Post-training Follow-up Research Articles

Putative risk and resiliency factors after an augmented training program for preventing posttraumatic stress injuries among public safety personnel from diverse sectors

ABSTRACT Mental health disorders are particularly prevalent among public safety personnel (PSP). Emotional Resilience Skills Training (ERST) is a cognitive behavioural training program for PSP based on the Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders (i.e. Unified Protocol). The current study was designed to assess whether ERST is associated with reduced putative risk factors for mental disorders and increased individual resilience. The PSP-PTSI Study used a longitudinal prospective sequential experimental cohort design that engaged each participant for approximately 16 months. PSP from diverse sectors (i.e. firefighters, municipal police, paramedics, public safety communicators) completed self-report measures of several putative risk variables (i.e. anxiety sensitivity, fear of negative evaluation, pain anxiety, illness and injury sensitivity, intolerance of uncertainty, state anger) and resilience at three time points: pre-training (n = 191), post-training (n = 103), and 1-year follow-up (n = 41). Participant scores were statistically compared across time points. Participants reported statistically significantly lower scores on all putative risk variables except pain anxiety, and statistically significantly higher resilience from pre- to post-training. Changes were sustained at 1-year follow-up. The results indicate that ERST is associated with reductions in several putative risk variables and improvement in resilience among PSP.

Cerebral blood flow and structural connectivity after working memory or physical training in paediatric cancer survivors – Exploratory findings

ABSTRACT Paediatric cancer survivors often suffer from cognitive long-term difficulties. Consequently, strengthening cognition is of major clinical relevance. This study investigated cerebral changes in relation to cognition in non-brain tumour paediatric cancer survivors after working memory or physical training compared to a control group. Thirty-four children (≥one-year post-treatment) either underwent eight weeks of working memory training (n = 10), physical training (n = 11), or a waiting period (n = 13). Cognition and MRI, including arterial spin labelling and diffusion tensor imaging, were assessed at three time points (baseline, post-training, and three-month follow-up). Results show lower cerebral blood flow immediately after working memory training (z = −2.073, p = .038) and higher structural connectivity at the three-month follow-up (z = −2.240, p = .025). No cerebral changes occurred after physical training. Short-term changes in cerebral blood flow correlated with short-term changes in cognitive flexibility (r = −.667, p = .049), while long-term changes in structural connectivity correlated with long-term changes in working memory (r = .786, p = .021). Despite the caution given when interpreting data from small samples, this study suggests a link between working memory training and neurophysiological changes. Further research is needed to validate these findings.

The Effects of Suicide Prevention Gatekeeper Training on Behavioral Intention and Intervention Behavior: A Systematic Review and Meta-Analysis.

To understand the current state of research, a systematic review and meta-analysis were conducted to synthesize the effects of suicide prevention gatekeeper training (GKT) on participant behavioral intention to intervene and participant suicide intervention behaviors. Included studies examined GKT with adult participants and measured either behavioral intention to conduct a suicide intervention or the utilization of suicide intervention skills. Searches yielded a total of 43 studies from 46 reports, comprising 21,720 participants. To quantify change over time, the standardized mean gain effect size metric was utilized. Large effect sizes were found for behavioral intention from pre-training to post-training (1.03, 95% CI [0.80, 1.25]) and short-term follow-up (0.78, 95% CI [0.59, 0.97]). Smaller effect sizes were found for intervention behavior from pre-training to short-term (0.33, 95% CI [0.21, 0.46]) and long-term follow-up (0.22, 95% CI [0.14, 0.30]). Although this meta-analysis reveals a positive effect for GKT on behavioral outcomes, the low methodological quality of the currently available evidence limits the ability to draw conclusions from the synthesis. This work informs policymakers and interventionists on best practices for GKT and highlights that additional, rigorous research is needed.

Effectiveness of Balance Exercise and Brisk Walking on Alleviating Nonmotor and Motor Symptoms in People With Mild-to-Moderate Parkinson Disease: A Randomized Clinical Trial With 6-Month Follow-up

ObjectiveTo investigate the effects of balance exercise and brisk walking on nonmotor and motor symptoms, balance and gait functions, walking capacity, and balance confidence in Parkinson disease (PD) at posttraining and 6-month follow-up. DesignTwo-arm, assessor-blinded randomized controlled trial SettingUniversity research laboratory and the community ParticipantsNinety-nine eligible individuals with mild-to-moderate PD InterventionsParticipants were randomized to balance and brisk walking group (B&B, n=49) or active control group (n=50). B&B received ten 90-minute sessions of balance exercises and brisk walking supervised by physical therapists for 6 months (week 1-6: weekly, week 7-26: monthly), whereas control practiced whole-body flexibility and upper limb strength exercise at same dosage (180 min/wk). Both groups performed unsupervised home exercises 2-3 times/wk during intervention and continued at follow-up. Main Outcome MeasuresPrimary outcomes were Movement Disorder Society Unified Parkinson Disease Rating Scale nonmotor (MDS-UPDRS-I) and motor (MDS-UPRDS-III) scores. Secondary outcomes were mini-Balance Evaluation Systems Test (mini-BEST) score, comfortable gait speed (CGS), 6-minute walk test (6MWT), dual-task timed-Up-and-Go (DTUG) time, and Activities-Specific Balance Confidence Scale score. ResultsEighty-three individuals completed the 6-month intervention with no severe adverse effects. The mean between-group (95% CI) difference for the MDS-UPDRS nonmotor score was 1.50 (0.19-2.81) at 6 months and 1.09 (−0.66 to 2.85) at 12 months. The mean between-group (95% CI) difference for the MDS-UPDRS motor score was 3.75 (0.69-6.80) at 6 months and 4.57 (1.05-8.01) at 12 months. At 6 and 12 months, there were significant between-group improvements of the B&B group in mini-BEST score, CGS, 6MWT, and DTUG time. ConclusionsThis combined balance and brisk walking exercise program alleviates nonmotor and motor symptoms and improves walking capacity, balance, and gait functions posttraining, with positive carryover effects for all except nonmotor outcomes, at 6-month follow-up in mild-to-moderate PD.

Recalling and anticipating positive events to improve the positive affect and mental health of adolescents: A cluster randomized controlled trial in secondary schools

This cluster randomized controlled trial examined the effectiveness of Positive Events Training (PET), a combined group training aimed at simultaneously improving positive autobiographical memory (AM) and episodic future thinking (EFT) among adolescents (12–16 years). Delivered as a universal school-based program, PET was compared with an active (creative writing) control group (CREAT). Effects on resilience, wellbeing, positive emotions, emotional response styles towards positive emotions (savoring, dampening), anhedonia, depressive symptoms, and multiple AM and EFT indices were examined. Adolescents (NPET = 95, NCREAT = 93) completed self-report scales at baseline, post-training and two-month follow-up. Multilevel models revealed that PET led to significant improvements in certain AM and EFT skills. Moreover, a decrease in anhedonia was observed at post-training. However, this effect did not withstand correction for multiple testing. Absence of changes in the other outcomes should be interpreted within the context of the universal school-based approach and the potential limited scope for detectable changes. Exploratory analyses suggest the importance of further investigating PET's potential in addressing positive affect dysregulations in indicated samples, and exploring perceived likelihood of generated future events and dampening as potential underlying mechanisms. Study limitations and future directions to maximize the demonstrated potential of PET are discussed.

The effect of Sleep Leadership Training on U.S. Army human performance team members

Most U.S. Servicemembers (SMs) get less than the recommended amount of sleep per night, which has been shown to be directly influenced by local leadership. Previous research demonstrated that a brief sleep leadership training (SLT) protocol resulted in improved knowledge and attitudes regarding sleep among U.S. Army leaders, and improvements in the sleep health of their SMs. Human Performance Teams (HPT) offer one solution to propel the cultural change related to sleep, however, little is known about HPT members' own sleep related knowledge, practices, attitudes, and beliefs. This mixed-methods study determined the effect of (SLT) on the sleep-related knowledge, practices, attitudes, beliefs, and perceived competency of HPT members, explored their experiences addressing SM sleep, and gauged their perceived value in receiving the training. Thirty-one individuals received 2 days of SLT. Baseline and 6-week post training follow-up measures were collected, and participants were invited to participate in semi-structured interviews to explore their unique experiences addressing sleep, as well as their perceived value in receiving SLT. Training had no significant effects on HPT members' sleep practices or sleep beliefs, some significant effects on their attitudes and knowledge about sleep, and significant effects on their perceived competence to address sleep in their units. Results suggest that HPT members benefited from the training through enhancement of their competence to address sleep with leadership. However, they struggle to obtain sufficient sleep themselves. More research is needed to identify methods of overcoming specific barriers to sleep imposed on SMs.

Barriers to healthcare data quality and recommendations in public health facilities in Dire Dawa city administration, eastern Ethiopia: a qualitative study.

Maintaining good quality of healthcare data at various levels is a critical challenge in developing countries. The barriers to healthcare data quality remain largely unexplored in eastern Ethiopia. This study aimed to assess the barriers to quality of healthcare data in urban public health facilities in the Dire Dawa city administration from 7 April to 7 May 2019. An institutional-based qualitative exploratory approach was used among 17 purposefully selected key informants. In-depth interviews were inductively coded using the ATLAS.ti 7.5.4 version software. Inductive analysis was used by semantically analyzing the explicit content of the data to determine our themes. Several key themes and subthemes with different barriers, some of which are mutually non-exclusive, were identified. These include: Organizational Barriers: Lack of an adequate health management information system and data clerk staff, poor management commitment, lack of post-training follow-up, work overload, frequent duty rotation, lack of incentives for good performers, lack of targeted feedback, and poor culture of information use. Behavioral/Individual Barriers: Gaps in the skill of managers and health professionals, lack of adequate awareness of each indicator and its definitions, inadequate educational competence, lack of feeling of ownership, poor commitment, lack of daily tallying, and lack of value for data. Technical Barriers: Lack of a standard form, diverse and too many data entry formats, manual data collection, shortage of supplies, failure to repair system break down in a timely manner, interruption in electricity and network, delay in digitizing health information systems, lack of post-training follow-up, and inadequate supervision. External Barriers: Poor collaboration between stakeholders, dependence on the software program of non-governmental organizations, and very hot weather conditions. Diverse and complex barriers to maintenance of data quality were identified. Developing standardized health management information system implementation plans, providing advanced supervisory-level training, supportive supervision, and site-level mentorship may be very effective in identifying and resolving bottleneck data quality issues. Healthcare managers should understand the imperative of data quality and accept responsibility for its improvement and maintenance. Interventions targeted only at supplies will not fully overcome limitations to data quality. Motivation of staff and recognition of best performance can motivate others and can create cooperation among staff.

Improvements in performance based measures of functional capacity and cognition after computerized functional skills training in older people with mild cognitive impairment and healthy comparators

With no pharmacological treatments for Mild Cognitive impairment (MCI), computerized training strategies have been attempted. A computerized skills training intervention, FUNSAT, previously produced training-related gains in cognition in MCI and in comparators with normal cognition (NC). A new remotely delivered version of FUNSAT was administered to a new sample of participants with NC and MCI. Outcomes measures included cognition (BAC) and functional capacity (VRFCAT) to examine training transfer. Participants with MCI (n = 92) and NC (n = 72) trained for up to 12 weeks on FUNSAT. Half the MCI participants started with 3 weeks of computerized cognitive training (CCT). Baseline, post-training, and 30-day follow-up scores on cognition and functional capacity were compared. Participants improved on both cognition (d = 0.80) and functional capacity (d = 0.64), with no differences in training gains across MCI and NC, although treatment with CCT in MCI was associated with similar gains with fewer FUNSAT training sessions. This is the first treatment study in MCI to demonstrate transfer to untrained measures of functional capacity. NC improved in cognition and functional capacity with skills training alone. These findings have implications for other conditions, such as schizophrenia, where functional capacity is a treatment target.

Effectiveness of Internet-Based Training on Psychotherapists’ Transcultural Competence: A Randomized Controlled Trial

Treating culturally diverse patients (CDPs) presents considerable challenges for psychotherapists, including language barriers, differing beliefs, and insecurities. Improving their transcultural competence requires training, but empirical evidence is lacking. This 6-week randomized controlled trial evaluated the impact of standardized internet-based training on psychotherapists’ transcultural competence (i.e., awareness, engagement, and handling challenges). Demographic data were collected before training. Transcultural competence was measured at pre-training, post-training, and 3-month follow-up. Training satisfaction was assessed at post-training and follow-up visits. In the guided training group (GTG; n = 83), psychotherapists received hands-on training with practical exercises, weekly knowledge assessments, and online feedback. The second condition comprised a non-guided control group (CG; n = 90) that received only text-based training. Primary analyses on both intent-to-treat ( n = 173) and completer analyses ( n = 95) indicated significant improvements in transcultural awareness and engagement after 6 weeks of training for both groups. Significant within-group improvements were noted, as evidenced by large Cohen’s d effect sizes for both groups. No between-group differences were observed. Qualitative assessments revealed that GTG participants evaluated the training’s concept and content significantly more positively than CG participants and felt significantly less insecure about treating CDPs. Such training could pave the way for the long-term development of innovative, culturally sensitive mental health care services that more effectively meet the needs of CDPs.

The evaluation of the effectiveness of a health promotion training on breast cancer survivors.

Increased early diagnosis and improved treatment options have decreased the mortality rate of breast cancer and increased the survival rate. Healthy lifestyle behaviors are very important in breast cancer survivors as they reduce mortality and morbidity rates, cancer recurrence frequency, and side effects of treatment and improve health. This study was conducted to evaluate the effectiveness of a health promotion training intervention in breast cancer survival. The study is a quasi-experimental, pre-test-post-test and single-group study. It was conducted with 43 women breast cancer survivors. The "Healthy Lifestyle Behaviors Scale II" was used to collect the data. Four sessions of training were given to the women once a week, and a 3-month post-training follow-up was performed. The t-test, Wilcoxon analysis, and Spearmen correlation analysis were used to evaluate the data. Pre-training and post-training scores in the sub-dimensions and total scores of the healthy lifestyle behavior scale showed that the training was highly effective. There was a significant increase in all sub-dimensions and total scale post-training scores (P < 0.05). In the correlation analysis, a negative correlation was found between age and physical activity, between elapsed time after diagnosis and nutrition, and between elapsed time after diagnosis and spiritual development (P < 0,05). However, there was a positive correlation between educational status and nutrition (P < 0.05). The results show that a health promotion training program covering physical activity/exercise, healthy nutrition, effective communication, coping with stress, and increasing health responsibility had positive effects on healthy lifestyle behaviors in this population, and age, educational status, and elapsed time after diagnosis influence healthy lifestyle behaviors in survival.

Clinical and neuroimaging correlates in a pilot randomized trial of aerobic exercise for major depression

BackgroundAerobic exercise (AE) combined with pharmacotherapy is known to reduce depressive symptoms; however, studies have not focused on long-term AE for volumetric changes of brain regions (amygdala, thalamus, and nucleus accumbens [NAcc]) linked to the control of affective responses and hopelessness in individuals with major depression (MD). In addition, AE with motor complexity (AEMC) would be more effective than AE in causing brain plasticity. We compared the effects of 24 weeks of AE and AEMC combined with pharmacotherapy on clinical and volumetric outcomes in individuals with MD. MethodsForty medicated individuals with MD were randomly assigned to nonexercising control (C), AE, and AEMC groups. The training groups exercised for 60 min, twice a week for 24 weeks. Clinical and volumetric outcomes were assessed before and after the 24 weeks. Effect size (ES) and confidence interval (CI) were calculated for within-group and between-groups changes. ResultsAE and AEMC reduced hopelessness (ES = −0.73 and ES = −0.62, respectively) and increased affective responses (ES = 1.24 and ES = 1.56, respectively). Only AE increased amygdala (ES = 0.27 left and ES = 0.34 right), thalamus (ES = 0.33 left and ES = 0.26 right) and left NAcc (ES = 0.54) volumes. AE was more effective than the C group in reducing hopelessness and causing brain plasticity. The changes in the right amygdala volume showed a strong trend in explaining 72 % of the changes in affective responses following AE (p = 0.06). LimitationLack of posttraining follow-up and small sample size. ConclusionThese preliminary data indicate that AE combined with pharmacotherapy can cause clinical improvement and brain plasticity in individuals with MD.

Specific Training Improves the Detection and Management of Patient-Ventilator Asynchrony.

Patient-ventilator asynchrony is common in patients undergoing mechanical ventilation. The proportion of health-care professionals capable of identifying and effectively managing different types of patient-ventilator asynchronies is limited. A few studies have developed specific training programs, but they mainly focused on improving patient-ventilator asynchrony detection without assessing the ability of health-care professionals to determine the possible causes. We conducted a 36-h training program focused on patient-ventilator asynchrony detection and management for health-care professionals from 20 hospitals in Latin America and Spain. The training program included 6 h of a live online lesson during which 120 patient-ventilator asynchrony cases were presented. After the 6-h training lesson, health-care professionals were required to complete a 1-h training session per day for the subsequent 30 d. A 30-question assessment tool was developed and used to assess health-care professionals before training, immediately after the 6-h training lecture, and after the 30 d of training (1-month follow-up). One hundred sixteen health-care professionals participated in the study. The median (interquartile range) of the total number of correct answers in the pre-training, post-training, and 1-month follow-up were significantly different (12 [8.75-15], 18 [13.75-22], and 18.5 [14-23], respectively). The percentages of correct answers also differed significantly between the time assessments. Study participants significantly improved their performance between pre-training and post-training (P < .001). This performance was maintained after a 1-month follow-up (P = .95) for the questions related to the detection, determination of cause, and management of patient-ventilator asynchrony. A specific 36-h training program significantly improved the ability of health-care professionals to detect patient-ventilator asynchrony, determine the possible causes of patient-ventilator asynchrony, and properly manage different types of patient-ventilator asynchrony.

Computerized Cognitive and Skills Training in Older People With Mild Cognitive Impairment: Using Ecological Momentary Assessment to Index Treatment-Related Changes in Real-World Performance of Technology-Dependent Functional Tasks

ObjectivesCognitive and functional skills training improves skills and cognitive test performance, but the true test of efficacy is real-world transfer. We trained participants with mild cognitive impairment (MCI) or normal cognition (NC) for up to 12 weeks on six technology-related skills using remote computerized functional skills assessment and training (FUNSAT) software. Using ecological momentary assessment (EMA), we measured real-world performance of the technology-related skills over 6 months and related EMA-identified changes in performance to training gains. DesignRandomized clinical trial with post-training follow-up. SettingA total of 14 Community centers in New York City and Miami. ParticipantsOlder adults with normal cognition (n = 72) or well-defined MCI (n = 92), ranging in age from 60 to 90, primarily female, and racially and ethnically diverse. InterventionComputerized cognitive and skills training. MeasurementsEMA surveys measuring trained and untrained functional skills 3 or more days per week for 6 months and training gains from baseline to end of training. ResultsTraining gains in completion times across all 6 tasks were significant (p <0.001) for both samples, with effect sizes more than 1.0 SD for all tasks. EMA surveys detected increases in performance for both trained (p <0.03) and untrained (p <0.001) technology-related skills for both samples. Training gains in completion times predicted increases in performance of both trained and untrained technology-related skills (all p <0.001). ConclusionsComputerized training produces increases in real-world performance of important technology-related skills. These gains continued after the end of training, with greater gains in MCI participants.

Evaluation of Post-Training Monitoring of CHWs in Community-Based Epidemiological Surveillance Activities (SEBAC): Case of the Districts of Kadiolo, Kati and Kangaba in Mali from 2020 to 2021

The post-training follow-up of actors is undeniable for an effective and efficient implementation of community surveillance activities (SEBAC). We evaluated the supervision data from the three SEBAC health districts (Kadiolo, Kati and Kangaba). The variables analyzed are as follows: The percentage of CHWs mastering the case definitions: in Kati (100%), Kangaba (82.87%) and Kadiolo (71.97%). Next, knowledge of coding: at Kati 99.18%, Kadiolo 95.62% and Kangaba 84.08%. Regarding the number of notified cases: in Kadiolo 124 cases (36%), Kati 123 (35.8%) cases and Kangaba 97 cases (28.2%). Also, for the filling of the notification and score registers: at Kati 99.18% and 100%, Kadiolo 86.18% and 86.18% and Kangaba 82.12% and 80%. As for investigations, the three districts have a parity rate of 100%; for home visits, Kati has a rate of 100%, followed by Kadiolo 95.23% and Kangaba 92.80%. Also, for the number of CHWs having sent at least one SMS: Kati 100%, Kadiolo 98.52% and Kangaba 91.50%. Finally, for data completeness, Kangaba district has 85.68%, Kadiolo 71.56% and Kati 48.91%. Post-training supervision is an effective means for building capacity in the implementation of activities, correcting shortcomings, and a source of motivation for actors. Keywords: Supervision, community-based surveillance, post-training follow-up, SEBAC, CHW.

Effects of problem-solving skills development training on resilience, perceived stress, and self-efficacy in nursing students: A randomised controlled trial

AimThis study aimed to investigate the effects of problem-solving skills development training for nursing students on their levels of resilience, perceived stress, and self-efficacy. BackgroundAlthough there are many studies on the problem-solving skills of nursing students, few have been based on the social problem-solving model. Most are cross-sectional and descriptive studies. Surprisingly, the number of studies that examine the effects of training for problem solving in nursing students is also quite limited. DesignThis was a single-blind, randomised controlled trial. MethodsThe study was conducted at the department of nursing of a state university in Western Turkey. Seventy-two second-year nursing students initially participated in the study. The mean age of the participants was 19.97 ± 1.39 years. Of the participants, 72.2% were women, and 70.8% did not consider themselves academically successful. Participants were randomly assigned to the experimental or control group. The experimental group received problem-solving skills development training based on the Social Problem-Solving Model once a week in a total of seven weeks (eight sessions), in which two sessions were in the last week. Duration of each session took at least 55 min and 150 min at max. Data were collected using a self-administered questionnaire that included a personal information form, Resilience Scale for Nurses, Social Problem Solving-Inventory-Short Form, Perceived Stress Scale, and General Self-Efficacy Scale. Measurements were performed at three different times: at the beginning of the study (T0), immediately after the training provided to the experimental group (T1), and one month follow-up measurement after the intervention (T2). Repeated-measures analysis of variance and covariance were performed to analyse data. ResultsThe mean post-training and 1-month follow-up scores for problem-solving, resilience, and self-efficacy of the students in the experimental group (the mean of T1 and T2 scores) were significantly higher, and the mean post-training and 1-month follow-up perceived stress scores of the students in the experimental group was significantly lower than those of the control group. ConclusionsThis study concluded that problem-solving skills training based on a social problem-solving model provided to nursing students increased their social problem solving, resilience, and self-efficacy levels and reduced their perceived stress. Therefore, further studies that plan intervention and training programs aimed at improving the social problem-solving levels of nursing students and include social problem-solving courses in university curricula are recommended.

Longitudinal changes in mental health professionals’ perceived trauma care competencies after participation in a brief online training programme

ABSTRACT Background: Further developments in trauma care training for mental health staff are needed to ensure that trauma survivors are recognised and get the most effective care. The evaluation of the effects of trauma care training programs would enable the untangling of the most efficient ways of building the competence of clinicians who encounter trauma-exposed patients in their routine clinical practice. Objective: We aimed to analyse longitudinal changes in mental health professionals’ perceived trauma care competencies after a brief online trauma care training, and to examine associations between these changes and specific work-related characteristics. Method: In total, 223 mental health professionals, 96.4% women, 42 years on average, and 51.6% with more than 10 years of clinical practice, participated in a brief online trauma care training programme. The Readiness to Work with Trauma-Exposed Patients Scale (RTEPS) was used to measure perceived trauma care competencies at the pre-training, post-training, and at a 3-month follow-up. Results: Training had a significant effect on all measured perceived trauma care competencies of assessment, treatment and affect tolerance at post-training and 3-month follow-up. We also found that many years of unspecific clinical practice did not contribute to perceived trauma care competencies, and the training was perceived equally beneficial by professionals with more or less clinical practice. Conclusions: Our study indicates that brief training can have lasting effects on clinicians’ self-confidence in trauma care. Further investigation of factors associated with the effects of training might help to increase the effectiveness of the training programs.

Virtual Worlds Technology to Enhance Training for Primary Care Providers in Assessment and Management of Posttraumatic Stress Disorder Using Motivational Interviewing: Pilot Randomized Controlled Trial.

Many individuals with posttraumatic stress disorder (PTSD) first present to primary care rather than specialty mental health care. Primary care providers often lack the training required to assess and treat patients with PTSD. Virtual trainings have emerged as a convenient and effective way of training primary care providers in PTSD assessment and communication methods (ie, motivational interviewing [MI]). The aim of this study was to conduct a pilot randomized controlled trial of a synchronous Virtual Worlds (VW; a virtual world where learners were immersed as avatars) training versus an asynchronous web-based training on PTSD and MI, comparing the feasibility, acceptability, usability, and preliminary efficacy of 2 different training platforms among primary care providers. Participating primary care providers were randomized to a VW and a web-based PTSD training. Outcomes were collected at baseline, posttraining, and 90-days follow-up. Standardized patient interviews measured participants' communication skills in assessing and managing patients with PTSD symptoms. Compared to the web-based training, the VW training platform achieved larger learning gains in MI (ie, partnership and empathy) and in discussing pharmacotherapy and psychotherapy for PTSD. Both VW and web-based trainings led to increases in PTSD knowledge and primary care providers' self-confidence. The asynchronous web-based PTSD training improved PTSD-related knowledge and self-confidence but was not as effective as the VW immersive experience in teaching MI or clinical management. Because VW training is synchronous and new for many learners, it required more time, facilitation, and technical support. As computer technology improves, VW educational interventions may become more feasible, particularly in teaching clinical skills. ClinicalTrials.gov NCT03898271; https://tinyurl.com/mu479es5.

Nurturing child social-emotional development: evaluation of a pre-post and 2-month follow-up uncontrolled pilot training for caregivers and educators

BackgroundSocial-emotional capacities contribute to children’s mental health by helping them navigate their own and others’ emotional states and forge healthy relationships. Caregivers and educators are critical socialization agents in early and middle childhood, but gaps remain in the systematic integration of social-emotional research into caregiver and educator trainings. The aim of this pilot study was to test the feasibility and preliminary efficacy of a social-emotional training designed to promote caregivers’ and educators’ capacities to support social-emotional development in children ages 3–8 years.MethodsFifty adults (n = 24 caregivers of children ages 3–8 years, n = 26 educators working with children ages 3–8 years) participated in a virtual training over 3 weeks. Participants completed pre-training, post-training, and 2-month follow-up questionnaires evaluating their knowledge of social-emotional concepts, use of training strategies, mental health, and satisfaction with the training. Caregivers also reported children’s social-emotional capacities and mental health.ResultsOn average, caregivers and educators completed 83% of the virtual training sessions and reported high satisfaction with the training. Further, preliminary evidence indicated that caregivers’ and educators’ knowledge of social-emotional concepts increased pre- to post-training and was maintained at the 2-month follow-up. Increases in caregivers’ and educators’ knowledge and greater use of training strategies were associated with improvements in children’s social-emotional capacities and caregivers’ and educators’ own mental health.ConclusionsThese pilot results support the feasibility of infusing evidence-based social-emotional content into caregiver and educator training initiatives aimed at nurturing child social-emotional development and mental health. The results inform future evaluation of the short- and long-term benefits of this training with a full-scale randomized controlled trial design.

Efficacy of interactive manual dexterity training after stroke: a pilot single-blinded randomized controlled trial

ObjectiveTo compare the efficacy of Dextrain Manipulandum™ training of dexterity components such as force control and independent finger movements, to dose-matched conventional therapy (CT) post-stroke.MethodsA prospective, single-blind, pilot randomized clinical trial was conducted. Chronic-phase post-stroke patients with mild-to-moderate dexterity impairment (Box and Block Test (BBT) > 1) received 12 sessions of Dextrain or CT. Blinded measures were obtained before and after training and at 3-months follow-up. Primary outcome was BBT-change (after–before training). Secondary outcomes included changes in motor impairments, activity limitations and dexterity components. Corticospinal excitability and short intracortical inhibition (SICI) were measured using transcranial magnetic stimulation.ResultsBBT-change after training did not differ between the Dextrain (N = 21) vs CT group (N = 21) (median [IQR] = 5[2–7] vs 4[2–7], respectively; P = 0.36). Gains in BBT were maintained at the 3-month post-training follow-up, with a non-significant trend for enhanced BBT-change in the Dextrain group (median [IQR] = 3[− 1–7.0], P = 0.06). Several secondary outcomes showed significantly larger changes in the Dextrain group: finger tracking precision (mean ± SD = 0.3 ± 0.3N vs − 0.1 ± 0.33N; P < 0.0018), independent finger movements (34.7 ± 25.1 ms vs 7.7 ± 18.5 ms, P = 0.02) and maximal finger tapping speed (8.4 ± 7.1 vs 4.5 ± 4.9, P = 0.045). At follow-up, Dextrain group showed significantly greater improvement in Motor Activity Log (median/IQR = 0.7/0.2–0.8 vs 0.2/0.1–0.6, P = 0.05). Across both groups SICI increased in patients with greater BBT-change (Rho = 0.80, P = 0.006). Comparing Dextrain subgroups with maximal grip force higher/lower than median (61.2%), BBT-change was significantly larger in patients with low vs high grip force (7.5 ± 5.6 vs 2.9 ± 2.8; respectively, P = 0.015).ConclusionsAlthough immediate improvements in gross dexterity post-stroke did not significantly differ between Dextrain training and CT, our findings suggest that Dextrain enhances recovery of several dexterity components and reported hand-use, particularly when motor impairment is moderate (low initial grip force). Findings need to be confirmed in a larger trial.Trial registration ClinicalTrials.gov NCT03934073 (retrospectively registered)

POST TRAINING SUPPORT EFFICACY OF ENTREPRENEURSHIP TRAINING INSTITUTES IN KARNATAKA–AN ANALYSIS

Marketing is an important process in meeting out the needs of a target market by exploring, creating and delivering the values Education and training provide suitable ground for economic development and especially the creation of entrepreneurs is the key to growth. Entrepreneurs are the wealth and job creators as well as play a major role in the ecosystem of development. Governments in India have established many such institutions to motivate, train, orient, and develop entrepreneurs. Rural development and self-employment training institutions originated during the 1980s in Karnataka State and the Ministry of Rural Development has replicated the same all over the country under the sponsorship of District lead Banks. These institutes offer training on various entrepreneurial skills and help the trainees to be successful entrepreneurs. The major objective of the study is to measure and suggest the training institutes regarding the post-training follow-up activities performed by the institutes as received by the trainees. The study was conducted in Karnataka State with the responses collected from 356 trained entrepreneurs who have established businesses and operating them at good or moderate levels. The results were analyzed using percentages and found that the majority have not received any support from the institute. It is suggested to make follow-up genuine to get the real outcomes of training received at the institute. KEY TERMS: Entrepreneurship Training, Follow Up, Post Training Support, Training Institute