Hours Of Training Research Articles

FEATURES OF TRAINING A YOUNG DOCTOR IN MODERN CONDITIONS

Reforming the system of primary health care in healthcare in the Russian Federation over the past decade has been a priority task of the state. On instructions from the President, the Government continues to create conditions to increase the availability of medical care. A decision was made to expand the capabilities of the primary health care development program in rural areas, urban settlements and small towns of the country. This resolution was signed by Prime Minister Mikhail Mishustin (Resolution No. 2226 dated December 21, 2023). In the course of the conducted survey of 128 district therapists of the Stavropol Territory who started medical practice immediately after graduation, the main problems they faced when starting their work were identified: lack of practical training for independent professional activity, the assignment of a mentor to not every young specialist; insufficient equipment of the workplace with the necessary tools; incomplete computerization jobs (especially in rural areas); not all district doctors are assigned nurses; the number of attached population in 1 therapeutic area exceeds the norm. The difficulties of the professional activity of young specialists were associated with an insufficient number of hours of practical training in 5-6 years of study at the university and the cancellation of the internship. In order to revive the traditions of mentoring and increase the level of competence of young district therapists who received a diploma after 2017, the Ministry of Health of the Stavropol Territory, together with the Department of Polyclinic Therapy of Stavropol State Medical University, organized the work of the "School of a young therapist", which showed great effectiveness in the practical activities of young doctors in the region.

A Pilot Investigation Into the Use of Teledentistry and Artificial Intelligence to Assess Dental Erosion in Competitive Swimmers.

The aim of the study was to assess the prevalence of dental erosion in competitive swimmers using teledentistry and artificial intelligence. An opportunistic sample of 20 competitive swimmers was recruited. The participants reported that they carried out an average of 2.40 h of training per day, 4.45 days per week. Data gathering was carried out remotely. The subjects completed a digital questionnaire and uploaded three photos of their mouth. Intraoral photographs were analyzed using the "Intact-Tooth" application to assess dental erosion. A statistical analysis was carried out to verify a possible correlation between the collected data. The average calculated Basic Erosive Wear Examination (BEWE) index was 13.95, and 11 subjects (55%) had a severe BEWE (≥ 14). More than 40% of the participants disagreed about having social issues related to tooth hypersensitivity. Considering only subjects with a severe total BEWE value, we have observed an indirect correlation between the degree of dental erosion and diet (Pearson coefficient r = -0.57), whereas a direct correlation was observed between dental erosion and age (r = 0.493) and between BEWE and weekly training hours (r = 0.217). Because of their lifestyle, competitive swimmers can be considered at a higher risk of developing dental erosion. In this context, teledentistry and AI tools can be effectively used to intercept those at the highest risk and prevent the occurrence of conditions. Dental erosion assessment in competitive swimmers using teledentistry and AI.

Agricultural peer mentors for mental health support

ABSTRACT Stress and mental health challenges are common in the agricultural community, both in the United States and worldwide, especially in rural communities. We recruited farmers, ranchers, and allied agriculturalists across Hawaiʻi to serve as peer mental health mentors (ag mentors). Participation required 14 hours of training including Mental Health First Aid, Question Persuade Refer, internal online resources and webinars with local mental/behavioural health professionals. Thirty-four participants completed all trainings with statistically significant gains (p < .05) in knowledge of what is considered “good” mental health, and increases in confidence in detecting signs and symptoms of mental health challenges in oneself and others. Results also showed greater de-stigmatising attitudes about mental health, and more confidence with respect to providing options for assistance. Qualitative comments also highlighted enthusiastic endorsement of the program. The findings suggest an effective a community-based relational approach to addressing farmer mental health that is consistent with the Hawaiian value of ʻohana (family) and relational ontology.

Parent-Led Applied Behavior Analysis to Impact Clinical Outcomes for Individuals on the Autism Spectrum: Retrospective Chart Review.

Autism spectrum disorder (ASD) can have traits that impact multiple domains of functioning and quality of life, which can persevere throughout life. To mitigate the impact of ASD on the long-term trajectory of an individual's life, it is imperative to seek early and adequate treatment via scientifically validated approaches, of which applied behavior analysis (ABA) is the gold standard. ABA treatment must be delivered via a behavior technician with oversight from a board-certified behavior analyst. However, shortages in certified ABA therapists create treatment access barriers for individuals on the autism spectrum. Increased ASD prevalence demands innovations for treatment delivery. Parent-led treatment models for neurodevelopmental conditions are effective yet underutilized and may be used to fill this care gap. This study reports findings from a retrospective chart review of clinical outcomes for children that received parent-led ABA treatment and intends to examine the sustained impact that modifications to ABA delivery have had on a subset of patients of Montera, Inc. dba Forta ("Forta"), as measured by progress toward skill acquisition within multiple focus areas (FAs). Parents received ≥40 hours of training in ABA prior to initiating treatment, and patients were prescribed focused (<25 hours/week) or comprehensive (>25-40 hours/week) treatment plans. Retrospective data were evaluated over ≥90 days for 30 patients. The clinical outcomes of patients were additionally assessed by age (2-5 years, 6-12 years, 13-22 years) and utilization of prescribed treatment. Treatment encompassed skill acquisition goals; to facilitate data collection consistency, successful attempts were logged within a software application built in-house. Improved goal achievement success between weeks 1-20 was observed for older age, all utilization, and both treatment plan type cohorts. Success rates increased over time for most FAs, with the exception of executive functioning in the youngest cohort and comprehensive plan cohort. Goal achievement experienced peaks and declines from week to week, as expected for ABA treatment; however, overall trends indicated increased skill acquisition success rates. Of 40 unique combinations of analysis cohorts and FAs, 20 showed statistically significant positive linear relationships (P<.05). Statistically significant positive linear relationships were observed in the high utilization cohort (communication with P=.04, social skills with P=.02); in the fair and full utilization cohorts (overall success with P=.03 for the fair utilization cohort and P=.001 for the full utilization cohort, and success in emotional regulation with P<.001 for the fair utilization cohort and P<.001 for the full utilization cohort); and in the comprehensive treatment cohort (communication with P=.001, emotional regulation with P=.045). Parent-led ABA can lead to goal achievement and improved clinical outcomes and may be a viable solution to overcome treatment access barriers that delay initiation or continuation of care.

ANALISIS MANAJEMEN PELATIHAN DI RUMAH SAKIT

Training management is crucial to ensure that the training process runs smoothly and meets both organizational and employee goals. At Hermina Hospital Bogor, 22.5% of employees have not met the minimum required training hours. The training process faces challenges, including limited space, incomplete attendance, and scheduling issues. This study aimed to analyze the gaps in training at Hermina Hospital Bogor, using both quantitative and qualitative methods from March to May 2023. Qualitative data were gathered through interviews with three key informants, selected via purposive sampling, and observations of the training process. Quantitative data were obtained from implementation surveys and pre-post tests for the Isolation Awareness training, involving 31 participants. Qualitative analysis used content analysis, while the Wilcoxon test was applied for quantitative data. The training process includes needs assessment, planning, implementation, and evaluation. Training needs are identified through gap analysis, covering issues raised in morning meetings, unit evaluation results, and proposals from stakeholders, competencies performance gaps. Implementation challenges include rescheduling and participant absence. Online training faces additional barriers, such as a lack of computers and poor internet connectivity. Improvements in training management can be achieved by developing training facilities, enhancing online tools and e-learning modules, and increasing participant involvement through the Documentation System application.

3D vs. 2D-4 K: Performance and self-perception of laparoscopic novices in a randomized prospective teaching intervention using standard tasks and box trainers

ObjectiveThe use of three-dimensional (3D) laparoscopy in surgical practice and training has been an area of research and discussion. Studies have suggested that 3D vision can improve speed and precision compared to traditional two-dimensional (2D) displays, while other authors found no benefits on the learning curves of laparoscopic novices. Modern two-dimensional laparoscopy with a resolution of 3840 × 2160 pixels (2D-4 K) seems to improve laparoscopic view and helps learners orient without stereopsis. However, evidence comparing these systems for laparoscopic training is limited. Therefore, the impact of viewing mode (2D-4 K vs. 3D) on learning and task proficiency remains unclear.DesignWe performed a two-hour teaching intervention on basic laparoscopic skills for novices. In this parallel group randomized study, we randomly assigned learners to 2D-4 K or 3D teaching and performed tasks of increasing difficulty and complexity using standard laparoscopy box trainers. Before the last and most challenging task, learners had to crossover to the other laparoscopy setup. Our hypothesis was that learners would be faster and more precise when using a 3D setup. The primary endpoint was task proficiency measured by speed and failure rate. Secondary outcomes were performance using the viewing mode of the other group without familiarization, self-perception, and career aspirations before and after the teaching intervention, expressed on a Likert scale.SettingThe study was performed by the Department of General, Visceral and Thoracic Surgery at the German Armed Forces Hospital Ulm, which is an academic teaching hospital of the University of Ulm.ParticipantsThirty-eight laparoscopic novices, including medical students and junior residents, participated voluntarily in this teaching intervention. Group allocation was performed via the virtual coin flip method. Apparently, participants and tutors were not blinded to group assignment. No formal approval by the ethics committee was needed for this noninvasive study in compliance with the World Medical Association Declaration of Helsinki as discussed with the ethics committee of the University of Ulm.ResultsThirty-eight laparoscopy novices were randomized in the study. The 3D group (n = 19) was significantly faster than the 2D-4 K group (n = 19) (p = .008) in a standard box trainer model, with 134.45 ± 41.45 s vs. 174.99 ± 54.03 s for task 1 and 195.97 ± 49.78 s vs. 276.56 ± 139.20 s for task 2, and the effect was consistent throughout the learning curve. The failure rate was not significantly affected by the viewing mode. After crossover to the other laparoscopy system, precision and time were not significantly different between the groups. Learners rated the difficulty of laparoscopy lower on a Likert scale after having two hours of basic laparoscopy training. The study was funded by the hospital’s teaching budget.ConclusionsLaparoscopic novices can benefit from a 3D laparoscopy training setup. Exclusive 3D training prior to a complex task on a 2D-4 K setup does not negatively affect the learner’s performance.

Cardiac magnetic resonance characteristics of the athlete's heart: deeper insights into cardiac remodelling

Abstract Cardiac magnetic resonance (CMR) offers precise quantification for myocardial parameters. Understanding the effects of different training volumes on the athlete’s heart could be the key to distinguishing between cardiac conditions. This study aims to investigate CMR parameters including T1- and T2 mapping in healthy athletes and less active individuals and explore their relationship with training volumes in both sexes. We included healthy athletes (weekly training hours &amp;gt;7) and less active age- and sex-matched control individuals (weekly training hours ≤6), and performed CMR examinations. We assessed ventricular volumes, masses, and function, and conducted T1- and T2-mapping on non-contrast short-axis images. A total of 270 CMR examinations were conducted, comprising 185 athletes (119 males, mean age 22±6 years, weekly training hours: 19±7) and 85 controls (50 males, mean age 26±3 years, weekly training hours: 3±2). In male athletes compared to less active individuals, we observed pronounced signs of sports-related cardiac remodeling, including increased end-diastolic volume and mass index (Left ventricular end-diastolic volume index (LVEDVi): 120±16 vs 97±12 ml/m2, p&amp;lt;0.001; left ventricular mass index (LVMi): 70±14 vs 53±9 g/m2, p&amp;lt;0.001). Similarly, female athletes exhibited significant sports adaptations compared to controls (LVEDVi: 103±12 vs 86±11 ml/m2, p&amp;lt;0.001; LVMi: 54±9 vs 39±5 g/m2, p&amp;lt;0.001). T1-mapping values in athletes were lower than in the control group for both sexes (males: 939±25 vs 961±20 p&amp;lt;0.001, females: 966±21 vs 985±17, p&amp;lt;0.001). T1 values showed negative correlations with training hours (r=-0.362, p&amp;lt;0.001), LVEDVi (r=-0.411, p&amp;lt;0.001), and LVMi (r=-0.546, p&amp;lt;0.001). A significant association between T1 values and training hours persisted across various models. In the raw model, every additional training hour correlated with a T1 reduction of 0.946 ms (p&amp;lt;0.001). Adjusting for age, sex, and heart rate (HR) in model 2, the association remained significant, with each additional training hour corresponding to a T1 reduction of 0.825 ms (p&amp;lt;0.001). Further adjustments for LVMi in model 3 revealed a significant association, with a decrease of 0.565 ms in T1 values for each additional training hour (p=0.002). Among athletes, training years associated with decreased T1 and increased ventricular end-diastolic volumes and myocardial mass indices (LVEDVi: r=0,232, p=0,002; p&amp;lt;0,001; LVMi: r=0,279, p&amp;lt;0,001; T1-mapping: r=-0,169; p=0,026). Examining the differences between sexes we found that female athletes respond slightly less to a unit of exercise compared to males. Our findings underscore that different training hours and invested years have a meaningful impact on physiological adaptation. Female athletes’ heart responds slightly less to these effects. But in both sexes, higher training hours resulted in lower T1 and this relationship persisted independent of the influences of age, HR, and LVMi.

Predictors of ventricular and atrial feature tracking-derived global longitudinal strain in healthy athletes and volunteers

Abstract Background Feature tracking (FT) strain analysis provides insights into the mechanics of the heart and carries essential prognostic and diagnostic information without prolonging image acquisition during cardiac magnetic resonance (CMR) scans. However, data regarding CMR-derived FT strain in athletes is scarce, especially in the atria. We explored the determinants of FT global longitudinal strain (GLS) values concerning all four cardiac chambers in healthy competitive athletes and less active volunteers. Methods Long- and short-axis cine sequences were analyzed with Medis Suite v4.0 (Leiden, The Netherlands) to assess FT strain. After excluding individuals with preexisting pathologies and images with quality issues, subjects were classified by sport types following the 2020 ESC Sports Cardiology Guidelines. Multiple linear regression models were constructed to assess the impact of age, sex (male=0, female=1), weekly training hours, and sports category (power coded as 0, mixed as 1, endurance as 2) on GLS values. Atrial strain values are positive, and ventricular ones are negative. Intercepts/constants are denoted as "baseline" for easier comprehension. Results Native CMR scans acquired at a tertiary cardiac centre of 596 healthy Caucasian subjects (411 athletes: 145 females, mean age 21±6, range 14-36 years; and 185 volunteers: 86 females, mean age 24±5, range 13-35 years) were included. Athletes had a high exercise load versus the controls who performed no or maximum recreational physical activity (19±7 vs. 3±2 hours/week, p&amp;lt;.001). When assessing athletes (weekly training≥6h), RA GLS (baseline: 34%, p&amp;lt;.001) is increased in females (β=2.0) but is expected to decrease with every one-hour increase in training hours (β=-0.2). LA GLS is notably affected by sex alone (baseline: 37%, β=3.6, p&amp;lt;.001), suggesting markedly higher values for females. RV GLS (baseline: -30%, p&amp;lt;.001) is associated with both age and training hours (β=0.1 for each), making it less negative. Conversely, LV GLS (baseline: -25%, p&amp;lt;.0001) is significantly modulated by all studied factors, with sports category (β=0.5), age, and training hours (β=0.1 each) increasing values and sex decreasing them (β=-0.9). In less active volunteers (weekly training&amp;lt;6h), sex (β=4.7) is the only significant factor for RA GLS (baseline: 33%, p=.04), and sports category (β=2.7, the group included 98 recreational athletes with low training loads) for LA GLS (baseline: 38%, p=.04). No variables were retained in the model for RV GLS, but sex (β=-1.4) remained a predictor in the LV GLS model (baseline: -21%, p=.002). Conclusion GLS shows significant variations influenced by age, sex, sports category, and training hours across all four heart chambers in athletes. These effects appear mostly inconclusive among less active individuals. This data calls for further advanced analyses of athlete's hearts to refine differentiation methods between healthy adaptation and cardiac pathologies.Left atrial FT analysisModel outputs for GLS predictions

Conversation circles – an inventive way to talk about and address migratory related mental health

Abstract Refugees in European countries face psychological stressors stemming from pre-, peri- and post-migration experiences. In Sweden, a mental health promotion program for newly settled refugees “Ways Forward - After the escape”, was tried out to mitigate the consequences of negative migratory experiences. The program included training of course leaders and implementation of conversation circles for participants, i.e., short in-depth courses for smaller groups led by a trained leader. The objective of the program was to equip civic communicators working within the Introduction program for refugees with the necessary skills to lead conversation circles on mental health in cities in the south of Sweden. During 2020-2023, 43 course leaders were trained and 55 refugees participated in conversation circles. The course leader training included 50 hours of training on themes of the program “Ways Forward”; health and well-being, loss and identity, grief and forgiveness, reconciliation and acceptance, stress and stress management, trauma and trauma-conscious care. The conversation circles for participants were given in 3-hour modules x 10 occasions. 1. How did the course leaser perceive the utility of the training for their work with the target group? 2. In what ways has the intervention assisted the participants in navigating their mental and well-being in Sweden? The results showed that course leaders acquired new knowledge and practical skills and tools to lead reflective conversations about mental health related to migration. Participants reported a higher awareness of mental health issues, less stigma, trying out new coping techniques and increased motivation to seek help. Short training courses for civic communicators on migratory mental health increased knowledge and gave new skills and tools to lead conversation circles. Newly settled refugees reported higher awareness, new tools and less stigma to talk about mental health following participation in conversation circles. Key messages • Short training courses on mental health related to migration increased knowledge and gave new skills and tools to lead conversation circles. • Newly settled refugees reported higher awareness, new tools and less stigma to talk about mental health following participation in conversation circles.

Identifying factors affecting sports achievement and endurance using artificial intelligence

Abstract Introduction Sports achievements and performance are not solely based on outstanding endurance, especially in tactical and technical sports. Artificial intelligence (AI) can help us to identify correlations that can contribute to the successful preparation of athletes. Purpose Our aim was to further analyze and evaluate our previously initiated AI-based sports performance studies, identifying the parameters that determine athletes’ achievement and endurance. Methods First, sports cardiology screening was performed in all athletes containing the following examinations: patient’s history, ECG, laboratory test, body composition analysis, echocardiography and cardiopulmonary exercise testing. A database from the sports cardiology screening results was established. Then, we created two scoring systems based on the best ever result (Achievement Score) and the performance on the cardiopulmonary exercise test (Endurance Score). We identified the most important influencing factors using a neural network and characterized the strength of the variables using Shappley Additive Explanation (SHAP) values. Results We examined 1932 tests of 891 athletes and the AI analysis included 917 tests of 546 athletes (20.2±6.2 years, males: 397, 72.7%). Majority of the examined athletes were swimmers (27.4%), followed by basketball players (21.8%), water polo players (15.2%), handball players (13.3%) and football players (13.1%). The most important Achievement Score determinants were the weekly training hours (SHAP=0.27), training years (SHAP=0.26) and the age (SHAP=0.15). Meanwhile, Endurance Score was mainly affected by skeletal muscle mass (SHAP=0.85), weight (SHAP=0.6) and peak heart rate during exercise (SHAP=0.32). Our results were validated on a test population (N=102) and in the Achievement Score the mean absolute error (MAE) was 0.64, the determination coefficient (R2) was 0.56, in Endurance Score the MAE was 0.84 and the R2 was 0.71. Conclusion Based on our results, while endurance is mainly determined by the athlete’s physical characteristics, in athletic achievement experience is more important. With our scoring systems the athlete’s achievement and endurance can be predicted well.

Analysis of implementation science strategies to train laparoscopic surgical skills among Liberian surgeons using ALL-SAFE.

Significant disparities exist in laparoscopic training opportunities for surgeons in low- and middle-income countries (LMICs). ALL-SAFE is an innovative, low-cost training system for LMIC surgeons' laparoscopic development. However, strategies to implement and scale ALL-SAFE are unstudied. We aimed to assess the impact of implementation science strategies on ALL-SAFE uptake in Liberia, a novel and low-resource context. This study used implementation science approaches to evaluate ALL-SAFE uptake in three Liberian hospitals: John F. Kennedy Medical Center, Phebe, and ELWA. Five validated implementation strategies of program orientation, local champions, network weaving, feedback mechanisms, and practical supervision were piloted. All five strategies were implemented at two hospitals, while four strategies, excluding clinician supervision, were implemented at the final site as a pseudo-control, to evaluate the impact of resource-intensive supervision. Participants included surgical consultants, residents, and medical students. Engagement was assessed with mixed methods including participant number, practice hours, module completion rates, and strategy feasibility through end-user interviews. Across three hospitals, 33 participants used ALL-SAFE for 87.8 total training hours (5,268min). Participant numbers varied across sites (NJFK = 20, 80%; NPhebe = 7, 88%; NELWA = 6, 86%), as did practice times (TotalJFK = 3,060min, Median time/ParticipantJFK = 103min; TotalPhebe = 1,434min, Median time/ParticipantPhebe = 126min; TotalELWA = 774min, Median time/ParticipantELWA = 100min). Sites with practical supervision demonstrated higher engagement than those without (P = 0.042). Interviews (n = 8) revealed positive perceptions toward program orientation, practical supervision, and network weaving. Participants recommended thirteen additional strategies for sustainability including translating ALL-SAFE skills to patient care. Our study is one of the first to evaluate implementation science strategies for laparoscopic training in sub-Saharan Africa. The implementation bundles of five validated strategies were considered feasible by Liberian surgeons in both urban and rural hospitals. Mixed methods suggested a positive association between engagement and the resource-intensive practical supervision strategy. Future studies should focus on quantifying individual strategy contributions with rigorous implementation designs and assessing sustainability strategies.

Impact of Daily Lower-Body Negative Pressure or Cycling Followed by Venous Constrictive Thigh Cuffs on Bedrest-Induced Orthostatic Intolerance.

Orthostatic intolerance occurs following immobilization in patients on Earth and in astronauts after spaceflight. Head-down tilt bedrest is a terrestrial model for weightlessness and induces orthostatic intolerance. We hypothesized that lower-body negative pressure (LBNP) or cycling followed by wearing venous constrictive thigh cuffs mitigates orthostatic intolerance after head-down tilt bedrest. We enrolled 47 healthy individuals (20 women, 35±9 years) to a 30-day strict head-down tilt bedrest study. During bedrest, they were assigned to 6 hours of 25 mm Hg LBNP (n=12) per day and 1 hour of supine cycling followed by 6 hours of venous constriction through thigh cuffs 6 days per week (n=12), 6 hours of daily upright sitting (positive control, n=11), or no countermeasure (negative control, n=12). We measured orthostatic tolerance as the time to presyncope during 80° head-up tilt testing with incremental LBNP before and immediately after bedrest. We determined plasma volume with carbon monoxide rebreathing before and at the end of bedrest. After bedrest, orthostatic tolerance decreased 540±457 seconds in the control group, 539±68 seconds in the cycling group, 217±379 seconds in the LBNP group, and 289±89 seconds in the seated group (P<0.0001 time point, P=0.009 for group differences). Supine and upright heart rate increased in all groups following bedrest. Plasma volume was only maintained in the cycling group but decreased in all others (interaction countermeasure×time point P<0.0001). Six hours of moderate LBNP training was as effective as sitting in attenuating orthostatic intolerance after 30 days of head-down tilt bedrest. Daily cycling exercise followed by 6 hours of wearing venous constrictive thigh cuffs, while maintaining plasma volume, did not improve orthostatic tolerance. URL: https://www.bfarm.de/EN; Identifiers: DRKS00027643 and DRKS00030848.

Integrating the ideas of mindful meditation into physical activities to improve executive function skills of kindergarten children

This study aimed to examine whether physical activities based on mindful meditation can significantly enhance executive function (EF) skills in kindergarten children. A pre-experimental design was used, and purposive sampling was conducted to recruit the participants. A total of 87 kindergarten children were recruited, including 66 regular children and 21 who were screened as having a risk of Attention Deficit Hyperactivity Disorder (ADHD) based on a t-score of ≥ 1.5 on the Swanson, Nolan, and Pelham Rating Scale-IV (SNAP-IV). The participants received one hour of training every day, four days per week, for eight weeks. The modified Thai version of the Behavior Rating Inventory of Executive Function-Preschool (BRIEF-P) was administered before and after the intervention. Paired t-tests were conducted to determine if there were any significant differences between the pre- and post-tests for children with and without a risk of ADHD. Independent t-tests were also conducted to determine if there were any significant differences between children with and without a risk of ADHD. The intervention significantly enhanced the participants' performance on the full BRIEF scale and all subscales (inhibition, cognitive flexibility, emotion control, working memory, and planning). Additionally, significant differences in cognitive flexibility, inhibition, and emotion management were found between children with and without a risk of ADHD in the pre- and post-tests. Overall, the intervention effectively enhanced the executive function of kindergarten students at risk of ADHD. However, interpretation of the study’s results should be done with caution due to the lack of a control group and random sampling. A true experimental design is suggested to overcome these limitations.

Fungal Skin Infections in Beach Volleyball Athletes in Greece

Background/Objectives: Fungal infections, commonly referred to as mycoses, are widespread and affect various parts of the body. Common types of fungal skin infections include tinea pedis, tinea unguim, tinea cruris, tinea versicolor, and tinea manuum. Athletes, in particular, are at a higher risk of contracting these infections due to several factors inherent to their training and competitive environments. Methods: This research examined the incidence, anatomical distribution, and seasonal occurrence of fungal skin infections among beach volleyball athletes in Greece. The study cohort consisted of 785 participants, with an average age of 28.4 years. Variables recorded included gender, the seasonal periods during which athletes might be more prone to injuries, and the specific body areas affected by fungal infections. In addition, training-related data such as weekly training frequency, and daily training duration were collected. Results: Incidence rates correlated in relation to gender: male, tinea pedis (p &lt; 0.000), tinea manuum (p &lt; 0.010); number of weekly trainings: tinea pedis (p &lt; 0.000), tinea unguium (p &lt; 0.043), tinea cruris (p &lt; 0.008), tinea versicolor (p &lt; 0.038), tinea manuum (p &lt; 0.043); average hours of daily training: tinea unguium (p &lt; 0.039), tinea manuum (p &lt; 0.039). Conclusions: Athletic activities often involve exposure to warm, moist conditions that promote fungal growth. Locker rooms, showers, and equipment can harbor fungi, spreading infections among athletes. Understanding these infections is essential for effective prevention and management, as they can impact performance and health if untreated. Proper hygiene, antifungal treatments, and public health measures are crucial to reducing the risk in athletic settings.

Job Satisfaction Among First-Generation Migrant Physicians in Anesthesiology and Intensive Care Medicine in Germany

Background/Objectives: This study examines job satisfaction, burnout, and well-being among first-generation migrant physicians in anesthesiology and intensive care medicine in Germany, comparing them to their native German counterparts. Methods: A cross-sectional survey design was utilized, collecting data from 513 physicians, 110 of whom identified as having a migration background. Job satisfaction was measured using the Warr-Cook-Wall (WCW) Job Satisfaction Scale, burnout was assessed with the Copenhagen Burnout Inventory (CBI), and well-being was evaluated using the WHO-5 Well-Being Index. Results: The job satisfaction ratings revealed no significant differences between migrant and German physicians in most dimensions, including physical workload, freedom to choose work methods, satisfaction with colleagues, responsibility, income, skill utilization, and variety in work tasks. However, migrant physicians reported significantly higher satisfaction with recognition received for their work and lower dissatisfaction with working hours. Burnout assessments showed that migrant physicians experienced higher psychological strain, perceiving every work hour as more exhausting and having significantly less energy for family and friends. Migrant physicians reported higher difficulty and frustration in working with patients. Well-being items indicated that migrant physicians felt less energetic and active but found their daily life more filled with interesting activities. Notably, the multivariate analyses of the total scale scores did not show significant associations between migration background and the overall outcome scales. Conclusions: The findings indicate unique challenges faced by migrant physicians, particularly in terms of recognition and patient-related burnout. These results highlight the need for targeted interventions to support migrant physicians, including cultural competence training and flexible working hours to enhance their job satisfaction and overall well-being. Addressing these issues is crucial for maintaining the quality of patient care and the occupational health of migrant physicians in Germany.

Pathway to Trauma-Informed Rehabilitation Counseling: Vocational Rehabilitation Counselors’ Training Experiences and Use of Trauma-Relevant Knowledge in Daily Practice

The compelling evidence regarding the prevalence and profound impacts of traumatic experiences on individuals with disabilities underscores the need to establish trauma-informed service environments within vocational rehabilitation (VR). In an initial endeavor towards cultivating trauma-informed service, this study investigates the VR counselors’ professional training experiences in the topical areas of trauma. Further, the applicability of the Technology Acceptance Model (TAM 2) is examined in elucidating the utilization of trauma knowledge by VR counselors in their practices. A needs assessment focusing on trauma training was distributed to 169 VR counselors to measure their trauma-related training history and utilization of trauma knowledge in practices. Path analysis was employed to examine the relationship between training experience and the actual use of trauma knowledge in counseling based on the TAM 2 framework. Participants reported having 9.71 hours of post-graduate training. Path analysis suggested adding three additional paths to the original research model, explaining how post-graduate training leads to the use of trauma knowledge in VR service through perceived ease of use, usefulness, attitude toward using, and behavioral intention. The profession of rehabilitation counseling needs to incorporate more trauma-related training into its practice, education, and research to better serve individuals with disabilities and improve the effectiveness of services.

USING PREDICTIVE ANALYTICS TO IMPROVE SURVEILLANCE OF HEAT-RELATED ILLNESS DURING MILITARY TRAINING

Background: Heat-related illnesses are a critical concern for military personnel, especially those unfamiliar with hot climate regions. The Royal Thai Army (RTA) implements a 10-week military training program encompassing four phases: (1) Heat acclimatization training, (2) Combat fundamentals and unarmed combat training, (3) Armed combat training and tactical training, and (4) Field training exercise and evaluations. Objective: This study aimed to conduct a predictive analysis of heat-related illnesses to enhance prevention programs. Methods: The study utilized secondary data from the RTA Medical Department, incorporating variables such as age, occupation, education, underlying diseases, smoking and alcohol consumption, sleep duration, exercise, medication history, body mass index (BMI), weight loss, body temperature, dark urine, heat rash, and environmental humidity. Multiple machine learning algorithms were employed to develop predictive models. Results: The samples comprised 809 male recruits (103,051 encounters) with an average age of 22. Approximately 12% of the recruits had a BMI ≥30 kg/m2, while nearly 70% and 90% reported tobacco use and alcohol consumption in the past 12 months, respectively. Among the recruits, 16% reported substance use within the preceding 30 days. The eXtreme Gradient Boosting (XGB) model achieved 91% accuracy in predicting heat-related illnesses before Phase 2. The top five predictive variables were Lopburi Province (central region), Songkhla Province (southern region), and Bangkok (capital city), sleep duration before joining military training (hours), and age (years). Conclusion: This study, which applied machine learning techniques to predict heat-related illnesses among Thai recruits, can potentially impact the health and training of military personnel. The comparative analysis of various algorithms identified the XGB model as the optimal performer in predicting heat-related illnesses during the combat fundamentals and unarmed combat training phase. However, it is essential to note that further study is needed to enhance the applicability of our predictive model, which includes expanding its use to new cohorts of Thai conscripts, underscoring our research’s ongoing nature.

Psychoeducation as burnout prevention for Hungarian teachers

The aim of this study is to examine the role of psychoeducation in preventing burnout among Hungarian teachers. Psychoeducation is a structured method of delivering professional information, combining elements of education, cognitive-behavioral therapy, and grouptherapy, with the goal of developing coping strategies to maintain health and ensure therapeutic collaboration. As part of the research, a 30-hour training program was developed and implemented with two groups, consisting of kindergarten and special education teachers (N=35). The core components of the training included self-awareness exercises, autogenic training techniques, and conflict management strategies. Changes in participants' burnout levels, psychological immune systems, coping methods, and perceived social support were assessed using pre- and post-training questionnaires (Maslach Burnout Inventory Educator Survey (MBI-ES), Oláh’s Psychological Immune System Survey, Coping Methods Questionnaire, MOS SSS-H Social Support Questionnaire, and Mental Health Test). A significant reduction in burnout was observed. The findings support previous research indicating that psychoeducation can effectively reduce stress and burnout, though its effectiveness may depend on various factors, such as the length and intensity of the program, as well as participants' motivation and commitment. Future research should involve larger sample sizes and longitudinal designs to assess the long-term benefits of psychoeducational interventions more accurately for teacher burnout.

Paramedic educational programs maintain entry level competency throughout the COVID-19 pandemic.

The COVID-19 pandemic required unprecedented changes to emergency medical services (EMS) educational frameworks in the United States. It is unclear if pandemic-related changes impacted paramedic educational outcomes. We aimed to evaluate curricular and performance changes resulting from the initial COVID-19 pandemic on paramedic educational programs. We performed a retrospective cross-sectional evaluation of paramedic educational programs in 2019 and 2020 using the Committee on Accreditation of Educational Programs for the Emergency Medical Services Professions annual reports. These reports contain detailed program components and measures of program success. We included programs reporting at least one graduate in the study period. Descriptive statistics (proportions [%], median [interquartile range, IQR]) were calculated for paramedic program characteristics in 2019 and 2020, as well as pandemic specific curriculum changes. Wilcoxon rank-sum and Fisher's exact tests were used to evaluate differences in characteristics by year. The number of paramedic educational programs in our population decreased from 640 programs in 2019 to 612 in 2020, with a statistically significant decrease in clinical hours (2019: 219 [IQR 168‒272]; 2020: 200.5 [IQR 157‒261]). There was no difference in first or third-attempt certification examination success between years. Temporary shutdown was experienced in 34% of programs (duration: 3weeks [2‒7]) and 72% of required curricular changes. Curricular changes commonly included decreased in-person education (86%), traditional classroom lectures (78%), number of clinical sites (78%), and increased online didactic education (92%). Only 20% of programs decreased laboratory simulation or total training hours. During the pandemic, paramedic educational programs changed educational delivery with no observed differences on overall program performance. Identifying key curricular changes and best practices for implementation may be necessary to better optimize future educational delivery.

Mindfulness-based relapse prevention targeting psychological craving and trait mindfulness in young Chinese women with methamphetamine dependence: a randomized controlled trial.

We recruited 58 MA-dependent young adult females from a compulsory isolation drug rehabilitation center in Sichuan Province and randomly divided them into an MBRP group (n = 29) and a control group (n = 29) according to their degree of psychological craving. The MBRP group received 2 hours of MBRP training twice a week for 4 weeks, alongside routine treatment at the drug rehabilitation center. Meanwhile, the control group solely received routine treatment at the drug rehabilitation center without any additional interventions. The assessment was conducted before and immediately after the intervention, with the Compulsive Drug Use Scale (OCDUS) used to assess craving and the Five-Factor Mindfulness Scale (FFMQ) used to assess trait mindfulness. Also, a "mental feedback monitoring balance" instrument was used to assess concentration and relaxation during some training sessions. This randomized trial was conducted to evaluate the effectiveness of decreasing psychological craving and increasing trait mindfulness. At baseline, there were no significant differences in total or dimension scores for FFMQ or OCDUS between the two groups (all P > 0.05). After the intervention, the repeated measures ANOVA showed a significant time main effect on changes in observing, non-judging, and non-reacting scores (all P < 0.05), and a significant interaction effect between time and group on both FFMQ total score and OCDUS score (P < 0.01 or P < 0.05). Mental feedback monitoring indicated significant improvement in concentration and relaxation after breath meditation exercises (P < 0.05 or P < 0.001). Additionally, the MBRP group showed improved relaxation during the body scan exercise (P < 0.01). MBRP training can improve the trait mindfulness of MA addicts and reduce psychological cravings effectively.