Longer Training Programs Research Articles

Epidemiology of musculoskeletal injury in military recruits: a systematic review and meta-analysis

BackgroundInjuries are a common occurrence in military recruit training, however due to differences in the capture of training exposure, injury incidence rates are rarely reported. Our aim was to determine the musculoskeletal injury epidemiology of military recruits, including a standardised injury incidence rate.MethodsEpidemiological systematic review following the PRISMA 2020 guidelines. Five online databases were searched from database inception to 5th May 2021. Prospective and retrospective studies that reported data on musculoskeletal injuries sustained by military recruits after the year 2000 were included. We reported on the frequency, prevalence and injury incidence rate. Incidence rate per 1000 training days (Exact 95% CI) was calculated using meta-analysis to allow comparisons between studies. Observed heterogeneity (e.g., training duration) precluded pooling of results across countries. The Joanna Briggs Institute Quality Assessment Checklist for Prevalence Studies assessed study quality.ResultsThis review identified 41 studies comprising 451,782 recruits. Most studies (n = 26; 63%) reported the number of injured recruits, and the majority of studies (n = 27; 66%) reported the number of injuries to recruits. The prevalence of recruits with medical attention injuries or time-loss injuries was 22.8% and 31.4%, respectively. Meta-analysis revealed the injury incidence rate for recruits with a medical attention injury may be as high as 19.52 injuries per 1000 training days; and time-loss injury may be as high as 3.97 injuries per 1000 training days. Longer recruit training programs were associated with a reduced injury incidence rate (p = 0.003). The overall certainty of the evidence was low per a modified GRADE approach.ConclusionThis systematic review with meta-analysis highlights a high musculoskeletal injury prevalence and injury incidence rate within military recruits undergoing basic training with minimal improvement observed over the past 20 years. Longer training program, which may decrease the degree of overload experienced by recruit, may reduce injury incidence rates. Unfortunately, reporting standards and reporting consistency remain a barrier to generalisability.Trial registrationPROSPERO (Registration number: CRD42021251080).

Creating an evidence-based pediatric urology advanced practice provider orientation program

The authors sought to understand the background and training of pediatric urology advanced practice providers (APP) to create an orientation program that improves APP preparation for subspecialization in pediatric urology. Obtaining these data will allow for the development of an evidence-based approach to educating the new pediatric urology APP at a national level. An anonymous survey was sent to the 331 members of the Pediatric Urology Nurses & Specialists (PUNS) professional organization to assess the qualities of orientation and training at institutions across the nation. Descriptive statistics were used to characterize the results of the survey for this group of participants. A total of 49 participants (15% response rate) participated in this survey. Most participants reported completion of a one to three-month orientation program (57.2%) that was moderately structured (57.1%). The overall mean self-rating of preparedness was 6.2 out of 10 at the conclusion of their training. However, this rating varied between participants who had training programs under and over three months duration (p < .001). Most respondents felt that they were not optimally prepared to enter the field. The survey results show that longer training programs (at least three months) lead to higher levels of self-assuredness. The pediatric urology APP orientation program at the authors' institution will be adjusted to meet the concerns of the survey participants to ensure a more equipped team of advanced practice providers. The authors hope that this will serve as a guideline for institutions across the country to train pediatric urology APPs.

BOSU, KANGOO JUMP, NINTENDO-Wii BALANCE BOARD ANTRENMANLARININ İŞİTME ENGELLİ SEDANTERLERDE ÇEVİKLİK ÜZERİNE ETKİSİ

In this study, it was aimed to determine the effect of different balance training on the agility variables of hearing impaired female sedentaries. 51 hearing impaired female students between the ages of 14-22 were included. We have created training groups who hearing impairment close to each others. Nintendo-wii, (n=13), Bosu (n=13), Kangoo Jumps (n=15) and control group (n=10). The training groups received 60 minutes of training for 2 days a week for 8 weeks. The control group, on the other hand, continued its daily education programs by not participating in any activities. Hexagonal Obstacle Test ’was used to measure agility score. Arithmetic mean and standard deviation values were determined in order to define the age, height, weight and hearing impairment levels of the participants. Kruskal-Wallis test was used to examine whether there was a significant difference between the pre-test measurements of the groups, and Wilcoxon signed rank test was used to observe the change between pre-test and post-test measurements. The dynamic balance pre-test and post-test values of all groups were compared by means of two-way analysis of variance for repeated measures. End of the 8-week training programs, the agility scores of the Nintendo-Wii, Kangoo Jumps and Bosu groups were found to be significantly different in favor of the post-test between the pre-test and post-test mean scores. To conclude effect size we used Eta square test. As a result of this, training with the Bosu ball was found to improve agility values, but not as much effect size as Nintendo and Kangoo Jump shoes. We recommend the use of these equipment that improve agility skills in individuals with hearing impairment, but it is thought that better results will be obtained if longer training programs are implemented.

Changes in Lymphocyte Composition and Functionality After Intensive Training and Exhausting Exercise in Rats.

Exhausting exercise can have a deleterious effect on the immune system. Nevertheless, the impact of exercise intensity on lymphocyte composition and functionality remains uncertain. The aim of this study was to establish the influence of intensive training on lymphoid tissues (blood, thymus, and spleen) in Wistar rats. Two intensive training programs were performed: a short program, running twice a day for 2 weeks and ending with a final exhaustion test (S-TE group), and a longer program, including two exhaustion tests plus three runs per week for 5 weeks. After this last training program, samples were obtained 24 h after a regular training session (T group), immediately after an additional exhaustion test (TE group) and 24 h later (TE24 group). The composition of lymphocytes in the blood, thymus, and spleen, the function of spleen cells and serum immunoglobulins were determined. In the blood, only the TE group modified lymphocyte proportions. Mature thymocytes’ proportions decreased in tissues obtained just after exhaustion. There was a lower percentage of spleen NK and NKT cells after the longer training program. In these rats, the T group showed a reduced lymphoproliferative activity, but it was enhanced immediately after the final exhaustion. Cytokine secretion was modified after the longer training (T group), which decreased IFN-γ and IL-10 secretion but increased that of IL-6. Higher serum IgG concentrations after the longer training program were detected. In conclusion, the intensive training for 5 weeks changed the lymphocyte distribution among primary and secondary lymphoid tissues and modified their function.

The effect of monetary compensation on cognitive training outcomes

Recent work has established the possibility that messaging and incentive during recruitment may influence the outcome of cognitive training. These factors may impact intrinsic and extrinsic motivation to complete a training intervention, and one provocative single session study suggests that recruitment messaging may be responsible for an expectancy effect in certain training experiments. To examine the effects of payment and payment messaging during recruitment on a longer training program, participants were recruited to complete a twenty-session working memory regimen with or without payment, and with messaging that either emphasized payment or improving cognition. Significant group differences were observed at baseline; unpaid participants reported a significantly higher number of cognitive failures compared to compensated participants. However, both paid and unpaid training groups improved on transfer measures compared to an active control group, and payment had no effect on transfer. An additional post-test survey within the compensated group revealed different motivational orientations that were associated with significant performance differences on the visuospatial reasoning factor at baseline. While these differences in motivation were not predictive of transfer or training gain, it is possible that other elements of the study, including researcher involvement, may also play a role in determining the extent to which participants demonstrate transfer on untrained tasks. We conclude that while payment and recruitment messaging may affect training and transfer performance to some degree, a variety of additional factors likely contribute to the outcome of any individual study and the influence of certain factors may matter less during a longer-term program.

Improving emergency preparedness system readiness through simulation and interprofessional education.

We applied emerging evidence in simulation science to create a curriculum in emergency response for health science students and professionals. Our research project was designed to (1) test the effectiveness of specific immersive simulations, (2) create reliable assessment tools for emergency response and team communication skills, and (3) assess participants' retention and transfer of skills over time. We collected both quantitative and qualitative data about individual and team knowledge, skills, and attitudes. Content experts designed and pilot-tested scaled quantitative tools. Qualitative evaluations administered immediately after simulations and longitudinal surveys administered 6-12 months later measured student participants' individual perceptions of their confidence, readiness for emergency response, and transfer of skills to their day-to-day experience. Results from 312 participants enrolled in nine workshops during a 24-month period indicated that the 10-hour curriculum is efficient (compared with larger-scale or longer training programs) and effective in improving skills. The curriculum may be useful for public health practitioners interested in addressing public health emergency preparedness competencies and Institute of Medicine research priority areas.

Do Firms Benefit from Active Labour Market Policies?

This paper investigates the link between variation in the supply of workers who participate in specific types of active labour market policies (ALMPs) and firm performance using a new exceptionally informative German employer-employee data base. For identification we exploit that German local employment agencies (LEAs) have a high degree of autonomy in determining their own mix of ALMPs and that firms' hiring regions overlap only imperfectly with the areas of responsibility of the LEAs. Our results indicate that in general firms do not benefit from ALMPs and in some cases may even be harmed by certain programs, in particular by subsidized employment and longer training programs. These findings complement the negative assessment of the cost-effectiveness of ALMPs from the empirical literature on the effects for participants.

Déjà Vu? Short-term training in Germany 1980–1992 and 2000–2003

Short–term training has recently become the largest active labor market program in Germany regarding the number of participants. Little is known on the effectiveness of different types of short–term training and on their long–run effects. This paper estimates the effects of short–term training programs in West Germany starting in the time period 1980 to 1992 and 2000 to 2003 regarding the two outcomes employment and participation in longer training programs. We find that short–term training shows mostly persistently positive and often significant employment effects. Short–term training focusing on testing and monitoring search effort shows slightly smaller effects compared to the pure training variant. The lock–in periods lasted longer in the 1980s and 1990s compared to the early 2000s. Short–term training results in higher future participation in longer training programs and this effect was much stronger for the earlier time period.

Deja Vu? Short-Term Training in Germany 1980-1992 and 2000-2003

Short-term training has recently become the largest active labor market program in Germany regarding the number of participants. Little is known on the effectiveness of different types of short-term training and on their long-run effects. This paper estimates the effects of short-term training programs in West Germany starting in the time period 1980 to 1992 and 2000 to 2003 regarding the two outcomes employment and participation in longer training programs. We find that short-term training shows mostly persistently positive and often significant employment effects. Short-term training focusing on testing and monitoring search effort shows slightly smaller effects compared to the pure training variant. The lock-in periods lasted longer in the 1980s and 1990s compared to the early 2000s. Short-term training results in higher future participation in longer training programs and this effect was much stronger for the earlier time period.

Evaluating Continuous Training Programs Using the Generalized Propensity Score

This paper assesses the dynamics of treatment effects arising from variation in the duration of training. We use German administrative data that have the extraordinary feature that the amount of treatment varies continuously from 10 days to 395 days (i.e. 13 months).This feature allows us to estimate a continuous dose-response function that relates each value of the dose, i.e. days of training, to the individual post-treatment employment probability (the response). The dose-response function is estimated after adjusting for covariate imbalance using the generalized propensity score, a recently developed method for covariate adjustment under continuous treatment regimes. Our data have the advantage that we can consider both the actual and planned training durations as treatment variables: If only actual durations are observed, treatment effect estimates may be biased because of endogenous exits. Our results indicate an increasing dose-response function for treatments of up to 100 days, which then flattens out. That is, longer training programs do not seem to add an additional treatment effect.

Evaluating Continuous Training Programs Using the Generalized Propensity Score

This paper assesses the dynamics of treatment effects arising from variation in the duration of training. We use German administrative data that have the extraordinary feature that the amount of treatment varies continuously from 10 days to 395 days (i.e. 13 months).This feature allows us to estimate a continuous dose-response function that relates each value of the dose, i.e. days of training, to the individual post-treatment employment probability (the response). The dose-response function is estimated after adjusting for covariate imbalance using the generalized propensity score, a recently developed method for covariate adjustment under continuous treatment regimes. Our data have the advantage that we can consider both the actual and planned training durations as treatment variables: If only actual durations are observed, treatment effect estimates may be biased because of endogenous exits. Our results indicate an increasing dose-response function for treatments of up to 100 days, which then flattens out. That is, longer training programs do not seem to add an additional treatment effect.

Improving exercise capacity, 6 wk training tends to reduce circulating endothelin after heart transplantation

Short-term survival is no longer the pivotal issue after heart transplantation but, most heart-transplant (Htx) patients still present with increased circulating endothelin-1 (ET) and reduced exercise capacity. ET-1 limits both exercise-induced vasodilation and blood flow redistribution toward acting muscles and might be accessible to training. This study was performed to investigate the effect of training on ET-1 and whether an eventual training-induced improvement in exercise capacity may be related to reduced baseline or exercise circulating ET-1 in Htx patients. Five Htx patients performed a maximal bicycle exercise test and an endurance exercise test before and after a training program of 18 exercises sessions during 6 wk. ET-1 was determined by radioimmunoassay at rest, end endurance exercise and 30 min recovery, before and after training. Training improved significantly Htx's maximal oxygen uptake (+13.1 +/- 4.8%; p < 0.05) and also reduced significantly the endurance exercise-induced heart rate increase. Resting ET-1 was increased in Htx (5.98 +/- 1.88 vs. 1.61 +/- 0.25 pmol/L in controls; p < 0.01) but although ET-1 modulation might participate in training-induced beneficial effects, training failed to modulate either resting or exercise ET-1 plasma level. Training-induced improvement in exercise capacity might not mainly due to decreased ET-1 after heart transplantation. Further supporting the usefulness of training, these preliminary data suggest that improved exercise capacity may not be mainly due to decreased ET-1 in Htx patients. Further, larger scale studies will be needed to investigate whether an impaired nitric oxide pathway stimulation might explain such results and whether a longer training program can reduce local ET-1, arising from working muscles after heart transplantation.

Attitudes among Department of Veterans Affairs pharmacists toward postgraduate education and training

The results of a survey of the attitudes of Department of Veterans Affairs (VA) pharmacists toward postgraduate education and training are reported. In January 1990 an anonymous questionnaire was mailed to 800 randomly selected VA pharmacists. The mailing occurred one month after the announcement of new policies for recruiting and retaining VA pharmacists that allow salaries to be determined on the basis of education, job responsibilities, publishing, and other professional activities and accomplishments. Recipients were asked to provide educational and demographic data, information on their work settings and job responsibilities, and their perceptions of the benefits of and barriers to additional education and training. Of the 800 questionnaires mailed, 310 (38.8%) usable responses were received. The majority (77%) of the pharmacists held B.S. degrees only. One-day to one-week training programs had been attended by 74.5% of the respondents; at least 61.6% desired to attend such programs, and many indicated the desire to attend longer training programs. Some 48.3% of the B.S.-level pharmacists had expressed an interest in earning another pharmacy-related degree. More than 40% of the respondents saw time, money, and the location of programs as barriers. Perceived benefits included personal development, enhanced job satisfaction, and improved patient care; only 1.9% perceived no benefit. Seventy-seven percent believed that salary should reflect the level of professional training. VA pharmacists desire additional education and training and believe that such programs may enhance patient care and reduce staff turnover.

Effect of training on cardiovascular response to exercise in women.

Seventeen women (mean age 31 yr) participated in a training program divided into an initial 9-wk period and a subsequent 52-wk period, during which time 6 continued to exercise and the remainder detrained. Improvements in VO2max were significant (+34%) during the initial 9 wk and small (+5%) for the final 52 wk. Four women who stopped training showed a decrease in VO2max (-10%) during the last phase. During the initial 9 wk, central adaptation was important, with SV showing an increase of 28% at 80% VO2max. Peripheral adaptation (a-v O2 difference) was unchanged. Subjects who trained an additional 52 wk showed a slight drop in SV at submaximal work loads from the initial increase following the first 9 wk. When compared with the initial test the change at 9 wk in peripheral adaptation was a small and nonsignificant rise, followed by a significant increase at 61 wk. Women who are very unfit initially (predicted VO2max of 28 ml/kg-min), apparently adapt to the initial training with a central change followed by a much stronger peripheral adaptation during a longer training program.