however, there is no national consensus regarding the competencies to guide curriculum development. We therefore aimed to define national residency competencies for basic perioperative POCUS proficiency. We adopted a Delphi process to delineate relevant POCUS competencies whereby we circulated an online survey to academic anesthesiologists identified as POCUS leads/experts (n = 25) at all 17 Canadian anesthesiology residency programs. After reviewing a list of competencies derived from the Royal College of Physicians and Surgeons of Canada's National Curriculum, we asked participants to accept, refine, delete, or add competencies. Three rounds were completed between 2022 and 2023. We discarded items with < 50% agreement, revised those with 50-79% agreement based upon feedback provided, and maintained unrevised those items with ≥ 80% agreement. We initially identified and circulated (Round 1) 74 competencies across 19 clinical domains (e.g., basics of ultrasound [equipment, nomenclature, clinical governance, physics]; cardiac [left ventricle, right ventricle, valve assessment, pericardial effusion, intravascular volume status] and lung ultrasound anatomy, image acquisition, and image interpretation; and clinical applications [monitoring and serial assessments, persistent hypotension, respiratory distress, cardiac arrest]). After three Delphi rounds (and 100% response rate maintained), panellists ultimately agreed upon 75 competencies. Through national expert consensus, this study identified POCUS competencies suitable for curriculum development and assessment in perioperative anesthesiology. Next steps include designing and piloting a POCUS curriculum and assessment tool(s) based upon these nationally defined competencies.

A National 20-year Analysis of Weight Lifting-related Injuries and Fractures Among Adolescents.

Increasing strength through weightlifting has become a core component of competitive sports training, recreational exercise programs, and school physical education classes. Although many health benefits exist, there is concern for injury, especially with improper supervision and accelerated progression of training loads. Though organizations have advocated safe training practices, trends in the national health burden of injuries, specifically fractures, associated with weightlifting in the adolescent population have not been investigated. The National Electronic Injury Surveillance System database was queried between 2002 and 2021 for patients aged 11 to 21 years presenting to US Emergency Departments with weight lifting-related injuries. The narrative component of each case identified was analyzed to include only patients noted to be using weightlifting equipment or free weights at the time of injury. Estimates and analyses were performed with 95% CIs. Although there has been some variability in weight lifting-related injuries, the incidence remained roughly constant over the 20 years ( R2 =0.0364). 14,497 cases were identified, reflecting a national estimate of 540,986 total injuries and an annual estimate of 27,049 injuries. Most injuries occurred among 15-to-18-year olds (44.1%±1.6%) and 19-to-21-year olds (38.3%±2.0%). The most common injuries were sprain/strain (36.7%±1.3%), contusion/abrasion (15.7%±0.7%), and fracture (9.9%±0.3%). There were 53,813 estimated fractures, giving an annual incidence of 2,691 fractures. As a portion of all injuries, the number of fractures decreased significantly as patients got older, accounting for 26.8%±3.3% at age 11 and only 8.3%±0.9% at age 21 ( R2 =0.6626). Fingers (37.1%±1.8%) and toes (27.9%±1.4%) were the most fractured body parts. Overall, fractures mainly occurred either at school (25.3%±2.0%) or places of recreation (24.7%±2.2%). Despite the guidelines to improve safety, the national health burden of weight lifting-related injuries among adolescents has remained constant over the past 20 years. Given that most of the fractures occur in the distal extremities, such as toes and fingers, at school and places of recreation, there may be an opportunity to promote safer weightlifting practices and the development of weightlifting equipment with in-built safety mechanisms, especially at gyms and schools. Level III-prognostic.

Automated Sparse and Low-Rank Shallow Autoencoders for Recommendation

Collaborative filtering (CF) works have demonstrated the robust capabilities of Shallow Autoencoders on implicit feedback, showcasing highly competitive performance with other reasonable approaches (e.g., iALS and VAE-CF). However, despite their dual advantages of high performance and simple construction, EASE still exhibits several major shortcomings that must be addressed. To be more precise, the scalability of EASE is limited by the number of items, which determines the storage and inversion cost of a large dense matrix; the square-loss optimization objective does not consistently meet the recommendation task’s requirement for predicting personalized rankings, resulting in sub-optimal outcomes; the regularization coefficients are sensitive and require re-calibration with different datasets, leading to an exhaustive and time-consuming fine-tuning process. In order to address these obstacles, we propose a novel approach called Similarity-Structure Aware Shallow Autoencoder (AutoS 2 AE) that aims to enhance both recommendation accuracy and model efficiency. Our method introduces three similarity structures: Co-Occurrence, KNN, and NSW graphs, which replace the large dense matrix in EASE with a sparse structure, thus facilitating model compression. Additionally, we optimize the model by incorporating a low-rank training component into the matrix and applying a weighted square loss for improved ranking-oriented approximations. To automatically tune the hyperparameters, we further design two validation losses on the validation set for guidance and update the hyperparameters using the gradients of these validation losses. Both theoretical analyses regarding the introduction of similarity structures and empirical evaluations on multiple real-world datasets demonstrate the effectiveness of our proposed method, which significantly outperforms competing baselines.

Theory and practice for assessing structural integrity and dynamical integrity of high-speed trains

PurposeThe safety and reliability of high-speed trains rely on the structural integrity of their components and the dynamic performance of the entire vehicle system. This paper aims to define and substantiate the assessment of the structural integrity and dynamical integrity of high-speed trains in both theory and practice. The key principles and approaches will be proposed, and their applications to high-speed trains in China will be presented.Design/methodology/approachFirst, the structural integrity and dynamical integrity of high-speed trains are defined, and their relationship is introduced. Then, the principles for assessing the structural integrity of structural and dynamical components are presented and practical examples of gearboxes and dampers are provided. Finally, the principles and approaches for assessing the dynamical integrity of high-speed trains are presented and a novel operational assessment method is further presented.FindingsVehicle system dynamics is the core of the proposed framework that provides the loads and vibrations on train components and the dynamic performance of the entire vehicle system. For assessing the structural integrity of structural components, an open-loop analysis considering both normal and abnormal vehicle conditions is needed. For assessing the structural integrity of dynamical components, a closed-loop analysis involving the influence of wear and degradation on vehicle system dynamics is needed. The analysis of vehicle system dynamics should follow the principles of complete objects, conditions and indices. Numerical, experimental and operational approaches should be combined to achieve effective assessments.Originality/valueThe practical applications demonstrate that assessing the structural integrity and dynamical integrity of high-speed trains can support better control of critical defects, better lifespan management of train components and better maintenance decision-making for high-speed trains.

Improved metric-based meta learning with attention mechanism for few-shot cross-domain train bearing fault diagnosis

Traction motor bearings, as a crucial component of subway trains, play a pivotal role in ensuring the safety of train operations. Therefore, intelligent diagnosis of train bearings holds significant importance. However, due to the complex and dynamic nature of bearing conditions coupled with limited fault data availability, traditional diagnostic methods fail to yield satisfactory results. To address this issue, we propose an improved metrics-based meta-learning approach for accurate few-shot cross-domain fault diagnosis of train bearings. Firstly, we introduce a 1D-signal channel attention mechanism that effectively extracts latent features and enhances recognition accuracy. Secondly, by incorporating the Adabound algorithm into our model framework, we further enhance its classification performance. Finally, through several case studies, we demonstrate the effectiveness of our proposed method in comparison to other approaches within similar settings.

Disparities in Mentorship and Implications for US Surgical Resident Education and Wellness

Many surgeons cite mentorship as a critical component of training. However, little evidence exists regarding factors associated with mentorship and the influence of mentorship on trainee education or wellness. To evaluate factors associated with surgical trainees' perceptions of meaningful mentorship, assess associations of mentorship with resident education and wellness, and evaluate programmatic variation in mentorship. A voluntary, anonymous survey was administered to clinically active residents in all accredited US general surgery residency programs following the 2019 American Board of Surgery In-Service Training Examination. Data were analyzed from July 2019 to July 2022. Residents were asked, "Do you have a mentor who genuinely cares about you and your career?" Resident characteristics associated with report of meaningful mentorship were evaluated with multivariable logistic regression. Associations of mentorship with education (clinical and operative autonomy) and wellness (career satisfaction, burnout, thoughts of attrition, suicidality) were examined using cluster-adjusted multivariable logistic regression controlling for resident and program factors. Residents' race and ethnicity were self-identified using US census categories (American Indian or Alaska Native, Asian, Black or African American, Native Hawaiian or Other Pacific Islander, and White), which were combined and dichotomized as non-Hispanic White vs non-White or Hispanic. A total of 6956 residents from 301 programs completed the survey (85.6% response rate); 6373 responded to all relevant questions (2572 [40.3%] female; 2539 [39.8%] non-White or Hispanic). Of these, 4256 (66.8%) reported meaningful mentorship. Non-White or Hispanic residents were less likely than non-Hispanic White residents to report meaningful mentorship (odds ratio [OR], 0.81, 95% CI, 0.71-0.91). Senior residents (postgraduate year 4/5) were more likely to report meaningful mentorship than interns (OR, 3.06; 95% CI, 2.59-3.62). Residents with meaningful mentorship were more likely to endorse operative autonomy (OR, 3.87; 95% CI, 3.35-4.46) and less likely to report burnout (OR, 0.52; 95% CI, 0.46-0.58), thoughts of attrition (OR, 0.42; 95% CI, 0.36-0.50), and suicidality (OR, 0.47; 95% CI, 0.37-0.60) compared with residents without meaningful mentorship. One-third of trainees reported lack of meaningful mentorship, particularly non-White or Hispanic trainees. Although education and wellness are multifactorial issues, mentorship was associated with improvement; thus, efforts to facilitate mentorship are needed, especially for minoritized residents.

An appraisal of psychotherapy training during psychiatry residency program in India: A national survey.

The need for psychotherapy training (PT) has been recognized worldwide and is considered an integral component of postgraduate psychiatry training. Our study aims to assess the quality of PT received by psychiatrists during their postgraduate studies and its impact on their current practice. To evaluate the quality of PT and its effect on the current psychiatry practice. An anonymous web-based survey was conducted on registered psychiatrists practicing in India to evaluate the level and quality of PT received during their postgraduate studies. The survey indicates that PT was included in the postgraduate psychiatry curriculum (73.8%). However, more than 50% of responders reported no separate posting, evaluation, logbook, or guidelines related to PT. Most (95.4%) psychiatrists think their PT could have been better. PT was satisfying in medical colleges in terms of inclusion in the curriculum (7.70, P = .021), psychotherapy rotations (16.48, P = <0.001), supervision of sessions (14.80, P = 0.001), lectures on psychotherapy (10.13, P = 0.006), periodic psychotherapy meet/forum (19.35, P = <0.001), maintenance of psychotherapy logbook/records (7.65, P = 0.022), institutional or departmental guideline related to PT (20.55, P = <0.001), and overall quality of PT (22.05, P = .005 and 31.81, P = <.001). Time constraint is the most common (49.9%) barrier in delivering psychotherapy. PT is not well organized, consistent, and uniform in psychiatry training; there is a prevailing sense of inadequacy and dissatisfaction among the country's psychiatrists with a perceived need to improve and learn PT.

Practice makes perfect: The learner-doctor blueprint for proficient physicians.

In the process of producing competent and efficient medical graduates, clinical teaching is an integral component of undergraduate training. Even though clinical training has been linked with multiple benefits and plays a defining role in transforming a medical student into a competent doctor, it has some inherent challenges. The learner-doctor method emphasizes learning by doing and has the potential to counter the identified challenges in the traditional mode of clinical training. The learner-doctor method places emphasis on collaborative learning, wherein students learn by experiential learning and active participation in patient care. This method not only fosters the development of clinical skills but also cultivates critical thinking, teamwork, empathy, and effective communication. A number of activities or strategies must be planned and implemented to ensure that the set objectives of the learner-doctor method are accomplished by the medical institutions. In conclusion, as medical education continues to evolve, the learner-doctor method of clinical training is a dynamic approach to bridging the gap between theoretical knowledge and practical skills. As this method enables medical students to actively engage in patient care and improve their critical thinking, it becomes the need of the hour that every medical institution should explore the opportunity to effectively implement the same in their settings.

Clinical Research Primer for Medical Students: Overview and Illustrative Experiences

Abstract Background The ability to participate in clinical scholarship is a foundational component of modern evidence-based medical practice, empowering improvement across essentially every aspect of clinical care. In tandem, the need for comprehensive exposure to clinical research has been identified as a critical component of medical student training and preparation for residency that is underserved by traditional undergraduate medical education models. The goal of the current work was to provide guidelines and recommendations to assist novice medical students in taking ownership of their research education. Methods The Clinical Research Primer was composed from pooled research documents compiled by the study authors and our institutional neurosurgery student research group. The Primer was then structured as the natural evolution of a research project from its inception through the submission process. Results We divided the foundational components of the Clinical Research Primer into seven domains, each representing a landmark in the development of a peer-reviewed study, and a set of skills critical for junior scholars to develop. These vital components included the following: pitching and designing clinical studies, developing a research workflow, navigating the Institutional Review Board, data collection and analysis, manuscript writing and editing, submission mechanics, and tracking research projects for career development. Conclusion We anticipate that the tools included in the Clinical Research Primer will increase student research productivity and preparedness for residency. Although our recommendations are informed by our experiences within neurosurgery, they have been written in a manner that should generalize to almost any field of clinical study.

Maximize Workplace-Based Learning Through Application of Learning Theories

Workplace-based learning refers to a learning experience that enables medical students to acquire knowledge and skills via supervised application of their professional roles in authentic workplace settings. The learning triad in workplace learning comprises patients, medical students, and doctor–teacher. The success and effectiveness of workplace-based learning will eventually be determined by the kind of interaction and relationship between these stakeholders. There are three components of workplace learning, namely task, context, and learner. Learning theories occupy a special place in not only determining how people learn but also laying down the platform for medical educators to facilitate learning among medical students. To conclude, workplace-based learning is a crucial and indispensable component of medical undergraduate training. Acknowledging the merits of the same, it is crucial that it needs to be strengthened in each of the medical colleges. Further, awareness about learning theories and the application of the same for facilitating learning among medical students in workplace settings can prove to be instrumental, and thus medical educators should always work on the similar lines.

Creating a New Border Culture in the Midst of the Climate Crisis: Activism and Pedagogy Strategies for Teacher Preparation

This paper documents the efforts of an activist group that came to teach about activist efforts, climate change/climate justice/climate crisis issues, and to create leaders in one border community. The leaders of this three-day workshop are a part of an activist organization named SOMOS Sunrise, the Latine constituency of the Sunrise movement. In this paper, I will analyze the climate change workshop training days and components of the workshops. Secondly, this paper will document a climate cohort education group conducted with undergraduate students and pre-service teachers the following summer. This climate cohort helped articulate art activism and public speaking opportunities to advocate for change with the city council. The implications for teacher preparation programs and strategies to situate situate climate activism as a tool to reimagine border culture within the climate change/climate crisis will be discussed.

High-flow nasal cannula during pulmonary rehabilitation for people with chronic obstructive pulmonary disease: Asystematic review and meta-analysis.

Chronic obstructive pulmonary disease (COPD) is an increasingly concerning global public health issue due to its high burden of morbidity and mortality. Pulmonary rehabilitation (PR) is a comprehensive intervention to improve patients' physical and psychological conditions, commonly involving oxygen supplementation. The potential benefits of high-flow nasal cannula (HFNC) have recently sparked interest as oxygen therapy. In this context, this study aims to assess the effects of HFNC during the exercise training component of a PR program in people with COPD. Systematic review (CRD42022330929). We included randomised controlled trials (RCTs), including crossover RCTs with adults with stable COPD. We included trials using oxygen therapy with HFNC during the exercise training component of a PR programme. disease-specific health-related quality of life (HRQoL), exercise capacity (EC) and adverse events. treatment adherence, breathlessness and future exacerbations. We included five studies with 300 participants with moderate to severe COPD. The certainty of the evidence was primarily low or very low for all outcomes of interest due to risk of bias, inconsistency or imprecision. HFNC has little to no difference in HRQoL (4 studies, 129 participants, MD 0.17, 95% CI -1.20 to 1.54; I2 50%). HFNC may result in little to no difference in EC (3 studies, 212 participants, mean difference 18.73, 95% CI -20.49 to 28.94; I2 56%), and we are uncertain about the effect of HFNC on breathlessness (4 studies; 244 participants, MD of -0.07, 95% CI -0.4 to 0.26; I2 63%). Only one study with 44 participants reported a participant's withdrawal because of progressive dyspnoea during lower limb exercise. We are uncertain about the effect of HFNC during the exercise component of a PR programme in HRQoL, EC or dyspnoea compared to usual care or conventional supplementary oxygen. Non-domiciliary oxygen patients showed improvements in HRQoL, EC and dyspnoea.

Psychedelic-assisted Therapy Training: Firsthand Experience of Non-Ordinary States of Consciousness in the Development of Competence

Introduction This review explores the benefits of incorporating personal experience(s) with non-ordinary states of consciousness as a core component of Psychedelic-Assisted Therapy (PaT) training.The program incorporates an optional experiential training component. We collaborate with professionals affiliated with a Canadian non-profit organization specializing in PaT experiential training. As do other stakeholders in this field– including program developers, educators, and researchers–we navigate a rapidly evolving and often ambiguous landscape, where infrastructure and regulations are lagging scientific data and best practices. Given the potential for differing perspectives, the authors acknowledge that their personal experiences could be a potential source of bias, influencing objectivity.ObjectivesConversely, these lived experiences could be seen as valuable contributions, enriching perspectives on the role of experiential training. In that context, our intention is to provide a comprehensive review, presenting arguments both in favour of and against the integration of experiential training in PaT.MethodsThere is an urgent need for establishing legal training and practice options, bridging the underground with best practices, with all practitioners operating within a regulated and ethically accountable framework. Such a proactive strategy would mitigate the risks associated with unregulated training in a field with relatively few guidelines on how to develop competency.ResultsAn in-training PaT experience supports personal comfort, self-assuredness, and confidence supporting others in non-ordinary states of consciousness, with contemporary researchers/experts highlighting the specific challenges among therapists who lack lived experience. These might include holding unrealistic expectations, being unaware of the impacts of set and setting, and misunderstandingConclusions Whether or not therapists engage in experiential training - serving a dual in one’s own healing process, it is imperative that they maintain their own wellness practices. This proactive/primary prevention strategy would improve well-being and resilience, reducing secondary mental health consequences for patients and providers. Cultivating a culture of self-care within the mental health field should be an overarching priority for training programs and professional organizations, without which we are left with broken people in support of broken people. Current rates of burnout, absenteeism and early retirement suggest that we are already on that trajectory and should serve as a call to action.Disclosure of InterestNone Declared

Role Of Exercise Intensity in Skeletal Muscle Hypertrophy

Endurance training, a form of physical activity that relies on continuous aerobic exercise and repetitive muscle contractions, is widely acknowledged for its positive effects on overall physical fitness. Aerobic exercise, an essential component of endurance training, has numerous benefits including improved cardiovascular and respiratory health, increased muscle endurance, and enhanced resistance against fatigue. It has also been found to contribute to skeletal muscles, potentially by stimulating the synthesis of proteins involved in muscle fiber formation. Although resistance exercise has been favored for promoting muscle growth, some suggests that aerobic exercise can also produce skeletal muscle hypertrophy comparable to that of resistance exercise if performed correctly. The duration, intensity, and specific type of aerobic exercise play important roles in determining skeletal muscle mass. The mammalian target of rapamycin (mTOR) known as a key regulator of muscle protein synthesis that associated with exercise activity. Several signaling pathways, such as Akt/mTOR and MAPK, are involved in controlling muscle protein synthesis during exercise. This review aimed to understand the impact of aerobic exercise intensity and other training parameters on skeletal muscle, to provide valuable insights for optimizing exercise programs and fostering muscle hypertrophy. In this review, we had systematically searched PubMed and Google Scholar from January 2013 to May 2023. Our result indicated that aerobic exercise can be expected to promote skeletal muscle hypertrophy and improve muscle mass and function. The regulation of skeletal muscle mass is complex, involving various signaling pathways such as mTOR, as well as the influence of hormones and growth factors.