Post-training Phase Research Articles

Effects of brisk walking with or without music on body composition, standing balance, cardiovascular parameters, and salivary biomarkers in older women.

This study aimed to assess and compare changes in body composition, standing balance, cardiovascular parameters, and salivary biomarkers, particularly salivary antioxidant status, after brisk walking training with or without music in older women. Twenty-four subjects were randomly assigned to brisk walking groups: with music (BWM) (n=12) or without music (BW) (n=12). Eighteen subjects completed the exercise training (9 in each group), and their data were used for analysis. The research protocols were classified into three phases: pretraining phase, training phase, and posttraining phase, while the data collection was divided into four sessions: resting condition, during treadmill exercise testing, immediately posttreadmill exercise testing, and 5-min posttreadmill exercise testing defined as after the cool-down session. The results showed that 8 weeks of home-based brisk walking with or without music did not improve standing balance, blood pressure, salivary biomarkers including total protein concentration, and antioxidant status but maintained or prevented the decline of these parameters. Only the BWM group reduced fat mass relative to increasing fat-free mass (P<0.05) and improved recovery heart rate (P<0.05) by modifying cardiac autonomic control in posttreadmill exercise testing. Therefore, brisk walking with preferred music can be a tool to delay the progression of cardiovascular dysfunction in older women. A longer duration of the exercise program and larger groups of participants are needed for further investigation of brisk walking with or without music on physiological and biochemical changes.

Experiences of Private Sector Employees on Transfer of Soft Skills Trainings

The issue of low training transfer remains prevalent despite private organizations' efforts in conducting soft skills training programs for its employees. Varying experiences of training transfer process are also reported. In this context, the purpose of this study aimed to explore the experiences of participants of private organizations of Nepal during soft skills training (reaction level), and their experiences while applying the knowledge and skills back to their workplace. The research design was qualitative and a total of 34 employees from four private companies of Nepal participated in this study who had attended a soft-skills training. Data was collected using five focus group discussions (FGDs) and thematic analysis used in which three overarching themes were generated with 25 categories and 210 codes. The study found that the participants had perceived soft skill training as the means for refreshments and socialization. In the post-training phase, they experienced changes in their mindset and improvement in interpersonal relationship with others in their workplace. Besides, irrespective of whether they participated in indoor or outdoor based programs, the duration and content of the program and their perspective towards whether they took it as an actual training or just a means of refreshment also affected their training transfer intentions. They experienced that for training transfer to occur, their own willingness to transfer guided by training content’s job relevance, micro-sessions based training designs, and importantly the post training interventions and support from employers or HR/line managers were necessary. Practical and research implications have been discussed in the paper.

Medical Device-Related Pressure Injury Care and Prevention Training Program (DevICeU): Effects on intensive care nurses' knowledge, prevention performance and point prevalence

ObjectiveTo determine the effect of the training given to intensive care unit (ICU) nurses to prevent medical device-related pressure injuries (MDRPIs) on nurses' knowledge levels, their prevention performance, and the point prevalence (PP) of MDRPIs. Research Methodology/DesignA pre-post test intervention study without a control group. SettingThe study was conducted between May and July 2023 with ICU nurses in three phases: pre-training phase (E0) (104 nurses, 116 patients), training implementation phase (E) and post-training phase (E1) (89 nurses, 120 patients). Main Outcome MeasuresThe data were collected by using the Patient (E0, E1) and Nurse (E0) Characteristic Forms, MDRPI Follow-up and Prevalence Form (E0, E1), D.E.V.I.C.E Performance Observation Checklist (E0, E1), MDRPI Knowledge Assessment Questionnaire (E0, E1), Braden Pressure Ulcer Risk Assessment Scale (E0, E1), Pressure Injury Grading Form (E0, E1), and Feedback Form about the Training Process (E). ResultsThe mean MDRPI knowledge score of the nurses increased significantly from E0 to E1 (13.23 ± 1.43 vs. 20.02 ± 1.30, p = 0.001), with the highest improvement in the staging and prevention themes. Nurses’ MDRPI prevention performance increased significantly from E0 to E1 (2.15 ± 1.01 vs. 11.17 ± 1.65, p = 0.001). There was a significant difference between the PP rate at E0 (61.2 %) and E1 (27.5 %) (p = 0.001). ConclusionThe study indicated that the training on MDRPIs given to ICU nurses increased their knowledge and prevention performance and decreased the prevalence of MDRPIs. However, further studies with a larger sample size are needed to confirm these findings. Implications for clinical practiceSince MDRPIs have more complex staging and prevention practices than conventional PIs, they require the adoption of a training approach that includes visual materials and practical methods in addition to theoretical knowledge. Accurate definitions of medical device dimensions and fixation, skin assessment, and prevention practices will lead to the desired outcome of reducing MDRPIs in ICUs.

Investigating Whether the Mass of a Tool Replica Influences Virtual Training Learning Outcomes.

Virtual Reality (VR) has emerged as a promising solution to address the pressing concern of transferring know-how in the manufacturing industry. Making an immersive training experience often involves designing an instrumented replica of a tool whose use is to be learned through virtual training. The process of making a replica can alter its mass, making it different from that of the original tool. As far as we know, the influence of this difference on learning outcomes has never been evaluated. To investigate this subject, an immersive training experience was designed with pre and post-training phases under real conditions, dedicated to learning the use of a rotary tool. 80 participants took part in this study, split into three groups: a control group performing the virtual training using a replica with the same mass as the original tool ($\mathrm{m}=100\%$), a second group that used a replica with a lighter mass than the original tool ($\mathrm{m}= 50\%$) and a third group using a replica heavier than the original tool ($\mathrm{m}=150\%$). Despite variations in the mass of the replica used for training, this study revealed that the learning outcomes remained comparable across all groups, while also demonstrating significant enhancements in certain performance measures, including task completion time. Overall, these findings provide useful insights regarding the design of tool replicas for immersive training.

Effect of in-hospital training on medical errors made by teams during neonatal resuscitation.

Neonatal resuscitation is one of the most critical and risky events that requires a high level of individual skill and team performance. To evaluate the effect of training of resuscitation teams on the frequency and type of medical errors (ME) that result from neonatal resuscitation. A prospective observational study was performed using a checklist to detect ME related to neonatal resuscitation. The rate of ME was 24.82%. There was a significant reduction in the percentage of errors from 17.28% in pre- pre-training phase to 7.54% in post post-training phase. Near miss MEs (98.77%) were significantly higher than adverse events. The active errors were significantly higher than latent errors, P <0.001, and decreased from 39.19% during pre-training to 19.64% in the post-training phase. The commission ME s were significantly higher than the omission, P <0.001. The latent errors percentage was 41.17% of the total errors and were not significantly reduced after training. Training sessions reduced ME that occurred during resuscitation, however careful distinguishing and recognizing the type of MEs is important to plan for further reduction of errors. Special attention to latent errors is imperative as it needs a specific approach rather than just training.

The Effect of Simulation Training on Enhancing Nursing Students' Perceptions to Incorporate Patients' Families Into Treatment Plans: A Randomized Experimental Study.

As clinical placement in bachelor's nursing programs becomes increasingly difficult, simulation is becoming increasingly common to enhance learning. Blended learning incorporating simulation videos provides students with the opportunity to observe and learn from exemplary practices while bridging the gap between theoretical knowledge and its practical application. This study aimed to investigate the effect of simulation training on enhancing nursing students' perception of integrating patient's families' assessments into their treatment plan. A quantitative, experimental research design was used, with a control (56) and intervention group (67) from levels 7 and 8 senior nursing students at King Saud Bin Abdulaziz University for Health Sciences, College of Nursing, Jeddah, assigned randomly to each group. The tool consists of three sections: personal information, a Van Gelderen family rubric, and a role-play survey. The validity and reliability of the tools were confirmed by the original developer. In the current study, the reported Cronbach's alpha was 95%. A total of 123 studentsparticipated in the study. Their ages ranged between 19 and 23 yearsand 23 years and above, with a mean age of 21.3 ± 1.3 among the control group and 22.2 ± 1.1 among the experimental group. There was an improvement in the mean scores in the post-training phase compared to the pre-training phase in the experimental group, with a statistically significant difference at p < 0.05. However, there were no significant differences noted between the control and experimental groups in the pre-training phase compared to the statistically significant difference noted between the two groups in the post-training phase. The findings of the study indicated that the utilization of scenario-based standardized patient-simulated exercises, guided by dedicated faculty and accompanied by reflective debriefing exercises, proved to be an effective approach for bridging the gap between theoretical knowledge and its application in clinical practice. Therefore, the study prompts curriculum revisions to incorporate family assessment into nursing practices, as well as evidence-based strategies, such as learning activities that use standardized patient or high-fidelity simulation technology to address and possibly reduce the theory-practice gap for graduates when entering clinical practice.

The Effect of Guild Training Courses on the Health Knowledge and Performance of Operators of Food Preparation and Distribution Centers in Zarand in 2021

Background: The present study aimed to investigate the effect of guild training courses on the health knowledge and performance of food operators in food preparation and distribution centers in Zarand, Kerman, Iran in 2021. Methods: This quasi-experimental (uncontrolled) study was conducted on 120 food operators in food preparation and distribution centers in Zarand. The data were collected using the Health Knowledge and Performance Questionnaire. The questionnaire was completed at the time of enrollment and in the final evaluation phase. The food operators’ performance was evaluated two weeks before and one month after the completion of the training course in the food operators’ workplace through questions and checklists. The knowledge and performance scores for the participants ranged from 0 to 100. The collected data were analyzed with SPSS-23 software using paired and independent samples t tests, analysis of variance (ANOVA), and Pearson correlation test. Results: The participants’ mean age was 36.73±8.92 years. The mean scores of health knowledge were 65.70±21.60 and 89.62±12.12 before and after the training course, respectively, showing a statistically significant increase in the post-training phase (P&lt;0.001). Moreover, the mean scores of health performance were 78.70±7.50 and 82.42±6.65 before and after the training course, respectively, indicating a statistically significant increase in the participants’ health performance in the post-training phase (P&lt;0.001). Conclusion: The findings revealed that guild training courses are effective in improving the health knowledge and performance of food operators in food preparation and distribution centers. Thus, the potential of guild training courses can be used to raise food operators’ and workers’ awareness of health-related problems and provide effective solutions.

The modulating effect of lexical predictability on perceptual learning of degraded speech

Predictive coding is considered to be an important mechanism for perceptual learning. Posterior prediction-error minimization can lead to higher rates of lasting changes in the representational hierarchy, and hence is likely to enhance the process of learning. In the field of speech processing, although considerable studies have demonstrated that a highly predictive sentence context can facilitate the perception of forthcoming word, it remains to be examined that how this type of predictability affects the perceptual learning of speech (especially degraded speech). The present study, therefore, aimed to examine whether and how the lexical predictability of spoken sentences modulates perceptual learning of speech embedded in noise, by using spoken sentences as training stimuli and strictly controlling the semantic-context constraint of these training sentences. The current study adopted a “pretest-training-posttest” procedure. Two groups of subjects participated in this perceptual learning study, with cognitive and language abilities matched across these two groups. For one group, the spoken sentences used for training all have a highly predictive semantic context; for another group, the training sentences all have a low predictive context. The results showed that both the reaction time and accuracy of the speech-in-noise intelligibility test were significantly improved in the post-training phase compared to the pre-training phase; moreover, the learning-related improvement was significantly enhanced in participants with weak-constraint sentences as training stimuli (compared to those with strong-constraint sentences as training stimuli). This enhancement effect of low lexical predictability on learning-related improvement supports a prediction-error based account of perceptual learning.

Improving Employee Work Motivation at PT.X through Stress Management Training: An Experimental Study on the Production Team

This study aimed to determine the impact of stress management training on the work motivation of production employees at PT. X. The hypothesis of the study posited that the work motivation of employees would be higher after receiving stress management training compared to before the training. The study involved 11 production employees who exhibited low to moderate work motivation and experienced high to moderate job stress. The data collection technique employed in this study was the work motivation scale. The research design utilized a one-group pre-test post-test design, and the data were analyzed using the Wilcoxon signed-rank test, a non-parametric statistical analysis. The results of the Wilcoxon test revealed a significance value of 0.003 &lt; 0.050, indicating that the research hypothesis was supported. Therefore, a significant difference in work motivation was observed between the pre-training and post-training phases among the employees

Cognitive elements of learning and discriminability in anti-phishing training

People adjust decisions based on their experiences; and it is important to know how to shape these experiences effectively to improve their future decisions. We conducted laboratory experiments to study an effective way to shape end-users’ experiences to improve their detection of phishing emails. Despite technical and training-based solutions to phishing detection, malicious emails continue to reach people broadly. The end-user’s susceptibility towards phishing emails could be due to lack of experience in phishing, lack of motivation or inappropriate knowledge of phishing cues. In this paper, we study the effects of two experimental variables during a training phase: The frequency of phishing emails (low frequency-25%, medium frequency-50%, and high frequency-75%), and the type of feedback provided on the decisions made (outcome or detail feedback). The individual’s base susceptibility to phishing emails was measured in a pre-training phase in which 20% of the emails were phishing and compared to a similar post-training phase. The results show that the type of feedback provided during training affected participants’ sensitivity to detecting subsequent phishing emails. In addition, the frequency of phishing emails during training impacted their likelihood of classifying subsequent emails as phishing or legitimate. The results of these experiments show that anti-phishing training must be carefully designed taking into consideration the impact that these design choices have on human learning and decision making.

Body into Narrative: Behavioral and Neurophysiological Signatures of Action Text Processing After Ecological Motor Training

Embodied cognition research indicates that sensorimotor training can influence action concept processing. Yet, most studies employ isolated (pseudo)randomized stimuli and require repetitive single-effector responses, thus lacking ecological validity. Moreover, the neural signatures of these effects remain poorly understood. Here, we examined whether immersive bodily training can modulate behavioral and functional connectivity correlates of action-verb processing in naturalistic narratives. The study involved three phases. First, in the Pre-training phase, 32 healthy persons listened to an action text (rich in movement descriptions) and a non-action text (focused on its characters’ perceptual and mental processes), completed comprehension questionnaires, and underwent resting-state electroencephalogram (EEG) recordings. Second, in the four-day Training phase, half the participants completed an exergaming intervention (eliciting full-body movements for 60 min a day) while the remaining half played static videogames (requiring no bodily engagement other than button presses). Finally, in the Post-training phase, all participants repeated the Pre-training protocol with different action and non-action texts and a new EEG session. We found that exergaming selectively reduced action-verb outcomes and fronto-posterior functional connectivity in the motor-sensitive ∼ 10–20 Hz range, both patterns being positively correlated. Conversely, static videogame playing yielded no specific effect on any linguistic category and did not modulate functional connectivity. Together, these findings suggest that action-verb processing and key neural correlates can be focally influenced by full-body motor training in a highly ecological setting. Our study illuminates the role of situated experience and sensorimotor circuits in action-concept processing, addressing calls for naturalistic insights on language embodiment.

L2 Learners’ Understanding of Achievement Emotions and Emotion Regulation Strategies: Contributions of a Longitudinal Emotion Regulation Initiative

Developing L2 learners’ emotional balance through adaptive regulation is a significant determinant of successful learning. Despite the recent surge of interest in emotion regulation (ER) programs, research on L2 learners’ ER strategies is surprisingly underdeveloped. To address this gap, the current qualitative study explored ten L2 learners’ understanding of achievement emotions and ER strategies throughout a longitudinal ER-oriented training course. Data were collected from four rounds of semi-structured interviews and diaries at different junctures of time. Data analysis revealed that the most frequent ER strategies in the pre-training phase were distraction and suppression, which showed a gradual decrease in the post-training phases. However, the use of self-regulated learning strategies and reassurance had the lowest frequency, showing a great improvement during the post-training phases. Additionally, the students grew in regulating their emotions across four major areas: (a) sufficient perceived control over negative emotions in high-stakes situations, (b) use of explicit ER strategies, (c) efficient use of competency-oriented strategies, and (d) decreased distraction as a function of negative simulators. The study provides implications for employing ER-based training to transform students’ negative emotional experiences into positive emotions.

Parity-based cumulative fairness-aware boosting

Data-driven AI systems can lead to discrimination on the basis of protected attributes like gender or race. One cause for this is the encoded societal biases in the training data (e.g., under-representation of females in the tech workforce), which is aggravated in the presence of unbalanced class distributions (e.g., when “hired” is the minority class in a hiring application). State-of-the-art fairness-aware machine learning approaches focus on preserving the overall classification accuracy while mitigating discrimination. In the presence of class-imbalance, such methods may further aggravate the problem of discrimination by denying an already underrepresented group (e.g., females) the fundamental rights of equal social privileges (e.g., equal access to employment). To this end, we propose AdaFair, a fairness-aware boosting ensemble that changes the data distribution at each round, taking into account not only the class errors but also the fairness-related performance of the model defined cumulatively based on the partial ensemble. Except for the in-training boosting of the group discriminated over each round, AdaFair directly tackles imbalance during the post-training phase by optimizing the number of ensemble learners for balanced error performance. AdaFair can facilitate different parity-based fairness notions and mitigate effectively discriminatory outcomes.

Thermovision as a Tool for Athletes to Verify the Symmetry of Work of Individual Muscle Segments.

In the presented research, we characterised the temperature profiles and the degree of preparation for exercise of individual muscle groups of athletes We hypothesise that by means of thermal imaging studies, the effectiveness of the warm-up can be monitored to determine whether the effort of individual muscles is equal and symmetrical, which can help to avoid a potential injury. In the study, thermographic imaging was performed on a group of athletes exercising on a rowing ergometer involving almost 80% of the muscle parts of the human body for intense and symmetrical exercise. Thermovision studies have confirmed, based on the increased temperature of the muscle areas, that the rowing ergometer involves many muscle groups in training. Moreover, based on the shape of the temperature function obtained from individual body regions of interest, it was shown that conventional exercise on a rowing ergometer causes almost symmetrical work of the right and left sides of the body. Obtained temperature changes in most of the studied muscle areas showed minimum temperature reached the beginning of training—mostly phases 1 and 2. During the subsequent phases, the temperature increase was monitored, stopping at resting temperature. Significantly, temperature variations did not exceed 0.5 °C in all post-training phases. Statistical analyses did not show any significant differences in the symmetry of right and left muscle areas corresponding to the muscle location temperature. Thermal imaging may be an innovative wholly non-invasive and safe method, because checking induces adaptation processes, which may become indicators of an athlete’s efficiency. The imaging can be continuously repeated, and automatic comparison of average temperature or temperature difference may provide some clues that protect athletes from overtraining or serious injuries.

Pentylenetetrazole-induced seizures cause impairment of memory acquisition and consolidation in zebrafish (Danio rerio)

Epilepsy is characterized by the occurrence of seizures, and the high prevalence of epilepsy-associated comorbidities affects the quality of patients’ life. We investigated the effects of pentylenetetrazole (PTZ) exposure in zebrafish cognitive performance on inhibitory avoidance test. The animals were exposed to 7.5 mM PTZ for 10 min, in the acquisition (before training) and in the consolidation memory phases (after training). In the acquisition phase, the animals were submitted to PTZ-induced seizures and trained in periods of 1, 24, or 48 h after exposure, and 24 h after training were tested. In the consolidation phase, animals were trained and exposed to PTZ 10 min after training and were tested 24 h later. Control groups in periods of 1, 24, or 48 h before or 10 min after training showed a significantly increased latency to enter the dark compartment. The latencies between training and test sessions did not differ in PTZ groups of animals exposed and trained 1 and 24 h or exposed to PTZ 10 min after training. At 48 h, animals exposed to PTZ showed an increased latency to enter the dark compartment. Animals exposed to PTZ and trained 1 h later increased the traveled distance, when compared to the control group. Traveled distance did not differ in animals that were exposed to PTZ and trained 24 and 48 h, or 10 min after training. Our findings indicate that PTZ causes a cognitive deficit in the pre-and post-training phase, allowing us to explore the influence of seizures at different memory phases.

Do Physical Education Teachers Use Socioconstructivist Communication Patterns in Their Classes?

Purpose: This study aims to identify socioconstructivist communication patterns used by physical education teachers and their evolution after participating in a training intervention. Method: The authors analyzed 812 units (messages containing constructivist discursive strategies) employed by two physical education teachers in two teaching modules using observational methodology. The data were analyzed by polar coordinate analysis. Results: In the pretraining phase, Teacher 1 presents two discursive patterns with questions–answers–literal incorporation of student-answers into the teachers’ communication, and another formed by praise questions. Teacher 2 generated praise-questions only. In the posttraining phase, Teacher 1 maintains one of the initial patterns and generates another consisting of questions-incorporation of students’ actions into the teacher’s communication. Teacher 2 incorporates two new patterns composed of information demands that are associated with the use of a specific frame of reference, or meta-statement. Discussion: The use of polar coordinate analysis revealed the presence of communication patterns and their evolution. Conclusion: The training intervention has resulted in changes in the communicative patterns of teachers. The custom-made instrument has allowed knowing the discursive strategies

Effects of Spatial Training Paradigms on Auditory Spatial Refinement in Normal-Hearing Listeners: A Comparative Study.

Background and ObjectivesThis study compared the effectiveness of two spatial training programs using real and virtual sound sources in refining spatial acuity skills in listeners with normal hearing.Subjects and MethodsThe study was conducted on two groups of 10 participants each; groups I and II underwent spatial training using real and virtual sound sources, respectively. The study was conducted in three phases: pre-training, training, and post-training phases. At the pre- and post-training phases, the spatial acuity of the participants was measured using real sound sources through the localization test, and virtual sound sources through the virtual acoustic space identification (VASI) test. The thresholds of interaural time difference (ITD) and interaural level difference (ILD) were also measured. In the training phase, Group I participants underwent localization training using loudspeakers in free field, while participants in Group II were subjected to virtual acoustic space (VAS) training using virtual sound sources from headphones. Both the training methods consisted of 5-8 sessions (20 min each) of systematically presented stimuli graded according to duration and back attenuation (for real source training) or number of VAS locations (for virtual source training).ResultsResults of independent t-scores comparing the spatial learning scores (pre vs. post-training) for each measure showed differences in performance between the two groups. Group II performed better than Group I on the VASI test, while the Group I out-performed Group II on the ITD. Both groups improved equally on the localization test and ILD.ConclusionsBased on the present findings, we recommend the use of VAS training as it has practical implications due to its cost effectiveness, need for minimal equipment, and end user usefulness.

Partnering a Compensatory Application with Activity-Aware Prompting to Improve Use in Individuals with Amnestic Mild Cognitive Impairment: A Randomized Controlled Pilot Clinical Trial.

Compensatory aids can help mitigate the impact of progressive cognitive impairment on daily living. We evaluate whether the learning and sustained use of an Electronic Memory and Management Aid (EMMA) application can be augmented through a partnership with real-time, activity-aware transition-based prompting delivered by a smart home. Thirty-two adults who met criteria for amnestic mild cognitive impairment (aMCI) were randomized to learn to use the EMMA app on its own (N = 17) or when partnered with smart home prompting (N = 15). The four-week, five-session manualized EMMA training was conducted individually in participant homes by trained clinicians. Monthly questionnaires were completed by phone with trained personnel blind to study hypotheses. EMMA data metrics were collected continuously for four months. For the partnered condition, activity-aware prompting was on during training and post-training months 1 and 3, and off during post-training month 2. The analyzed aMCI sample included 15 EMMA-only and 14 partnered. Compared to the EMMA-only condition, by week four of training, participants in the partnered condition were engaging with EMMA more times daily and using more basic and advanced features. These advantages were maintained throughout the post-training phase with less loss of EMMA app use over time. There was little differential impact of the intervention on self-report primary (everyday functioning, quality of life) and secondary (coping, satisfaction with life) outcomes. Activity-aware prompting technology enhanced acquisition, habit formation and long-term use of a digital device by individuals with aMCI. (ClinicalTrials.gov NCT03453554).

General and Specific Effects of Stereo Learning.

Technological advancements in virtual reality challenge the human vision, especially stereopsis, a function, which characterizes how two eyes coordinate to form a unified three-dimensional (3D) representation of the external world and is found to be deficient in 30% of the normal population. Although a few previous studies have consistently found that the perceptual learning of stereopsis significantly improved stereoacuity, an underlying mechanism of stereo learning remains heavily debated. Here, we trained subjects with normal stereo vision (assessed with the FLY Stereo Acuity Test) to judge stereopsis containing three types of binocular disparity orders (i.e., zero-, first-, and second-order), aiming to systematically examine the characteristics and plasticity of stereo learning. Thirty subjects were randomly assigned to the three training groups (each for the zero-, first-, or second-order disparity separately). The disparity thresholds were measured before and after training. The disparity threshold was measured in 10 additional control subjects only at the pre- and post-training phase. Stereoscopic images were displayed through a shutter goggle, which is synchronized to a monitor. We found that the training significantly improved the zero-, first-, and second-order disparity threshold by 52.42, 36.28, and 14.9% in the zero-order training condition; 30.44, 63.74, and 21.07% in the first-order training condition; and 30.77, 25.19, and 75.12% in the second-order training condition, respectively. There was no significant improvement in the control group. Interestingly, the greatest improvements in the first- and second-order disparity threshold were found in the corresponding disparity training group; on the contrary, the improvements in the zero-order disparity threshold were comparable across all the three disparity training groups. Our findings demonstrated both general (related to the zero-order disparity) and specific improvements (related to the first- and second-order disparity) in stereo learning, suggesting that stereo training occurs at different visual processing stages and its effects might depend on the specific training sites.

A quality improvement intervention to improve early initiation of breastfeeding among newborns delivered at a secondary level hospital in northern India

BackgroundEarly initiation of breastfeeding (EIBF) has been shown to be associated with reduced neonatal mortality, but many barriers exist that lead to the delay of EIBF. We aimed at improving EIBF among newborns delivered at a secondary care hospital using standard quality improvement methods of root-cause analysis and the Plan-Do-Study-Act (PDSA) cycle. MethodsThe study was conducted in the year 2016–17 at a 50-bedded secondary care hospital in northern India. A baseline assessment of the timing of breastfeeding initiation was done, and factors contributing to delayed initiation of breastfeeding were analysed. Interventions were planned and implemented in short sequential PDSA cycles. The rapid-cycle aspect of PDSA began with piloting a new process, followed by examining results and responding by problem-solving, after which the next PDSA cycle was initiated. The percentage of newborns receiving breastfeeding within 1 h of birth was assessed on a monthly basis. ResultsThe rate of early initiation of breastfeeding improved from 52% at baseline to 97% in the immediate post-training phase. After an initial fall due to the shortage of staff, the EIBF rate was sustained at 91% after six months. ConclusionEIBF can be achieved through the involvement of all stakeholders, team-building, and commitment from managerial staff using the QI (Quality Improvement) approach.