Standardized Training Program Research Articles

Assessing basic motor competences, physical fitness, and executive function in 4-5-year-old children: a longitudinal study in a primary care setting

BackgroundTo evaluate the progression of physical fitness (PF), basic motor competence (BMC), and executive function (EF) over one year in children aged 4–5 years at a health center.MethodsIn this longitudinal analysis, children’s BMC was evaluated using the MOBAK KG test for object and self-movement. The PREFIT Battery gauged PF through handgrip strength, standing long jump, and other fitness measures, while the Early Years Toolbox appraised EF.ResultsAdjustments for confounding factors showed notable improvements in BMC, particularly in object movement (OM; mean difference 0.789, p = 0.044) and self-movement (SM; mean difference 0.842, p = 0.037), with overall MOBAK scores also increasing (mean difference 1.632, p = 0.018). Enhancements in the standing long jump (mean difference 9.036 cm, p = 0.014) and EF tasks “Mr. Ant” (mean difference 0.669, p < 0.001) and “Go/No-Go” (mean difference 0.120, p < 0.001) were evident, signifying substantial BMC gains and some progress in PF and EF.ConclusionThis research underscores the positive impact of regular training on BMC and PF in young children. Significant BMC development and associated improvements in PF and EF over the study period highlight the importance of structured activities in early childhood. These findings advocate for standardized training programs to enhance childhood health and encourage active lifestyles.Trial registrationNCT05741879. Registered February 14, 2023, Version 1.

Pharmacist administered parenteral medications: A descriptive report of an inpatient training program

AbstractIntroductionParenteral medication administration is a crucial aspect of in‐hospital patient care and has been historically managed by nurses and physicians. Despite pharmacists' extensive training in the medication use process, their underutilization in medication administration stems from various factors, including the lack of formalized training, limited awareness by other healthcare professionals, and unclear legal guidance. This report discusses the implementation and outcomes of a pharmacist medication administration program at a large academic medical center.MethodsThe initiative began by revising hospital policies, enabling pharmacists to administer medications during emergencies. Documentation and communication protocols were established. Training included an online module and hands‐on sessions covering various topics with a focus on parenteral medication administration and medication safety. Following completion of the program, competency of pharmacists was assessed by pharmacists experienced in intravenous administration using simulated patient case scenarios. Following implementation, the frequency and characteristics of pharmacist administered medications were captured and described.ResultsThirty pharmacists, including 11 residents, participated. Seven pharmacists administered 349 doses of medications to 284 patients in emergency situations. Administrations by pharmacists included 227 titratable infusions, 72 intermittent or continuous infusions, 49 intravenous pushes, and 1 intranasal naloxone. Classes of medications included high risk products such as vasopressors, sedatives, antiarrhythmics, and thrombolytics. No extravasations or infiltrations were reported.ConclusionImplementation of the pharmacist medication administration program signifies significant progress in strengthening the pharmacists' role in patient care at the bedside specifically highlighting the competency of pharmacists to administer parenteral products during emergency situations. The absence of adverse events highlights the feasibility and safety of integrating pharmacists into the bedside team. As the landscape of health‐system pharmacy evolves, embracing standardized training programs like ours reemphasize pharmacists' essential contributions to the multidisciplinary healthcare teams, ultimately enhancing patient care and safety.

Differences between resident self-assessments and faculty- assessments on Anesthesiology Milestones and associated factors: a cross-sectional study.

Accurate self-assessment is crucial for the professional development of physicians. There has been sparse data on the accuracy of self-assessments on Anesthesiology Milestones. The aim of this study was to investigate the differences between resident self-assessments and faculty-assessments on Anesthesiology Milestones and the associated factors. This was a cross-sectional study conducted in a general tertiary university-affiliated hospital. We included anesthesia residents who were enrolled in the standardized residency training program in postgraduate year two and three at the time of the Milestone evaluation. We requested evaluations of competencies from both the Clinical Competency Committee faculty and the anesthesia residents themselves, utilizing the Chinese version of Anesthesiology Milestones in January 2023 and January 2024. The primary outcome was the differences between self- and faculty-assessments, calculated by subtracting the faculty-rated score from the self-rated score on each subcompetency. A total of 46 and 42 residents were evaluated in year 2023 and 2024, respectively. The self-rated sum score was significantly higher than that rated by faculty [mean (standardized deviation): 120.39 (32.41) vs. 114.44 (23.71), P = 0.008 in paired t test] with an intraclass correlation coefficient of 0.55 [95% confidence interval (CI): 0.31 to 0.70]. The Bland-Altman plots revealed significant overestimation in patient care (bias 0.32, 95% CI: 0.05 to 0.60), practice-based learning and improvement (bias 0.45, 95% CI: 0.07 to 0.84), and professionalism (bias 0.37, 95% CI: 0.02 to 0.72). Ratings from residents with master's degrees (mean difference: -1.06, 95% CI: -1.80 to -0.32, P = 0.005) and doctorate degrees (mean difference: -1.14, 95% CI: -1.91 to -0.38, P = 0.003) were closer to the faculty-assessments than residents with bachelor's degrees. Compared with patient care, the differences between self- and faculty- rated scores were smaller in medical knowledge (mean difference: -0.18, 95% CI: -0.35 to -0.02, P = 0.031) and interpersonal and communication skills (mean difference: -0.41, 95% CI: -0.64 to -0.19, P < 0.001) in the generalized estimating equation logistic regression model. This study revealed that residents tended to overestimate themselves, emphasizing the need to improve the accuracy of Milestones self-assessment. The differences between self- and faculty-assessments were associated with residents' degrees and domains of competency.

Complications of pediatric enteral nutrition at home: a systematic review of quantitative research

Objective: Identifying complications related to enteral nutrition at home in children is important in terms of establishing standard discharge education and training programs to support parents in managing complications. The study aimed to synthesize current evidence on the complications of pediatric enteral nutrition at home. Methods: The study was conducted according to PRISMA recommendations. Eight databases were reviewed between 2012 and 2022 in Turkish, German, and English languages. Articles were assessed in three stages: title, abstract, and full text. The review included 18 studies that met all the inclusion criteria. The Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instruments were used to assess the quality appraisal of the studies. Results: A total of 18 studies with 19,531 children were included from 14 countries. The outcome measures were major and minor complications with pediatric enteral nutrition at home. 11 of the 18 papers included were retrospective studies on complications of PEG. In studies reporting the overall rate of major complications ranged from 0% to 14.3%, and the most common complications were reoperation (2.64%-12.4%), and gastrocolic fistula/perforation (0.9%-3.8%). In studies reporting the overall rate of minor complications, the rate ranged from 16.4%-73.6% and the most common complications were infection (8.2%-31.9%), dislodgement (1.6%-21%), skin granulation (4%-50.4%), and vomiting (1%-49.89%). Conclusion: This systematic review reveals that the rate of complications in pediatric enteral nutrition at home cannot be underestimated. Healthcare providers should plan their practice considering these complications to support parents in managing complications of pediatric enteral nutrition at home.

Attitudes toward communication skills with learner needs assessment within radiology residency programs in China: a cross-sectional survey

BackgroundCommunication skills (CS) represent a core competency in radiology residency training. However, no structured curriculum exists to train radiology residents in CS in China. The aim of this study was to evaluate the status and prevalence of doctor–patient communication training among radiology residents in nine Chinese accredited radiology residency training programs and to determine whether there is a perceived need for a formalized curriculum in this field.MethodsWe administered a cross-sectional online survey to radiology residents involved in CS training at nine standard residency training programs in China. The questionnaire developed for this study included CS training status, residents’ demographics, attitudes toward CS training, communication needs, and barriers. Residents’ attitudes toward CS training were measured with the Communication Skills Attitude Scale (CSAS) and its subscales, a positive attitude scale (PAS) and negative attitude scale (NAS).ResultsA total of 133 (48.36%) residents participated in the survey. The mean total scores on the two dimensions of the CSAS were 47.61 ± 9.35 in the PAS and 36.34 ± 7.75 in the NAS. Factors found to be significantly associated with the PAS included receiving previous training in CS, medical ethics, or humanities and the doctor’s attire. We found that first-year residents and poor personal CS were the most influential factors on the NAS. Only 58.65% of participants reported having previously received CS training during medical school, and 72.93% of respondents reported failure in at least one difficult communication during their residency rotation. Most of those surveyed agreed that CS can be learned through courses and were interested in CS training. Some of the most common barriers to implementing formal CS training were a lack of time, no standardized curriculum, and a lack of materials and faculty expertise.ConclusionsMost residents had a very positive attitude toward CS training and would value further training, despite the limited formal CS training for radiology residents in China. Future efforts should be made to establish and promote a standard and targeted CS curriculum for Chinese radiology residents.

Stimulating Aerobic Energy Supply Reactions of Athletes in Rugby Union

Objectives. The study purpose was to evaluate the effectiveness of an experimental program of training means aimed at stimulating reactions of aerobic energy supply of athletes who are part of Ukraine national rugby union team. Material and methods. The athletes of the Ukrainian national rugby union team were divided into two homogeneous groups (experimental and control) consisting of 15 individuals. The experimental group underwent a specialized program aimed at developing aerobic energy supply, whereas the control group followed a standard training program. The object of study focused on the training process of Ukraine national rugby union team. Results. The results of testing rugby players in the experimental group demonstrated reliable changes in reactions of aerobic energy supply under the influence of a program of special training sessions. The most significant alterations were noted in the indicators of kinetics and stability of reactions. The indicators of O2 consumption and pulmonary ventilation in the intensity zone of anaerobic metabolism threshold increased significantly. There was a tendency to increase indicators characterizing the power of the respiratory response (max VE), in particular under conditions of growing fatigue (% excess VE). However, there were no significant changes in indicators of aerobic capacities components in the athletes’ control group. Conclusions. We believe that the mentioned indicators mostly reflect specialized manifestations of rugby players’ aerobic capacities and impact the increase of athletes’ special functional capabilities. This has been confirmed by the results of the analysis of urgent adaptive responses registered in model conditions of competition activity. As a result of the implementation of the specified experimental programme during the preparation process, the Ukrainian national team achieved 2nd place at the European Rugby Union Championship in the Trophy division of the 2022-2023 season.

Effect of HIIT on Motor Performance in Female Handball Players

Abstract: The aim of this study was to investigate the effects of interval training at four different intensities in addition to handball training for 8 weeks on aerobic-anaerobic, speed and agility pa-rameters in female handball players. Twenty female handball players (experimental group: 10; control group: 10) voluntarily participated in the studyThe experimental group trained in high-intensity interval training (HIIT) 3 days a week for 8 weeks in addition to handball training, while the control group was allowed to continue their standard training program. The anaerobic capacity, speed, and agility of the experimental and control groups were measured twice before and after an 8-week training program. The HIIT training program for the experimental group was adapted to the movements most commonly used in handball. The values of the data obtained from the handball players were analyzed. ANOVA for mixed measures was applied to determine the difference between the pre-test and post-test values of the experimental and control groups. There was a statistically significant difference (p &lt; 0.05) between the pre and post-test values of the 20-m sprint test of the experimental and control groups of HIIT training for handball players, while there was no statistically significant difference between the pre and post-test values of the anaerobic capacity and agility test of HIIT training. In conclusion, it is recommended to include HIIT training in the training periodization of handball players during the season, and it is believed that it will have a positive effect on players' speed performance.

Addressing Differences in Knowledge and Experience in Trauma Care Capabilities Among an International Team of Military Medical Care Providers in a Deployed Setting.

Military medical personnel are crucial in providing life-saving care at the point of injury (POI) in challenging environments such as combat zones and disaster areas. This article examines the specialized training US Military medical personnel undergo before deployment and the increasing trend of deploying as part of multinational forces in operations like those in Afghanistan with NATO and non-NATO countries. Integrating medical teams from diverse backgrounds poses significant challenges in maintaining a cohesive and efficient team due to varying trauma management training standards and medical practices among the allied forces. Tactical Combat Casualty Care (TCCC) training and the development of clinical practice guidelines (CPG) by the US Joint Trauma Service have been key strategies by the US Military to standardize care. However, the variation in trauma management training among NATO allies and the differences in medical subspecialties and approaches can lead to inefficiencies and reduced effectiveness in a multinational trauma center setting. For instance, the approach to trauma care can significantly differ between the US and European countries, impacting the interoperability and teamwork in multinational medical teams. To address these challenges, the article highlights the importance of standardized medical training programs that include cultural awareness to enhance the effectiveness of multidisciplinary, multinational medical teams. It also underscores the necessity for standardized international trauma training in the face of increasing global conflicts and the potential for large-scale combat operations. The article discusses the "Trauma Tuesday" program implemented in Kabul, Afghanistan, as an example of how intensive training and simulation exercises can improve team dynamics, knowledge, and skills in trauma management among a diverse team from various nations. The need for ongoing education and developing a standard for managing trauma patients in international teams is emphasized to ensure effective communication and coordination. The article suggests that multinational trauma training can significantly improve team cohesion and critical life-saving skills, essential for future battlefields where access to definitive care may be delayed. Further research is recommended to explore the best methods for achieving effective multinational medical team integration and training standardization.

The effectiveness of a blended-learning training methodology on the dialysis nurse’s perception of competence. Quasi-experimental study

Introduction: Nurses providing care to individuals with chronic kidney disease undergoing hemodialysis must have specific training in dialysis techniques. Therefore, Dialysis Nurses should develop specific and differentiated competencies throughout their professional career. Blended learning plays a fundamental role in modernizing education, making it more accessible, flexible, and tailored to the needs of nurses. It offers opportunities to improve the quality of learning and promote collaboration and innovation in the educational process.Objectives: The study’s objectives were to assess the influence of sociodemographic variables (age and education) and acquired training (frequency and duration) on the competence profile and to evaluate the effectiveness of a training program in HD techniques on the perception of competence of Dialysis Nurses.Material and Methods: Quasi-experimental, pre and post-test study without a control group.Results: Age, frequency, and duration of training influence dialysis nurses’ perceptions of competence. Participants showed a significant improvement in some domains of dialysis nurses’ perceptions of competence after the implementation of a training program in HD techniques.Conclusions: A properly structured and standardized training program for dialysis nurses is an asset in acquiring, consolidating, and updating knowledge.

PERLINDUNGAN KANAK-KANAK DI MALAYSIA: MENILAI KEBERKESANAN JAGAAN PELIHARA DARI PERSPEKTIF UNDANG-UNDANG

Foster care serves as a crucial support system for children in need of care and protection in Malaysia who cannot live with their biological families due to issues such as neglect, abuse, or abandonment. This article examines the concept of foster care, its legal implementation, and challenges. By scrutinizing existing legislation, the paper aims to identify areas for improvement to enhance the effectiveness of foster care as part of the child protection system in Malaysia. The foster care system in Malaysia is primarily governed by the Child Act 2001 and managed by the Social Welfare Department in providing family-based care, especially for abandoned children. This article employs a qualitative study, revealing challenges and limitations within the existing legal framework. The findings indicate that there is no specific law governing foster care in Malaysia. Therefore, the article emphasizes the need to enhance the effectiveness of foster care legislation by increasing resources and support for foster parents, implementing standardized training programs for them, strengthening monitoring and evaluation mechanisms, and encouraging cooperation and information sharing among relevant agencies. This is to ensure positive outcomes and long-term welfare for children in foster care in Malaysia.

The Effect of a Repeated Standardized Patient-Based End-of-Life Care Training Program on Nursing Students' Knowledge, Attitudes, and Emotions Toward End-of-Life Patients.

Sufficient knowledge of end-of-life care, positive attitudes, and emotions regarding death and dying are essential criteria for showcasing favorable palliative care educational results to undergraduate nursing students. However, nursing students have negative attitudes toward end-of-life care and know little about it. This study aimed to examine the effect of a repeated standardized patient-based training program (intervention) on nursing students' knowledge, attitudes, and emotions about end-of-life patients. This study adopted a pretest-posttest quasi-experimental research design. The sample consisted of 50 fourth-year nursing students divided into intervention (n = 25) and control (n = 25) groups. All participants attended the intervention. The intervention group attended the intervention twice, while the control group attended it only once. Data were collected using a personal information form, the Frommelt Attitudes Toward Care of the Dying Scale, the Positive and Negative Affect Schedule, and the End-of-Life Care Nursing Questionnaire. The data were analyzed using descriptive statistics, Pearson's Chi-square test, dependent groups t test, Pearson-Spearman, Mann-Whitney test, Wilcoxon test, and Friedman test. The intervention helped participants learn more about end-of-life care (χ2 = 27.167, P = .000; F = 42.725, P = .000) and develop more positive attitudes toward end-of-life patients (F = 13.279, P = .000; F = 6.934, P = .000). The intervention also helped participants develop communication skills. Universities should integrate repeated standardized patient-based into nursing curricula.

Development of physical qualities of high school students in the football section of the school sports club

Introduction. According to the World Study of School Physical Education, sports games, gymnastics and athletics make up almost 80% of physical education curricula in primary and secondary schools. Possibilities of using certain types of sports games, for example, football, in the physical education of high school students are not sufficiently considered. The study aims to determine the effective methodology for developing the physical qualities of high school students in the football section of the school sports club. Materials and methods of research. 20 students aged 16 took part in the experiment. The research work was carried out at the Secondary School of the Betty-Mokhk village of Nozhai-Yurtovsky district, the Chechen Republic (Russian Federation). A sectional group was formed from the students of the experimental group (10 people), which, in addition to the school physical education program, additionally played football at the school sports club. The total volume of the educational and training program was 144 hours. Methods of mathematical statistic were the arithmetic mean and Student's t-test. Research results. The experimental methodology was developed in the form of an educational and training program for football based on a standard sports training program for football players aged 15-17 by the Russian Football Union and recommended for football sports training organizations in the Russian Federation. During the experiment, testing was carried out according to the standards included in the All-Russian Physical Culture and Sports Complex ‘Ready for Labor and Defense’ to identify the level of physical fitness of students. Comparative analysis and mathematical processing of the experiment results showed statistically significant changes in indicators of agility (t = 3.9; p &lt; 0.01), speed (t = 2.3; p &lt; 0.05), endurance (t = 2.9; p &lt; 0.05), strength (t = 3.8; p &lt; 0.01), and flexibility (t = 3.3; p &lt; 0.01). Conclusion. The data obtained demonstrate the positive dynamics of the methodology for a sportsoriented approach through football in sectional classes within the school’s sports club. This proves the effectiveness of the chosen method, namely increasing the volume of physical activity through sectional work in the school sports club, taking into account the interests of students in physical education and sports activities.

Proposal of a standardized training curriculum for open and robot-assisted kidney transplantation.

Standardized training programs for open (OKT) and robot-assisted kidney transplantation (RAKT) remain unmet clinical needs. To fill this gap, we designed a modified Delphi Consensus aiming to propose the first structured surgical curricula for both OKT and RAKT, involving a multispecialty international panel of experts. Two web-based surveys were built drafting two separate series of statements (for OKT and RAKT, respectively). The two surveys were delivered to a panel of 63 experts (for OKT) and 21 experts (for RAKT), selected considering their experience, academic profile and involvement in international associations. Consensus was defined as ≥75% agreement between the responders. Overall, 25/63 (40%) and 14/21 (67%) participated in the first round of the Delphi Consensus for the development of the structured curriculum for OKT and RAKT, respectively. During the second round, the experts reached consensus on all statements, as well as on the domains composing the structure of the training pathway: 1) eligibility criteria for trainees and host centres; 2) theoretical training; 3) simulation; 4) real case observation; and 5) modular training in the operating theatre. To the best of our knowledge, this is the first proposal of a dedicated curriculum for OKT and RAKT grounded on insights from international experts of different specialties. Our proposed curriculum provides the foundation to standardize the education and training in KT across Europe and beyond.

Implementing health and safety standards in Offshore Wind Farms

Offshore wind farms represent a significant source of renewable energy, but their operation poses unique health and safety challenges due to the harsh marine environment and remote locations. This review explores the implementation of health and safety standards in offshore wind farms, highlighting key challenges and proposing solutions to mitigate risks. The offshore environment presents numerous hazards to workers, including adverse weather conditions, rough seas, and complex machinery. Ensuring the health and safety of personnel working in such environments requires comprehensive risk assessments, stringent safety protocols, and robust emergency response plans. However, the remote nature of offshore wind farms complicates rescue and evacuation procedures, necessitating specialized training and equipment for personnel. One of the primary challenges in implementing health and safety standards is the dynamic nature of offshore operations, which demand continuous monitoring and adaptation to changing conditions. Furthermore, the integration of multiple stakeholders, including project developers, contractors, and regulatory bodies, requires effective communication and collaboration to ensure compliance with safety regulations. To address these challenges, innovative technologies such as remote monitoring systems and predictive analytics can enhance safety performance by providing real-time data on environmental conditions and equipment status. Additionally, the development of standardized safety protocols and training programs tailored to the offshore wind industry can improve the competence and readiness of personnel in emergency situations. Implementing health and safety standards in offshore wind farms is crucial for safeguarding the well-being of workers and minimizing operational risks. By addressing the unique challenges of the offshore environment and adopting proactive safety measures, the industry can ensure sustainable growth while prioritizing the health and safety of its workforce.

Long-term evaluation of the Hernia Compact course of the German Hernia School.

Since 2011, the German Hernia Society has developed the German Hernia School (GHS) as a standardized hernia surgery training program for younger surgeons, consisting of the Hernia Compact basic module. It is a standardized three day training program (cadaver workshop, ultrasound simulation training, and hands-on training). After 12years of experience, a survey was conducted to evaluate the long term effect of this training. Using an anonymous online-questionnaire, we contacted from September 2023 to October 2023 the Hernia Compact course participants via the congress organizer "Weitmeer" and the German Hernia Society. This online questionnaire contains 18 multiple choice questions regarding participants' age, gender, professional experience, participation in other modules of the German Hernia School, the effect of the course on their daily practice and their specific interest in hernia and abdominal wall surgery. A total of 146 participants responded to the anonymous online questionnaire. A majority of 132 of 146 participants (90.42%) responded that this course improved the quality of surgical and hernia training (n = 146, no missing data). 141 of 146 individuals (96.58%) recommended the course to surgical colleagues (n = 146, no missing data). There were 89.73% of participants, (n = 146, no missing data) that developed a specific interest in hernia and abdominal wall surgery after the course. For 78.08% (n = 146, no missing data) of participants hernia and abdominal wall surgery was one of the most important activities in their daily surgical practice. The standardized Hernia Compact basic course of the German Hernia School appears to have a huge impact on the quality of hernia surgery training in Germany and Austria. It might also help generate a specific interest in hernia surgery among participants.

Exploring the potential impact of applying web-based training program on nurses' knowledge, skills, and attitudes regarding evidence-based practice: A quasi-experimental study.

Evidence-based practice (EBP) has gained significant importance in clinical practice worldwide, including in nursing. This study aimed to explore the potential impact of applying a web-based training program on nurses' knowledge, skills, and attitudes regarding EBP. A quasi-experimental pretest-posttest research design was utilized with a purposive sample of 64 professional nurses who agreed to participate. The study took place in different hospitals and primary healthcare centers in the Bisha Governorate, Aseer region, Saudi Arabia. A four-week standardized web-based training program was implemented using an online learning approach. Nurses were provided with an online self-rated data collection tool through the Google Forms platform. The findings indicated a highly significant difference in the total knowledge and EBP skills mean scores of the post-intervention (53.08±15.9) and (66.03±8.95), respectively compared to pre-intervention (P<0.05). Additionally, there was marked improvement in the mean scores of the positive attitude of the training sessions post-intervention compared to pre-intervention. The program was also well-received by the nurses in terms of quality and usability. The program has the potential to enhance nurses' knowledge, skills, and attitudes toward EBP. Therefore, healthcare organizations may consider adopting web-based training as a means of continuing professional education to promote EBP competencies among nurses.

Investigating the Influence of Personalized Training on the Optimization of Some Psychomotor Behaviors Among Junior Gymnasts in the Training Process (Moldova Region, Romania)

The purpose of the study was identified by the effort to complement the standard sports training programme with a portfolio of innovative means and methods to optimise the process of achieving performance in gymnastics competitions. The group of subjects investigated was female and consisted of 19 gymnasts, aged 10 - 12 years. They were tested initially and finally to determine the effects that going through the training program had on the analyzed indicators. The Matorin, Flamingo, Balance Plate Position Maintenance and the "Y" tests were used in the research. We used descriptive statistics (Arithmetic Mean, Standard Deviation, Median, Confidence Interval and Coefficient of Variation) and significance tests which were used to assess the statistical significance of the difference between the means for two sets of scores (STUDENT paired sample t-test and Wilcoxon test). Based on the results recorded, we identified a significant difference between the mean values for the two tests. Following the results obtained, we can confirm that they help to form an overall picture from the perspective of motor skills on gymnasts and that there is a significant effectiveness of the motor intervention program in the sports training process.

Narrative review in learning curve and pediatric robotic training program.

Studying learning curve (LC) for robotic procedures and developing an adequate training program are two fundamental steps to standardize robotic procedures. With this aim, we analyzed the literature to study the LCs of different robotic procedures and the availability of standardized training problems. The PubMed database was searched in the period from January 1995 to September 2022. Articles presenting LC and potential training programs in the pediatric population were chosen. Twenty papers were screened describing LC of robotic-assisted laparoscopic pyeloplasty (n=12), fundoplication (n=4), cholecystectomy (n=2), choledochal cyst resection (n=1), nephrectomy/partial nephrectomy (n=1) and lingual tonsillectomy (n=1), with a total of 1,251 procedures. In 10 studies there was only one single surgeon; nine had more than one; one did not specify how many surgeons participated. Twelve papers were retrospective single-center, three multicentric retrospective, four prospective and one was compared a retrospective case series to a prospective cohort. Most of these studies focused on operative time as the primary outcome. It was analyzed as the only outcome in three articles, along with complications in 14, time to discharge in eight, blood loss in three and pain killer use in three. The selected studies analyzed LC impacting operative planning (n=20), training (n=10) and costs (n=2). There is still a long way to go to complete a standardized functional training for robotic surgery procedures in pediatric surgery. Moreover, the progressive reduction in costs expected in the years to come will play a key role in progressing the diffusion of this technology enabling the collection of data necessary to create a standardized pediatric surgery robotic training program.

Implementation of a high fidelity simulation based training program for physicians of children requiring long term invasive home ventilation: a study by ISPAT team.

The number of children requiring long-term invasive home ventilation (LTIHV) has increased worldwide in recent decades. The training of physicians caring for these children is crucial since they are at high risk for complications and adverse events. This study aimed to assess the efficacy of a comprehensive high-fidelity simulation-based training program for physicians caring for children on LTIHV. A multimodal training program for tracheostomy and ventilator management was prepared by ISPAT (IStanbul PAediatric Tracheostomy) team. Participants were subjected to theoretical and practical pre-tests which evaluated their knowledge levels and skills for care, follow-up, and treatment of children on LTIHV. Following the theoretical education and hands-on training session with a simulation model, theoretical and practical post-tests were performed. Forty-three physicians from 7 tertiary pediatric clinics in Istanbul were enrolled in the training program. Seventy percent of them had never received standardized training programs about patients on home ventilation previously. The total number of correct answers from the participants significantly improved after the theoretical training (p < 0.001). The number of participants who performed the steps correctly also significantly increased following the hands-on training session (p < 0.001). All of the 43 participants who responded rated the course overall as good or excellent. The knowledge and skills of clinicians caring for children on LTIHV can be enhanced through a comprehensive training program consisting of theoretical training combined with hands-on training in a simulation laboratory.

Safety, Health and its Relation to Reliability in Oil and Gas Industry

Accident and incident occurrences have led to loss of invaluable cost in the oil and gas industry. Accidents or incidents however don‟t just occur but are caused by preceding events. This project clearly outlines the principals involved in accident/ incident investigation, critically reviews the techniques used in root cause analysis in order to identify their strengths and weaknesses, provides a detailed knowledge of the key phases employed in root cause analysis and develops recommendations for improvement and generation of implementation of root cause analysis report. On conclusion of this thesis through recommendations developed, lives will be saved by providing a safe and healthy working environment for personnel and the public in general, down time minimized, huge cost saved through adequate maintenance of facilities/ equipment, minimal or negligible insurance claims etc. This will thus ensure safety, health and reliability in the vibrant oil and gas industry. Despite having a standard training program, the level of competency to investigate accidents and incidents adequately and comprehensively vary from one safety professional or investigation team to another. This could be attributed to the number and types of accidents/incidents investigated i.e. experience, the frequency at which the investigations are carried out, information and documentation available for assessment, skills etc. Though these factors vary with age, experience, personal ability and industry, certain skills are essentially required for any accident or incident investigation. They include the following; Careful observation and understanding of key factors at the scene of the incident/accident and other areas of relevance to the occurrence An understanding of the technical, physical and chemical aspects of the incident/accident as the case may be Interviewing personnel and witnesses Taking of appropriate photographs and preparation of adequate sketches Ability of adequately record all relevant factors for future reference Evaluations of documentation i.e. work permits, operational manuals, and repairs/maintenance certification etc. Report writing The correct interpretation of relevant health and safety laws. Development of appropriate remedial action to prevent reoccurrence.