Utility of the Lone Star Retractor System in Microsurgical Carotid Endarterectomy.

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Toyota, Shingo; Kumagai, Tetsuya; Goto, Tetsu; Mori, Kanji; Taki, Takuyu

2017-05-01

The retractor system is an important device in carotid endarterectomy (CEA). We applied the Lone Star (LS) Retractor System, which is a self-retaining retractor originally designed for improved visualization in many other surgical fields, in microsurgical CEA. The LS disposal retractor (14.1 cm × 14.1 cm) and LS elastic stays (5-mm sharp hook) were used as a retractor system in 38 consecutive CEAs. Using the LS retractor system, a shallow operative field could be obtained by lifting up the connective tissue surrounding the deep structures hooked by the LS elastic stays. The LS elastic stays were quick and easy to handle in the microsurgical operative field. There were no complications using the LS retractor system. The application of the LS retractor system in microsurgical CEA is feasible. An additional merit is that it is single use. Copyright © 2017 Elsevier Inc. All rights reserved.

Microsurgical replantation of a small segment of thumb volar skin.

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Akyürek, Mustafa; Safak, Tunç

2004-06-01

This report presents a case of microsurgical replantation of a volar skin segment of the thumb. In a 24-year-old patient, a heavy object falling over the dominant thumb resulted in a crush-avulsion injury of a pure skin segment measuring 4 x 2 cm. Examination revealed that the distal fingertip as well as the bone-tendon structures remained intact. Exploration demonstrated that both neurovascular bundles were included in the avulsed skin segment. Microsurgical replantation was achieved successfully, repairing the radial digital artery at both ends with vein grafts as well as anastomosing a palmar vein. Both digital nerves were coapted proximally and distally. An excellent functional and cosmetic result was accomplished with a good sensory recovery. The authors conclude that microsurgical replantation should be attempted in cases of more proximal pure skin avulsions, even if the injury spares distal fingertip tissue or bone-tendon units. In such cases, replantation is superior to any other method of reconstruction. Liberal use of vein grafts is crucial to achieve success.

Japanese Neurosurgeons and Microsurgical Anatomy: A Historical Review

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MATSUSHIMA, Toshio; KAWASHIMA, Masatou; MATSUSHIMA, Ken; WANIBUCHI, Masahiko

2015-01-01

Research in microneurosurgical anatomy has contributed to great advances in neurosurgery in the last 40 years. Many Japanese neurosurgeons have traveled abroad to study microsurgical anatomy and played major roles in advancing and spreading the knowledge of anatomy, overcoming their disadvantage that the cadaver study has been strictly limited inside Japan. In Japan, they initiated an educational system for surgical anatomy that has contributed to the development and standardization of Japanese neurosurgery. For example, the Japanese Society for Microsurgical Anatomy started an annual educational meeting in the middle of 1980s and published its proceedings in Japanese every year for approximately 20 years. These are some of the achievements that bring worldwide credit to Japanese neurosurgeons. Not only should Japanese neurosurgeons improve their educational system but they should also contribute to the international education in this field, particularly in Asia. PMID:25797782

Predictive factors for natural pregnancy after microsurgical reconstruction in patients with primary epididymal obstructive azoospermia.

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Harza, Mihai; Voinea, Sebastian; Ismail, Gener; Gagiu, Cristian; Baston, Catalin; Preda, Adrian; Manea, Ioan; Priporeanu, Tiberiu; Sinescu, Ioanel

2014-01-01

Primary epididymal obstructive azoospermia (OA) is the most prevalent form of OA in nonvasectomized patients and has been less studied. We aim to assess the results with microsurgical vasoepididymostomy used in the treatment of men diagnosed with primary epididymal obstructive azoospermia and to identify the factors associated with natural pregnancy occurring after microsurgical reconstruction. This prospective study included consecutive patients with epididymal OA who underwent microsurgical reconstruction in our center. Clinical and biological data were obtained every three months during follow-up. Occurrence of natural pregnancy was the primary study outcome. In total, 36 patients underwent microsurgical reconstruction. The mean age was 34 ± 4.5 years (range 24-46 years). Median follow-up time was 15 [IQR 12-21] months. The total patency rate was 77.7% (n = 28). During follow-up, 8 (22.2%) natural pregnancies occurred. The overall live birth rate was 100%. Low FSH levels (HR: 0.22; 95% CI: 0.052-0.88; P = 0.032) and higher total motile sperm count (TMSC) (HR: 1.001; 95% CI 1-1.001; P = 0.012) were associated with a higher rate of natural pregnancy. Our data suggest that microsurgical vasoepididymostomy is an effective therapy of primary epididymal OA. Baseline lower FSH and higher TMSC were independent predictors for natural pregnancy occurrence.

Current practice and feasibility in microlaryngeal surgery: microsurgical pressing excision technique.

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Lee, Ka-Wo; Chiang, Feng-Yu

2009-12-01

Since the introduction of endolaryngeal microsurgery, several basic microsurgical techniques have been described for the removal of benign vocal fold lesions. These techniques include conventional incision or dissection, bimanual retraction and cutting, microflap technique and the CO2 laser. Until recently, only a few microsurgical methods have emerged as new choices for the treatment of benign vocal fold lesions. This article introduces an innovative method that can precisely remove benign sessile vocal fold lesions with epithelial keratosis or hyperplasia without jeopardizing the intermediate or deep layer of the lamina propria. Instead of using conventional vertically opening microinstruments, this microsurgical pressing excision technique (MPET) utilized two pairs of custom-made horizontally left-opening or right-opening, curved microscissors/curved cupped microforceps to remove right or left vocal fold lesions accordingly. Using one instrument at a time, the lesion was subsequently removed with the microscissors and microforceps in a press-evert-cut manner. Among a total of 553 cases, the treatment results were satisfactory, with 520 (94%) patients retaining a satisfactory/normal (G0) voice 2 months postoperatively. More importantly, no patient's voice was worse postoperatively. This technique has several advantages: utilizing one instrument at a time can maximize exposure of the narrow endoscopic view, adjusting the pressing force makes precise excision easy in a well controlled horizontal plane. The MPET is particularly useful for removing sessile vocal nodules (especially those with epithelial keratosis), epithelial hyperplasia and leukoplakia in patients with difficult endolaryngeal exposure. This could be a well tolerated and precise microsurgical technique.

Predictive Factors for Natural Pregnancy after Microsurgical Reconstruction in Patients with Primary Epididymal Obstructive Azoospermia

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Mihai Harza

2014-01-01

Full Text Available Primary epididymal obstructive azoospermia (OA is the most prevalent form of OA in nonvasectomized patients and has been less studied. We aim to assess the results with microsurgical vasoepididymostomy used in the treatment of men diagnosed with primary epididymal obstructive azoospermia and to identify the factors associated with natural pregnancy occurring after microsurgical reconstruction. This prospective study included consecutive patients with epididymal OA who underwent microsurgical reconstruction in our center. Clinical and biological data were obtained every three months during follow-up. Occurrence of natural pregnancy was the primary study outcome. In total, 36 patients underwent microsurgical reconstruction. The mean age was 34±4.5 years (range 24–46 years. Median follow-up time was 15 [IQR 12–21] months. The total patency rate was 77.7% (n=28. During follow-up, 8 (22.2% natural pregnancies occurred. The overall live birth rate was 100%. Low FSH levels (HR: 0.22; 95% CI: 0.052–0.88; P=0.032 and higher total motile sperm count (TMSC (HR: 1.001; 95% CI 1–1.001; P=0.012 were associated with a higher rate of natural pregnancy. Our data suggest that microsurgical vasoepididymostomy is an effective therapy of primary epididymal OA. Baseline lower FSH and higher TMSC were independent predictors for natural pregnancy occurrence.

Microvascular Anastomosis Training in Neurosurgery: A Review

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Vadim A. Byvaltsev

2018-01-01

Full Text Available Cerebrovascular diseases are among the most widespread diseases in the world, which largely determine the structure of morbidity and mortality rates. Microvascular anastomosis techniques are important for revascularization surgeries on brachiocephalic and carotid arteries and complex cerebral aneurysms and even during resection of brain tumors that obstruct major cerebral arteries. Training in microvascular surgery became even more difficult with less case exposure and growth of the use of endovascular techniques. In this text we will briefly discuss the history of microvascular surgery, review current literature on simulation models with the emphasis on their merits and shortcomings, and describe the views and opinions on the future of the microvascular training in neurosurgery. In “dry” microsurgical training, various models created from artificial materials that simulate biological tissues are used. The next stage in training more experienced surgeons is to work with nonliving tissue models. Microvascular training using live models is considered to be the most relevant due to presence of the blood flow. Training on laboratory animals has high indicators of face and constructive validity. One of the future directions in the development of microsurgical techniques is the use of robotic systems. Robotic systems may play a role in teaching future generations of microsurgeons. Modern technologies allow access to highly accurate learning environments that are extremely similar to real environment. Additionally, assessment of microsurgical skills should become a fundamental part of the current evaluation of competence within a microneurosurgical training program. Such an assessment tool could be utilized to ensure a constant level of surgical competence within the recertification process. It is important that this evaluation be based on validated models.

Biliary fibrosis in microsurgical extrahepatic cholestasis in the rat.

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Sánchez-Patán, Fernando; Anchuelo, Raquel; Corcuera, María-Teresa; Casado, Isabel; Gómez-Aguado, Fernando; Aller, María-Angeles; Cruz, Arturo; Alonso, María-José; Arias, Jaime

2008-01-01

A new model of extrahepatic cholestasis, using a microsurgical technique, is performed as an alternative to the traditional model of the bile duct ligated-rat, in order to study the stage of fibrosis in the long-term. Male Wistar rats were divided into two groups: I (Sham-operated, n = 9) and II [Microsurgical Cholestasis (MC), n = 10]. After 4 weeks, portal pressure, types of portosystemic collateral circulation, mesenteric venous vasculopathy, hepatic function test, and liver histopathology were studied by using the Knodell index and fibrosis was determined by reticulin and Sirius red stains. The animals with MC presented portal hypertension with extrahepatic portosistemic collateral circulation, associated with mesenteric venous vasculopathy and increased plasma levels of bilirubin (6.30 +/- 1.80 vs. 0.22 +/- 0.37 mg/dL; P = 0.0001), alkaline phosphatase (293.00 +/- 82.40 vs. 126.30 +/- 33.42 U/L; P = 0.001), AST (380.00 +/- 78.50 vs. 68.33 +/- 11.74 IU/L; P = 0.0001), ALT (87.60 +/- 22.32 vs. 42.22 +/- 7.89 IU/L; P = 0.0001), and LDH (697.76 +/- 75.13 vs. 384.80 +/- 100.03 IU/L; P = 0.0001). On the contrary, plasma levels of albumin decreased (2.72 +/- 0.12 mg/dl vs. 2.99 +/- 0.10; P = 0.001). The microsurgical resection of the extrahepatic biliary tract in the rat produces an experimental model of hepatic inflammation, characterized by a high Knodell hepatic activity index (4), bile proliferation, and fibrosis.

A didactic and hands-on module enhances resident microsurgical knowledge and technical skill.

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El Ahmadieh, Tarek Y; Aoun, Salah G; El Tecle, Najib E; Nanney, Allan D; Daou, Marc R; Harrop, James; Batjer, Hunt H; Bendok, Bernard R

2013-10-01

Simulation has been adopted as a powerful training tool in many areas of health care. However, it has not yet been systematically embraced in neurosurgery because of the absence of validated tools, assessment scales, and curricula. To use our validated microanastomosis module and scale to evaluate the effects of an educational intervention on the performance of neurosurgery residents at the 2012 Congress of Neurological Surgeons Annual Meeting. The module consisted of an end-to-end microanastomosis of a 3-mm vessel and was divided into 3 phases: (1) a cognitive and microsuture prelecture testing phase, (2) a didactic lecture, and (3) a cognitive and microsuture postlecture testing phase. We compared resident knowledge and technical proficiency from the pretesting and posttesting phases. One neurosurgeon and 7 neurosurgery residents participated in the study. None had previous experience in microsurgery. The average score on the microsuture prelecture and postlecture tests, as measured by our assessment scale, was 32.50 and 39.75, respectively (P = .001). The number of completed sutures at the end of each procedure was higher for 75% of participants in the postlecture testing phase (P = .03). The average score on the cognitive postlecture test (12.75) was significantly better than that of the cognitive prelecture test (8.38; P = .001). Simulation has the potential to enhance resident education and to elevate proficiency levels. Our data suggest that a focused microsurgical module that incorporates a didactic component and a technical component can enhance resident knowledge and technical proficiency in microsurgical anastomosis.

The Effects of Music on Microsurgical Technique and Performance: A Motion Analysis Study.

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Shakir, Afaaf; Chattopadhyay, Arhana; Paek, Laurence S; McGoldrick, Rory B; Chetta, Matthew D; Hui, Kenneth; Lee, Gordon K

2017-05-01

Music is commonly played in operating rooms (ORs) throughout the country. If a preferred genre of music is played, surgeons have been shown to perform surgical tasks quicker and with greater accuracy. However, there are currently no studies investigating the effects of music on microsurgical technique. Motion analysis technology has recently been validated in the objective assessment of plastic surgery trainees' performance of microanastomoses. Here, we aimed to examine the effects of music on microsurgical skills using motion analysis technology as a primary objective assessment tool. Residents and fellows in the Plastic and Reconstructive Surgery program were recruited to complete a demographic survey and participate in microsurgical tasks. Each participant completed 2 arterial microanastomoses on a chicken foot model, one with music playing, and the other without music playing. Participants were blinded to the study objectives and encouraged to perform their best. The order of music and no music was randomized. Microanastomoses were video recorded using a digitalized S-video system and deidentified. Video segments were analyzed using ProAnalyst motion analysis software for automatic noncontact markerless video tracking of the needle driver tip. Nine residents and 3 plastic surgery fellows were tested. Reported microsurgical experience ranged from 1 to 10 arterial anastomoses performed (n = 2), 11 to 100 anastomoses (n = 9), and 101 to 500 anastomoses (n = 1). Mean age was 33 years (range, 29-36 years), with 11 participants right-handed and 1 ambidextrous. Of the 12 subjects tested, 11 (92%) preferred music in the OR. Composite instrument motion analysis scores significantly improved with playing preferred music during testing versus no music (paired t test, P music was significant even after stratifying scores by order in which variables were tested (music first vs no music first), postgraduate year, and number of anastomoses (analysis of variance, P music in

Suicide intervention training evaluation: a preliminary report.

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Tierney, R J

1994-01-01

To date, very little work has been done on evaluating training in suicide intervention. This study developed and piloted a comprehensive method for evaluating suicide intervention training by applying three studies of immediate training effects on (a) suicide intervention abilities, (b) attitudes to suicide and suicide intervention, and (c) knowledge about suicide. The focus of the evaluation was a broadly used 2-day suicide intervention training program. Changes in suicide intervention abilities were measured by the Suicide Intervention Response Inventory (SIRI) and by performance in simulated suicide intervention situations, scored with the Suicide Intervention Protocol (SIP). Subjects consisted of 19 workshop participants in a pre-post condition and 17 participants in a post-test only condition. Results indicated significant increases in skills in suicide intervention situations. No significant effects were noted on the SIRI. Results from the attitudes and knowledge studies were very preliminary. They are reported here so that others may become aware of the methodology being used and the status of evaluation of the target program. Implications for further research are discussed.

[Microsurgical drezotomy for the treatment of spasticity of the lower limbs].

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Mertens, P; Sindou, M

1998-09-01

Ablative functional neurosurgery can be useful in some selected patients for the treatment of harmful spasticity in the lower limbs. Microsurgical drezotomy was introduced in 1972, on the basis of anatomical studies of the human dorsal root entry zone (DREZ) showing a topographical segregation of the afferent fibers according to their size and thus functional destinations. It consists of a 3 mm deep microsurgical lesion directed at a 45 degree angle in the postero-lateral sulcus, penetrating the DREZ in its ventro-lateral aspect, at the level of all the rootlets considered as involved in spasticity (and pain). It destroys mainly the lateral (nociceptive) and central (myotatic) afferent fibers as well as the facilitatory medial part of the Lissauer tract, whilst sparing most of the medial (lemniscal) fibers and the inhibitor lateral part of the Lissauer tract. We report a series of 121 bedridden patients suffering from harmful spasticity in one (15) or both (106) lower limbs and treated with microsurgical drezotomy. Surgery was decided on because of abnormal postures in flexion in two-thirds of the patients and in hyperextension in one-third, additional pain in 75 of them, and hyperactive bladder in 38 cases. The post-operative results were evaluated after a mean follow-up time of 5 years and 6 months. Both spasticity and spasms were significantly decreased or suppressed respectively in 78% and 88% of the patients. When present, pain was relieved without abolition of sensation in 82%. These benefits resulted in either disappearance or marked reduction of the abnormal postures and articular limitation in 90% of the patients. When present preoperatively, urinary leakage disappeared in 85% of the cases. Mild to severe complications occurred in 32 patients and precipitated or were responsible for death in 6 cases (5%). This is explained by the fact that most of the patients, especially those affected by multiple sclerosis, were in very precarious general and

Supraorbital Keyhole Microsurgical Fenestration of Symptomatic Temporal Arachnoid Cysts in Children: Advantages and Limitations.

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Elkheshin, Sherif; Soliman, Ahmed

2017-01-01

To investigate the impact of endoscope-assisted microsurgical fenestration on temporal arachnoid cysts, and to determine the advantages and limitations of the technique. Twenty-five children with symptomatic temporal arachnoid cysts were operated via eyebrow supraorbital keyhole microsurgical fenestration targeting the medial cyst wall. Preoperative magnetic resonance imaging (MRI) of the brain was done for all patients. Preoperative clinical presentation of the patients included headache (80%), nausea & vomiting (64%), drug resistant epilepsy (52%), macrocephaly (12%) papilledema (28%), motor weakness in the form of right-sided hemiparesis (12%) and cranial nerve palsy. Postoperative complete subsidence of headache was noted in 50%, while 20% remained unchanged. Drug resistant epilepsy improved in 69% of the patients. Postoperative MRI showed initial decrease in cyst volume as early as 3 months, only in a range of 5-12% volume reduction, and the late follow-up done at 6 and 18 months continued to show further reduction reported to be significant (p CSF) collection was the most common complication (20%). Only 1 patient experienced CSF leak mandating cysto-peritoneal shunting. Conclusıon: Eyebrow supraorbital keyhole microsurgical fenestration for temporal arachnoid cysts can be performed with a fairly low risk of complications and yields a favorable improvement in clinical and neuroimaging outcomes.

Lessons Learned from Delayed Versus Immediate Microsurgical Reconstruction of Complex Maxillectomy and Midfacial Defects: Experience in a Tertiary Center in Mexico.

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Santamaria, Eric; de la Concha, Erika

2016-10-01

Microsurgical reconstruction of complex midfacial and maxillectomy defects is among the most challenging procedures in plastic surgery, and it often requires composite flaps to improve functional and aesthetic results. Various factors have been identified as having influence in the outcome of microsurgical reconstruction. In this article, the authors present their experience with immediate and delayed reconstruction of complex maxillectomy defects in a tertiary center in Mexico. The authors present a total of 37 patients with microsurgical reconstruction of a complex maxillectomy defect; 13 patients had immediate and 24 had delayed reconstructions. The authors recommend doing immediate reconstruction when feasible. Copyright © 2016 Elsevier Inc. All rights reserved.

Nasolabial facial artery and vein as recipient vessels for midface microsurgical reconstruction.

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Oh, Suk Joon; Jeon, Man Kyung; Koh, Sung Hoon

2011-05-01

Although free flap transfer is commonly performed to reconstruct facial defects, the submandibular facial artery and vein have historically been considered as adequate recipient vessels for microsurgical reconstruction. If the vascular pedicles of the free flap are short, vein grafts are necessary. The purpose of this study was to determine the indications for and effectiveness of using the nasolabial facial vessels for midfacial reconstruction. A retrospective chart review of 6 patients undergoing microsurgical reconstruction for defects of the face revealed 6 free tissue transfers in which the nasolabial facial artery and vein were considered for use as recipient vessels. Flap success rates were evaluated. Six patients (5 men and 1 woman) underwent 6 free flap transfers. Five anterior helix free flaps were used for the reconstruction of defects in the lower third of the nose. Nasal defects were due to trauma in 4 patients and squamous cell carcinoma in 1 patient. In 1 neurofibromatosis type 1 case, a radial forearm flap was used for reconstruction of the left orbital defect. The facial artery and vein in the nasolabial fold were used as the recipient artery and vein in every case. The mean length of follow-up was 5.8 years. All flaps survived. All patients were satisfied with the degree of aesthetic improvement after surgery.Use of the facial artery and vein in the nasolabial fold for facial reconstruction is reliable and safe. The nasolabial facial artery and vein should be considered as primary recipient vessels in microsurgical reconstruction of the midface.

Improving outcomes in microsurgical breast reconstruction: lessons learnt from 406 consecutive DIEP/TRAM flaps performed by a single surgeon.

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Damen, Tim H C; Morritt, Andrew N; Zhong, Toni; Ahmad, Jamil; Hofer, Stefan O P

2013-08-01

Multiple preoperative, intraoperative and postoperative decisions can influence the outcome of microsurgical breast reconstruction. We have simplified the decision-making process by incorporating a number of algorithms into our microsurgical breast reconstruction practice and critically review our results in this study. Prospectively maintained databases for all microsurgical breast reconstructions performed by a single surgeon over a nine-year period were examined to determine: patient demographics; operative details including flap choice, donor and recipient vessel selection; and, details of intraoperative and early postoperative (406 Consecutive free flap microsurgical breast reconstructions (164 unilateral and 121 bilateral) were performed in 285 patients over the study period. Deep inferior epigastric artery perforator (DIEP) flaps (88%, n=359) were used most commonly followed by muscle-sparing transverse rectus abdominis musculocutaneous (MS-TRAM) flaps (11%, n=44), and fascial-sparing TRAM (FS-TRAM) flaps (0.7%, n=3). One-hundred-seventy-one (48%) DIEP flaps were based on a single perforator while 188 (52%) had multiple perforators. The internal mammary (IM) artery and vein were used as the recipient vessels for 99% (n=403) of flaps. A second venous anastomosis was required for 11.8 percent (n=48) of flaps. Partial flap failure occurred in nine (2.2%) flaps while total flap failure occurred in two flaps (0.5%). Minimum follow-up was three months. Incorporating a number of algorithms into our practice has enabled us to simplify the decision-making processes involved in microsurgical breast reconstruction and to consistently obtain successful surgical outcomes. Copyright © 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Examining Length of Hospital Stay after Microsurgical Breast Reconstruction: Evaluation in a Case-Control Study

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Jordan D. Frey, MD

2017-12-01

Conclusions:. Multiple patient-specific, intra-operative, and post-operative outcomes factors are associated with increased length of stay with immediate and delayed microsurgical breast reconstruction.

Preliminary power train design for a state-of-the-art electric vehicle

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Ross, J. A.; Wooldridge, G. A.

1978-01-01

The state-of-the-art (SOTA) of electric vehicles built since 1965 was reviewed to establish a base for the preliminary design of a power train for a SOTA electric vehicle. The performance of existing electric vehicles were evaluated to establish preliminary specifications for a power train design using state-of-the-art technology and commercially available components. Power train components were evaluated and selected using a computer simulation of the SAE J227a Schedule D driving cycle. Predicted range was determined for a number of motor and controller combinations in conjunction with the mechanical elements of power trains and a battery pack of sixteen lead-acid batteries - 471.7 kg at 0.093 MJ/Kg (1040 lbs. at 11.7 Whr/lb). On the basis of maximum range and overall system efficiency using the Schedule D cycle, an induction motor and 3 phase inverter/controller was selected as the optimum combination when used with a two-speed transaxle and steel belted radial tires. The predicted Schedule D range is 90.4 km (56.2 mi). Four near term improvements to the SOTA were identified, evaluated, and predicted to increase range approximately 7%.

Robotic instrumentation: Evolution and microsurgical applications

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Sijo J Parekattil

2010-01-01

Full Text Available This article presents a review of the history and evolution of robotic instrumentation and its applications in urology. A timeline for the evolution of robotic instrumentation is presented to better facilitate an understanding of our current-day applications. Some new directions including robotic microsurgical applications (robotic assisted denervation of the spermatic cord for chronic orchialgia and robotic assisted vasectomy reversal are presented. There is a paucity of prospective comparative effectiveness studies for a number of robotic applications. However, right or wrong, human nature has always led to our infatuation with the concept of using tools to meet our needs. This chapter is a brief tribute to where we have come from and where we may be potentially heading in the field of robotic assisted urologic surgery.

Treatment of fingertip amputation: comparison of results between microsurgical replantation and pocket principle.

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Yabe, Tetsuji; Tsuda, Tomoyuki; Hirose, Shunsuke; Ozawa, Toshiyuki

2012-05-01

In this article, a comparison of replantation using microsurgical replantation (replantation) and the Brent method and its modification (pocket principle) in the treatment of fingertip amputation is reported. As a classification of amputation level, we used Ishikawa's subzone classification of fingertip amputation, and the cases of amputations only in subzone 2 were included in this study. Between these two groups, there was no statistical difference in survival rate, postoperative atrophy, or postoperative range of motion. In terms of sensory recovery, some records were lost and exact study was difficult. But there was no obvious difference between these cases. In our comparison of microsurgical replantation versus the pocket principle in treatment of subzone 2 fingertip amputation, there was no difference in postoperative results. Each method has pros and cons, and the surgeon should choose which technique to use based on his or her understanding of the characteristics of both methods. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Role of Adjuvant Radiosurgery after Thoracoscopic Microsurgical Resection of a Spinal Schwannoma

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Toba N. Niazi

2012-01-01

Full Text Available Stereotactic radiosurgery to benign tumors of the spine has not been advocated as a primary treatment modality because of the favorable prognosis for these lesions after gross-total resection. There is even less evidence regarding its use as an adjuvant to neurosurgical resection of benign recurrent spinal disease. We describe the case of a 30-year-old man with a thoracic spinal schwannoma who had an interval increase of his lesion five months after thoracoscopic microsurgical resection. The patient opted for noninvasive stereotactic radiosurgery in lieu of additional surgical excision and has had stable disease 15 months after radiosurgical treatment with the linear accelerator (LINAC system. In this setting, stereotactic radiosurgery provided a useful adjunct to thoracoscopic microsurgical resection. Future Class I and II evidence should be sought to evaluate the utility of stereotactic radiosurgery as a primary treatment modality or as an adjuvant for microneurosurgical resection of benign spinal lesions in patients who want noninvasive treatment after disease recurrence or who harbor medical comorbidities that would preclude them from being safe surgical candidates.

Microsurgical spinothalamic chordotomy in the treatment of cancer pain.

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Slavik, E; Ivanović, S; Grujisić, D; Djurović, B; Nikolić, I

2005-01-01

Advances in cancer treatment continue to lengthen survival among cancer patients. As patients live longer, the need for effective pain control has gained increased importance for improving quality of life. In patients who do not respond to all available conservative methods of therapy for cancer pain, surgical methods have been applied; one of them is the open high thoracic spinothalamic chordotomy. We present a group of 86 patients suffering from nociceptive cancer pain, caused by compression of lumbosacral plexus. All patients were treated by microsurgical open high thoracic spinothalamic chordotomy. These patients did not respond to any available conservative treatment. Immediately after surgery 68 (79%) patients had total pain relief. Of the remaining 18 (21%) patients, significant pain relief was achieved in 9 (10%), while in the remaining 9 patients this procedure had no effect. After a 6-month follow-up, total pain relief remained in 62 (72%) and significant pain relief in 10 (17%) of the patients. From 62 of patients with well-defined unilateral pain treated by "moderately deep" chordotomy, total pain relief was achieved in 53 (85%), lasting for 6 months in 49 (79%) of them. These results show that microsurgical chordotomy can achieve total control of intractable cancer pain in the majority (79%) of patients, especially in those with well-defined unilateral pain (85%), indicating the usefullness of this surgical approach in the treatment of nociceptive cancer pain.

Preliminary training of a self-pumped loop phase-conjugate mirror based on a photorefractive crystal

International Nuclear Information System (INIS)

Mogaddam, Mehran Wahdani; Shuvalov, Vladimir V

2006-01-01

It is shown by the example of a loop self-pumped phase-conjugate (SPPC) mirror based on a photorefractive crystal (PRC) BaTiO 3 that formation of a phase-conjugate (PC) wave in a SPPC mirror can be considerably accelerated by using a preliminary training of the mirror. For this purpose, it is necessary to direct preliminary an auxiliary (training) optical field on the SPPC mirror, which contains some information on the properties of the input signal whose wave front will be conjugated later. This procedure provides the writing of static refractive-index gratings in the PRC already at the training stage. The presence of these gratings ensures a much more rapid (by 6-20 times) production of volume refractive-index gratings required for the efficient conjugation of the signal radiation. Several variants of static and dynamic SPPC mirror training procedures are simulated and their efficiencies are compared. (nonlinear optical phenomena)

Preliminary assessment report for Fort Custer Training Center, Installation 26035, Augusta, Michigan

International Nuclear Information System (INIS)

Flaim, S.; Krokosz, M.

1993-08-01

This report presents the results of the preliminary assessment (PA) conducted by Argonne National Laboratory at the Michigan Army National Guard property near Augusta, Michigan. Preliminary assessments of federal facilities are being conducted to compile the information necessary for completing preremedial activities and to provide a basis for establishing corrective actions in response to releases of hazardous substances. The principal objective of the PA is to characterize the site accurately and determine the need for further action by examining site activities, quantities of hazardous substances present, and potential pathways by which contamination could affect public health and the environment. This PA satisfies, for the Fort Custer Training Center, phase I of the Department of Defense Installation Restoration Program. The environmentally significant operations associated with the property are (1) storage of hazardous materials and hazardous waste, (2) storage and dispensing of fuel, (3) washing of vehicles and equipment, and (4) weapons training ranges that may have accumulated lead

Orbitopterional Approach for the Resection of a Suprasellar Craniopharyngioma: Adapting the Strategy to the Microsurgical and Pathologic Anatomy.

Science.gov (United States)

Nguyen, Vincent; Basma, Jaafar; Klimo, Paul; Sorenson, Jeffrey; Michael, L Madison

2018-04-01

Objectives  To describe the orbitopterional approach for the resection of a suprasellar craniopharyngioma with emphasis on the microsurgical and pathological anatomy of such lesions. Design  After completing the orbitopterional craniotomy in one piece including a supraorbital ridge osteotomy, the Sylvian fissure was split in a distal to proximal direction. The ipsilateral optic nerve and internal carotid artery were identified. Establishing a corridor to the tumor through both the opticocarotid and optic cisterns allowed for a wide angle of attack. Using both corridors, a microsurgical gross total resection was achieved. A radical resection required transection of the stalk at the level of the hypothalamus. Photographs of the region are borrowed from Dr Rhoton's laboratory to illustrate the microsurgical anatomy. Understanding the cisternal and topographic relationships of the optic nerve, optic chiasm, and internal carotid artery is critical to achieving gross total resection while preserving normal anatomy. Participants  The surgery was performed by the senior author assisted by Dr. Jaafar Basma. The video was edited by Dr. Vincent Nguyen. Outcome Measures  Outcome was assessed with extent of resection and postoperative visual function. Results  A gross total resection of the tumor was achieved. The patient had resolution of her bitemporal hemianopsia. She had diabetes insipidus with normal anterior pituitary function. Conclusions  Understanding the microsurgical anatomy of the suprasellar region and the pathological anatomy of craniopharyngiomas is necessary to achieve a good resection of these tumors. The orbitopterional approach provides the appropriate access for such endeavor. The link to the video can be found at: https://youtu.be/Be6dtYIGqfs .

Preoperative Prediction of the Necessity for Anterior Clinoidectomy During Microsurgical Clipping of Ruptured Posterior Communicating Artery Aneurysms.

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Kamide, Tomoya; Burkhardt, Jan-Karl; Tabani, Halima; Safaee, Michael M; Lawton, Michael T

2018-01-01

Although most posterior communicating artery (PCoA) aneurysms can be clipped easily with excellent results, some require anterior clinoidectomy for safe and complete clipping. To review our microsurgical series of ruptured PCoA aneurysms and identify the preoperative predictors for anterior clinoidectomy during microsurgical clipping for PCoA aneurysms. Results from microsurgical clipping of 104 patients with ruptured PCoA aneurysms were reviewed retrospectively. Distances and angles were obtained from computed tomographic angiography and compared between the anterior and nonanterior clinoidectomy groups. Anterior clinoidectomy was required in 19 of the 104 cases (18%). None developed surgical complications due to anterior clinoid process (ACP) resection, including postoperative visual deficit. Univariate and multivariate analyses revealed that the distances from the ACP tip to the aneurysmal proximal neck and from the ACP line to the aneurysmal proximal neck were statistically significant predictive factors for the need of anterior clinoidectomy. Based on a receiver operating characteristic analysis, the distances from the ACP tip to the aneurysmal proximal neck PCoA aneurysm surgery, the distances from the ACP tip to the aneurysmal proximal neck and from the ACP line to the aneurysmal proximal neck were both found to be useful predictors of whether anterior clinoidectomy was required. Copyright © 2017 Elsevier Inc. All rights reserved.

In vivo porcine training model for cranial neurosurgery.

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Regelsberger, Jan; Eicker, Sven; Siasios, Ioannis; Hänggi, Daniel; Kirsch, Matthias; Horn, Peter; Winkler, Peter; Signoretti, Stefano; Fountas, Kostas; Dufour, Henry; Barcia, Juan A; Sakowitz, Oliver; Westermaier, Thomas; Sabel, Michael; Heese, Oliver

2015-01-01

Supplemental education is desirable for neurosurgical training, and the use of human cadaver specimen and virtual reality models is routine. An in vivo porcine training model for cranial neurosurgery was introduced in 2005, and our recent experience with this unique model is outlined here. For the first time, porcine anatomy is illustrated with particular respect to neurosurgical procedures. The pros and cons of this model are described. The aim of the course was to set up a laboratory scenery imitating an almost realistic operating room in which anatomy of the brain and neurosurgical techniques in a mentored environment free from time constraints could be trained. Learning objectives of the course were to learn about the microsurgical techniques in cranial neurosurgery and the management of complications. Participants were asked to evaluate the quality and utility of the programme via standardized questionnaires by a grading scale from A (best) to E (worst). In total, 154 residents have been trained on the porcine model to date. None of the participants regarded his own residency programme as structured. The bleeding and complication management (97%), the realistic laboratory set-up (89%) and the working environment (94%) were favoured by the vast majority of trainees and confirmed our previous findings. After finishing the course, the participants graded that their skills in bone drilling, dissecting the brain and preserving cerebral vessels under microscopic magnification had improved to level A and B. In vivo hands-on courses, fully equipped with microsurgical instruments, offer an outstanding training opportunity in which bleeding management on a pulsating, vital brain represents a unique training approach. Our results have shown that education programmes still lack practical training facilities in which in vivo models may act as a complementary approach in surgical training.

Stereotaxic microsurgical procedures of cerebral intracranial tumors guided by image and attended by computer

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Lopez Flores, Gerardo; Guerra Figueredo, Eritk; Ochoa Zaldivar, Luis

2000-01-01

It is reported that spatial guidance during microsurgery is an essential element. This application of stereotaxic surgery is shown at the International Center of Neurological Restoration (Cirene) from May, 1994, to February, 1998, on describing the performance of 65 microsurgical procedures under stereotaxic conditions among 62 patients with cerebral intracranial tumors. The procedure was divided into 3 stages: image acquisition, Cat, surgical planning , with Stasis planning system, and microsurgical procedures that included the Leksell, Micromar and Esteroflex stereotaxic systems. 27 of the total of patients presented glial tumors; 33, non-glial; and only 2 non-neoplastic lesions of diverse localization and size. 30 total resections We're made. Surgical morbidity was minimum and there was no surgical mortality. The main advantages of this method are: exact localization of the craniotomy, easy spatial guidance, and the opportunity to distinguish the limits between the tumor and the sound tissue. The possibility to apply Esteroflex to cerebral microsurgery was demonstrated

Comparison of vasovasostomy with conventional microsurgical suture and fibrin adhesive in rats

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Wilson F. Busato Junior

2007-12-01

Full Text Available OBJECTIVE: Microsurgical procedures are currently the gold standard for vasovasostomy with excellent results, but it takes an increased operative time demanding special training and experience in microsurgery. The objective of this study is to reach the same results with reduced operative time. MATERIALS AND METHODS: Male adults Wistar rats were divided into 3 groups: I 20 rats in control group, II 20 with conventional one-layer microsuture and III 20 with fibrin glue. After four weeks each rat was left for two weeks with two female rats. RESULTS: The fertility rates were 80% in group I, 70% in group II and 65% in group III (p > 0.05. In group II granuloma was found in 75% of the rats, while in group III in 85% (p 0.05. Overall operative time was 41.7 ± 2.49 and 28.55 ± 1.14 minutes in groups II and III (p < 0.05 and the time to anastomosis of 24.6 ± 1.8 and 9.35 ± 0.78 minutes (p < 0.05, respectively. CONCLUSIONS: We can conclude that vasovasostomy with fibrin adhesive has the same results of the conventional microsurgery technique but with a reduced operative time and a simplified procedure.

Microsurgical management of cerebral aneurysms based in CT angiography with three-dimensional reconstruction (3D-CTA) and without preoperative cerebral angiography

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Gonzalez-Darder, J.M.; Pesudo-Martinez, J.V.; Feliu-Tatay, R.A.

2001-01-01

Objective. To study the possibilities of the microsurgical management of ruptured intracranial aneurysms with the sole preoperative information provided by computed tomography angiography with three-dimensional reconstruction (3D-CTA). Methods. Patients were studied with 3D-CTA after diagnosis of subarachnoid hemorrhage. If the study had an adequate quality and revealed an aneurysm congruent with the clinical findings or neurological examination and/or with the location of the bleeding on computed tomography (CT) scan an early microsurgical clipping of the lesion was done. When the quality of the 3D-CTA study was not adequate or the quality being adequate displayed no lesions or the findings were not accurate enough to warrant direct microsurgical treatment, the patient was studied with cerebral digital substraction (DS) angiography. A total of 44 consecutive patients harboring a total of 47 intracranial aneurysms diagnosed by 3D-CTA and without preoperative DS angiography were submitted to microsurgical clipping and included in the study. Results. The overall mortality was 15.9 % and the favorable results evaluated 6 months after discharge by means of the Glasgow outcome scale reached 70.4 %. All lesions were successfully clipped. Surgery was done a mean of 4.1 days after the admission bleeding. A total of four microlesions undiagnosed by 3D-CTA were found at surgery and clipped. Postoperative DS angiography and necropsy findings were also used as control of the 3D-CTA findings but no additional information was provided excepting the finding in DS angiography of an asymptomatic intracavemous aneurysm. Therefore the sensitivity of the 3D-CTA for diagnosis of symtomatic aneurysms was 100 % and the overall sensitivity 90.4 %. Conclusions. We have reached similar results in patients operated on with or without preoperative angiography. 3D-CTA provides very valuable anatomical information, which has an additional value in the microsurgical treatment of aneurysms of the

Microvascular anastomosis simulation using a chicken thigh model: Interval versus massed training.

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Schoeff, Stephen; Hernandez, Brian; Robinson, Derek J; Jameson, Mark J; Shonka, David C

2017-11-01

To compare the effectiveness of massed versus interval training when teaching otolaryngology residents microvascular suturing on a validated microsurgical model. Otolaryngology residents were placed into interval (n = 7) or massed (n = 7) training groups. The interval group performed three separate 30-minute practice sessions separated by at least 1 week, and the massed group performed a single 90-minute practice session. Both groups viewed a video demonstration and recorded a pretest prior to the first training session. A post-test was administered following the last practice session. At an academic medical center, 14 otolaryngology residents were assigned using stratified randomization to interval or massed training. Blinded evaluators graded performance using a validated microvascular Objective Structured Assessment of Technical Skill tool. The tool is comprised of two major components: task-specific score (TSS) and global rating scale (GRS). Participants also received pre- and poststudy surveys to compare subjective confidence in multiple aspects of microvascular skill acquisition. Overall, all residents showed increased TSS and GRS on post- versus pretest. After completion of training, the interval group had a statistically significant increase in both TSS and GRS, whereas the massed group's increase was not significant. Residents in both groups reported significantly increased levels of confidence after completion of the study. Self-directed learning using a chicken thigh artery model may benefit microsurgical skills, competence, and confidence for resident surgeons. Interval training results in significant improvement in early development of microvascular anastomosis skills, whereas massed training does not. NA. Laryngoscope, 127:2490-2494, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

Microsurgical DREZotomy in the treatment of chronic pain due to spinal cord and cauda equina injuries: 2 cases report and related literature review

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LIU Qing-jun

2013-10-01

Full Text Available Objective The dorsal root entry zone (DREZ is a hyperactive focus in neuropathic pain (NP syndromes, and DREZotomy has been used in selective cases of NP. This study aims to investigate the therapeutic effect of microsurgical DREZotomy in chronic pain due to spinal cord and cauda equina injuries. Methods Two patients suffered with chronic pain due to spinal cord and cauda equina injuries were treated with microsurgical DREZotomy, and postoperative therapeutic effect and complications were observed. Results One patient had great pain, and the pain was alleviated 2 weeks after surgery, while carbamazepine (300 mg/d was administered continously. Another patient was completely free of pain 2 weeks after surgery, and no recurrence occurred during 3-year follow up. No severe complications were found in the 2 patients. Conclusion Microsurgical DREZotomy is an effective approach in treating chronic pain due to spinal cord and cauda equina injuries.

Microsurgical Resection of a Common Peroneal Nerve Schwannoma: A 3-Dimensional Operative Video.

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Budohoski, Karol P; Guilfoyle, Mathew R; Kenyon, Olivia; Barone, Damiano G; Santarius, Thomas; Trivedi, Rikin A

2018-01-01

Peripheral nerve sheath tumors are benign entities that manifest with pain or neurological deficits from mass effect. Treatment is mostly surgical, however, the aggressiveness of treatment needs to be carefully considered with respect to preserving function. We present a case of a 62-year-old male with a 2-year history of left lower extremity pain radiating toward the dorsolateral foot. There was a tender and palpable mass in the lateral popliteal fossa with imaging consistent with Schwannoma of the common peroneal nerve. The patient was counseled for surgery and informed consent was obtained. Microsurgical resection was undertaken and gross total resection was achieved without compromise of function. We demonstrate the placement of neurophysiological monitoring electrodes in all 3 compartment of the calf as well as the use of stimulation to identify a nonfunctioning area for entering the nerve sheath. Anatomy of the popliteal fossa and microsurgical technique for resection of nerve sheath tumors are discussed. When dealing with these pathologies, it is important to use intraoperative neurophysiology as well as careful technique in order to achieve maximal resection without compromising neurological function. Copyright © 2017 by the Congress of Neurological Surgeons.

Minimal intervention dentistry II: part 6. Microscope and microsurgical techniques in periodontics.

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Sitbon, Y; Attathom, T

2014-05-01

Different aspects of treatment for periodontal diseases or gingival problems require rigorous diagnostics. Magnification tools and microsurgical instruments, combined with minimally invasive techniques can provide the best solutions in such cases. Relevance of treatments, duration of healing, reduction of pain and post-operative scarring have the potential to be improved for patients through such techniques. This article presents an overview of the use of microscopy in periodontics, still in the early stages of development.

Microsurgical Performance After Sleep Interruption: A NeuroTouch Simulator Study.

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Micko, Alexander; Knopp, Karoline; Knosp, Engelbert; Wolfsberger, Stefan

2017-10-01

In times of the ubiquitous debate about doctors' working hour restrictions, it is still questionable if the physician's performance is impaired by high work load and long shifts. In this study, we evaluated the impact of sleep interruption on neurosurgical performance. Ten medical students and 10 neurosurgical residents were tested on the virtual-reality simulator NeuroTouch by performing an identical microsurgical task, well rested (baseline test), and after sleep interruption at night (stress test). Deviation of total score, timing, and excessive force on tissue were evaluated. In addition, vital parameters and self-assessment were analyzed. After sleep interruption, total performance score increased significantly (45.1 vs. 48.7, baseline vs. stress test, P = 0.048) while timing remained stable (10.1 vs. 10.4 minutes for baseline vs. stress test, P > 0.05) for both students and residents. Excessive force decreased in both groups during the stress test for the nondominant hand (P = 0.05). For the dominant hand, an increase of excessive force was encountered in the group of residents (P = 0.05). In contrast to their results, participants of both groups assessed their performance worse during the stress test. In our study, we found an increase of neurosurgical simulator performance in neurosurgical residents and medical students under simulated night shift conditions. Further, microsurgical dexterity remained unchanged. Based on our results and the data in the available literature, we cannot confirm that working hour restrictions will have a positive effect on neurosurgical performance. Copyright © 2017 Elsevier Inc. All rights reserved.

Microsurgical Decompression of the Cochlear Nerve to Treat Disabling Tinnitus via an Endoscope-Assisted Retrosigmoid Approach: The Padua Experience.

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Di Stadio, Arianna; Colangeli, Roberta; Dipietro, Laura; Martini, Alessandro; Parrino, Daniela; Nardello, Ennio; D'Avella, Domenico; Zanoletti, Elisabetta

2018-05-01

The use of surgical cochlear nerve decompression is controversial. This study aimed at investigating the safety and validity of microsurgical decompression via an endoscope-assisted retrosigmoid approach to treat tinnitus in patients with neurovascular compression of the cochlear nerve. Three patients with disabling tinnitus resulting from a loop in the internal auditory canal were evaluated with magnetic resonance imaging and tests of pure tone auditory, tinnitus, and auditory brain response (ABR) to identify the features of the cochlear nerve involvement. We observed a loop with a caliber greater than 0.8 mm in all patients. Patients were treated via an endoscope-assisted retrosigmoid microsurgical decompression. After surgery, none of the patients reported short-term or long-term complications. After surgery, tinnitus resolved immediately in 2 patients, whereas in the other patient symptoms persisted although they improved; in all patients, hearing was preserved and ABR improved. Microsurgical decompression via endoscope-assisted retrosigmoid approach is a promising, safe, and valid procedure for treating tinnitus caused by cochlear nerve compression. This procedure should be considered in patients with disabling tinnitus who have altered ABR and a loop that has a caliber greater than 0.8 mm and is in contact with the cochlear nerve. Copyright © 2018 Elsevier Inc. All rights reserved.

Preliminary Analyses Showed Short-Term Mental Health Improvements after a Single-Day Manager Training.

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Boysen, Elena; Schiller, Birgitta; Mörtl, Kathrin; Gündel, Harald; Hölzer, Michael

2018-01-10

Psychosocial working conditions attract more and more attention when it comes to mental health in the workplace. Trying to support managers to deal with their own as well as their employees' psychological risk factors, we conducted a specific manager training. Within this investigation, we wanted to learn about the training's effects and acceptance. A single-day manager training was provided in a large industrial company in Germany. The participants were asked to fill out questionnaires regarding their own physical and mental health condition as well as their working situation. Questionnaires were distributed at baseline, 3-month, and 12-month follow-up. At this point of time the investigation is still ongoing. The current article focuses on short-term preliminary effects. Analyses only included participants that already completed baseline and three months follow-up. Preliminary results from three-month follow-up survey ( n = 33, nmale = 30, Mage = 47.5) indicated positive changes in the manager's mental health condition measured by the Patient Health Questionnaire for depression (PHQ-9: Mt1 = 3.82, Mt2 = 3.15). Training managers about common mental disorders and risk factors at the workplace within a single-day workshop seems to promote positive effects on their own mental health. Especially working with the managers on their own early stress symptoms might have been an important element.

Design and preliminary evaluation of an exoskeleton for upper limb resistance training

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Wu, Tzong-Ming; Chen, Dar-Zen

2012-06-01

Resistance training is a popular form of exercise recommended by national health organizations, such as the American College of Sports Medicine (ACSM) and the American Heart Association (AHA). This form of training is available for most populations. A compact design of upper limb exoskeleton mechanism for homebased resistance training using a spring-loaded upper limb exoskeleton with a three degree-of-freedom shoulder joint and a one degree-of-freedom elbow joint allows a patient or a healthy individual to move the upper limb with multiple joints in different planes. It can continuously increase the resistance by adjusting the spring length to train additional muscle groups and reduce the number of potential injuries to upper limb joints caused by the mass moment of inertia of the training equipment. The aim of this research is to perform a preliminary evaluation of the designed function by adopting an appropriate motion analysis system and experimental design to verify our prototype of the exoskeleton and determine the optimal configuration of the spring-loaded upper limb exoskeleton.

THE TRANSFORMATIONAL PROCESSES INVOLVING MOTOR SKILLS THAT OCCUR UNDER THE INFLUENCE OF BASIC PRELIMINARY TRAINING IN YOUNG HANDBALL PLAYERS

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Markovic Sasa

2011-06-01

Full Text Available The population from which we extracted a sample of 76 subjects consisted of elementary school students in Kursumlija, all male, aged 12-13, who were divided into a sub-sample consisting of 38 young handball players who took part in the training sessions of a school of handball and another sub-sample consisting of 38 non-athletes, who only took part in their regular physical education classes. The aim of the research was to determine the transformation processes involving motor skills, which occur under the influence of basic preliminary training in young handball players. The subject matter of the study was to examine whether a statistically significant increase in the level of motor skills would occur under the influence of physical exercise as part of basic preliminary training in the final as compared to the initial state. Six motor tests which define the dimensions of explosive and repetitive strength were used. The results of the research indicate that significant transformational processes involving the motor skills of young handball players occurred in the final as compared to the initial measuring, under the influence of basic preliminary training.

A novel attention training paradigm based on operant conditioning of eye gaze: Preliminary findings.

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Price, Rebecca B; Greven, Inez M; Siegle, Greg J; Koster, Ernst H W; De Raedt, Rudi

2016-02-01

Inability to engage with positive stimuli is a widespread problem associated with negative mood states across many conditions, from low self-esteem to anhedonic depression. Though attention retraining procedures have shown promise as interventions in some clinical populations, novel procedures may be necessary to reliably attenuate chronic negative mood in refractory clinical populations (e.g., clinical depression) through, for example, more active, adaptive learning processes. In addition, a focus on individual difference variables predicting intervention outcome may improve the ability to provide such targeted interventions efficiently. To provide preliminary proof-of-principle, we tested a novel paradigm using operant conditioning to train eye gaze patterns toward happy faces. Thirty-two healthy undergraduates were randomized to receive operant conditioning of eye gaze toward happy faces (train-happy) or neutral faces (train-neutral). At the group level, the train-happy condition attenuated sad mood increases following a stressful task, in comparison to train-neutral. In individual differences analysis, greater physiological reactivity (pupil dilation) in response to happy faces (during an emotional face-search task at baseline) predicted decreased mood reactivity after stress. These Preliminary results suggest that operant conditioning of eye gaze toward happy faces buffers against stress-induced effects on mood, particularly in individuals who show sufficient baseline neural engagement with happy faces. Eye gaze patterns to emotional face arrays may have a causal relationship with mood reactivity. Personalized medicine research in depression may benefit from novel cognitive training paradigms that shape eye gaze patterns through feedback. Baseline neural function (pupil dilation) may be a key mechanism, aiding in iterative refinement of this approach. (c) 2016 APA, all rights reserved).

Microsurgical one-stage treatment of intracranial mirror aneurysms via bilateral frontolateral approaches

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Hong-guang WANG

2016-08-01

Full Text Available Objective To investigate surgical strategies, clinical effects and complications of microsurgical one-stage treatment of intracranial mirror aneurysms via bilateral frontolateral approaches.  Methods Review clinical data of 18 cases with anterior circulation mirror aneurysms who underwent one-stage clipping via bilateral frontolateral approaches from July 2010 to July 2015 admitted to Department of Neurosurgery in Tianjin Huanhu Hospital. The operative efficacy was evaluated according to postoperative Glasgow Outcome Scale (GOS.  Results The 36 aneurysms in 18 patients were successfully clipped via bilateral frontolateral approaches at one-stage, including 18 posterior communicating artery (PCoA mirror aneurysms in 9 cases and 18 middle cerebral artery (MCA mirror aneurysms in 9 cases. GOS score of 5 was discovered in 16 cases, and 4 was discovered in 2 cases after operation. One case underwent ventriculoperitoneal shunting (VPS due to communicating hydrocephalus, one case got postoperative pulmonary infection and no death occurred. Intracranial CTA at 6 months postoperatively showed aneurysms of 18 patients were clipped completely, the parent artery blood flow was smooth, and no recurrence was found.  Conclusions Microsurgical one-stage clipping via bilateral frontolateral approaches for treating intracranial mirror aneurysms is a sugrical method with small incision, fitting surgical field, high safety, satisfactory effect and good prognosis, which is a new minimally invasive neurosurgical technique. DOI: 10.3969/j.issn.1672-6731.2016.08.012

Microsurgical free flap reconstructions of head and neck region in 406 cases: a 13-year experience.

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Gerressen, Marcus; Pastaschek, Claudia Inge; Riediger, Dieter; Hilgers, Ralf-Dieter; Hölzle, Frank; Noroozi, Nelson; Ghassemi, Alireza

2013-03-01

The reconstruction of extended soft tissue and bony defects in the maxillofacial region with microsurgical flaps is considered to be the therapy of first choice. The aim of this retrospective study was to detect different influencing factors concerning flap survival. We examined the data of 406 patient cases (121 female and 285 male cases; mean age, 57 years) undergoing reconstruction with a microsurgical flap in our facility between 1998 and 2010. In these cases 326 soft tissue flaps (radial forearm flap, scapula flap, latissimus dorsi flap, anterolateral thigh flap, lateral arm flap, and jejunum flap) and 80 bony flaps (fibula flap and deep circumflex iliac artery flap) were examined. Evaluated parameters were, among others, the timing of reconstruction, defect localization, and recipient vessels used (external vs internal jugular system), as well as anticoagulative management. We statistically analyzed data by means of a χ(2) test, taking account of the odds ratio with P < .05, which was deemed significant. The overall flap survival rate was approximately 92%, without any gender- or age-specific differences. Primary reconstructions proceeded distinctly more successfully than secondary reconstructions (P < .01). Likewise, the defect localization exerted a significant effect on the survival rate (P = .01), with a more caudal localization affecting flap survival positively. Finally, neither the anticoagulation regimen nor the choice of recipient vein system exercised an influence on the survival rate. Microsurgical tissue transfer is a convenient and reliable method in maxillofacial surgery, provided that one is aware of the determining factors for success. Copyright © 2013 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Technical Nuances of Exposing Rat Common Carotid Arteries for Practicing Microsurgical Anastomosis.

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Tayebi Meybodi, Ali; Aklinski, Joseph; Gandhi, Sirin; Lawton, Michael T; Preul, Mark C

2018-04-17

Animal models are commonly used in training protocols for microsurgical vascular anastomosis. Rat common carotid arteries (CCAs) are frequently used for this purpose. Much attention has been paid to the technical details of various anastomosis configurations using these arteries. However, technical nuances of exposing rat CCAs have been understudied. The purpose of this study is to describe nuances of technique for safely and efficiently exposing rat CCAs in preparation for a vascular anastomosis. Bilateral CCAs were exposed and prepared for anastomosis in 10 anesthetized Sprague-Dawley rats through a midline cervical incision. The exposed length of the CCA was measured. Additionally, technical nuances of exposure and surgically relevant anatomic details were recorded. The CCAs were exposed from the sternoclavicular joint to their bifurcation (average length, 19.1 ± 2.8 mm). Tenets important for a safe and efficient exposure of the CCAs included 1) generous subcutaneous dissection to expose the external jugular veins (EJVs), 2) avoiding injury to or compression of the EJVs, 3) superior mobilization of the salivary glands, 4) division of internal jugular veins, 5) opening the carotid sheath at its midlevel and from medial to lateral, and 6) avoiding injury to the vagus nerve or sympathetic trunk. Using the principles introduced in this study, trainees may safely and efficiently expose rat CCAs in preparation for a bypass. Copyright © 2018 Elsevier Inc. All rights reserved.

Establishment of Next-Generation Neurosurgery Research and Training Laboratory with Integrated Human Performance Monitoring.

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Bernardo, Antonio

2017-10-01

Quality of neurosurgical care and patient outcomes are inextricably linked to surgical and technical proficiency and a thorough working knowledge of microsurgical anatomy. Neurosurgical laboratory-based cadaveric training is essential for the development and refinement of technical skills before their use on a living patient. Recent biotechnological advances including 3-dimensional (3D) microscopy and endoscopy, 3D printing, virtual reality, surgical simulation, surgical robotics, and advanced neuroimaging have proved to reduce the learning curve, improve conceptual understanding of complex anatomy, and enhance visuospatial skills in neurosurgical training. Until recently, few means have allowed surgeons to obtain integrated surgical and technological training in an operating room setting. We report on a new model, currently in use at our institution, for technologically integrated surgical training and innovation using a next-generation microneurosurgery skull base laboratory designed to recreate the setting of a working operating room. Each workstation is equipped with a 3D surgical microscope, 3D endoscope, surgical drills, operating table with a Mayfield head holder, and a complete set of microsurgical tools. The laboratory also houses a neuronavigation system, a surgical robotic, a surgical planning system, 3D visualization, virtual reality, and computerized simulation for training of surgical procedures and visuospatial skills. In addition, the laboratory is equipped with neurophysiological monitoring equipment in order to conduct research into human factors in surgery and the respective roles of workload and fatigue on surgeons' performance. Copyright © 2017 Elsevier Inc. All rights reserved.

Direct costs of microsurgical management of radiosurgically amenable intracranial pathology in Germany: an analysis of meningiomas, acoustic neuromas, metastases and arteriovenous malformations of less than 3 cm in diameter

International Nuclear Information System (INIS)

Wellis, G.; Nagel, R.; Vollmar, C.; Steiger, H.-J.

2003-01-01

The purpose of the analysis was to appreciate and compare the effective direct costs of microsurgical treatment of intracranial pathology potentially amenable to radiosurgery as they arose in 1998-99. Treatment costs of 127 microsurgically treated patients harboring an arteriovenous malformation (AVM), acoustic neuroma, meningioma or brain metastasis potentially amenable to radiosurgery were reviewed. Costs for the surgical procedure, ICU rare, medical and nursing care on the ward, interclinical bills (ICB) for services provided by other departments and the overhead for basic hotel service were added. For comparison gamma knife costs were calculated by dividing the global operating cost of the gamma knife centre by the number of patients treated in 1999. Average hospitalization time for the entire microsurgical patients was 15.4 + 8.6 days. The patients spent an average of 1.2 ± 2.8 days on ICU. Average operating time for all patients, including preparation, was 393 ± 118 minutes. Average costs for the microsurgical therapy were Eur 10814 ± 6108. These consisted of Eur 1417 ± 426 for the surgical procedure, Eur 1188 ± 2658 for ICU care, Eur 2333 ± 1582 for medical and nursing care on the ward, Eur 1671 ± 1433 for interclinical bills and Eur 4204 ± 2338 for basic hotel service (overhead, Eur 273 per day). 70 % of the microsurgically treated patients needed ancillary inpatient rehabilitation or radiotherapy resulting in an average additional cost for all patients of Eur 2744. Furthermore 20 % of the microsurgically treated patients required an unplanned readmission after discharge, resulting in an average additional costs for all patients of Eur 1684. Average overall costs per patient including ancillary therapy and unplanned read-missions amounted to Eur 15242. For comparison, gamma knife treatment costs per patient amounted to Eur 7920 in 1999. The current analysis showed that for established radiosurgical indications the primary costs of microsurgery

Microsurgical resection of incompletely obliterated intracranial arteriovenous malformations following stereotactic radiosurgery

International Nuclear Information System (INIS)

Chang, S.D.; Steinberg, G.K.; Levy, R.P.; Marks, M.P.; Frankel, K.A.; Shuster, D.L.; Marcellus, M.L.

1998-01-01

Radiosurgery is effective in obliterating small arteriovenous malformations (AVMs), but less successful in thrombosing larger AVMs. This study reviewed patients who underwent surgical resection of their large AVMs following failed radiosurgical obliteration. AVMs from 36 patients (aged 7 to 64 years, mean 29.9) were surgically resected 1 to 11 years after radiosurgery. Initial AVM volumes were 0.7 to 117 cm 3 (mean 21.6 cm 3 ), and radiosurgical doses ranged from 4.6 to 45 Gray equivalent (GyE) (mean 21.1 GyE). Thirty AVMs (83%) were located in eloquent tissue. Venous drainage was deep (14), superficial (13), or both (9). Spetzler grades were II (2), III (12), IV (18), and V (4). Nine patients suffered rehemorrhage after radiosurgery but prior to surgery, while three patients developed radiation necrosis. Twenty-seven patients underwent endovascular embolization prior to surgery. During microsurgical resection, the AVMs were found to be significantly less vascular and more easily resected, compared to AVMs in patients who had not received radiosurgery. Histology showed endothelial proliferation with hyaline and mineralization in vessel walls. Partial or complete thrombosis of some AVM vessels, and evidence of vessel and brain necrosis were noted in many cases. Clinical outcome was excellent or good in 34 cases, with two patients dying of rebleeding from residual AVM. Five patients were neurologically worse following microsurgical resection. Final outcome was largely related to the pretreatment grade. Radiosurgery several years prior to surgical resection appears useful in treating unusually large and complex AVMs. (author)

A Preliminary Multiple Case Report of Neurocognitive Training for Children With AD/HD in China

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Han Jiang

2015-06-01

Full Text Available This preliminary multiple case study examined the behavioral outcomes of neurocognitive training on children with attention-deficit/hyperactivity disorder (AD/HD in China, as well as parent acceptance of the treatment. The training approach targeted working memory, impulse control, and attention/relaxation (via brain electrical activity. Outcome measures included overt behavior as rated by parents and teachers, AD/HD symptom frequency, and parent opinion/feedback. Training was completed by five individuals and delivered via a themed computer game with electroencephalogram (EEG input via a wireless, single-channel, dry-sensor, portable measurement device. The objective (i.e., training outcomes and EEG and subjective (i.e., parent ratings/feedback and teacher ratings data suggested that use of the neurocognitive training resulted in reduced AD/HD behaviors and improvement in socially meaningful outcomes. The parents expressed satisfaction with the training procedure and outcomes. It is concluded that the innovative neurocognitive training approach is effective for improving behavior and reducing symptoms of AD/HD for children in China.

New nonabsorbable stent versus a microsurgical procedure for vasectomy reversal: evaluating tissue reactions at the anastomosis in rabbits

NARCIS (Netherlands)

Vrijhof, Eric J.; de Bruine, Adriaan; Zwinderman, Aeilko; Lycklama à Nijeholt, August A. B.; Koole, Leo

2005-01-01

To investigate whether a newly designed nonabsorbable polymeric stent for the reconstruction of the vas deferens provided less stricturing at the site of the anastomosis in comparison with the conventional microsurgical reconstruction of the vas deferens. Prospective randomized study in 26 rabbits,

Microsurgical replantation and postoperative leech treatment of a large severed nasal segment

DEFF Research Database (Denmark)

Stemann Andersen, Peter; Elberg, Jens Jørgen

2012-01-01

The survival of a microsurgically replanted segment of nose in a 41-year-old woman was facilitated by the assistance of the medicinal leech Hirudo medicinalis. An arterial microanastomosis was made to a severed partial segment of nose with no possibility of recreating a venous anastomosis. The re....... The resulting venous congestion was treated with nine days of treatment with a medical leech until venous neovascularisation had been achieved. At follow-up six months after discharge there was a well-heeled nasal segment and a satisfying functional - as well as cosmetic - result....

Transplantation and microsurgical anastomosis of free omental grafts: experimental animal model of a new operative technique in dogs.

Science.gov (United States)

Pap-Szekeres, Jozsef; Cserni, Gabor; Furka, Istvan; Svebis, Mihaly; Cserni, Tamas; Brath, Endre; Nemeth, Norbert; Miko, Iren

2003-01-01

Our objective was the elaboration of a new animal model for the free transplantation of an omental flap and the examination of its viability in dogs. The cooled omental flap from the abdomen was freely transplanted to the lateral cervical region, and its blood supply was established with microsurgical anastomoses. The technique was developed in 5 dogs, and short-term survival examinations were later carried out in 3 cases by means of this method. Postoperative viability was assessed by angiography, methylene blue testing, and histology. Of the 3 transplanted grafts, 2 still survived 1 week after the operation. For technical reasons, 1 flap thrombotized. For determination of the viability of the transplanted graft, histology proved best. Vital reactions, including granulation tissue and angiogenesis, were present on the histological slides. The short-term survival of an omental flap can be ensured with microsurgical transplantation in dogs. Copyright 2003 Wiley-Liss, Inc.

Cerebellar anatomy as applied to cerebellar microsurgical resections

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Alejandro Ramos

2012-06-01

Full Text Available OBJECTIVE: To define the anatomy of dentate nucleus and cerebellar peduncles, demonstrating the surgical application of anatomic landmarks in cerebellar resections. METHODS: Twenty cerebellar hemispheres were studied. RESULTS: The majority of dentate nucleus and cerebellar peduncles had demonstrated constant relationship to other cerebellar structures, which provided landmarks for surgical approaching. The lateral border is separated from the midline by 19.5 mm in both hemispheres. The posterior border of the cortex is separated 23.3 mm from the posterior segment of the dentate nucleus; the lateral one is separated 26 mm from the lateral border of the nucleus; and the posterior segment of the dentate nucleus is separated 25.4 mm from the posterolateral angle formed by the junction of lateral and posterior borders of cerebellar hemisphere. CONCLUSIONS: Microsurgical anatomy has provided important landmarks that could be applied to cerebellar surgical resections.

Monitoring in microvascular tissue transfer by measurement of oxygen partial pressure: four years experience with 125 microsurgical transplants.

Science.gov (United States)

Jonas, René; Schaal, Thomas; Krimmel, Michael; Gülicher, Dirk; Reinert, Siegmar; Hoffmann, Jürgen

2013-06-01

In a prospective study, the characteristics and benefit of an invasive measurement of oxygen partial pressure (pO(2)) with the aid of a polarographic sensor were investigated in 125 microsurgical reconstructions of the head and neck area over a period of 45 months. Measurements were performed over 96 h in eight different types of microsurgically revascularized flaps for extra- and intraoral reconstructions and were evaluated separately for each flap type. Of 125 reconstructions the system indicated malperfusion in 18 cases. Salvage surgery was performed in 17 cases due to venous thrombosis (6 cases), arterial thrombosis (3 cases), a combination of arterial and venous thrombosis (2 cases), rheological problems (3 cases), venous insufficiency by hematoma (2 cases) and kinking of vessels (1 case). In 10 cases salvage surgery was successful, 7 flaps were lost despite salvage surgery. In all these cases, the polarographic probe indicated the necessity of salvage surgery correctly. After 96 h no malperfusion was seen. Postoperatively, a common and characteristic development of the oxygen partial pressure in different types of flaps was seen. Initially, a clear increase of pO(2) could be measured. During 96 h, a slow decrease of pO(2) was observed. In conclusion polarographic measurement of pO(2) can be an excellent apparative supplement for the postoperative clinical control of microsurgically revascularized transplants. In buried flaps, this technique represents the only reliable method for transplant monitoring. Copyright © 2012 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Training habits and injuries of masters' level football players: a preliminary report.

Science.gov (United States)

Newsham-West, R; Button, C; Milburn, P D; Mündermann, A; Sole, G; Schneiders, A G; Sullivan, S J

2009-05-01

To profile training habits and injuries in football players participating in a national Masters tournament. A cross-sectional retrospective study design was used to survey male football players attending the 2008 New Zealand Masters Games. Information regarding player demographics, football injuries, football related training, and risk factors for injury were collected. 199 Players were recruited, with a median age of 44 yrs (range 35-73) and a median football playing history of 15 yrs (range 0-66). Irrespective of age, 112 (84%) players included a warm-up and 104 (78%) included a stretching regime in their regular training programme. In the 12 months prior to the tournament, 128 football related injuries were reported by 93 players (64 injuries/100 players or 46 injured players/100 players). The most frequently injured region was the lower limb; specifically the lower leg (n=23), ankle (n=18), hamstring (n=17), knee (n=15), and Achilles tendon (n=15). This study provides a preliminary insight into the training habits and injury profiles of Masters football players. Despite all players including some form of injury prevention strategy in their training, a significant number of players experienced an injury in the 12 months prior to the tournament.

Novel mouse model for simulating microsurgical tumor excision with facial nerve preservation.

Science.gov (United States)

Lim, Jae H; Boyle, Glen M; Panizza, Benedict

2016-01-01

To determine the feasibility of using a mouse tumor model as a microsurgical training tool for otolaryngology-head and neck surgery (OHNS) trainees. Animal study. We injected athymic nude mice with human cutaneous squamous cell carcinoma (A431 cell line) deep to the parotid region overlying the masseter muscle. We sacrificed the animals 1 to 3 weeks postinjection, once a visible tumor growth was confirmed. We then asked 10 OHNS trainees to excise the tumor with preservation of the facial nerves under a high-magnification dissecting microscope. The trainees graded the tasks in several areas of specific measures using a visual analogue scale (VAS) including 1) tumor texture, 2) surgical realism, 3) usefulness, and 4) difficulty of the task. Noticeable tumor growth occurred within 5 days following A431 cell injection and reached measureable size (0.5-1.5 cm) within 1 to 3 weeks. The tumor displaced the facial nerve laterally and medially, with few demonstrating infiltration of the nerve. VAS scores (± standard deviation) were 8.1 (± 1.7), 7.7 (± 2.5), 9.0 (± 0.9) and 6.6 (± 1.9) for tumor texture, surgical realism, usefulness, and the difficulty of the task, respectively. We demonstrate a novel, reliable and cost-effective mouse model for simulating tumor extirpation microsurgery with preservation of important neural structures. OHNS trainees have found this simulation model to be realistic, useful, and appropriately challenging. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

Microsurgical robotic system for the deep surgical field: development of a prototype and feasibility studies in animal and cadaveric models.

Science.gov (United States)

Morita, Akio; Sora, Shigeo; Mitsuishi, Mamoru; Warisawa, Shinichi; Suruman, Katopo; Asai, Daisuke; Arata, Junpei; Baba, Shoichi; Takahashi, Hidechika; Mochizuki, Ryo; Kirino, Takaaki

2005-08-01

To enhance the surgeon's dexterity and maneuverability in the deep surgical field, the authors developed a master-slave microsurgical robotic system. This concept and the results of preliminary experiments are reported in this paper. The system has a master control unit, which conveys motion commands in six degrees of freedom (X, Y, and Z directions; rotation; tip flexion; and grasping) to two arms. The slave manipulator has a hanging base with an additional six degrees of freedom; it holds a motorized operating unit with two manipulators (5 mm in diameter, 18 cm in length). The accuracy of the prototype in both shallow and deep surgical fields was compared with routine freehand microsurgery. Closure of a partial arteriotomy and complete end-to-end anastomosis of the carotid artery (CA) in the deep operative field were performed in 20 Wistar rats. Three routine surgical procedures were also performed in cadavers. The accuracy of pointing with the nondominant hand in the deep surgical field was significantly improved through the use of robotics. The authors successfully closed the partial arteriotomy and completely anastomosed the rat CAs in the deep surgical field. The time needed for stitching was significantly shortened over the course of the first 10 rat experiments. The robotic instruments also moved satisfactorily in cadavers, but the manipulators still need to be smaller to fit into the narrow intracranial space. Computer-controlled surgical manipulation will be an important tool for neurosurgery, and preliminary experiments involving this robotic system demonstrate its promising maneuverability.

A clinical case of single-stage correction of penetration combined orofacial defect with two microsurgical autografts

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A. D. Kaprin

2015-01-01

resected mandible, and autografting into the chronically infected area.Single-stage repair, including that using a few microsurgical autografts, is the operation of choice for adequate anatomic and functional rehabilitation, permits the promptest recovery of patients, reduces a postoperative period, and allows them to undergo an antitumor treatment cycle. However, the repair is possible, when the risk of disease progression is low, in specialized centers and when there are trained head and neck surgery and reconstructive microsurgery specialists and anesthesiologists.

The results of surgical treatment of oviductal infertility with use of microsurgical technique

International Nuclear Information System (INIS)

Cislo, M.; Murawski, M.; Palczynski, B.

1993-01-01

40 women were operated on infertility due to oviductal factor. This kind of infertility has been previously diagnosed by hysterosalpingography examination and then verified in 22 cases (55%) by laparoscopy combined with chromotubation. The operations were carried out with use of microsurgical technique and instruments. At the same time the prophylactics of postoperative intraperitoneal adhesions was applied. Seven pregnancies were obtained, that makes 17.5% of success. It is an outcome comparable with results presented by many other world centers of gynecological microsurgery. (author)

Case Report: Microsurgical excision of grade 5 cerebral AVM [version 2; referees: 1 approved, 2 approved with reservations

Directory of Open Access Journals (Sweden)

Sunil Munakomi

2016-07-01

Full Text Available In this case report, we discuss the microsurgical management of a Spetzler-Martin grade 5 arteriovenous malformation (AVM in a young boy who presented with a hemorrhagic episode and had a high calculated risk of rebleeding. We also outline the rationale for choosing the management option.

A Preliminary Evaluation of Reach: Training Early Childhood Teachers to Support Children's Social and Emotional Development

Science.gov (United States)

Conners-Burrow, Nicola A.; Patrick, Terese; Kyzer, Angela; McKelvey, Lorraine

2017-01-01

This paper describes the development, implementation and preliminary evaluation of the Reaching Educators and Children (REACH) program, a training and coaching intervention designed to increase the capacity of early childhood teachers to support children's social and emotional development. We evaluated REACH with 139 teachers of toddler and…

A preliminary report of music-based training for adult cochlear implant users: rationales and development

Science.gov (United States)

Gfeller, Kate; Guthe, Emily; Driscoll, Virginia; Brown, Carolyn J.

2015-01-01

Objective This paper provides a preliminary report of a music-based training program for adult cochlear implant (CI) recipients. Included in this report are descriptions of the rationale for music-based training, factors influencing program development, and the resulting program components. Methods Prior studies describing experience-based plasticity in response to music training, auditory training for persons with hearing impairment, and music training for cochlear implant recipients were reviewed. These sources revealed rationales for using music to enhance speech, factors associated with successful auditory training, relevant aspects of electric hearing and music perception, and extant evidence regarding limitations and advantages associated with parameters for music training with CI users. This information formed the development of a computer-based music training program designed specifically for adult CI users. Results Principles and parameters for perceptual training of music, such as stimulus choice, rehabilitation approach, and motivational concerns were developed in relation to the unique auditory characteristics of adults with electric hearing. An outline of the resulting program components and the outcome measures for evaluating program effectiveness are presented. Conclusions Music training can enhance the perceptual accuracy of music, but is also hypothesized to enhance several features of speech with similar processing requirements as music (e.g., pitch and timbre). However, additional evaluation of specific training parameters and the impact of music-based training on speech perception of CI users are required. PMID:26561884

Microsurgical anatomy of the abducens nerve.

Science.gov (United States)

Joo, Wonil; Yoshioka, Fumitaka; Funaki, Takeshi; Rhoton, Albert L

2012-11-01

The aim of this study is to demonstrate and review the detailed microsurgical anatomy of the abducens nerve and surrounding structures along its entire course and to provide its topographic measurements. Ten cadaveric heads were examined using ×3 to ×40 magnification after the arteries and veins were injected with colored silicone. Both sides of each cadaveric head were dissected using different skull base approaches to demonstrate the entire course of the abducens nerve from the pontomedullary sulcus to the lateral rectus muscle. The anatomy of the petroclival area and the cavernous sinus through which the abducens nerve passes are complex due to the high density of critically important neural and vascular structures. The abducens nerve has angulations and fixation points along its course that put the nerve at risk in many clinical situations. From a surgical viewpoint, the petrous tubercle of the petrous apex is an intraoperative landmark to avoid damage to the abducens nerve. The abducens nerve is quite different from the other nerves. No other cranial nerve has a long intradural path with angulations and fixations such as the abducens nerve in petroclival venous confluence. A precise knowledge of the relationship between the abducens nerve and surrounding structures has allowed neurosurgeon to approach the clivus, petroclival area, cavernous sinus, and superior orbital fissure without surgical complications. Copyright © 2012 Wiley Periodicals, Inc.

Open Tibia Shaft Fractures and Soft-Tissue Coverage: The Effects of Management by an Orthopaedic Microsurgical Team.

Science.gov (United States)

VandenBerg, James; Osei, Daniel; Boyer, Martin I; Gardner, Michael J; Ricci, William M; Spraggs-Hughes, Amanda; McAndrew, Christopher M

2017-06-01

To compare the timing of soft-tissue (flap) coverage and occurrence of complications before and after the establishment of an integrated orthopaedic trauma/microsurgical team. Retrospective cohort study. A single level 1 trauma center. Twenty-eight subjects (13 pre- and 15 post-integration) with open tibia shaft fractures (OTA/AO 42A, 42B, and 42C) treated with flap coverage between January 2009 and March 2015. Flap coverage for open tibia shaft fractures treated before ("preintegration") and after ("postintegration") implementation of an integrated orthopaedic trauma/microsurgical team. Time from index injury to flap coverage. The unadjusted median time to coverage was 7 days (95% confidence interval, 5.9-8.1) preintegration, and 6 days (95% confidence interval, 4.6-7.4) postintegration (P = 0.48). For preintegration, 9 (69%) of the patients experienced complications, compared with 7 (47%) postintegration (P = 0.23). After formation of an integrated orthopaedic trauma/microsurgery team, we observed a 1-day decrease in median days to coverage from index injury. Complications overall were lowered in the postintegration group, although statistically insignificant. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Prediction of the microsurgical window for skull-base tumors by advanced three-dimensional multi-fusion volumetric imaging

International Nuclear Information System (INIS)

Oishi, Makoto; Fukuda, Masafumi; Saito, Akihiko; Hiraishi, Tetsuya; Fujii, Yukihiko; Ishida, Go

2011-01-01

The surgery of skull base tumors (SBTs) is difficult due to the complex and narrow surgical window that is restricted by the cranium and important structures. The utility of three-dimensional multi-fusion volumetric imaging (3-D MFVI) for visualizing the predicted window for SBTs was evaluated. Presurgical simulation using 3-D MFVI was performed in 32 patients with SBTs. Imaging data were collected from computed tomography, magnetic resonance imaging, and digital subtraction angiography. Skull data was processed to imitate actual bone resection and integrated with various structures extracted from appropriate imaging modalities by image-analyzing software. The simulated views were compared with the views obtained during surgery. All craniotomies and bone resections except opening of the acoustic canal in 2 patients were performed as simulated. The simulated window allowed observation of the expected microsurgical anatomies including tumors, vasculatures, and cranial nerves, through the predicted operative window. We could not achieve the planned tumor removal in only 3 patients. 3-D MFVI afforded high quality images of the relevant microsurgical anatomies during the surgery of SBTs. The intraoperative deja-vu effect of the simulation increased the confidence of the surgeon in the planned surgical procedures. (author)

Successful microsurgical penile replantation following self amputation in a schizophrenic patient

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Saurabh Gyan

2010-01-01

Full Text Available Amputation of the penis is a rare condition reported from various parts of the world as isolated cases or small series of patients; the common etiology is self-mutilating sharp amputation or an avulsion or crush injury in an industrial accident. A complete reconstruction of all penile structures should be attempted in one stage which provides the best chance for full rehabilitation of the patient. We report here a single case of total amputation of the penis in an acute paranoid schizophrenic patient .The penis was successfully reattached using a microsurgical technique. After surgery, near-normal appearance and function including a good urine flow and absence of urethral stricture, capabilities of erection and near normal sensitivity were observed.

Microsurgical reconstruction of the head and neck region: Current concepts of maxillofacial surgery units worldwide.

Science.gov (United States)

Kansy, Katinka; Mueller, Andreas Albert; Mücke, Thomas; Koersgen, Friederike; Wolff, Klaus Dietrich; Zeilhofer, Hans-Florian; Hölzle, Frank; Pradel, Winnie; Schneider, Matthias; Kolk, Andreas; Smeets, Ralf; Acero, Julio; Haers, Piet; Ghali, G E; Hoffmann, Jürgen

2015-10-01

Microvascular surgery following tumor resection has become an important field of oral maxillofacial surgery (OMFS). Following the surveys on current reconstructive practice in German-speaking countries and Europe, this paper presents the third phase of the project when the survey was conducted globally. The DOESAK questionnaire has been developed via a multicenter approach with maxillofacial surgeons from 19 different hospitals in Germany, Austria and Switzerland. It was distributed in three different phases to a growing number of maxillofacial units in German-speaking clinics, over Europe and then worldwide. Thirty-eight units from Germany, Austria and Switzerland, 65 remaining European OMFS-departments and 226 units worldwide responded to the survey. There is wide agreement on the most commonly used flaps, intraoperative rapid sections and a trend towards primary bony reconstruction. No uniform concepts can be identified concerning osteosynthesis of bone transplants, microsurgical techniques, administration of supportive medication and postoperative monitoring protocols. Microsurgical reconstruction is the gold standard for the majority of oncologic cases in Europe, but worldwide, only every second unit has access to this technique. The DOESAK questionnaire has proven to be a valid and well accepted tool for gathering information about current practice in reconstructive OMFS surgery. The questionnaire has been able to demonstrate similarities, differences and global inequalities. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Endoport-Assisted Microsurgical Treatment of a Ruptured Periventricular Aneurysm

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Ching-Jen Chen

2016-01-01

Full Text Available Background and Importance. Ruptured periventricular aneurysms in patients with moyamoya disease represent challenging pathologies. The most common methods of treatment include endovascular embolization and microsurgical clipping. However, rare cases arise in which the location and anatomy of the aneurysm make these treatment modalities particularly challenging. Clinical Presentation. We report a case of a 34-year-old female with moyamoya disease who presented with intraventricular hemorrhage. CT angiography and digital subtraction angiography revealed an aneurysm located in the wall of the atrium of the right lateral ventricle. Distal endovascular access was not possible, and embolization risked the sacrifice of arteries supplying critical brain parenchyma. Using the BrainPath endoport system, the aneurysm was able to be accessed. Since the fusiform architecture of the aneurysm prevented clip placement, the aneurysm was ligated with electrocautery. Conclusion. We demonstrate the feasibility of endoport-assisted approach for minimally invasive access and treatment of uncommon, distally located aneurysms.

Comparative study on preliminary breakdown pulse trains observed in Johor, Malaysia and Florida, USA

Science.gov (United States)

Baharudin, Z. A.; Ahmad, Noor Azlinda; Fernando, M.; Cooray, V.; Mäkelä, J. S.

2012-11-01

In this paper, the preliminary breakdown (PB) pulse train preceding the negative first return stroke (RS) is recorded using a broad band antenna system. These analyses were carried out in Johor Bahru, Malaysia and Florida, United States. This is a novel initiative at examining and identifying the characteristics of the PB pulse trains in the negative cloud-to-ground flashes observed in Malaysia. The arithmetic mean of the total pulse train duration is 12.3 ms and the weighted arithmetic mean of the pulse durations and interpulse intervals are 11 μs and 152 μs, respectively. The arithmetic mean ratio between the maximum peak amplitude of the PB pulse and the peak RS electric field was 27.8%, and the corresponding value in Florida was 29.4%. The arithmetic mean of the time duration between the most active part of the pulse train, and the RS was 57.6 ms in Malaysia and 22 ms in Florida. A qualitative comparison of our results with those obtained earlier in Sri Lanka, Sweden and Finland supports the hypothesis that the PBP/RS ratio is higher in the northern regions compared to the tropical regions.

Preliminary assessment report for National Guard Training Center, Georgia Army National Guard, Fort Stewart, Georgia

International Nuclear Information System (INIS)

1993-07-01

This report presents the results of the preliminary assessment (PA) conducted by Argonne National Laboratory at the Georgia Army National Guard (GAARNG) facility near Hinesville, Georgia, known as the National Guard Training Center (NGTC). Preliminary assessments of federal facilities are being conducted to compile the information necessary for completing preremedial activities and to provide a priority basis for completing corrective actions (where necessary) in response to releases of hazardous substances. The principal objective of the PA is to characterize the site accurately and determine the need for further action by examining previous site activities, types and quantities of hazardous substances utilized, and potential pathways by which contamination could affect public health and the environment. The scope of this assessment is limited to the facilities and past activities contained within the NGTC. Preliminary assessment site score sheet information is also provided for the NGTC. However, this assessment report is intended to be read in conjunction with a previous IRP assessment of Fort Stewart completed in 1992 (USATHAMA 1992) and to provide comprehensive information on the NGTC area for incorporation with information contained in that previous assessment for the entirety of Fort Stewart

Introduction of microsurgery in Vietnam by a charitable organization: a 15-year experience.

Science.gov (United States)

Merrell, J Craig; Tien, Nguyen Viet; Son, Nguyen Tai; An, Luu Ngoc; Sellers, Daniel; Russell, Robert; Manktelow, Ralph; Wei, Fu-Chan; Orgill, Dennis P

2007-04-01

Microsurgical procedures, although equipment- and labor-intensive, allow efficient treatment of selected soft-tissue, bone, and peripheral nerve defects. The precise surgical skills required and the high equipment and institutional costs have been deterrents to initiating programs in developing countries. The authors report their 15-year international effort in facilitating the development of microsurgical techniques in Vietnam. The authors reviewed their educational, logistical, and operative experience from 11 Operation Smile International missions to Vietnam and the microsurgical procedures performed independently by Vietnamese surgeons at the Central Military Hospital 108 in Hanoi. Over 15 years, Operation Smile International missions to Vietnam performed 108 free tissue transfer operations with 15 peripheral nerve transfer procedures and 143 nonmicrosurgical reconstructive operations. Visiting surgeons with specialized expertise taught facial reanimation, flap prefabrication, and perforator flaps. During this same period, Vietnamese surgeons became facile with microsurgical techniques and independently performed a wide array of these procedures in the institutions visited. Vietnamese surgeons have organized microsurgery divisions within some hospital departments and now teach microsurgical techniques. Repeated missions allowed for patient follow-up, staged procedures, educational exchange, and quality control. Several Vietnamese surgeons have traveled abroad to obtain additional training and have set up training programs in other areas of Vietnam. Charitable organizations can help surgeons in developing countries master complex microsurgical techniques through short-term medical missions, donation of equipment and supplies, and the encouragement of institutional support. A continuing education program, including local conferences, microsurgical laboratory training facilities, and study abroad, can aid this introduction.

Validation of Reverse-Engineered and Additive-Manufactured Microsurgical Instrument Prototype.

Science.gov (United States)

Singh, Ramandeep; Suri, Ashish; Anand, Sneh; Baby, Britty

2016-12-01

With advancements in imaging techniques, neurosurgical procedures are becoming highly precise and minimally invasive, thus demanding development of new ergonomically aesthetic instruments. Conventionally, neurosurgical instruments are manufactured using subtractive manufacturing methods. Such a process is complex, time-consuming, and impractical for prototype development and validation of new designs. Therefore, an alternative design process has been used utilizing blue light scanning, computer-aided designing, and additive manufacturing direct metal laser sintering (DMLS) for microsurgical instrument prototype development. Deviations of DMLS-fabricated instrument were studied by superimposing scan data of fabricated instrument with the computer-aided designing model. Content and concurrent validity of the fabricated prototypes was done by a group of 15 neurosurgeons by performing sciatic nerve anastomosis in small laboratory animals. Comparative scoring was obtained for the control and study instrument. T test was applied to the individual parameters and P values for force (P direct application of these additive-manufactured instruments in the operating room requires further validation. © The Author(s) 2016.

Microsurgical Clipping of an Anterior Communicating Artery Aneurysm Using a Novel Robotic Visualization Tool in Lieu of the Binocular Operating Microscope: Operative Video.

Science.gov (United States)

Klinger, Daniel R; Reinard, Kevin A; Ajayi, Olaide O; Delashaw, Johnny B

2018-01-01

The binocular operating microscope has been the visualization instrument of choice for microsurgical clipping of intracranial aneurysms for many decades. To discuss recent technological advances that have provided novel visualization tools, which may prove to be superior to the binocular operating microscope in many regards. We present an operative video and our operative experience with the BrightMatterTM Servo System (Synaptive Medical, Toronto, Ontario, Canada) during the microsurgical clipping of an anterior communicating artery aneurysm. To the best of our knowledge, the use of this device for the microsurgical clipping of an intracranial aneurysm has never been described in the literature. The BrightMatterTM Servo System (Synaptive Medical) is a surgical exoscope which avoids many of the ergonomic constraints of the binocular operating microscope, but is associated with a steep learning curve. The BrightMatterTM Servo System (Synaptive Medical) is a maneuverable surgical exoscope that is positioned with a directional aiming device and a surgeon-controlled foot pedal. While utilizing this device comes with a steep learning curve typical of any new technology, the BrightMatterTM Servo System (Synaptive Medical) has several advantages over the conventional surgical microscope, which include a relatively unobstructed surgical field, provision of high-definition images, and visualization of difficult angles/trajectories. This device can easily be utilized as a visualization tool for a variety of cranial and spinal procedures in lieu of the binocular operating microscope. We anticipate that this technology will soon become an integral part of the neurosurgeon's armamentarium. Copyright © 2017 by the Congress of Neurological Surgeons

AGR-2 Irradiated Test Train Preliminary Inspection and Disassembly First Look

Energy Technology Data Exchange (ETDEWEB)

Ploger, Scott [Idaho National Lab. (INL), Idaho Falls, ID (United States); Demkowciz, Paul [Idaho National Lab. (INL), Idaho Falls, ID (United States); Harp, Jason [Idaho National Lab. (INL), Idaho Falls, ID (United States)

2015-05-01

The AGR 2 irradiation experiment began in June 2010 and was completed in October 2013. The test train was shipped to the Materials and Fuels Complex in July 2014 for post-irradiation examination (PIE). The first PIE activities included nondestructive examination of the test train, followed by disassembly of the test train and individual capsules and detailed inspection of the capsule contents, including the fuel compacts and their graphite fuel holders. Dimensional metrology was then performed on the compacts, graphite holders, and steel capsule shells. AGR 2 disassembly and metrology were performed with the same equipment used successfully on AGR 1 test train components. Gamma spectrometry of the intact test train gave a preliminary look at the condition of the interior components. No evidence of damage to compacts or graphite components was evident from the isotopic and gross gamma scans. Disassembly of the AGR 2 test train and its capsules was conducted rapidly and efficiently by employing techniques refined during the AGR 1 disassembly campaign. Only one major difficulty was encountered while separating the test train into capsules when thermocouples (of larger diameter than used in AGR 1) and gas lines jammed inside the through tubes of the upper capsules, which required new tooling for extraction. Disassembly of individual capsules was straightforward with only a few minor complications. On the whole, AGR 2 capsule structural components appeared less embrittled than their AGR 1 counterparts. Compacts from AGR 2 Capsules 2, 3, 5, and 6 were in very good condition upon removal. Only relatively minor damage or markings were visible using high resolution photographic inspection. Compact dimensional measurements indicated radial shrinkage between 0.8 to 1.7%, with the greatest shrinkage observed on Capsule 2 compacts that were irradiated at higher temperature. Length shrinkage ranged from 0.1 to 0.9%, with by far the lowest axial shrinkage on Capsule 3 compacts�

A Preliminary Review of Fatigue Among Rail Staff

OpenAIRE

Jialin Fan; Andrew P. Smith

2018-01-01

Background: Fatigue is a severe problem in the rail industry, which may jeopardize train crew's health and safety. Nonetheless, a preliminary review of all empirical evidence for train crew fatigue is still lacking. The aim of the present paper is, therefore, to provide a preliminary description of occupational fatigue in the rail industry. This paper reviews the literature with the research question examining the risk factors associated with train crew fatigue, covering both papers published...

Preliminary assessment report for Grubbs/Kyle Training Center, Smyrna/Rutherford County Regional Airport, Installation 47340, Smyrna, Tennessee

International Nuclear Information System (INIS)

Dennis, C.; Stefano, J.

1993-07-01

This report presents the results of the preliminary assessment (PA) conducted by Argonne National Laboratory at the Tennessee Army National Guard (TNARNG) property near Smyrna, Tennessee. Preliminary assessments of federal facilities are being conducted to compile the information necessary for completing preremedial activities and to provide a basis for establishing corrective actions in response to releases of hazardous substances. The principal objective of the PA is to characterize the site accurately and determine the need for further action by examining site activities, quantities of hazardous substances present, and potential pathways by which contamination could affect public health and the environment. This PA satisfies, for the Grubbs/Kyle Training Center property, the requirement of the Department of Defense Installation Restoration Program

Microsurgical Composite Tissue Transplantation

Science.gov (United States)

Serafin, Donald; Georgiade, Nicholas G.

1978-01-01

Since 1974, 69 patients with extensive defects have undergone reconstruction by microsurgical composite tissue transplantation. Using this method, donor composite tissue is isolated on its blood supply, removed to a distant recipient site, and the continuity of blood flow re-established by microvascular anastomoses. In this series, 56 patients (81%) were completely successful. There have been eight (12%) failures, primarily in the extremities. There have been five (7%) partial successes, (i.e., a microvascular flap in which a portion was lost requiring a secondary procedure such as a split thickness graft). In those patients with a severely injured lower extremity, the failure rate was the greatest. Most of these were arterial (six of seven). These failures occurred early in the series and were thought to be related to a severely damaged recipient vasculature. This problem has been circumvented by an autogenous interpositional vein graft, permitting more mobility of flap placement. In the upper extremity, all but one case were successful. Early motion was permitted, preventing joint capsular contractures and loss of function. Twenty-three cases in the head and neck region were successful (one partial success). This included two composite rib grafts to the mandible. Prolonged delays in reconstruction following extirpation of a malignancy were avoided. A rapid return to society following complete reconstruction was ensured. Nine patients presented for reconstruction of the breast and thorax following radical mastectomy. All were successfully reconstructed with this new technique except one patient. Its many advantages include immediate reconstruction without delayed procedures and no secondary deformity of the donor site. Healthy, well vascularized tissue can now be transferred to a previously irradiated area with no tissue loss. This new method offers many advantages to older methods of reconstruction. Length of hospital stay and immobilization are reduced. The

Giant partially thrombosed 4 th ventricular posterior inferior cerebellar artery aneurysm; microsurgical management

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Forhad Hossain Chowdhury

2014-01-01

Full Text Available A 42-year-old woman presented with a 3-month history of progressive occipital headache, vomiting, walking difficulty, and repeated fall. She had no history of sudden and severe headache. She had positive cerebellar signs, predominantly on the right side. Computerized tomography (CT scan, CT angiogram, and magnetic resonance image (MRI of the brain showed suspected partially thrombosed giant 4 th ventricular posterior inferior cerebellar artery aneurysm. Patient developed severe hypersensitivity reaction during both CT scan and MRI after contrast injection. Though needed, digital subtraction angiogram (DSA of cerebral vessels was not done. The aneurysm was managed by microsurgical clipping of the aneurysm neck and partial excision of thrombosed aneurysm. Here, we report the details of management of these difficult giant aneurysm without DSA.

Microsurgical anatomy of the central lobe.

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Frigeri, Thomas; Paglioli, Eliseu; de Oliveira, Evandro; Rhoton, Albert L

2015-03-01

The central lobe consists of the pre- and postcentral gyri on the lateral surface and the paracentral lobule on the medial surface and corresponds to the sensorimotor cortex. The objective of the present study was to define the neural features, craniometric relationships, arterial supply, and venous drainage of the central lobe. Cadaveric hemispheres dissected using microsurgical techniques provided the material for this study. The coronal suture is closer to the precentral gyrus and central sulcus at its lower rather than at its upper end, but they are closest at a point near where the superior temporal line crosses the coronal suture. The arterial supply of the lower two-thirds of the lateral surface of the central lobe was from the central, precentral, and anterior parietal branches that arose predominantly from the superior trunk of the middle cerebral artery. The medial surface and the superior third of the lateral surface were supplied by the posterior interior frontal, paracentral, and superior parietal branches of the pericallosal and callosomarginal arteries. The venous drainage of the superior two-thirds of the lateral surface and the central lobe on the medial surface was predominantly through the superior sagittal sinus, and the inferior third of the lateral surface was predominantly through the superficial sylvian veins to the sphenoparietal sinus or the vein of Labbé to the transverse sinus. The pre- and postcentral gyri and paracentral lobule have a morphological and functional anatomy that differentiates them from the remainder of their respective lobes and are considered by many as a single lobe. An understanding of the anatomical relationships of the central lobe can be useful in preoperative planning and in establishing reliable intraoperative landmarks.

Diploid, but not haploid, human embryonic stem cells can be derived from microsurgically repaired tripronuclear human zygotes

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Fan, Yong; Li, Rong; Huang, Jin; Yu, Yang; Qiao, Jie

2013-01-01

Human embryonic stem cells have shown tremendous potential in regenerative medicine, and the recent progress in haploid embryonic stem cells provides new insights for future applications of embryonic stem cells. Disruption of normal fertilized embryos remains controversial; thus, the development of a new source for human embryonic stem cells is important for their usefulness. Here, we investigated the feasibility of haploid and diploid embryo reconstruction and embryonic stem cell derivation using microsurgically repaired tripronuclear human zygotes. Diploid and haploid zygotes were successfully reconstructed, but a large proportion of them still had a tripolar spindle assembly. The reconstructed embryos developed to the blastocyst stage, although the loss of chromosomes was observed in these zygotes. Finally, triploid and diploid human embryonic stem cells were derived from tripronuclear and reconstructed zygotes (from which only one pronucleus was removed), but haploid human embryonic stem cells were not successfully derived from the reconstructed zygotes when two pronuclei were removed. Both triploid and diploid human embryonic stem cells showed the general characteristics of human embryonic stem cells. These results indicate that the lower embryo quality resulting from abnormal spindle assembly contributed to the failure of the haploid embryonic stem cell derivation. However, the successful derivation of diploid embryonic stem cells demonstrated that microsurgical tripronuclear zygotes are an alternative source of human embryonic stem cells. In the future, improving spindle assembly will facilitate the application of triploid zygotes to the field of haploid embryonic stem cells. PMID:23255130

Advanced technical skills are required for microsurgical clipping of posterior communicating artery aneurysms in the endovascular era.

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Sanai, Nader; Caldwell, Nolan; Englot, Dario J; Lawton, Michael T

2012-08-01

Many neurosurgeons feel competent clipping posterior communicating artery (PCoA) aneurysms and include this lesion in their practice. However, endovascular therapy removes simple aneurysms that would have been easiest to clip with the best results. What remains are aneurysms with complex anatomy and technical challenges that are not well described. A contemporary surgical series with PCoA aneurysms is reviewed to define the patients, microsurgical techniques, and outcomes in current practice. A total of 218 patients had 218 PCoA aneurysms that were treated microsurgically during an 11-year period. Complexities influencing aneurysm management included (1) large/giant size; (2) fetal posterior cerebral artery; (3) previous coiling; (4) anterior clinoidectomy; (5) adherence of the anterior choroidal artery (AChA); (6) intraoperative aneurysm rupture; (7) complex clipping; and (8) atherosclerotic calcification. Simple PCoA aneurysms were encountered in 113 patients (51.8%) and complex aneurysms in 105 (48.2%). Adherent AChA (13.8%) and intraoperative rupture (11.5%) were the most common complexities. Simple aneurysms had favorable outcomes in 86.6% of patients, whereas aneurysms with 1 or multiple complexities had favorable outcomes in 78.2% and 75.0%, respectively. Intraoperative rupture (P PCoA aneurysms requires advanced techniques including clinoidectomy, AChA microdissection, complex clipping, and facility with intraoperative rupture. Microsurgery is recommended for recurrent aneurysms after coiling, complex branches, aneurysms causing oculomotor nerve palsy, multiple aneurysms, and patients with hematomas.

Clinical study on microsurgical treatment of lumbar disc herniation assisted by METRx system

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Xin-gang ZHAO

2016-04-01

Full Text Available Objective To explore the techniques and curative effect of microsurgical procedures assisted by minimal exposure tubular retractor system (METRx in the treatment of lumbar disc herniation (LDH.  Methods A total of 51 LDH patients, including 24 patients with L4-5 herniation and 27 patients with L5-S1 herniation, underwent discectomy assisted by METRx system. The operation time, intraoperative blood loss, postoperative complications and hospital stay were recorded. Visual Analogue Scale (VAS and Oswestry Disability Index (ODI were used to evaluate the degree of low back pain before operation, one week, 3 months after operation, and in the last follow-up. Lumbar MRI was used to evaluate the decompression of spinal canal.  Results The success rate of operations in 51 cases was 98.04% (50/51. The average operation time was 125 min, the average intraoperative blood loss was 50 ml, the mean hospital stay was 5 d, all patients were followed up for 6-48 months (average 24 months. Compared with preoperation, both VAS and ODI scores decreased significantly one week after operation (P = 0.036, 0.029, 3 months after operation (P = 0.018, 0.023 and in the last follow-up (P = 0.007, 0.013. The improvement rate of ODI was 35.37% in the last follow-up. No infection, postoperative cerebrospinal fluid (CSF fistula, neurological defects or incision infection was found. One patient presented acute abdominalgia on the 2nd day after operation, and was diagnosed as annexitis. One patient showed nerve root irritation symptoms after operation caused by thick nerve root during the surgery. They were cured after symptomatic treatment.  Conclusions Microsurgical procedures for treating LDH assisted by METRx system can effectively relieve nerve root compression, protect the dural sac and nerve roots, and reduce surgical complications. DOI: 10.3969/j.issn.1672-6731.2016.04.008

[The use of a microsurgical precision technic for applying a gastroduodenal anastomosis in a Billroth-I gastric resection].

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Galkin, R A; Makarov, I V

1998-01-01

Advantages of the formation of gastroduodenal anastomosis using the microsurgical precision technique as compared to the two-row interrupted Albert-Lembert suture and the one-row suture of Pirogov-Mateshuk were established in an experimental investigation in 63 dogs. The article describes the precision suture technique proposed by the authors which was used in Billroth-I resection of the stomach in 15 patients. It was shown that the use of the precision suture resulted in healing by the first intention type, without motor evacuatory disorders and with shorter time of hospital treatment.

Botulinum toxin in preparation of oral cavity for microsurgical reconstruction.

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Corradino, Bartolo; Di Lorenzo, Sara; Mossuto, Carmela; Costa, Renato Patrizio; Moschella, Francesco

2010-01-01

Infiltration of botulinum toxin in the major salivary glands allows a temporary reduction of salivation that begins 8 days afterwards and returns to normal within 2 months. The inhibition of salivary secretion, carried out before the oral cavity reconstructive surgery, could allow a reduction of the incidence of oro-cutaneous fistulas and local complications. Saliva stagnation is a risk factor for patients who have to undergo reconstructive microsurgery of the oral cavity, because of fistula formation and local complications in the oral cavity. The authors suggest infiltration of botulinum toxin in the major salivary glands to reduce salivation temporarily during the healing stage. During the preoperative stage, 20 patients with oral cavity carcinoma who were candidates for microsurgical reconstruction underwent sialoscintigraphy and a quantitative measurement of the salivary secretion. Injection of botulinum toxin was carried out in the salivary glands 4 days before surgery. The saliva quantitative measurement was repeated 3 and 8 days after infiltration, sialoscintigraphy after 15 days. In all cases, the saliva quantitative measurement revealed a reduction of 50% and 70% of the salivary secretion after 72 h and 8 days, respectively. A lower rate of local complications was observed.

The Acceptability and Potential Utility of Cognitive Training to Improve Working Memory in Persons Living With HIV: A Preliminary Randomized Trial.

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Towe, Sheri L; Patel, Puja; Meade, Christina S

HIV-associated neurocognitive impairments that impact daily function persist in the era of effective antiretroviral therapy. Cognitive training, a promising low-cost intervention, has been shown to improve neurocognitive functioning in some clinical populations. We tested the feasibility, acceptability, and preliminary effects of computerized cognitive training to improve working memory in persons living with HIV infection (PLWH) and working memory impairment. In this randomized clinical trial, we assigned 21 adult PLWH to either an experimental cognitive training intervention or an attention-matched control training intervention. Participants completed 12 training sessions across 10 weeks with assessments at baseline and post-training. Session attendance was excellent and participants rated the program positively. Participants in the experimental arm demonstrated improved working memory function over time; participants in the control arm showed no change. Our results suggest that cognitive training may be a promising intervention for working memory impairment in PLWH and should be evaluated further. Copyright © 2017 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

Microsurgical clipping of ophthalmic artery aneurysms: surgical results and visual outcomes with 208 aneurysms.

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Kamide, Tomoya; Tabani, Halima; Safaee, Michael M; Burkhardt, Jan-Karl; Lawton, Michael T

2018-01-26

OBJECTIVE While most paraclinoid aneurysms can be clipped with excellent results, new postoperative visual deficits are a concern. New technology, including flow diverters, has increased the popularity of endovascular therapy. However, endovascular treatment of paraclinoid aneurysms is not without procedural risks, is associated with higher rates of incomplete aneurysm occlusion and recurrence, and may not address optic nerve compression symptoms that surgical debulking can. The increasing endovascular management of paraclinoid aneurysms should be justified by comparisons to surgical benchmarks. The authors, therefore, undertook this study to define patient, visual, and aneurysm outcomes in the most common type of paraclinoid aneurysm: ophthalmic artery (OphA) aneurysms. METHODS Results from microsurgical clipping of 208 OphA aneurysms in 198 patients were retrospectively reviewed. Patient demographics, aneurysm morphology (size, calcification, etc.), clinical characteristics, and patient outcomes were recorded and analyzed. RESULTS Despite 20% of these aneurysms being large or giant in size, complete aneurysm occlusion was accomplished in 91% of 208 cases, with OphA patency preserved in 99.5%. The aneurysm recurrence rate was 3.1% and the retreatment rate was 0%. Good outcomes (modified Rankin Scale score 0-2) were observed in 96.2% of patients overall and in all 156 patients with unruptured aneurysms. New visual field defects (hemianopsia or quadrantanopsia) were observed in 8 patients (3.8%), decreased visual acuity in 5 (2.4%), and monocular blindness in 9 (4.3%). Vision improved in 9 (52.9%) of the 17 patients with preoperative visual deficits. CONCLUSIONS The most important risk associated with clipping OphA aneurysms is a new visual deficit. Meticulous microsurgical technique is necessary during anterior clinoidectomy, aneurysm dissection, and clip application to optimize visual outcomes, and aggressive medical management postoperatively might potentially

Microsurgical tunica albuginea transplantation in an animal model

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Salvatore Sansalone

2017-01-01

Full Text Available Several andrological diseases require surgical repair or reconstruction of tunica albuginea, which envelops the corpora cavernosa penis. Despite intense research efforts involving a variety of biological materials, such as skin, muscle aponeurosis, human dura mater, tunica vaginalis, and pericardium, engineered tunica albuginea suitable for graft use is yet to be obtained. The study investigates microsurgical tunica albuginea allotransplantation in an animal model with the purpose of creation of an organ-specific tissue bank to store penile tissue, from cadaveric donors and male-to-female trans-sexual surgery, for allogeneic transplantation. Materials were tunica albuginea tissue explanted from 15 donor rats, cryopreserved at −80°C, gamma-irradiated, and implanted in 15 recipient rats, of which three rats were used as controls. Penile grafts were explanted at different time intervals; after macroscopic evaluation of the organ, the grafts were processed to morphological, histochemical, and immunohistochemical examinations by light microscopy. Detection of pro-inflammatory cytokines was also performed. Examination of the tunica albuginea allografts collected 1, 3, or 6 months after surgery and of control tunica albuginea fragments showed that tunica albuginea implants achieved biointegration with adjacent tissue at all-time points. The integration of cryopreserved rat tunica albuginea allografts, documented by our study, encourages the exploration of tunica albuginea allotransplantation in humans. In conclusion, the effectiveness and reliability of the tunica albuginea conditioning protocol described here suggest the feasibility of setting up a tunica albuginea bank as a further tissue bank.

Microsurgical Resection of Suprasellar Craniopharyngioma-Technical Purview.

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Nanda, Anil; Narayan, Vinayak; Mohammed, Nasser; Savardekar, Amey R; Patra, Devi Prasad

2018-04-01

Objectives  Complete surgical resection is an important prognostic factor for recurrence and is the best management for craniopharyngioma. This operative video demonstrates the technical nuances in achieving complete resection of a suprasellar craniopharyngioma. Design and Setting  The surgery was performed in a middle-aged lady who presented with the history of progressive bitemporal hemianopia and excessive sleepiness over 8 months. On imaging, suprasellar craniopharyngioma was identified. The tumor was approached through opticocarotid cistern and lamina terminalis. Exposure of bilateral optic nerves, right internal carotid artery, anterior cerebral artery, and its perforator branches was then afforded and the tumor was gross totally resected. Results  The author demonstrates step-by-step technique of microsurgical resection of suprasellar craniopharyngioma. The narrow corridor to deeper structures, intricacies of multiple perforator vessels, and the technique of arachnoid and capsule dissection are the main challenging factors for the gross total resection of craniopharyngioma. The tumor portion which lies under the ipsilateral optic nerve is a blind spot region with a high chance of leaving residual tumor. Mobilization of optic nerve may endanger visual function too. The use of handheld mirror ['mirror-technique'] helps in better visualization of this blind spot and achieve complete excision. Conclusions  The technical pearls of craniopharyngioma surgery include the optimum utilization of translamina terminalis route, wide opening of the cisterns, meticulous separation of deep perforator vessels, capsular mobilization/traction avoidance, and the use of "mirror-technique" for blind-spot visualization. These surgical strategies help to achieve complete resection without causing neurological deficit. The link to the video can be found at: https://youtu.be/9wHJ4AUpG50 .

Computer-based attention training in the schools for children with attention deficit/hyperactivity disorder: a preliminary trial.

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Steiner, Naomi J; Sheldrick, Radley Christopher; Gotthelf, David; Perrin, Ellen C

2011-07-01

Objective. This study examined the efficacy of 2 computer-based training systems to teach children with attention deficit/hyperactivity disorder (ADHD) to attend more effectively. Design/methods. A total of 41 children with ADHD from 2 middle schools were randomly assigned to receive 2 sessions a week at school of either neurofeedback (NF) or attention training through a standard computer format (SCF), either immediately or after a 6-month wait (waitlist control group). Parents, children, and teachers completed questionnaires pre- and postintervention. Results. Primary parents in the NF condition reported significant (P ADHD index, the BASC Attention Problems Scale, and on the Behavioral Rating Inventory of Executive Functioning (BRIEF). Conclusion. This randomized control trial provides preliminary evidence of the effectiveness of computer-based interventions for ADHD and supports the feasibility of offering them in a school setting.

Step training in a rat model for complex aneurysmal vascular microsurgery

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Martin Dan

2015-12-01

Full Text Available Introduction: Microsurgery training is a key step for the young neurosurgeons. Both in vascular and peripheral nerve pathology, microsurgical techniques are useful tools for the proper treatment. Many training models have been described, including ex vivo (chicken wings and in vivo (rat, rabbit ones. Complex microsurgery training include termino-terminal vessel anastomosis and nerve repair. The aim of this study was to describe a reproducible complex microsurgery training model in rats. Materials and methods: The experimental animals were Brown Norway male rats between 10-16 weeks (average 13 and weighing between 250-400g (average 320g. We performed n=10 rat hind limb replantations. The surgical steps and preoperative management are carefully described. We evaluated the vascular patency by clinical assessment-color, temperature, capillary refill. The rats were daily inspected for any signs of infections. The nerve regeneration was assessed by foot print method. Results: There were no case of vascular compromise or autophagia. All rats had long term survival (>90 days. The nerve regeneration was clinically completed at 6 months postoperative. The mean operative time was 183 minutes, and ischemia time was 25 minutes.

A pilot training program for people in recovery of mental illness as vocational peer support workers in Hong Kong - Job Buddies Training Program (JBTP): A preliminary finding.

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Yam, Kevin Kei Nang; Lo, William Tak Lam; Chiu, Rose Lai Ping; Lau, Bien Shuk Yin; Lau, Charles Ka Shing; Wu, Jen Kei Yu; Wan, Siu Man

2016-10-24

The present study reviews the delivery of a pilot curriculum-mentorship-based peer vocational support workers training in a Hong Kong public psychiatric hospital. The present paper reports (1) on the development of a peer vocational support workers training - Job Buddies Training Program (JBTP) in Hong Kong; and (2) preliminary findings from both quantitative and qualitative perspectives. The curriculum consists of 15-session coursework, 8-session storytelling workshop and 50-hour practicum to provide Supported Employment Peer Service (SEPS) under the mentorship of occupational therapists. Six trainees were assessed using three psychosocial assessments and qualitative methods. Compared to the baseline, the Job Buddies (JB) trainees showed an increase in awareness of their own recovery progress, occupational competence and problem-solving skills at the end of the training. Their perceived level of self-stigma was also lessened. In post-training evaluation, all Job Buddies trainees said they perceived positive personal growth and discovered their own strengths. They also appreciated the help from their mentors and gained mutual support from other trainees and from exposure with various mini-projects in the training. This pilot study provides an example of incorporating peer support and manualized training into existing work rehabilitation service for our JB trainees. Further studies on the effectiveness of service provided by peer support workers and for development on the potential use of peer support workers in other clinical and rehabilitation settings with larger subjects will be fruitful. Copyright © 2016. Published by Elsevier B.V.

Effects of Palliative Care Training Program on Knowledge, Attitudes, Beliefs and Experiences Among Student Physiotherapists: A Preliminary Quasi-experimental Study

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Kumar, Senthil P; Jim, Anand; Sisodia, Vaishali

2011-01-01

Background: Physiotherapists play an inherent role in the multidisciplinary palliative care team. Existing knowledge, attitudes, beliefs and experiences influence their team participation in palliative care. Aims: The objective of this study was to assess the changes in knowledge, attitudes, beliefs and experiences among student physiotherapists who attended a palliative care training program. Settings and Design: Preliminary quasi-experimental study design, conducted at an academic...

Preliminary assessment report for Grubbs/Kyle Training Center, Smyrna/Rutherford County Regional Airport, Installation 47340, Smyrna, Tennessee. Installation Restoration Program

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Dennis, C.; Stefano, J.

1993-07-01

This report presents the results of the preliminary assessment (PA) conducted by Argonne National Laboratory at the Tennessee Army National Guard (TNARNG) property near Smyrna, Tennessee. Preliminary assessments of federal facilities are being conducted to compile the information necessary for completing preremedial activities and to provide a basis for establishing corrective actions in response to releases of hazardous substances. The principal objective of the PA is to characterize the site accurately and determine the need for further action by examining site activities, quantities of hazardous substances present, and potential pathways by which contamination could affect public health and the environment. This PA satisfies, for the Grubbs/Kyle Training Center property, the requirement of the Department of Defense Installation Restoration Program.

[Microsurgical removal of olfactory groove meningiomas].

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Liang, Ri-Sheng; Zhou, Liang-Fu; Mao, Ying; Zhang, Rong; Yang, Wei-Zhong

2011-01-01

To explore an effective method for further improving the surgical results of treatment of olfactory groove meningiomas. Sixty seven cases of olfactory groove meningiomas were treated by microneurosurgery, among which fifty seven were de novo cases, eight were recurrent tumors and the other two re-recurrent cases. Modified Derome approach was used in 12 cases, bilateral subfrontal approach in 28 cases, modified pterional approach in 21 cases and unilateral subfrontal approach in six cases. Tumors were resected microsurgically with radical removal of invaded dura, bone, and paranasal sinus mucosa. Reconstruction was performed in patients with skull base defect. Simpson grade I removal was accomplished in 59 cases, grade II in seven cases and grade IV in one case. Among 57 patients with de novo tumor, Simpson I resection was accomplished in 54 cases. Postoperative rhinorrhea and intracranial infection occurred in one case and was cured after temporal lumbar CSF drainage and antibiotic therapy. Two patients (2.9%) died within one month after operation, i.e.one aged patient of heart failure and the other of severe hypothalamus complication. Forty seven patients (72.3%) were followed up from one to ten years with an average of five years and four months. With the exception of two cases died, among the alive 45 patients, there were only three patients with tumor recurrence, which had undergone Simpson II or IV tumor resection. No recurrence was found in cases with Simpson I tumor removal. Previous blurred vision was not improved in three patients, hemiparalysis in two patients, and the other patients recovered well, resuming previous jobs or being able to take care themselves. Total tumor removal (Simpson I) should be the surgical goal for treatment of olfactory groove meningiomas, especially for de novo cases. An appropriate approach is fundamental in the effort to remove an OGM totally. Appropriate anterior skull base reconstruction with vascularized material is

[The speed of nerve-conduction after micro-surgical suture of the tibial nerve of the rabbit (author's transl)].

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Weigert, M; Mellerowicz, H; Werhahn, C

1975-10-01

Isolated division of the tibial nerve in the thigh preserving the peroneal and sural nerves does not cause loss of normal position of the animal, in particular of sitting. Nor does it lead to pressure sores. The animals are fitter then after division of the sciatic nerve. Microsurgical suture of the isolated tibial nerve in the thigh of the rabbit with 1 or 2 simple sutures with 10 x 0 thread show that an average recovery can be achieved in over 80 per cent. As few sutures as possible should be used. Otherwise there with be scarring and no return of function.

Visual-spatial ability is more important than motivation for novices in surgical simulator training: a preliminary study.

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Schlickum, Marcus; Hedman, Leif; Felländer-Tsai, Li

2016-02-21

To investigate whether surgical simulation performance and previous video gaming experience would correlate with higher motivation to further train a specific simulator task and whether visual-spatial ability would rank higher in importance to surgical performance than the above. It was also examined whether or not motivation would correlate with a preference to choose a surgical specialty in the future and if simulator training would increase the interest in choosing that same work field. Motivation and general interest in surgery was measured pre- and post-training in 30 medical students at Karolinska Institutet who were tested in a laparoscopic surgical simulator in parallel with measurement of visual-spatial ability and self-estimated video gaming experience. Correlations between simulator performance metrics, visual-spatial ability and motivation were statistically analyzed using regression analysis. A good result in the first simulator trial correlated with higher self-determination index (r =-0.46, p=0.05) in male students. Visual-spatial ability was the most important underlying factor followed by intrinsic motivation score and finally video gaming experience (p=0.02, p=0.05, p=0.11) regarding simulator performance in male students. Simulator training increased interest in surgery when studying all subjects (p=0.01), male subjects (p=0.02) as well as subjects with low video gaming experience (p=0.02). This preliminary study highlights individual differences regarding the effect of simulator training on motivation that can be taken into account when designing simulator training curricula, although the sample size is quite small and findings should be interpreted carefully.

Effects of an Off-Axis Pivoting Elliptical Training Program on Gait Function in Persons With Spastic Cerebral Palsy: A Preliminary Study.

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Tsai, Liang-Ching; Ren, Yupeng; Gaebler-Spira, Deborah J; Revivo, Gadi A; Zhang, Li-Qun

2017-07-01

This preliminary study examined the effects of off-axis elliptical training on reducing transverse-plane gait deviations and improving gait function in 8 individuals with cerebral palsy (CP) (15.5 ± 4.1 years) who completed an training program using a custom-made elliptical trainer that allows transverse-plane pivoting of the footplates during exercise. Lower-extremity off-axis control during elliptical exercise was evaluated by quantifying the root-mean-square and maximal angular displacement of the footplate pivoting angle. Lower-extremity pivoting strength was assessed. Gait function and balance were evaluated using 10-m walk test, 6-minute-walk test, and Pediatric Balance Scale. Toe-in angles during gait were quantified. Participants with CP demonstrated a significant decrease in the pivoting angle (root mean square and maximal angular displacement; effect size, 1.00-2.00) and increase in the lower-extremity pivoting strength (effect size = 0.91-1.09) after training. Reduced 10-m walk test time (11.9 ± 3.7 seconds vs. 10.8 ± 3.0 seconds; P = 0.004; effect size = 1.46), increased Pediatric Balance Scale score (43.6 ± 12.9 vs. 45.6 ± 10.8; P = 0.042; effect size = 0.79), and decreased toe-in angle (3.7 ± 10.5 degrees vs. 0.7 ± 11.7 degrees; P = 0.011; effect size = 1.22) were observed after training. We present an intervention to challenge lower-extremity off-axis control during a weight-bearing and functional activity for individuals with CP. Our preliminary findings suggest that this intervention was effective in enhancing off-axis control, gait function, and balance and reducing in-toeing gait in persons with CP.

Guiding role of typical cases in clinical training for ophthalmology professional degree graduate students

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Zhe Wang

2014-05-01

Full Text Available With the change of the concept of graduate enrollment, the recruiting proportion of clinical medicine professional degree graduate students is more and more, and the training of professional degree graduate students is increasingly focusing on practical. In our experience in clinical training for ophthalmology professional degree graduate students, increasing the ward clinical practice time is important. For particular emphasis on the guiding role of the typical cases, each professional group combined their professional characteristics of the typical cases to instruct the graduate students, training their clinical diagnosis and treatment ability, training their microsurgical techniques. From clinical medical writing, record summary, literature review, professional degree graduate students could expand their knowledge structure, practice their thesis writing ability. Based on the typical cases, expansion of knowledge coverage, they could improve the ability of diagnosis and treatment for special disease cases. In this rigorous training system, professional degree graduate students can learn by analogy, and focus on typical cases to get the most intuitive panoramic understanding of the diseases, with a minimum of time to master the most clinical knowledge, to enrich clinical experience, and to lay the foundation for future work in the assessment.

Robot-assisted microsurgical forceps with haptic feedback for transoral laser microsurgery.

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Deshpande, Nikhil; Chauhan, Manish; Pacchierotti, Claudio; Prattichizzo, Domenico; Caldwell, Darwin G; Mattos, Leonardo S

2016-08-01

In this paper, a novel, motorized, multi-degrees-of-freedom (DoF), microsurgical forceps tool is presented, which is based on a master-slave teleoperation architecture. The slave device is a 7-DoF manipulator with: (i) 6-DoF positioning and orientation, (ii) 1 open/close gripper DoF; and (iii) an integrated force/torque sensor for tissue grip-force measurement. The master device is a 7-DoF haptic interface which teleoperates the slave device, and provides haptic feedback in its gripper interface. The combination of the device and the surgeon interface replaces the manual, hand-held device providing easy-to-use and ergonomic tissue control, simplifying the surgical tasks. This makes the system suitable to real surgical scenarios in the operating room (OR). The performance of the system was analysed through the evaluation of teleoperation control and characterization of gripping force. The new system offers an overall positioning error of less than 400 μm demonstrating its safety and accuracy. Improved system precision, usability, and ergonomics point to the potential suitability of the device for the OR and its ability to advance haptic-feedback-enhanced transoral laser microsurgeries.

Improvement of technical training of sportswomen in rhythmic gymnastics by means of acrobatics at the stage of preliminary basic preparation

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Petro Kyzim

2016-10-01

Full Text Available Purpose: to prove experimentally the technique of improvement of technical training of sportswomen in rhythmic gymnastics by means of acrobatics at the stage of preliminary basic preparation. Material & Methods: the following methods of the research were used: analysis and synthesis of references, pedagogical observations, pedagogical testing, pedagogical experiment, method of expert assessment (qualimetry, methods of mathematical statistics. Results: the level of technical skill of performance of pre-acrobatic elements by sportswomen of rhythmic gymnastics before carrying out the pedagogical experiment is determined. The dynamics of indicators of the level of technical preparedness of sportswomen of rhythmic gymnastics is defined. Conclusions: it is established that additional resources of acrobatics influence significantly the level of technical preparedness of sportswomen of rhythmic gymnastics at the stage of preliminary basic preparation.

Continuous Curvilinear Capsulorhexis Training and Non-Rhexis Related Vitreous Loss: The Specificity of Virtual Reality Simulator Surgical Training (An American Ophthalmological Society Thesis).

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McCannel, Colin A

2017-08-01

To assess the specificity of simulation-based virtual reality ophthalmic cataract surgery training on the Eyesi ophthalmic virtual reality surgical simulator, and test the hypothesis that microsurgical motor learning is highly specific. Retrospective educational interventional case series. The rates of vitreous loss and retained lens material, and vitreous loss and retained lens material associated with an errant continuous curvilinear capsulorhexis (CCC) were assessed among 1037 consecutive cataract surgeries performed during four consecutive academic years at a teaching hospital. The data were grouped by Eyesi use and capsulorhexis intensive training curriculum (CITC) completion. The main intervention was the completion of the CITC on the Eyesi. In the Eyesi simulator experience-based stratification, the vitreous loss rate was similar in each group (chi square p=0.95) and was not preceded by an errant CCC in 86.2% for "CITC done at least once", 57.1% for "CITC not done, but some Eyesi use", and 48.9% for "none" training groups (p=4×10-5). Retained lens material overall and occurring among the errant CCC cases was similar among training groups (p=0.82 and p=0.71, respectively). Eyesi capsulorhexis training was not associated with lower vitreous loss rates overall. However, non-errant CCC associated vitreous loss was higher among those who underwent Eyesi capsulorhexis training. Training focused on the CCC portion of cataract surgery may not reduce vitreous loss unassociated with an errant CCC. It is likely that surgical training is highly specific to the task being trained. Residents may need to be trained for all surgical steps with adequate intensity to minimize overall complication rates.

Using a situational judgement test for selection into dental core training: a preliminary analysis.

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Rowett, E; Patterson, F; Cousans, F; Elley, K

2017-05-12

Objective and setting This paper describes the evaluation of a pilot situational judgement test (SJT) for selection into UK Dental Core Training (DCT). The SJT's psychometric properties, group differences based on gender and ethnicity, and candidate reactions were assessed.Methods The SJT targets four non-academic attributes important for success in DCT. Data were collected alongside live selection processes from five Health Education England local teams in the UK (N = 386). Candidates completed the pilot SJT and an evaluation questionnaire to examine their reactions to the test.Results SJT scores were relatively normally distributed and showed acceptable levels of internal reliability (α = 0.68). Difficulty level and partial correlations between scenarios and SJT total score were in the expected ranges (64.61% to 90.03% and r = 0.06 to 0.41, respectively). No group differences were found for gender, and group differences between White and BME candidates were minimal. Most candidates perceived the SJT as relevant to the target role, appropriate and fair.Conclusions This study demonstrated the potential suitability of an SJT for use in DCT selection. Future research should replicate these preliminary findings in other cohorts, and assess the predictive validity of the SJT for predicting key training and practice-based outcomes.

Preliminary development of the Active Colonoscopy Training Model

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Choi J

2011-06-01

Full Text Available JungHun Choi1, Kale Ravindra1, Randolph Robert1, David Drozek21Mechanical Engineering, Ohio University, Athens, OH, USA; 2College of Osteopathic Medicine, Ohio University, Athens, OH, USAAbstract: Formal colonoscopy training requires a significant amount of time and effort. In particular, it requires actual patients for a realistic learning experience. The quality of colonoscopy training varies, and includes didactic courses and procedures proctored by skilled surgeons. A colonoscopy training model is occasionally used as part of the training method, but the effects are minute due to both the simple and tedious training procedures. To enhance the educational effect of the colonoscopy training model, the Active Colonoscopy Training Model (ACTM has been developed. ACTM is an interactive colonoscopy training device which can create the environment of a real colonoscopy procedure as closely as possible. It comprises a configurable rubber colon, a human torso, sensors, a display, and the control part. The ACTM provides audio and visual interaction to the trainee by monitoring important factors, such as forces caused by the distal tip and the shaft of the colonoscope and the pressure to open up the lumen and the localization of the distal tip. On the computer screen, the trainee can easily monitor the status of the colonoscopy, which includes the localization of the distal tip, maximum forces, pressure inside the colon, and surgery time. The forces between the rubber colon and the constraints inside the ACTM are measured and the real time display shows the results to the trainee. The pressure sensors will check the pressure at different parts of the colon. The real-time localized distal tip gives the colonoscopy trainee easier and more confident operation without introducing an additional device in the colonoscope. With the current need for colonoscopists and physicians, the ACTM can play an essential role resolving the problems of the current

Performance adaptive training control strategy for recovering wrist movements in stroke patients: a preliminary, feasibility study

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Sandini Giulio

2009-12-01

Full Text Available Abstract Background In the last two decades robot training in neuromotor rehabilitation was mainly focused on shoulder-elbow movements. Few devices were designed and clinically tested for training coordinated movements of the wrist, which are crucial for achieving even the basic level of motor competence that is necessary for carrying out ADLs (activities of daily life. Moreover, most systems of robot therapy use point-to-point reaching movements which tend to emphasize the pathological tendency of stroke patients to break down goal-directed movements into a number of jerky sub-movements. For this reason we designed a wrist robot with a range of motion comparable to that of normal subjects and implemented a self-adapting training protocol for tracking smoothly moving targets in order to facilitate the emergence of smoothness in the motor control patterns and maximize the recovery of the normal RoM (range of motion of the different DoFs (degrees of Freedom. Methods The IIT-wrist robot is a 3 DoFs light exoskeleton device, with direct-drive of each DoF and a human-like range of motion for Flexion/Extension (FE, Abduction/Adduction (AA and Pronation/Supination (PS. Subjects were asked to track a variable-frequency oscillating target using only one wrist DoF at time, in such a way to carry out a progressive splinting therapy. The RoM of each DoF was angularly scanned in a staircase-like fashion, from the "easier" to the "more difficult" angular position. An Adaptive Controller evaluated online performance parameters and modulated both the assistance and the difficulty of the task in order to facilitate smoother and more precise motor command patterns. Results Three stroke subjects volunteered to participate in a preliminary test session aimed at verify the acceptability of the device and the feasibility of the designed protocol. All of them were able to perform the required task. The wrist active RoM of motion was evaluated for each patient at the

Optimizing microsurgical skills with EEG neurofeedback

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Benjamin Larry

2009-07-01

Full Text Available Abstract Background By enabling individuals to self-regulate their brainwave activity in the field of optimal performance in healthy individuals, neurofeedback has been found to improve cognitive and artistic performance. Here we assessed whether two distinct EEG neurofeedback protocols could develop surgical skill, given the important role this skill plays in medicine. Results National Health Service trainee ophthalmic microsurgeons (N = 20 were randomly assigned to either Sensory Motor Rhythm-Theta (SMR or Alpha-Theta (AT groups, a randomized subset of which were also part of a wait-list 'no-treatment' control group (N = 8. Neurofeedback groups received eight 30-minute sessions of EEG training. Pre-post assessment included a skills lab surgical procedure with timed measures and expert ratings from video-recordings by consultant surgeons, together with state/trait anxiety self-reports. SMR training demonstrated advantages absent in the control group, with improvements in surgical skill according to 1 the expert ratings: overall technique (d = 0.6, p Conclusion SMR-Theta neurofeedback training provided significant improvement in surgical technique whilst considerably reducing time on task by 26%. There was also evidence that AT training marginally reduced total surgery time, despite suboptimal training efficacies. Overall, the data set provides encouraging evidence of optimised learning of a complex medical specialty via neurofeedback training.

Amblyopia treatment of adults with dichoptic training using the virtual reality oculus rift head mounted display: preliminary results.

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Žiak, Peter; Holm, Anders; Halička, Juraj; Mojžiš, Peter; Piñero, David P

2017-06-28

The gold standard treatments in amblyopia are penalizing therapies, such as patching or blurring vision with atropine that are aimed at forcing the use of the amblyopic eye. However, in the last years, new therapies are being developed and validated, such as dichoptic visual training, aimed at stimulating the amblyopic eye and eliminating the interocular supression. To evaluate the effect of dichoptic visual training using a virtual reality head mounted display in a sample of anisometropic amblyopic adults and to evaluate the potential usefulness of this option of treatment. A total of 17 subjects (10 men, 7 women) with a mean age of 31.2 years (range, 17-69 year) and anisometropic amblyopia were enrolled. Best corrected visual acuity (BCVA) and stereoacuity (Stereo Randot graded circle test) changes were evaluated after 8 sessions (40 min per session) of dichoptic training with the computer game Diplopia Game (Vivid Vision) run in the Oculus Rift OC DK2 virtual reality head mounted display (Oculus VR). Mean BCVA in amblyopic eye improved significantly from a logMAR value of 0.58 ± 0.35 before training to a post-training value of 0.43 ± 0.38 (p virtual reality head mounted display seems to be an effective option of treatment in adults with anisometropic amblyopia. Future clinical trials are needed to confirm this preliminary evidence. Trial ID: ISRCTN62086471 . Date registered: 13/06/2017. Retrospectively registered.

Modified classification and single-stage microsurgical repair of posttraumatic infected massive bone defects in lower extremities.

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Yang, Yun-fa; Xu, Zhong-he; Zhang, Guang-ming; Wang, Jian-wei; Hu, Si-wang; Hou, Zhi-qi; Xu, Da-chuan

2013-11-01

Posttraumatic infected massive bone defects in lower extremities are difficult to repair because they frequently exhibit massive bone and/or soft tissue defects, serious bone infection, and excessive scar proliferation. This study aimed to determine whether these defects could be classified and repaired at a single stage. A total of 51 cases of posttraumatic infected massive bone defect in lower extremity were included in this study. They were classified into four types on the basis of the conditions of the bone defects, soft tissue defects, and injured limb length, including Type A (without soft tissue defects), Type B (with soft tissue defects of 10 × 20 cm or less), Type C (with soft tissue defects of 10 × 20 cm or more), and Type D (with the limb shortening of 3 cm or more). Four types of single-stage microsurgical repair protocols were planned accordingly and implemented respectively. These protocols included the following: Protocol A, where vascularized fibular graft was implemented for Type A; Protocol B, where vascularized fibular osteoseptocutaneous graft was implemented for Type B; Protocol C, where vascularized fibular graft and anterior lateral thigh flap were used for Type C; and Protocol D, where limb lengthening and Protocols A, B, or C were used for Type D. There were 12, 33, 4, and 2 cases of Types A, B, C, and D, respectively, according to this classification. During the surgery, three cases of planned Protocol B had to be shifted into Protocol C; however, all microsurgical repairs were completed. With reference to Johner-Wruhs evaluation method, the total percentage of excellent and good results was 82.35% after 6 to 41 months of follow-up. It was concluded that posttraumatic massive bone defects could be accurately classified into four types on the basis of the conditions of bone defects, soft tissue coverage, and injured limb length, and successfully repaired with the single-stage repair protocols after thorough debridement. Thieme Medical

A new strategy of fingertip reattachment: sequential use of microsurgical technique and pocketing of composite graft.

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Kim, K S; Eo, S R; Kim, D Y; Lee, S Y; Cho, B H

2001-01-01

Many methods have been used to reattach amputated fingertips. Of these methods, microsurgery has been accepted as the procedure of choice because the defining characteristic of a microsurgically replanted finger is that its surival in the recipient bed is predicated on functioning intravascular circulation. Although considerable progress has been made in the techniques for microvascular replantation of amputated fingers, the replantation of an amputated fingertip is difficult because digital arteries branch into small arteries. This is in addition to digital veins that run from both sides of the nail bed to the median dorsal sides, which are difficult to separate from the immobile soft tissue. Furthermore, even with the most technically skilled microsurgeon, replantation failure often occurs, especially in severe injury cases. Therefore, the technique is not the only protection against failure, and a new strategy of fingertip reattachment is needed. From March of 1997 to December of 1999, 12 fingers of 11 patients with zone 1 or zone 2 fingertip amputations that were reattached microsurgically but were compromised were deepithelialized, reattached, and then inserted into the abdominal pocket. All had been complete amputations with crushing injuries. Approximately 3 weeks later, the fingers were depocketed and covered with a skin graft. Of the 12 fingers, 7 survived completely and 3 had partial necrosis on less than one-third the volume of the amputated part. The complete survival rate was approximately 58 percent. The results of the above 10 fingers were satisfactory from both functional and cosmetic aspects. The authors believe that this high success rate was achieved because the deepithelialized finger pulp was placed in direct contact with the deep abdominal fascia, which was equipped with plentiful vascularity, not subcutaneous fat. In addition, the pocketing was performed promptly before necrosis of the compromised fingertip occurred. From the results of this

The Stanford Microsurgery and Resident Training (SMaRT) Scale: validation of an on-line global rating scale for technical assessment.

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Satterwhite, Thomas; Son, Ji; Carey, Joseph; Echo, Anthony; Spurling, Terry; Paro, John; Gurtner, Geoffrey; Chang, James; Lee, Gordon K

2014-05-01

We previously reported results of our on-line microsurgery training program, showing that residents who had access to our website significantly improved their cognitive and technical skills. In this study, we report an objective means for expert evaluators to reliably rate trainees' technical skills under the microscope, with the use of our novel global rating scale. "Microsurgery Essentials" (http://smartmicrosurgery.com) is our on-line training curriculum. Residents were randomly divided into 2 groups: 1 group reviewed this online resource and the other did not. Pre- and post-tests consisted of videotaped microsurgical sessions in which the trainee performed "microsurgery" on 3 different models: latex glove, penrose drain, and the dorsal vessel of a chicken foot. The SMaRT (Stanford Microsurgery and Resident Training) scale, consisting of 9 categories graded on a 5-point Likert scale, was used to assess the trainees. Results were analyzed with ANOVA and Student t test, with P less than 0.05 indicating statistical significance. Seventeen residents participated in the study. The SMaRT scale adequately differentiated the performance of more experienced senior residents (PGY-4 to PGY-6, total average score=3.43) from less experienced junior residents (PGY-1 to PGY-3, total average score=2.10, P0.05). Additionally, junior residents who had access to our website showed a significant increase in their graded technical performance by 0.7 points when compared to residents who did not have access to the website who showed an improvement of only 0.2 points (P=0.01). Our SMaRT scale is valid and reliable in assessing the microsurgical skills of residents and other trainees. Current trainees are more likely to use self-directed on-line education because of its easy accessibility and interactive format. Our global rating scale can help ensure residents are achieving appropriate technical milestones.

The Effect of Low Volume Interval Training on Resting Blood Pressure in Pre-hypertensive Subjects: A Preliminary Study.

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Skutnik, Benjamin C; Smith, Joshua R; Johnson, Ariel M; Kurti, Stephanie P; Harms, Craig A

2016-01-01

Clinically pre-hypertensive adults are at a greater risk of developing hypertension, stiffened arteries, and other cardiovascular risks. Endurance exercise training has been shown to improve elevated resting blood pressure and C-reactive protein (CRP) levels. However, a primary barrier preventing individuals from engaging in regular physical activity is a lack of time. The purpose of our study was to determine if a high-intensity interval training (HIIT) protocol would be as effective as continuous aerobic endurance training (ET) on resting blood pressure in pre-hypertensive participants. Additionally, this study investigated the effects of HIIT vs. ET on CRP. Twelve pre-hypertensive participants (33.3±6.1 yrs; 3M/9W) participated in 8 weeks of cycle ergometer exercise training. The ET exercised for 30 continuous min/day, 4 days/week at 40% VO2max reserve. The HIIT exercised at a 1:1 work-to-rest for 20 min/day, 3 days/week at 60% peak power. Resting mean arterial pressure and CRP were compared throughout the study. Both groups showed decreases (pHIIT: -8.6 ± 4.8 mmHg) following the 8 weeks. For CRP, there was a significant decrease (p=0.014) as a main effect of time. VO2max increased (pHIIT and ET. These preliminary data suggest HIIT and ET similarly decreased resting blood pressure and increased VO2max.

Microsurgical principles and postoperative adhesions: lessons from the past.

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Gomel, Victor; Koninckx, Philippe R

2016-10-01

"Microsurgery" is a set of principles developed to improve fertility surgery outcomes. These principles were developed progressively based on common sense and available evidence, under control of clinical feedback obtained with the use of second-look laparoscopy. Fertility outcome was the end point; significant improvement in fertility rates validated the concept clinically. Postoperative adhesion formation being a major cause of failure in fertility surgery, the concept of microsurgery predominantly addresses prevention of postoperative adhesions. In this concept, magnification with a microscope or laparoscope plays a minor role as technical facilitator. Not surprisingly, the principles to prevent adhesion formation are strikingly similar to our actual understanding: gentle tissue handling, avoiding desiccation, irrigation at room temperature, shielding abdominal contents from ambient air, meticulous hemostasis and lavage, avoiding foreign body contamination and infection, administration of dexamethasone postoperatively, and even the concept of keeping denuded areas separated by temporary adnexal or ovarian suspension. The actual concepts of peritoneal conditioning during surgery and use of dexamethasone and a barrier at the end of surgery thus confirm without exception the tenets of microsurgery. Although recent research helped to clarify the pathophysiology of adhesion formation, refined its prevention and the relative importance of each factor, the clinical end point of improvement of fertility rates remains demonstrated for only the microsurgical tenets as a whole. In conclusion, the principles of microsurgery remain fully valid as the cornerstones of reproductive microsurgery, whether performed by means of open access or laparoscopy. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Semantic Feature Training for the Treatment of Anomia in Alzheimer Disease: A Preliminary Investigation.

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Flanagan, Kieran J; Copland, David A; van Hees, Sophia; Byrne, Gerard J; Angwin, Anthony J

2016-03-01

This is a preliminary investigation into the effectiveness of semantic feature training for the treatment of anomia in Alzheimer disease (AD). Anomia is a common clinical characteristic of AD. It is widely held that anomia in AD is caused by the combination of cognitive deficits and progressive loss of semantic feature information. Therapy that aims to help participants relearn or retain semantic features should, therefore, help treat anomia in AD. Two men with AD and one man with progressive nonfluent aphasia received 10 treatment sessions focused on relearning the names of 20 animals and 20 fruits. Within each category, half of the items were of high and half were of low typicality. We individualized treatment items to each participant, using items that each had not named correctly at baseline. Treatment sessions consisted of naming, category sorting, and semantic feature verification tasks. Both participants with AD showed post-treatment improvements in naming, and one maintained the treatment effects at 6-week follow-up. The semantic category of the treatment items influenced post-treatment outcomes, but typicality did not. In contrast to the participants with AD, the man with progressive nonfluent aphasia had no improvement in naming ability. Our results suggest the potential viability of semantic feature training to treat anomia in AD and, therefore, the need for further research.

Towards a Global Understanding and Standardisation of Education and Training in Microsurgery

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Clement Chi Ming Leung

2013-07-01

Full Text Available With an increasing emphasis on microsurgery skill acquisition through simulated training, the need has been identified for standardised training programmes in microsurgery. We have reviewed microsurgery training courses available across the six continents of the World. Data was collected of relevant published output from PubMed, MEDLINE (Ovid, and EMBASE (Ovid searches, and from information available on the Internet of up to six established microsurgery course from each of the six continents of the World. Fellowships and courses that concentrate on flap harvesting rather than microsurgical techniques were excluded. We identified 27 centres offering 39 courses. Total course length ranged from 20 hours to 1,950 hours. Student-to-teacher ratios ranged from 2:1 to 8:1. Only two-thirds of courses offered in-vivo animal models. Instructions in microvascular end-to-end and end-to-side anastomoses were common, but peripheral nerve repair or free groin flap transfer were not consistently offered. Methods of assessment ranged from no formal assessment, where an instructor monitored and gave instant feedback, through immediate assessment of patency and critique on quality of repair, to delayed re-assessment of patency after a 12 to 24 hours period. Globally, training in microsurgery is heterogeneous, with variations primarily due to resource and regulation of animal experimentation. Despite some merit to diversity in curricula, there should be a global minimum standard for microsurgery training.

Effects of dialectical behaviour therapy-mindfulness training on emotional reactivity in borderline personality disorder: preliminary results.

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Feliu-Soler, Albert; Pascual, Juan C; Borràs, Xavier; Portella, Maria J; Martín-Blanco, Ana; Armario, Antonio; Alvarez, Enric; Pérez, Víctor; Soler, Joaquim

2014-01-01

Emotional dysregulation has been proposed as a hallmark of borderline personality disorder (BPD). Mindfulness techniques taught in dialectical behaviour therapy (DBT) appear to be effective in reducing affective symptoms and may enhance emotion regulation in BPD patients. In the present study, we assessed whether 10 weeks of DBT-mindfulness (DBT-M) training added to general psychiatric management (GPM) could improve emotion regulation in BPD patients. A total of 35 patients with BPD were included and sequentially assigned to GPM (n = 17) or GPM plus DBT-M (n = 18). Participants underwent a negative emotion induction procedure (presentation of standardized unpleasant images) both pre-intervention and post-intervention. Clinical evaluation was also performed before and after treatment. No differences were observed in emotional response at the post-treatment session. However, patients in the DBT-M group showed greater improvement in clinical symptoms. Formal mindfulness practice was positively correlated with clinical improvements and lower self-reported emotional reactivity. Our preliminary results suggest that mindfulness training reduces some psychiatric symptoms but may not have a clear effect on how patients respond to emotional stimuli in an experimental setting. No clear effect of mindfulness training was observed on emotional response to a negative emotion induction procedure. Application of the DBT-M module jointly to GPM induced better clinical outcomes than GPM alone. Formal mindfulness practice showed a positive impact on emotion regulation and clinical improvement. Copyright © 2013 John Wiley & Sons, Ltd.

Microsurgical Repair of Ruptured Aneurysms Associated with Moyamoya-Pattern Collateral Vessels of the Middle Cerebral Artery: A Report of Two Cases.

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Lang, Min; Moore, Nina Z; Witek, Alex M; Kshettry, Varun R; Bain, Mark D

2017-09-01

Patients with Moyamoya or other intracranial steno-occlusive disease are at risk for developing aneurysms associated with flow through collateral vessels. Because these lesions are rare, the optimal management remains unclear. Here, we describe 2 cases of microsurgical repair of ruptured collateral vessel aneurysms associated with middle cerebral artery (MCA) occlusion. The first patient was a 61-year-old man who presented with right frontal and intraventricular hemorrhage. Angiography revealed chronic right M1 occlusion and a 3-mm spherical lenticulostriate aneurysm. The frontal lobe hematoma was evacuated to reveal the aneurysm, which was safely cauterized and resected by coagulating and dividing the lenticulostriate parent vessel. The procedure was carried out with neuronavigation guidance and intraoperative neuromonitoring. The patient was discharged with no neurologic deficits. The second patient was a 53-year-old woman who presented with subarachnoid and intracerebral hemorrhage. Computed tomography angiogram showed a 2-mm saccular MCA aneurysm. Emergency left decompressive hemicraniectomy and hematoma evacuation were performed. The aneurysm, arising from a small collateral type vessel, was safely clipped without complications. Postoperative angiography revealed absence of the superior MCA trunk with a dense network of collateral vessels at the site of the clipped aneurysm. The patient recovered well and was ambulating independently 6 months postoperatively. No rebleeding occurred in the 2 patients. Our experience suggests that patients with MCA occlusion can harbor associated aneurysms related to flow through collateral vessels and can present with hemorrhage. Microsurgical repair of these aneurysms can be performed safely to prevent rebleeding. Copyright © 2017 Elsevier Inc. All rights reserved.

Preliminary framework for Familiar Auditory Sensory Training (FAST) provided during coma recovery.

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Pape, Theresa Louise-Bender; Rosenow, Joshua M; Harton, Brett; Patil, Vijaya; Guernon, Ann; Parrish, Todd; Froehlich, Kathleen; Burress, Catherine; McNamee, Shane; Herrold, Amy A; Weiss, Bessie; Wang, Xue

2012-01-01

Since there remains a need to examine the nature of the neural effect and therapeutic efficacy/effectiveness of sensory stimulation provided to persons in states of seriously impaired consciousness, a passive sensory stimulation intervention, referred to as the Familiar Auditory Sensory Training (FAST) protocol, was developed for examination in an ongoing, double-blind, randomized clinical trial (RCT). The FAST protocol is described in this article according to the preliminary framework, which is a synthesis of knowledge regarding principles of plasticity and capabilities of the human brain to automatically and covertly process sensory input. Feasibility issues considered during the development of the intervention are also described. To enable replication of this intervention, we describe procedures to create the intervention and lessons learned regarding the creation process. The potential effect of the intervention is illustrated using functional brain imaging of nondisabled subjects. This illustration also demonstrates the relevance of the rationale for designing the FAST protocol. To put the intervention within the context of the scientific development process, the article culminates with a description of the study design for the ongoing RCT examining the efficacy of the FAST protocol.

Microsurgical and Endoscopic Anatomy for Intradural Temporal Bone Drilling and Applications of the Electromagnetic Navigation System: Various Extensions of the Retrosigmoid Approach.

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Matsushima, Ken; Komune, Noritaka; Matsuo, Satoshi; Kohno, Michihiro

2017-07-01

The use of the retrosigmoid approach has recently been expanded by several modifications, including the suprameatal, transmeatal, suprajugular, and inframeatal extensions. Intradural temporal bone drilling without damaging vital structures inside or beside the bone, such as the internal carotid artery and jugular bulb, is a key step for these extensions. This study aimed to examine the microsurgical and endoscopic anatomy of the extensions of the retrosigmoid approach and to evaluate the clinical feasibility of an electromagnetic navigation system during intradural temporal bone drilling. Five temporal bones and 8 cadaveric cerebellopontine angles were examined to clarify the anatomy of retrosigmoid intradural temporal bone drilling. Twenty additional cerebellopontine angles were dissected in a clinical setting with an electromagnetic navigation system while measuring the target registration errors at 8 surgical landmarks on and inside the temporal bone. Retrosigmoid intradural temporal bone drilling expanded the surgical exposure to allow access to the petroclival and parasellar regions (suprameatal), internal acoustic meatus (transmeatal), upper jugular foramen (suprajugular), and petrous apex (inframeatal). The electromagnetic navigation continuously guided the drilling without line of sight limitation, and its small devices were easily manipulated in the deep and narrow surgical field in the posterior fossa. Mean target registration error was less than 0.50 mm during these procedures. The combination of endoscopic and microsurgical techniques aids in achieving optimal exposure for retrosigmoid intradural temporal bone drilling. The electromagnetic navigation system had clear advantages with acceptable accuracy including the usability of small devices without line of sight limitation. Copyright © 2017 Elsevier Inc. All rights reserved.

Transsphenoidal hypophysectomy in beagle dogs: evaluation of a microsurgical technique

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Meij, B. P. [Utrecht University, Utrecht (Netherlands); Voorhout, G.; Ingh, T.S.G.A.M. van den; Hazewinkel, H. A.W.; Verlaat, J.W. van ' t

1997-07-15

Objective-Assessment of a microsurgical technique for transsphenoidalhypophysectomy in dogs. Study Design-Prospective study using physicalexamination, pituitary function testing, computed tomography (CT), and histological examination at autopsy. Animals or Sample Population-Eight laboratory beagle dogs. Methods-Pituitary function was assessed before and at 10 weeks after hypophysectomy by combined administration of four releasing hormones (anterior pituitary), administration of haloperidol (pars intermedia), and infusion of hypertonic saline (posterior pituitary). Results-CT imaging enabled accurate preoperative localization of the pituitary. Appropriate positioning and surgical technique facilitated exposure of the pituitary and its extraction without hemorrhage. Postoperative recovery was generally uncomplicated. None of the eight dogs had somatotropic. gonadotropic, lactotropic, melanotropic, or posterior pituitary responses to stimulation at 10 weeks after hypophysectomy. Four dogs (ACTH nonresponders) also had no corticotropicresponse and four (ACTH responders) bad small but significant responses in the combined anterior pituitary function test. Adrenocortical atrophy was more pronounced in the ACTH nonresponders than in the responders. No residual pituitary tissue was found along the ventral hypothalamic diencephalon but nests of pituitary cells were found embedded infibrous tissue in the sella turcica. Conclusions-The surgical technique proved to be safe and effective. Microscopic nests of pituitary cells in the sella turcica may be responsible for residual corticotropic response to hypophysiotropic stimulation after hypophysectomy. Clinical Relevance-The surgical technique may be used in the treatment of dogs with pituitary-dependent hyperadrenocorticism. The corticotropic response is the most sensitive criterion in assessing completeness of hypophysectomy in dogs. (C) Copyright 1997 by The American College of Veterinary Surgeons.

Microsurgical head and neck tissue repair by visceral mini-autografting

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A. D. Kaprin

2015-01-01

Full Text Available Objective. To minimize surgical trauma in patients with head and neck tumors during microsurgical plasty with visceral autografts.Subjects and methods. Clinical experience has been gained in the treatment of 53 patients with locally advanced craniofascial (n = 27 and oropharyngeal (n = 36 cancers. Abdominal organs were used for plastic closure of extensive defects after surgical resection. Paraumbilical incision allowing for an adequate approach into the abdominal cavity with minimal external trauma in the anterior abdominal wall was chosen as an access procedure. Video-assisted techniques were used to excise the midline aponeurosis. Donor organs, such as the omentum, greater curvature of the stomach, transverse colon, small intestine were taken through a mini-laparotomic incision to the anterior abdominal wall, then the vascular pedicle was exposed and a visceral autograft was made. After forming and cutting off the autograft, organ anastomoses were created extracorporeally.Results. Mini-access surgery could be completed in 50 of the 53 cases (4 patients had previously undergone abdominal interventions. Omental (n = 26, colo-omental (n = 15, gastro-omental (n = 7, and entero-omental (n = 5 flaps were made and prepared for autografting. No intra- or postoperative abdominal complications were found.Conclusion. Minimally invasive technologies used to create visceral authografts for head and neck tissue repair can minimize surgical trauma and reduce treatment duration. The indications for this access are the debilitating state of a cancer patient or the young age of a patient who does not wish to have an additional scar in the donor region.

Transsphenoidal hypophysectomy in beagle dogs: evaluation of a microsurgical technique

International Nuclear Information System (INIS)

Meij, B.P.; Voorhout, G.; Ingh, T.S.G.A.M. van den; Hazewinkel, H.A.W.; Verlaat, J.W. van 't

1997-01-01

Objective-Assessment of a microsurgical technique for transsphenoidalhypophysectomy in dogs. Study Design-Prospective study using physicalexamination, pituitary function testing, computed tomography (CT), and histological examination at autopsy. Animals or Sample Population-Eight laboratory beagle dogs. Methods-Pituitary function was assessed before and at 10 weeks after hypophysectomy by combined administration of four releasing hormones (anterior pituitary), administration of haloperidol (pars intermedia), and infusion of hypertonic saline (posterior pituitary). Results-CT imaging enabled accurate preoperative localization of the pituitary. Appropriate positioning and surgical technique facilitated exposure of the pituitary and its extraction without hemorrhage. Postoperative recovery was generally uncomplicated. None of the eight dogs had somatotropic. gonadotropic, lactotropic, melanotropic, or posterior pituitary responses to stimulation at 10 weeks after hypophysectomy. Four dogs (ACTH nonresponders) also had no corticotropicresponse and four (ACTH responders) bad small but significant responses in the combined anterior pituitary function test. Adrenocortical atrophy was more pronounced in the ACTH nonresponders than in the responders. No residual pituitary tissue was found along the ventral hypothalamic diencephalon but nests of pituitary cells were found embedded infibrous tissue in the sella turcica. Conclusions-The surgical technique proved to be safe and effective. Microscopic nests of pituitary cells in the sella turcica may be responsible for residual corticotropic response to hypophysiotropic stimulation after hypophysectomy. Clinical Relevance-The surgical technique may be used in the treatment of dogs with pituitary-dependent hyperadrenocorticism. The corticotropic response is the most sensitive criterion in assessing completeness of hypophysectomy in dogs. (C) Copyright 1997 by The American College of Veterinary Surgeons

[Microsurgical anatomy importance of A1-anterior communicating artery complex].

Science.gov (United States)

Monroy-Sosa, Alejandro; Pérez-Cruz, Julio César; Reyes-Soto, Gervith; Delgado-Hernández, Carlos; Macías-Duvignau, Mario Alberto; Delgado-Reyes, Luis

2013-01-01

The anterior cerebral artery originates from the bifurcation of the internal carotid artery lateral to the optic chiasm, then joins with its contralateral counterpart via the anterior communicating artery. A1-anterior communicating artery complex is the most frequent anatomical variants and is the major site of aneurysms between 30 to 37%. Know the anatomy microsurgical, variants anatomical and importance of complex precommunicating segment-artery anterior communicating in surgery neurological of the pathology vascular, mainly aneurysms, in Mexican population. The study was performed in 30 brains injected. Microanatomy was studied (length and diameter) of A1-anterior communicating artery complex and its variants. 60 segments A1, the average length of left side was 11.35 mm and 11.84 mm was right. The average diameter of left was 1.67 mm and the right was 1.64 mm. The average number of perforators on the left side was 7.9 and the right side was 7.5. Anterior communicating artery was found in 29 brains of the optic chiasm, its course depended on the length of the A1 segment. The average length of the segment was 2.84 mm, the average diameter was 1.41 mm and the average number of perforators was 3.27. A1-anterior communicating artery complex variants were found in 18 (60%) and the presence of two blister-like aneurysms. It is necessary to understand the A1-anterior communicating artery complex microanatomy of its variants to have a three-dimensional vision during aneurysm surgery.

Nuclear-related training and education offered by nonacademic organizations (preliminary)

International Nuclear Information System (INIS)

Howard, L.

1981-11-01

The results of a survey of nuclear-related training and education provided by nonacademic training organizations are presented in this report. The survey instrument was distributed by the Institute of Nuclear Power Operations to 136 training organizations. The scope of the survey was not intended to be comprehensive, but rather to include the primary sources of nonacademic nuclear-related training and education offered to utility personnel. The survey universe was compiled from training organizations listed in the 1981 Nuclear News Buyer's Guide. Forty-three percent of the survey population (59 organizations) responded to the questionnaire of which 31 percent (42) reported they offered nuclear-related training programs and 12 percent (17) reported they did not offer any nuclear-related training

Towards a Global Understanding and Standardisation of Education and Training in Microsurgery

Directory of Open Access Journals (Sweden)

Clement Chi Ming Leung

2013-07-01

Full Text Available With an increasing emphasis on microsurgery skill acquisition through simulated training, the need has been identified for standardised training programmes in microsurgery. We have reviewed microsurgery training courses available across the six continents of the World. Data was collected of relevant published output from PubMed, MEDLINE (Ovid, and EMBASE (Ovid searches, and from information available on the Internet of up to six established microsurgery course from each of the six continents of the World. Fellowships and courses that concentrate on flap harvesting rather than microsurgical techniques were excluded. We identified 27 cen­tres offering 39 courses. Total course length ranged from 20 hours to 1,950 hours. Student­to­teacher ratios ranged from 2:1 to 8:1. Only two­thirds of courses offered in-vivo animal models. Instructions in microvascular end­to­end and end­to­side anastomoses were common, but peripheral nerve repair or free groin flap transfer were not consistently offered. Methods of assessment ranged from no formal assessment, where an instructor monitored and gave instant feedback, through immediate assessment of patency and critique on quality of repair, to delayed re­assessment of patency after a 12 to 24 hours period. Globally, training in micro­surgery is heterogeneous, with variations primarily due to resource and regulation of animal experimentation. Despite some merit to diversity in curricula, there should be a global min­imum standard for microsurgery training.

Efficacy and safety of 0.75% ropivacaine instillation into subinguinal wound in patients after bilateral microsurgical varicocelectomy: a bi-center, randomized, double-blind, placebo-controlled trial

Directory of Open Access Journals (Sweden)

Cui WS

2017-07-01

Full Text Available Wan Shou Cui,1,* Yu Seob Shin,2,3,* Jae Hyung You,3 A Ram Doo,4 Kiran Kumar Soni,3 Jong Kwan Park3 1Andrology Center, Peking University First Hospital, Beijing, People’s Republic of China; 2Department of Urology, Armed Forces Capital Hospital, Seongnam, 3Department of Urology, Chonbuk National University and Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute and Medical Device Clinical Trial Center of Chonbuk National University Hospital, Jeonju, 4Department of Anesthesiology and Pain Medicine, Chonbuk National University Medical School, Jeonju, Republic of Korea *These authors contributed equally to this work Objective: To evaluate the efficacy and safety of 0.75% ropivacaine instillation into inguinal wound in patients who have undergone bilateral microsurgical varicocelectomy.Patients and methods: Eighty-five men who were screened for bilateral varicoceles from March 2015 to July 2016 were randomized for the treatment. All patients underwent inguinal varicocelectomy by general anesthesia. After ligation of the internal spermatic veins from the spermatic cord, additional delivery of testis through inguinal incision site was done to ligate external spermatic veins and gubernacular veins. Before repairing external oblique aponeurosis, 6 mL of 0.75% ropivacaine and 6 mL of normal saline were instilled under the fascia and around the funiculus (spermatic cord by a randomized and double-blind method. Visual analog scale (VAS pain score and Prince Henry Pain Score (PHPS were used for evaluating operative sites at 1, 2, 4, and 8 hours and 7 days after surgery. Safety and tolerability were evaluated throughout the course of this study by assessing adverse events.Results: A total of 55 men completed the study. Of these 55 men, 31 received instillation of ropivacaine on the left operative site, while 24 received instillation of ropivacaine on the right operative site. VAS pain scores and PHPS in

Training the Antifragile Athlete: A Preliminary Analysis of Neuromuscular Training Effects on Muscle Activation Dynamics.

Science.gov (United States)

Kiefer, Adam W; Myer, Gregory D

2015-10-01

Athletic injuries typically occur when the stable, emergent coordination between behavioral processes breaks down due to external noise, or variability. A physiological system that operates at an optimal point on a spectrum of rigidity and flexibility may be better prepared to handle extreme external variability, and the purpose of the current experiment was to examine whether targeted neuromuscular training resulted in changes to the rigidity and flexibility of the gluteal muscle tonus signal as measured with electromyography prior to the landing phase of a drop vertical jump task. 10 adolescent female athletes who participated in a targeted 10-week neuromuscular training program and 6 controls participated, and their tonus dynamics were examined with recurrence quantification analysis prior to training and after the 10-week program. The dependent measures, percent laminarity (%LAM) and percent determinism (%DET) were hypothesized to decrease following training, and were submitted to a one tailed mixed-model ANOVA. The training group exhibited a decrease in %LAM and %DET after training compared to pre-training and controls. The present findings indicate increased metaflexibility (i.e., greater intermittency and an increase in internal randomness) in tonus dynamics following neuromuscular training, and have important implications for the prevention of musculoskeletal injury in sport, specifically within the context of external noise and antifragility.

Preliminary safety analysis of high-intensity interval training (HIIT) in persons with chronic stroke.

Science.gov (United States)

Carl, Daniel L; Boyne, Pierce; Rockwell, Bradley; Gerson, Myron; Khoury, Jane; Kissela, Brett; Dunning, Kari

2017-03-01

The purpose of this study was to assess safety via electrocardiographic (ECG), blood pressure (BP), heart rate (HR), and orthopedic responses to 3 different high-intensity interval training (HIIT) protocols in persons with stroke. Eighteen participants (10 male; 61.9 + 8.3 years of age; 5.8 + 4.2 years poststroke) completed a symptom-limited graded exercise test (GXT) with ECG monitoring to screen for eligibility and determine HR peak. The 3 HIIT protocols involved repeated 30 s bursts of treadmill walking at maximum speed alternated with rest periods of 30 s (P30), 1 min (P60), or 2 min (P120). Sessions were performed in random order and included 5 min warm up, 20 min HIIT, and 5 min cool down. Variables measured included ECG activity, BP, HR, signs and symptoms of cardiovascular intolerance, and orthopedic concerns. Generalized linear mixed models and Tukey-Kramer adjustment were used to compare protocols using p HIIT session. HIIT elicited HRs in excess of 88% of measured HR peak including 6 (P30), 8 (P60), and 2 (P120) participants eliciting a HR response above their GXT HR peak . Both maximum BP and HR were significantly higher in P30 and P60 relative to P120. Preliminary data indicate that persons with chronic stroke who have been prescreened with an ECG stress test, a symptom-limited GXT, and a harness for fall protection may safely participate in HIIT, generating substantially higher HRs than what is seen in traditional moderate intensity training.

A preliminary evaluation of the training effects of a didactic and simulation-based psychological first aid program in students and school counselors in South Korea.

Science.gov (United States)

Lee, Jong-Sun; You, Sungeun; Choi, Yun-Kyeung; Youn, Hyae-Young; Shin, Hye Sook

2017-01-01

The present study aimed to examine the training effects of a didactic and simulation-based psychological first aid (PFA) program. Based on the competency-based model, the study sought to examine whether the PFA training would enhance knowledge, skills, and attitudes. Study 1 examined the training effects of the PFA program in a sample of undergraduate and graduate students in psychology. Study 2 was conducted with school counselors. In both studies, all participants completed a one-day PFA workshop with a 3-hour didactic lecture and a 3-hour simulation-based practice. Assessments were conducted prior to the didactic lecture and upon completion of the simulation-based practice. In study 1, an examination of pre- and posttest comparisons indicated that the training significantly improved students' PFA knowledge and perceived competence in PFA skill. In study 2, the same PFA training significantly improved school counselors' PFA knowledge, perceived competence in PFA skill, perceived preparedness and confidence to provide psychological assistance for future disasters, but their perceived willingness to participate in psychological assistance did not significantly change after the training. This study provides preliminary evidence supporting the effectiveness of the PFA training program using a combined method of didactic and simulation-based practice for disaster mental health providers in Korea.

A preliminary evaluation of the training effects of a didactic and simulation-based psychological first aid program in students and school counselors in South Korea.

Directory of Open Access Journals (Sweden)

Jong-Sun Lee

Full Text Available The present study aimed to examine the training effects of a didactic and simulation-based psychological first aid (PFA program. Based on the competency-based model, the study sought to examine whether the PFA training would enhance knowledge, skills, and attitudes. Study 1 examined the training effects of the PFA program in a sample of undergraduate and graduate students in psychology. Study 2 was conducted with school counselors. In both studies, all participants completed a one-day PFA workshop with a 3-hour didactic lecture and a 3-hour simulation-based practice. Assessments were conducted prior to the didactic lecture and upon completion of the simulation-based practice. In study 1, an examination of pre- and posttest comparisons indicated that the training significantly improved students' PFA knowledge and perceived competence in PFA skill. In study 2, the same PFA training significantly improved school counselors' PFA knowledge, perceived competence in PFA skill, perceived preparedness and confidence to provide psychological assistance for future disasters, but their perceived willingness to participate in psychological assistance did not significantly change after the training. This study provides preliminary evidence supporting the effectiveness of the PFA training program using a combined method of didactic and simulation-based practice for disaster mental health providers in Korea.

Effects Of Desensitization Treatment On Core-Condition Training

Science.gov (United States)

Fry, P. S.

1973-01-01

Pre- and posttest ratings on measures of helping skills such as empathy, respect, concreteness, and genuineness were obtained in the preliminary and advanced training. A significant training effect was obtained for both groups. Desensitization treatment was a significant source of variance for the experimental subjects in training. (Author/LA)

Microsurgical and Tractographic Anatomy of the Supplementary Motor Area Complex in Humans.

Science.gov (United States)

Bozkurt, Baran; Yagmurlu, Kaan; Middlebrooks, Erik H; Karadag, Ali; Ovalioglu, Talat Cem; Jagadeesan, Bharathi; Sandhu, Gauravjot; Tanriover, Necmettin; Grande, Andrew W

2016-11-01

To evaluate the microsurgical anatomy of the fiber tract connections of the supplementary motor area (SMA) and pre-SMA, and examine its potential functional role with reference to clinical trials in the literature. Ten postmortem formalin-fixed human brains (20 sides) and 1 cadaveric head were prepared following Klingler's method. The fiber dissection was performed in a stepwise fashion, from lateral to medial and also from medial to lateral, under an operating microscope, with 3D images captured at each stage. Our findings were supported by in vivo magnetic resonance imaging tractography in 2 healthy subjects. The connections of the SMA complex, composed of the pre-SMA and the SMA proper, are composed of short "U" association fibers and the superior longitudinal fasciculus I, cingulum, claustrocortical fibers, callosal fibers, corticospinal tract, frontal aslant tract, and frontostriatal tract. The claustrocortical fibers may play an important role in the integration of motor, language, and limbic functions of the SMA complex. The frontostriatal tract connects the pre-SMA to the putamen and caudate nucleus, and also forms parts of both the internal capsule and the dorsal external capsule. The SMA complex has numerous connections throughout the cerebrum. An understanding of these connections is important for presurgical planning for lesions in the frontal lobe and helps explain symptoms related to SMA injury. Copyright © 2016 Elsevier Inc. All rights reserved.

The effects of strength and power training on single-step balance recovery in older adults: a preliminary study.

Science.gov (United States)

Pamukoff, Derek N; Haakonssen, Eric C; Zaccaria, Joseph A; Madigan, Michael L; Miller, Michael E; Marsh, Anthony P

2014-01-01

Improving muscle strength and power may mitigate the effects of sarcopenia, but it is unknown if this improves an older adult's ability to recover from a large postural perturbation. Forward tripping is prevalent in older adults and lateral falls are important due to risk of hip fracture. We used a forward and a lateral single-step balance recovery task to examine the effects of strength training (ST) or power (PT) training on single-step balance recovery in older adults. Twenty older adults (70.8±4.4 years, eleven male) were randomly assigned to either a 6-week (three times/week) lower extremity ST or PT intervention. Maximum forward (FLean(max)) and lateral (LLean(max)) lean angle and strength and power in knee extension and leg press were assessed at baseline and follow-up. Fifteen participants completed the study (ST =7, PT =8). Least squares means (95% CI) for ΔFLean(max) (ST: +4.1° [0.7, 7.5]; PT: +0.6° [-2.5, 3.8]) and ΔLLean(max) (ST: +2.2° [0.4, 4.1]; PT: +2.6° [0.9, 4.4]) indicated no differences between groups following training. In exploratory post hoc analyses collapsed by group, ΔFLean(max) was +2.4° (0.1, 4.7) and ΔLLean(max) was +2.4° (1.2, 3.6). These improvements on the balance recovery tasks ranged from ~15%-30%. The results of this preliminary study suggest that resistance training may improve balance recovery performance, and that, in this small sample, PT did not lead to larger improvements in single-step balance recovery compared to ST.

[Quality of Life and Functional Outcome after Microsurgical Decompression in Lumbar Spinal Stenosis: a Register Study].

Science.gov (United States)

Zarghooni, Kourosh; Beyer, Frank; Papadaki, Joanna; Boese, Christoph Kolja; Siewe, Jan; Schiffer, Gereon; Eysel, Peer; Bredow, Jan

2017-08-01

Introduction Because of recent increases in life expectancy, lumbar spinal stenosis (LSS) has become one of the most common degenerative changes in the spine. In patients not responding to conservative therapy, microsurgical decompression is the gold standard of operative treatment for degenerative LSS. The goal of the current study is to evaluate quality of life after microsurgical decompression for LSS, using data from the DWG Register (previously Spine Tango). Methods 36 patients were included in this single-center, prospective, observational study from January 2013 to June 2014. Data were collected from the Spine Tango or DWG Register. The core outcome measure index (COMI), Oswestry Disability Index (ODI), and the quality of life questionnaire EuroQoL-5D were used. Data were collected prior to surgery as well as six weeks, six months, and twelve months after the operation. Results The patient cohort comprised 13 females and 23 males (36.1 and 63.9 %). Complete 12-month follow-up data on 21 patients were available for analysis. Compared to preoperative measures, the COMI score increased 8.1 ± 1.5 over the entire follow up, with 4.5 ± 3.1 at 6 weeks (p < 0.001), 4.8 ± 3.1 at 6 months, and 3.8 ± 3.2 at 12 months. ODI scores, measuring spinal function impairment, were significantly better than preoperative values overall (47.5 ± 17.3) and after 6 weeks (29.1 ± 22.4; p < 0.005), 6 months (30.0 ± 19.3), and 12 months (23.8 ± 18.2). Quality of life measures improved in a similar manner (preoperative: 0.36 ± 0.38; 6 weeks: 0.57 ± 0.34 (p < 0.019); 6 months: 0.62 ± 0.28; 12 months: 0.67 ± 0.31). Conclusion Our study shows that LSS patients without previous surgery and neurologic deficits can expect significant pain relief and improved quality of life already six weeks after undergoing stabilizing decompression. There was an increase in positive postoperative effects over 12 months. The DWG

An integrated gait rehabilitation training based on Functional Electrical Stimulation cycling and overground robotic exoskeleton in complete spinal cord injury patients: Preliminary results.

Science.gov (United States)

Mazzoleni, S; Battini, E; Rustici, A; Stampacchia, G

2017-07-01

The aim of this study is to investigate the effects of an integrated gait rehabilitation training based on Functional Electrical Stimulation (FES)-cycling and overground robotic exoskeleton in a group of seven complete spinal cord injury patients on spasticity and patient-robot interaction. They underwent a robot-assisted rehabilitation training based on two phases: n=20 sessions of FES-cycling followed by n= 20 sessions of robot-assisted gait training based on an overground robotic exoskeleton. The following clinical outcome measures were used: Modified Ashworth Scale (MAS), Numerical Rating Scale (NRS) on spasticity, Penn Spasm Frequency Scale (PSFS), Spinal Cord Independence Measure Scale (SCIM), NRS on pain and International Spinal Cord Injury Pain Data Set (ISCI). Clinical outcome measures were assessed before (T0) after (T1) the FES-cycling training and after (T2) the powered overground gait training. The ability to walk when using exoskeleton was assessed by means of 10 Meter Walk Test (10MWT), 6 Minute Walk Test (6MWT), Timed Up and Go test (TUG), standing time, walking time and number of steps. Statistically significant changes were found on the MAS score, NRS-spasticity, 6MWT, TUG, standing time and number of steps. The preliminary results of this study show that an integrated gait rehabilitation training based on FES-cycling and overground robotic exoskeleton in complete SCI patients can provide a significant reduction of spasticity and improvements in terms of patient-robot interaction.

Cognitive control training for emotion-related impulsivity.

Science.gov (United States)

Peckham, Andrew D; Johnson, Sheri L

2018-06-01

Many forms of psychopathology are tied to a heightened tendency to respond impulsively to strong emotions, and this tendency, in turn, is closely tied to problems with cognitive control. The goal of the present study was to test whether a two-week, six-session cognitive control training program is efficacious in reducing emotion-related impulsivity. Participants (N = 52) reporting elevated scores on an emotion-related impulsivity measure completed cognitive control training targeting working memory and response inhibition. A subset of participants were randomized to a waitlist control group. Impulsivity, emotion regulation, and performance on near and far-transfer cognitive tasks were assessed at baseline and after completion of training. Emotion-related impulsivity declined significantly from pre-training to post-training and at two-week follow-up; improvements were not observed in the waitlist control group. A decrease in brooding rumination and an increase in reappraisal were also observed. Participants showed significant improvements on trained versions of the working memory and inhibition tasks as well as improvements on an inhibition transfer task. In sum, these preliminary findings show that cognitive training appears to be well-tolerated for people with significant emotion-driven impulsivity. Results provide preliminary support for the efficacy of cognitive training interventions as a way to reduce emotion-related impulsivity. Copyright © 2018 Elsevier Ltd. All rights reserved.

Transversus Abdominis Plane Blocks with Single-Dose Liposomal Bupivacaine in Conjunction with a Nonnarcotic Pain Regimen Help Reduce Length of Stay following Abdominally Based Microsurgical Breast Reconstruction.

Science.gov (United States)

Jablonka, Eric M; Lamelas, Andreas M; Kim, Julie N; Molina, Bianca; Molina, Nathan; Okwali, Michelle; Samson, William; Sultan, Mark R; Dayan, Joseph H; Smith, Mark L

2017-08-01

Side effects associated with use of postoperative narcotics for pain control can delay recovery after abdominally based microsurgical breast reconstruction. The authors evaluated a nonnarcotic pain control regimen in conjunction with bilateral transversus abdominis plane blocks on facilitating early hospital discharge. A retrospective analysis was performed of consecutive patients who underwent breast reconstruction using abdominally based free flaps, with or without being included in a nonnarcotic protocol using intraoperative transversus abdominis plane blockade. During this period, the use of locoregional analgesia evolved from none (control), to continuous bupivacaine infusion transversus abdominis plane and catheters, to single-dose transversus abdominis plane blockade with liposomal bupivacaine solution. Demographic factors, length of stay, inpatient opioid consumption, and complications were reported for all three groups. One hundred twenty-eight consecutive patients (182 flaps) were identified. Forty patients (62 flaps) were in the infusion-liposomal bupivacaine group, 48 (66 flaps) were in the single-dose blockade-catheter group, and 40 (54 flaps) were in the control group. The infusion-liposomal bupivacaine patients had a significantly shorter hospital stay compared with the single-dose blockade-catheter group (2.65 ± 0.66 versus 3.52 ± 0.92 days; p plane blocks performed with single injections of liposomal bupivacaine help facilitate early hospital discharge after abdominally based microsurgical breast reconstruction. A trend toward consistent discharge by postoperative day 2 was seen. This could result in significant cost savings for health care systems. Therapeutic, III.

Highly Realistic Training for Navy Corpsmen: A Follow-up Assessment

Science.gov (United States)

2017-10-12

based training for military medical providers. One such training is highly realistic training. Based on the success of the Infantry Immersion ...observation with minimal participation improves paediatric emergency medicine knowledge, skills and confidence. Emergency Medicine Journal , 32(3), 195... immersive training for Navy corpsmen: Preliminary results. Military Medicine, 179(12), 1439–1443. Booth-Kewley, S., McWhorter, S. K., Dell’Acqua, R

Checklist for Staff Technology Training.

Science.gov (United States)

Anderson, Mary Alice

1997-01-01

Presents a planning checklist for staff technology training. Includes forming a committee and developing proposals, contacting pertinent people, handling publicity, sending invitations, distributing schedules/registration information, arranging for equipment, purchasing prizes, conducting preliminary checks on equipment and software, ordering…

Neurosurgical tactile discrimination training with haptic-based virtual reality simulation.

Science.gov (United States)

Patel, Achal; Koshy, Nick; Ortega-Barnett, Juan; Chan, Hoi C; Kuo, Yong-Fan; Luciano, Cristian; Rizzi, Silvio; Matulyauskas, Martin; Kania, Patrick; Banerjee, Pat; Gasco, Jaime

2014-12-01

To determine if a computer-based simulation with haptic technology can help surgical trainees improve tactile discrimination using surgical instruments. Twenty junior medical students participated in the study and were randomized into two groups. Subjects in Group A participated in virtual simulation training using the ImmersiveTouch simulator (ImmersiveTouch, Inc., Chicago, IL, USA) that required differentiating the firmness of virtual spheres using tactile and kinesthetic sensation via haptic technology. Subjects in Group B did not undergo any training. With their visual fields obscured, subjects in both groups were then evaluated on their ability to use the suction and bipolar instruments to find six elastothane objects with areas ranging from 1.5 to 3.5 cm2 embedded in a urethane foam brain cavity model while relying on tactile and kinesthetic sensation only. A total of 73.3% of the subjects in Group A (simulation training) were able to find the brain cavity objects in comparison to 53.3% of the subjects in Group B (no training) (P  =  0.0183). There was a statistically significant difference in the total number of Group A subjects able to find smaller brain cavity objects (size ≤ 2.5 cm2) compared to that in Group B (72.5 vs. 40%, P  =  0.0032). On the other hand, no significant difference in the number of subjects able to detect larger objects (size ≧ 3 cm2) was found between Groups A and B (75 vs. 80%, P  =  0.7747). Virtual computer-based simulators with integrated haptic technology may improve tactile discrimination required for microsurgical technique.

Safety and economic study of special trains

International Nuclear Information System (INIS)

Loscutoff, W.V.; Hall, R.J.

1976-01-01

A comparative evaluation is being conducted of the safety and economics of special (35 mph and less) and regular trains for shipment of spent fuels. The approach, pertinent considerations, and results to date are discussed. The preliminary conclusion is that special train requirements have potential for only a small reduction in the accident likelihood, while increasing the cost

Alternative Approach to Traumatic Stensen’s Duct Injuries Accompanied by Glandular Involvement: Botulinum Toxin Injection to the Gland in Conjunction with Microsurgical Repair of the Duct in an Acute Setting

OpenAIRE

Mert Çalış; Zeynep Öz; Hakan Uzun; Burçe Özgen; Alp Çetin3; Ali Emre Aksu

2017-01-01

Objective: The aim of this study was to evaluate the long-term results of a simultaneous application of botulinum toxin to the parotid gland in conjunction with the microsurgical repair of the duct in an acute setting and to encourage using botulinum toxin as a first-line option to prevent future complications associated with glandular involvement. Material and Methods: Three patients who were referred to the Plastic Surgery Clinic by the emergency room of the Hacettepe University Hospita...

Rapid learning curve assessment in an ex vivo training system for microincisional glaucoma surgery.

Science.gov (United States)

Dang, Yalong; Waxman, Susannah; Wang, Chao; Parikh, Hardik A; Bussel, Igor I; Loewen, Ralitsa T; Xia, Xiaobo; Lathrop, Kira L; Bilonick, Richard A; Loewen, Nils A

2017-05-09

Increasing prevalence and cost of glaucoma have increased the demand for surgeons well trained in newer, microincisional surgery. These procedures occur in a highly confined space, making them difficult to learn by observation or assistance alone as is currently done. We hypothesized that our ex vivo outflow model is sensitive enough to allow computing individual learning curves to quantify progress and refine techniques. Seven trainees performed nine trabectome-mediated ab interno trabeculectomies in pig eyes (n = 63). An expert surgeon rated the procedure using an Operating Room Score (ORS). The extent of outflow beds accessed was measured with canalograms. Data was fitted using mixed effect models. ORS reached a half-maximum on an asymptote after only 2.5 eyes. Surgical time decreased by 1.4 minutes per eye in a linear fashion. The ablation arc followed an asymptotic function with a half-maximum inflection point after 5.3 eyes. Canalograms revealed that this progress did not correlate well with improvement in outflow, suggesting instead that about 30 eyes are needed for true mastery. This inexpensive pig eye model provides a safe and effective microsurgical training model and allows objective quantification of outcomes for the first time.

Habit reversal training and educational group treatments for children with tourette syndrome: A preliminary randomised controlled trial.

Science.gov (United States)

Yates, Rachel; Edwards, Katie; King, John; Luzon, Olga; Evangeli, Michael; Stark, Daniel; McFarlane, Fiona; Heyman, Isobel; İnce, Başak; Kodric, Jana; Murphy, Tara

2016-05-01

Quality of life of children with Tourette Syndrome (TS) is impacted greatly by its symptoms and their social consequences. Habit Reversal Training (HRT) is effective but has not, until now, been empirically evaluated in groups. This randomised controlled trial evaluated feasibility and preliminary efficacy of eight HRT group sessions compared to eight Education group sessions. Thirty-three children aged 9-13 years with TS or Chronic Tic Disorder took part. Outcomes evaluated were tic severity and quality of life (QoL). Tic severity improvements were found in both groups. Motor tic severity (Yale Global Tic Severity Scale) showed greatest improvements in the HRT group. Both groups showed a strong tendency toward improvements in patient reported QoL. In conclusion, group-based treatments for TS are feasible and exposure to other children with tics did not increase tic expression. HRT led to greater reductions in tic severity than Education. Implications, such as cost-effectiveness of treatment delivery, are discussed. Copyright © 2016. Published by Elsevier Ltd.

Focal Dystonia in Hemiplegic Upper Limb: Favorable Effect of Cervical Microsurgical DREZotomy Involving the Ventral Horn - A Report of 3 Patients.

Science.gov (United States)

Sindou, Marc; Georgoulis, George

2016-01-01

Focal dystonia in hemiplegic upper limbs is poorly responsive to medications or classical neurosurgical treatments. Only repeated botulinum toxin injections show efficacy, but in most severe cases effects are transient. Cervical DREZ lesioning, which has proven efficacious in hyperspasticity when done deeply (3-5 mm) in the dorsal horn, may have favorable effects on the dystonic component when performed down to, and including, the base of the ventral horn (5-6 mm in depth). Three patients underwent deep cervical microsurgical DREZotomy (MDT) for focal dystonia in the upper limb. Hypertonia was reduced, and sustained dystonic postures were suppressed. Residual motor function (hidden behind hypertonia) came to the surface. Cervical MDT may be a useful armamentarium for treating refractory focal dystonia in the upper limb. © 2016 S. Karger AG, Basel.

Qualification and training of quality assurance personnel

International Nuclear Information System (INIS)

Ribeiro da Costa, J.

1980-01-01

Introduction. Qualification and certification: definitions; approach of the problem. A first attempt for its solutions. The 'sample' course; results and conclusions. Planning a comprehensive program: results. Analysis and preliminary conclusions. Absorption of the know-how and planning further programs for training. Development and updating the general training course with the introduction of German experience - summary of results. General planning of a training course for quality and reliability are as for the next courses. Evaluation, grading and final results awarded to participants, as followed in QA-Training courses - certification. Future trends (tentative) - conclusions. (orig./RW)

Changes in gray matter volume after microsurgical lumbar discectomy: A longitudinal analysis

Directory of Open Access Journals (Sweden)

Michael eLuchtmann

2015-02-01

Full Text Available People around the world suffer chronic lower back pain. Because spine imaging often does not explain the degree of perceived pain reported by patients, the role of the processing of nociceptor signals in the brain as the basis of pain perception is gaining increased attention. Modern neuroimaging techniques (including functional and morphometric methods have produced results that suggest which brain areas may play a crucial role in the perception of acute and chronic pain. In this study, we examined twelve patients with chronic low back pain and sciatica, both resulting from lumbar disc herniation. Structural magnetic resonance imaging (MRI of the brain was performed one day prior to and about four weeks after microsurgical lumbar discectomy. The subsequent MRI revealed an increase in gray matter volume in the basal ganglia but a decrease in volume in the hippocampus, which suggests the complexity of the network that involves movement, pain processing, and aspects of memory. Interestingly, volume changes in the hippocampus were significantly correlated to preoperative pain intensity but not to the duration of chronic pain. Mapping structural changes of the brain that result from lumbar disc herniation has the potential to enhance our understanding of the neuropathology of chronic low back pain and sciatica and therefore may help to optimize the decisions we make about conservative and surgical treatments in the future. The possibility of illuminating more of the details of central pain processing in lumbar disc herniation, as well as the accompanying personal and economic impact of pain relief worldwide, calls for future large-scale clinical studies.

ENGLISH / PIDGIN-ENGLISH (WES-KOS), PRELIMINARY GLOSSARY.

Science.gov (United States)

SCHNEIDER, GILBERT D.

THIS PRELIMINARY GLOSSARY OF ENGLISH / PIDGIN-ENGLISH (WES-KOS) HAS BEEN USED IN PEACE CORPS TRAINING PROGRAMS. WES-KOS (IN USE SINCE THE 18TH CENTURY) IS USED THROUGHOUT WEST AFRICA, HOWEVER THE GLOSSES IN THIS TEXT ARE THE COMMON CULTURAL-LINGUISTIC EQUIVALENTS USED IN WEST CAMEROON AND EASTERN NIGERIA. A BRIEF STATEMENT IS GIVEN IN THE…

Effects of virtual reality-based training with BTs-Nirvana on functional recovery in stroke patients: preliminary considerations.

Science.gov (United States)

De Luca, Rosaria; Russo, Margherita; Naro, Antonino; Tomasello, Provvidenza; Leonardi, Simona; Santamaria, Floriana; Desireè, Latella; Bramanti, Alessia; Silvestri, Giuseppe; Bramanti, Placido; Calabrò, Rocco Salvatore

2018-02-02

Cognitive impairment occurs frequently in post-stroke patients. This study aimed to determine the effects of a virtual reality training (VRT) with BTs-Nirvana (BTsN) on the recovery of cognitive functions in stroke patients, using the Interactive-Semi-Immersive Program (I-SIP). We enrolled 12 subjects (randomly divided into two groups: experimental group (EG); and control group (CG)), who attended the Laboratory of Robotic and Cognitive Rehabilitation of IRCCS Neurolesi of Messina from January to June 2016. The EG underwent a VRT with BTsN, whereas CG received a standard cognitive treatment. Both the groups underwent the same conventional physiotherapy program. Each treatment session lasted 45 minutes and was repeated three times a week for 8 weeks. All the patients were evaluated by a specific clinical-psychometric battery before (T0), immediately (T1), and one month (T2) after the end of the training. At T1, the EG presented a greater improvement in the trunk control test (p = 0.03), the Montreal Cognitive Assessment (p = 0.01), the selective attention assessment scores (p = 0.01), the verbal memory (p = 0.03), and the visuospatial and constructive abilities (p = 0.01), as compared to CG. Moreover, such amelioration persisted at T2 only in the EG. According to these preliminary data, VRT with I-SIP can be considered a useful complementary treatment to potentiate functional recovery, with regard to attention, visual-spatial deficits, and motor function in patients affected by stroke.

Modern use of smartphone applications in the perioperative management in microsurgical breast reconstruction

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Rozen, Warren Matthew; Marsh, Daniel; Chow, Whitney T.H.; Vickers, Tobias; Khan, Lubna; Miller, George S.; Hunter-Smith, David J.; Ramakrishnan, Venkat V.

2016-01-01

Background Advances in mobile telecommunication, improved mobile internet and affordability have led to a significant increase in smartphone use within medicine. The capability of instant messaging, photography, videography, word processing, drawing and internet access allow significant potential in this small portable device. Smartphone use within medicine has grown tremendously worldwide given its affordability, improved internet and capabilities. Methods We have searched for apps specifically helpful in the perioperative care of microsurgical breast reconstructive patients. Results The useful apps have been subdivided: (I) communication apps—multimedia messaging, WhatsApp, PicSafeMedi: allow efficient communication via text, picture and video messages leading to earlier assessment and definitive management of free flaps; (II) storage apps—Notability, Elogbook: electronic storage of patient notes and logbooks of case which can be shared with others if required; (III) educational apps—FlapApp, Touch Surgery, PubMed on tap: step by step guides to surgical procedures to aid learning and medical journal database; (IV) flap monitoring app—SilpaRamanitor: free flap monitoring app based on photographic analysis for earlier detection of compromised flaps. Conclusions There has been remarkable growth in smartphones use among surgeons. Apps are being developed for every conceivable use. The future will be in wearable smart devices that allow continuous monitoring with the potential to instigate change should deviations from the norm occur. The smart watch is the start of this digital revolution. PMID:27047783

The role of a preliminary PGY-3 in general surgery training.

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Tarpley, Margaret J; Van Way, Charles; Friedell, Mark; Deveney, Karen; Farley, David; Mellinger, John; Scott, Bradford; Tarpley, John

2014-01-01

Even before the preliminary postgraduate year (PGY)-3 was eliminated from surgical residency, it had become increasingly difficult to fill general surgery PGY-4 vacancies. This ongoing need prompted the Association of Program Directors in Surgery (APDS) leadership to form a task force to study the possibility of requesting the restoration of the preliminary PGY-3 to Accreditation Council for Graduate Medical Education-approved general surgery residency programs. The task force conducted a 10-year review of the APDS list serve to ascertain the number of advertised PGY-4 open positions. Following the review of the list serve, the task force sent IRB-approved electronic REDCap surveys to 249 program directors (PDs) in general surgery. The list serve review revealed more than 230 requests for fourth-year residents, a number that most likely underestimates the need, as such, vacancies are not always advertised through the APDS. A total of 119 PDs (~48%) responded. In the last 10 years, these 119 programs needed an average of 2 PGY-4 residents (range: 0-8), filled 1.3 positions (range: 0-7), and left a position unfilled 1.3 times (range: 0-7). Methods for finding PGY-4 residents included making personal contacts with other PDs (52), posting on the APDS Topica List Serve (47), and using the APDS Web site for interested candidates on residency and fellowship job listings (52). Reasons for needing a PGY-4 resident included residents leaving the program (82), extra laboratory years (39), remediation (31), and approved program expansion (21), as well as other issues. Satisfaction scores for the added PGY-4 residents were more negative (43) than positive (30). Problems ranged from lack of preparation to professionalism. When queried as to an optimal number of preliminary residents needed nationally at the PGY-3 level, responses varied from 0 to 50 (34 suggested 10). The survey of PDs supports the need for the reintroduction of a limited number of Accreditation Council for

Clinical study on microsurgical treatment for craniopharyngioma in a single consecutive institutional series of 335 patients.

Science.gov (United States)

Guo, Fuyou; Wang, Guoqing; Suresh, Vigneyshwar; Xu, Dingkang; Zhang, Xiaoyang; Feng, Mengzhao; Wang, Fang; Liu, Xianzhi; Song, Laijun

2018-04-01

The optimal management of craniopharyngioma is still controversial. The aim of this study is to explore microsurgical outcomes of craniopharyngioma in 335 cases. Clinical data of 335 consecutive patients with craniopharyngioma between March 2011 and March 2017 were retrospectively analyzed. Gross total resection (GTR) was achieved in 265 cases (79.1%), subtotal resection (STR) was obtained in 70 cases (20.9%). The GTR rate was 81.93% in pediatric group and 78.17% in adult group respectively, no significant difference regarding the GTR rate was found in adult group compared with in pediatric group (p > 0.05). However, there was a noticeable difference in the elevated hypothalamic obesity in children group compared with in adult group after operation (p  0.05). Additionally, there were no statistically significant differences for recurrence-free curves between GTR and STR plus adjuvant radiotherapy (p > 0.05). Present findings demonstrated that tumor recurrence and surgical times contribute to negative total resection for craniopharyngioma. Postoperative precise adjuvant radiotherapy was considered in selected cases if pursuit of GTR was rather dangerous under disadvantageous removal factors. Copyright © 2018 Elsevier B.V. All rights reserved.

Irisin and exercise training in humans - results from a randomized controlled training trial.

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Hecksteden, Anne; Wegmann, Melissa; Steffen, Anke; Kraushaar, Jochen; Morsch, Arne; Ruppenthal, Sandra; Kaestner, Lars; Meyer, Tim

2013-11-05

The recent discovery of a new myokine (irisin) potentially involved in health-related training effects has gained great attention, but evidence for a training-induced increase in irisin remains preliminary. Therefore, the present study aimed to determine whether irisin concentration is increased after regular exercise training in humans. In a randomized controlled design, two guideline conforming training interventions were studied. Inclusion criteria were age 30 to 60 years, Physical performance provided positive control for the overall efficacy of training. Differences between groups were tested for significance using analysis of variance. For post hoc comparisons with the control group, Dunnett's test was used. Maximum performance increased significantly in the training groups compared with controls (controls: ±0.0 ± 0.7 km/h; AET: 1.1 ± 0.6 km/h, P error probability = 0.7). The general upward trend was mainly accounted for by a negative association of irisin concentration with the storage duration of frozen serum samples (P storage of samples from initial tests.

Preliminary design package for solar heating and hot water system

Science.gov (United States)

1976-01-01

Two prototype solar heating and hot water systems for use in single-family dwellings or commercial buildings were designed. Subsystems included are: collector, storage, transport, hot water, auxiliary energy, and government-furnished site data acquisition. The systems are designed for Yosemite, California, and Pueblo, Colorado. The necessary information to evaluate the preliminary design for these solar heating and hot water systems is presented. Included are a proposed instrumentation plan, a training program, hazard analysis, preliminary design drawings, and other information about the design of the system.

Medical Engineering and Microneurosurgery: Application and Future.

Science.gov (United States)

Morita, Akio; Sora, Shigeo; Nakatomi, Hirofumi; Harada, Kanako; Sugita, Naohiko; Saito, Nobuhito; Mitsuishi, Mamoru

2016-10-15

Robotics and medical engineering can convert traditional surgery into digital and scientific procedures. Here, we describe our work to develop microsurgical robotic systems and apply engineering technology to assess microsurgical skills. With the collaboration of neurosurgeons and an engineering team, we have developed two types of microsurgical robotic systems. The first, the deep surgical systems, enable delicate surgical procedures such as vessel suturing in a deep and narrow space. The second type allows for super-fine surgical procedures such as anastomosing artificial vessels of 0.3 mm in diameter. Both systems are constructed with master and slave manipulator robots connected to local area networks. Robotic systems allowed for secure and accurate procedures in a deep surgical field. In cadaveric models, these systems showed a good potential of being useful in actual human surgeries, but mechanical refinements in thickness and durability are necessary for them to be established as clinical systems. The super-fine robotic system made the very intricate surgery possible and will be applied in clinical trials. Another trial included the digitization of surgical technique and scientific analysis of surgical skills. Robotic and human hand motions were analyzed in numerical fashion as we tried to define surgical skillfulness in a digital format. Engineered skill assessment is also feasible and should be useful for microsurgical training. Robotics and medical engineering should bring science into the surgical field and training of surgeons. Active collaboration between medical and engineering teams and academic and industry groups is mandatory to establish such medical systems to improve patient care.

Superfund Hazard Ranking System Training Course

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The Hazard Ranking System (HRS) training course is a four and ½ day, intermediate-level course designed for personnel who are required to compile, draft, and review preliminary assessments (PAs), site inspections (SIs), and HRS documentation records/packag

Simulation training for emergency obstetric and neonatal care in Senegal preliminary results.

Science.gov (United States)

Gueye, M; Moreira, P M; Faye-Dieme, M E; Ndiaye-Gueye, M D; Gassama, O; Kane-Gueye, S M; Diouf, A A; Niang, M M; Diadhiou, M; Diallo, M; Dieng, Y D; Ndiaye, O; Diouf, A; Moreau, J C

2017-06-01

To describe a new training approach for emergency obstetric and neonatal care (EmONC) introduced in Senegal to strengthen the skills of healthcare providers. The approach was based on skills training according to the so-called "humanist" method and on "lifesaving skills". Simulated practice took place in the classroom through 13 clinical stations summarizing the clinical skills needed for EmONC. Evaluation took place in all phases, and the results were recorded in a database to document the progress of each learner. This approach was used to train 432 providers in 10 months and to document the increase in each participants' technical achievements. The combination of training with the "learning by doing" model ensured that providers learned and mastered all EmONC skills and reduced the missed learning opportunities observed in former EmONC training sessions. Assessing the impact of training on EmONC indicators and introducing this learning modality in basic training are the two major challenges we currently face.

Evaluation of train-speed control algorithms

Energy Technology Data Exchange (ETDEWEB)

Slavik, M.M. [BKS Advantech (Pty.) Ltd., Pretoria (South Africa)

2000-07-01

A relatively simple and fast simulator has been developed and used for the preliminary testing of train cruise-control algorithms. The simulation is done in software on a PC. The simulator is used to gauge the consequences and feasibility of a cruise-control strategy prior to more elaborate testing and evaluation. The tool was used to design and pre-test a train-cruise control algorithm called NSS, which does not require knowledge of exact train mass, vertical alignment, or actual braking force. Only continuous measurements on the speed of the train and electrical current are required. With this modest input, the NSS algorithm effected speed changes smoothly and efficiently for a wide range of operating conditions. (orig.)

Alternative Approach to Traumatic Stensen’s Duct Injuries Accompanied by Glandular Involvement: Botulinum Toxin Injection to the Gland in Conjunction with Microsurgical Repair of the Duct in an Acute Setting

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Mert Çalış

2017-12-01

Full Text Available Objective: The aim of this study was to evaluate the long-term results of a simultaneous application of botulinum toxin to the parotid gland in conjunction with the microsurgical repair of the duct in an acute setting and to encourage using botulinum toxin as a first-line option to prevent future complications associated with glandular involvement. Material and Methods: Three patients who were referred to the Plastic Surgery Clinic by the emergency room of the Hacettepe University Hospital after maxillofacial trauma are reviewed in this study. Exploration of the facial nerve and Stensen’s duct was planned for all patients within the first 72 hours after their injuries. After intraoral catheterization of the Stensen’s duct through the papilla using an epidural catheter, microsurgical end-to-end anastomosis was performed. Concurrently, 100 units of botulinum toxin A was injected at standardized eight points to the parotid gland. Results: Postoperative magnetic resonance (MR sialography revealed patency in all patients at the end of postoperative first year. The mean postoperative parotid volume of the injured and non-injured sides were 19.82±10.55 cm3 and 17.79±10.98 cm3, respectively, and the results were found to be comparable. Fibrillation potentials in the postoperative electromyography recordings and clinical examination demonstrated nerve regeneration. Conclusion: Botulinum toxin A appears to be effective in treating duct injuries accompanied by glandular involvement in an acute setting, as well as in preventing long-term complications.

Initiation and preliminary evaluation of an oncology pharmacy training course for staff pharmacists.

Science.gov (United States)

Saylor, Matthew S; Blanchette, Lisa M; Smith, Morgan B; Cambron, Katie; Andricopulos, Katie; Brown, M Jay

2016-08-01

There is currently a disparity between oncology pharmacy job openings and PGY2 trained pharmacists completing residency training each year. As a result, pharmacists without specialized training in oncology are filling much needed oncology positions and may need on-the-job oncology training. To improve oncology knowledge among non-PGY2 trained pharmacists working in oncology positions, Novant Health coordinated an Oncology Pharmacy Training Course (OPTC). The primary objective was to assess efficacy of the OPTC through evaluation of post-intervention oncology knowledge. Secondary objectives included efficacy of each lecture, assessment of knowledge improvement in those with and without residency or chemotherapy training, and assessment of satisfaction with the OPTC. This was a prospective, cohort study. All pharmacists expressing interest in the OPTC were included unless PGY2 oncology residency trained or Board-Certified in Oncology Pharmacy (BCOP). Participants were invited to attend twice monthly lectures and were evaluated using questionnaires at baseline, 1, 3, 6, and 12 months. At the 3-month evaluation, 29 pharmacists completed the per-protocol evaluation. Knowledge scores increased from a mean of 29.6% to 52.2% (p trained. Baseline knowledge scores were slightly higher in the chemotherapy-trained than training naïve participants (mean 42.5% vs. 27.4%). Both groups experienced significantly improved knowledge scores at 3 months (mean 59% and 48.1% respectively, p staff pharmacists in a community hospital system. This improvement in knowledge is consistent regardless of baseline chemotherapy training. © The Author(s) 2015.

Views of physicians in training on the ethical and legal issues in preliminary reporting of echocardiographic data.

Science.gov (United States)

McDonald, R W; Rice, M J; Marcella, C P; Reller, M D; Imus, R L

1991-01-01

Cardiac sonographers may be pressured by physicians into giving diagnostic interpretations of echocardiographic data. This study investigated the issue of preliminary reporting of echocardiographic data. A questionnaire was sent to 292 physicians; 85 physicians (29%) responded. Seventy-two physicians (87%) thought they had more than a minimal knowledge of echocardiography, 94% wanted a written or verbal preliminary report, and 84% thought that giving a preliminary report should be part of the cardiac sonographer's job. If abnormalities were found, 80% wanted the results before a cardiologist reviewed the study, and 56% would want a diagnostic rather than a descriptive report. Fifty-four physicians (64%) would pressure the cardiac sonographer into giving a preliminary echocardiographic report and would use this information to manage the patient. The majority of the physicians thought that it is legal for the cardiac sonographer to give a preliminary echocardiogram report. Eighty percent said that the cardiac sonographer would not be "practicing medicine without a license," and 82% that the sonographer would not be "aiding and abetting the unauthorized practice of medicine." This data would indicate that physicians at Oregon Health Sciences University want the cardiac sonographer to give preliminary echocardiographic results, even though the sonographer may be breaking state statutes.

Digital Skill Training Research: Preliminary Guidelines for Distributed Learning

National Research Council Canada - National Science Library

Childs, Jerry

2001-01-01

This task was aimed at the development of guidelines for distributed learning (DL). A matrix was generated to evaluate the effectiveness of various DL media for training representative knowledge/skill types...

The second stage of long-term training in team games: experimental assessment of traditional training system

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Maksimenko I.G

2010-03-01

Full Text Available The features of construction of the traditional system of preparation of young sportsmen are certain on the stage of the preliminary base training. In researches 200 players took part in age 12-15 years. The indexes of frequency of cardiac rhythm, expenses of energy, competition activity of young sportsmen are presented. Indexes are fixed during implementation of the different typical trainings programs, participating in bilateral and official games. The typical rations of feed are analysed. The results of deep medical inspection are rotined.

Extending brain-training to the affective domain: increasing cognitive and affective executive control through emotional working memory training.

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Susanne Schweizer

Full Text Available So-called 'brain-training' programs are a huge commercial success. However, empirical evidence regarding their effectiveness and generalizability remains equivocal. This study investigated whether brain-training (working memory [WM] training improves cognitive functions beyond the training task (transfer effects, especially regarding the control of emotional material since it constitutes much of the information we process daily. Forty-five participants received WM training using either emotional or neutral material, or an undemanding control task. WM training, regardless of training material, led to transfer gains on another WM task and in fluid intelligence. However, only brain-training with emotional material yielded transferable gains to improved control over affective information on an emotional Stroop task. The data support the reality of transferable benefits of demanding WM training and suggest that transferable gains across to affective contexts require training with material congruent to those contexts. These findings constitute preliminary evidence that intensive cognitively demanding brain-training can improve not only our abstract problem-solving capacity, but also ameliorate cognitive control processes (e.g. decision-making in our daily emotive environments.

Group training in interpersonal problem-solving skills for workplace adaptation of adolescents and adults with Asperger syndrome: a preliminary study.

Science.gov (United States)

Bonete, Saray; Calero, María Dolores; Fernández-Parra, Antonio

2015-05-01

Adults with Asperger syndrome show persistent difficulties in social situations which psychosocial treatments may address. Despite the multiple studies focusing on social skills interventions, only some have focused specifically on problem-solving skills and have not targeted workplace adaptation training in the adult population. This study describes preliminary data from a group format manual-based intervention, the Interpersonal Problem-Solving for Workplace Adaptation Programme, aimed at improving the cognitive and metacognitive process of social problem-solving skills focusing on typical social situations in the workplace based on mediation as the main strategy. A total of 50 adults with Asperger syndrome received the programme and were compared with a control group of typical development. The feasibility and effectiveness of the treatment were explored. Participants were assessed at pre-treatment and post-treatment on a task of social problem-solving skills and two secondary measures of socialisation and work profile using self- and caregiver-report. Using a variety of methods, the results showed that scores were significantly higher at post-treatment in the social problem-solving task and socialisation skills based on reports by parents. Differences in comparison to the control group had decreased after treatment. The treatment was acceptable to families and subject adherence was high. The Interpersonal Problem-Solving for Workplace Adaptation Programme appears to be a feasible training programme. © The Author(s) 2014.

Game-Based Virtual Reality Canoe Paddling Training to Improve Postural Balance and Upper Extremity Function: A Preliminary Randomized Controlled Study of 30 Patients with Subacute Stroke.

Science.gov (United States)

Lee, Myung Mo; Lee, Kyeong Jin; Song, Chang Ho

2018-04-27

BACKGROUND Virtual reality (VR) training with motion-controlled console games can be incorporated into stroke rehabilitation programs. The use of a variety of gaming software can provide the patient with an opportunity to perform activities that are exciting, entertaining, and that may not be feasible in clinical environments. The aim of this preliminary randomized controlled study was to investigate the effects of game-based VR canoe paddling training, when combined with conventional physical rehabilitation programs, on postural balance and upper extremity function in 30 patients with subacute stroke. MATERIAL AND METHODS Thirty patients, who were within six months following the diagnosis of stroke, were randomly allocated to either the experimental group (n=15) or the control group (n=15). All participants participated in a conventional rehabilitation program. Also, the experimental group (n=15) performed the VR canoe paddling training for 30 minutes each day, three times per week, for five weeks. After five weeks, outcomes of changes in postural balance and upper extremity function were evaluated and compared between the two groups. RESULTS At five weeks, postural balance and upper extremity function showed significant improvements in both patients groups when compared with the baseline measurements (pGame-based VR canoe paddling training is an effective rehabilitation therapy that enhances postural balance and upper extremity function in patients with subacute stroke when combined with conventional physical rehabilitation programs.

Automated Motor Skills Training Optimized for Individual Differences.

Science.gov (United States)

1980-11-01

Several preliminary applications of adaptive training to I complex synthetic flight trainers have been attempted (Loses, I ,5 I Ellis, Norman , and Matheny...Association, San Francisco, 1976. Lowes, A. H., Ellis, N. C., Norman , D. A., and Matheny, W. 3. Improving piloting skills in turbulent air using a self...intercept observer. Orlando, Florida: Naval Training Equipment Center, NAVTRAEQUIPCEN 71-C-6219-1, 1973. Smallwood , R. D. A decision structure for

Progression of vestibular schawnnoma after GammaKnife radiosurgery: A challenge for microsurgical resection.

Science.gov (United States)

Aboukaïs, Rabih; Bonne, Nicolas-Xavier; Touzet, Gustavo; Vincent, Christophe; Reyns, Nicolas; Lejeune, Jean-Paul

2018-05-01

We aimed to evaluate the outcome of patients who underwent salvage microsurgery for vestibular schwannoma (VS) that failed primary Gammaknife radiosurgery (GKS). Among the 1098 patients who received GKS for the treatment of VS in our center between January 2004 and December 2012, the follow-up was organized in our institution for 290 patients who lived in our recruitment area. Tumor progression was noted in 23 patients. A salvage microsurgical resection was performed in 11 patients, who were included in our study. Grading of facial function was done according to the House & Brackman scale. The mean age at diagnosis was 50.2 years (19-68 years) and the mean follow-up was 9.4 years (4-13 years). The mean dose was 11.8 Gy (11-12 Gy) and the mean volume was 922 mm3 (208-2500 mm3). The mean period between GKS and diagnosis of tumor progression was 32 months (18-72 months). Concerning salvage microsurgery, complete resection was obtained in 8 patients. Small residual tumor on the facial nerve was deliberately left in 3 patients and no tumor progression was noted with a mean follow-up of 26 months. At last follow-up, facial nerve function was grade 1 in 4 patients, grade 2 in 3 patients, grade 3 in 1 patient and grade 4 in 3 patients. Salvage surgery of recurrent vestibular schwannoma after failed initial GKS remains a good treatment. However, facial nerve preservation is more challenging in this case and small tumor remnant could be sometimes deliberately left. Copyright © 2018 Elsevier B.V. All rights reserved.

Surgical planning for microsurgical excision of cerebral arterio-venous malformations using virtual reality technology.

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Ng, Ivan; Hwang, Peter Y K; Kumar, Dinesh; Lee, Cheng Kiang; Kockro, Ralf A; Sitoh, Y Y

2009-05-01

To evaluate the feasibility of surgical planning using a virtual reality platform workstation in the treatment of cerebral arterio-venous malformations (AVMs) Patient-specific data of multiple imaging modalities were co-registered, fused and displayed as a 3D stereoscopic object on the Dextroscope, a virtual reality surgical planning platform. This system allows for manipulation of 3D data and for the user to evaluate and appreciate the angio-architecture of the nidus with regards to position and spatial relationships of critical feeders and draining veins. We evaluated the ability of the Dextroscope to influence surgical planning by providing a better understanding of the angio-architecture as well as its impact on the surgeon's pre- and intra-operative confidence and ability to tackle these lesions. Twenty four patients were studied. The mean age was 29.65 years. Following pre-surgical planning on the Dextroscope, 23 patients underwent microsurgical resection after pre-surgical virtual reality planning, during which all had documented complete resection of the AVM. Planning on the virtual reality platform allowed for identification of critical feeders and draining vessels in all patients. The appreciation of the complex patient specific angio-architecture to establish a surgical plan was found to be invaluable in the conduct of the procedure and was found to enhance the surgeon's confidence significantly. Surgical planning of resection of an AVM with a virtual reality system allowed detailed and comprehensive analysis of 3D multi-modality imaging data and, in our experience, proved very helpful in establishing a good surgical strategy, enhancing intra-operative spatial orientation and increasing surgeon's confidence.

Trade-off results and preliminary designs of Near-Term Hybrid Vehicles

Science.gov (United States)

Sandberg, J. J.

1980-01-01

Phase I of the Near-Term Hybrid Vehicle Program involved the development of preliminary designs of electric/heat engine hybrid passenger vehicles. The preliminary designs were developed on the basis of mission analysis, performance specification, and design trade-off studies conducted independently by four contractors. THe resulting designs involve parallel hybrid (heat engine/electric) propulsion systems with significant variation in component selection, power train layout, and control strategy. Each of the four designs is projected by its developer as having the potential to substitute electrical energy for 40% to 70% of the petroleum fuel consumed annually by its conventional counterpart.

Using a site-specific technical error to establish training responsiveness: a preliminary explorative study.

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Weatherwax, Ryan M; Harris, Nigel K; Kilding, Andrew E; Dalleck, Lance C

2018-01-01

Even though cardiorespiratory fitness (CRF) training elicits numerous health benefits, not all individuals have positive training responses following a structured CRF intervention. It has been suggested that the technical error (TE), a combination of biological variability and measurement error, should be used to establish specific training responsiveness criteria to gain further insight on the effectiveness of the training program. To date, most training interventions use an absolute change or a TE from previous findings, which do not take into consideration the training site and equipment used to establish training outcomes or the specific cohort being evaluated. The purpose of this investigation was to retrospectively analyze training responsiveness of two CRF training interventions using two common criteria and a site-specific TE. Sixteen men and women completed two maximal graded exercise tests and verification bouts to identify maximal oxygen consumption (VO 2 max) and establish a site-specific TE. The TE was then used to retrospectively analyze training responsiveness in comparison to commonly used criteria: percent change of >0% and >+5.6% in VO 2 max. The TE was found to be 7.7% for relative VO 2 max. χ 2 testing showed significant differences in all training criteria for each intervention and pooled data from both interventions, except between %Δ >0 and %Δ >+7.7% in one of the investigations. Training nonresponsiveness ranged from 11.5% to 34.6%. Findings from the present study support the utility of site-specific TE criterion to quantify training responsiveness. A similar methodology of establishing a site-specific and even cohort specific TE should be considered to establish when true cardiorespiratory training adaptations occur.

Effects of palliative care training program on knowledge, attitudes, beliefs and experiences among student physiotherapists: A preliminary quasi-experimental study

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Senthil P Kumar

2011-01-01

Full Text Available Background: Physiotherapists play an inherent role in the multidisciplinary palliative care team. Existing knowledge, attitudes, beliefs and experiences influence their team participation in palliative care. Aims: The objective of this study was to assess the changes in knowledge, attitudes, beliefs and experiences among student physiotherapists who attended a palliative care training program. Settings and Design: Preliminary quasi-experimental study design, conducted at an academic institution. Materials and Methods: Fifty-two student physiotherapists of either gender (12 male, 40 female of age (20.51±1.78 years who attended a palliative care training program which comprised lectures and case examples of six-hours duration participated in this study. The study was performed after getting institutional approval and obtaining participants′ written informed consent. The lecture content comprised WHO definition of palliative care, spiritual aspects of life, death and healing, principles, levels and models of palliative care, and role of physiotherapists in a palliative care team. The physical therapy in palliative care-knowledge, attitudes, beliefs and experiences scale (PTiPC-KABE Scale- modified from palliative care attitudes scale were used for assessing the participants before and after the program. Statistical Analysis: Paired t-test and Wilcoxon signed rank test at 95% confidence interval using SPSS 11.5 for Windows. Results: Statistically significant differences (P<0.05 were noted for all four subscales- knowledge (7.84±4.61 points, attitudes (9.46±8.06 points, beliefs (4.88±3.29 points and experiences (15.8±11.28 points out of a total score of 104 points. Conclusions: The focus-group training program produced a significant positive change about palliative care in knowledge, attitudes, beliefs and experiences among student physiotherapists.

Methods of Physical Recreation of Students Trained in Kickboxing Section

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C. А. Пашкевич

2016-09-01

Full Text Available Research objective: to evaluate the effectiveness of implementing sports massage in recreation of kickboxing students to improve their sports performance. Materials and methods. The research used: review and analysis of literature, pedagogical observations, physiological (relay test, strength endurance test, fatigue intensity assessment and statistical methods. The participants of the research were three groups (5 persons in each group. The first group of students (C1 received preliminary warming massage (20 min, the second group (C2 received recreational massage after the training (20 min, the third group (C3 had passive rest before and after the training (20 min. Before and after the massage session, assessment of the response rate and strength endurance took place three times during the training (at the beginning, in the middle, and at the end with regard to the level of the students’ fatigue intensity during the training. For the rough evaluation of the cause-effect relationship between the influencing factor and the effect appearance, the research used the relative risk indicator (RR. Research results. The sports massage reduced the athletes’ fatigue during the training (RR = 5.0, p < 0.05, i.e. the coach could increase the training load without any significant impact on the functional systems of the athletes. The preliminary massage had a more distinct positive effect on the students’ response rate and endurance indicators. The recreational massage improved only the students’ endurance processes during the training.

Introducing handheld computing into a residency program: preliminary results from qualitative and quantitative inquiry.

OpenAIRE

Manning, B.; Gadd, C. S.

2001-01-01

Although published reports describe specific handheld computer applications in medical training, we know very little yet about how, and how well, handheld computing fits into the spectrum of information resources available for patient care and physician training. This paper reports preliminary quantitative and qualitative results from an evaluation study designed to track changes in computer usage patterns and computer-related attitudes before and after introduction of handheld computing. Pre...

Superfund Hazard Ranking System Training Course: Table of Contents

Science.gov (United States)

The Hazard Ranking System (HRS) training course is a four and ½ day, intermediate-level course designed for personnel who are required to compile, draft, and review preliminary assessments (PAs), site inspections (SIs), and HRS documentation records/packag

A preliminary study of cognitive-behavioral family-based treatment versus parent training for young children with obsessive-compulsive disorder.

Science.gov (United States)

Rosa-Alcázar, Ana I; Iniesta-Sepúlveda, Marina; Storch, Eric A; Rosa-Alcázar, Ángel; Parada-Navas, José L; Olivares Rodríguez, José

2017-01-15

Cognitive-Behavioral Family-Based Treatment (CBFT) is the standard of care in young children with OCD. Developmental considerations, parent desires, and cost-effective advantages motivate research to explore the relative efficacy of parent-only interventions. The main goal in this study was to test the effectiveness and feasibility of a parent only intervention for OCD in young children, comparing, in a preliminary fashion the relative efficacy of reducing obsessive-compulsive symptoms through two treatment conditions: 1) an individual CBFT for early OCD involving both parents and children, and 2) the family component of the intervention involving only individual Parent Training (PT). Twenty treatment-seeking families from two private outpatient clinics in Spain were alternately assigned to one of the two treatment conditions. Participants had a primary diagnosis of OCD and a mean age of 6.62 years (65% males). Interventions were conducted by the same therapist and the assessments were administered by independent clinicians who were blind to the experimental conditions of the participants. Assessment time-points were pretreatment, posttreatment, and 3-month follow-up (including diagnosis, symptom severity, global functioning, family accommodation, externalizing and internalizing symptoms, and satisfaction measures). The two ways of implementation, involving child and parents (CBFT) or involving only parents (PT), produced clinical improvements and were well-accepted by parents and children. The CBFT condition was superior to the PT condition in reducing externalizing problems. reduced sample size and absence of randomization were the main limitations of this study. these results suggest, in a preliminary manner, that the need to have the child present at session with the clinician could be decreased for some children, as well as the overall feasibility of working only with parents for the implementation of CBT for OCD in very young children. Copyright © 2016

Long-term visual outcome after microsurgical removal of occipital lobe cavernomas.

Science.gov (United States)

Kivelev, Juri; Koskela, Elina; Setälä, Kirsi; Niemelä, Mika; Hernesniemi, Juha

2012-08-01

Cavernomas in the occipital lobe are relatively rare. Because of the proximity to the visual cortex and incoming subcortical tracts, microsurgical removal of occipital cavernomas may be associated with a risk of visual field defects. The goal of the study was to analyze long-term outcome after operative treatment of occipital cavernomas with special emphasis on visual outcome. Of the 390 consecutive patients with cavernomas who were treated at Helsinki University Central Hospital between 1980 and 2011, 19 (5%) had occipital cavernomas. Sixteen patients (4%) were surgically treated and are included in this study. The median age was 39 years (range 3-59 years). Seven patients (56%) suffered from hemorrhage preoperatively, 5 (31%) presented with visual field deficits, 11 (69%) suffered from seizures, and 4 (25%) had multiple cavernomas. Surgery was indicated for progressive neurological deterioration. The median follow-up after surgery was 5.25 years (range 0.5-14 years). All patients underwent thorough neuroophthalmological assessment to determine visual outcome after surgery. Visual fields were classified as normal, mild homonymous visual field loss (not disturbing the patient, driving allowed), moderate homonymous visual field loss (disturbing the patient, driving prohibited), and severe visual field loss (total homonymous hemianopia or total homonymous quadrantanopia). At the last follow-up, 4 patients (25%) had normal visual fields, 6 (38%) had a mild visual field deficit, 1 (6%) complained of moderate visual field impairment, and 5 (31%) had severe homonymous visual field loss. Cavernomas seated deeper than 2 cm from the pial surface carried a 4.4-fold risk of postoperative visual field deficit relative to superficial ones (p = 0.034). Six (55%) of the 11 patients presenting with seizures were seizure-free postoperatively. Eleven (69%) of 16 patients had no disability during the long-term follow-up. Surgical removal of occipital cavernomas may carry a

Effectiveness of a psychoeducational skill training DVD program to reduce stress in Chinese American dementia caregivers: results of a preliminary study.

Science.gov (United States)

Gallagher-Thompson, Dolores; Wang, Peng-Chih; Liu, Weiling; Cheung, Vinnie; Peng, Rebecca; China, Danielle; Thompson, Larry W

2010-04-01

Prior research (Gallagher-Thompson, D., Gray, H., Tang, P., Pu, C.-Y., Tse, C., Hsu, S., et al. (2007). Impact of in-home intervention versus telephone support in reducing depression and stress of Chinese caregivers: Results of a pilot study. American Journal of Geriatric Psychiatry, 15, 425-434.) found that an in-home behavioral management program, derived conceptually from cognitive behavioral theories (CBT), was effective in reducing caregiver related stress and depressive symptoms in Chinese American dementia caregivers (CGs). Results were promising, but a more cost-effective intervention is needed to serve this growing population. Past work also found that a psychoeducational videotaped training program based on CBT was effective in reducing stress due to caregiving in Caucasian and African American dementia family CGs (Steffen, 2000, Anger management for dementia caregivers: A preliminary study using video and telephone interventions. Behavior Therapy, 31, 281-299.). To date no research has been conducted using a technological medium to deliver a similar kind of intervention to Chinese American caregivers. The present study evaluated the effectiveness of a similar but culturally "tailored" program in which 70 CGs were randomly assigned to a 12-week CBT skill training program delivered on a DVD, or to a general educational DVD program on dementia. Both were available in Mandarin Chinese or English as preferred. Pre post change analyses indicated that CGs did not differ on change in level of negative depressive symptoms, but positive affect was higher, and patient behaviors were appraised as less stressful and bothersome, for CGs in the CBT skill training program. They were also more satisfied with the program overall and reported that they believed they were able to give care more effectively. Results encourage further development of theoretically based interventions, delivered using modern technology, for this ever increasing group of CGs.

Microsurgery Workout: A Novel Simulation Training Curriculum Based on Nonliving Models.

Science.gov (United States)

Rodriguez, Jose R; Yañez, Ricardo; Cifuentes, Ignacio; Varas, Julian; Dagnino, Bruno

2016-10-01

Currently, there are no valid training programs based solely on nonliving models. The authors aimed to develop and validate a microsurgery training program based on nonliving models and assess the transfer of skills to a live rat model. Postgraduate year-3 general surgery residents were assessed in a 17-session program, performing arterial and venous end-to-end anastomosis on ex vivo chicken models. Procedures were recorded and rated by two blinded experts using validated global and specific scales (objective structured assessment of technical skills) and a validated checklist. Operating times and patency rates were assessed. Hand-motion analysis was used to measure economy of movements. After training, residents performed an arterial and venous end-to-end anastomosis on live rats. Results were compared to six experienced surgeons in the same models. Values of p < 0.05 were considered statistically significant. Learning curves were achieved. Ten residents improved their median global and specific objective structured assessment of technical skills scores for artery [10 (range, 8 to 10) versus 28 (range, 27 to 29), p < 0.05; and 8 (range, 7 to 9) versus 28 (range, 27 to 28), p < 0.05] and vein [8 (range, 8 to 11) versus 28 (range, 27 to 28), p < 0.05; and 8 (range, 7 to 9) versus 28 (range, 27 to 29), p < 0.05]. Checklist scores also improved for both procedures (p < 0.05). Trainees were slower and less efficient than experienced surgeons (p < 0.05). In the living rat, patency rates at 30 minutes were 100 percent and 50 percent for artery and vein, respectively. Significant acquisition of microsurgical skills was achieved by trainees to a level similar to that of experienced surgeons. Acquired skills were transferred to a more complex live model.

Training Technology Handbook for System Acquisition Planners: Preliminary Version.

Science.gov (United States)

1981-09-01

ION ALL COINTROLS XIAPNL IN VIH €1U11T- OPTIMALLY L OCALIs T-I E ElsA IEI MALFUNCTIOW TO THE CO--- INRT o I*LEVEL TWDE O IS EDS TEAR DOE %AIll ow...contact EXAMPLE OF HOW Tl lS SECTION SHOULD BE FOLLOWED the Chief of Navy Education and Training (CNET) for assistance and/or referral. ISTE CNET is

A Preliminary Review of Fatigue Among Rail Staff

Directory of Open Access Journals (Sweden)

Jialin Fan

2018-05-01

Full Text Available Background: Fatigue is a severe problem in the rail industry, which may jeopardize train crew's health and safety. Nonetheless, a preliminary review of all empirical evidence for train crew fatigue is still lacking. The aim of the present paper is, therefore, to provide a preliminary description of occupational fatigue in the rail industry. This paper reviews the literature with the research question examining the risk factors associated with train crew fatigue, covering both papers published in refereed journals and reports from trade organizations and regulators. It assesses the progress of research on railway fatigue, including research on the main risk factors for railway fatigue, the association between fatigue and railway incidents, and how to better manage fatigue in the railway industry.Methods: Systematic searches were performed in both science and industry databases. The searches considered studies published before August 2017. The main exclusion criterion was fatigue not being directly measured through subjective or objective methods.Results: A total of 31 studies were included in the main review. The causes of fatigue included long working hours, heavy workload, early morning or night shifts, and insufficient sleep. Poor working environment, particular job roles, and individual differences also contributed to fatigue.Conclusion: Fatigue in the rail industry includes most of the features of occupational fatigue, and it is also subject to industry-specific factors. The effect of fatigue on well-being and the fatigued population in the railway industry are still not clear. Future studies can consider associations between occupational risk factors and perceived fatigue by examining the prevalence of fatigue and identifying the potential risk factors in staff within the railway industry.

Synergy Repetition Training versus Task Repetition Training in Acquiring New Skill.

Science.gov (United States)

Patel, Vrajeshri; Craig, Jamie; Schumacher, Michelle; Burns, Martin K; Florescu, Ionut; Vinjamuri, Ramana

2017-01-01

Traditionally, repetitive practice of a task is used to learn a new skill, exhibiting as immediately improved performance. Research suggests, however, that a more experience-based rather than exposure-based training protocol may allow for better transference of the skill to related tasks. In synergy-based motor control theory, fundamental motor skills, such as hand grasping, are represented with a synergy subspace that captures essential motor patterns. In this study, we propose that motor-skill learning through synergy-based mechanisms may provide advantages over traditional task repetition learning. A new task was designed to highlight the range of motion and dexterity of the human hand. Two separate training strategies were tested in healthy subjects: task repetition training and synergy training versus a control. All three groups showed improvements when retested on the same task. When tested on a similar, but different set of tasks, only the synergy group showed improvements in accuracy (9.27% increase) compared to the repetition (3.24% decline) and control (3.22% decline) groups. A kinematic analysis revealed that although joint angular peak velocities decreased, timing benefits stemmed from the initial feed-forward portion of the task (reaction time). Accuracy improvements may have derived from general improved coordination among the four involved fingers. These preliminary results warrant further investigation of synergy-based motor training in healthy individuals, as well as in individuals undergoing hand-based rehabilitative therapy.

Cognitive Task Analysis of Business Jet Pilots' Weather Flying Behaviors: Preliminary Results

Science.gov (United States)

Latorella, Kara; Pliske, Rebecca; Hutton, Robert; Chrenka, Jason

2001-01-01

This report presents preliminary findings from a cognitive task analysis (CTA) of business aviation piloting. Results describe challenging weather-related aviation decisions and the information and cues used to support these decisions. Further, these results demonstrate the role of expertise in business aviation decision-making in weather flying, and how weather information is acquired and assessed for reliability. The challenging weather scenarios and novice errors identified in the results provide the basis for experimental scenarios and dependent measures to be used in future flight simulation evaluations of candidate aviation weather information systems. Finally, we analyzed these preliminary results to recommend design and training interventions to improve business aviation decision-making with weather information. The primary objective of this report is to present these preliminary findings and to document the extended CTA methodology used to elicit and represent expert business aviator decision-making with weather information. These preliminary findings will be augmented with results from additional subjects using this methodology. A summary of the complete results, absent the detailed treatment of methodology provided in this report, will be documented in a separate publication.

Effects of robotic treadmill training on functional mobility, walking capacity, motor symptoms and quality of life in ambulatory patients with Parkinson's disease: a preliminary prospective longitudinal study.

Science.gov (United States)

Paker, Nurdan; Bugdayci, Derya; Goksenoglu, Goksen; Sen, Aysu; Kesiktas, Nur

2013-01-01

preliminary study, robotic treadmill training was useful to improve the functional mobility, walking capacity and motor symptoms in mild to moderate PD. Robotic treadmill training provided a transient improvement in the quality of life during the treatment.

Personal Computer-less (PC-less) Microcontroller Training Kit

Science.gov (United States)

Somantri, Y.; Wahyudin, D.; Fushilat, I.

2018-02-01

The need of microcontroller training kit is necessary for practical work of students of electrical engineering education. However, to use available training kit not only costly but also does not meet the need of laboratory requirements. An affordable and portable microcontroller kit could answer such problem. This paper explains the design and development of Personal Computer Less (PC-Less) Microcontroller Training Kit. It was developed based on Lattepanda processor and Arduino microcontroller as target. The training kit equipped with advanced input-output interfaces that adopted the concept of low cost and low power system. The preliminary usability testing proved this device can be used as a tool for microcontroller programming and industrial automation training. By adopting the concept of portability, the device could be operated in the rural area which electricity and computer infrastructure are limited. Furthermore, the training kit is suitable for student of electrical engineering student from university and vocational high school.

Microsurgical resection of ventral foramen magnum meningiomas via a far-lateral suboccipital approach

Institute of Scientific and Technical Information of China (English)

Zhihua Cheng; Zhilin Guo; Meixiu Ding

2006-01-01

BACKGROUND: In recent years some reports have been published propagating microsurgical resection of ventral foramen magnum meningiomas (VFMMs). Operative approaches to these lesions have been studied by various authors, but remain controversial.OBJECTIVE: To discuss the operative technique and outcome in patients with VFMMs who had been treatedvia a far lateral suboccipital approach.DESIGN: Retrospectively clinic case investigation. SElrING: Department of Neurosurgery, the Ninth People's Hospital, Medical School of Shanghai Jiao Tong University.PARTICIPANTS: Between January 1997 and June 2003, 10 patients were treated surgically with VFMMs in Department of Neurosurgery, the Ninth People's Hospital, Medical School of Shanghai Jiao Tong University. In the series of 10 patients, ages ranged from 37 to 72 years, mean (53±10) years, were consisted of 6 males and 4 females. All the subjects were informed of the treatment plan and agreed to join the experiment. Early symptoms included headache and upper cervical pain. The time between the first occurrence of symptoms and the diagnosis ranged from 6 months to 17 months, mean (10.3±3.4) months. Main presenting symptoms were unilateral upper extremity sensory and motor deficits in 6 cases, swallowing difficulties in 2 and spastic quadriparesis in 2. VFMMs were demonstrated as round by the computed tomographic (CT) scan and magnetic resonance imaging (MRI) in all patients. The maximum diameter of tumors ranged from 2 to 4 cm,mean (2.55±0.57) cm, including 2 cm in one case, 2.0-3.0 cm in six and 3.0-4.0 cm in three.METHODS: ①All tumors were removed via the far lateral suboccipital approach. Resection of the posterior 5 mm of the condyle was necessary in one patient whose tumors' diameter were 2 cm. The patient was situated in the lateral decubitus position. The head was fixed in a Mayfield headrest. A C-shaped incision made behind the ear 2 cm medial to the mastoid process, turning vertically down to the level C4, to

Anatomia microcirúrgica do hipocampo na Amígdalo-hipocampectomia seletiva sob a perspectiva da técnica de Niemeyer e método pré-operatório para maximizar a corticotomia Hippocampal microsurgical anatomy regarding the selective amygdalohippocampectomy in the Niemeyer’s technique perspective and preoperative method to maximize the corticotomy

Directory of Open Access Journals (Sweden)

Gustavo Rassier Isolan

2007-12-01

Full Text Available O conhecimento da anatomia microcirúrgica do hipocampo tem importância fundamental na cirurgia da epilepsia do lobo temporal. Uma das técnicas mais utilizadas na cirurgia da epilepsia é a técnica de Niemeyer. OBJETIVO: Descrever em detalhes a anatomia do hipocampo e mostrar uma técnica na qual pontos de referências anatômicos pré-operatórios visualizados na RNM são usados para guiar a corticotomia. MÉTODO: Foram utilizados 20 hemisférios cerebrais e 8 cadáveres para dissecções anatômicas microcirúrgicas do lobo temporal e hipocampo para identificação e descrição das principais estruturas do hipocampo. Foram estudados prospectivamente 32 pacientes com epilepsia do lobo temporal refratários ao tratamento clínico submetidos a amígdalo-hipocampectomia seletiva pela técnica de Niemeyer três parâmetros anatômicos foram mensurados na RNM pré operatória e transferidos para o ato cirúrgico. RESULTADOS: O hipocampo foi dividido em cabeça, corpo e cauda e sua anatomia microcirúrgica descrita em detalhes. As medidas adquiridas são apresentadas e discutidas. CONCLUSÃO: A complexa anatomia do hipocampo pode ser entendida de uma forma tridimensional durante dissecções microcirúrgicas. As medidas pré-operatórias mostraram-se guias anatômicos úteis para corticotomia na técnica de Niemeyer.The deep knowledge of hippocampal microsurgical anatomy is paramount in epilepsy surgery. One of the most used techniques is those proposed by Niemeyer. PURPOSE: To describe the hippocampal anatomy in details and to present a technique which preoperative anatomical points in MRI are identified to guide the corticotomy. METHOD: Microsurgical dissections were performed in twenty brain hemispheres and eight cadaveric heads to identify temporal lobe and hippocampus structures. Thirty two patients with drug-resistent temporal lobe epilepsy underwent a selective amygdalohippocampectomy with Niemeyer’s technique being measured three

Integrated Rolling Stock Planning for Suburban Passenger Trains

DEFF Research Database (Denmark)

Thorlacius, Per

used, the result being the loss of optimality. The talk will present a new, integrated rolling stock planning model in which the many requirements are handled all at the same time. Preliminary results from DSB S-tog, the suburban train operator of the City of Copenhagen will also be presented.......A central issue for operators of passenger trains is providing sufficient number of seats while minimising operating costs. This process must be conducted taking a large number of practical, railway oriented requirements into account. Because of this complexity, a stepwise solution was previously...

Influence of training and competitive sessions on peripheral β-endorphin levels in training show jumping horses.

Science.gov (United States)

Cravana, Cristina; Medica, P; Ragonese, G; Fazio, E

2017-01-01

To investigate the effects of training sessions on circulating β-endorphin changes in sport horses before and after competition and to ascertain whether competition would affect this response. A total of 24 trained jumping horses were randomly assigned to one of two training groups: Group A (competing) and Group B (not competing). To determined plasma β-endorphin concentrations, two pre- and post-competition training weeks at aerobic workout and two competitive show jumping event days at anaerobic workout were measured before, 5 and 30 min after exercise. Exercise intensity is described using lactate concentrations and heart rate. The circuit design, intensity, and duration of training sessions were the same for both groups. In Group A, one-way analysis of variance for repeated measures (RM-ANOVA) showed significant effects of exercise on β-endorphin changes (F=14.41; prelease of β-endorphin and it may depend on the duration of the exercise program. Moreover, the responses during exercise in the course of post-competition training sessions seem to be significantly different from those the pre-competition training. These data show that the preliminary competitive stress induced additional significant changes of β-endorphin pattern. It would reflect the need of a long-lasting modulation of fatigue and pain perception related to the effect of an additional physical and mental effort for the consecutive competitive and training sessions.

Simulator fidelity and training effectiveness: a comprehensive bibliography with selected annotations

International Nuclear Information System (INIS)

Rankin, W.L.; Bolton, P.A.; Shikiar, R.; Saari, L.M.

1984-05-01

This document contains a comprehensive bibliography on the topic of simulator fidelity and training effectiveness, prepared during the preliminary phases of work on an NRC-sponsored project on the Role of Nuclear Power Plant Simulators in Operator Licensing and Training. Section A of the document is an annotated bibliography consisting of articles and reports with relevance to the psychological aspects of simulator fidelity and the effectiveness of training simulators in a variety of settings, including military. The annotated items are drawn from a more comprehensive bibliography, presented in Section B, listing documents treating the role of simulators in operator training both in the nuclear industry and elsewhere

Rat allotransplantation of epigastric microsurgical flaps: a study of rejection and the immunosuppressive effect of cyclosporin A

Directory of Open Access Journals (Sweden)

Carramaschi Fábio R.

2000-01-01

Full Text Available The rejection of allotransplantation of epigastric microsurgical flaps and the effect of immunosuppression have been studied in 58 rats. Three sets of experiments were planned: (1 Wistar Furth isogenic donors and receptors (control set; (2 Brown Norway donors and Wistar Furth receptors (rejection set; and (3 Brown Norway donors and Wistar Furth immunosuppressed receptors (cyclosporin A set. Cyclosporin A (10 mg/kg/d treated rats had a transplantation survival rate of up to 30 days: 83.3% among isogenic animals and 60% among allogeneic. There was 100% rejection by the 9th day after the transplantation in allogeneic non-immunosuppressed rats. Biopsies embedded with historesin were taken from the flap and normal contralateral skin (used as control on the 3rd, 7th, 15th, and 30th days after the surgery. A quantitative study of infiltrating lymphocytes in the flaps, with and without cyclosporin A, was done by evaluating the local inflammatory infiltrate. A significant increase in the number of lymphocytes among the rejection and immunosuppressed groups was seen, as compared to the isogenic set. Local lymphocytosis in allogeneic non-immunosuppressed transplantations reached its highest level on the 3rd day after surgery, before gross findings of rejection, which could only be seen by naked eye on the 5th or 6th day. Therefore, we conclude that cyclosporin A is effective in preserving allogenic transplantation in rats. Biopsies of transplanted areas may contribute to earlier diagnosis of the need for immunosuppressive therapy.

Evaluation of Exercise Tolerance in Dialysis Patients Performing Tai Chi Training: Preliminary Study

Directory of Open Access Journals (Sweden)

Wioletta Dziubek

2016-01-01

Full Text Available Introduction. Patients with end-stage renal disease (ESRD have poor physical performance and exercise capacity due to frequent dialysis treatments. Tai Chi exercises can be very useful in the area of rehabilitation of people with ESRD. Objectives. The aim of the study was to assess exercise capacity in ESRD patients participating in 6-month Tai Chi training. Patients and Methods. Twenty dialysis patients from Wroclaw took part in the training; at the end of the project, 14 patients remained (age 69.2±8.6 years. A 6-minute walk test (6MWT and spiroergometry were performed at the beginning and after 6 months of training. Results. After 6 months of Tai Chi, significant improvements were recorded in mean distance in the 6MWT (387.89 versus 436.36 m, rate of perceived exertion (7.4 versus 4.7, and spiroergometry (8.71 versus 10.08 min. Conclusions. In the ESRD patients taking part in Tai Chi training, a definite improvement in exercise tolerance was recorded after the 6-month training. Tai Chi exercises conducted on days without dialysis can be an effective and interesting form of rehabilitation for patients, offering them a chance for a better quality of life and fewer falls and hospitalisations that are the result of it.

Training in Information Management for Army Brigade and Battalion Staff: Methods and Preliminary Findings

National Research Council Canada - National Science Library

Freeman, Jared

1997-01-01

Training, training Support software, and measurement instruments were developed to help Army brigade and below staff manage information and overcome information overload in a digital messaging environment...

Quality or Quantity: A Statement for Teacher Training in Turkey

Directory of Open Access Journals (Sweden)

Ali AZAR

2011-01-01

Full Text Available Developed countries are initiating and implementing effective and appropriate technics in the field of teacher training. In Turkey, much research has been done in order to determine the qualification of teachers and, by this way, to train qualified teachers. Ministry of Education, Turkish Council of Higher Education, Faculties of Education and Faculties of Sciences have cooperated some certification systems, however, the research which is not supported by preliminary studies but exposured to political coercions lowered the quality of education. Besides, quantity is increased by pedagogical formation programs. In this study, Turkish teacher training system is analyzed with respect to quantity and quality.

Benefits of extending and adjusting the level of difficulty on computerized cognitive training for children with intellectual disabilities.

Science.gov (United States)

Ottersen, Jon; Grill, Katja M

2015-01-01

Training on working memory (WM) improves attention and WM in children with attention-deficit hyperactivity disorder and memory impairments. However, for children with intellectual disabilities (ID), the results have been less encouraging. In this preliminary study it was hypothesized that children with ID would benefit from an extended amount of training and that the level of difficulty during training would affect the outcome. We included 21 children with mild or moderate ID aged 8-13 years. They went through between 37 and 50 training sessions with an adaptive computerized program on WM and non-verbal reasoning (NVR). The children were divided into two subgroups with different difficulty levels during training. The transfer to untrained cognitive tests was compared to the results of 22 children with ID training only 25 sessions, and to a control group. We found that the training group with the extended training program improved significantly on a block design task measuring NVR and on a WM task compared to the control group. There was also a significantly larger improvement on block design relative to the training group with the shorter training time. The children that received easier training tasks also improved significantly more on a verbal WM task compared to children with more demanding tasks. In conclusion, these preliminary data suggest that children with ID might benefit from cognitive training with longer training periods and less demanding tasks, compared to children without disabilities.

Benefits of extending and adjusting the level of difficulty on computerized cognitive training for children with intellectual disabilities

Directory of Open Access Journals (Sweden)

Jon eOttersen

2015-08-01

Full Text Available Training on working memory (WM improves attention and working memory in children with attention-deficit hyperactivity disorder and memory impairments. However, for children with intellectual disabilities (ID, the results have been less encouraging. In this preliminary study it was hypothesized that children with ID would benefit from an extended amount of training and that the level of difficulty during training would affect the outcome. We included 21 children with mild or moderate intellectual disabilities aged 8–13 years. They went through between 37 and 50 training sessions with an adaptive computerized program on WM and non-verbal reasoning (NVR. The children were divided into two subgroups with different difficulty levels during training. The transfer to untrained cognitive tests was compared to the results of 22 children with intellectual disabilities training only 25 sessions, and to a control group. We found that the training group with the extended training program improved significantly on a block design task measuring NVR and on a WM task compared to the control group. There was also a significantly larger improvement on block design relative to the training group with the shorter training time. The children that received easier training tasks also improved significantly more on a verbal WM task compared to children with more demanding tasks.In conclusion, these preliminary data suggest that children with ID might benefit from cognitive training with longer training periods and less demanding tasks, compared to children without disabilities.

Metacognitive and social cognition training (MSCT) in schizophrenia: a preliminary efficacy study.

Science.gov (United States)

Rocha, Nuno B F; Queirós, Cristina

2013-10-01

Psychosocial interventions have proven to be effective in treating social cognition in people with psychotic disorders. The current study aimed to determine the effects of a metacognitive and social cognition training (MSCT) program, designed to both remediate deficits and correct biases in social cognition. Thirty-five clinically stable outpatients were recruited and assigned to the MSCT program (n=19) for 10 weeks (18 sessions) or to the TAU group (n=16), and they all completed pre- and post-treatment assessments of social cognition, cognitive biases, functioning and symptoms. The MSCT group demonstrated a significant improvement in theory of mind, social perception, emotion recognition and social functioning. Additionally, the tendency to jump to conclusions was significantly reduced among the MSCT group after training. There were no differential benefits regarding clinical symptoms except for one trend group effect for general psychopathology. The results support the efficacy of the MSCT format, but further development of the training program is required to increase the benefits related to attributional style. © 2013 Elsevier B.V. All rights reserved.

Training teacher-librarians in KwaZulu Natal | Hoskins | Innovation

African Journals Online (AJOL)

The Advanced Certificate in Education School Library Development and Management at the University of KwaZulu-Natal was started in 2004 to train teacher-librarians. A preliminary study was done to investigate the status of school libraries in the schools from which the educators came and the use of information and ...

A Preliminary Analysis of the Outcomes of Students Assisted by VET FEE-HELP: Summary

Science.gov (United States)

National Centre for Vocational Education Research (NCVER), 2015

2015-01-01

This summary highlights the key findings from the report "A preliminary analysis of the outcomes of students assisted by VET FEE-HELP". VET FEE-HELP is an income-contingent loan scheme that assists eligible students undertaking certain vocational education training (VET) courses with an approved provider by paying for all or part of…

Processing speed and working memory training in multiple sclerosis: a double-blind randomized controlled pilot study.

Science.gov (United States)

Hancock, Laura M; Bruce, Jared M; Bruce, Amanda S; Lynch, Sharon G

2015-01-01

Between 40-65% of multiple sclerosis patients experience cognitive deficits, with processing speed and working memory most commonly affected. This pilot study investigated the effect of computerized cognitive training focused on improving processing speed and working memory. Participants were randomized into either an active or a sham training group and engaged in six weeks of training. The active training group improved on a measure of processing speed and attention following cognitive training, and data trended toward significance on measures of other domains. Results provide preliminary evidence that cognitive training with multiple sclerosis patients may produce moderate improvement in select areas of cognitive functioning.

[Intraoperative magnetic resonance imaging-guided functional neuronavigation plus intraoperative neurophysiological monitoring for microsurgical resection of lesions involving hand motor area].

Science.gov (United States)

Miao, Xing-lu; Chen, Zhi-juan; Yang, Wei-dong; Wang, Zeng-guang; Yu, Qing; Yue, Shu-yuan; Zhang, Jian-ning

2013-01-15

To explore the methods and applications of intraoperative magnetic resonance imaging (iMRI)-guided functional neuronavigation plus intraoperative neurophysiological monitoring (IONM) for microsurgical resection of lesions involving hand motor area. A total of 16 patients with brain lesions adjacent to hand motor area were recruited from January 2011 to April 2012. All of them underwent neuronavigator-assisted microsurgery. Also IONM was conducted to further map hand motor area and epileptogenic focus. High-field iMRI was employed to update the anatomical and functional imaging date and verify the extent of lesion resection. Brain shifting during the functional neuronavigation was corrected by iMRI in 5 patients. Finally, total lesion resection was achieved in 13 cases and subtotal resection in 3 cases. At Months 3-12 post-operation, hand motor function improved (n = 10) or remained unchanged (n = 6). None of them had persistent neurological deficit. The postoperative seizure improvement achieved Enge II level or above in 9 cases of brain lesions complicated with secondary epilepsy. Intraoperative MRI, functional neuronavigation and neurophysiological monitoring technique are complementary in microsurgery of brain lesions involving hand motor area. Combined use of these techniques can obtain precise location of lesions and hand motor functional structures and allow a maximum resection of lesion and minimization of postoperative neurological deficits.

[Uterine autologous transplantation in cynomolgus monkeys: a preliminary report of 6 case].

Science.gov (United States)

Wang, Yifeng; Zhu, Ying; Yu, Ping; Chen, Gaowen; Cai, Baota; Zhang, Zhengguang; Liu, Na; Lü, Xiaogang; Xiong, Juxiang; Zhong, Lijuan; Rao, Junhua

2014-12-23

To evaluate the surgical feasibility of uterine autologous transplantation in female cynomolgus monkeys and explore the effect of microsurgical technique. From May 2011 to March 2014, 6 female cynomolgus monkeys, aged 7 to 12 years, were randomly divided into 2 surgical groups. In group A, gross surgeries were performed with naked eyes. In group B, uterine re-transplantation was performed under 10-time-magnifying microscopy. Anatomical data and operative durations were recorded and analyzed. Viable uterine tissue and vascular patency were observed on trans-abdominal ultrasonography and second-look laparotomy after 3 months. The average uterus retrieval time, average vascular anastomotic time, average perfusion time and average total operative time of group B were 88.7, 147.3 and 320.0 min versus 123.7, 180.7 and 393.7 min in group A. The average perfusion durations were 35.0 and 27.3 min. And there was no inter-group difference. A total of 12 successful vascular procedures (including 6 internal iliac arteries and 6 uterine-ovary veins) of vascular anastomosis were recorded in group B versus 4 cases (including 1 artery and 3 veins) in group A (vein, P > 0.05; artery, P trans-abdominal ultrasonography and second-look laparotomy. Two survivors resumed cyclicity at days 17 and 50 respectively as a sign of re-established uterine function. This study has demonstrated the feasibility of uterus transplantation by vascular anastomosis in cynomolgus monkeys. And assistance of microsurgical technique can significantly improve the success rate of arterial anastomosis during uterus transplantation.

Effect of somatosensory and neurofeedback training on balance in older healthy adults: a preliminary investigation.

Science.gov (United States)

Azarpaikan, Atefeh; Taheri Torbati, Hamidreza

2017-10-23

The aim of this study was to assess the effectiveness of balance training with somatosensory and neurofeedback training on dynamic and static balance in healthy, elderly adults. The sample group consisted of 45 healthy adults randomly assigned to one of the three test groups: somatosensory, neurofeedback, and a control. Individualization of the balance program started with pre-tests for static and dynamic balances. Each group had 15- and 30-min training sessions. All groups were tested for static (postural stability) and dynamic balances (Berg Balance Scale) in acquisition and transfer tests (fall risk of stability and timed up and go). Improvements in static and dynamic balances were assessed by somatosensory and neurofeedback groups and then compared with the control group. Results indicated significant improvements in static and dynamic balances in both test groups in the acquisition test. Results revealed a significant improvement in the transfer test in the neurofeedback and somatosensory groups, in static and dynamic conditions, respectively. The findings suggest that these methods of balance training had a significant influence on balance. Both the methods are appropriate to prevent falling in adults. Neurofeedback training helped the participants to learn static balance, while somatosensory training was effective on dynamic balance learning. Further research is needed to assess the effects of longer and discontinuous stimulation with somatosensory and neurofeedback training on balance in elderly adults.

Preliminary design for an institutional needs assessment process to guide the development of training programs at the Department of Energy Central Training Academy

International Nuclear Information System (INIS)

Golder, T.; Laktasic, S.

1987-01-01

In order to provide and maintain a high level of nuclear security at DOE installations, the Office of Safeguards and Security (OSS) is charged with the deployment of highly trained security staff at each DOE site. Faced with this mission, OSS must ensure that both Safeguards and Security personnel are adequately trained to meet present as well as potential future insider and outside threats. A major step toward meeting this goal was to begin to standardize training, establish an elite training cadre, and create a central training facility to implement training for safeguards and security personnel. These requirements were actualized by the creation of the Central Training Academy. After a 9 month start-up and 2 years of initial operation, the CTA can now provide a historical perspective on its evolution, early program development, and future plans and challenges. Central to future program planning at the Academy is the development and implementation of an internal DOE needs assessment process which is the focus of this study. Once institutionalized, the system would allow for the Academy to accurately assess and translate OSS needs into requirements for both OSS Safeguards and Security personnel and place the Academy in position to develop and tailor Tactical and Specialized programs that reflect and respond to changing threats and technological advances

A preliminary evaluation of Acceptance and Commitment Therapy (ACT) training in Sierra Leone

OpenAIRE

Stewart, Corinna; White, Ross G.; Ebert, Beate; Mays, Iain; Nardozzi, Jennifer; Bockarie, Hannah

2016-01-01

Concerted efforts are being made to scale up psychological interventions in low and middle-income countries (LMIC). Acceptance and Commitment Therapy (ACT) aims to reduce psychological inflexibility and has been shown to be effective for treating a range of mental health difficulties. ACT training workshops have been shown to reduce the psychological inflexibility of individuals receiving training. There is a dearth of research investigating the acceptability and potential efficacy of ACT in ...

Overdose prevention training with naloxone distribution in a prison in Oslo, Norway: a preliminary study.

Science.gov (United States)

Petterson, Aase Grønlien; Madah-Amiri, Desiree

2017-11-21

Prison inmates face a ten times increased risk of experiencing a fatal drug overdose during their first 2 weeks upon release than their non-incarcerated counterparts. Naloxone, the antidote to an opioid overdose, has been shown to be feasible and effective when administered by bystanders. Given the particular risk that newly released inmates face, it is vital to assess their knowledge about opioid overdoses, as well as the impact of brief overdose prevention training conducted inside prisons. Prison inmates nearing release (within 6 months) in Oslo, Norway, voluntarily underwent a brief naloxone training. Using a questionnaire, inmates were assessed immediately prior to and following a naloxone training. Descriptive statistics were performed for main outcome variables, and the Wilcoxon signed-rank test was used to compare the participants' two questionnaire scores from pre-and post-training. Participating inmates (n = 31) were found to have a high baseline knowledge of risk factors, symptoms, and care regarding opioid overdoses. Nonetheless, a brief naloxone training session prior to release significantly improved knowledge scores in all areas assessed (p < 0.001). The training appears to be most beneficial in improving knowledge regarding the naloxone, including its use, effect, administration, and aftercare procedures. Given the high risk of overdosing that prison inmates face upon release, the need for prevention programs is critical. Naloxone training in the prison setting may be an effective means of improving opioid overdose response knowledge for this particularly vulnerable group. Naloxone training provided in the prison setting may improve the ability of inmates to recognize and manage opioid overdoses after their release; however, further studies on a larger scale are needed.

The development and preliminary testing of a multimedia patient–provider survivorship communication module for breast cancer survivors

Science.gov (United States)

Wen, Kuang-Yi; Miller, Suzanne M.; Stanton, Annette L.; Fleisher, Linda; Morra, Marion E.; Jorge, Alexandra; Diefenbach, Michael A.; Ropka, Mary E.; Marcus, Alfred C.

2012-01-01

Objective This paper describes the development of a theory-guided and evidence-based multimedia training module to facilitate breast cancer survivors’ preparedness for effective communication with their health care providers after active treatment. Methods The iterative developmental process used included: (1) theory and evidence-based content development and vetting; (2) user testing; (3) usability testing; and (4) participant module utilization. Results Formative evaluation of the training module prototype occurred through user testing (n = 12), resulting in modification of the content and layout. Usability testing (n = 10) was employed to improve module functionality. Preliminary web usage data (n = 256, mean age = 53, 94.5% White, 75% college graduate and above) showed that 59% of the participants accessed the communication module, for an average of 7 min per login. Conclusion The iterative developmental process was informative in enhancing the relevance of the communication module. Preliminary web usage results demonstrate the potential feasibility of such a program. Practice implications Our study demonstrates survivors’ openness to the use of a web-based communication skills training module and outlines a systematic iterative user and interface program development and testing process, which can serve as a prototype for others considering such an approach. PMID:22770812

The development and preliminary testing of a multimedia patient-provider survivorship communication module for breast cancer survivors.

Science.gov (United States)

Wen, Kuang-Yi; Miller, Suzanne M; Stanton, Annette L; Fleisher, Linda; Morra, Marion E; Jorge, Alexandra; Diefenbach, Michael A; Ropka, Mary E; Marcus, Alfred C

2012-08-01

This paper describes the development of a theory-guided and evidence-based multimedia training module to facilitate breast cancer survivors' preparedness for effective communication with their health care providers after active treatment. The iterative developmental process used included: (1) theory and evidence-based content development and vetting; (2) user testing; (3) usability testing; and (4) participant module utilization. Formative evaluation of the training module prototype occurred through user testing (n = 12), resulting in modification of the content and layout. Usability testing (n = 10) was employed to improve module functionality. Preliminary web usage data (n = 256, mean age = 53, 94.5% White, 75% college graduate and above) showed that 59% of the participants accessed the communication module, for an average of 7 min per login. The iterative developmental process was informative in enhancing the relevance of the communication module. Preliminary web usage results demonstrate the potential feasibility of such a program. Our study demonstrates survivors' openness to the use of a web-based communication skills training module and outlines a systematic iterative user and interface program development and testing process, which can serve as a prototype for others considering such an approach. Copyright © 2012. Published by Elsevier Ireland Ltd.

Development and validation of trauma surgical skills metrics: Preliminary assessment of performance after training.

Science.gov (United States)

Shackelford, Stacy; Garofalo, Evan; Shalin, Valerie; Pugh, Kristy; Chen, Hegang; Pasley, Jason; Sarani, Babak; Henry, Sharon; Bowyer, Mark; Mackenzie, Colin F

2015-07-01

Maintaining trauma-specific surgical skills is an ongoing challenge for surgical training programs. An objective assessment of surgical skills is needed. We hypothesized that a validated surgical performance assessment tool could detect differences following a training intervention. We developed surgical performance assessment metrics based on discussion with expert trauma surgeons, video review of 10 experts and 10 novice surgeons performing three vascular exposure procedures and lower extremity fasciotomy on cadavers, and validated the metrics with interrater reliability testing by five reviewers blinded to level of expertise and a consensus conference. We tested these performance metrics in 12 surgical residents (Year 3-7) before and 2 weeks after vascular exposure skills training in the Advanced Surgical Skills for Exposure in Trauma (ASSET) course. Performance was assessed in three areas as follows: knowledge (anatomic, management), procedure steps, and technical skills. Time to completion of procedures was recorded, and these metrics were combined into a single performance score, the Trauma Readiness Index (TRI). Wilcoxon matched-pairs signed-ranks test compared pretraining/posttraining effects. Mean time to complete procedures decreased by 4.3 minutes (from 13.4 minutes to 9.1 minutes). The performance component most improved by the 1-day skills training was procedure steps, completion of which increased by 21%. Technical skill scores improved by 12%. Overall knowledge improved by 3%, with 18% improvement in anatomic knowledge. TRI increased significantly from 50% to 64% with ASSET training. Interrater reliability of the surgical performance assessment metrics was validated with single intraclass correlation coefficient of 0.7 to 0.98. A trauma-relevant surgical performance assessment detected improvements in specific procedure steps and anatomic knowledge taught during a 1-day course, quantified by the TRI. ASSET training reduced time to complete vascular

Trained Quantity Abilities in Horses (Equus caballus: A Preliminary Investigation

Directory of Open Access Journals (Sweden)

Maria Elena Miletto Petrazzini

2014-07-01

Full Text Available Once believed to be a human prerogative, the capacity to discriminate between quantities now has also been reported in several vertebrates. To date, only two studies investigated numerical abilities in horses (Equus caballus but reported contrasting data. To assess whether horses can be trained to discriminate between quantities, I have set up a new experimental protocol using operant conditioning. One adult female was trained to discriminate between 1 and 4 (Test 1 in three different conditions: non-controlled continuous variables (numerical and continuous quantities that co-vary with number are simultaneously available, 50% controlled continuous variables (intermediate condition, and 100% controlled continuous variables (only numerical information available. The subject learned the discrimination in all conditions, showing the capacity to process numerical information. When presented with a higher numerical ratio (2 vs. 4, Test 2, the subject still discriminated between the quantities but its performance was statistically significant only in the non-controlled condition, suggesting that the subject used multiple cues in presence of a more difficult discrimination. On the whole, the results here reported encourage the use of this experimental protocol as a valid tool to investigate the capacity to process numerical and continuous quantities in horses in future research.

Web-based home rehabilitation gaming system for balance training

Directory of Open Access Journals (Sweden)

Oleh Kachmar

2014-06-01

Full Text Available Currently, most systems for virtual rehabilitation and motor training require quite complex and expensive hardware and can be used only in clinical settings. Now, a low-cost rehabilitation game training system has been developed for patients with movement disorders; it is suitable for home use under the distant supervision of a therapist. It consists of a patient-side application installed on a home computer and the virtual rehabilitation Game Server in the Internet. System can work with different input gaming devices connected through USB or Bluetooth, such as a Nintendo Wii balance board, a Nintendo Wii remote, a MS Kinect sensor, and custom made rehabilitation gaming devices based on a joystick. The same games can be used with all training devices. Assessment of the Home Rehabilitation Gaming System for balance training was performed on six patients with Cerebral Palsy, who went through daily training sessions for two weeks. Preliminary results showed balance improvement in patients with Cerebral Palsy after they had completed home training courses. Further studies are needed to establish medical requirements and evidence length.

School Improvement Plans and Student Achievement: Preliminary Evidence from the Quality and Merit Project in Italy

Science.gov (United States)

Caputo, Andrea; Rastelli, Valentina

2014-01-01

This study provides preliminary evidence from an Italian in-service training program addressed to lower secondary school teachers which supports school improvement plans (SIPs). It aims at exploring the association between characteristics/contents of SIPs and student improvement in math achievement. Pre-post standardized tests and text analysis of…

Preliminary exploration of the postgraduate education reform in interventional radiology

International Nuclear Information System (INIS)

Ni Caifang; Ouyang Yong

2012-01-01

Interventional radiology now is facing many challenges. The education quality has declined, and the high-level professional talents have been lost. This paper aims to analyze the present situation of the postgraduate education and the relevant issues in the field of interventional radiology, and to make a preliminary exploration into how we can train the postgraduates to become qualified interventional radiologists with high comprehensive quality in order to meet the urgent requirements demanded by the development of interventional radiology. (authors)

Preliminary Evidence for Training-Induced Changes of Morphology and Phantom Limb Pain

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Sandra Preißler

2017-06-01

Full Text Available The aim of this study was to investigate whether a special prosthetic training in phantom limb pain patients aimed at increasing the functional use of the prosthesis leads to neural morphological plasticity of brain structures and a reduction in phantom limb pain. For chronic pain disorders, it was shown that morphological alterations due to pain might become at least partially reversed by pain therapies. Phantom limb pain is a chronic pain disorder that is frequently followed by neural plasticity of anatomical brain structures. In our study, 10 patients with amputation of the upper limb participated in a two-week training with a myoelectric prosthesis with somatosensory feedback. Grip strength was fed back with electrocutaneous stimulus patterns applied to the stump. Phantom limb pain was assessed before and after the two-week training. Similarly, two T1 weighted MRI scans were conducted for longitudinal thickness analyses of cortical brain structures. As result of this treatment, patients experienced a reduction in phantom limb pain and a gain in prosthesis functionality. Furthermore, we found a change of cortical thickness in small brain areas in the visual stream and the post-central gyrus ipsilateral to the amputation indicating morphological alterations in brain areas involved in vision and pain processing.

Preliminary report of an intervention to improve mammography skills of radiologists

International Nuclear Information System (INIS)

D'Orsi, C.J.; Karellas, A.; Costanza, M.E.; Gaw, V.P.

1989-01-01

This paper presents a preliminary report of an intervention to improve mammography skills of radiologists. Although implementation of the screening guidelines has not occurred as readily as had been anticipated, use of mammograms is increasing. As the demand for this relatively new technology increases, both the availability of the test and the quality of the test done are valid concerns. Until recently, few radiology training programs provided trainees with opportunities to develop these skills. As a result, few radiologists who have been in practice more than five years have had formal training in the interpretation of mammograms. Thus providing practicing radiologists with the opportunities to develop skills in mammographic interpretation will serve to increase both availability and quality of mammographic exams

A laser microsurgical method of cell wall removal allows detection of large-conductance ion channels in the guard cell plasma membrane

Science.gov (United States)

Miedema, H.; Henriksen, G. H.; Assmann, S. M.; Evans, M. L. (Principal Investigator)

1999-01-01

Application of patch clamp techniques to higher-plant cells has been subject to the limitation that the requisite contact of the patch electrode with the cell membrane necessitates prior enzymatic removal of the plant cell wall. Because the wall is an integral component of plant cells, and because cell-wall-degrading enzymes can disrupt membrane properties, such enzymatic treatments may alter ion channel behavior. We compared ion channel activity in enzymatically isolated protoplasts of Vicia faba guard cells with that found in membranes exposed by a laser microsurgical technique in which only a tiny portion of the cell wall is removed while the rest of the cell remains intact within its tissue environment. "Laser-assisted" patch clamping reveals a new category of high-conductance (130 to 361 pS) ion channels not previously reported in patch clamp studies on plant plasma membranes. These data indicate that ion channels are present in plant membranes that are not detected by conventional patch clamp techniques involving the production of individual plant protoplasts isolated from their tissue environment by enzymatic digestion of the cell wall. Given the large conductances of the channels revealed by laser-assisted patch clamping, we hypothesize that these channels play a significant role in the regulation of ion content and electrical signalling in guard cells.

Nuclear research reactor IEA-R1 heat exchanger inlet nozzle flow - a preliminary study

International Nuclear Information System (INIS)

Angelo, Gabriel; Andrade, Delvonei Alves de; Fainer, Gerson; Angelo, Edvaldo

2009-01-01

As a computational fluid mechanics training task, a preliminary model was developed. ANSYS-CFX R code was used in order to study the flow at the inlet nozzle of the heat exchanger of the primary circuit of the nuclear research reactor IEA-R1. The geometry of the inlet nozzle is basically compounded by a cylinder and two radial rings which are welded on the shell. When doing so there is an offset between the holes through the shell and the inlet nozzle. Since it is not standardized by TEMA, the inlet nozzle was chosen for a preliminary study of the flow. Results for the proposed model are presented and discussed. (author)

Changes in circulating angiogenic factors after an acute training bout before and after resistance training with or without whole-body-vibration training

Science.gov (United States)

Beijer, Åsa; Degens, Hans; May, Francisca; Bloch, Wilhelm; Rittweger, Joern; Rosenberger, Andre

2012-07-01

Both Resistance Exercise and Whole-Body-Vibration training are currently considered as countermeasures against microgravity-induced physiological deconditioning. Here we investigated the effects of whole-body vibration superimposed upon resistance exercise. Within this context, the present study focuses on changes in circulating angiogenic factors as indicators of skeletal muscle adaption. Methods: Twenty-six healthy male subjects (25.2 ± 4.2 yr) were included in this two-group parallel-designed study and randomly assigned to one of the training interventions: either resistance exercise (RE) or resistance vibration exercise (RVE). Participants trained 2-3 times per week for 6 weeks (completing 16 training sessions), where one session took 9 ± 1 min. Participants trained with weights on a guided barbell. The individual training load was set at 80% of their 1-Repetition-Maximum. Each training session consisted of three sets with 8 squats and 12 heel raises, following an incremental training design with regards to weight (RE and RVE) and vibration frequency (RVE only). The vibration frequency was increased from 20 Hz in the first week till 40 Hz during the last two weeks with 5-Hz weekly increments. At the first and 16 ^{th} training session, six blood samples (pre training and 2 min, 5 min, 15 min, 35 min and 75 min post training) were taken. Circulating levels of vascular endothelial growth factor (VEGF), Endostatin and Matrix Metalloproteinases -2 and -9 (MMPs) were determined in serum using Enzyme-linked Immunosorbent Assays. Results: MMP-2 levels increased by 7.0% (SE = 2.7%, P < 0.001) within two minutes after the exercise bout and then decreased to 5.7% below baseline (SE = 2.4%, P < 0.001) between 15 and 75 minutes post exercise. This response was comparable before and after the training programs (P = 0.70) and also between the two intervention groups (P = 0.42). Preliminary analyses indicate that a similar pattern applies to circulating MMP-9, VEGF and

Social cognitive training in adolescents with chromosome 22q11.2 deletion syndrome: feasibility and preliminary effects of the intervention.

Science.gov (United States)

Shashi, V; Harrell, W; Eack, S; Sanders, C; McConkie-Rosell, A; Keshavan, M S; Bonner, M J; Schoch, K; Hooper, S R

2015-10-01

Children with chromosome 22q11.2 deletion syndrome (22q11DS) often have deficits in social cognition and social skills that contribute to poor adaptive functioning. These deficits may be of relevance to the later occurrence of serious psychiatric illnesses such as schizophrenia. Yet, there are no evidence-based interventions to improve social cognitive functioning in children with 22q11DS. Using a customised social cognitive curriculum, we conducted a pilot small-group-based social cognitive training (SCT) programme in 13 adolescents with 22q11DS, relative to a control group of nine age- and gender-matched adolescents with 22q11DS. We found the SCT programme to be feasible, with high rates of compliance and satisfaction on the part of the participants and their families. Our preliminary analyses indicated that the intervention group showed significant improvements in an overall social cognitive composite index. SCT in a small-group format for adolescents with 22q11DS is feasible and results in gains in social cognition. A larger randomised controlled trial would permit assessment of efficacy of this promising novel intervention. © 2015 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

New control and safety rod unit for the training reactor of the Dresden Technical University

International Nuclear Information System (INIS)

Adam, E.; Schab, J.; Knorr, J.

1983-01-01

The extension of the experimental training of students at the training reactor AKR of the Dresden Technical University requires the reconstruction of the reactor with a new control and safety rod unit. The specific conditions at the AKR led to a new variant. Results of preliminary experiments, design and mode of operation of the first unit as well as hitherto gained operation experiences are presented. (author)

A microsurgical anterior cervical approach and the immediate impact of mechanical retractors: A case control study

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Rodrigo Ramos-Zúñiga

2015-01-01

Full Text Available Introduction: A microsurgical anterior cervical approach with discectomy and fusion (MACDF is one of the most widely used procedures for treating radicular disorders. This approach is highly successful; however, it is not free from complications. These can be associated with soft tissue injuries. Aim of the Study: The recognition of the risks for these complications should be identified for timely prevention and safe treatment. Materials and Methods: Study Design: Retrospective case control study. This study includes a retrospective case series of 37 patients, paying special attention to immediate complications related to the use of mechanical retraction of soft tissue (dysphagia, dysphonia, esophageal lesions and local hematoma; and a comparative analysis of the outcomes after changes in the retraction method. Results: All selected cases had a positive neurological symptom response in relation to neuropathic pain. Dysphagia and dysphonia were found during the first 72 h in 94.1% of the cases in which automatic mechanical retraction was used for more than one hour during the surgical procedure. A radical change was noted in the reduction of the symptoms after the use of only manual protective blades without automatic mechanical retraction: 5.1% dysphagia and 0% dysphonia in the immediate post-operative period, P = 0.001. Conclusions: Soft tissue damage due to the use of automatic retractors in MACDF is not minor and leads to general discomfort in the patient in spite of good neurological results. These problems most often occur when automatic retractors are used continuously for more than 1 hour, as well as when they are used in multiple levels. Dysphagia, dysphonia and local pain decreased with the use of transient manual blades for retraction, and with intermittent release following minimally invasive principles.

Feasibility, acceptability and preliminary psychological benefits of mindfulness meditation training in a sample of men diagnosed with prostate cancer on active surveillance: results from a randomized controlled pilot trial.

Science.gov (United States)

Victorson, David; Hankin, Vered; Burns, James; Weiland, Rebecca; Maletich, Carly; Sufrin, Nathaniel; Schuette, Stephanie; Gutierrez, Bruriah; Brendler, Charles

2017-08-01

In a pilot randomized controlled trial, examine the feasibility and preliminary efficacy of an 8-week, mindfulness training program (Mindfulness Based Stress Reduction) in a sample of men on active surveillance on important psychological outcomes including prostate cancer anxiety, uncertainty intolerance and posttraumatic growth. Men were randomized to either mindfulness (n = 24) or an attention control arm (n = 19) and completed self-reported measures of prostate cancer anxiety, uncertainty intolerance, global quality of life, mindfulness and posttraumatic growth at baseline, 8 weeks, 6 months and 12 months. Participants in the mindfulness arm demonstrated significant decreases in prostate cancer anxiety and uncertainty intolerance, and significant increases in mindfulness, global mental health and posttraumatic growth. Participants in the control condition also demonstrated significant increases in mindfulness over time. Longitudinal increases in posttraumatic growth were significantly larger in the mindfulness arm than they were in the control arm. While mindfulness training was found to be generally feasible and acceptable among participants who enrolled in the 8-week intervention as determined by completion rates and open-ended survey responses, the response rate between initial enrollment and the total number of men approached was lower than desired (47%). While larger sample sizes are necessary to examine the efficacy of mindfulness training on important psychological outcomes, in this pilot study posttraumatic growth was shown to significantly increase over time for men in the treatment group. Mindfulness training has the potential to help men cope more effectively with some of the stressors and uncertainties associated with active surveillance. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

A Preliminary Study on the Feasibility of Using a Virtual Reality Cognitive Training Application for Remote Detection of Mild Cognitive Impairment.

Science.gov (United States)

Zygouris, Stelios; Ntovas, Konstantinos; Giakoumis, Dimitrios; Votis, Konstantinos; Doumpoulakis, Stefanos; Segkouli, Sofia; Karagiannidis, Charalampos; Tzovaras, Dimitrios; Tsolaki, Magda

2017-01-01

It has been demonstrated that virtual reality (VR) applications can be used for the detection of mild cognitive impairment (MCI). The aim of this study is to provide a preliminary investigation on whether a VR cognitive training application can be used to detect MCI in persons using the application at home without the help of an examiner. Two groups, one of healthy older adults (n = 6) and one of MCI patients (n = 6) were recruited from Thessaloniki day centers for cognitive disorders and provided with a tablet PC with custom software enabling the self-administration of the Virtual Super Market (VSM) cognitive training exercise. The average performance (from 20 administrations of the exercise) of the two groups was compared and was also correlated with performance in established neuropsychological tests. Average performance in terms of duration to complete the given exercise differed significantly between healthy(μ  = 247.41 s/ sd = 89.006) and MCI (μ= 454.52 s/ sd = 177.604) groups, yielding a correct classification rate of 91.8% with a sensitivity and specificity of 94% and 89% respectively for MCI detection. Average performance also correlated significantly with performance in Functional Cognitive Assessment Scale (FUCAS), Test of Everyday Attention (TEA), and Rey Osterrieth Complex Figure test (ROCFT). The VR application exhibited very high accuracy in detecting MCI while all participants were able to operate the tablet and application on their own. Diagnostic accuracy was improved compared to a previous study using data from only one administration of the exercise. The results of the present study suggest that remote MCI detection through VR applications can be feasible.

Human Factors in Training - Space Medicine Proficiency Training

Science.gov (United States)

Connell, Erin; Arsintescu, Lucia

2009-01-01

The early Constellation space missions are expected to have medical capabilities very similar to those currently on the Space Shuttle and International Space Station (ISS). For Crew Exploration Vehicle (CEV) missions to ISS, medical equipment will be located on ISS, and carried into CEV in the event of an emergency. Flight Surgeons (FS) on the ground in Mission Control will be expected to direct the Crew Medical Officer (CMO) during medical situations. If there is a loss of signal and the crew is unable to communicate with the ground, a CMO would be expected to carry out medical procedures without the aid of a FS. In these situations, performance support tools can be used to reduce errors and time to perform emergency medical tasks. Work on medical training has been conducted in collaboration with the Medical Training Group at the Space Life Sciences Directorate and with Wyle Lab which provides medical training to crew members, Biomedical Engineers (BMEs), and to flight surgeons under the JSC Space Life Sciences Directorate s Bioastronautics contract. The space medical training work is part of the Human Factors in Training Directed Research Project (DRP) of the Space Human Factors Engineering (SHFE) Project under the Space Human Factors and Habitability (SHFH) Element of the Human Research Program (HRP). Human factors researchers at Johnson Space Center have recently investigated medical performance support tools for CMOs on-orbit, and FSs on the ground, and researchers at the Ames Research Center performed a literature review on medical errors. The work proposed for FY10 continues to build on this strong collaboration with the Space Medical Training Group and previous research. This abstract focuses on two areas of work involving Performance Support Tools for Space Medical Operations. One area of research building on activities from FY08, involved the feasibility of just-in-time (JIT) training techniques and concepts for real-time medical procedures. In Phase 1

Safety and feasibility of inpatient exercise training in pediatric heart failure: a preliminary report.

Science.gov (United States)

McBride, Michael G; Binder, Tracy Jo; Paridon, Stephen M

2007-01-01

To determine the safety and feasibility of an inpatient exercise training program for a group of pediatric heart transplantation candidates on multiple inotropic support. Children with end-stage heart disease often require heart transplantation. Currently, no data exist on the safety and feasibility of an inpatient exercise training program in pediatric patients awaiting heart transplantation while on inotropic support. Twenty ambulatory patients (11 male; age, 13.6 +/- 3.2 years) were admitted, listed, and subsequently enrolled into an exercise training program while awaiting heart transplantation. Patient diagnoses consisted of dilated cardiomyopathy (n = 15), restrictive cardiomyopathy (n = 1), and failing single-ventricle physiology (n = 4). Inotropic support consisted of a combination of dobutamine, dopamine, or milrinone. Exercise sessions were scheduled three times a week lasting from 30 to 60 minutes and consisted of aerobic and musculoskeletal conditioning. Over 6.2 +/- 4.2 months, 1,251 of a possible 1,508 exercise training sessions were conducted, with a total of 615 hours (26.3 +/- 2.7 min/session) dedicated to low-intensity aerobic exercise. Reasons for noncompliance included a change in medical status, staffing, or patient cooperation. Two adverse episodes (seizures) occurred, neither of which resulted in termination from the program. No adverse episodes of hypotension or significant complex arrhythmias occurred. No complication of medication administration or loss of intravenous access occurred. Data from this study indicate that pediatric patients on inotropic support as a result of systemic ventricular or biventricular heart failure can safely participate in exercise training programs with relatively moderate to high compliance.

Police Training to Align Law Enforcement and HIV Prevention: Preliminary Evidence From the Field

Science.gov (United States)

Agrawal, Alpna; Moreau, Bruce; Kumar, Pratima; Weiss-Laxer, Nomi; Heimer, Robert

2011-01-01

Having identified gaps in implementation of Rhode Island's syringe access law and police occupational safety education, public health and police professionals developed police training to boost legal knowledge, improve syringe access attitudes, and address needlestick injuries. Baseline data (94 officers) confirmed anxiety about needlestick injuries, poor legal knowledge, and occupational risk overestimation. Before training, respondents believed that syringe access promotes drug use (51%), increases likelihood of police needlestick injuries (58%), and fails to reduce epidemics (38%). Pretraining to posttraining evaluation suggested significant shifts in legal and occupational safety knowledge; changes in attitudes toward syringe access were promising. Training that combines occupational safety with syringe access content can help align law enforcement with public health goals. Additional research is needed to assess street-level effect and to inform intervention tailoring. PMID:21940924

Notification: Audit of EPA's Office of Criminal Enforcement, Forensics and Training's Law Enforcement Availability Pay Reporting

Science.gov (United States)

Project #OA-FY18-0075, November 30, 2017. The EPA OIG plans to begin preliminary research on the EPA Office of Criminal Enforcement, Forensics and Training's (OCEFT's) law enforcement availability pay (LEAP) reporting.

Pilot Study of a School-Based Parent Training Program for Preschoolers with ASD

Science.gov (United States)

Ingersoll, Brooke R; Wainer, Allison L

2013-01-01

This study investigated the feasibility and preliminary effectiveness of a parenting training program designed for early intervention and early childhood special education (EI/ESCE) programs serving students with autistic spectrum disorders. Thirteen teachers representing three intermediate school districts implemented the intervention with 27…

Comparison of attention training and cognitive therapy in the treatment of social phobia: a preliminary investigation.

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Donald, Juliet; Abbott, Maree J; Smith, Evelyn

2014-01-01

Prominent models of social phobia highlight the role played by attentional factors, such as self-focused attention, in the development and maintenance of social phobia. Elevated self-focused attention is associated with increases in self-rated anxiety. Treatments that aim to modify and change attentional processes, specifically self-focused attention, will have a direct effect on social phobia symptoms. Thus, Attention Training targets attentional focus. The present study aimed to investigate the efficacy of Attention Training in comparison to an established treatment for social phobia, Cognitive Therapy. Participants (Intention-to-treat = 45; completers = 30) were allocated to either 6 weeks of Attention Training or Cognitive Therapy. It was hypothesized that both treatments would be effective in reducing social phobia symptoms, but that Attention Training would work primarily by reducing levels of self-focused attention. The results found an overall effectiveness of both treatment conditions in reducing social phobia symptoms. However, Attention Training significantly improved scores on the Self-Focused Attention questionnaire and the Brief Fear of Negative Evaluation questionnaire compared to Cognitive Therapy. Attention Training seems to be a promising treatment for social phobia.

A virtual-reality simulator and force sensation combined catheter operation training system and its preliminary evaluation.

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Wang, Yu; Guo, Shuxiang; Tamiya, Takashi; Hirata, Hideyuki; Ishihara, Hidenori; Yin, Xuanchun

2017-09-01

Endovascular surgery benefits patients because of its superior short convalescence and lack of damage to healthy tissue. However, such advantages require the operator to be equipped with dexterous skills for catheter manipulation without resulting in collateral damage. To achieve this goal, a training system is in high demand. A training system integrating a VR simulator and a haptic device has been developed within this context. The VR simulator is capable of providing visual cues which assist the novice for safe catheterization. In addition, the haptic device cooperates with VR simulator to apply sensations at the same time. The training system was tested by non-medical subjects over a five days training session. The performance was evaluated in terms of safety criteria and task completion time. The results demonstrate that operation safety is improved by 15.94% and task completion time is cut by 18.80 s maximum. Moreover, according to subjects' reflections, they are more confident in operation. The proposed training system constructs a comprehensive training environment that combines visualization and force sensation. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Effects of Robot Assisted Gait Training in Progressive Supranuclear Palsy (PSP: a preliminary report.

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Patrizio eSale

2014-04-01

Full Text Available Background and Purpose: Progressive supranuclear palsy (PSP is a rare neurodegenerative disease clinically characterized by prominent axial extrapyramidal motor symptoms with frequent falls. Over the last years the introduction of robotic technologies to recover lower limb function has been greatly employed in the rehabilitative practice. This observational trial is aimed at investigating the feasibility, the effectiveness and the efficacy of end-effector robot training in people with PSP.Method: Pilot observational trial.Participants: Five cognitively intact participants with PSP and gait disorders.Interventions: Patients were submitted to a rehabilitative program of robot-assisted walking sessions for 45 minutes, 5 times a week for 4 weeks.Main outcome measures: The spatiotemporal parameters at the beginning (T0 and at the end of treatment (T1 were recorded by a gait analysis laboratory.Results: Robot training was feasible, acceptable and safe and all participants completed the prescribed training sessions. All patients showed an improvement in the gait index (Mean velocity, Cadence, Step length and Step width (T0 versus T1.Conclusions: Robot training is a feasible and safe form of rehabilitation for cognitively intact people with PSP. This innovative approach can contribute to improve lower limb motor recovery. The focus on gait recovery is another quality that makes this research important for clinical practice. On the whole, the simplicity of treatment, the lack of side effects and the positive results in the patients support the recommendation to extend the trials of this treatment. Further investigation regarding the effectiveness of robot training in time is necessary.Trial registration: ClinicalTrials.gov NCT01668407.

Environmental Scan of Weight Bias Exposure in Primary Health Care Training Programs

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Russell-Mayhew, Shelly; Nutter, Sarah; Alberga, Angela; Jelinski, Susan; Ball, Geoff D. C.; Edwards, Alun; Oddie, Scott; Sharma, Arya M.; Pickering, Barbara; Forhan, Mary

2016-01-01

Negative attitudes and beliefs about individuals with obesity (also known as weight bias) have negative consequences for physical and mental health for individuals with obesity and impact the quality of care provided by health professionals. A preliminary environmental scan of college and university training programs was conducted consisting of 67…

Avoiding radiation exposure while training to locate a radioactive source: a virtual reality exercise

International Nuclear Information System (INIS)

Marins, E.R.; Cotelli do Espírito Santo, A.; Abreu Mól, A. C. de; Cunha, G.; Landau, L.

2015-01-01

A technician undergoing radioprotection training must learn to use radiation detectors. Practical exercises involve being near to radiation sources. The work here presented reduces the exposure to individuals using a virtual environment to achieve preliminary apprenticeship prior using real radioactive sources. (authors)

Brain responses to biological motion predict treatment outcome in young adults with autism receiving Virtual Reality Social Cognition Training: Preliminary findings.

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Yang, Y J Daniel; Allen, Tandra; Abdullahi, Sebiha M; Pelphrey, Kevin A; Volkmar, Fred R; Chapman, Sandra B

2017-06-01

Autism Spectrum Disorder (ASD) is characterized by remarkable heterogeneity in social, communication, and behavioral deficits, creating a major barrier in identifying effective treatments for a given individual with ASD. To facilitate precision medicine in ASD, we utilized a well-validated biological motion neuroimaging task to identify pretreatment biomarkers that can accurately forecast the response to an evidence-based behavioral treatment, Virtual Reality-Social Cognition Training (VR-SCT). In a preliminary sample of 17 young adults with high-functioning ASD, we identified neural predictors of change in emotion recognition after VR-SCT. The predictors were characterized by the pretreatment brain activations to biological vs. scrambled motion in the neural circuits that support (a) language comprehension and interpretation of incongruent auditory emotions and prosody, and (b) processing socio-emotional experience and interpersonal affective information, as well as emotional regulation. The predictive value of the findings for individual adults with ASD was supported by regression-based multivariate pattern analyses with cross validation. To our knowledge, this is the first pilot study that shows neuroimaging-based predictive biomarkers for treatment effectiveness in adults with ASD. The findings have potentially far-reaching implications for developing more precise and effective treatments for ASD. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Computerised working-memory focused cognitive remediation therapy for psychosis--A preliminary study.

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Hargreaves, A; Dillon, R; Anderson-Schmidt, H; Corvin, A; Fitzmaurice, B; Castorina, M; Robertson, I H; Donohoe, G

2015-12-01

Cognitive deficits are a core feature of schizophrenia and related psychotic disorders and are associated with decreased levels of functioning. Behavioural interventions have shown success in remediating these deficits; determining how best to maximise this benefit while minimising the cost is an important next step in optimising this intervention for clinical use. To examine the effects of a novel working-memory focused cognitive remediation (CR) training on cognitive difficulties based on internet delivery of training and weekly telephone support. Participants with a diagnosis of psychosis (n=56) underwent either 8 weeks of CR (approximately 20 h) or 8 weeks of treatment as usual (TAU). General cognitive ability, working memory and episodic memory were measured both pre and post intervention for all participants. In addition to improvements on trained working memory tasks, CR training was associated with significant improvements in two tests of verbal episodic memory. No association between CR and changes in general cognitive ability was observed. Effect sizes for statistically significant changes in memory were comparable to those reported in the literature based primarily on 1:1 training. The cognitive benefits observed in this non-randomised preliminary study indicate that internet-based working memory training can be an effective cognitive remediation therapy. The successes and challenges of an internet-based treatment are discussed. Copyright © 2015 Elsevier B.V. All rights reserved.

Informatics in radiology: web-based preliminary reporting system for radiology residents with PACS integration.

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O'Connell, Timothy; Chang, Debra

2012-01-01

While on call, radiology residents review imaging studies and issue preliminary reports to referring clinicians. In the absence of an integrated reporting system at the training sites of the authors' institution, residents were typing and faxing preliminary reports. To partially automate the on-call resident workflow, a Web-based system for resident reporting was developed by using the free open-source xAMP Web application framework and an open-source DICOM (Digital Imaging and Communications in Medicine) software toolkit, with the goals of reducing errors and lowering barriers to education. This reporting system integrates with the picture archiving and communication system to display a worklist of studies. Patient data are automatically entered in the preliminary report to prevent identification errors and simplify the report creation process. When the final report for a resident's on-call study is available, the reporting system queries the report broker for the final report, and then displays the preliminary report side by side with the final report, thus simplifying the review process and encouraging review of all of the resident's reports. The xAMP Web application framework should be considered for development of radiology department informatics projects owing to its zero cost, minimal hardware requirements, ease of programming, and large support community.

Virtual Reality Simulator Systems in Robotic Surgical Training.

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Mangano, Alberto; Gheza, Federico; Giulianotti, Pier Cristoforo

2018-06-01

The number of robotic surgical procedures has been increasing worldwide. It is important to maximize the cost-effectiveness of robotic surgical training and safely reduce the time needed for trainees to reach proficiency. The use of preliminary lab training in robotic skills is a good strategy for the rapid acquisition of further, standardized robotic skills. Such training can be done either by using a simulator or by exercises in a dry or wet lab. While the use of an actual robotic surgical system for training may be problematic (high cost, lack of availability), virtual reality (VR) simulators can overcome many of these obstacles. However, there is still a lack of standardization. Although VR training systems have improved, they cannot yet replace experience in a wet lab. In particular, simulated scenarios are not yet close enough to a real operative experience. Indeed, there is a difference between technical skills (i.e., mechanical ability to perform a simulated task) and surgical competence (i.e., ability to perform a real surgical operation). Thus, while a VR simulator can replace a dry lab, it cannot yet replace training in a wet lab or operative training in actual patients. However, in the near future, it is expected that VR surgical simulators will be able to provide total reality simulation and replace training in a wet lab. More research is needed to produce more wide-ranging, trans-specialty robotic curricula.

Long-Term Facial Nerve Outcomes after Microsurgical Resection of Vestibular Schwannomas in Patients with Preoperative Facial Nerve Palsy.

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Mooney, Michael A; Hendricks, Benjamin; Sarris, Christina E; Spetzler, Robert F; Almefty, Kaith K; Porter, Randall W

2018-06-01

Objectives  This study aimed at evaluating facial nerve outcomes in vestibular schwannoma patients presenting with preoperative facial nerve palsy. Design  A retrospective review. Setting  Single-institution cohort. Participants  Overall, 368 consecutive patients underwent vestibular schwannoma resection. Patients with prior microsurgery or radiosurgery were excluded. Main Outcome Measures  Incidence, House-Brackmann grade. Results  Of 368 patients, 9 had confirmed preoperative facial nerve dysfunction not caused by prior treatment, for an estimated incidence of 2.4%. Seven of these nine patients had Koos grade 4 tumors. Mean tumor diameter was 3.0 cm (range: 2.1-4.4 cm), and seven of nine tumors were subtotally resected. All nine patients were followed up clinically for ≥ 6 months. Of the six patients with a preoperative House-Brackmann grade of II, two improved to grade I, three were stable, and one patient worsened to grade III. Of the three patients with grade III or worse, all remained stable at last follow-up. Conclusions  Preoperative facial nerve palsy is rare in patients with vestibular schwannoma; it tends to occur in patients with relatively large lesions. Detailed long-term outcomes of facial nerve function after microsurgical resection for these patients have not been reported previously. We followed nine patients and found that eight (89%) of the nine patients had either stable or improved facial nerve outcomes after treatment. Management strategies varied for these patients, including rates of subtotal versus gross-total resection and the use of stereotactic radiosurgery in patients with residual tumor. These results can be used to help counsel patients preoperatively on expected outcomes of facial nerve function after treatment.

Cognitive Gains from Gist Reasoning Training in Adolescents with Chronic-Stage Traumatic Brain Injury

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Lori G. Cook

2014-06-01

Full Text Available Adolescents with traumatic brain injury (TBI typically demonstrate good recovery of previously acquired skills. However, higher-order and later emergent cognitive functions are often impaired and linked to poor outcomes in academic and social/behavioral domains. Few control trials exist that test cognitive treatment effectiveness at chronic recovery stages. The current pilot study compared the effects of two forms of cognitive training, gist reasoning (top-down versus rote memory learning (bottom-up, on ability to abstract meanings, recall facts, and utilize core executive functions (i.e., working memory, inhibition in 20 adolescents (ages 12-20 who were six months or longer post-TBI. Participants completed eight 45-minute sessions over one month. After training, the gist reasoning group (n = 10 exhibited significant improvement in ability to abstract meanings and increased fact recall. This group also showed significant generalizations to untrained executive functions of working memory and inhibition. The memory training group (n = 10 failed to show significant gains in ability to abstract meaning or on other untrained specialized executive functions, although improved fact recall approached significance. These preliminary results suggest that relatively short-term training (6 hours utilizing a top-down reasoning approach is more effective than a bottom-up rote learning approach in achieving gains in higher-order cognitive abilities in adolescents at chronic stages of TBI. These findings need to be replicated in a larger study; nonetheless, the preliminary data suggest that traditional cognitive intervention schedules need to extend to later-stage training opportunities. Chronic-stage, higher-order cognitive trainings may serve to elevate levels of cognitive performance in adolescents with TBI.

Causal role for inverse reasoning on obsessive-compulsive symptoms: Preliminary evidence from a cognitive bias modification for interpretation bias study.

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Wong, Shiu F; Grisham, Jessica R

2017-12-01

The inference-based approach (IBA) is a cognitive account of the genesis and maintenance of obsessive-compulsive disorder (OCD). According to the IBA, individuals with OCD are prone to using inverse reasoning, in which hypothetical causes form the basis of conclusions about reality. Several studies have provided preliminary support for an association between features of the IBA and OCD symptoms. However, there are currently no studies that have investigated the proposed causal relationship of inverse reasoning in OCD. In a non-clinical sample (N = 187), we used an interpretive cognitive bias procedure to train a bias towards using inverse reasoning (n = 64), healthy sensory-based reasoning (n = 65), or a control condition (n = 58). Participants were randomly allocated to these training conditions. This manipulation allowed us to assess whether, consistent with the IBA, inverse reasoning training increased compulsive-like behaviours and self-reported OCD symptoms. Results indicated that compared to a control condition, participants trained in inverse reasoning reported more OCD symptoms and were more avoidant of potentially contaminated objects. Moreover, change in inverse reasoning bias was a small but significant mediator of the relationship between training condition and behavioural avoidance. Conversely, training in a healthy (non-inverse) reasoning style did not have any effect on symptoms or behaviour relative to the control condition. As this study was conducted in a non-clinical sample, we were unable to generalise our findings to a clinical population. Findings generally support the IBA model by providing preliminary evidence of a causal role for inverse reasoning in OCD. Copyright © 2017 Elsevier Ltd. All rights reserved.

Sail training: an innovative approach to graduate nurse preceptor development.

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Nicol, Pam; Young, Melisa

2007-01-01

A 1-day sail-training program that aims to increase graduate nurse preceptor skills was evaluated. Preliminary results suggest that this experiential learning is an effective way to develop graduate nurse preceptors. Awareness of graduate nurses' needs has been heightened, and skills in clinical teaching have been developed. It is indicated from the limited results that the outcomes are sustained over time, but further evaluation is needed.

Benefits of music training in mandarin-speaking pediatric cochlear implant users.

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Fu, Qian-Jie; Galvin, John J; Wang, Xiaosong; Wu, Jiunn-Liang

2015-02-01

The aims of this study were to assess young (5- to 10-year-old) Mandarin-speaking cochlear implant (CI) users' musical pitch perception and to assess the benefits of computer-based home training on performance. Melodic contour identification (MCI) was used to assess musical pitch perception in 14 Mandarin-speaking pediatric CI users; the instrument timbre and the contour length were varied as experimental parameters. Six subjects received subsequent MCI training on their home computer in which auditory and visual feedback were provided. MCI performance was generally poor (grand mean=33.3% correct) and highly variable, with scores ranging from 9.3% to 98.1% correct; there was no significant effect of instrument timbre or contour length on performance (p>.05). After 4 weeks of training, performance sharply improved. Follow-up measures that were conducted 8 weeks after training was stopped showed no significant decline in MCI performance. For the 6 trained subjects, there was a significant effect of contour length for the training and follow-up measures. These preliminary data suggest that although baseline MCI performance initially may be poor, training may greatly improve Mandarin-speaking pediatric CI users' melodic pitch perception.

Medical waste management training for healthcare managers - a necessity?

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Ozder, Aclan; Teker, Bahri; Eker, Hasan Huseyin; Altındis, Selma; Kocaakman, Merve; Karabay, Oguz

2013-07-16

This is an interventional study, since a training has been given, performed in order to investigate whether training has significant impact on knowledge levels of healthcare managers (head-nurses, assistant head nurses, hospital managers and deputy managers) regarding bio-medical waste management. The study was conducted on 240 volunteers during June - August 2010 in 12 hospitals serving in Istanbul (private, public, university, training-research hospitals and other healthcare institutions). A survey form prepared by the project guidance team was applied to the participants through the internet before and after the training courses. The training program was composed of 40 hours of theory and 16 hours of practice sessions taught by persons known to have expertise in their fields. Methods used in the analysis of the data chi-square and t-tests in dependent groups. 67.5% (162) of participants were female. 42.5% (102) are working in private, and 21.7% in state-owned hospitals. 50.4% are head-nurses, and 18.3% are hospital managers.A statistically significant difference was found among those who had received medical waste management training (preliminary test and final test) and others who had not (pnecessity for the safety of patients and important for its contribution to the economy of the country.

Effects of categorization training in patients with TBI during postacute rehabilitation: preliminary findings.

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Constantinidou, Fofi; Thomas, Robin D; Scharp, Victoria L; Laske, Kate M; Hammerly, Mark D; Guitonde, Suchita

2005-01-01

Previous research suggests that traumatic brain injury (TBI) interferes with the ability to extract and use attributes to describe objects. This study explored the effects of a systematic Categorization Program (CP) in participants with TBI and noninjured controls. Ten persons with moderate to severe TBI who received comprehensive postacute rehabilitation services and 13 matched noninjured controls participated in the study. All participants received CP training for 3 to 5 hours per week for 10 to 12 weeks that consisted of 8 levels and targeted concept formation, object categorization, and decision-making abilities. The Mayo-Portland Adaptability Inventory-3 (MPAI-3) and the Community Integration Questionnaire (CIQ). Two Categorization Tests (administered pretraining and posttraining) and 3 Probe Tasks (administered at specified intervals during training) assessed skills relating to categorization. Both groups showed significant improvement in categorization performance after the CP training on the 2 Categorization Tests related to the CP. They also were able to generalize and apply categorization and sorting skills in new situations (as measured by the Probe Tasks). Participants with TBI had improved functional outcome performance measured by the MPAI-3 and the CIQ. The systematic and hierarchical structure of the CP is beneficial to participants with TBI during postacute rehabilitation. This study contributes to the growing body of evidence supporting cognitive rehabilitation after moderate to severe TBI.

Livebirth and utero-placental insufficiency in Papio hamadryas baboons with uterus angiosome perfused by bilateral utero-ovarian microsurgical anastomoses alone.

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Beran, B; Arnolds, K; Shockley, M; Rivas, K; Medina, M; Escobar, P F; Tzakis, A; Falcone, T; Sprague, M L; Zimberg, S

2017-09-01

Can the baboon uterus support a gestation to livebirth with an angiosome using microsurgically anastomosed utero-ovarian vessels and lacking uterine arteries and veins? Our angiosome model allows healthy livebirth albeit with risk of fetal growth restriction and stillbirth. Uterine transplant can provide livebirth in humans, but requires a living donor to undergo a prolonged laparotomy for hysterectomy. In an attempt to avoid the time-consuming dissection of the uterine vein, our group has previously shown maintenance of baboon uterine menstrual function after ligation of the uterine vein and after ligation of both the uterine artery and uterine vein. In a 19-month timespan, three baboons underwent laparotomy to surgically alter uterine perfusion, and pregnancy outcomes were monitored after spontaneous mating in a breeding colony. Three nulligravid female Papio hamadryas baboons in a breeding colony underwent laparotomy to ligate uterine arteries and veins along with colpotomy and cervico-vaginal anastomosis. During the same surgery, the utero-ovarian arteries and veins were microsurgically transected and re-anastomosed to themselves. Intraoperative organ perfusion was confirmed with laser angiography. After a recovery period, monitoring of menstrual cycling via menstrual blood flow and sex-skin cycling occurred, as well as uterine viability via sonography and cervical biopsy. Each baboon was released to the breeding colony for spontaneous mating and pregnancies dated by menstrual calendar and compared with early ultrasound. Delivery outcomes were monitored in each including neonate weight and placental pathology. In the event of a stillbirth, the animal was returned to the breeding colony for repeat mating attempts. After achieving a livebirth, the maternal baboon was removed from the study. Each baboon in the trial underwent successful surgery with all uteri demonstrating viability and return of menstrual function within 10 weeks of surgery. Pregnancies occurred

PENINGKATAN SELF ESTEEM SISWA KORBAN BULLYING MELALUI TEKNIK ASSERTIVE TRAINING

Directory of Open Access Journals (Sweden)

Mujiyati Mujiyati

2015-01-01

Full Text Available This study is based on students’ problem who undergone the decreasing of self-esteem due to bullying that students receive in their environment. The long-term goal which going to be achieved is related to self esteem problem of students bullying victims that is capable to solve problem by using effective and tested product through counseling with assertive training technique. This study used research and development method. The steps are: (1 preliminary research; (2 designing model; (3 developing model; (4 testing model restrictively; (5 analysing model; (6 revising model; (7 testing model widely; (8 dissemination of model; and (9 recommending tested model. The result of study showed that the model of counseling through assertive training was empirically proven effective to improve self esteem of students bullying victims.Keywords: Self Esteem, Bullying, Assertive Training

Training Methods for Image Noise Level Estimation on Wavelet Components

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A. De Stefano

2004-12-01

Full Text Available The estimation of the standard deviation of noise contaminating an image is a fundamental step in wavelet-based noise reduction techniques. The method widely used is based on the mean absolute deviation (MAD. This model-based method assumes specific characteristics of the noise-contaminated image component. Three novel and alternative methods for estimating the noise standard deviation are proposed in this work and compared with the MAD method. Two of these methods rely on a preliminary training stage in order to extract parameters which are then used in the application stage. The sets used for training and testing, 13 and 5 images, respectively, are fully disjoint. The third method assumes specific statistical distributions for image and noise components. Results showed the prevalence of the training-based methods for the images and the range of noise levels considered.

Treatment of Unruptured Intracranial Aneurysms and Cognitive Performance: Preliminary Results of a Prospective Clinical Trial.

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Bründl, Elisabeth; Böhm, Christina; Lürding, Ralf; Schödel, Petra; Bele, Sylvia; Hochreiter, Andreas; Scheitzach, Judith; Zeman, Florian; Brawanski, Alexander; Schebesch, Karl-Michael

2016-10-01

Few studies have addressed the effect of treatment of unruptured intracranial aneurysm (UIA) on cognitive function. Neuropsychological assessment after UIA treatment is underreported, and prospective trials have repeatedly been demanded. In 2014, we conducted a prospective controlled study to evaluate the differences in cognitive processing caused by the treatment of anterior circulation UIAs. Thirty patients were enrolled until September 2015. Ten patients received endovascular aneurysm occlusion (EV), 10 patients were treated microsurgically (MS), and 10 patients with surgically treated degenerative lumbar spine disease (LD) served as control. All patients underwent extended standardized neuropsychological assessment before (t 1 ) and 6 weeks after treatment (t 2 ). Tests included verbal, visual, and visuospatial memory, psychomotor functioning, executive functioning, and its subdomains verbal fluency and cognitive flexibility. We statistically evaluated intragroup and intergroup changes. Intragroup comparisons and group-rate analysis showed no significant impairment in overall neuropsychological performance, either postinterventionally or postoperatively. However, the postoperative performance in cognitive processing speed, cognitive flexibility, and executive functioning was significantly worse in the MS group than in the EV (P = 0.038) and LD group (P = 0.02). Compared with the EV group, patients with MS showed significant postoperative impairment in a subtest for auditory-verbal memory (Wechsler Memory Scale, Fourth Edition, Logical Memory II; MS vs. EV P = 0.011). The MS group trended toward posttreatment impairment in subtests for verbal fluency and semantic memory (Regensburg Word Fluency Test; MS vs. EV P = 0.083) and in auditory-verbal memory (Wechsler Memory Scale, Fourth Edition, Logical Memory II; MS vs. LD P = 0.06). Our preliminary data showed no effect of anterior circulation UIA treatment on overall neuropsychological function but impaired

The Level of Anxiety and Depression in Dialysis Patients Undertaking Regular Physical Exercise Training--a Preliminary Study.

Science.gov (United States)

Dziubek, Wioletta; Kowalska, Joanna; Kusztal, Mariusz; Rogowski, Łukasz; Gołębiowski, Tomasz; Nikifur, Małgorzata; Szczepańska-Gieracha, Joanna; Zembroń-Łacny, Agnieszka; Klinger, Marian; Woźniewski, Marek

2016-01-01

The aim of the study was to evaluate the effects of a six-month physical training undertaken by haemodialysis (HD) patients, on the depression and anxiety. Patients with end stage renal disease (ESRD) were recruited from the dialysis station at the Department of Nephrology and Transplantation Medicine in Wroclaw. Physical training took place at the beginning of the first 4-hours of dialysis, three times a week for six months. A personal questionnaire, Beck Depression Inventory (BDI) and State-Trait Anxiety Inventory (STAI) were used in the study. A total of 28 patients completed the study: 20 were randomised to endurance training and 8 were randomised to resistance training. Statistical analysis of depression and anxiety at the initial (t1) and final examination (t2) indicated a significant reduction in depression and anxiety, particularly anxiety as a trait (X2) in the whole study group. The change in anxiety as a state correlated with the disease duration, duration of dialysis and the initial level of anxiety as a state (t1X1). The change in anxiety as a trait significantly correlated with age and the initial level of anxiety (t1X2). Undertaking physical training during dialysis by patients with ESRD is beneficial in reducing their levels of anxiety and depression. Both resistance and endurance training improves mood, but only endurance training additionally results in anxiety reduction. © 2016 S. Karger AG, Basel.

The Level of Anxiety and Depression in Dialysis Patients Undertaking Regular Physical Exercise Training - a Preliminary Study

Directory of Open Access Journals (Sweden)

Wioletta Dziubek

2016-02-01

Full Text Available Background/Aims: The aim of the study was to evaluate the effects of a six-month physical training undertaken by haemodialysis (HD patients, on the depression and anxiety. Methods: Patients with end stage renal disease (ESRD were recruited from the dialysis station at the Department of Nephrology and Transplantation Medicine in Wroclaw. Physical training took place at the beginning of the first 4-hours of dialysis, three times a week for six months. A personal questionnaire, Beck Depression Inventory (BDI and State-Trait Anxiety Inventory (STAI were used in the study. Results: A total of 28 patients completed the study: 20 were randomised to endurance training and 8 were randomised to resistance training. Statistical analysis of depression and anxiety at the initial (t1 and final examination (t2 indicated a significant reduction in depression and anxiety, particularly anxiety as a trait (X2 in the whole study group. The change in anxiety as a state correlated with the disease duration, duration of dialysis and the initial level of anxiety as a state (t1X1. The change in anxiety as a trait significantly correlated with age and the initial level of anxiety (t1X2. Conclusions: Undertaking physical training during dialysis by patients with ESRD is beneficial in reducing their levels of anxiety and depression. Both resistance and endurance training improves mood, but only endurance training additionally results in anxiety reduction.

Surgical reimplantation of penile glans amputation in children during circumcision

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Bouassida Khaireddine

2014-01-01

Full Text Available Circumcision is one of the oldest and most commonly performed surgical procedures. Unfortunately, various complications may occur during circumcision, ranging from trivial to tragic such as penile amputation which is a serious complication and a challenging injury to treat. We describe two cases of non-microsurgical successful reattachment of a distal penile glans which were amputated during circumcision. In the first case, a 5-year-old child underwent circumcision by an urologist under local anesthesia. In the second one, a 3-year-old child underwent circumcision by a general practitioner who used to make circumcision. In this article, the literature is reviewed; results and potential complications of this surgery are also discussed. Glans sensation was present, early morning erection was maintained, and there was an erectile response during penile manipulation in both cases. Although circumcision is not technically difficult, it should be taken seriously. The use of microsurgical reattachment is not always possible, especially in pediatric cases; it also requires special equipment and training.

Business System Planning Project, Preliminary System Design

International Nuclear Information System (INIS)

EVOSEVICH, S.

2000-01-01

CH2M HILL Hanford Group, Inc. (CHG) is currently performing many core business functions including, but not limited to, work control, planning, scheduling, cost estimating, procurement, training, and human resources. Other core business functions are managed by or dependent on Project Hanford Management Contractors including, but not limited to, payroll, benefits and pension administration, inventory control, accounts payable, and records management. In addition, CHG has business relationships with its parent company CH2M HILL, U.S. Department of Energy, Office of River Protection and other River Protection Project contractors, government agencies, and vendors. The Business Systems Planning (BSP) Project, under the sponsorship of the CH2M HILL Hanford Group, Inc. Chief Information Officer (CIO), have recommended information system solutions that will support CHG business areas. The Preliminary System Design was developed using the recommendations from the Alternatives Analysis, RPP-6499, Rev 0 and will become the design base for any follow-on implementation projects. The Preliminary System Design will present a high-level system design, providing a high-level overview of the Commercial-Off-The-Shelf (COTS) modules and identify internal and external relationships. This document will not define data structures, user interface components (screens, reports, menus, etc.), business rules or processes. These in-depth activities will be accomplished at implementation planning time

Microsurgical anatomy and clinic significance of posterior inferior cerebellar artery%小脑后下动脉的显微解剖研究及其临床意义

Institute of Scientific and Technical Information of China (English)

吴江; 张世明; 徐峰

2010-01-01

目的 研究小脑后下动脉的显微解剖,为神经外科手术提供临床解剖资料.方法 手术显微镜下观察测量20具(共40侧)人脑标本的小脑后下动脉(PICA)的起始行径、直径、主要分支、穿动脉及分布,检查PICA与脑神经根的关系.结果 40侧标本共发出PICA 35支,平均管径(1.6±0.6)mm,距离椎基底动脉汇合点平均(16±5)mm.在35支PICA中28支PICA走行在第Ⅻ脑神经根之间,7支走行在第Ⅻ脑神经根下方,32支走行在第Ⅺ脑神经根之间.结论 PICA是椎基动脉系统重要的分支,变异多,走行与脑神经关系密切,熟悉解剖结构,在后颅窝手术中予以保护具有重要意义.%Objective To study the microsurgical anatomy of the posterior inferior cerebellar artery (PICA) for neurosurgery. Methods Twenty Chinese adult brain samples (40 sides) were measured with microscope for the diameters, lengths, origins, courses, and the branches of the PICA. The relationship between the PICA and cranial nerves was also checked. Results There were 35 PICAs in 20 brain samples.The mean diameter of the PICAs was (1.6±0.6) mm, the mean length from PICAs' origin of vertebral artery to the vertebrobasilar junction was (16±5) mm. In 35 PICAs,28 PICAs go through the rootlets of Ⅻ cranial nerves,7 PICAs go inferior Ⅻ cranial nerves, and 32 PICAs go through the rootlets of Ⅺ cranial nerves. Conclusions PICA is an important branch artery with more variation and complex relationship to the cranial nerves trend in the vertebral artery system. It is necessary to master the microsurgical anatomy of PICA and to be careful protection during the neurosurgical operations.

Microsurgical clipping in forty patients with unruptured anterior cerebral circulation aneurysms: an investigation into cognitive outcome Clipagem microcirúrgica em 40 pacientes com aneurisma de circulação cerebral anterior não-roto: uma investigação cognitiva

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Arthur A Pereira-Filho

2010-10-01

Full Text Available OBJECTIVE: It is a consensus that most unruptured intracranial aneurysms (UIA can be treated with acceptably low morbidity. However, some studies recently reported postoperative cognitive impairment, suggesting that it could be attributable to surgical damage. Our goal is to evaluate cognitive function before and after microsurgical clipping in patients with UIA. METHOD: A consecutive series of 40 patients who underwent microsurgical clipping for UIA were studied. The cognitive assessment (Mini Mental State Examination, MMSE was performed immediately before and at least one month after surgery. Paired Student's "t" test and analysis of variance (ANOVA were used for statistical purposes. RESULTS: The mean MMSE score in the preoperative analysis was 28.12 (SD, 1.34. In the postoperative period the mean MMSE score was 28.40 (SD, 1.46. Paired Student's "t" test was applied to the scores and no significant difference was found (p=0.315. ANOVA did not find independent associations between MMSE scores and age, hypertension, smoking, dyslipidemia, education, aneurysm location, number, laterality or size. CONCLUSION: The present study suggests that microsurgical clipping for UIA does not result in major cognitive dysfunction as determined by the MMSEOBJETIVO: É consenso que a maioria dos aneurismas intracranianos não-rotos (AINR podem ser tratados com aceitável taxa de morbidade. Entretanto, alguns estudos reportaram déficits cognitivos no pós-operatório, sugerindo que poderiam ser atribuídos ao dano cirúrgico. O objetivo desse estudo é avaliar a função cognitiva antes e após clipagem microcirúrgica em pacientes com AINR. MÉTODO: Uma série de 40 pacientes com AINR submetidos à clipagem microcirúrgica foi estudada. A avaliação cognitiva (Mini Exame do Estado Mental, MEEM foi realizada antes e após a intervenção cirúrgica. A análise estatística foi realizada com teste "t" de Student e análise de variância (ANOVA. RESULTADOS: A m

Structured Feedback Training for Time-Out: Efficacy and Efficiency in Comparison to a Didactic Method.

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Jensen, Scott A; Blumberg, Sean; Browning, Megan

2017-09-01

Although time-out has been demonstrated to be effective across multiple settings, little research exists on effective methods for training others to implement time-out. The present set of studies is an exploratory analysis of a structured feedback method for training time-out using repeated role-plays. The three studies examined (a) a between-subjects comparison to more a traditional didactic/video modeling method of time-out training, (b) a within-subjects comparison to traditional didactic/video modeling training for another skill, and (c) the impact of structured feedback training on in-home time-out implementation. Though findings are only preliminary and more research is needed, the structured feedback method appears across studies to be an efficient, effective method that demonstrates good maintenance of skill up to 3 months post training. Findings suggest, though do not confirm, a benefit of the structured feedback method over a more traditional didactic/video training model. Implications and further research on the method are discussed.

The Effect of Life Skills Training on Mental Health of Iranian Middle School Students: A Preliminary Study

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Saman Jamali

2016-12-01

Full Text Available Objective: This research aimed to study the effect of life skill training on mental health of Iranian middle school students.Method: This experimental study was conducted In 2015 on 100 students of city of Ghaemshahr (North of Iran, who were randomly selected and divided into two equal groups of intervention (n = 50 and control (n = 50. Qualified trainers provided eight sessions (two sessions a week for 2 hours of life skills training to the intervention group for one month. The control group did not participate in any training sessions during the same period. Mental health in both groups was assessed by a questionnaire pre- and post-training. Data were analyzed using descriptive and infernal (ANCOVA and paired t-test statistic tests.Results: The average age of the participants in both groups was 13.5±1.01. ANCOVA test results revealed that the average score of violence, addiction, stress and sensation-seeking before and after the training was statistically significant in the intervention group and control groups (p<0.001.Conclusion: Life skills training had positive effects on mental health of the participants. Given the importance of mental health in modern societies, it is necessary for schools to incorporate life skills in their curriculum to support the mental health of adolescents.

A Preliminary Evaluation of Instructional Effectiveness of Online Training Implemented at a Government Agency in Thailand

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Supanakorn-Davila, Supawan; Bolliger, Doris U.

2012-01-01

Online training has become popular in the professional development of government employees in Thailand. One large government agency developed an online program to provide training to its employees across the country using two systems: an Internet and Intranet-based system. With the new program implemented, the evaluation of the instructional…

Influence of training and competitive sessions on peripheral β-endorphin levels in training show jumping horses

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Cristina Cravana

2017-01-01

program. Moreover, the responses during exercise in the course of post-competition training sessions seem to be significantly different from those the pre-competition training. These data show that the preliminary competitive stress induced additional significant changes of β-endorphin pattern. It would reflect the need of a long-lasting modulation of fatigue and pain perception related to the effect of an additional physical and mental effort for the consecutive competitive and training sessions.

Endoscopic-assisted interhemispheric parieto-occipital transtentorial approach for microsurgical resection of a pineal region tumor: operative video and technical nuances.

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Liu, James K

2016-01-01

The angle of the straight sinus and tentorium cerebelli can often influence the choice of surgical approach to the pineal region. The supracerebellar infratentorial approach can be technically challenging and a relative contraindication in cases where the angle of the straight sinus and tentorium is very steep. Similarly, an occipital transtentorial approach, which uses a low occipital craniotomy at the junction of the superior sagittal sinus and transverse sinus, may not provide the best trajectory to the pineal region in patients with a steep tentorium. In addition, this approach often necessitates retraction on the occipital lobe to access the tentorial incisura and pineal region, which can increase the risk of visual compromise. In this operative video, the author demonstrates an alternative route using an endoscopic-assisted interhemispheric parieto-occipital transtentorial approach to a pineal region tumor in a patient with a steep straight sinus and tentorium. The approach provided a shorter route and more direct trajectory to the tumor at the tentorial incisura, and avoided direct fixed retraction on the occipital lobe when performed using the lateral position, thereby minimizing visual complications. This video atlas demonstrates the operative technique and surgical nuances, including the application of endoscopic-assisted microsurgical resection and operative pearls for preservation of the deep cerebral veins. In summary, the parieto-occipital transtentorial approach with endoscopic assistance is an important approach in the armamentarium for surgical management of pineal region tumors. The video can be found here: https://youtu.be/Ph4veG14aTk .

Research on the Reform of the Preliminary Course of Architectural Design Based on Innovation & Practice Ability Training

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Yuping, Cai; Shuang, Liang

2017-01-01

The traditional undergraduate education mode of architecture has been unable to adapt to the rapid development of society. Taking the junior professional course of architecture--the preliminary course of architectural design as an example, this paper analyzes the problems existing in the current professional courses of lower grades, puts forward…

Strengthening capacity for monitoring and evaluation through short course training in Kenya

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Hesborn Wao

2017-04-01

Conclusions: This study provides preliminary evidence of potential of the use of short course training as an approach to strengthening capacity in M&E in less-developed countries such as Kenya. It underscores the importance of participants’ self-stated objective(s as an element to be considered in the enhancement of knowledge, attitudes and skills needed for acceptable capacity building in M&E.

Developing a Model of Advanced Training to Promote Career Advancement for Certified Genetic Counselors: An Investigation of Expanded Skills, Advanced Training Paths, and Professional Opportunities.

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Baty, Bonnie J; Trepanier, Angela; Bennett, Robin L; Davis, Claire; Erby, Lori; Hippman, Catriona; Lerner, Barbara; Matthews, Anne; Myers, Melanie F; Robbins, Carol B; Singletary, Claire N

2016-08-01

There are currently multiple paths through which genetic counselors can acquire advanced knowledge and skills. However, outside of continuing education opportunities, there are few formal training programs designed specifically for the advanced training of genetic counselors. In the genetic counseling profession, there is currently considerable debate about the paths that should be available to attain advanced skills, as well as the skills that might be needed for practice in the future. The Association of Genetic Counseling Program Directors (AGCPD) convened a national committee, the Committee on Advanced Training for Certified Genetic Counselors (CATCGC), to investigate varied paths to post-master's training and career development. The committee began its work by developing three related grids that view career advancement from the viewpoints of the skills needed to advance (skills), ways to obtain these skills (paths), and existing genetic counselor positions that offer career change or advancement (positions). Here we describe previous work related to genetic counselor career advancement, the charge of the CATCGC, our preliminary work in developing a model through which to view genetic counselor advanced training and career advancement opportunities, and our next steps in further developing and disseminating the model.

Residents' training to retinal photocoagulation: virtual reality compared to conventional apprenticeship

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Peugnet, Frederic; Dubois, Patrick; Rouland, Jean-Francois

1998-06-01

Virtual reality is one of these recent technologies which can provide an efficient help in the field of surgical apprenticeship. We achieved an original training simulator for retinal photocoagulation destined to the residents of the ophthalmological department. This paper describes the comparison between this new training tool and the conventional practice. Two groups of residents, randomly selected, were trained exclusively by one of these methods. These two groups were under the responsibility of two distinct experts. A final evaluation was made by a third and different expert, ignoring the training mode practiced by each of the residents. The study lasted six months. The results show that this new training mode is at least as efficient as the current one in terms of elapsed time and efficiency. It may even reduce the training duration. These results confirm that a pedagogical simulator could give a new approach in the medical teaching, particularly in its management. Such a device may solve the problems of practitioner's lack of disponibility and of patients' safety and comfort during a conventional training. Furthermore, it could bring an objective way to value the students; practical ability. On the other hand, this preliminary study emphasizes the difficulties in introducing a new modality in a traditional teaching environment.

An EMG-driven exoskeleton hand robotic training device on chronic stroke subjects: task training system for stroke rehabilitation.

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Ho, N S K; Tong, K Y; Hu, X L; Fung, K L; Wei, X J; Rong, W; Susanto, E A

2011-01-01

An exoskeleton hand robotic training device is specially designed for persons after stroke to provide training on their impaired hand by using an exoskeleton robotic hand which is actively driven by their own muscle signals. It detects the stroke person's intention using his/her surface electromyography (EMG) signals from the hemiplegic side and assists in hand opening or hand closing functional tasks. The robotic system is made up of an embedded controller and a robotic hand module which can be adjusted to fit for different finger length. Eight chronic stroke subjects had been recruited to evaluate the effects of this device. The preliminary results showed significant improvement in hand functions (ARAT) and upper limb functions (FMA) after 20 sessions of robot-assisted hand functions task training. With the use of this light and portable robotic device, stroke patients can now practice more easily for the opening and closing of their hands at their own will, and handle functional daily living tasks at ease. A video is included together with this paper to give a demonstration of the hand robotic system on chronic stroke subjects and it will be presented in the conference. © 2011 IEEE

Effect of strength training on orthostatic hypotension in older adults.

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Brilla, L R; Stephens, A B; Knutzen, K M; Caine, D

1998-01-01

This preliminary study attempted to identify the frequency of orthostatic hypotension (OH) in community dwelling older adults who volunteered to participate in an 8-week, heavy-resistance, strength-training program. It also assessed the effect of the strength-training program on OH. From a larger study (n = 53) on high-resistance strength training in older adults (mean age 71.4 +/- 6.6 years), a subset of subjects (n = 24), mean age 71.0 +/- 5.8 years, was evaluated who met at least one criterion for OH. All subjects were tested for resting blood pressures (BP) and heart rates (HR) in the supine, sitting, and standing positions. Also noted was their response to orthostatism in rising from a cot after 10 minutes and rising from a chair after 5 minutes. The subset was not different from the overall group in gender ratio, age, or effect of medication on BP. The treatment was an 8-week strength-training program at 80% of their one repetition maximum. Significant changes (P response to the orthostatic challenge, significant (P positive adaptation to an orthostatic challenge.

Modeling the Effects of Stress: An Approach to Training

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Cuper, Taryn

2010-01-01

Stress is an integral element of the operational conditions experienced by combat medics. The effects of stress can compromise the performance of combat medics who must reach and treat their comrades under often threatening circumstances. Examples of these effects include tunnel vision, loss of motor control, and diminished hearing, which can result in an inability to perceive further danger, satisfactorily treat the casualty, and communicate with others. While many training programs strive to recreate this stress to aid in the experiential learning process, stress inducement may not always be feasible or desired. In addition, live simulations are not always a practical, convenient, and repeatable method of training. Instead, presenting situational training on a personal computer is proposed as an effective training platform in which the effects of stress can be addressed in a different way. We explore the cognitive and motor effects of stress, as well as the benefits of training for mitigating these effects in real life. While many training applications focus on inducing stress in order to "condition" the stress response, the author explores the possibilities of modeling stress to produce a similar effect. Can presenting modeled effects of stress help prepare or inoculate soldiers for stressful situations in which they must perform at a high level? This paper investigates feasibility of modeling stress and describes the preliminary design considerations of a combat medic training system that utilizes this method of battlefield preparation.

[Empathy, inter-professional collaboration, and lifelong medical learning in Spanish and Latin-American physicians-in-training who start their postgraduate training in hospitals in Spain. Preliminary outcomes].

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San-Martín, Montserrat; Roig-Carrera, Helena; Villalonga-Vadell, Rosa M; Benito-Sevillano, Carmen; Torres-Salinas, Miquel; Claret-Teruel, Gemma; Robles, Bernabé; Sans-Boix, Antonia; Alcorta-Garza, Adelina; Vivanco, Luis

2017-01-01

To identify similarities and differences in empathy, abilities toward inter-professional collaboration, and lifelong medical learning, between Spanish and Latin-American physicians-in-training who start their posgraduate training in teaching hospitals in Spain. Observational study using self-administered questionnaires. Five teaching hospitals in the province of Barcelona, Spain. Spanish and Latin-American physicians-in-training who started their first year of post-graduate medical training. Empathy was measured using the Jefferson scale of empathy. Abilities for inter-professional collaboration were measured using the Jefferson scale attitudes towards nurse-physician collaboration. Learning was measured using the Jefferson scale of medical lifelong learning scale. From a sample of 156 physicians-in-training, 110 from Spain and 40 from Latin America, the Spanish group showed the highest empathy (pempathy and inter-professional collaboration for the whole sample (r=+0.34; pempathy in the development of inter-professional collaboration abilities. In Latin-American physicians who start posgraduate training programs, lifelong learning abilities have a positive influence on the development of other professional competencies. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Comprehensive Training of Engineering Students through Continuing Education

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Miguel Reynoso Flores

2014-01-01

Full Text Available This paper addresses a priority for student training in general and particularly for future engineers. Although this issue has been frequently addressed in recent years, proposals are still insufficient for engineering students. This paper is aimed at theoretically and empirically demonstrating the potential of continuing education as one of the key areas that engineering schools have for the comprehensive training of students. Preliminary results of a research project commissioned by the School of Mechanical and Electrical Engineering (Facultad de Ingeniería Mecánica y Electrica-FIME of Universidad Autónoma de Nuevo León, Mexico, are presented to respond to the need to improve the learning process of students with a comprehensive approach. The research justification and some of the results obtained in the exploratory phase are also described.

Preliminary Monthly Climatological Summaries

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National Oceanic and Atmospheric Administration, Department of Commerce — Preliminary Local Climatological Data, recorded since 1970 on Weather Burean Form 1030 and then National Weather Service Form F-6. The preliminary climate data pages...

Medical Waste Management Training for Healthcare Managers - a Necessity?

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Aclan Ozder

2013-07-01

Full Text Available Background:This is an interventional study, since a training has been given, performed in order to investigate whether training has significant impact on knowledge levels of healthcare managers (head-nurses, assistant head nurses, hospital managers and deputy managers regarding bio-medical waste management.Methods:The study was conducted on 240 volunteers during June – August 2010 in 12 hospitals serving in Istanbul (private, public, university, training-research hospitals and other healthcare institutions. A survey form prepared by the project guidance team was applied to the participants through the internet before and after the training courses. The training program was composed of 40 hours of theory and 16 hours of practice sessions taught by persons known to have expertise in their fields. Methods used in the analysis of the data chi-square and t-tests in dependent groups.Results:67.5% (162 of participants were female. 42.5% (102 are working in private, and 21.7% in state-owned hospitals. 50.4% are head-nurses, and 18.3% are hospital managers.A statistically significant difference was found among those who had received medical waste management training (preliminary test and final test and others who had not (p<0.01. It was observed that information levels of all healthcare managers who had received training on waste management had risen at the completion of that training session.Conclusion:On the subject of waste management, to have trained healthcare employees who are responsible for the safe disposal of wastes in hospitals is both a necessity for the safety of patients and important for its contribution to the economy of the country.

Implementing CDIO project-based learning in training of Heat and Power engineers

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Boiko, E. A.; Shishmarev, P. V.; Karabarin, D. I.; Yanov, S. R.; Pikalova, A. A.

2017-11-01

This paper presents the experience and current results of CDIO standards implementation in training of bachelors in Heat and Power Engineering at Thermal Power Stations academic department in Siberian Federal University. It provides information on methodology of modernization of educational programs, curricula and programs of disciplines in transition to CDIO project-based learning technology. Preliminary assessment and analysis of lessons learned and scaling perspectives are given.

Cerebral Reorganization in Subacute Stroke Survivors after Virtual Reality-Based Training: A Preliminary Study

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Xiang Xiao

2017-01-01

Full Text Available Background. Functional magnetic resonance imaging (fMRI is a promising method for quantifying brain recovery and investigating the intervention-induced changes in corticomotor excitability after stroke. This study aimed to evaluate cortical reorganization subsequent to virtual reality-enhanced treadmill (VRET training in subacute stroke survivors. Methods. Eight participants with ischemic stroke underwent VRET for 5 sections per week and for 3 weeks. fMRI was conducted to quantify the activity of selected brain regions when the subject performed ankle dorsiflexion. Gait speed and clinical scales were also measured before and after intervention. Results. Increased activation in the primary sensorimotor cortex of the lesioned hemisphere and supplementary motor areas of both sides for the paretic foot (p<0.01 was observed postintervention. Statistically significant improvements were observed in gait velocity (p<0.05. The change in voxel counts in the primary sensorimotor cortex of the lesioned hemisphere is significantly correlated with improvement of 10 m walk time after VRET (r=−0.719. Conclusions. We observed improved walking and increased activation in cortical regions of stroke survivors after VRET training. Moreover, the cortical recruitment was associated with better walking function. Our study suggests that cortical networks could be a site of plasticity, and their recruitment may be one mechanism of training-induced recovery of gait function in stroke. This trial is registered with ChiCTR-IOC-15006064.

Autogenic-feedback training: A preventive method for space adaptation syndrome

Science.gov (United States)

Cowings, Patricia S.; Sharp, Joseph C.; Toscano, William B.; Kamiya, Joe; Miller, Neal E.

1987-01-01

The progress made to date on the reduction of data for Spacelab 3 Shuttle experiment, No. 3AFT23 is reported. Four astronauts participated as subjects in this experiment. Crewmen A and B served as treatment subjects (i.e., received preflight training for control of their own motion sickness symptoms) and Crewmen C and D served as control (i.e., did not receive training). A preliminary evaluation of Autogenic Feedback Training (AFT) was made from visual inspections of graphs that were generated from the preflight and inflight and inflight physiological data which included: (1) Baseline rotating chair tests for all crewmen; (2) Posttraining rotating chair tests of treatment groups subjects; (3) Preflight data from Joint Integrated Simulations for all crewmen; and (4) Flight data for all crewmen during mission days 0 through 4, and mission day 6 for treatment subjects only. A summary of the findings suggested by these data is outlined.

High-Intensity Interval Training as an Efficacious Alternative to Moderate-Intensity Continuous Training for Adults with Prediabetes

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Mary E. Jung

2015-01-01

Full Text Available Aims. High-intensity interval training (HIIT leads to improvements in various markers of cardiometabolic health but adherence to HIIT following a supervised laboratory intervention has yet to be tested. We compared self-report and objective measures of physical activity after one month of independent exercise in individuals with prediabetes who were randomized to HIIT (n=15 or traditional moderate-intensity continuous training (MICT, n=17. Method. After completing 10 sessions of supervised training participants were asked to perform HIIT or MICT three times per week for four weeks. Results. Individuals in HIIT (89 ± 11% adhered to their prescribed protocol to a greater extent than individuals in MICT (71 ± 31% as determined by training logs completed over one-month follow-up (P = 0.05, Cohen’s d = 0.75. Minutes spent in vigorous physical activity per week measured by accelerometer were higher in HIIT (24 ± 18 as compared to MICT (11 ± 10 at one-month follow-up (P = 0.049, Cohen’s d = 0.92. Cardiorespiratory fitness and systolic blood pressure assessed at one-month follow-up were equally improved (P’s < 0.05. Conclusions. This study provides preliminary evidence that individuals with prediabetes can adhere to HIIT over the short-term and do so at a level that is greater than MICT.

Preliminary Evaluation of a Novel Simulation-Based Tool for Training Rapid Decision-Making Skills

National Research Council Canada - National Science Library

Christ, Richard E

2006-01-01

...). SimFX is different from other desktop trainers in that it uses a discrete, outcome-driven simulation for training leader decision making rather than a simulation driven by inputs from the virtual operating environment...

Differential cardiac effects of aerobic interval training versus moderate continuous training in a patient with schizophrenia: a case report.

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Marco eHerbsleb

2014-08-01

Full Text Available Increased cardiovascular morbidity and mortality rates for patients with schizophrenia are reported to contribute to their reduced life expectancy. Common reasons for increased cardiac mortality rates include cigarette smoking, obesity, dyslipidemia, diabetes and poorer health behavior in general. The majority of excess mortality among people with schizophrenia is caused by cardiovascular complications. Reduced vagal activity might be one important mechanism leading to this increased cardiac mortality and has been consistently described in patients and their healthy first-degree relatives.In this case study, we compared two different aerobic exercise regimes in one patient with chronic schizophrenia to investigate their effects on cardiovascular regulation. The patient completed a 6-week period of moderate continuous training followed by a 6-week period of interval training, each regime 2 times per week, on a stationary bicycle. This was followed by a 6-week period of detraining. Primary outcome measures examined heart rate (HR and heart rate variability (HRV at rest while secondary measures assessed fitness parameters such as the ventilatory threshold 1 (VT1. We observed that interval training was far more effective than moderate continuous training in increasing HRV, as indicated by RMSSD (improvement to baseline 27% vs. 18%, and reducing resting heart rate (-14% vs. 0%. Improvement in VT1 (21% vs. -1% was only observed after interval training. Our study provides preliminary data that the type of intervention is highly influential for improving cardiac function in patients with schizophrenia. While cardiovascular function might be influenced by continuous training to some degree, no such effect was present in this patient with schizophrenia. In addition, the beneficial effect of interval training on heart rate regulation vanished completely after a very short period of detraining after the intervention.

Face, content, and construct validity of human placenta as a haptic training tool in neurointerventional surgery.

Science.gov (United States)

Ribeiro de Oliveira, Marcelo Magaldi; Nicolato, Arthur; Santos, Marcilea; Godinho, Joao Victor; Brito, Rafael; Alvarenga, Alexandre; Martins, Ana Luiza Valle; Prosdocimi, André; Trivelato, Felipe Padovani; Sabbagh, Abdulrahman J; Reis, Augusto Barbosa; Maestro, Rolando Del

2016-05-01

OBJECT The development of neurointerventional treatments of central nervous system disorders has resulted in the need for adequate training environments for novice interventionalists. Virtual simulators offer anatomical definition but lack adequate tactile feedback. Animal models, which provide more lifelike training, require an appropriate infrastructure base. The authors describe a training model for neurointerventional procedures using the human placenta (HP), which affords haptic training with significantly fewer resource requirements, and discuss its validation. METHODS Twelve HPs were prepared for simulated endovascular procedures. Training exercises performed by interventional neuroradiologists and novice fellows were placental angiography, stent placement, aneurysm coiling, and intravascular liquid embolic agent injection. RESULTS The endovascular training exercises proposed can be easily reproduced in the HP. Face, content, and construct validity were assessed by 6 neurointerventional radiologists and 6 novice fellows in interventional radiology. CONCLUSIONS The use of HP provides an inexpensive training model for the training of neurointerventionalists. Preliminary validation results show that this simulation model has face and content validity and has demonstrated construct validity for the interventions assessed in this study.

Head teacher professional networks in Italy: preliminary results of a national survey

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Maurissens Isabel de

2016-06-01

Full Text Available In this article, we present the preliminary results of a national survey conducted by INDIRE on head teachers communities and professional networks. About one-fourth of the total population of Italian public school leaders participated in the survey. One of the main intents of this research is to contribute to understanding of the phenomenon of professional networks frequented by school leaders and to pave the way for a further reflection on how to use such networks for head teachers’ training so as to support their daily professional practice conducted too often in isolation.

A review of simulation-enhanced, team-based cardiopulmonary resuscitation training for undergraduate students.

Science.gov (United States)

Onan, Arif; Simsek, Nurettin; Elcin, Melih; Turan, Sevgi; Erbil, Bülent; Deniz, Kaan Zülfikar

2017-11-01

Cardiopulmonary resuscitation training is an essential element of clinical skill development for healthcare providers. The International Liaison Committee on Resuscitation has described issues related to cardiopulmonary resuscitation and emergency cardiovascular care education. Educational interventions have been initiated to try to address these issues using a team-based approach and simulation technologies that offer a controlled, safe learning environment. The aim of the study is to review and synthesize published studies that address the primary question "What are the features and effectiveness of educational interventions related to simulation-enhanced, team-based cardiopulmonary resuscitation training?" We conducted a systematic review focused on educational interventions pertaining to cardiac arrest and emergencies that addressed this main question. The findings are presented together with a discussion of the effectiveness of various educational interventions. In conclusion, student attitudes toward interprofessional learning and simulation experiences were more positive. Research reports emphasized the importance of adherence to established guidelines, adopting a holistic approach to training, and that preliminary training, briefing, deliberate practices, and debriefing should help to overcome deficiencies in cardiopulmonary resuscitation training. Copyright © 2017 Elsevier Ltd. All rights reserved.

Preliminary construction of a service provider--informed domestic violence research agenda.

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Murray, Christine E; Welch, Metoka L

2010-12-01

This article presents the results of a statewide survey of domestic violence (DV) service providers that focused on the needs, background characteristics, and opinions of service providers related to research. The survey included an examination of service providers' motivation for working in the field, research background and training, and perceptions of research as well as the topics they believe are important for researchers to study, the resources they consult to learn about DV, and their suggestions to help researchers learn more about the nature of their work. The results are integrated into a preliminary agenda for future DV research that accounts for the needs and insight of service providers.

Motor Training in Degenerative Spinocerebellar Disease: Ataxia-Specific Improvements by Intensive Physiotherapy and Exergames

Science.gov (United States)

2014-01-01

The cerebellum is essentially involved in movement control and plays a critical role in motor learning. It has remained controversial whether patients with degenerative cerebellar disease benefit from high-intensity coordinative training. Moreover, it remains unclear by which training methods and mechanisms these patients might improve their motor performance. Here, we review evidence from different high-intensity training studies in patients with degenerative spinocerebellar disease. These studies demonstrate that high-intensity coordinative training might lead to a significant benefit in patients with degenerative ataxia. This training might be based either on physiotherapy or on whole-body controlled videogames (“exergames”). The benefit shown in these studies is equal to regaining one or more years of natural disease progression. In addition, first case studies indicate that even subjects with advanced neurodegeneration might benefit from such training programs. For both types of training, the observed clinical improvements are paralleled by recoveries in ataxia-specific dysfunctions (e.g., multijoint coordination and dynamic stability). Importantly, for both types of training, the retention of the effects seems to depend on the frequency and continuity of training. Based on these studies, we here present preliminary recommendations for clinical practice, and articulate open questions that might guide future studies on neurorehabilitation in degenerative spinocerebellar disease. PMID:24877117

Motor Training in Degenerative Spinocerebellar Disease: Ataxia-Specific Improvements by Intensive Physiotherapy and Exergames

Directory of Open Access Journals (Sweden)

Matthis Synofzik

2014-01-01

Full Text Available The cerebellum is essentially involved in movement control and plays a critical role in motor learning. It has remained controversial whether patients with degenerative cerebellar disease benefit from high-intensity coordinative training. Moreover, it remains unclear by which training methods and mechanisms these patients might improve their motor performance. Here, we review evidence from different high-intensity training studies in patients with degenerative spinocerebellar disease. These studies demonstrate that high-intensity coordinative training might lead to a significant benefit in patients with degenerative ataxia. This training might be based either on physiotherapy or on whole-body controlled videogames (“exergames”. The benefit shown in these studies is equal to regaining one or more years of natural disease progression. In addition, first case studies indicate that even subjects with advanced neurodegeneration might benefit from such training programs. For both types of training, the observed clinical improvements are paralleled by recoveries in ataxia-specific dysfunctions (e.g., multijoint coordination and dynamic stability. Importantly, for both types of training, the retention of the effects seems to depend on the frequency and continuity of training. Based on these studies, we here present preliminary recommendations for clinical practice, and articulate open questions that might guide future studies on neurorehabilitation in degenerative spinocerebellar disease.

Autogenic Feedback Training Applications for Man in Space

Science.gov (United States)

Cowings, Patricia S.; Wade, Charles E. (Technical Monitor)

1994-01-01

Finding an effective treatment for the motion sickness-like symptoms that occur in space has become a high priority for NASA. This paper reviews the back-round research and procedures of an experiment designed to prevent space motion sickness in shuttle crewmembers. The preventive method used, Autogenic - Feedback Training (AFT) involves training subjects to control voluntarily several of their own physiological responses to environmental stressors. AFT has been used reliably to increase tolerance to motion sickness during around based tests in over 300 men and women under a variety of conditions that induce motion sickness, and preliminary evidence from space suggests that AFT may be an effective treatment for space motion sickness as well. Other applications of AFT described include; (1) a potential treatment for post flight orthostatic intolerance, a serious biomedical problem resulting from long duration exposure to micro-g and (2) improving pilot performance during emergency flying conditions.

Working Memory Training in ADHD: Controlling for Engagement, Motivation, and Expectancy of Improvement (Pilot Study).

Science.gov (United States)

Mawjee, Karizma; Woltering, Steven; Lai, Nathan; Gotlieb, Howell; Kronitz, Reena; Tannock, Rosemary

2017-09-01

The aim of this study was to evaluate whether a shortened-length session of CogMed Working Memory Training (CWMT) would be a suitable active control group and evaluate study protocol to aid in design refinements for a larger randomized controlled trial (RCT). Thirty-eight post-secondary students diagnosed with ADHD were randomized into 25 sessions of standard (45 min/session) or shortened (15 min/session) CWMT, or into a waitlist control group. There was no significant difference in completion rate or training index score between the standard- and shortened-length groups indicating that both groups showed improvement and put forth good effort during training. Preliminary findings suggest that shorter training sessions may induce similar levels of engagement, motivation, and expectancy of improvement in participants. We conclude that a larger scale RCT that utilizes shortened-length training as an active control group is warranted, but that a few modifications to the study protocol will be required.

Lower Limb Voluntary Movement Improvement Following a Robot-Assisted Locomotor Training in Spinal Cord Injury

Directory of Open Access Journals (Sweden)

Mirbagheri Mehdi

2011-12-01

Full Text Available Individuals with spinal cord injury (SCI suffer from severe impairments in voluntary movements. Literature reports a reduction in major kinematic and kinetic parameters of lower limbs’ joints. A body weight support treadmill training with robotic assistance has been widely used to improve lower-extremity function and locomotion in persons with SCI. Our objective was to explore the effects of 4-weeks robot-assisted locomotor training on voluntary movement of the ankle musculature in patients with incomplete SCI. In particular, we aimed to characterize the therapeutic effects of Lokomat training on kinematic measures (range of motion, velocity, smoothness during a dorsiflexion movement. We hypothesized that training would improve these measures. Preliminary results show an improvement of kinematic parameters during ankle dorsiflexion voluntary movement after a 4-weeks training in the major part of our participants. Complementary investigations are in progress to confirm these results and understand underlying mechanisms associated with the recovery.

Does perturbation-based balance training prevent falls? Systematic review and meta-analysis of preliminary randomized controlled trials.

Science.gov (United States)

Mansfield, Avril; Wong, Jennifer S; Bryce, Jessica; Knorr, Svetlana; Patterson, Kara K

2015-05-01

Older adults and individuals with neurological conditions are at an increased risk for falls. Although physical exercise can prevent falls, certain types of exercise may be more effective. Perturbation-based balance training is a novel intervention involving repeated postural perturbations aiming to improve control of rapid balance reactions. The purpose of this study was to estimate the effect of perturbation-based balance training on falls in daily life. MEDLINE (1946-July 2014), EMBASE (1974-July 2014), PEDro (all dates), CENTRAL (1991-July 2014), and Google Scholar (all dates) were the data sources used in this study. Randomized controlled trials written in English were included if they focused on perturbation-based balance training among older adults or individuals with neurological conditions and collected falls data posttraining. Two investigators extracted data independently. Study authors were contacted to obtain missing information. A PEDro score was obtained for each study. Primary outcomes were proportion of participants who reported one or more falls (ie, number of "fallers") and the total number of falls. The risk ratio (proportion of fallers) and rate ratio (number of falls) were entered into the analysis. Eight studies involving 404 participants were included. Participants who completed perturbation-based balance training were less likely to report a fall (overall risk ratio=0.71; 95% confidence interval=0.52, 0.96; P=.02) and reported fewer falls than those in the control groups (overall rate ratio=0.54; 95% confidence interval=0.34, 0.85; P=.007). Study authors do not always identify that they have included perturbation training in their intervention; therefore, it is possible that some appropriate studies were not included. Study designs were heterogeneous, preventing subanalyses. Perturbation-based balance training appears to reduce fall risk among older adults and individuals with Parkinson disease. © 2015 American Physical Therapy Association.

TECHNICAL TRAINING SEMINAR

CERN Multimedia

Davide Vitè

2002-01-01

Wednesday 22 May From 14:00 to 17:00 - Training Centre Auditorium - bldg. 593, room 11 Reliability, Availability, Maintainability and Safety (RAMS) Philippe Galley, Vincent Brindejonc / LIGERON S.A., Saint Aubin, France This seminar will address Reliability, Availability, Maintainability and Safety (RAMS) engineering concepts to guarantee availability and safety of critical equipments, in particular in a high technology and R&D environment. Applications of these concepts will be presented. 14h00-14h30 Introduction to Reliability, Availability, Maintainability and Safety activities: general introduction to RAMS, basic definitions, integration of RAMS in a large project. 14h40-16h10 RAMS methodologies: Functional Analysis methodologies Preliminary Hazard Analysis Failure Mode Effects and Criticality Analysis (FMECA) Fault Tree Analysis Use of standards for Reliability predictions Reliability Block Diagrams for a system Advanced models, e.g. Markov's Graphs 16h30-17h00 Presentation of the activ...

Adapting the helpful responses questionnaire to assess communication skills involved in delivering contingency management: preliminary psychometrics.

Science.gov (United States)

Hartzler, Bryan

2015-08-01

A paper/pencil instrument, adapted from Miller and colleagues' (1991) Helpful Responses Questionnaire (HRQ), was developed to assess clinician skill with core communicative aspects involved in delivering contingency management (CM). The instrument presents a single vignette consisting of six points of client dialogue to which respondents write 'what they would say next.' In the context of an implementation/effectiveness hybrid trial, 19 staff clinicians at an opiate treatment program completed serial training outcome assessments before, following, and three months after CM training. Assessments included this adaptation of the HRQ, a multiple-choice CM knowledge test, and a recorded standardized patient encounter scored for CM skillfulness. Study results reveal promising psychometric properties for the instrument, including strong scoring reliability, internal consistency, concurrent and predictive validity, test-retest reliability and sensitivity to training effects. These preliminary findings suggest the instrument is a viable, practical method to assess clinician skill in communicative aspects of CM delivery. Copyright © 2015 Elsevier Inc. All rights reserved.

Transfer of training effects in stroke patients with apraxia: an exploratory study.

Science.gov (United States)

Geusgens, Chantal; van Heugten, Caroline; Donkervoort, Mireille; van den Ende, Els; Jolles, Jelle; van den Heuvel, Wim

2006-04-01

The goal of the present study was to examine the transfer of the effects of cognitive strategy training for stroke patients with apraxia from trained to non-trained tasks. In strategy training, the occurrence of transfer is expected as the training programme is aimed, not at relearning specific tasks, but at teaching patients new ways to handle the problems resulting from the impairment. Exploratory analyses were conducted on data previously collected in a randomised controlled trial on the efficacy of the strategy training. A total of 113 left hemisphere stroke patients were randomly assigned to a strategy training group and a group receiving occupational therapy as usual. Assessment of apraxia, motor functioning and activities of daily living (ADL) took place at baseline, after an eight-week treatment period, and five months after baseline. The primary outcome measure consisted of standardised ADL observations of trained and non-trained tasks. The analyses showed that in both treatment groups, the scores on the ADL observations for non-trained tasks improved significantly after eight weeks of training as compared with the baseline score. Change scores of non-trained activities were larger in the strategy training group as compared with the usual treatment group. By using previously collected data we are able to illustrate the potential transfer of treatment effects in a large sample of stroke patients. We found indications for the occurrence of transfer, although the study was not originally designed for the purpose of evaluating transfer. Therefore these results are worth exploring more profoundly. We will further investigate our preliminary conclusions in a new prospective study which is specifically designed to examine the transfer of training effects.

Autogenic training as a therapy for adjustment disorder in adolescents

Directory of Open Access Journals (Sweden)

Jojić Boris R.

2005-01-01

Full Text Available INTRODUCTION Autogenic training is a widespread technique used in psychotherapy. The British school of autogenic training cites a large list of diseases, health states, and life changes, in which autogenic training can be of help. We wanted to explore the application of autogenic training as a therapy for adjustment disorder in adolescents. The sample consisted of a homogeneous group of 31 individuals, with an average age of 17.3±0.2 years, who were diagnosed with adjustment disorder, F 43.2, in accordance with ICD 10 search criteria. OBJECTIVE The aim of our work was to figure out the influence of autogenic training on adjustment disorder, through biophysical and biochemical indicators, and to research the efficacy of autogenic training as a therapy for adjustment disorder in adolescents. METHOD We observed adjustment disorder indicators and their changes in three phases, using initial, final, and control values, which we measured immediately before the beginning, immediately after the completion, and six months after the completion, of the practical course in autogenic training. We measured systolic and diastolic arterial blood pressure, brachial pulse rates, cortisol levels in plasma, cholesterol levels in blood, as well as glucose concentrations. During that period, autogenic training was employed as the sole therapy. RESULTS The study confirmed our preliminary assumptions. The measurements we performed showed that arterial blood pressure, pulse rates, cholesterol and cortisol concentrations, after the application of autogenic training among adolescents suffering from adjustment disorder, were lower than the initial values. They remained lower even six months after the completion of the practical course in autogenic training. CONCLUSION We concluded that autogenic training significantly decreases the values of physiological indicators of adjustment disorder, diminishes the effects of stress in an individual, and eases the adaptation of

Autogenic training as a therapy for adjustment disorder in adults

Directory of Open Access Journals (Sweden)

Jojić Boris R.

2005-01-01

Full Text Available Introduction. Autogenic training is a widely recognised psychotherapy technique. The British School of Autogenic Training cites a large list of disorders, states, and changes, where autogenic training may prove to be of help. We wanted to explore the application of autogenic training as a therapy for adjustment disorder in adults. Our sample consisted of a homogeneous group of 35 individuals, with an average age of 39.3±1.6 years, who were diagnosed with adjustment disorder, F 43.2, in accordance with ICD 10 search criteria. Aim. The aim of our study was to research the effectiveness of autogenic training as a therapy for adjustment disorder in adults, by checking the influence of autogenic training on the biophysical and biochemical indicators of adjustment disorder. Method. We measured the indicators of adjustment disorder and their changes in three phases: before the beginning, immediately after the beginning, and six months after the completion, of a practical course in autogenic training. We measured systolic and diastolic arterial blood pressure, brachial pulse rate as well as the levels of cortisol in plasma, of cholesterol in blood, and of glucose. During that period, autogenic training functioned as the sole therapy. Results. The study confirmed our preliminary assumptions. The measurements we performed demonstrated that arterial blood pressure, pulse rate, concentration of cholesterol and cortisol, after the application of autogenic training among the subjects suffering from adjustment disorder, were lower in comparison to the initial values. These values remained lower even six months after the completion of the practical course in autogenic training. Conclusion. Autogenic training significantly decreases the values of physiological indicators of adjustment disorder, diminishes the effects of stress in an individual, and helps adults to cope with stress, facilitating their recuperation.

[Autogenic training as a therapy for adjustment disorder in adults].

Science.gov (United States)

Jojić, Boris R; Leposavić, Ljubica M

2005-01-01

Autogenic training is a widely recognised psychotherapy technique. The British School of Autogenic Training cites a large list of disorders, states, and changes, where autogenic training may prove to be of help. We wanted to explore the application of autogenic training as a therapy for adjustment disorder in adults. Our sample consisted of a homogeneous group of 35 individuals, with an average age of 39.3 +/- 1.6 years, who were diagnosed with adjustment disorder, F 43.2, in accordance with ICD 10 search criteria. The aim of our study was to research the effectiveness of autogenic training as a therapy for adjustment disorder in adults, by checking the influence of autogenic training on the biophysical and biochemical indicators of adjustment disorder. We measured the indicators of adjustment disorder and their changes in three phases: before the beginning, immediately after the beginning, and six months after the completion, of a practical course in autogenic training. We measured systolic and diastolic arterial blood pressure, brachial pulse rate as well as the levels of cortisol in plasma, of cholesterol in blood, and of glucose. During that period, autogenic training functioned as the sole therapy. The study confirmed our preliminary assumptions. The measurements we performed demonstrated that arterial blood pressure, pulse rate, concentration of cholesterol and cortisol, after the application of autogenic training among the subjects suffering from adjustment disorder, were lower in comparison to the initial values. These values remained lower even six months after the completion of the practical course in autogenic training. Autogenic training significantly decreases the values of physiological indicators of adjustment disorder, diminishes the effects of stress in an individual, and helps adults to cope with stress, facilitating their recuperation.

[Autogenic training as a therapy for adjustment disorder in adolescents].

Science.gov (United States)

Jojić, Boris R; Leposavić, Ljubica M

2005-01-01

Autogenic training is a widespread technique used in psychotherapy. The British school of autogenic training cites a large list of diseases, health states, and life changes, in which autogenic training can be of help. We wanted to explore the application of autogenic training as a therapy for adjustment disorder in adolescents. The sample consisted of a homogeneous group of 31 individuals, with an average age of 17.3 +/- 0.2 years, who were diagnosed with adjustment disorder, F 43.2, in accordance with ICD 10 search criteria. The aim of our work was to figure out the influence of autogenic training on adjustment disorder, through biophysical and biochemical indicators, and to research the efficiacy of autogenic training as a therapy for adjustment disorder in adolescents. We observed adjustment disorder indicators and their changes in three phases, using initial, final, and control values, which we measured immediately before the beginning, immediately after the completion, and six months after the completion, of the practical course in autogenic training. We measured systolic and diastolic arterial blood pressure, brachial pulse rates, cortisol levels in plasma, cholesterol levels in blood, as well as glucose concentrations. During that period, autogenic training was employed as the sole therapy. The study confirmed our preliminary assumptions. The measurements we performed showed that arterial blood pressure, pulse rates, cholesterol and cortisol concentrations, after the application of autogenic training among adolescents suffering from adjustment disorder, were lower than the initial values. They remained lower even six months after the completion of the practical course in autogenic training. We concluded that autogenic training significantly decreases the values of physiological indicators of adjustment disorder, diminishes the effects of stress in an individual, and eases the adaptation of adolescents to stress, helping with recovery.

Job Training and Education of Disconnected Young Adults in New Orleans: Preliminary Analysis of Federal Funding Streams

Science.gov (United States)

Finance Project, 2012

2012-01-01

Baptist Community Ministries asked The Finance Project to examine the expenditure of federal funds for job training and education of New Orleans' disconnected young adults (i.e., persons between ages 16 and 24 who are not in school or work). Four major sources of federal funding for job training and education of this population are available: the…

Serious Gaming for Improvised Explosive Device Neutralization Training

Directory of Open Access Journals (Sweden)

Chan Christopher C.K.

2016-01-01

Full Text Available An improvised explosive device (IED is a “homemade” bomb intended to cause great harm when it explodes. The public safety task of identifying and neutralizing IEDs falls to military and police services often called explosive disposal units (EDU who act to neutralize the threat associated with the IED either rendering it inoperable or destroying it safely. EDUs train in various aspects of explosive handling and investigation but are limited in the tools available for safely analyzing real world bombs. This paper describes a game based approach to IED training that employs an interactive 3D simulation to spatially identify key IED components of interest. We give an example of how this approach might be used and provide a preliminary evaluation of its potential effectiveness. We employ images formed from a Digital Imaging and Communications in Medicine (DICOM system captured using Magnetic Resonance Imaging (MRI technology to a virtual IED in a game. Empirical evaluation and EDU testimony suggest accurate representation of the IED and the potential efficacy of the proposed approach for successfully identifying components in the bomb for the purposes of EDU training.

BIPS-FS preliminary design, miscellaneous notes

International Nuclear Information System (INIS)

1976-01-01

A compendium of flight system preliminary design internal memos and progress report extracts for the Brayton Isotope Power System Preliminary Design Review to be held July 20, 21, and 22, 1975 is presented. The purpose is to bring together those published items which relate only to the preliminary design of the Flight System, Task 2 of Phase I. This preliminary design effort was required to ensure that the Ground Demonstration System will represent the Flight System as closely as possible

Virtual Reality Job Interview Training in Adults with Autism Spectrum Disorder

Science.gov (United States)

Smith, Matthew J.; Ginger, Emily; Wright, Katherine; Wright, Michael; Taylor, Julie Lounds; Humm, Laura Boteler; Olsen, Dale; Bell, Morris D.; Fleming, Michael F.

2014-01-01

The feasibility and efficacy of Virtual Reality Job Interview Training (VR-JIT) was assessed in a single-blinded randomized controlled trial. Adults with autism spectrum disorder were randomized to VR-JIT (n=16) or treatment as usual (TAU) (n=10) groups. VR-JIT consisted of simulated job interviews with a virtual character and didactic training. Participants attended 90% of lab-based training sessions and found VR-JIT easy-to-use, enjoyable, and they felt prepared for future interviews. VR-JIT participants had greater improvement during live standardized job interview role-play performances than TAU participants (p=0.046). A similar pattern was observed for self-reported self-confidence at a trend level (p=0.060). VR-JIT simulation performance scores increased over time (R-Squared=0.83). Results indicate preliminary support for the feasibility and efficacy of VR-JIT, which can be administered using computer software or via the internet. PMID:24803366

45 CFR 150.217 - Preliminary determination.

Science.gov (United States)

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Preliminary determination. 150.217 Section 150.217... Are Failing To Substantially Enforce HIPAA Requirements § 150.217 Preliminary determination. If, at... designees). (b) Notifies the State of CMS's preliminary determination that the State has failed to...

Testing an empirically derived mental health training model featuring small groups, distributed practice and patient discussion.

Science.gov (United States)

Murrihy, Rachael C; Byrne, Mitchell K; Gonsalvez, Craig J

2009-02-01

Internationally, family doctors seeking to enhance their skills in evidence-based mental health treatment are attending brief training workshops, despite clear evidence in the literature that short-term, massed formats are not likely to improve skills in this complex area. Reviews of the educational literature suggest that an optimal model of training would incorporate distributed practice techniques; repeated practice over a lengthy time period, small-group interactive learning, mentoring relationships, skills-based training and an ongoing discussion of actual patients. This study investigates the potential role of group-based training incorporating multiple aspects of good pedagogy for training doctors in basic competencies in brief cognitive behaviour therapy (BCBT). Six groups of family doctors (n = 32) completed eight 2-hour sessions of BCBT group training over a 6-month period. A baseline control design was utilised with pre- and post-training measures of doctors' BCBT skills, knowledge and engagement in BCBT treatment. Family doctors' knowledge, skills in and actual use of BCBT with patients improved significantly over the course of training compared with the control period. This research demonstrates preliminary support for the efficacy of an empirically derived group training model for family doctors. Brief CBT group-based training could prove to be an effective and viable model for future doctor training.

Exploratory shaft facility preliminary designs - Permian Basin

International Nuclear Information System (INIS)

1983-09-01

The purpose of the Preliminary Design Report, Permian Basin, is to provide a description of the preliminary design for an Exploratory Shaft Facility in the Permian Basin, Texas. This issue of the report describes the preliminary design for constructing the exploratory shaft using the Large Hole Drilling method of construction and outlines the preliminary design and estimates of probable construction cost. The Preliminary Design Report is prepared to complement and summarize other documents that comprise the design at the preliminary stage of completion, December 1982. Other design documents include drawings, cost estimates and schedules. The preliminary design drawing package, which includes the construction schedule drawing, depicts the descriptions in this report. For reference, a list of the drawing titles and corresponding numbers are included in the Appendix. The report is divided into three principal sections: Design Basis, Facility Description, and Construction Cost Estimate. 30 references, 13 tables

A pilot study of combined working memory and inhibition training for children with AD/HD.

Science.gov (United States)

Johnstone, Stuart J; Roodenrys, Steven; Phillips, Elise; Watt, Annele J; Mantz, Sharlene

2010-03-01

Building on recent favourable outcomes using working memory (WM) training, this study examined the behavioural and physiological effect of concurrent computer-based WM and inhibition training for children with attention-deficit hyperactivity disorder (AD/HD). Using a double-blind active-control design, 29 children with AD/HD completed a 5-week at-home training programme and pre- and post-training sessions which included the assessment of overt behaviour, resting EEG, as well as task performance, skin conductance level and event-related potentials (ERPs) during a Go/Nogo task. Results indicated that after training, children from the high-intensity training condition showed reduced frequency of inattention and hyperactivity symptoms. Although there were trends for improved Go/Nogo performance, increased arousal and specific training effects for the inhibition-related N2 ERP component, they failed to reach standard levels of statistical significance. Both the low- and high-intensity conditions showed resting EEG changes (increased delta, reduced alpha and theta activity) and improved early attention alerting to Go and Nogo stimuli, as indicated by the N1 ERP component, post-training. Despite limitations, this preliminary work indicates the potential for cognitive training that concurrently targets the interrelated processes of WM and inhibition to be used as a treatment for AD/HD.

Feasibility of Training and Delivering Compassionate Touch in Long-Term Care.

Science.gov (United States)

Han, Areum; Kunik, Mark E

2017-09-19

Limited evidence supports the use of therapeutic touch for people with dementia (PWD). Interventions incorporating a person-centered approach to touch delivered by staff may benefit PWD and staff in long-term care settings. The Compassionate Touch ® (CT) program provides skilled human touch and a compassionate presence following a person-centered approach and touch protocol. The purpose of this study was to determine the feasibility of training and delivering CT. An online survey was sent via email to 112 staff who attended the CT coach training. Descriptive statistics and thematic analysis were used to analyze closed-and open-ended questions of the survey. Twenty-four staff members completed the survey and reported positive perspectives about the training, use of the program, and benefits for PWD and themselves. Five themes emerged, including (1) benefits for residents, (2) challenges in using CT, (3) when to use CT, (4) training staff, and (5) needed support. Preliminary findings from the present research show potential benefits of using the CT program for residents, challenges participants faced in using the program and training other staff, and support needed to overcome these challenges. Programs such as CT may benefit PWD and staff in residential care settings.

A Study on Evaluation of Training Program for MCR Operators of SMART Simulator

Energy Technology Data Exchange (ETDEWEB)

Park, Hyun Jun; Lee, Joon Ku; Jeong, Kwang Il [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

2015-10-15

It is important to develop a training program by simulators in main control room of nuclear power plants because there is no an operation expert and no operating experience in the pre-construction phase of nuclear power plants. It is also necessary to develop a training program and its evaluation method taking human error into account. The purpose of this study is developing evaluation model of simulators. In a training program, once training requirements are selected, evaluation of training is as important as its implementation. Training effectiveness is available value in a simulator-based environment. The main control room of SMART (System-integrated Modular Advanced ReacTor) is consist of workstation, visual display units such as LDP and FPD based on digital systems. Cognitive behaviors of a high level are required to operators in these man-machine interface system (MMIS). Therefore, it is essential to identify training requirements and to develop its evaluation model. Virtual Environments such as a simulator have utilized by a lot of industries and companies for training and accident prevention. Simulators have three primary benefits. The first is that training by simulators is less expensive than those in real environment. The second is that simulators enable safety enhancement using systematic training program. The third is that simulators provide a preliminary to prevent human error. It is significant to apply TER, TCR, TCE in evaluation of training effect. It is expected that these could be applied to revise training criteria and enable to consider efficiency in terms of cost and benefit.

A Study on Evaluation of Training Program for MCR Operators of SMART Simulator

International Nuclear Information System (INIS)

Park, Hyun Jun; Lee, Joon Ku; Jeong, Kwang Il

2015-01-01

It is important to develop a training program by simulators in main control room of nuclear power plants because there is no an operation expert and no operating experience in the pre-construction phase of nuclear power plants. It is also necessary to develop a training program and its evaluation method taking human error into account. The purpose of this study is developing evaluation model of simulators. In a training program, once training requirements are selected, evaluation of training is as important as its implementation. Training effectiveness is available value in a simulator-based environment. The main control room of SMART (System-integrated Modular Advanced ReacTor) is consist of workstation, visual display units such as LDP and FPD based on digital systems. Cognitive behaviors of a high level are required to operators in these man-machine interface system (MMIS). Therefore, it is essential to identify training requirements and to develop its evaluation model. Virtual Environments such as a simulator have utilized by a lot of industries and companies for training and accident prevention. Simulators have three primary benefits. The first is that training by simulators is less expensive than those in real environment. The second is that simulators enable safety enhancement using systematic training program. The third is that simulators provide a preliminary to prevent human error. It is significant to apply TER, TCR, TCE in evaluation of training effect. It is expected that these could be applied to revise training criteria and enable to consider efficiency in terms of cost and benefit

Analysis of international practice patterns regarding postvasectomy fertility options.

Science.gov (United States)

Blach, Ola; Shridharani, Anand N; Sandlow, Jay I

2014-05-01

To review the management of postvasectomy fertility options by urologists with vs without andrology fellowship and compare the features of practice in the USA vs UK. We conducted an audit of all American Urological Association-affiliated urologists regarding their practice in managing men requesting vasectomy reversal (VR). Standards of practice were assessed against 10 index parameters deemed, by 1 UK study, to reflect best practice. Fisher exact test was used to test the hypothesis that management of postvasectomy fertility options and practice of VR are no different when undertaken by urologists with vs without andrology training and no different in the USA vs UK. Three hundred twenty-five of 645 US respondents (50.4%) practiced VR vs 178 of 213 (83.6%) in the UK; only 11.9% in the US and 10% in the UK performed >25 and >15 (P <.0001) VR/year, respectively. Compared with the UK urologists the US urologists offered more detailed information on all fertility options and/or outcomes, used microsurgical techniques more often, but less frequently counseled couples together, and referred patients to specialist centers for in vitro fertilization with intracytoplasmic sperm injection (P <.0001-.05). Only 74 of the US and 61 of the UK urologists were fellowship-trained in andrology. Most non-fellowship-trained urologists, in both the countries, performed <5 VR/year and were, statistically, significantly less likely to counsel couples about all fertility options, be conversant in in vitro fertilization with intracytoplasmic sperm injection, provide individualized outcomes data, and use microsurgical techniques (P <.0001-.05). Significant differences exist in the standards of practice between both the US and UK urologists performing VR. Concordance with the indices of "best practice" improves with andrology training and increasing number of procedures performed. Copyright © 2014 Elsevier Inc. All rights reserved.

High-Intensity Interval Training After Stroke: An Opportunity to Promote Functional Recovery, Cardiovascular Health, and Neuroplasticity.

Science.gov (United States)

Crozier, Jennifer; Roig, Marc; Eng, Janice J; MacKay-Lyons, Marilyn; Fung, Joyce; Ploughman, Michelle; Bailey, Damian M; Sweet, Shane N; Giacomantonio, Nicholas; Thiel, Alexander; Trivino, Michael; Tang, Ada

2018-04-01

Stroke is the leading cause of adult disability. Individuals poststroke possess less than half of the cardiorespiratory fitness (CRF) as their nonstroke counterparts, leading to inactivity, deconditioning, and an increased risk of cardiovascular events. Preserving cardiovascular health is critical to lower stroke risk; however, stroke rehabilitation typically provides limited opportunity for cardiovascular exercise. Optimal cardiovascular training parameters to maximize recovery in stroke survivors also remains unknown. While stroke rehabilitation recommendations suggest the use of moderate-intensity continuous exercise (MICE) to improve CRF, neither is it routinely implemented in clinical practice, nor is the intensity always sufficient to elicit a training effect. High-intensity interval training (HIIT) has emerged as a potentially effective alternative that encompasses brief high-intensity bursts of exercise interspersed with bouts of recovery, aiming to maximize cardiovascular exercise intensity in a time-efficient manner. HIIT may provide an alternative exercise intervention and invoke more pronounced benefits poststroke. To provide an updated review of HIIT poststroke through ( a) synthesizing current evidence; ( b) proposing preliminary considerations of HIIT parameters to optimize benefit; ( c) discussing potential mechanisms underlying changes in function, cardiovascular health, and neuroplasticity following HIIT; and ( d) discussing clinical implications and directions for future research. Preliminary evidence from 10 studies report HIIT-associated improvements in functional, cardiovascular, and neuroplastic outcomes poststroke; however, optimal HIIT parameters remain unknown. Larger randomized controlled trials are necessary to establish ( a) effectiveness, safety, and optimal training parameters within more heterogeneous poststroke populations; (b) potential mechanisms of HIIT-associated improvements; and ( c) adherence and psychosocial outcomes.

Prospective double-blind preoperative pain clinic screening before microsurgical denervation of the spermatic cord in patients with testicular pain syndrome.

Science.gov (United States)

Oomen, Robert J A; Witjens, Annemijke C; van Wijck, Albert J M; Grobbee, Diederik E; Lock, Tycho M T W

2014-09-01

Testicular pain syndrome (TPS), defined as an intermittent or constant pain in one or both testicles for at least 3 months, resulting in significant reduction of daily activities, is common. Microsurgical denervation of the spermatic cord (MDSC) has been suggested as an effective treatment option. The study population comprised 180 TPS patients admitted to our outpatient urology clinic between 1999 and 2011. On 3 different occasions, patients were offered a double-blind, placebo-controlled temporary blockade of the spermatic cord. A single blockade consisted of 10 mL 2% lidocaine, 10 mL 0.25% bupivacaine, or 10 mL 0.9% sodium chloride. If the results of these blockades were positive, MDSC was offered. All MDSCs were performed by a single urologist (M.T.W.T.L.) using an inguinal approach. Pain reduction was determined at prospective follow-up. This study evaluated 180 patients. Most patients (61.1%) had undergone a scrotal or inguinal procedure. Patients had complaints during sexual activities (51.7%), sitting (37.5%), and/or cycling (36.7%); 189 randomized blockades were offered to all patients. There was a positive response in 37% and a negative response in 51%. MDSC was performed on 58 testicular units, including 3 patients with a negative outcome of the blockades. At mean follow-up of 42.8 months, 86.2% had a ≥ 50% reduction of pain and 51.7% were completely pain free. MDSC is a valuable treatment option for TPS patients because in this study 86.2% experienced a ≥ 50% reduction of pain. To prevent superfluous diagnostics and treatment, it is mandatory to follow a systematic protocol in the treatment of TPS. Copyright © 2014 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

Energy dispersive X-ray diffraction as a means to identify illicit materials: A preliminary optimisation study

Energy Technology Data Exchange (ETDEWEB)

Cook, Emily [Department of Medical Physics and Bioengineering, UCL, London WC1E 6BT (United Kingdom)]. E-mail: ecook@medphys.ucl.ac.uk; Fong, Ruby [Clinical Physics Department, St Bartholomew' s Hospital, London EC1A 7BE (United Kingdom); Horrocks, Julie [Clinical Physics Department, St Bartholomew' s Hospital, London EC1A 7BE (United Kingdom); Wilkinson, David [HOSDB, Woodcock Hill, Sandridge, Herts. AL4 9HQ (United Kingdom); Speller, Robert [Department of Medical Physics and Bioengineering, UCL, London WC1E 6BT (United Kingdom)

2007-08-15

Energy dispersive X-ray diffraction is proposed as a suitable non-destructive method to rapidly identify illicit drugs in parcels. A preliminary data set of 7 illicit drug samples and a possible cutting agent has been collected with a range of count times using a tungsten target X-ray source, a high resolution HpGe detector and a variable geometry diffraction cell. These results have been used to calibrate and train multivariate analysis software to predict the drug content in previously unseen spectra.

Energy dispersive X-ray diffraction as a means to identify illicit materials: A preliminary optimisation study

International Nuclear Information System (INIS)

Cook, Emily; Fong, Ruby; Horrocks, Julie; Wilkinson, David; Speller, Robert

2007-01-01

Energy dispersive X-ray diffraction is proposed as a suitable non-destructive method to rapidly identify illicit drugs in parcels. A preliminary data set of 7 illicit drug samples and a possible cutting agent has been collected with a range of count times using a tungsten target X-ray source, a high resolution HpGe detector and a variable geometry diffraction cell. These results have been used to calibrate and train multivariate analysis software to predict the drug content in previously unseen spectra

Outreach to the Public on Earthquake and Tsunami Safety with Limited Human Resources: Train the Trainers Pilot Program in Puerto Rico

Science.gov (United States)

Gonzalez Ruiz, W.; Vanacore, E. A.; Gomez, G.; Martinez Colon, J. F.; Perez, F.; Baez-Sanchez, G.; Flores Hots, V. E.; Lopez, A. M.; Huerfano, V.; Figueroa, J. M.

2017-12-01

Given the limited human resources available to interact directly with the public and disseminate information on earthquake and tsunami safety, the Puerto Rico Seismic Network has developed the Train the Trainers course, designed exclusively for emergency management officers (EMOs). This three-day training course provides a complete package of educational tools that will allow EMOs to present standard conferences, and lectures, with the appropriate and accurate information for different audiences on earthquake and tsunami hazard and safety. Here we present preliminary observations and lessons learned from the pilot program that was offered in July 2017 to 20 EMOs from the twelve Puerto Rico Emergency Management Agency (PREMA) zones and two students from the University of Puerto Rico Mayaguez. To ensure sufficient preparation, the training course provided evaluation tools including written and practical exams that participants were required to score 80% or more to complete the training successfully. Of the 20 EMO participants, 18 EMOs passed the final exam. Preliminary analysis of the pre-test scores and the post-test scores, show a score improvement between 8% to 46% amongst the participants. These 18 participants will receive a certificate as well as tools and resources to offer earthquakes and tsunamis conferences for up to two years across Puerto Rico and its outlying islands. To ensure that the pilot participants will provide conferences to the public PRSN required a signed commitment to give at least 5 conferences in one year from each participant and PRSN will monitor the participants for the next two years to evaluate the efficacy of the program. However, based on the preliminary data this program appears to be an effective method to increase the amount of outreach professionals on the Island.

Autogenic Training and Hand Temperature Biofeedback in the Treatment of Migraine: A Preliminary Analysis.

Science.gov (United States)

Jessup, B.; And Others

The possibility of alleviating migraine headaches by autogenic relaxation training, with or without hand temperature biofeedback, was assessed. The study examined five independent groups in a bi-directional control group design. Volunteer migraine sufferers served as subjects, each participating for 12 weeks. The first four weeks of the study were…

Development of subliminal persuasion system to improve the upper limb posture in laparoscopic training: a preliminary study.

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Zhang, Di; Sessa, Salvatore; Kong, Weisheng; Cosentino, Sarah; Magistro, Daniele; Ishii, Hiroyuki; Zecca, Massimiliano; Takanishi, Atsuo

2015-11-01

Current training for laparoscopy focuses only on the enhancement of manual skill and does not give advice on improving trainees' posture. However, a poor posture can result in increased static muscle loading, faster fatigue, and impaired psychomotor task performance. In this paper, the authors propose a method, named subliminal persuasion, which gives the trainee real-time advice for correcting the upper limb posture during laparoscopic training like the expert but leads to a lower increment in the workload. A 9-axis inertial measurement unit was used to compute the upper limb posture, and a Detection Reaction Time device was developed and used to measure the workload. A monitor displayed not only images from laparoscope, but also a visual stimulus, a transparent red cross superimposed to the laparoscopic images, when the trainee had incorrect upper limb posture. One group was exposed, when their posture was not correct during training, to a short (about 33 ms) subliminal visual stimulus. The control group instead was exposed to longer (about 660 ms) supraliminal visual stimuli. We found that subliminal visual stimulation is a valid method to improve trainees' upper limb posture during laparoscopic training. Moreover, the additional workload required for subconscious processing of subliminal visual stimuli is less than the one required for supraliminal visual stimuli, which is processed instead at the conscious level. We propose subliminal persuasion as a method to give subconscious real-time stimuli to improve upper limb posture during laparoscopic training. Its effectiveness and efficiency were confirmed against supraliminal stimuli transmitted at the conscious level: Subliminal persuasion improved upper limb posture of trainees, with a smaller increase on the overall workload.

Targeting paretic propulsion to improve poststroke walking function: a preliminary study.

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Awad, Louis N; Reisman, Darcy S; Kesar, Trisha M; Binder-Macleod, Stuart A

2014-05-01

To determine the feasibility and safety of implementing a 12-week locomotor intervention targeting paretic propulsion deficits during walking through the joining of 2 independent interventions, walking at maximal speed on a treadmill and functional electrical stimulation of the paretic ankle musculature (FastFES); to determine the effects of FastFES training on individual subjects; and to determine the influence of baseline impairment severity on treatment outcomes. Single group pre-post preliminary study investigating a novel locomotor intervention. Research laboratory. Individuals (N=13) with locomotor deficits after stroke. FastFES training was provided for 12 weeks at a frequency of 3 sessions per week and 30 minutes per session. Measures of gait mechanics, functional balance, short- and long-distance walking function, and self-perceived participation were collected at baseline, posttraining, and 3-month follow-up evaluations. Changes after treatment were assessed using pairwise comparisons and compared with known minimal clinically important differences or minimal detectable changes. Correlation analyses were run to determine the correlation between baseline clinical and biomechanical performance versus improvements in walking speed. Twelve of the 13 subjects that were recruited completed the training. Improvements in paretic propulsion were accompanied by improvements in functional balance, walking function, and self-perceived participation (each Pstudy of this promising locomotor intervention for persons poststroke. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

High fidelity simulation based team training in urology: a preliminary interdisciplinary study of technical and nontechnical skills in laparoscopic complications management.

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Lee, Jason Y; Mucksavage, Phillip; Canales, Cecilia; McDougall, Elspeth M; Lin, Sharon

2012-04-01

Simulation based team training provides an opportunity to develop interdisciplinary communication skills and address potential medical errors in a high fidelity, low stakes environment. We evaluated the implementation of a novel simulation based team training scenario and assessed the technical and nontechnical performance of urology and anesthesiology residents. Urology residents were randomly paired with anesthesiology residents to participate in a simulation based team training scenario involving the management of 2 scripted critical events during laparoscopic radical nephrectomy, including the vasovagal response to pneumoperitoneum and renal vein injury during hilar dissection. A novel kidney surgical model and a high fidelity mannequin simulator were used for the simulation. A debriefing session followed each simulation based team training scenario. Assessments of technical and nontechnical performance were made using task specific checklists and global rating scales. A total of 16 residents participated, of whom 94% rated the simulation based team training scenario as useful for communication skill training. Also, 88% of urology residents believed that the kidney surgical model was useful for technical skill training. Urology resident training level correlated with technical performance (p=0.004) and blood loss during renal vein injury management (p=0.022) but not with nontechnical performance. Anesthesia resident training level correlated with nontechnical performance (p=0.036). Urology residents consistently rated themselves higher on nontechnical performance than did faculty (p=0.033). Anesthesia residents did not differ in the self-assessment of nontechnical performance compared to faculty assessments. Residents rated the simulation based team training scenario as useful for interdisciplinary communication skill training. Urology resident training level correlated with technical performance but not with nontechnical performance. Urology residents

Ethical Competence Training for Members on Clinical Ethics Committees (CEC)

DEFF Research Database (Denmark)

Knox, Jeanette Bresson Ladegaard

2017-01-01

To address the moral questions in patient care and medical practice, Danish hospitals are starting to solicit clinical ethics committees (CEC). As in other places around the world, CECs in Denmark is an interdisciplinary group that includes physicians, nurses, social workers, psychologists, lawyers...... lingering moral quandaries. Thus, the creation of CECs in Denmark has raised the question of qualifications for those who serve on a committee. When the Danish Society of Clinical Ethics was formed in 2012, it was therefore at the forefront of its agenda to establish a training program that would offer...... valuable contributions to the ethical aspect of medical decision making and to serve as an important resource for health care providers, patients and their families. This article describes the history, development and preliminary results of the current training program as well as reflects on future ideas...

A "Smart" Force-Limiting Instrument for Microsurgery: Laboratory and In Vivo Validation.

Directory of Open Access Journals (Sweden)

Hani J Marcus

Full Text Available Residents are required to learn a multitude of skills during their microsurgical training. One such skill is the judicious application of force when handling delicate tissue. An instrument has been developed that indicates to the surgeon when a force threshold has been exceeded by providing vibrotactile feedback. The objective of this study was to validate the use of this "smart" force-limiting instrument for microsurgery. A laboratory and an in vivo experiment were performed to evaluate the force-limiting instrument. In the laboratory experiment, twelve novice surgeons were randomly allocated to use either the force-limiting instrument or a standard instrument. Surgeons were then asked to perform microsurgical dissection in a model. In the in vivo experiment, an intermediate surgeon performed microsurgical dissection in a stepwise fashion, alternating every 30 seconds between use of the force-limiting instrument and a standard instrument. The primary outcomes were the forces exerted and the OSATS scores. In the laboratory experiment, the maximal forces exerted by novices using the force-limiting instrument were significantly less than using a standard instrument, and were comparable to intermediate and expert surgeons (0.637N versus 4.576N; p = 0.007. In the in vivo experiment, the maximal forces exerted with the force-limiting instrument were also significantly less than with a standard instrument (0.441N versus 0.742N; p 0.1. In conclusion, the development and use of this force-limiting instrument in a clinical setting may improve patient safety.

Training in Techniques and Translation: Novel Nuclear Medicine Imaging Agents for Oncology and Neurology

Energy Technology Data Exchange (ETDEWEB)

Tu, Zhude [Washington Univ., St. Louis, MO (United States)

2012-08-01

The goal of this grant was to provide critical interdisciplinary research training for the next generation of radiochemists and nuclear medicine physicians through a collaboration between basic science and clinical faculty who are actively involved in the development, application, and translation of radiopharmaceuticals. Following the four year funding support period, the 10 postdocs, graduate students, as well as clinical physicians who received training have become faculty members, or senior radiochemists at different academic institutes or industry. With respect to scientific accomplishments, 26 peer-reviewed articles have been published to date as well as numerous poster and oral presentations. The goals of all four scientific projects were completed and several promising radiotracers identified for transfer into clinical investigation for human use. Some preliminary data generated from this training grant led several successful NIH grant proposals for the principal investigators.

A Comparison of Two Control Display Unit Concepts on Flight Management System Training

Science.gov (United States)

Abbott, Terence S.

1997-01-01

One of the biggest challenges for a pilot in the transition to a 'glass' cockpit is understanding the flight management system (FMS). Because of both the complex nature of the FMS and the pilot-FMS interface, a large portion of transition training is devoted to the FMS. The current study examined the impact of the primary pilot-FMS interface, the control display unit (CDU), on FMS training. Based on the hypothesis that the interface design could have a significant impact on training, an FMS simulation with two separate interfaces was developed. One interface was similar to a current-generation design, and the other was a multiwindows CDU based on graphical user interface techniques. For both application and evaluation reasons, constraints were applied to the graphical CDU design to maintain as much similarity as possible with the conventional CDU. This preliminary experiment was conducted to evaluate the interface effects on training. Sixteen pilots with no FMS experience were used in a between-subjects test. A time-compressed, airline-type FMS training environment was simulated. The subjects were trained to a fixed-time criterion, and performance was measured in a final, full-mission simulation context. This paper describes the technical approach, simulation implementation, and experimental results of this effort.

Preliminary data suggesting the efficacy of attention training for school-aged children with ADHD.

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Tamm, Leanne; Epstein, Jeffery N; Peugh, James L; Nakonezny, Paul A; Hughes, Carroll W

2013-04-01

A pilot randomized clinical trial was conducted to examine the initial efficacy of Pay Attention!, an intervention training sustained, selective, alternating, and divided attention, in children diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD). After a diagnostic and baseline evaluation, school-aged children with ADHD were randomized to receive 16 bi-weekly sessions of Pay Attention! (n=54) or to a waitlist control group (n=51). Participants completed an outcome evaluation approximately 12 weeks after their baseline evaluation. Results showed significant treatment effects for parent and clinician ratings of ADHD symptoms, child self-report of ability to focus, and parent ratings of executive functioning. Child performance on neuropsychological tests showed significant treatment-related improvement on strategic planning efficiency, but no treatment effects were observed on other neuropsychological outcomes. Treatment effects were also not observed for teacher ratings of ADHD. These data add to a growing body of literature supporting effects of cognitive training on attention and behavior, however, additional research is warranted. Copyright © 2012 Elsevier Ltd. All rights reserved.

Value of the individual components subject training gymnasts according to the survey of coaches with different skills

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N. O. Andreeva

2014-09-01

Full Text Available Purpose : assess the significance of the individual components subject training gymnasts according to the survey of coaches with different skills. Material : two groups of coaches with different qualifications (n = 40. The first group of coaches -, experience from 1 to 10 years (n = 20; the second group - work experience from 11 to 25 years (n = 20. Gymnasts preliminary stage of basic training. Coaches are asked to answer 15 questions. Results : the content of questioning coaches gymnastics shows the relevance of the basic problems of technical training of young gymnasts (throwing and catching objects. The most difficult exercises in the training and improvement are throws and catches the ball (coefficient of concordance W = 0,814. The necessity of the development and use of new techniques for analyzing sports equipment exercises with the ball, learning and improving them. Conclusions : basic technical training and preparedness of gymnasts to perform exercises with objects represent a problem that is solved enough in theory and practice gymnastics.

Effects of Virtual Reality Training using Xbox Kinect on Motor Function in Stroke Survivors: A Preliminary Study.

Science.gov (United States)

Park, Dae-Sung; Lee, Do-Gyun; Lee, Kyeongbong; Lee, GyuChang

2017-10-01

Although the Kinect gaming system (Microsoft Corp, Redmond, WA) has been shown to be of therapeutic benefit in rehabilitation, the applicability of Kinect-based virtual reality (VR) training to improve motor function following a stroke has not been investigated. This study aimed to investigate the effects of VR training, using the Xbox Kinect-based game system, on the motor recovery of patients with chronic hemiplegic stroke. This was a randomized controlled trial. Twenty patients with hemiplegic stroke were randomly assigned to either the intervention group or the control group. Participants in the intervention group (n = 10) received 30 minutes of conventional physical therapy plus 30 minutes of VR training using Xbox Kinect-based games, and those in the control group (n = 10) received 30 minutes of conventional physical therapy only. All interventions consisted of daily sessions for a 6-week period. All measurements using Fugl-Meyer Assessment (FMA-LE), the Berg Balance Scale (BBS), the Timed Up and Go test (TUG), and the 10-meter Walk Test (10mWT) were performed at baseline and at the end of the 6 weeks. The scores on the FMA-LE, BBS, TUG, and 10mWT improved significantly from baseline to post intervention in both the intervention and the control groups after training. The pre-to-post difference scores on BBS, TUG, and 10mWT for the intervention group were significantly more improved than those for the control group (P <.05). Evidence from the present study supports the use of additional VR training with the Xbox Kinect gaming system as an effective therapeutic approach for improving motor function during stroke rehabilitation. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Implementation of a formal in-training assessment programme in anaesthesiology and preliminary results of acceptability

DEFF Research Database (Denmark)

Ringsted, C; Østergaard, D; van der Vleuten, C P M

2003-01-01

BACKGROUND: A new reform on postgraduate education in Denmark requires a formal in-training assessment in all specialties. The aim of this study was to survey the implementation and acceptability of the first example of a nation-wide in-training assessment programme for first-year trainees...... in anaesthesiology developed by a working group under the Danish Society of Anaesthesiology and Intensive Care Medicine. METHODS: A questionnaire about the implementation of the programme in practice and the characteristics of the trainees was sent to the educational responsible consultant (ERC) in each of the 26...... anaesthetic departments in the country with first-year trainees in anaesthesiology. Standard evaluations of the assessment programme were regularly collected from trainees. RESULTS: Twenty-five (96%) departments returned the questionnaire. In total the departments reported on 100 trainees and 83 of these had...

Comparing the effects of mechanical perturbation training with a compliant surface and manual perturbation training on joints kinematics after ACL-rupture.

Science.gov (United States)

Nawasreh, Zakariya; Failla, Mathew; Marmon, Adam; Logerstedt, David; Snyder-Mackler, Lynn

2018-05-23

Performing physical activities on a compliant surface alters joint kinematics and increases joints stiffness. However, the effect of compliant surface on joint kinematics after ACL-rupture is yet unknown. To compare the effects of mechanical perturbation training with a compliant surface to manual perturbation training on joint kinematics after ACL-rupture. Sixteen level I/II athletes with ACL-rupture participated in this preliminary study. Eight patients received mechanical perturbation with compliant surface (Mechanical) and 8 patients received manual perturbation training (Manual). Patients completed standard gait analysis before (Pre) and after (Post) training. Significant group-by-time interactions were found for knee flexion angle at initial contact (IC) and peak knee flexion (PKF) (pMechanical:27.68+4.08°, p = 0.011), hip rotation angle at PKE (Manual:-3.40+4.78°, Mechanical:5.43+4.78°, p Mechanical:0.55+2.23°, p = 0.039). Main effects of time were found for hip adduction angle at PKE (Pre:6.98+4.48°, Post:8.41+4.91°, p = 0.04), knee adduction angle at IC (Pre:-2.90+3.50°, Post:-0.62+2.58°, p = 0.03), ankle adduction angle at IC (Pre:2.16+3.54, Post:3.8+3.68, p = 0.008), and ankle flexion angle at PKF (Pre:-4.55+2.77°, Post:-2.39+3.48°, p = 0.01). Training on a compliant surface induces different effects on joint kinematics compared to manual perturbation training after ACL-rupture. Manual perturbation improved hip alignment and increased knee flexion angles, while mechanical training decreased knee flexion angles throughout the stance phase. Administering training on a compliant surface after ACL-rupture may help improving dynamic knee stability, however, long-term effects on knee health needs to be determined. Copyright © 2018 Elsevier B.V. All rights reserved.

Training symmetry of weight distribution after stroke: a randomized controlled pilot study comparing task-related reach, Bobath and feedback training approaches.

Science.gov (United States)

Mudie, M H; Winzeler-Mercay, U; Radwan, S; Lee, L

2002-09-01

To determine (1) the most effective of three treatment approaches to retrain seated weight distribution long-term after stroke and (2) whether improvements could be generalized to weight distribution in standing. Inpatient rehabilitation unit. Forty asymmetrical acute stroke subjects were randomly allocated to one of four groups in this pilot study. Changes in weight distribution were compared between the 10 subjects of each of three treatment groups (task-specific reach, Bobath, or Balance Performance Monitor [BPM] feedback training) and a no specific treatment control group. One week of measurement only was followed by two weeks of daily training sessions with the treatment to which the subject was randomly allocated. Measurements were performed using the BPM daily before treatment sessions, two weeks after cessation of treatment and 12 weeks post study. Weight distribution was calculated in terms of mean balance (percentage of total body weight) or the mean of 300 balance points over a 30-s data run. In the short term, the Bobath approach was the most effective treatment for retraining sitting symmetry after stroke (p = 0.004). Training with the BPM and no training were also significant (p = 0.038 and p = 0.035 respectively) and task-specific reach training failed to reach significance (p = 0.26). At 12 weeks post study 83% of the BPM training group, 38% of the task-specific reach group, 29% of the Bobath group and 0% of the untrained group were found to be distributing their weight to both sides. Some generalization of symmetry training in sitting to standing was noted in the BPM training group which appeared to persist long term. Results should be treated with caution due to the small group sizes. However, these preliminary findings suggest that it might be possible to restore postural symmetry in sitting in the early stages of rehabilitation with therapy that focuses on creating an awareness of body position.

Aerobic exercise in adolescents with obesity: preliminary evaluation of a modular training program and the modified shuttle test

Directory of Open Access Journals (Sweden)

van der Baan-Slootweg Olga H

2007-04-01

Full Text Available Abstract Background Increasing activity levels in adolescents with obesity requires the development of exercise programs that are both attractive to adolescents and easily reproducible. The aim of this study was to develop a modular aerobic training program for adolescents with severe obesity, with a focus on variety, individual targets and acquiring physical skills. We report here the effects on aerobic fitness from a pilot study. Furthermore, we examined the feasibility of the modified shuttle test (MST as an outcome parameter for aerobic fitness in adolescents with severe obesity. Methods Fifteen adolescents from an inpatient body weight management program participated in the aerobic training study (age 14.7 ± 2.1 yrs, body mass index 37.4 ± 3.5. The subjects trained three days per week for 12 weeks, with each session lasting 30–60 minutes. The modular training program consisted of indoor, outdoor and swimming activities. Feasibility of the MST was studied by assessing construct validity, test-retest reliability and sensitivity to change. Results Comparing pretraining and end of training period showed large clinically relevant and significant improvements for all aerobic indices: e.g. VO2 peak 17.5%, effect size (ES 2.4; Wmax 8%, ES 0.8. In addition, a significant improvement was found for the efficiency of the cardiovascular system as assessed by the oxygen pulse (15.8%, ES 1.6. Construct validity, test-retest reliability and sensitivity to change of the MST were very good. MST was significantly correlated with VO2 peak (r = 0.79 and Wmax (r = 0.84 but not with anthropometric measures. The MST walking distance improved significantly by 32.5%, ES 2.5. The attendance rate at the exercise sessions was excellent. Conclusion This modular, varied aerobic training program has clinically relevant effects on aerobic performance in adolescents with severe obesity. The added value of our aerobic training program for body weight management programs

Targeted training of the decision rule benefits rule-guided behavior in Parkinson's disease.

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Ell, Shawn W

2013-12-01

The impact of Parkinson's disease (PD) on rule-guided behavior has received considerable attention in cognitive neuroscience. The majority of research has used PD as a model of dysfunction in frontostriatal networks, but very few attempts have been made to investigate the possibility of adapting common experimental techniques in an effort to identify the conditions that are most likely to facilitate successful performance. The present study investigated a targeted training paradigm designed to facilitate rule learning and application using rule-based categorization as a model task. Participants received targeted training in which there was no selective-attention demand (i.e., stimuli varied along a single, relevant dimension) or nontargeted training in which there was selective-attention demand (i.e., stimuli varied along a relevant dimension as well as an irrelevant dimension). Following training, all participants were tested on a rule-based task with selective-attention demand. During the test phase, PD patients who received targeted training performed similarly to control participants and outperformed patients who did not receive targeted training. As a preliminary test of the generalizability of the benefit of targeted training, a subset of the PD patients were tested on the Wisconsin card sorting task (WCST). PD patients who received targeted training outperformed PD patients who did not receive targeted training on several WCST performance measures. These data further characterize the contribution of frontostriatal circuitry to rule-guided behavior. Importantly, these data also suggest that PD patient impairment, on selective-attention-demanding tasks of rule-guided behavior, is not inevitable and highlight the potential benefit of targeted training.

Preliminary Findings in the Development of a Theoretical Framework for Investigating ICT Integration in Teacher Education

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Suthagar Narasuman

2012-06-01

Full Text Available The following report is the result of a preliminary investigation in the development of a theoretical framework for investigating ICT integration, particularly in TESL (Teaching of English as a Second Language teacher training. The study is primarily an empirical effort to develop a theoretical framework for investigating ICT integration in TESL teacher training. In identifying the predictive variables for the framework, the researchers conducted an intensive review of the literature which included a review of various models used in studies on ICT integration. The contributing variables identified in the present study were age, gender, experience, ICT proficiency, attitude, access to ICT infrastructure, support services, and exposure to ICT professional development programmes. In developing the framework, the study sought to determine the extent to which the observed variability in ICT integration could be predicted by these factors. The sample comprised 266 respondents working at the faculty or English Language Unit in various teacher training institutions across the country. The study predominantly employed quantitative methods of data collection. Interview data was used to corroborate information derived from the survey data.

Strength Training Following Hematopoietic Stem Cell Transplantation

Science.gov (United States)

Hacker, Eileen Danaher; Larson, Janet; Kujath, Amber; Peace, David; Rondelli, Damiano; Gaston, Lisa

2010-01-01

Background Patients receiving high-dose chemotherapy and hematopoietic stem cell transplantation (HSCT) experience considerable reductions in physical activity and deterioration of their health status. Objective The purpose of this pilot study was to test the effects of strength training compared to usual activity on physical activity, muscle strength, fatigue, health status perceptions, and quality of life following HSCT. Interventions/Methods Nineteen subjects were randomized to the exercise or control group. Moderate intensity strength training began following discharge from the hospital. Dependent variables included physical activity, muscle strength, fatigue, health status perceptions and quality of life. Variables were measured prior to admission to the hospital for HSCT, day 8 following HSCT, and six weeks following discharge from the hospital. Results Significant time effects were noted for many variables with anticipated declines in physical activity, muscle strength, fatigue, and health status perceptions immediately after HSCT with subsequent improvements six weeks following hospital discharge. One group effect was noted with subjects in the exercise group reporting less fatigue than subjects in the control group. Although no significant interactions were detected, the trends suggest that the exercise group may be more physically active following the intervention compared to the usual activity group. Conclusions This study demonstrates the potential positive effects of strength training on physical activity, fatigue, and quality of life in people receiving high-dose chemotherapy and HSCT. Implications for Practice Preliminary evidence is provided for using strength training to enhance early recovery following HSCT. Elastic resistance bands are easy to use and relatively inexpensive. PMID:21116175

Communicative-pragmatic impairment in schizophrenia: Cognitive rehabilitative training

Directory of Open Access Journals (Sweden)

Francesca Marina Bosco

2016-02-01

Full Text Available This paper aims to verify in patients with schizophrenia, the efficacy of Cognitive Pragmatic Treatment (CPT, a new remediation program for improving communicative-pragmatic abilities. The CPT program consists of 20 group sessions, focused on several communication modalities, i.e. linguistic, extralinguistic and paralinguistic, Theory of Mind (ToM and other cognitive functions that can affect communicative performance, such as awareness and planning. A group of 17 patients with schizophrenia participated in the training. They were tested before and after training, using the equivalent forms of the Assessment Battery for Communication (ABaCo, a tool for evaluating the comprehension and production of a wide range of pragmatic phenomena such as, i.e. direct and indirect speech acts, irony and deceit, and a series of neuropsychological and ToM tests. The results showed a significant improvement in patients’ performance following the program, on both comprehension and production tasks, and in all the communication modalities assessed by the ABaCo, i.e. linguistic, extralinguistic, paralinguistic and social appropriateness. The improvement of patients’ performance persisted after three months from the end of the training, as shown by the follow-up tests. These preliminary findings support the efficacy of the CPT program in improving communicative-pragmatic abilities in the patients.

No difference between mechanical perturbation training with compliant surface and manual perturbation training on knee functional performance after ACL rupture.

Science.gov (United States)

Nawasreh, Zakariya; Logerstedt, David; Failla, Mathew; Snyder-Mackler, Lynn

2017-10-27

Manual perturbation training improves dynamic knee stability and functional performance after anterior cruciate ligament rupture (ACL-rupture). However, it is limited to static standing position and does not allow time-specific perturbations at different phase of functional activities. The purpose of this study was to investigate whether administering mechanical perturbation training including compliant surface provides effects similar to manual perturbation training on knee functional measures after an acute ACL-rupture. Sixteen level I/II athletes with ACL-ruptures participated in this preliminary study. Eight patients received mechanical (Mechanical) and eight subjects received manual perturbation training (Manual). All patients completed a functional testing (isometric quadriceps strength, single-legged hop tests) and patient-reported measures (Knee Outcome Survey-Activities of Daily Living Scale (KOS-ADLS), Global Rating Score (GRS), International Knee Documentation Committee 2000 (IKDC 2000) at pre- and post-training. 2 × 2 ANOVA was used for data analysis. No significant group-by-time interactions were found for all measures (p > 0.18). Main effects of time were found for single hop (Pre-testing: 85.14% ± 21.07; Post-testing: 92.49% ± 17.55), triple hop (Pre-testing: 84.64% ± 14.17; Post-testing: 96.64% ± 11.14), KOS-ADLS (Pre-testing: 81.13% ± 11.12; Post-testing: 88.63% ± 12.63), GRS (Pre-testing: 68.63% ± 15.73; Post-testing: 78.81% ± 13.85), and IKDC 2000 (Pre-testing: 66.66% ± 9.85; Post-testing: 76.05% ± 14.62) (p training using compliant surfaces induce effects similar to manual perturbation training on knee functional performance after acute ACL-rupture. The clinical significance is both modes of training improve patients' functional-performance and limb-to-limb movement symmetry, and enhancing the patients' self-reported of knee functional measures after ACL rupture. Mechanical

North Korean refugee doctors' preliminary examination scores

Directory of Open Access Journals (Sweden)

Sung Uk Chae

2016-12-01

Full Text Available Purpose Although there have been studies emphasizing the re-education of North Korean (NK doctors for post-unification of the Korean Peninsula, study on the content and scope of such re-education has yet to be conducted. Researchers intended to set the content and scope of re-education by a comparative analysis for the scores of the preliminary examination, which is comparable to the Korean Medical Licensing Examination (KMLE. Methods The scores of the first and second preliminary exams were analyzed by subject using the Wilcoxon signed rank test. The passing status of the group of NK doctors for KMLE in recent 3 years were investigated. The multiple-choice-question (MCQ items of which difficulty indexes of NK doctors were lower than those of South Korean (SK medical students by two times of the standard deviation of the scores of SK medical students were selected to investigate the relevant reasons. Results The average scores of nearly all subjects were improved in the second exam compared with the first exam. The passing rate of the group of NK doctors was 75%. The number of MCQ items of which difficulty indexes of NK doctors were lower than those of SK medical students was 51 (6.38%. NK doctors’ lack of understandings for Diagnostic Techniques and Procedures, Therapeutics, Prenatal Care, and Managed Care Programs was suggested as the possible reason. Conclusion The education of integrated courses focusing on Diagnostic Techniques and Procedures and Therapeutics, and apprenticeship-style training for clinical practice of core subjects are needed. Special lectures on the Preventive Medicine are likely to be required also.

User-friendly cognitive training for the elderly: a technical report.

Science.gov (United States)

Boquete, Luciano; Rodríguez-Ascariz, José Manuel; Amo-Usanos, Carlos; Martínez-Arribas, Alejandro; Amo-Usanos, Javier; Otón, Salvador

2011-01-01

This article presents a system that implements a cognitive training program in users' homes. The system comprises various applications designed to create a daily brain-fitness regime. The proposed mental training system uses television and a remote control specially designed for the elderly. This system integrates Java applications to promote brain-fitness training in three areas: arithmetic, memory, and idea association. The system comprises the following: Standard television set, simplified wireless remote control, black box (system's core hardware and software), brain-fitness games (language Java), and Wi-Fi-enabled Internet-connected router. All data from the user training sessions are monitored through a control center. This control center analyzes the evolution of the user and the proper performance of the system during the test. The implemented system has been tested by six healthy volunteers. The results for this user group demonstrated the accessibility and usability of the system in a controlled real environment. The impressions of the users were very favorable, and they reported high adaptability to the system. The mean score for usability and accessibility assigned by the users was 3.56 out of 5 points. The operation stress test (over 200 h) was successful. The proposed system was used to implement a cognitive training program in users' homes, which was developed to be a low-cost tool with a high degree of user interactivity. The results of this preliminary study indicate that this user-friendly system could be adopted as a form of cognitive training for the elderly.

Training project on Radiological Protection in medicine. Use of new technologies

International Nuclear Information System (INIS)

Ruis-Cruces, R.; Perez-Martinez, M.; Pastor Vega, J. M.; Diez de los Rios Delgado, A.

2003-01-01

Radiological protection training addressed to physicians should start during the teaching graduate and postgraduate studies, and a third phase only for those physicians using X rays and radioactive sources in diagnosis and treatment of diseases. To show a training project addressed to the teaching graduate students based on the new technologies, such as web online and interactive CD-ROM. Development of a web-online including information in.pdf (adobe acrobat) format and additional tools (as data bases, videos, news and class meetings, FAQ, tutorials). Moreover, we propose to development an interactive CD-ROM which will be used as a practical tool to complete the obligatory subject on radiological protection in the University of Malaga (Spain). We show the preliminary phase of the project. The web-online is being developed with the Microsoft FrontPage software. The first version of the CR-ROM is being developed in html format. These tools based on new technologies will be a very important support for radiological protection training, which is recommended by International Organizations (EC Report R116 and IAE Action Plan 2002-2006). (Author) 4 refs

Athletic training in badminton players modulates the early C1 component of visual evoked potentials: a preliminary investigation.

Science.gov (United States)

Jin, Hua; Xu, Guiping; Zhang, John X; Ye, Zuoer; Wang, Shufang; Zhao, Lun; Lin, Chong-De; Mo, Lei

2010-12-01

One basic question in brain plasticity research is whether individual life experience in the normal population can affect very early sensory-perceptual processing. Athletes provide a possible model to explore plasticity of the visual cortex as athletic training in confrontational ball games is quite often accompanied by training of the visual system. We asked professional badminton players to watch video clips related to their training experience and predict where the ball would land and examined whether they differed from non-player controls in the elicited C1, a visual evoked potential indexing V1 activity. Compared with controls, the players made judgments significantly more accurately, albeit not faster. An early ERP component peaking around 65 ms post-stimulus with a scalp topography centering at the occipital pole (electrode Oz) was observed in both groups and interpreted as the C1 component. With comparable latency, amplitudes of this component were significantly enhanced for the players than for the non-players, suggesting that it can be modulated by long-term physical training. The results present a clear case of experience-induced brain plasticity in primary visual cortex for very early sensory processing. Copyright © 2010 Elsevier B.V. All rights reserved.

Attitudes to research and research training among ophthalmologists and ophthalmology trainees in New Zealand.

Science.gov (United States)

Jayasundera, Thiran; Fisk, Michael; McGhee, Charles N J

2003-08-01

To determine the attitudes to research and research training among ophthalmologists and ophthalmology trainees in New Zealand. A structured, self-administered questionnaire was devised and after preliminary validation a postal survey was sent to all ophthalmologists and ophthalmology registrars and fellows in New Zealand. A total of 82 replies were received from 115 questionnaires sent out; a response rate of 71.3%. An overwhelming majority found research to have benefited their education, clinical practice and career; 67.1% of the respondents intended to do research in the future. Although a majority (56.4%) felt research to be beneficial to ophthalmology training, 42.3% felt research would be of limited or no benefit when selecting candidates for vocational training. However, 97.5% of respondents felt that ophthalmology trainees should undertake some form of research during training, with most supporting small studies or case reports (44.4%) or a short structured training course in research (42.0%). Interestingly, 86.6% felt that research methodology and data analysis should be taught in a structured fashion with most supporting courses or seminars of a few weeks duration during the vocational training period. Many ophthalmologists felt inadequately equipped or trained to mentor and supervise trainees undertaking research and 41.5% of consultant ophthalmologists felt further training to fulfil this role would be beneficial. This survey suggests that New Zealand ophthalmologists generally approve of and support a place for research, possibly of a more structured design, during ophthalmology training.

Virtual Sensorimotor Training for Balance: Pilot Study Results for Children With Fetal Alcohol Spectrum Disorders.

Science.gov (United States)

Jirikowic, Tracy; Westcott McCoy, Sarah; Price, Robert; Ciol, Marcia A; Hsu, Lin-Ya; Kartin, Deborah

2016-01-01

To examine the effects of Sensorimotor Training to Affect Balance, Engagement, and Learning (STABEL), a virtual reality system to train sensory adaptation for balance control, for children with fetal alcohol spectrum disorders (FASDs). Twenty-three children with FASDs received STABEL training in a university laboratory, or home, or were controls. The Movement Assessment Battery for Children-2nd edition (MABC-2) and Pediatric Clinical Test of Sensory Interaction for Balance-2 (P-CTSIB-2) were analyzed by group (lab, home, and control), session (pre-STABEL, 1 week post-STABEL, and 1 month post-STABEL), and group-by-session interaction. Significant effects were group and session for MABC-2 Balance and interaction for MABC-2 Total Motor and P-CTSIB-2. Preliminary results support improved sensory adaptation, balance, and motor performance post-STABEL, which warrant further study with a larger, randomized sample.

28 CFR 2.48 - Revocation: Preliminary interview.

Science.gov (United States)

2010-07-01

... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Revocation: Preliminary interview. 2.48....48 Revocation: Preliminary interview. (a) Interviewing officer. A parolee who is retaken on a warrant issued by a Commissioner shall be given a preliminary interview by an official designated by the Regional...

Potential contributions of training intensity on locomotor performance in individuals with chronic stroke.

Science.gov (United States)

Holleran, Carey L; Rodriguez, Kelly S; Echauz, Anthony; Leech, Kristan A; Hornby, T George

2015-04-01

Many interventions can improve walking ability of individuals with stroke, although the training parameters that maximize recovery are not clear. For example, the contribution of training intensity has not been well established and may contribute to the efficacy of many locomotor interventions. The purpose of this preliminary study was to evaluate the effects of locomotor training intensity on walking outcomes in individuals with gait deficits poststroke. Using a randomized cross-over design, 12 participants with chronic stroke (>6-month duration) performed either high-intensity (70%-80% of heart rate reserve; n = 6) or low-intensity (30%-40% heart rate reserve; n = 6) locomotor training for 12 or fewer sessions over 4 to 5 weeks. Four weeks following completion, the alternate training intervention was performed. Training intensity was manipulated by adding loads or applying resistance during walking, with similar speeds, durations, and amount of stepping practice between conditions. Greater increases in 6-Minute Walk Test performance were observed following high-intensity training compared with low-intensity training. A significant interaction of intensity and order was also observed for 6-Minute Walk Test and peak treadmill speed, with the largest changes in those who performed high-intensity training first. Moderate correlations were observed between locomotor outcomes and measures of training intensity. This study provides the first evidence that the intensity of locomotor practice may be an important independent determinant of walking outcomes poststroke. In the clinical setting, the intensity of locomotor training can be manipulated in many ways, although this represents only 1 parameter to consider.Video Abstract available for more insights from the authors (see Supplemental Digital Content 1, http://links.lww.com/JNPT/A90).

A Lower Limb Rehabilitation Robot in Sitting Position with a Review of Training Activities.

Science.gov (United States)

Eiammanussakul, Trinnachoke; Sangveraphunsiri, Viboon

2018-01-01

Robots for stroke rehabilitation at the lower limbs in sitting/lying position have been developed extensively. Some of them have been applied in clinics and shown the potential of the recovery of poststroke patients who suffer from hemiparesis. These robots were developed to provide training at different joints of lower limbs with various activities and modalities. This article reviews the training activities that were realized by rehabilitation robots in literature, in order to offer insights for developing a novel robot suitable for stroke rehabilitation. The control system of the lower limb rehabilitation robot in sitting position that was introduced in the previous work is discussed in detail to demonstrate the behavior of the robot while training a subject. The nonlinear impedance control law, based on active assistive control strategy, is able to define the response of the robot with more specifications while the passivity property and the robustness of the system is verified. A preliminary experiment is conducted on a healthy subject to show that the robot is able to perform active assistive exercises with various training activities and assist the subject to complete the training with desired level of assistance.

A Lower Limb Rehabilitation Robot in Sitting Position with a Review of Training Activities

Directory of Open Access Journals (Sweden)

Trinnachoke Eiammanussakul

2018-01-01

Full Text Available Robots for stroke rehabilitation at the lower limbs in sitting/lying position have been developed extensively. Some of them have been applied in clinics and shown the potential of the recovery of poststroke patients who suffer from hemiparesis. These robots were developed to provide training at different joints of lower limbs with various activities and modalities. This article reviews the training activities that were realized by rehabilitation robots in literature, in order to offer insights for developing a novel robot suitable for stroke rehabilitation. The control system of the lower limb rehabilitation robot in sitting position that was introduced in the previous work is discussed in detail to demonstrate the behavior of the robot while training a subject. The nonlinear impedance control law, based on active assistive control strategy, is able to define the response of the robot with more specifications while the passivity property and the robustness of the system is verified. A preliminary experiment is conducted on a healthy subject to show that the robot is able to perform active assistive exercises with various training activities and assist the subject to complete the training with desired level of assistance.

Training of nuclear power professionals in international courses

International Nuclear Information System (INIS)

Kanter, M.A.

1979-01-01

Argonne National Laboratory has presented nine international courses in the IAEA Nuclear Power Training Program. Five have been overview courses fifteen weeks in length and four have been specialized courses ranging from five to nine weeks. A total of 286 participants from 38 countries have been traned in these courses. The Argonne courses comprise approximately 40% of the Agency's program, which is also carried out in France, Spain, and the Federal Republic of Germany. The two types of overview courses, one covering the planning phase of a project and the other the construction and operation phase, surveyed all aspects of nuclear power programs--economic, managerial, regulatory, and technical. Experience has shown that the majority of the participants in those courses had concentrated interest in specialized areas. Specialized courses have now been offered on five specific subjects. Based on past course evaluations by our staff, 37% of those trained were judged capable of making significant contribution to their country's nuclear program, 44% were judged potentially capable of such contributions, 17% were capable of only limited contribution, and 2% were inappropriately selected. Participation in international training has been very useful because of the exposure to working experts and because of the interaction between participants from the different developing countries. It is clear that such courses of moderate length sometimes attract senior management personnel, but in general can best be directed to responsible staff at middle management levels. More junior staff would be more effectively trained at the national level. Preliminary results of a Center survey of those participants who were trained two years ago have confirmed these conclusions

Validating a Culturally-Sensitive Social Competence Training Programme for Adolescents with ASD in a Chinese Context: An Initial Investigation

Science.gov (United States)

Chan, Raymond Won Shing; Leung, Cecilia Nga Wing; Ng, Denise Ching Yiu; Yau, Sania Sau Wai

2018-01-01

Previous studies on social skills training on ASD were done almost exclusively in the West with children as the main subjects. Demonstrations of the applicability of social interventions in different cultures and age groups are warranted. The current study outlined the development and preliminary evaluation of a CBT-context-based social competence…

[Simulation-based intervention to improve anesthesiology residents communication with families of critically ill patients--preliminary prospective evaluation].

Science.gov (United States)

Berkenstadt, Haim; Perlson, Daria; Shalomson, Orit; Tuval, Atalia; Haviv-Yadid, Yael; Ziv, Amitai

2013-08-01

Although effective communication with families of critically ill patients is a vital component of quality care, training in this field is neglected. The article aims to validate communication skills training program for anesthesiology residents in the intensive care set up. Ten anesthesia residents, following 3 months of Intensive Care Unit (ICU) rotation, had 4 hours of lectures and one day simulation-based communication skills training with families of critically ill patients. Participants completed an attitude questionnaire over 3 time periods--before training [t1], immediately following training (t2) and three months following training (t3). The participants' communication skills were assessed by two blinded independent observers using the SEGUE framework while performing a simulation-based scenario at t1 and t3. Seven participants finished the study protocol. Participants ndicated communication importance as 3.68 +/- 0.58 (t1), 4.05 +/- 0.59 (t2), 4.13 +/- 0.64 (t3); their communication ability as 3.09 +/- 0.90 (t1), 3.70 +/- 0.80 (t2), 3.57 +/- 0.64 (t3); the contribution of lecture to communication 3.04 +/- 0.43 (t1), 3.83 +/- 0.39 (t2), 3.87 +/- 0.51 (t3), and contribution of simulation training to communication 3.00 +/- 0.71 (t1), 4.04 +/- 0.52 (t2), 3.84 +/- 0.31 (t3). The differences did not reach statistical significance. Objective assessment of the communication skills using the SEGUE framework indicated that 6/7 participants improved their communication skills, with communication ability before training at 2.66 +/- 0.83 and 1 month following training it was 3.38 +/- 0.78 (p = 0.09). This preliminary study demonstrates the value of communication skills training in the intensive care environment.

A systematic review: plyometric training programs for young children.

Science.gov (United States)

Johnson, Barbara A; Salzberg, Charles L; Stevenson, David A

2011-09-01

The purpose of this systematic review was to evaluate the efficacy and safety of plyometric training for improving motor performance in young children; to determine if this type of training could be used to improve the strength, running speed, agility, and jumping ability of children with low motor competence; and to examine the extent and quality of the current research literature. Primary research articles were selected if they (a) described the outcomes of a plyometric exercise intervention; (b) included measures of strength, balance, running speed, jumping ability, or agility; (c) included prepubertal children 5-14 years of age; and (d) used a randomized control trial or quasiexperimental design. Seven articles met the inclusion criteria for the final review. The 7 studies were judged to be of low quality (values of 4-6). Plyometric training had a large effect on improving the ability to run and jump. Preliminary evidence suggests plyometric training also had a large effect on increasing kicking distance, balance, and agility. The current evidence suggests that a twice a week program for 8-10 weeks beginning at 50-60 jumps a session and increasing exercise load weekly results in the largest changes in running and jumping performance. An alternative program for children who do not have the capability or tolerance for a twice a week program would be a low-intensity program for a longer duration. The research suggests that plyometric training is safe for children when parents provide consent, children agree to participate, and safety guidelines are built into the intervention.

On Preliminary Test Estimator for Median

OpenAIRE

Okazaki, Takeo; 岡崎, 威生

1990-01-01

The purpose of the present paper is to discuss about estimation of median with a preliminary test. Two procedures are presented, one uses Median test and the other uses Wilcoxon two-sample test for the preliminary test. Sections 3 and 4 give mathematical formulations of such properties, including mean square errors with one specified case. Section 5 discusses their optimal significance levels of the preliminary test and proposes their numerical values by Monte Carlo method. In addition to mea...

Information Support of Highly-Qualified Archers’ Training

Directory of Open Access Journals (Sweden)

А. П. Власов

2017-03-01

Full Text Available The objective is to ground the ways of improving the level of technical preparedness of highly-qualified archers by means of video and multimedia technologies. Materials and methods: The research studied motor actions of 25 athletes of the national team of Ukraine in archery when they were performing training exercises indoors (exercising area and outdoors (archery range. Each athlete’s technique of executing shooting exercises was video recorded in sequence from different angles (from above, from behind, from the front, from the left and the right sides depending on the shooting line with a digital video camera Sony DCR-XR150E. The processing of the video materials was done with the Dartfish Connekt software package. Results: The research grounds the need to use video and multimedia technologies in the process of training of highly-qualified archers. Such methods aim at improving the skills of both coaches and athletes by helping them better understand all aspects of the training exercises execution. Multimedia means offer a delayed-in-time opportunity to watch the video recording of the training after its preliminary computer processing. It enables the coach and the athlete to focus on the analysis of the execution of the entire exercise and its elements. The paper provides examples of the use of video technologies in archers’ training practice. Conclusions: Prospects of the use of the state-of-the-art computer technologies in sports training are infinite. Computer software and hardware systems should be available for most coaches. The task of the latter is to learn to use and implement them for the benefit of themselves and athletes. The task of the scientific groups and experts is to find a most convenient way for the coach to use the innovative technologies. The task of the software developer is to model intellectual programs to help the coach effectively analyze and evaluate his archers or team when preparing them for the most

Training Directors' Conceptualizations of the Intersections of Diversity and Trainee Competence Problems: A Preliminary Analysis

Science.gov (United States)

Miller, David S. Shen; Forrest, Linda; Elman, Nancy S.

2009-01-01

Counseling psychology has demonstrated leadership on multicultural issues through serious and committed attention to diversity in scholarship, conferences, and training and recruitment. Yet a survey of the literature on trainees with competence problems resulted in limited references to race/ethnicity and/or gender (REG). Using transcripts of…

Real-time fMRI feedback training may improve chronic tinnitus

Energy Technology Data Exchange (ETDEWEB)

Haller, Sven [University Hospital Basel, Institute of Radiology, Department of Neuroradiology, Basel (Switzerland); Department of Imaging and Medical Informatics, Geneva University Hospital, Institute of Neuroradiology, Geneva (Switzerland); Birbaumer, Niels [University of Tuebingen, Institute of Medical Psychology and Behavioral Neurobiology, Tuebingen (Germany); Instituto di Ricovero e Cura a Carattere Scientifico, Ospedale San Camillo, Venezia (Italy); Veit, Ralf [University of Tuebingen, Institute of Medical Psychology and Behavioral Neurobiology, Tuebingen (Germany)

2010-03-15

Tinnitus consists of a more or less constant aversive tone or noise and is associated with excess auditory activation. Transient distortion of this activation (repetitive transcranial magnetic stimulation, rTMS) may improve tinnitus. Recently proposed operant training in real-time functional magnetic resonance imaging (rtfMRI) neurofeedback allows voluntary modification of specific circumscribed neuronal activations. Combining these observations, we investigated whether patients suffering from tinnitus can (1) learn to voluntarily reduce activation of the auditory system by rtfMRI neurofeedback and whether (2) successful learning improves tinnitus symptoms. Six participants with chronic tinnitus were included. First, location of the individual auditory cortex was determined in a standard fMRI auditory block-design localizer. Then, participants were trained to voluntarily reduce the auditory activation (rtfMRI) with visual biofeedback of the current auditory activation. Auditory activation significantly decreased after rtfMRI neurofeedback. This reduced the subjective tinnitus in two of six participants. These preliminary results suggest that tinnitus patients learn to voluntarily reduce spatially specific auditory activations by rtfMRI neurofeedback and that this may reduce tinnitus symptoms. Optimized training protocols (frequency, duration, etc.) may further improve the results. (orig.)

Real-time fMRI feedback training may improve chronic tinnitus

International Nuclear Information System (INIS)

Haller, Sven; Birbaumer, Niels; Veit, Ralf

2010-01-01

Tinnitus consists of a more or less constant aversive tone or noise and is associated with excess auditory activation. Transient distortion of this activation (repetitive transcranial magnetic stimulation, rTMS) may improve tinnitus. Recently proposed operant training in real-time functional magnetic resonance imaging (rtfMRI) neurofeedback allows voluntary modification of specific circumscribed neuronal activations. Combining these observations, we investigated whether patients suffering from tinnitus can (1) learn to voluntarily reduce activation of the auditory system by rtfMRI neurofeedback and whether (2) successful learning improves tinnitus symptoms. Six participants with chronic tinnitus were included. First, location of the individual auditory cortex was determined in a standard fMRI auditory block-design localizer. Then, participants were trained to voluntarily reduce the auditory activation (rtfMRI) with visual biofeedback of the current auditory activation. Auditory activation significantly decreased after rtfMRI neurofeedback. This reduced the subjective tinnitus in two of six participants. These preliminary results suggest that tinnitus patients learn to voluntarily reduce spatially specific auditory activations by rtfMRI neurofeedback and that this may reduce tinnitus symptoms. Optimized training protocols (frequency, duration, etc.) may further improve the results. (orig.)

Preliminary data suggesting the efficacy of attention training for school-aged children with ADHD

OpenAIRE

Tamm, Leanne; Epstein, Jeffery N.; Peugh, James L.; Nakonezny, Paul A.; Hughes, Carroll W.

2013-01-01

A pilot randomized clinical trial was conducted to examine the initial efficacy of Pay Attention!, an intervention training sustained, selective, alternating, and divided attention, in children diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD). After a diagnostic and baseline evaluation, school-aged children with ADHD were randomized to receive 16 bi-weekly sessions of Pay Attention! (n = 54) or to a waitlist control group (n = 51). Participants completed an outcome evaluation ap...

Preliminary Evaluation of a Social Skills Training and Facilitated Play Early Intervention Programme for Extremely Shy Young Children in China

Science.gov (United States)

Li, Yan; Coplan, Robert J.; Wang, Yuemin; Yin, Jingtong; Zhu, Jingjing; Gao, Zhuqing; Li, Linhui

2016-01-01

The goal of this study was to provide a preliminary evaluation of a social skills and facilitated play early intervention programme to promote social interaction, prosocial behaviours and socio-communicative skills among young extremely shy children in China. Participants were a sample of n = 16 extremely shy young children attending kindergarten…

Neuroplasticity of selective attention: Research foundations and preliminary evidence for a gene by intervention interaction

Science.gov (United States)

Stevens, Courtney; Pakulak, Eric; Hampton Wray, Amanda; Bell, Theodore A.; Neville, Helen J.

2017-01-01

This article reviews the trajectory of our research program on selective attention, which has moved from basic research on the neural processes underlying selective attention to translational studies using selective attention as a neurobiological target for evidence-based interventions. We use this background to present a promising preliminary investigation of how genetic and experiential factors interact during development (i.e., gene × intervention interactions). Our findings provide evidence on how exposure to a family-based training can modify the associations between genotype (5-HTTLPR) and the neural mechanisms of selective attention in preschool children from lower socioeconomic status backgrounds. PMID:28819066

Neuroplasticity of selective attention: Research foundations and preliminary evidence for a gene by intervention interaction.

Science.gov (United States)

Isbell, Elif; Stevens, Courtney; Pakulak, Eric; Hampton Wray, Amanda; Bell, Theodore A; Neville, Helen J

2017-08-29

This article reviews the trajectory of our research program on selective attention, which has moved from basic research on the neural processes underlying selective attention to translational studies using selective attention as a neurobiological target for evidence-based interventions. We use this background to present a promising preliminary investigation of how genetic and experiential factors interact during development (i.e., gene × intervention interactions). Our findings provide evidence on how exposure to a family-based training can modify the associations between genotype (5-HTTLPR) and the neural mechanisms of selective attention in preschool children from lower socioeconomic status backgrounds.

Efficient generation of image chips for training deep learning algorithms

Science.gov (United States)

Han, Sanghui; Fafard, Alex; Kerekes, John; Gartley, Michael; Ientilucci, Emmett; Savakis, Andreas; Law, Charles; Parhan, Jason; Turek, Matt; Fieldhouse, Keith; Rovito, Todd

2017-05-01

Training deep convolutional networks for satellite or aerial image analysis often requires a large amount of training data. For a more robust algorithm, training data need to have variations not only in the background and target, but also radiometric variations in the image such as shadowing, illumination changes, atmospheric conditions, and imaging platforms with different collection geometry. Data augmentation is a commonly used approach to generating additional training data. However, this approach is often insufficient in accounting for real world changes in lighting, location or viewpoint outside of the collection geometry. Alternatively, image simulation can be an efficient way to augment training data that incorporates all these variations, such as changing backgrounds, that may be encountered in real data. The Digital Imaging and Remote Sensing Image Image Generation (DIRSIG) model is a tool that produces synthetic imagery using a suite of physics-based radiation propagation modules. DIRSIG can simulate images taken from different sensors with variation in collection geometry, spectral response, solar elevation and angle, atmospheric models, target, and background. Simulation of Urban Mobility (SUMO) is a multi-modal traffic simulation tool that explicitly models vehicles that move through a given road network. The output of the SUMO model was incorporated into DIRSIG to generate scenes with moving vehicles. The same approach was used when using helicopters as targets, but with slight modifications. Using the combination of DIRSIG and SUMO, we quickly generated many small images, with the target at the center with different backgrounds. The simulations generated images with vehicles and helicopters as targets, and corresponding images without targets. Using parallel computing, 120,000 training images were generated in about an hour. Some preliminary results show an improvement in the deep learning algorithm when real image training data are augmented with

Amblyopia treatment of adults with dichoptic training using the virtual reality oculus rift head mounted display: preliminary results

OpenAIRE

Žiak, Peter; Holm, Anders; Halička, Juraj; Mojzis, Peter; Piñero, David P.

2017-01-01

Background The gold standard treatments in amblyopia are penalizing therapies, such as patching or blurring vision with atropine that are aimed at forcing the use of the amblyopic eye. However, in the last years, new therapies are being developed and validated, such as dichoptic visual training, aimed at stimulating the amblyopic eye and eliminating the interocular supression. Purpose To evaluate the effect of dichoptic visual training using a virtual reality head mounted display in a sample ...

Ride comfort analysis with physiological parameters for an e-health train.

Science.gov (United States)

Lee, Youngbum; Shin, Kwangsoo; Lee, Sangjoon; Song, Yongsoo; Han, Sungho; Lee, Myoungho

2009-12-01

Transportation by train has numerous advantages over road transportation, especially with regard to energy efficiency, ecological features, safety, and punctuality. However, the contrast in ride comfort between standard road transportation and train travel has become a competitive issue. The ride comfort enhancement technology of tilting trains (TTX) is a particularly important issue in the development of the Korean high-speed railroad business. Ride comfort is now defined in international standards such as UIC13 and ISO2631. The Korean standards such as KSR9216 mainly address physical parameters such as vibration and noise. In the area of ride comfort, living quality parameter techniques have recently been considered in Korea, Japan, and Europe. This study introduces biological parameters, particularly variations in heart rate, as a more direct measure of comfort. Biological parameters are based on physiological responses rather than on purely external mechanical parameters. Variability of heart rate and other physiological parameters of passengers are measured in a simulation involving changes in the tilting angle of the TTX. This research is a preliminary study for the implementation of an e-health train, which would provide passengers with optimized ride comfort. The e-health train would also provide feedback on altered ride comfort situations that can improve a passenger's experience and provide a healthcare service on the train. The aim of this research was to develop a ride comfort evaluation system for the railway industry, the automobile industry, and the air industry. The degree of tilt correlated with heart rate, fatigue, and unrelieved alertness.

An inventory to assess empathic concern for disability and accessibility: development and preliminary psychometric investigation

Directory of Open Access Journals (Sweden)

Motohide Miyahara

2017-11-01

Full Text Available Cultivating empathy and prosocial attitude towards disability is a first step for university students to become the leaders of society and professions to create accessible environments and inclusive society. Gauging levels of empathy and prosocial attitude towards disability among the students is important for evaluating the adequacy of disability training and education. We developed and conducted an initial psychometric validation of a novel inventory in Japanese and English languages to assess Empathic Concern for Disability and Accessibility (ECDA in Japan and New Zealand. Preliminary psychometric evaluation indicates strong internal consistency in the Japanese sample (α = .96 and the New Zealand sample (α = .93. Exploratory factor analysis demonstrated a four-factor solution for both samples. The present study has resulted in the development of the ECDA that demonstrated initial support for internal consistency and construct validity. The ECDA may be used for the cross-cultural comparisons of disability training and education.

Safety of strength training in premenopausal women: musculoskeletal injuries from a two-year randomized trial.

Science.gov (United States)

Warren, Meghan; Schmitz, Kathryn H

2009-01-01

The health benefits of strength training must be weighed against risks, including injuries. A prior study observed 4.2 injuries that limited usual activities for a day per 1000 strength training sessions among men and women. The analysis herein explores the incidence rates of musculoskeletal injuries from strength training in women. Randomized controlled trial. SETTING; Free-living community. A total of 163 injury-free, overweight, sedentary, premenopausal women aged 25 to 44 years. Two years of strength training (n = 81) or standard care (n = 82). The intervention followed published guidelines (U.S. Department of Health and Human Services) with hypothesized injury prevention strategies. An injury survey was administered at years 1 and 2. Injury was defined as physical activity or strength training associated injuries that limited daily activities for 1 week or more. Denominators for rate calculation were accelerometer-measured physical activity and strength training attendance (strength training only). The between-group probability of injuries was assessed using generalized estimating equations. Injury incidence rates were higher in strength training compared with standard care. In strength training, the injury rates were 3.6 per 1000 strength training sessions (95% confidence interval: 2.5-4.8 per 1000) for physical activity-related injuries, and 2.6 per 1000 (95% confidence interval: 1.5-3.6 per 1000) for strength training-related injuries. Injury rates varied by definition and denominator. Strength training had lower injury rates than previously reported, providing preliminary support for the prevention strategies. The finding of strength training injuries underscores the need for balancing the benefits against the potential risks of this exercise modality.

Training teachers to teach mental health skills to staff in primary care settings in a vast, under-populated area.

Science.gov (United States)

Goldberg, D P; Gask, L; Zakroyeva, A; Proselkova, E; Ryzhkova, N; Williams, P

2012-12-01

Background The Arkhangelsk Oblast is an area the size of France with a sparsely distributed population. The existing primary care staff have had very little training in the management of mental health disorders, despite the frequency of these disorders in the population. They requested special teaching on depression, suicide, somatisation and alcohol problems. Methods An educational intervention was developed in partnership with mental health and primary care staff in Russia, to develop mental health skills using established, evidence-based methods. After a preliminary demonstration of teaching methods to be employed, a 5-day full-time teaching course was offered to trainers of general practitioners and feldshers. Results The findings are presented by providing details of improvements that occurred over a 3-month period in four areas, namely depression in primary care, somatic presentations of distress, dealing with suicidal patients, and alcohol problems. We present preliminary data on how the training has generalised since our visits to Archangelsk. Conclusions Teachers who are used to teaching by didactic lectures can be taught the value of short introductory talks that invite discussion, and mental health skills can be taught using role play. The content of such training should be driven by perceived local needs, and developed in conjunction with local leaders and teachers within primary care services. Further research will be needed to establish the impact on clinical outcomes.

Craving to quit: psychological models and neurobiological mechanisms of mindfulness training as treatment for addictions.

Science.gov (United States)

Brewer, Judson A; Elwafi, Hani M; Davis, Jake H

2013-06-01

Humans suffer heavily from substance use disorders and other addictions. Despite much effort that has been put into understanding the mechanisms of the addictive process, treatment strategies have remained suboptimal over the past several decades. Mindfulness training, which is based on ancient Buddhist models of human suffering, has recently shown preliminary efficacy in treating addictions. These early models show remarkable similarity to current models of the addictive process, especially in their overlap with operant conditioning (positive and negative reinforcement). Further, they may provide explanatory power for the mechanisms of mindfulness training, including its effects on core addictive elements, such as craving, and the underlying neurobiological processes that may be active therein. In this review, using smoking as an example, we will highlight similarities between ancient and modern views of the addictive process, review studies of mindfulness training for addictions and their effects on craving and other components of this process, and discuss recent neuroimaging findings that may inform our understanding of the neural mechanisms of mindfulness training. 2013 APA, all rights reserved

A Comparison of Training Experience, Training Satisfaction, and Job Search Experiences between Integrated Vascular Surgery Residency and Traditional Vascular Surgery Fellowship Graduates.

Science.gov (United States)

Colvard, Benjamin; Shames, Murray; Schanzer, Andres; Rectenwald, John; Chaer, Rabih; Lee, Jason T

2015-10-01

The first 2 integrated vascular residents in the United States graduated in 2012, and in 2013, 11 more entered the job market. The purpose of this study was to compare the job search experiences of the first cohort of integrated 0 + 5 graduates to their counterparts completing traditional 5 + 2 fellowship programs. An anonymous, Web-based, 15-question survey was sent to all 11 graduating integrated residents in 2013 and to the 25 corresponding 5 + 2 graduating fellows within the same institution. Questions focused on the following domains: training experience, job search timelines and outcomes, and overall satisfaction with each training paradigm. Survey response was nearly 81% for the 0 + 5 graduates and 64% for the 5 + 2 graduates. Overall, there was no significant difference between residents and fellows in the operative experience obtained as measured by the number of open and endovascular cases logged. Dedicated research time during the entire training period was similar between residents and fellows. Nearly all graduates were extremely satisfied with their training and had positive experiences during their job searches with respect to starting salaries, numbers of offers, and desired practice type. More 0 + 5 residents chose academic and mixed practices over private practices compared with 5 + 2 fellowship graduates. Although longer term data are needed to understand the impact of the addition of 0 + 5 graduating residents to the vascular surgery work force, preliminary survey results suggest that both training paradigms (0 + 5 and 5 + 2) provide positive training experiences that result in excellent job search experiences. Based on the current and future need for vascular surgeons in the work force, the continued growth and expansion of integrated 0 + 5 vascular surgery residency positions as an alternative to traditional fellowship training is thus far justified. Copyright © 2015 Elsevier Inc. All rights reserved.

23 CFR 645.109 - Preliminary engineering.

Science.gov (United States)

2010-04-01

... 23 Highways 1 2010-04-01 2010-04-01 false Preliminary engineering. 645.109 Section 645.109 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC OPERATIONS UTILITIES Utility Relocations, Adjustments, and Reimbursement § 645.109 Preliminary engineering. (a) As...

The Effects of Home-Based Cognitive Training on Verbal Working Memory and Language Comprehension in Older Adulthood

Science.gov (United States)

Payne, Brennan R.; Stine-Morrow, Elizabeth A. L.

2017-01-01

Effective language understanding is crucial to maintaining cognitive abilities and learning new information through adulthood. However, age-related declines in working memory (WM) have a robust negative influence on multiple aspects of language comprehension and use, potentially limiting communicative competence. In the current study (N = 41), we examined the effects of a novel home-based computerized cognitive training program targeting verbal WM on changes in verbal WM and language comprehension in healthy older adults relative to an active component-control group. Participants in the WM training group showed non-linear improvements in performance on trained verbal WM tasks. Relative to the active control group, WM training participants also showed improvements on untrained verbal WM tasks and selective improvements across untrained dimensions of language, including sentence memory, verbal fluency, and comprehension of syntactically ambiguous sentences. Though the current study is preliminary in nature, it does provide initial promising evidence that WM training may influence components of language comprehension in adulthood and suggests that home-based training of WM may be a viable option for probing the scope and limits of cognitive plasticity in older adults. PMID:28848421

The Effects of Home-Based Cognitive Training on Verbal Working Memory and Language Comprehension in Older Adulthood.

Science.gov (United States)

Payne, Brennan R; Stine-Morrow, Elizabeth A L

2017-01-01

Effective language understanding is crucial to maintaining cognitive abilities and learning new information through adulthood. However, age-related declines in working memory (WM) have a robust negative influence on multiple aspects of language comprehension and use, potentially limiting communicative competence. In the current study ( N = 41), we examined the effects of a novel home-based computerized cognitive training program targeting verbal WM on changes in verbal WM and language comprehension in healthy older adults relative to an active component-control group. Participants in the WM training group showed non-linear improvements in performance on trained verbal WM tasks. Relative to the active control group, WM training participants also showed improvements on untrained verbal WM tasks and selective improvements across untrained dimensions of language, including sentence memory, verbal fluency, and comprehension of syntactically ambiguous sentences. Though the current study is preliminary in nature, it does provide initial promising evidence that WM training may influence components of language comprehension in adulthood and suggests that home-based training of WM may be a viable option for probing the scope and limits of cognitive plasticity in older adults.

The Effects of Home-Based Cognitive Training on Verbal Working Memory and Language Comprehension in Older Adulthood

Directory of Open Access Journals (Sweden)

Brennan R. Payne

2017-08-01

Full Text Available Effective language understanding is crucial to maintaining cognitive abilities and learning new information through adulthood. However, age-related declines in working memory (WM have a robust negative influence on multiple aspects of language comprehension and use, potentially limiting communicative competence. In the current study (N = 41, we examined the effects of a novel home-based computerized cognitive training program targeting verbal WM on changes in verbal WM and language comprehension in healthy older adults relative to an active component-control group. Participants in the WM training group showed non-linear improvements in performance on trained verbal WM tasks. Relative to the active control group, WM training participants also showed improvements on untrained verbal WM tasks and selective improvements across untrained dimensions of language, including sentence memory, verbal fluency, and comprehension of syntactically ambiguous sentences. Though the current study is preliminary in nature, it does provide initial promising evidence that WM training may influence components of language comprehension in adulthood and suggests that home-based training of WM may be a viable option for probing the scope and limits of cognitive plasticity in older adults.

Transfer Learning for Video Recognition with Scarce Training Data for Deep Convolutional Neural Network

OpenAIRE

Su, Yu-Chuan; Chiu, Tzu-Hsuan; Yeh, Chun-Yen; Huang, Hsin-Fu; Hsu, Winston H.

2014-01-01

Unconstrained video recognition and Deep Convolution Network (DCN) are two active topics in computer vision recently. In this work, we apply DCNs as frame-based recognizers for video recognition. Our preliminary studies, however, show that video corpora with complete ground truth are usually not large and diverse enough to learn a robust model. The networks trained directly on the video data set suffer from significant overfitting and have poor recognition rate on the test set. The same lack-...

Preliminary design county plan Zeeland

International Nuclear Information System (INIS)

1987-01-01

The preliminary design 'Streekplan Zeeland' (Country plan Zeeland, with regard to the location of additional nuclear power plants in Zeeland, the Netherlands) has passed through a consultation and participation round. Thereupon 132 reactions have been received. These have been incorporated and answered in two notes. This proposal deals with the principal points of the preliminary design and treats also the remarks of the committees Environmental (town and country) Planning (RO), Provincial (town and country) Planning Committee (PPC) and Association of Communities of Zeeland (VZG), on the reply notes. The preliminary design with the modifications, collected in appendix 3, is proposed to be the starting point in the drawing-up of the design-country-plan. This design subsequently will pass the formal country-plan procedure. (author). 1 fig

Evidence Report: Risk of Performance Errors Due to Training Deficiencies

Science.gov (United States)

Barshi, Immanuel; Dempsey, Donna L.

2016-01-01

Substantial evidence supports the claim that inadequate training leads to performance errors. Barshi and Loukopoulos (2012) demonstrate that even a task as carefully developed and refined over many years as operating an aircraft can be significantly improved by a systematic analysis, followed by improved procedures and improved training (see also Loukopoulos, Dismukes, & Barshi, 2009a). Unfortunately, such a systematic analysis of training needs rarely occurs during the preliminary design phase, when modifications are most feasible. Training is often seen as a way to compensate for deficiencies in task and system design, which in turn increases the training load. As a result, task performance often suffers, and with it, the operators suffer and so does the mission. On the other hand, effective training can indeed compensate for such design deficiencies, and can even go beyond to compensate for failures of our imagination to anticipate all that might be needed when we send our crew members to go where no one else has gone before. Much of the research literature on training is motivated by current training practices aimed at current training needs. Although there is some experience with operations in extreme environments on Earth, there is no experience with long-duration space missions where crews must practice semi-autonomous operations, where ground support must accommodate significant communication delays, and where so little is known about the environment. Thus, we must develop robust methodologies and tools to prepare our crews for the unknown. The research necessary to support such an endeavor does not currently exist, but existing research does reveal general challenges that are relevant to long-duration, high-autonomy missions. The evidence presented here describes issues related to the risk of performance errors due to training deficiencies. Contributing factors regarding training deficiencies may pertain to organizational process and training programs for

Holmium:YAG laser stapedotomy: preliminary evaluation

Science.gov (United States)

Stubig, Ingrid M.; Reder, Paul A.; Facer, G. W.; Rylander, Henry G.; Welch, Ashley J.

1993-07-01

This study investigated the use of a pulsed Holmium:YAG ((lambda) equals 2.09 micrometers ) laser- fiber microsurgical system for laser stapedotomy. This system ablates human stapes bones effectively with minimal thermal damage. The study was designed to determine the effectiveness of the Ho:YAG laser (Schwartz Electro Optics, Inc., Orlando, FL) for stapedotomy and to evaluate temperature changes within the cochlea during the ablation process. Human cadaveric temporal bones were obtained and the stapes portion of the ossicular chain was removed. A 200 micrometers diameter low OH quartz fiber was used to irradiate these stapes bones in an air environment. The laser was pulsed at 2 Hz, 250 microsecond(s) ec pulse width and an irradiance range of 100 - 240 J/cm2 was used to ablate holes in the stapes footplate. The resultant stapedotomies created had smooth 300 micrometers diameter holes with a minimum of circumferential charring. Animal studies in-vivo were carried out in chinchillas to determine the caloric spread within the cochlea. A 0.075 mm Type T thermocouple was placed in the round window. Average temperature change during irradiation of the stapes footplate recorded in the round window was 3.6 degree(s)C. The data suggest that stapedotomy using the Ho:YAG laser can result in a controlled ablation of the stapes footplate with minimal thermal damage to the surrounding stapes. Optical coupling using fiberoptic silica fibers is an ideal method for delivering laser energy to the stapes during stapedotomy.

Acceptability and Preliminary Efficacy of a Lesbian, Gay, Bisexual, and Transgender-Affirmative Mental Health Practice Training in a Highly Stigmatizing National Context.

Science.gov (United States)

Lelutiu-Weinberger, Corina; Pachankis, John E

2017-10-01

Lesbian, gay, bisexual, and transgender (LGBT) individuals in Romania encounter pervasive stigma and discrimination and there is a high need for LGBT-competent mental health professionals (MHPs). We tested the impact of a pilot LGBT-affirmative training for MHPs in Romania on these professionals' LGBT-relevant attitudes, knowledge, and perception of clinical skills. We conducted a 2-day training for MHPs in Bucharest. Fifty-four attended and 33 provided training evaluation data at baseline and follow-up. The majority of trainees were female (90%) and heterosexual (73%) with a mean age of 36.4 (SD = 7.7). From baseline to follow-up, trainees demonstrated a significant increase in perceived LGBT-relevant clinical skills (P LGBT-affirmative practice attitudes (P LGBT individuals (P LGBT individuals were low at both baseline and follow-up. The majority of trainees reported being highly interested in the training (84%), which they reported had prepared them to interact with and care for LGBT individuals (74%). This pilot training appeared to be effective in increasing perceived LGBT competence among participating MHPs. This type of training model needs to be tested further in a randomized controlled trial with longer follow-up periods to assess intervention durability and implementation of clinical skills. Future trainings can be incorporated into existing curricula. National accreditation bodies might consider encouraging such training as part of standard educational requirements.

Goal Oriented Activity Towards Life Skill Training: Preliminary Indications of a Task-intensive Approach to Manage Cerebral Palsy

Directory of Open Access Journals (Sweden)

Saumen Gupta

2013-02-01

Full Text Available Purpose: To devise a viable programme of intervention for older people with Cerebral Palsy (CP. Methods: Using focus group interviews, a ‘top down’ model of intervention was devised among older children and adolescents with CP. Ten participants volunteered and a custom tailored approach was employed, in keeping with the participants’ goals. Results: The outcomes are described qualitatively. Conclusions: There are preliminary indications that the programme is versatile and feasible. Further trials must be conducted before conclusive comments can be made.

Exploratory shaft facility preliminary designs - Paradox Basin. Technical report

International Nuclear Information System (INIS)

1983-09-01

The purpose of the Preliminary Design Report, Paradox Basin, is to provide a description of the preliminary design for an Exploratory Shaft Facility in the Paradox Basin, Utah. This issue of the report describes the preliminary design for constructing the exploratory shaft using the Large Hole Drilling Method of construction and outlines the preliminary design and estimates of probable construction cost. The Preliminary Design Report is prepared to complement and summarize other documents that comprise the design at the preliminary stage of completion, December 1982. Other design documents include drawings, cost estimates and schedules. The preliminary design drawing package, which includes the construction schedule drawing, depicts the descriptions in this report. For reference, a list of the drawing titles and corresponding numbers is included in the Appendix. The report is divided into three principal sections: Design Basis, Facility Description, and Construction Cost Estimate. 30 references

Inclusive Training in Fencing as a Means of Changing Attitude to People with Disabilities

Directory of Open Access Journals (Sweden)

Р. Ю. Свічкар

2015-09-01

Full Text Available Research objective: to develop and improve the training of fencers using inclusive training in order to increase sport results and shape a positive attitude to people with disabilities. Methods. The co-training of the “Unifekht” Sports Club fencers and wheelchair fencers lasted for three months.  The athletes underwent the preliminary and the final testing on the target that showed a number of hits. Besides, during the individual lesson, the coach tested the athlete for the quality of performing attacking and defensive techniques. The preliminary and the final questionnaires revealed the opinions of the coaches, instructors of the Department of Fencing, fencers and wheelchair fencers and the students of the School of Physical Education and Sports of H. S. Skovoroda Kharkiv National Pedagogical University as to the attitude of the athletes of both categories to sports and “Invasport” in Ukraine. There were 40 respondents taking the questionnaires: 3rd-year students (10 people, fencers (10 people, instructors of the Department of Fencing (5 persons, wheelchair fencers (8 people, fencing coaches (5 persons, wheelchair fencing coaches (2 persons. Results. The study shows that, despite the high results of the athletes with disabilities, there exist certain problems in Ukraine that affect the willingness of people with disabilities to go in for sports. The main causes thereof are the low level of financial support and the low quality of medical care. By the research results, the respondents indicate the main criterion motivating people with special needs to do wheelchair fencing to be: self-expression and self-realization (68%, an opportunity to communicate (21%, and financial support (11%. The factors of low interest in wheelchair fencing are: lack of motivation to training people with special needs (26%; social policy of the state (23%; poor facilities and resources in the specialized institutions (20% of the respondents. At the same time

Preliminary evidence that allelic variation in the LMX1A gene influences training-related working memory improvement.

Science.gov (United States)

Bellander, Martin; Brehmer, Yvonne; Westerberg, Helena; Karlsson, Sari; Fürth, Daniel; Bergman, Olle; Eriksson, Elias; Bäckman, Lars

2011-06-01

LMX1A is a transcription factor involved in the development of dopamine (DA)-producing neurons in midbrain. Previous research has shown that allelic variations in three LMX1A single nucleotide polymorphisms (SNPs) were related to risk of Parkinson's disease (PD), suggesting that these SNPs may influence the number of mesencephalic DA neurons. Prompted by the established link between striatal DA functions and working memory (WM) performance, we examined two of these SNPs in relation to the ability to benefit from 4 weeks of WM training. One SNP (rs4657412) was strongly associated with the magnitude of training-related gains in verbal WM. The allele linked to larger gains has previously been suggested to be associated with higher dopaminergic nerve cell density. No differential gains of either SNP were observed for spatial WM, and the genotype groups were also indistinguishable in tests of attention, interference control, episodic memory, perceptual speed, and reasoning for both SNPs. This pattern of data is in agreement with previous findings from our group, suggesting that cognitive effects of DA-related genes may be more easily detected in a training context than for single-assessment performance scores. Copyright © 2011 Elsevier Ltd. All rights reserved.

Influence of moderate training on gait and work capacity of fibromyalgia patients: a preliminary field study.

Science.gov (United States)

Tiidus, Peter M; Pierrynowski, Michael; Dawson, Kimberley A

2002-12-01

This field study examined the influence of moderate intensity training on gait patterns and work capacity of individuals with fibromyalgia syndrome (FS). FS is a chronic condition of unknown etiology, characterized by muscle tenderness, pain and stiffness and often accompanied by depression and fatigue which seems to occur primarily in middle aged females. There is no known cure for FS but treatment often includes a prescription of mild exercise. Few studies have evaluated the effectiveness of mild exercise on work capacity and gait patterns in FS patients. Participants were 14 females (age 47.0 ± 7.6 y) who participated in a 10 wk community based aerobic, strength and stretching program designed for FS individuals. Subjects were evaluated pre- and post-program and at a 2 month follow up. Work capacity was estimated by a sub-maximal PWC 170 cycle ergometer test and a Borg perceived exertion scale. Gait was assessed using OptoTrack three dimensional kinematics with 16 channel analogue data acquisition system. Trunk flexibility was also assessed. No significant change in estimated work capacity or flexibility was seen between pre- post- and follow up times. Nevertheless, a significant increase in self selected walking speed (p gait pattern that was sustained in the follow up testing was noted. We had previously also reported a significant improvement in muscle pain and other fibromyalgia symptoms in this population consequent to the training program. It was concluded that mild exercise training that does not influence work capacity or trunk flexibility can nevertheless positively influence gait mechanics and fibromyalgia symptoms in female FS patients.

Promoting ergonomics in Algeria: activities of "the research and training laboratory" in the University of Oran.

Science.gov (United States)

Mebarki, Bouhafs; El-Bachir, Tebboune Cheikh

2012-01-01

The growing need in Algeria to develop ergonomics knowledge and practice in industry was behind the initiative to develop a training and research project within the ergonomics laboratory at Oran University. Since 2005 the laboratory team is running an academic option master in work design and ergonomics. The evaluation of the academic master in 2010 revealed the acute need of the local industry for professional competences in ergonomic and work psychology. A professional training master program in "ergonomics & work psychology" was then developed in partnership with local industry, five European Universities and six Universities from three Maghreb countries. Research projects were initiated around the two training programs, in conjunction with a number of ergonomics dissemination and promotion activities. Preliminary results of the project are presented and discussed in relation to the local context, and in the light of similar cases in Industrially Developing Countries.

Effects of memory strategy training on performance and event-related brain potentials of children with ADHD in an episodic memory task.

Science.gov (United States)

Jonkman, Lisa M; Hurks, Petra P; Schleepen, Tamara M J

2016-10-01

Evidence for memory problems in children with attention deficit hyperactivity disorder (ADHD) is accumulating. Attempting to counter such problems, in the present study children with ADHD aged 8-12 years underwent a six-week metacognitive memory strategy training (MST) or one of two other active trainings, either a metacognitive attention-perceptual-motor training (APM) or placebo training consisting of playing board games (PLA). Effects of the training on episodic memory and underlying brain processes were investigated by comparing performance and event-related brain potentials (ERPs) on pre- and post-training sessions in an old/new recognition task between the three training groups. Potential far transfer effects of the memory strategy training were investigated by measuring performance on neuropsychological attention and memory-span tasks and parent-rated ADHD symptoms. The metacognitive memory strategy training led to significantly improved memory performance and enhanced amplitude of left parietal P600 activity associated with the process of memory recollection when compared to PLA, but APM training evoked similar improvements. Memory performance gains were significantly correlated with the memory-related ERP effects. Preliminary far transfer effects of MST training were found on attention and working memory performance and on parent-rated ADHD symptoms, although these results need replication with larger and better IQ-matched groups.

Computer training of attention and inhibition for youngsters with obesity: A pilot study.

Science.gov (United States)

Verbeken, Sandra; Braet, Caroline; Naets, Tiffany; Houben, Katrijn; Boendermaker, Wouter

2018-04-01

Obesity is a widespread problem that starts from an early age. Previous studies suggest that obese youngsters have an attentional bias and an automatic approach tendency towards high-calorie food and display difficulties inhibiting impulses, which may result in a higher intake of (high-calorie) food. An interesting idea for improvement of the current obesity treatment is adding a program that enables to train their difficulties. Subjects were 36 youngsters aged 9-15 years old from an inpatient treatment program for obesity, randomized over a training group and an active control group. The training consisted of six training sessions with cognitive tasks aimed at enhancing inhibition towards unhealthy food items (with a go/no-go task), as well as decreasing a food approach bias (using an approach/avoidance task) and a food attentional bias (using a dot-probe task). The current study evaluated the feasibility, acceptability and initial effectiveness of the training and explores if these characteristics helps obese youngsters to maintain weight-loss once they return home at the end of their inpatient treatment program. Results on the cognitive performances were investigated during two measurement sessions, spread over 5 weeks while weight evolution was followed over 13 weeks. Results showed that the training program was feasible and acceptable to the majority of participants and clinicians. Furthermore, the preliminary findings suggest that the training tasks used were ineffective in this group of obese children. Lessons learned and suggestions for future research are discussed. Copyright © 2018 Elsevier Ltd. All rights reserved.

Basic principles simulators - concept training simulators

International Nuclear Information System (INIS)

Benkert, J.

1986-01-01

Basic Principles Simulators have the purpose of teaching general concepts, demonstrating and displaying the fundamental physical processes of a plant. They are used to illustrate theory to students and also to provide a preliminary training to the operators, to aquaint them with the basic dynamic interactions of the various systems during the normal operation of a plant, and to show the consequences of the most important and common transients and malfunctions. Basic principles simulators may vary in size from small desk cabinets to large panels. They represent with a certain detail the nuclear and thermohydraulic part of the plant. The availability of video displays allows to present detailed information about process parameters which are not shown on the control panels. In general the overall plant behaviour is represented well. Limitations are mostly found in the areas of logic and control. (orig./HP)

Learning by doing. Training health care professionals to become facilitator of moral case deliberation.

Science.gov (United States)

Stolper, Margreet; Molewijk, Bert; Widdershoven, Guy

2015-03-01

Moral case deliberation (MCD) is a dialogue among health care professionals about moral issues in practice. A trained facilitator moderates the dialogue, using a conversation method. Often, the facilitator is an ethicist. However, because of the growing interest in MCD and the need to connect MCD to practice, healthcare professionals should also become facilitators themselves. In order to transfer the facilitating expertise to health care professionals, a training program has been developed. This program enables professionals in health care institutions to acquire expertise in dealing with moral questions independent of the expertise of an (external) ethicist. Over the past 10 years, we developed a training program with a specific mix of theory and practice, aiming to foster the right attitude, skills and knowledge of the trainee. The content and the didactics of the training developed in line with the philosophy of MCD: pragmatic hermeneutics, dialogical ethics and Socratic epistemology. Central principles are: 'learning by doing', 'reflection instead of ready made knowledge', and 'dialogue on dialogue'. This paper describes the theoretical background and the didactic content of the current training. Furthermore, we present didactic tools which we developed for stimulating active learning. We also go into lessons we learned in developing the training. Next, we provide some preliminary data from evaluation research of the training program by participants. The discussion highlights crucial aspects of educating professionals to become facilitators of MCD. The paper ends with concluding remarks and a plea for more evaluative evidence of the effectiveness and meaning of this training program for doing MCD in institutions.

Cognitive Training Enhances Auditory Attention Efficiency in Older Adults

Directory of Open Access Journals (Sweden)

Jennifer L. O’Brien

2017-10-01

Full Text Available Auditory cognitive training (ACT improves attention in older adults; however, the underlying neurophysiological mechanisms are still unknown. The present study examined the effects of ACT on the P3b event-related potential reflecting attention allocation (amplitude and speed of processing (latency during stimulus categorization and the P1-N1-P2 complex reflecting perceptual processing (amplitude and latency. Participants completed an auditory oddball task before and after 10 weeks of ACT (n = 9 or a no contact control period (n = 15. Parietal P3b amplitudes to oddball stimuli decreased at post-test in the trained group as compared to those in the control group, and frontal P3b amplitudes show a similar trend, potentially reflecting more efficient attentional allocation after ACT. No advantages for the ACT group were evident for auditory perceptual processing or speed of processing in this small sample. Our results provide preliminary evidence that ACT may enhance the efficiency of attention allocation, which may account for the positive impact of ACT on the everyday functioning of older adults.

Artificial neural network classification using a minimal training set - Comparison to conventional supervised classification

Science.gov (United States)

Hepner, George F.; Logan, Thomas; Ritter, Niles; Bryant, Nevin

1990-01-01

Recent research has shown an artificial neural network (ANN) to be capable of pattern recognition and the classification of image data. This paper examines the potential for the application of neural network computing to satellite image processing. A second objective is to provide a preliminary comparison and ANN classification. An artificial neural network can be trained to do land-cover classification of satellite imagery using selected sites representative of each class in a manner similar to conventional supervised classification. One of the major problems associated with recognition and classifications of pattern from remotely sensed data is the time and cost of developing a set of training sites. This reseach compares the use of an ANN back propagation classification procedure with a conventional supervised maximum likelihood classification procedure using a minimal training set. When using a minimal training set, the neural network is able to provide a land-cover classification superior to the classification derived from the conventional classification procedure. This research is the foundation for developing application parameters for further prototyping of software and hardware implementations for artificial neural networks in satellite image and geographic information processing.

The West Virginia Occupational Safety and Health Initiative: practicum training for a new marketplace.

Science.gov (United States)

Meyer, J D; Becker, P E; Stockdale, T; Ducatman, A M

1999-05-01

Occupational medicine practice has experienced a shift from larger corporate medical departments to organizations providing services for a variety of industries. Specific training needs will accompany this shift in practice patterns; these may differ from those developed in the traditional industrial or corporate medical department setting. The West Virginia Occupational Health and Safety Initiative involves occupational medicine residents in consultation to a variety of small industries and businesses. It uses the expertise of occupational physicians, health and safety extension faculty, and faculty in engineering and industrial hygiene. Residents participate in multidisciplinary evaluations of worksites, and develop competencies in team-building, workplace health and safety evaluation, and occupational medical consulting. Specific competencies that address requirements for practicum training are used to measure the trainee's acquisition of knowledge and skills. Particular attention is paid to the acquisition of group problem-solving expertise, skills relevant to the current market in practice opportunities, and the specific career interests of the resident physician. Preliminary evaluation indicates the usefulness of training in evaluation of diverse industries and worksites. We offer this program as a training model that can prepare residents for the challenges of a changing marketplace for occupational health and safety services.

32 CFR 644.30 - Preliminary real estate work.

Science.gov (United States)

2010-07-01

... 32 National Defense 4 2010-07-01 2010-07-01 true Preliminary real estate work. 644.30 Section 644... PROPERTY REAL ESTATE HANDBOOK Project Planning Military (army and Air Force) and Other Federal Agencies § 644.30 Preliminary real estate work. (a) Preliminary real estate work is defined as that action taken...

An Automatic Identification Procedure to Promote the use of FES-Cycling Training for Hemiparetic Patients

Directory of Open Access Journals (Sweden)

Emilia Ambrosini

2014-01-01

Full Text Available Cycling induced by Functional Electrical Stimulation (FES training currently requires a manual setting of different parameters, which is a time-consuming and scarcely repeatable procedure. We proposed an automatic procedure for setting session-specific parameters optimized for hemiparetic patients. This procedure consisted of the identification of the stimulation strategy as the angular ranges during which FES drove the motion, the comparison between the identified strategy and the physiological muscular activation strategy, and the setting of the pulse amplitude and duration of each stimulated muscle. Preliminary trials on 10 healthy volunteers helped define the procedure. Feasibility tests on 8 hemiparetic patients (5 stroke, 3 traumatic brain injury were performed. The procedure maximized the motor output within the tolerance constraint, identified a biomimetic strategy in 6 patients, and always lasted less than 5 minutes. Its reasonable duration and automatic nature make the procedure usable at the beginning of every training session, potentially enhancing the performance of FES-cycling training.

Business plan: A preliminary approach to an unknown genre

Directory of Open Access Journals (Sweden)

Federico Navarro

2015-11-01

Full Text Available The business plan has been widely included in the curricula of economics degrees and is key to business practice worldwide, but has not been studied from a socio-discursive perspective yet due to restrictions in its social, spatial, and temporal circulation. Based on interviews and a qualitative analysis of a corpus of 38 texts written in Spanish, I aim to provide a preliminary description of the genre. Results indicate that a chain of four phases is associated to a continuum of social settings organized through entrepreneurial/corporate and expert/training variables; its rhetorical structure includes “describing present/potential situation of the company and market” and “describing future processes of strategic actions regarding the marketing, production, and financial plans”. This analysis offers methodological innovations to account for occluded genres, encourages the contrastive study of the business plan in different cultural and linguistic environments, and assists business teachers with a situated picture of the genre

Effectiveness of simulator-based echocardiography training of noncardiologists in congenital heart diseases.

Science.gov (United States)

Wagner, Robert; Razek, Vit; Gräfe, Florentine; Berlage, Thomas; Janoušek, Jan; Daehnert, Ingo; Weidenbach, Michael

2013-07-01

Congenital heart diseases (CHD) are responsible for substantial morbidity and mortality in neonates. The preliminary diagnosis often is made by noncardiologists. For this reason, there is a huge demand of training in echocardiography of CHD. This is difficult to achieve due to limited resources of specialized centers. The goal of this study was to investigate the training effect of the echocardiography simulator EchoCom on trainee's ability to diagnose CHD. We enrolled 10 residents for simulator-based training in echocardiography of CHD. All participants were instructed on the simulator's basic handling and had one hour to scan the first 9 datasets information (ventricular septal defect, atrial septal defect, atrioventricular septal defect, Tetralogy of Fallot, transposition of great arteries, congenital corrected transposition of great arteries, common arterial trunk, hypoplastic left heart syndrome, normal anatomy) and establish a diagnosis. No help was given except for support regarding simulator related issues. Afterward, 2 rounds of structured simulator based echocardiography training focused on echocardiographic anatomy, spatial orientation, standard views, and echocardiographic anatomy of different CHD followed. All participants completed a standardized questionnaire containing 10 multiple-choice (MC) questions focusing on basic theoretical knowledge in echocardiographic anatomy and common CHD. Almost all of the residents invited from the affiliated children's hospital had little (20%) or no experience (80%) in echocardiography of CHD. Their Pretest and Posttest scores showed significant improvement for both, MC test and performance test, respectively. Our study showed that simulator-based training in echocardiography in CHD could be very effective and may assist with training outside the scope of CHD. © 2013, Wiley Periodicals, Inc.

Design of the ILC Prototype FONT4 Digital Intra-Train Beam-Based Feedback System

International Nuclear Information System (INIS)

Burrows, P.; Queen Mary, U. of London; Christian, G.B.; Hartin, A.F.; Dabiri Khah, H.; White, G.R.; Oxford U.; Clarke, C.C.; Perry, C.; Oxford Instruments; Kalinin, A.; Daresbury; McCormick, D.J.; Molloy, S.; Ross, M.C.; SLAC

2007-01-01

We present the design of the FONT4 digital intra-train beam position feedback system prototype and preliminary results of initial beam tests at the Accelerator Test Facility (ATF) at KEK. The feedback system incorporates a fast analogue beam position monitor (BPM) front-end signal processor, a digital feedback board, and a kicker driver amplifier. The short bunchtrain, comprising 3 electron bunches separated by c. 150ns, in the ATF extraction line was used to test components of the prototype feedback system

Reliability and responsiveness of the Self-Efficacy in Assessing, Training and Spotting wheelchair skills (SEATS) outcome measure.

Science.gov (United States)

Rushton, Paula W; Smith, Emma M; Miller, William C; Kirby, R Lee; Daoust, Geneviève

2018-01-31

The aim of this study was to evaluate the internal consistency, test-retest reliability and responsiveness of the Self-Efficacy in Assessing, Training and Spotting manual wheelchair skills (SEATS-M) and Self-Efficacy in Assessing, Training and Spotting power wheelchair skills (SEATS-P). A 2-week test-retest design was used with a convenience sample of occupational and physical therapists who worked at a provincial rehabilitation centre (inpatient and outpatient services). Sixteen participants completed the SEATS-M and 18 participants completed the SEATS-P. For the SEATS-M assessment, training, spotting and documentation sections, Cronbach's alpha coefficients ranged from 0.90 to 0.97, the 2-week intraclass correlation coefficients (ICC 1,1 ) ranged from 0.81 to 0.95, the standard error of measurements (SEM) ranged from 5.06 to 8.70 and the smallest real differences (SRD) ranged from 6.24 to 8.18. For the SEATS-P assessment, training, spotting and documentation sections, Cronbach's alpha coefficients ranged from 0.83 to 0.92, the ICCs ranged from 0.72 to 0.86, the SEMs ranged from 4.54 to 8.91 and the SRDs ranged from 5.90 to 8.27. There is preliminary evidence that both the SEATS-M and the SEATS-P have high internal consistency, good test-retest reliability and support for responsiveness. These tools can be used in evaluating clinician self-efficacy with assessing, training, spotting and documenting wheelchair skills included on the Wheelchair Skills Test. Implications for Rehabilitation There is preliminary evidence that the SEATS-M and SEATS-P are reliable and responsive outcome measures that can be used to evaluate the self-efficacy of clinicians to administer the Wheelchair Skills Program. Measurement of clinicians' self-efficacy in this area of practice may enable an enhanced understanding of the areas in which clinicians lack self-efficacy, thereby informing the development of improved knowledge translation interventions.

Changes in frontal-parietal activation and math skills performance following adaptive number sense training: preliminary results from a pilot study.

Science.gov (United States)

Kesler, Shelli R; Sheau, Kristen; Koovakkattu, Della; Reiss, Allan L

2011-08-01

Number sense is believed to be critical for math development. It is putatively an implicitly learned skill and may therefore have limitations in terms of being explicitly trained, particularly in individuals with altered neurodevelopment. A case series study was conducted using an adaptive, computerised programme that focused on number sense and general problem-solving skills. The study was designed to investigate training effects on performance as well as brain function in a group of children with Turner syndrome who are at risk for math difficulties and altered development of math-related brain networks. Standardised measurements of math and math-related cognitive skills as well as functional magnetic resonance imaging (fMRI) were used to assess behavioural and neurobiological outcomes following training. Participants demonstrated significantly increased basic math skills, including number sense, and calculation as well as processing speed, cognitive flexibility and visual-spatial processing skills. With the exception of calculation, increased scores also were clinically significant (i.e., recovered) based on reliable change analysis. Participants additionally demonstrated significantly increased bilateral parietal lobe activation and decreased frontal-striatal and mesial temporal activation following the training programme. These findings show proof of concept for an accessible training approach that may be potentially associated with improved number sense, math and related skills, as well as functional changes in math-related neural systems, even among individuals at risk for altered brain development.

Training Community Mental Health Therapists to Deliver a Package of Evidence-Based Practice Strategies for School-Age Children with Autism Spectrum Disorders: A Pilot Study

Science.gov (United States)

Brookman-Frazee, Lauren I.; Drahota, Amy; Stadnick, Nicole

2012-01-01

Research on moving evidence-based practice (EBP) intervention strategies to community service settings for children with autism spectrum disorders (ASD) is urgently needed. The current pilot study addresses this need by examining the feasibility, acceptability and preliminary outcomes of training therapists practicing in community mental health…

Plutonium Immobilization Can Loading Preliminary Specifications

Energy Technology Data Exchange (ETDEWEB)

Kriikku, E.

1998-11-25

This report discusses the Plutonium Immobilization can loading preliminary equipment specifications and includes a process block diagram, process description, equipment list, preliminary equipment specifications, plan and elevation sketches, and some commercial catalogs. This report identifies loading pucks into cans and backfilling cans with helium as the top priority can loading development areas.

INFLUENCE OF MODERATE TRAINING ON GAIT AND WORK CAPACITY OF FIBROMYALGIA PATIENTS: A PRELIMINARY FIELD STUDY

Directory of Open Access Journals (Sweden)

Michael Pierrynowski

2002-12-01

Full Text Available This field study examined the influence of moderate intensity training on gait patterns and work capacity of individuals with fibromyalgia syndrome (FS. FS is a chronic condition of unknown etiology, characterized by muscle tenderness, pain and stiffness and often accompanied by depression and fatigue which seems to occur primarily in middle aged females. There is no known cure for FS but treatment often includes a prescription of mild exercise. Few studies have evaluated the effectiveness of mild exercise on work capacity and gait patterns in FS patients. Participants were 14 females (age 47.0± 7.6 y who participated in a 10 wk community based aerobic, strength and stretching program designed for FS individuals. Subjects were evaluated pre- and post-program and at a 2 month follow up. Work capacity was estimated by a sub-maximal PWC 170 cycle ergometer test and a Borg perceived exertion scale. Gait was assessed using OptoTrack three dimensional kinematics with 16 channel analogue data acquisition system. Trunk flexibility was also assessed. No significant change in estimated work capacity or flexibility was seen between pre- post- and follow up times. Nevertheless, a significant increase in self selected walking speed (p < 0.05 and a trend toward a more normal gait pattern that was sustained in the follow up testing was noted. We had previously also reported a significant improvement in muscle pain and other fibromyalgia symptoms in this population consequent to the training program. It was concluded that mild exercise training that does not influence work capacity or trunk flexibility can nevertheless positively influence gait mechanics and fibromyalgia symptoms in female FS patients

A pilot randomized controlled trial using EEG-based brain-computer interface training for a Chinese-speaking group of healthy elderly.

Science.gov (United States)

Lee, Tih-Shih; Quek, Shin Yi; Goh, Siau Juinn Alexa; Phillips, Rachel; Guan, Cuntai; Cheung, Yin Bun; Feng, Lei; Wang, Chuan Chu; Chin, Zheng Yang; Zhang, Haihong; Lee, Jimmy; Ng, Tze Pin; Krishnan, K Ranga Rama

2015-01-01

There is growing evidence that cognitive training (CT) can improve the cognitive functioning of the elderly. CT may be influenced by cultural and linguistic factors, but research examining CT programs has mostly been conducted on Western populations. We have developed an innovative electroencephalography (EEG)-based brain-computer interface (BCI) CT program that has shown preliminary efficacy in improving cognition in 32 healthy English-speaking elderly adults in Singapore. In this second pilot trial, we examine the acceptability, safety, and preliminary efficacy of our BCI CT program in healthy Chinese-speaking Singaporean elderly. Thirty-nine elderly participants were randomized into intervention (n=21) and wait-list control (n=18) arms. Intervention consisted of 24 half-hour sessions with our BCI-based CT training system to be completed in 8 weeks; the control arm received the same intervention after an initial 8-week waiting period. At the end of the training, a usability and acceptability questionnaire was administered. Efficacy was measured using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), which was translated and culturally adapted for the Chinese-speaking local population. Users were asked about any adverse events experienced after each session as a safety measure. The training was deemed easily usable and acceptable by senior users. The median difference in the change scores pre- and post-training of the modified RBANS total score was 8.0 (95% confidence interval [CI]: 0.0-16.0, P=0.042) higher in the intervention arm than waitlist control, while the mean difference was 9.0 (95% CI: 1.7-16.2, P=0.017). Ten (30.3%) participants reported a total of 16 adverse events - all of which were graded "mild" except for one graded "moderate". Our BCI training system shows potential in improving cognition in both English- and Chinese-speaking elderly, and deserves further evaluation in a Phase III trial. Overall, participants

A Preliminary Evaluation of Short Blended Online Training Workshop for TPACK Development Using Technology Acceptance Model

Science.gov (United States)

Alsofyani, Mohammed Modeef; Aris, Baharuddin bin; Eynon, Rebecca; Majid, Norazman Abdul

2012-01-01

The use of Short Blended Online Training (SBOT) for the development of Technological Pedagogical and Content Knowledge (TPACK) is a promising approach to facilitate the use of e-learning by academics. Adult learners prefer the blend of pedagogies such as the presentation, demonstration, practice and feedback if they are structured and…

Using VIIRS Day/Night Band to Measure Electricity Supply Reliability: Preliminary Results from Maharashtra, India

Directory of Open Access Journals (Sweden)

Michael L. Mann

2016-08-01

Full Text Available Unreliable electricity supplies are common in developing countries and impose large socio-economic costs, yet precise information on electricity reliability is typically unavailable. This paper presents preliminary results from a machine-learning approach for using satellite imagery of nighttime lights to develop estimates of electricity reliability for western India at a finer spatial scale. We use data from the Visible Infrared Imaging Radiometer Suite (VIIRS onboard the Suomi National Polar Partnership (SNPP satellite together with newly-available data from networked household voltage meters. Our results point to the possibilities of this approach as well as areas for refinement. With currently available training data, we find a limited ability to detect individual outages identified by household-level measurements of electricity voltage. This is likely due to the relatively small number of individual outages observed in our preliminary data. However, we find that the approach can estimate electricity reliability rates for individual locations fairly well, with the predicted versus actual regression yielding an R2 > 0.5. We also find that, despite the after midnight overpass time of the SNPP satellite, the reliability estimates derived are representative of daytime reliability.

Language Training: English Training

CERN Multimedia

2004-01-01

If you wish to participate in one of the following courses, please discuss with your supervisor and apply electronically directly from the course description pages that can be found on the Web at: http://www.cern.ch/Training/ or fill in an "application for training" form available from your Divisional Secretariat or from your DTO (Divisional Training Officer). Applications will be accepted in the order of their receipt. Language Training Françoise Benz tel. 73127 language.training@cern.ch General and Professional English Courses The next session will take place: from 1st March to 25 June 2004 (2 weeks break at Easter). These courses are open to all persons working on the Cern site, and to their spouses. For registration and further information on the courses, please consult our Web pages: http://cern.ch/Training or contact Mr. Liptow: tel. 72957.

Language Training: English Training

CERN Multimedia

2004-01-01

If you wish to participate in one of the following courses, please discuss with your supervisor and apply electronically directly from the course description pages that can be found on the Web at: http://www.cern.ch/Training/ or fill in an "application for training" form available from your Divisional Secretariat or from your DTO (Divisional Training Officer). Applications will be accepted in the order of their receipt. LANGUAGE TRAINING Françoise Benz tel. 73127 language.training@cern.ch General and Professional English Courses The next session will take place: from 1st March to 25 June 2004 (2 weeks break at Easter). These courses are open to all persons working on the Cern site, and to their spouses. For registration and further information on the courses, please consult our Web pages: http://cern.ch/Training or contact Mr. Liptow: tel. 72957.

Exercise training improves selected aspects of daytime functioning in adults with obstructive sleep apnea.

Science.gov (United States)

Kline, Christopher E; Ewing, Gary B; Burch, James B; Blair, Steven N; Durstine, J Larry; Davis, J Mark; Youngstedt, Shawn D

2012-08-15

To explore the utility of exercise training for improving daytime functioning in adults with obstructive sleep apnea (OSA). Forty-three sedentary and overweight/obese adults aged 18-55 years with at least moderate-severity untreated OSA (apnea-hypopnea index ≥ 15) were randomized to 12 weeks of moderate-intensity aerobic and resistance exercise training (n = 27) or low-intensity stretching control treatment (n = 16). As part of a trial investigating the efficacy of exercise training on OSA severity, daytime functioning was assessed before and following the intervention. Sleepiness, functional impairment due to sleepiness, depressive symptoms, mood, and quality of life (QOL) were evaluated with validated questionnaires, and cognitive function was assessed with a neurobehavioral performance battery. OSA severity was measured with one night of laboratory polysomnography before and following the intervention. Compared with stretching control, exercise training resulted in significant improvements in depressive symptoms, fatigue and vigor, and aspects of QOL (p improved following exercise versus control to a similar degree in terms of effect sizes (d > 0.5), though these changes were not statistically significant. No neurobehavioral performance improvements were found. Reduced fatigue following exercise training was mediated by a reduction in OSA severity, but changes in OSA severity did not significantly mediate improvement in any other measure of daytime functioning. These data provide preliminary evidence that exercise training may be helpful for improving aspects of daytime functioning of adults with OSA. Larger trials are needed to further verify the observed improvements.

Development of a personalized training system using the Lung Image Database Consortium and Image Database resource Initiative Database.

Science.gov (United States)

Lin, Hongli; Wang, Weisheng; Luo, Jiawei; Yang, Xuedong

2014-12-01

The aim of this study was to develop a personalized training system using the Lung Image Database Consortium (LIDC) and Image Database resource Initiative (IDRI) Database, because collecting, annotating, and marking a large number of appropriate computed tomography (CT) scans, and providing the capability of dynamically selecting suitable training cases based on the performance levels of trainees and the characteristics of cases are critical for developing a efficient training system. A novel approach is proposed to develop a personalized radiology training system for the interpretation of lung nodules in CT scans using the Lung Image Database Consortium (LIDC) and Image Database Resource Initiative (IDRI) database, which provides a Content-Boosted Collaborative Filtering (CBCF) algorithm for predicting the difficulty level of each case of each trainee when selecting suitable cases to meet individual needs, and a diagnostic simulation tool to enable trainees to analyze and diagnose lung nodules with the help of an image processing tool and a nodule retrieval tool. Preliminary evaluation of the system shows that developing a personalized training system for interpretation of lung nodules is needed and useful to enhance the professional skills of trainees. The approach of developing personalized training systems using the LIDC/IDRL database is a feasible solution to the challenges of constructing specific training program in terms of cost and training efficiency. Copyright © 2014 AUR. Published by Elsevier Inc. All rights reserved.

[Effect of high-intensity interval training on the reduction of glycosylated hemoglobin in type-2 diabetic adult patients].

Science.gov (United States)

Aguilera Eguía, Raúl Alberto; Russell Guzmán, Javier Antonio; Soto Muñoz, Marcelo Enrique; Villegas González, Bastián Eduardo; Poblete Aro, Carlos Emilio; Ibacache Palma, Alejandro

2015-03-05

Type 2 diabetes mellitus is one of the major non-communicable chronic diseases in the world. Its prevalence in Chile is significant, and complications associated with this disease involve great costs, which is why prevention and treatment of this condition are essential. Physical exercise is an effective means for prevention and treatment of type 2 diabetes mellitus. The emergence of new forms of physical training, such as "high intensity interval training", presents novel therapeutic alternatives for patients and health care professionals. To assess the validity and applicability of the results regarding the effectiveness of high intensity interval training in reducing glycosylated hemoglobin in adult patients with type 2 diabetes mellitus and answer the following question: In subjects with type 2 diabetes, can the method of high intensity interval training compared to moderate intensity exercise decrease glycosylated hemoglobin? We performed a critical analysis of the article "Feasibility and preliminary effectiveness of high intensity interval training in type 2 diabetes". We found no significant differences in the amount of glycosylated hemoglobin between groups of high intensity interval training and moderate-intensity exercise upon completion of the study (p>0.05). In adult patients with type 2 diabetes mellitus, high intensity interval training does not significantly improve glycosylated hemoglobin levels. Despite this, the high intensity interval training method shows as much improvement in body composition and physical condition as the moderate intensity exercise program.

Who would benefit from memory training? A pilot study examining the ceiling effect of concurrent cognitive stimulation

Directory of Open Access Journals (Sweden)

Kwok TCY

2011-03-01

Full Text Available Timothy CY Kwok1,2, Wai Wang Chau1, Kenneth SL Yuen1,3, Anita YM Wong4, Jessie CY Li1, Rebecca YY Shiu4, Florence KY Ho11Jockey Club Centre for Positive Ageing, Hong Kong; 2Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong; 3Laboratory of Neuropsychology, Department of Psychology, University of Hong Kong, Pokfulam, Hong Kong; 4The Hong Kong Chinese Women's Club Madam Wong Chan Sook Ying Memorial Care and Attention Home for the Aged, Hong KongAbstract: Diverse effects of memory training were observed in the literature. One possible factor is the amount of concurrent cognitive training received during the training program. In this pilot study, we recruited 24 elderly adults with or without concurrent cognitive stimulations to attend a memory-training program. Findings suggested that elderly people without concurrent cognitive stimulation could benefit from a memory-training program in the form of improved initiation and memory functioning. Self-rated quality of life measure also showed improvements alongside the cognitive benefits. Elderly people with regular concurrent cognitive stimulation, on the other hand, seemed to plateau in their level of performance and did not show any significant change. Our preliminary findings suggested nonlinear concurrent cognitive stimulation in the elderly.Keywords: memory training, cognitive training, dementia, Chinese, elderly 

Fine finger motor skill training with exoskeleton robotic hand in chronic stroke: stroke rehabilitation.

Science.gov (United States)

Ockenfeld, Corinna; Tong, Raymond K Y; Susanto, Evan A; Ho, Sze-Kit; Hu, Xiao-ling

2013-06-01

Background and Purpose. Stroke survivors often show a limited recovery in the hand function to perform delicate motions, such as full hand grasping, finger pinching and individual finger movement. The purpose of this study is to describe the implementation of an exoskeleton robotic hand together with fine finger motor skill training on 2 chronic stroke patients. Case Descriptions. Two post-stroke patients participated in a 20-session training program by integrating 10 minutes physical therapy, 20 minutes robotic hand training and 15 minutes functional training tasks with delicate objects(card, pen and coin). These two patients (A and B) had cerebrovascular accident at 6 months and 11 months respectively when enrolled in this study. Outcomes. The results showed that both patients had improvements in Fugl-Meyer assessment (FM), Action Research Arm Test (ARAT). Patients had better isolation of the individual finger flexion and extension based on the reduced muscle co-contraction from the electromyographic(EMG) signals and finger extension force after 20 sessions of training. Discussion. This preliminary study showed that by focusing on the fine finger motor skills together with the exoskeleton robotic hand, it could improve the motor recovery of the upper extremity in the fingers and hand function, which were showed in the ARAT. Future randomized controlled trials are needed to evaluate the clinical effectiveness.

A suspended act: increased reflectivity and gender-dependent electrophysiological change following Quadrato Motor Training.

Science.gov (United States)

Ben-Soussan, Tal Dotan; Berkovich-Ohana, Aviva; Glicksohn, Joseph; Goldstein, Abraham

2014-01-01

Quadrato Motor Training (QMT) is a specifically-structured walking meditation, aimed at improving reflectivity and lowering habitual thought and movement. Here we set out to examine the possible effect of QMT on reflectivity, employing the Hidden Figures Test (HFT), which assesses both spatial performance (measured by correct answers) as well as reflectivity (interpolated from correct answers and reaction time). In the first study (n = 24, only females), we showed that QMT significantly improves HFT performance, compared to two groups, controlling for cognitive or motor aspects of the QMT: Verbal Training (identical cognitive training with verbal response) and Simple Motor Training (similar motor training with reduced choice requirements). These results show that QMT improves HFT performance above the pre-post expected learning. In the second study, building on previous literature showing gender-dependent effects on cognitive performance, we conducted a preliminary pilot examining gender-dependent effect of training on reflectivity and its electrophysiological counterparts. EEG analyses focused on theta, alpha and gamma coherence. HFT performance and resting-state EEG were measured in 37 participants (20 males), using a within-subject pre-post design. Following training, HFT performance improved in both genders. However, we found a gender-dependent difference in functional connectivity: while theta and alpha intra-hemispheric coherence was enhanced in females, the opposite pattern was found in males. These results are discussed in relation to neuronal efficiency theory. Together, the results demonstrate that QMT improves spatial performance, and may involve a gender-dependent electrophysiological effect. This study emphasizes both the importance of studying gender-related training effects within the contemplative neuroscience endeavor, as well as the need to widen its scope toward including "contemplation in action."

Exploratory shaft facility preliminary designs - Gulf Interior Region salt domes

International Nuclear Information System (INIS)

1983-09-01

The purpose of the Preliminary Design Report, Gulf Interior Region, is to provide a description of the preliminary design for an Exploratory Shaft Facility on the Richton Dome, Mississippi. This issue of the report describes the preliminary design for constructing the exploratory shaft using the Large Hole Drilling method of construction and outlines the preliminary design and estimates of probable construction cost. The Preliminary Design Report is prepared to complement and summarize other documents that comprise the design at the preliminary stage of completion, December 1982. Other design documents include drawings, cost estimates and schedules. The preliminary design drawing package, which includes the construction schedule drawing, depicts the descriptions in this report. For reference, a list of the drawing titles and corresponding numbers are included in the Appendix. The report is divided into three principal sections: Design Basis, Facility Description and Construction Cost Estimate

Language Training: French Training

CERN Multimedia

2004-01-01

If you wish to participate in one of the following courses, please discuss with your supervisor and apply electronically directly from the course description pages that can be found on the Web at: http://www.cern.ch/Training/ or fill in an "application for training" form available from your Divisional Secretariat or from your DTO (Divisional Training Officer). Applications will be accepted in the order of their receipt. LANGUAGE TRAINING Françoise Benz tel. 73127 language.training@cern.ch General and Professional French Courses The next session will take place from 26 April to 02 July 2004. These courses are open to all persons working on the Cern site, and to their spouses. For registration and further information on the courses, please consult our Web pages: http://cern.ch/Training or contact Mrs. Benz: Tel. 73127. Writing Professional Documents in French The next session will take place from 26 April to 02 July 2004. This course is designed for people with a good level of s...

Language Training: French Training

CERN Multimedia

2004-01-01

If you wish to participate in one of the following courses, please discuss with your supervisor and apply electronically directly from the course description pages that can be found on the Web at: http://www.cern.ch/Training/ or fill in an "application for training" form available from your Divisional Secretariat or from your DTO (Divisional Training Officer). Applications will be accepted in the order of their receipt. LANGUAGE TRAINING Françoise Benz tel. 73127 language.training@cern.ch General and Professional French Courses The next session will take place from 26 April to 02 July 2004. These courses are open to all persons working on the Cern site, and to their spouses. For registration and further information on the courses, please consult our Web pages: http://cern.ch/Training or contact Mrs. Benz: Tel. 73127. Writing Professional Documents in French The next session will take place from 26 April to 02 July 2004. This course is designed for people with a good level...

Effects of long-term balance training with vibrotactile sensory augmentation among community-dwelling healthy older adults: a randomized preliminary study.

Science.gov (United States)

Bao, Tian; Carender, Wendy J; Kinnaird, Catherine; Barone, Vincent J; Peethambaran, Geeta; Whitney, Susan L; Kabeto, Mohammed; Seidler, Rachael D; Sienko, Kathleen H

2018-01-18

Sensory augmentation has been shown to improve postural stability during real-time balance applications. Limited long-term controlled studies have examined retention of balance improvements in healthy older adults after training with sensory augmentation has ceased. This pilot study aimed to assess the efficacy of long-term balance training with and without sensory augmentation among community-dwelling healthy older adults. Twelve participants (four males, eight females; 75.6 ± 4.9 yrs) were randomly assigned to the experimental group (n = 6) or control group (n = 6). Participants trained in their homes for eight weeks, completing three 45-min exercise sessions per week using smart phone balance trainers that provided written, graphic, and video guidance, and monitored trunk sway. During each session, participants performed six repetitions of six exercises selected from five categories (static standing, compliant surface standing, weight shifting, modified center of gravity, and gait). The experimental group received vibrotactile sensory augmentation for four of the six repetitions per exercise via the smart phone balance trainers, while the control group performed exercises without sensory augmentation. The smart phone balance trainers sent exercise performance data to a physical therapist, who recommended exercises on a weekly basis. Balance performance was assessed using a battery of clinical balance tests (Activity Balance Confidence Scale, Sensory Organization Test, Mini Balance Evaluation Systems Test, Five Times Sit to Stand Test, Four Square Step Test, Functional Reach Test, Gait Speed Test, Timed Up and Go, and Timed Up and Go with Cognitive Task) before training, after four weeks of training, and after eight weeks of training. Participants in the experimental group were able to use vibrotactile sensory augmentation independently in their homes. After training, the experimental group had significantly greater improvements in Sensory

Military Mental Health First Aid: Development and Preliminary Efficacy of a Community Training for Improving Knowledge, Attitudes, and Helping Behaviors.

Science.gov (United States)

Mohatt, Nathaniel Vincent; Boeckmann, Robert; Winkel, Nicola; Mohatt, Dennis F; Shore, Jay

2017-01-01

Persistent stigma, lack of knowledge about mental health, and negative attitudes toward treatment are among the most significant barriers to military service members and veterans seeking behavioral health care. With the high rates of untreated behavioral health needs among service members and veterans, identifying effective programs for reducing barriers to care is a national priority. This study adapted Mental Health First Aid (MHFA), an evidence-based program for increasing mental health knowledge, decreasing stigma, and increasing laypeople's confidence in helping and frequency of referring people in need, for military and veteran populations and pilot tested the adapted training program with 4 Army National Guard armories. A total of 176 community first responders (CFRs) participated in a comparative outcomes study, with 69 receiving the training and 107 participating in the control group. CFRs were individuals in natural positions within the Armory or home communities of Guard members to identify and help service members in mental health crisis. Surveys assessing confidence in helping, attitudes toward help seeking, knowledge of resources, use of MHFA practices, and stigma were completed before the training, immediately post-training, at 4 months post-training, and at 8 months post-training. Analyses included repeated measures analysis of variances on data from CFRs who received the training and mixed between-within subjects analysis of variances comparing the intervention and control group longitudinally at three time points. Institutional review board approval for this study was received from Montana State University and the U.S. Army Medical Department, Medical Research and Materiel Command, Human Research Protection Office. Significant and meaningful improvements in confidence (p stigma (p stigma (η 2 = 0.02), with a significant and meaningful difference observed for practice behaviors (p mental health support. In addition, there were positive growth

Working memory training in survivors of pediatric cancer: a randomized pilot study.

Science.gov (United States)

Hardy, Kristina K; Willard, Victoria W; Allen, Taryn M; Bonner, Melanie J

2013-08-01

Survivors of pediatric brain tumors and acute lymphoblastic leukemia (ALL) are at increased risk for neurocognitive deficits, but few empirically supported treatment options exist. We examined the feasibility and preliminary efficacy of a home-based, computerized working memory training program, CogmedRM, with survivors of childhood cancer. Survivors of brain tumors or ALL (n = 20) with identified deficits in attention and/or working memory were randomized to either the success-adapted computer intervention or a non-adaptive, active control condition. Specifically, children in the adaptive condition completed exercises that became more challenging with each correct trial, whereas those in the non-adaptive version trained with exercises that never increased in difficulty. All participants were asked to complete 25 training sessions at home, with weekly, phone-based coaching support. Brief assessments were completed pre-intervention and post-intervention; outcome measures included both performance-based and parent-report measures of working memory and attention. Eighty-five percent of survivors were compliant with the intervention, with no adverse events reported. After controlling for baseline intellectual functioning, survivors who completed the intervention program evidenced significant post-training improvements in their visual working memory and in parent-rated learning problems compared with those in the active control group. No differences in verbal working memory functioning were evident between groups, however. Home-based, computerized cognitive training demonstrates good feasibility and acceptability in our sample. Children with higher intellectual functioning at baseline appeared to benefit more from the training, although further study is needed to clarify the strength, scope, and particularly the generalizability of potential treatment effects. Copyright © 2012 John Wiley & Sons, Ltd.

El Sistema-inspired ensemble music training is associated with changes in children's neurocognitive functional integration: preliminary ERP evidence.

Science.gov (United States)

Hedayati, Nina; Schibli, Kylie; D'Angiulli, Amedeo

2016-12-01

Children (aged 9-12) training in an El Sistema-inspired program (OrKidstra) and a matched comparison group participated in an auditory Go/No-Go task while event-related potentials (ERPs) were recorded. Entire-sweep waveform patterns correlated with known ERP peaks associated with executive and other cognitive functions and indicated that the spread of neural activity in the initial 250 ms of executive attention processing (pre-P300) showed higher level of topographical overlap in OrKidstra children. In these children, late potentials (post-P300) concurrent with response control were more widely distributed and temporally coordinated. Intensive ensemble music training, we suggest, may be associated with neuroplastic changes facilitating integration of neural information.

A Preliminary Study on the Effects of Training Using Behavior Support Plan Quality Evaluation Guide (BSP-QE) to Improve Positive Behavioral Support Plans

Science.gov (United States)

Wright, Diana Browning; Mayer, G. Roy; Cook, Clayton R.; Crews, S. Dean; Kraemer, Bonnie Rawlings; Gale, Bruce

2007-01-01

The purpose of this research was to evaluate the effects of two trainings designed to increase the competencies of professionals to develop high quality positive behavior support plans for students that engage in problem behaviors that interfere with theirs and/or others' ability to learn. Training one consisted of training attendees on six key…

Preliminary Validation of a Parent-Child Relational Framework for Teaching Developmental Assessment to Pediatric Residents.

Science.gov (United States)

Regalado, Michael; Schneiderman, Janet U; Duan, Lei; Ragusa, Gisele

A parent-child relational framework was used as a method to train pediatric residents in basic knowledge and observation skills for the assessment of child development. Components of the training framework and its preliminary validation as an alternative to milestone-based approaches are described. Pediatric residents were trained during a 4-week clinical rotation to use a semistructured interview and observe parent-child behavior during health visits using clinical criteria for historical information and observed behavior that reflect developmental change in the parent-child relationship. Clinical impressions of concern versus no concern for developmental delay were derived from parent-child relational criteria and the physical examination. A chart review yielded 330 preterm infants evaluated using this methodology at 4 and 15 months corrected age who also had standardized developmental testing at 6 and 18 months corrected age. Sensitivities and specificities were computed to examine the validity of the clinical assessment compared with standardized testing. A subset of residents who completed 50 or more assessments during the rotation was timed at the end of 4 weeks. Parent-child behavioral markers elicited from the history and/or observed during the health visit correlated highly with standardized developmental assessment. Sensitivities and specificities were 0.72/0.98 and 0.87/0.96 at 4 to 6 and 15 to 18 months, respectively. Residents completed their assessments parent-child relational framework is a potentially efficient and effective approach to training residents in the clinical knowledge and skills of child development assessment. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Initiation of a European Radiation Protection Training and Education Plataforma (EUTERP Platform)

International Nuclear Information System (INIS)

Steen, J. van der; Fraaisma, F. S.; Marco Arboli, M.

2004-01-01

The European Commission, D.-G. Transport and Energy, has launched an initiative to establish a European Radiation Protection Training and Education Platform. To this end, a feasibility study is being carried out at the moment. The objective of this feasibility study is to initiate the necessary steps towards the creation of the Platform. It will make recommendations, based on the summary and conclusions obtained as a result of the exchange of information and experience between all involved radiation protection training and education bodies. The project will identify how the future Platform should be initiated and developed in order to achieve the expected results. This paper describes the objectives of the study and the objectives, composition and possible structure of the EUTERP Platform. A workshop will be held from 20-21 May at CIEMAT, Madrid, to identify the work programme and possibilities for the structure of the Platform. The preliminary results of the workshop will be presented in this presentation. (Author)

Transversus abdominis plane block reduces morphine consumption in the early postoperative period following microsurgical abdominal tissue breast reconstruction: a double-blind, placebo-controlled, randomized trial.

Science.gov (United States)

Zhong, Toni; Ojha, M; Bagher, Shaghayegh; Butler, Kate; Srinivas, Coimbatore; McCluskey, Stuart A; Clarke, Hance; O'Neill, Anne C; Novak, Christine B; Hofer, Stefan O P

2014-11-01

The analgesic efficacy of the transversus abdominis plane peripheral nerve block following abdominal tissue breast reconstruction has not been studied in a randomized controlled trial. The authors conducted a double-blind, placebo-controlled, 1:1 allocation, two-arm parallel group, superiority design, randomized controlled trial in patients undergoing microsurgical abdominally based breast reconstruction. Intraoperatively, epidural catheters were inserted under direct vision through the triangle of Petit on both sides of the abdomen into the transversus abdominis plane just before rectus fascial closure. Patients received either bupivacaine (study group) or saline (placebo group) through the catheters for 2 postoperative days. All patients received hydromorphone by means of a patient-controlled analgesic pump. The primary outcome was the difference in the parenteral opioid consumption on each postoperative day between the groups. The secondary outcome measures included the following: total in-hospital opioid; antinausea medication; pain, nausea, and sedation scores; Quality of Recovery Score; time to ambulation; and hospital stay duration. Between September of 2011 and June of 2013, 93 patients were enrolled: 49 received bupivacaine and 44 received saline. There were 11 postoperative complications (13 percent); none were related to the catheter. Primary outcomes were completed by 85 of 93 patients (91.3 percent); the mean parenteral morphine consumption was significantly reduced on postoperative day 1 in the bupivacaine group (20.7±20.1 mg) compared with 30.0±19.1 mg in the control group (p=0.02). There were no significant differences in secondary outcomes. Following abdominally based breast reconstruction, transversus abdominis plane peripheral nerve block is safe and significantly reduces morphine consumption in the early postoperative period. Therapeutic, II.

Preliminary study of HTS magnet using 2G wires for maglev train

International Nuclear Information System (INIS)

Ogata, Masafumi; Miyazaki, Yoshiki; Hasegawa, Hitoshi; Sasakawa, Takashi; Nagashima, Ken

2010-01-01

There are several advantages by applying a high temperature superconducting wire to an on-board superconducting magnet for the maglev train. At first, an increase of thermal capacity of superconducting coils contributes a stability of the superconducting state of the coils. In addition, a reliability of superconducting magnet improves by simplification of the magnet structure. And the weight of the superconducting magnet and the energy consumption of the on-board cryocooler will decrease. Therefore, we examined the possibility on application of the 2G wire with a high critical current density in a high magnetic field. We performed numerical analysis regarding the weight of a superconducting magnet and the energy consumption of an on-board cryocooler in consideration of the characteristics of the 2G wire. Furthermore, we have carried out the I c measurement for the commercial 2G wires under various experimental conditions such as temperature, magnetic field strength and angle. We also performed the trial manufacture and evaluation of I c characteristics for the small race track-shaped superconducting coil.

Preliminary study of HTS magnet using 2G wires for maglev train

Energy Technology Data Exchange (ETDEWEB)

Ogata, Masafumi; Miyazaki, Yoshiki; Hasegawa, Hitoshi; Sasakawa, Takashi; Nagashima, Ken, E-mail: ogata@rtri.or.j [Railway Technical Research Institute, Hikari-cho 2-8-38, Kokubunji-shi, Tokyo (Japan)

2010-06-01

There are several advantages by applying a high temperature superconducting wire to an on-board superconducting magnet for the maglev train. At first, an increase of thermal capacity of superconducting coils contributes a stability of the superconducting state of the coils. In addition, a reliability of superconducting magnet improves by simplification of the magnet structure. And the weight of the superconducting magnet and the energy consumption of the on-board cryocooler will decrease. Therefore, we examined the possibility on application of the 2G wire with a high critical current density in a high magnetic field. We performed numerical analysis regarding the weight of a superconducting magnet and the energy consumption of an on-board cryocooler in consideration of the characteristics of the 2G wire. Furthermore, we have carried out the I{sub c} measurement for the commercial 2G wires under various experimental conditions such as temperature, magnetic field strength and angle. We also performed the trial manufacture and evaluation of I{sub c} characteristics for the small race track-shaped superconducting coil.

Physiological responses of young thoroughbred horses to intermittent high-intensity treadmill training.

Science.gov (United States)

Ohmura, Hajime; Matsui, Akira; Hada, Tetsuro; Jones, James H

2013-08-17

to achieve higher aerobic fitness during training without subjecting their musculoskeletal systems to increased loading and risk of developing lameness. The findings of this preliminary study do not indicate a specific protocol to best achieve this goal.

Maria Auxiliadora Hospital in Lima, Peru as a model for neurosurgical outreach to international charity hospitals.

Science.gov (United States)

Hayden, Melanie G; Hughes, Samuel; Hahn, Edward J; Aryan, Henry E; Levy, Michael L; Jandial, Rahul

2011-01-01

A myriad of geopolitical and financial obstacles have kept modern neurosurgery from effectively reaching the citizens of the developing world. Targeted neurosurgical outreach by academic neurosurgeons to equip neurosurgical operating theaters and train local neurosurgeons is one method to efficiently and cost effectively improve sustainable care provided by international charity hospitals. The International Neurosurgical Children's Association (INCA) effectively improved the available neurosurgical care in the Maria Auxiliadora Hospital of Lima, Peru through the advancement of local specialist education and training. Neurosurgical equipment and training were provided for the local neurosurgeons by a mission team from the University of California at San Diego. At the end of 3 years, with one intensive week trip per year, the host neurosurgeons were proficiently and independently applying microsurgical techniques to previously performed operations, and performing newly learned operations such as neuroendoscopy and minimally invasive neurosurgery. Our experiences may serve as a successful template for the execution of other small scale, sustainable neurosurgery missions worldwide.

46 CFR 176.635 - Preliminary examination requirements.

Science.gov (United States)

2010-10-01

... 46 Shipping 7 2010-10-01 2010-10-01 false Preliminary examination requirements. 176.635 Section... (UNDER 100 GROSS TONS) INSPECTION AND CERTIFICATION Hull and Tailshaft Examinations § 176.635 Preliminary examination requirements. (a) If you exclusively use divers to examine the underwater hull plating, you must...

Treadmill Training with HAL Exoskeleton—A Novel Approach for Symptomatic Therapy in Patients with Limb-Girdle Muscular Dystrophy—Preliminary Study

Science.gov (United States)

Sczesny-Kaiser, Matthias; Kowalewski, Rebecca; Schildhauer, Thomas A.; Aach, Mirko; Jansen, Oliver; Grasmücke, Dennis; Güttsches, Anne-Katrin; Vorgerd, Matthias; Tegenthoff, Martin

2017-01-01

Purpose: Exoskeletons have been developed for rehabilitation of patients with walking impairment due to neurological disorders. Recent studies have shown that the voluntary-driven exoskeleton HAL® (hybrid assistive limb) can improve walking functions in spinal cord injury and stroke. The aim of this study was to assess safety and effects on walking function of HAL® supported treadmill therapy in patients with limb-girdle muscular dystrophy (LGMD). Materials and Methods: Three LGMD patients received 8 weeks of treadmill training with HAL® 3 times a week. Outcome parameters were 10-meter walk test (10 MWT), 6-minute walk test, and timed-up-and-go test (TUG). Parameters were assessed pre and post training and 6 weeks later (follow-up). Results: All patients completed the therapy without adverse reactions and reported about improvement in endurance. Improvements in outcome parameters after 8 weeks could be demonstrated. Persisting effects were observed after 6 weeks for the 10 MWT and TUG test (follow-up). Conclusions: HAL® treadmill training in LGMD patients can be performed safely and enables an intensive highly repetitive locomotor training. All patients benefitted from this innovative method. Upcoming controlled studies with larger cohorts should prove its effects in different types of LGMD and other myopathies. PMID:28848377

Treadmill Training with HAL Exoskeleton-A Novel Approach for Symptomatic Therapy in Patients with Limb-Girdle Muscular Dystrophy-Preliminary Study.

Science.gov (United States)

Sczesny-Kaiser, Matthias; Kowalewski, Rebecca; Schildhauer, Thomas A; Aach, Mirko; Jansen, Oliver; Grasmücke, Dennis; Güttsches, Anne-Katrin; Vorgerd, Matthias; Tegenthoff, Martin

2017-01-01

Purpose: Exoskeletons have been developed for rehabilitation of patients with walking impairment due to neurological disorders. Recent studies have shown that the voluntary-driven exoskeleton HAL® (hybrid assistive limb) can improve walking functions in spinal cord injury and stroke. The aim of this study was to assess safety and effects on walking function of HAL® supported treadmill therapy in patients with limb-girdle muscular dystrophy (LGMD). Materials and Methods: Three LGMD patients received 8 weeks of treadmill training with HAL® 3 times a week. Outcome parameters were 10-meter walk test (10 MWT), 6-minute walk test, and timed-up-and-go test (TUG). Parameters were assessed pre and post training and 6 weeks later (follow-up). Results: All patients completed the therapy without adverse reactions and reported about improvement in endurance. Improvements in outcome parameters after 8 weeks could be demonstrated. Persisting effects were observed after 6 weeks for the 10 MWT and TUG test (follow-up). Conclusions: HAL® treadmill training in LGMD patients can be performed safely and enables an intensive highly repetitive locomotor training. All patients benefitted from this innovative method. Upcoming controlled studies with larger cohorts should prove its effects in different types of LGMD and other myopathies.

Treadmill Training with HAL Exoskeleton—A Novel Approach for Symptomatic Therapy in Patients with Limb-Girdle Muscular Dystrophy—Preliminary Study

Directory of Open Access Journals (Sweden)

Matthias Sczesny-Kaiser

2017-08-01

Full Text Available Purpose: Exoskeletons have been developed for rehabilitation of patients with walking impairment due to neurological disorders. Recent studies have shown that the voluntary-driven exoskeleton HAL® (hybrid assistive limb can improve walking functions in spinal cord injury and stroke. The aim of this study was to assess safety and effects on walking function of HAL® supported treadmill therapy in patients with limb-girdle muscular dystrophy (LGMD.Materials and Methods: Three LGMD patients received 8 weeks of treadmill training with HAL® 3 times a week. Outcome parameters were 10-meter walk test (10 MWT, 6-minute walk test, and timed-up-and-go test (TUG. Parameters were assessed pre and post training and 6 weeks later (follow-up.Results: All patients completed the therapy without adverse reactions and reported about improvement in endurance. Improvements in outcome parameters after 8 weeks could be demonstrated. Persisting effects were observed after 6 weeks for the 10 MWT and TUG test (follow-up.Conclusions: HAL® treadmill training in LGMD patients can be performed safely and enables an intensive highly repetitive locomotor training. All patients benefitted from this innovative method. Upcoming controlled studies with larger cohorts should prove its effects in different types of LGMD and other myopathies.

Scope and purpose of the preliminary planning work

International Nuclear Information System (INIS)

Kalas, P.

1976-01-01

The results of preliminary planning work are usually expressed in a number of recommendations covering mainly: long-term national policy in the field of energy resources and selection of projects to be further studied at the feasibility level. Moreover, recommendations on further actions are made including: inventory of generation and transmission facilities recommended for the implementation in order to meet the load forecasted for medium-term period, preparation of a preliminary calender of decisions to be taken for the implementation of the projects recommended, preparation of a preliminary construction schedule, preparation of a preliminary investment program, preparation of a program of necessary engineering works, and performance of study on electricity rates which would adjust existing tariffs to proposed development program of the utility. (HP) [de

Adaptive Virtual Reality Training to Optimize Military Medical Skills Acquisition and Retention.

Science.gov (United States)

Siu, Ka-Chun; Best, Bradley J; Kim, Jong Wook; Oleynikov, Dmitry; Ritter, Frank E

2016-05-01

The Department of Defense has pursued the integration of virtual reality simulation into medical training and applications to fulfill the need to train 100,000 military health care personnel annually. Medical personnel transitions, both when entering an operational area and returning to the civilian theater, are characterized by the need to rapidly reacquire skills that are essential but have decayed through disuse or infrequent use. Improved efficiency in reacquiring such skills is critical to avoid the likelihood of mistakes that may result in mortality and morbidity. We focus here on a study testing a theory of how the skills required for minimally invasive surgery for military surgeons are learned and retained. Our adaptive virtual reality surgical training system will incorporate an intelligent mechanism for tracking performance that will recognize skill deficiencies and generate an optimal adaptive training schedule. Our design is modeling skill acquisition based on a skill retention theory. The complexity of appropriate training tasks is adjusted according to the level of retention and/or surgical experience. Based on preliminary work, our system will improve the capability to interactively assess the level of skills learning and decay, optimizes skill relearning across levels of surgical experience, and positively impact skill maintenance. Our system could eventually reduce mortality and morbidity by providing trainees with the reexperience they need to help make a transition between operating theaters. This article reports some data that will support adaptive tutoring of minimally invasive surgery and similar surgical skills. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

Preliminary results of steel containment vessel model test

International Nuclear Information System (INIS)

Matsumoto, T.; Komine, K.; Arai, S.

1997-01-01

A high pressure test of a mixed-scaled model (1:10 in geometry and 1:4 in shell thickness) of a steel containment vessel (SCV), representing an improved boiling water reactor (BWR) Mark II containment, was conducted on December 11-12, 1996 at Sandia National Laboratories. This paper describes the preliminary results of the high pressure test. In addition, the preliminary post-test measurement data and the preliminary comparison of test data with pretest analysis predictions are also presented

Bimanual elbow robotic orthoses: preliminary investigations on an impairment force feedback rehabilitation method

Directory of Open Access Journals (Sweden)

Gil eHerrnstadt

2015-03-01

Full Text Available Modern rehabilitation practices have begun integrating robots, recognizing their significant role in recovery. New and alternative stroke rehabilitation treatments are essential to enhance efficacy and mitigate associated health costs. Today’s robotic interventions can play a significant role in advancing rehabilitation. In addition, robots have an inherent ability to perform tasks accurately and reliably and are typically well suited to measure and quantify performance.Most rehabilitation strategies predominantly target activation of the paretic arm. However, bimanual upper limb rehabilitation research suggests potential in enhancing functional recovery. Moreover studies suggest limb coordination and synchronization can improve treatment efficacy.In this preliminary study, we aimed to investigate and validate our user-driven bimanual system in a reduced intensity rehab practice. A Bimanual Wearable Robotic Device (BWRD with a Master-Slave configuration for the elbow joint was developed to carry out the investigation. The BWRD incorporates position and force sensors for which respective control loops are implemented, and offers varying modes of operation ranging from passive to active training. The proposed system enables the perception of the movements, as well as the forces applied by the hemiparetic arm, with the non-hemiparetic arm. Eight participants with chronic unilateral stroke were recruited to participate in a total of three one-hour sessions per participant, delivered in a week. Participants underwent pre and post training functional assessments along with proprioceptive measures. The post assessment was performed at the end of the last training session.The protocol was designed to engage the user in an assortment of static and dynamic arm matching and opposing tasks. The training incorporates force feedback movements, force feedback positioning, and force matching tasks with same and opposite direction movements. We are able to

Technetium removal: preliminary flowsheet options

International Nuclear Information System (INIS)

Eager, K.M.

1995-01-01

This document presents the results of a preliminary investigation into options for preliminary flowsheets for 99Tc removal from Hanford Site tank waste. A model is created to show the path of 99Tc through pretreatment to disposal. The Tank Waste Remediation (TWRS) flowsheet (Orme 1995) is used as a baseline. Ranges of important inputs to the model are developed, such as 99Tc inventory in the tanks and important splits through the TWRS flowsheet. Several technetium removal options are discussed along with sensitivities of the removal schemes to important model parameters

A brain-computer interface based cognitive training system for healthy elderly: a randomized control pilot study for usability and preliminary efficacy.

Science.gov (United States)

Lee, Tih-Shih; Goh, Siau Juinn Alexa; Quek, Shin Yi; Phillips, Rachel; Guan, Cuntai; Cheung, Yin Bun; Feng, Lei; Teng, Stephanie Sze Wei; Wang, Chuan Chu; Chin, Zheng Yang; Zhang, Haihong; Ng, Tze Pin; Lee, Jimmy; Keefe, Richard; Krishnan, K Ranga Rama

2013-01-01

Cognitive decline in aging is a pressing issue associated with significant healthcare costs and deterioration in quality of life. Previously, we reported the successful use of a novel brain-computer interface (BCI) training system in improving symptoms of attention deficit hyperactivity disorder. Here, we examine the feasibility of the BCI system with a new game that incorporates memory training in improving memory and attention in a pilot sample of healthy elderly. This study investigates the safety, usability and acceptability of our BCI system to elderly, and obtains an efficacy estimate to warrant a phase III trial. Thirty-one healthy elderly were randomized into intervention (n = 15) and waitlist control arms (n = 16). Intervention consisted of an 8-week training comprising 24 half-hour sessions. A usability and acceptability questionnaire was administered at the end of training. Safety was investigated by querying users about adverse events after every session. Efficacy of the system was measured by the change of total score from the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) before and after training. Feedback on the usability and acceptability questionnaire was positive. No adverse events were reported for all participants across all sessions. Though the median difference in the RBANS change scores between arms was not statistically significant, an effect size of 0.6SD was obtained, which reflects potential clinical utility according to Simon's randomized phase II trial design. Pooled data from both arms also showed that the median change in total scores pre and post-training was statistically significant (Mdn = 4.0; pattention (p = 0.039), and delayed memory (pattention in healthy elderly, and appears to be safe, user-friendly and acceptable to senior users. Given the efficacy signal, a phase III trial is warranted. ClinicalTrials.gov NCT01661894.

Change of Direction Speed: Toward a Strength Training Approach with Accentuated Eccentric Muscle Actions.

Science.gov (United States)

Chaabene, Helmi; Prieske, Olaf; Negra, Yassine; Granacher, Urs

2018-03-28

There is growing evidence that eccentric strength training appears to have benefits over traditional strength training (i.e., strength training with combined concentric and eccentric muscle actions) from muscular, neuromuscular, tendinous, and metabolic perspectives. Eccentric muscle strength is particularly needed to decelerate and stabilize the body during the braking phase of a jump exercise or during rapid changes of direction (CoD) tasks. However, surprisingly little research has been conducted to elucidate the effects of eccentric strength training or strength training with accentuated eccentric muscle actions on CoD speed performance. In this current opinion article, we present findings from cross-sectional studies on the relationship between measures of eccentric muscle strength and CoD speed performance. In addition, we summarize the few available studies on the effects of strength training with accentuated eccentric muscle actions on CoD speed performance in athletic populations. Finally, we propose strength training with accentuated eccentric muscle actions as a promising element in strength and conditioning programs of sports with high CoD speed demands. Our findings from five cross-sectional studies revealed statistically significant moderate- to large-sized correlations (r = 0.45-0.89) between measures of eccentric muscle strength and CoD speed performance in athletic populations. The identified three intervention studies were of limited methodological quality and reported small- to large-sized effects (d = 0.46-1.31) of strength training with accentuated eccentric muscle actions on CoD speed performance in athletes. With reference to the available but preliminary literature and from a performance-related point of view, we recommend strength and conditioning coaches to include strength training with accentuated eccentric muscle actions in training routines of sports with high CoD speed demands (e.g., soccer, handball, basketball, hockey) to

The measurement of enhancement in mathematical abilities as a result of joint cognitive trainings in numerical and visual- spatial skills: A preliminary study

International Nuclear Information System (INIS)

Agus, M; Mascia, M L; Fastame, M C; Melis, V; Pilloni, M C; Penna, M P

2015-01-01

A body of literature shows the significant role of visual-spatial skills played in the improvement of mathematical skills in the primary school. The main goal of the current study was to investigate the impact of a combined visuo-spatial and mathematical training on the improvement of mathematical skills in 146 second graders of several schools located in Italy. Participants were presented single pencil-and-paper visuo-spatial or mathematical trainings, computerised version of the above mentioned treatments, as well as a combined version of computer-assisted and pencil-and-paper visuo-spatial and mathematical trainings, respectively. Experimental groups were presented with training for 3 months, once a week. All children were treated collectively both in computer-assisted or pencil-and-paper modalities. At pre and post-test all our participants were presented with a battery of objective tests assessing numerical and visuo-spatial abilities. Our results suggest the positive effect of different types of training for the empowerment of visuo-spatial and numerical abilities. Specifically, the combination of computerised and pencil-and-paper versions of visuo-spatial and mathematical trainings are more effective than the single execution of the software or of the pencil-and-paper treatment

The measurement of enhancement in mathematical abilities as a result of joint cognitive trainings in numerical and visual- spatial skills: A preliminary study

Science.gov (United States)

Agus, M.; Mascia, M. L.; Fastame, M. C.; Melis, V.; Pilloni, M. C.; Penna, M. P.

2015-02-01

A body of literature shows the significant role of visual-spatial skills played in the improvement of mathematical skills in the primary school. The main goal of the current study was to investigate the impact of a combined visuo-spatial and mathematical training on the improvement of mathematical skills in 146 second graders of several schools located in Italy. Participants were presented single pencil-and-paper visuo-spatial or mathematical trainings, computerised version of the above mentioned treatments, as well as a combined version of computer-assisted and pencil-and-paper visuo-spatial and mathematical trainings, respectively. Experimental groups were presented with training for 3 months, once a week. All children were treated collectively both in computer-assisted or pencil-and-paper modalities. At pre and post-test all our participants were presented with a battery of objective tests assessing numerical and visuo-spatial abilities. Our results suggest the positive effect of different types of training for the empowerment of visuo-spatial and numerical abilities. Specifically, the combination of computerised and pencil-and-paper versions of visuo-spatial and mathematical trainings are more effective than the single execution of the software or of the pencil-and-paper treatment.

Resident assistant training program for increasing alcohol, other drug, and mental health first-aid efforts.

Science.gov (United States)

Thombs, Dennis L; Gonzalez, Jennifer M Reingle; Osborn, Cynthia J; Rossheim, Matthew E; Suzuki, Sumihiro

2015-05-01

In college and university residence halls, resident assistants (RAs) are expected to serve as first-aid providers to students who may have alcohol, other drug, mental health, and academic problems. Despite this responsibility, evidence-based, first-aid programs have not been developed and tested for the RA workforce. The current study examined effects of an investigational first-aid program designed specifically for RAs. The online Peer Hero Training program is a novel approach to RA training in its use of interactive video dramatizations of incidents involving substance-using or distressed residents. A 9-month randomized trial conducted on eight US campuses compared RAs who participated in the Peer Hero Training program to RAs who received training-as-usual. Participation in the Peer Hero Training program significantly increased RA first-aid efforts for residential students who may have had alcohol, other drug, mental health, or academic problems 6 months after baseline. Compared with those in the training-as-usual condition, RAs in the Peer Hero Training program made more than 10 times as many first-aid efforts for possible alcohol problems, almost 14 times the number of first-aid efforts for possible drug use, almost 3 times the number of first-aid efforts for possible mental health problems, and 3 times the number of first-aid efforts for academic problems. There was no evidence that measured RA attitudes mediated the effects of the intervention. Results of this preliminary evaluation trial suggest that online training using interactive video dramatizations is a viable approach to strengthening RAs' ability to provide alcohol, other drugs, and mental health first-aid to undergraduates.

7 CFR 1780.55 - Preliminary engineering reports and Environmental Reports.

Science.gov (United States)

2010-01-01

... 7 Agriculture 12 2010-01-01 2010-01-01 false Preliminary engineering reports and Environmental..., Designing, Bidding, Contracting, Constructing and Inspections § 1780.55 Preliminary engineering reports and Environmental Reports. Preliminary engineering reports (PERs) must conform to customary professional standards...

Preliminary Context Analysis of Community Informatics Social ...

African Journals Online (AJOL)

Preliminary context analysis is always part of the feasibility study phase in the development of information system for Community Development (CD) purposes. In this paper, a context model and a preliminary context analysis are presented for Social Network Web Application (SNWA) for CD in the Niger Delta region of ...

Stereotactic radiotherapy for vestibular schwannoma

DEFF Research Database (Denmark)

Muzevic, Dario; Legcevic, Jelena; Splavski, Bruno

2014-01-01

BACKGROUND: Vestibular schwannomas (acoustic neuromas) are common benign tumours that arise from the Schwann cells of the vestibular nerve. Management options include observation with neuroradiological follow-up, microsurgical resection and stereotactic radiotherapy. OBJECTIVES: To assess...... the effect of stereotactic radiotherapy compared to observation, microsurgical resection, any other treatment modality, or a combination of two or more of the above approaches for vestibular schwannoma. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials; PubMed; EMBASE; CINAHL......; Web of Science; CAB Abstracts; ISRCTN and additional sources for published and unpublished trials. The date of the search was 24 July 2014. SELECTION CRITERIA: Randomised controlled trials (RCTs) exploring the efficacy of stereotactic radiotherapy compared with observation alone, microsurgical...

Development and evaluation of targeted psychological skills training for oncology nurses in managing stressful patient and family encounters.

Science.gov (United States)

Traeger, Lara; Park, Elyse R; Sporn, Nora; Repper-DeLisi, Jennifer; Convery, Mary Susan; Jacobo, Michelle; Pirl, William F

2013-07-01

To reduce workplace stress by developing a brief psychological skills training for nurses and to evaluate program feasibility, acceptability, and preliminary efficacy in decreasing burnout and stress. Intervention development and evaluation. Outpatient chemotherapy unit at a comprehensive cancer center. 26 infusion nurses and oncology social workers. Focus groups were conducted with nurses. Results informed the development and evaluation of training for nurses. Participants completed the Maslach Burnout Inventory and Perceived Stress Scale post-training. Burnout and stress. Focus groups indicated strong commitment among nurses to psychosocial care and supported the idea that relationships with patients and families were sources of reward and stress. Stressors included factors that interfered with psychosocial care such as difficult family dynamics, patient behaviors and end-of-life care issues. Psychological skills training was developed to address these stressors. Evaluations suggested that the program was feasible and acceptable to nurses. At two months, participants showed reductions in emotional exhaustion (p = 0.02) and stress (p = 0.04). Psychological skills training for managing difficult encounters showed feasibility, acceptability, and potential benefit in reducing emotional exhaustion and stress. Brief training that targets sources of clinical stress may be useful for nurses in outpatient chemotherapy units. Specific stressors in relationships with patients and families present challenges to nurses' therapeutic use of self. Targeted psychological skills training may help nurses problem-solve difficult encounters while taking care of themselves. System-level strategies are needed to support and promote training participation.

Predicting intention to attend and actual attendance at a universal parent-training programme: a comparison of social cognition models.

Science.gov (United States)

Thornton, Sarah; Calam, Rachel

2011-07-01

The predictive validity of the Health Belief Model (HBM) and the Theory of Planned Behaviour (TPB) were examined in relation to 'intention to attend' and 'actual attendance' at a universal parent-training intervention for parents of children with behavioural difficulties. A validation and reliability study was conducted to develop two questionnaires (N = 108 parents of children aged 4-7).These questionnaires were then used to investigate the predictive validity of the two models in relation to 'intention to attend' and 'actual attendance' at a parent-training intervention ( N = 53 parents of children aged 4-7). Both models significantly predicted 'intention to attend a parent-training group'; however, the TPB accounted for more variance in the outcome variable compared to the HBM. Preliminary investigations highlighted that attendees were more likely to intend to attend the groups, have positive attitudes towards the groups, perceive important others as having positive attitudes towards the groups, and report elevated child problem behaviour scores. These findings provide useful information regarding the belief-based factors that affect attendance at universal parent-training groups. Possible interventions aimed at increasing 'intention to attend' and 'actual attendance' at parent-training groups are discussed.

A pilot study examining the effects of low-volume high-intensity interval training and continuous low to moderate intensity training on quality of life, functional capacity and cardiovascular risk factors in cancer survivors.

Science.gov (United States)

Toohey, Kellie; Pumpa, Kate L; Arnolda, Leonard; Cooke, Julie; Yip, Desmond; Craft, Paul S; Semple, Stuart

2016-01-01

The aim of this study was to evaluate the effects of low-volume high-intensity interval training and continuous low to moderate intensity training on quality of life, functional capacity and cardiovascular disease risk factors in cancer survivors. Cancer survivors within 24 months post-diagnosis were randomly assigned into the low-volume high-intensity interval training group ( n  = 8) or the continuous low to moderate intensity training group ( n  = 8) group for 36 sessions (12 weeks) of supervised exercise. The low-volume high-intensity interval training (LVHIIT) group performed 7 × 30 s intervals (≥85% maximal heart rate) and the continuous low to moderate intensity training (CLMIT) group performed continuous aerobic training for 20 min (≤55% maximal heart rate) on a stationary bike or treadmill. Significant improvements (time) were observed for 13 of the 23 dependent variables (ES 0.05-0.61, p  ≤ 0.05). An interaction effect was observed for six minute walk test (18.53% [32.43-4.63] ES 0.50, p  ≤ 0.01) with the LVHIIT group demonstrating greater improvements. These preliminary findings suggest that both interventions can induce improvements in quality of life, functional capacity and selected cardiovascular disease risk factors. The LVHIIT program was well tolerated by the participants and our results suggest that LVHIIT is the preferred modality to improve fitness (6MWT); it remains to be seen which intervention elicits the most clinically relevant outcomes for patients. A larger sample size with a control group is required to confirm the significance of these findings.

Positive Reinforcement Training for Blood Collection in Grizzly Bears (Ursus arctos horribilis) Results in Undetectable Elevations in Serum Cortisol Levels: A Preliminary Investigation.

Science.gov (United States)

Joyce-Zuniga, Nicole M; Newberry, Ruth C; Robbins, Charles T; Ware, Jasmine V; Jansen, Heiko T; Nelson, O Lynne

2016-01-01

Training nonhuman animals in captivity for participation in routine husbandry procedures is believed to produce a lower stress environment compared with undergoing a general anesthetic event for the same procedure. This hypothesis rests largely on anecdotal evidence that the captive subjects appear more relaxed with the trained event. Blood markers of physiological stress responses were evaluated in 4 captive grizzly bears (Ursus arctos horribilis) who were clicker-trained for blood collection versus 4 bears who were chemically immobilized for blood collection. Serum cortisol and immunoglobulin A (IgA) and plasma β-endorphin were measured as indicators of responses to stress. Plasma β-endorphin was not different between the groups. Serum IgA was undetectable in all bears. Serum cortisol was undetectable in all trained bears, whereas chemically immobilized bears had marked cortisol elevations (p bears with extensive recent immobilization experience. These findings support the use of positive reinforcement training for routine health procedures to minimize anxiety.

The clinician-educator track: training internal medicine residents as clinician-educators.

Science.gov (United States)

Smith, C Christopher; McCormick, Ian; Huang, Grace C

2014-06-01

Although resident-as-teacher programs bring postgraduate trainees' teaching skills to a minimum threshold, intensive, longitudinal training is lacking for residents who wish to pursue careers in medical education. The authors describe the development, implementation, and preliminary assessment of the novel track for future clinician-educators that they introduced in the internal medicine residency program at Beth Israel Deaconess Medical Center in 2010. Categorical medical interns with a career interest in medical education apply to participate in the clinician-educator track (CET) at the midpoint of their first postgraduate year. CET residents complete a 2.5-year curriculum in which they review foundations of medical education, design and assess new curricula, and evaluate learners and programs. They apply these skills in a variety of clinical settings and receive frequent feedback from faculty and peers. All CET residents design and implement at least one medical education research project. A comprehensive evaluation plan to assess the impact of the CET on resident teaching skills, scholarly productivity, career selection, and advancement is under way. A preliminary evaluation demonstrates high satisfaction with the track among the first cohort of CET residents, who graduated in 2012. Compared with residents in the traditional resident-as-teacher program, CET residents reported higher gains in their confidence in core medical education skills. Although these preliminary data are promising, data will be collected over the next several years to explore whether the additional curricular time, faculty time, and costs and potential expansion to other institutions are justified.

Preliminary Hazard Classification for the 105-B Reactor

International Nuclear Information System (INIS)

Kerr, N.R.

1997-08-01

This document summarizes the inventories of radioactive and hazardous materials present within the 105-B Reactor and uses the inventory information to determine the preliminary hazard classification for the surveillance and maintenance activities of the facility. The result of this effort was the preliminary hazard classification for the 105-B Building surveillance and maintenance activities. The preliminary hazard classification was determined to be Nuclear Category 3. Additional hazard and accident analysis will be documented in a separate report to define the hazard controls and final hazard classification

Finding a Seat at the Table Meeting the Pedagogical Needs of Adjunct Faculty in the Community College the Development and Implementation of a Staff Training Plan

Science.gov (United States)

Spigelmyer, Frances Erickson

2011-01-01

This qualitative study via an action research design explored adjunct faculty pedagogical perceptions at Butler County Community College (BC3) in Butler, Pennsylvania. Based on a preliminary study by the researcher, adjunct survey data was analyzed to determine if there was a need for pedagogy training and, if so, what adjuncts believed that…

An evaluation of a data linkage training workshop for research ethics committees.

Science.gov (United States)

Tan, Kate M; Flack, Felicity S; Bear, Natasha L; Allen, Judy A

2015-03-04

In Australia research projects proposing the use of linked data require approval by a Human Research Ethics Committee (HREC). A sound evaluation of the ethical issues involved requires understanding of the basic mechanics of data linkage, the associated benefits and risks, and the legal context in which it occurs. The rapidly increasing number of research projects utilising linked data in Australia has led to an urgent need for enhanced capacity of HRECs to review research applications involving this emerging research methodology. The training described in this article was designed to respond to an identified need among the data linkage units in the Australian Population Health Research Network (PHRN) and HREC members in Australia. Five one-day face to face workshops were delivered in the study period to a total of 98 participants. Participants in the workshops represented all six categories of HREC membership composition listed in the National Health and Medical Research Centres' (NHMRC) National Statement on Ethical Conduct in Human Research. Participants were assessed at three time points, prior to the training (T1), immediately after the training (T2) and 8 to 17 months after the training (T3). Ninety participants completed the pre and post questionnaires; 58 of them completed the deferred questionnaire. Participants reported significant improvements in levels of knowledge, understanding and skills in each of the eight areas evaluated. The training was beneficial for those with prior experience in the area of ethics and data linkage as well as those with no prior exposure. Our preliminary work in this area demonstrates that the provision of intensive face to face ethics training in data linkage is feasible and has a significant impact on participant's confidence in reviewing HREC applications.

Practical training on porcine hearts enhances students' knowledge of human cardiac anatomy.

Science.gov (United States)

Musumeci, Giuseppe; Loreto, Carla; Mazzone, Venera; Szychlinska, Marta Anna; Castrogiovanni, Paola; Castorina, Sergio

2014-05-01

Historically, cadavers have been used for the study of anatomy. Nowadays, the territorial and legal limitations of this approach have led to the introduction of alternative teaching methods such as the use of practical exercise consisting of dissection and observation of animal organs. The aim of this study was to evaluate the use of practical training on animal organs compared with the traditional method of anatomy teaching, based on the dissection of human cadavers. In this study, we seek to demonstrate the usefulness of practical exercise on animal organs. This practical training was held a week after the series of lectures, thus leaving time for the students to learn and understand the topics discussed. Immediately after the lecture, all of the students completed a preliminary test to assess the immediate effect of the lecture. Immediately before the practical exercise, both control and experimental groups completed a second test to assess the effectiveness of personal study. Immediately after practical training, a third test was completed by the experimental group and the control group (no practical activity on animal organs) to highlight the added value of hands-on practice in addition to the lecture. Data obtained from statistical analysis showed a panatomy learning between control and experimental groups. Thus, the results of this study emphasize the utility of practical training on animal organs in learning and understanding anatomy, considering the limitations of the use of cadavers. Copyright © 2014 Elsevier GmbH. All rights reserved.

Evaluation of longitudinal loading of tank trains during motion in longitudinal changes of gradient

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S.V. Myamlin

2013-06-01

Full Text Available Purpose. To research the tank train longitudinal loading during motion by track sections with changes of gradient. The trains of different length that consist of bogie tank wagons should be examined. Influence of cargo type on longitudinal loading of train during motion in concave section of track should be evaluated. Methodology. The level of the largest longitudinal forces was estimated by mathematical simulation. It was assumed that change of gradient is formed by two grades with baffle platforms, length 50 meters, so that the algebraic difference of limiting grades vary from 10‰ to 40‰, pitch 10‰. The initial speeds were 40, 60, 80, 100, 120 km/h. For evaluation of the longitudinal loading the regulating braking and motion "by coasting" was considered. For evaluation of buffing loads the entry to the concave gradient change of expanded train is considered, and in order to determine the quasi-static forces the compressed train is considered. Findings. As a result of calculations the dependencies of maximal longitudinal forces in the trains on the cargo type, the algebraic difference of the grades, the number of tank wagons, the initial speed, motion modes, and initial gaps condition in the train were obtained. Originality. The longitudinal loading of freight cars of different length formed by the similar bogie tank wagons with one locomotive was obtained. The locomotive is placed in the train head during motion in concave track sections with various algebraic difference of the grades "on coasting" and during the regulating braking mode. The obtained results can be used for parameters standardization of profile elevation of the track. Practical value. The obtained results show that during operation of tank trains on track sections of complex breakage the most dangerous is regulating braking of preliminary compressed trains during entering on concave parts of track. Level of the greatest buffing and quasi-static longitudinal forces is

The effect of auditory perception training on reading performance of the 8-9-year old female students with dyslexia: A preliminary study

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Nafiseh Vatandoost

2014-01-01

Full Text Available Background and Aim: Dyslexia is the most common learning disability. One of the main factors have role in this disability is auditory perception imperfection that cause a lot of problems in education. We aimed to study the effect of auditory perception training on reading performance of female students with dyslexia at the third grade of elementary school.Methods: Thirty-eight female students at the third grade of elementary schools of Khomeinishahr City, Iran, were selected by multistage cluster random sampling of them, 20 students which were diagnosed dyslexic by Reading test and Wechsler test, devided randomly to two equal groups of experimental and control. For experimental group, during ten 45-minute sessions, auditory perception training were conducted, but no intervention was done for control group. An participants were re-assessed by Reading test after the intervention (pre- and post- test method. Data were analyed by covariance test.Results: The effect of auditory perception training on reading performance (81% was significant (p<0.0001 for all subtests execpt the separate compound word test.Conclusion: Findings of our study confirm the hypothesis that auditory perception training effects on students' functional reading. So, auditory perception training seems to be necessary for the students with dyslexia.

Space reactor preliminary mechanical design

International Nuclear Information System (INIS)

Meier, K.L.

1983-01-01

An analysis was performed on the SABRE reactor space power system to determine the effect of the number and size of heat pipes on the design parameters of the nuclear subsystem. Small numbers of thin walled heat pipes were found to give a lower subsystem mass, but excessive fuel swelling resulted. The SP-100 preliminary design uses 120 heat pipes because of acceptable fuel swelling and a minimum nuclear subsystem mass of 1875 kg. Salient features of the reactor preliminary design are: individual fuel modules, ZrO 2 block core mounts, bolted collar fuel module restraints, and a BeO central plug

Metacognitive Reflection and Insight Therapy for Early Psychosis: A preliminary study of a novel integrative psychotherapy.

Science.gov (United States)

Vohs, Jenifer L; Leonhardt, Bethany L; James, Alison V; Francis, Michael M; Breier, Alan; Mehdiyoun, Nikki; Visco, Andrew C; Lysaker, Paul H

2018-05-01

Poor insight impedes treatment in early phase psychosis (EPP). This manuscript outlines preliminary findings of an investigation of the novel metacognitively oriented integrative psychotherapy, Metacognitive Reflection and Insight Therapy, for individuals with early phase psychosis (MERIT-EP). Twenty adults with EPP and poor insight were randomized to either six months of MERIT-EP or treatment as usual (TAU). Therapists were trained and therapy was successfully delivered under routine, outpatient conditions. Insight, assessed before and after treatment, revealed significant improvement for the MERIT-EP, but not TAU, group. These results suggest MERIT-EP is feasible to deliver, accepted by patients, and leads to clinically significant improvements in insight. Copyright © 2017 Elsevier B.V. All rights reserved.

Physical exercise as a supplement to outpatient treatment of alcohol use disorders – design and preliminary results of a randomized controlled trial

DEFF Research Database (Denmark)

Sari, Sengül; Bilberg, Randi Marie; Roessler, Kirsten Kaya

Background and aim Alcohol use disorder is a widespread problem in Denmark and has severe impacts on health and quality of life of each individual. The clinical treatment of alcohol use disorder involves evidence-based knowledge on medical treatment, physical training, and psychological management...... the study and inform about the first preliminary results. Perspectives If this study detects a positive relationship between exercise as a supplement to alcohol treatment and patients’ alcohol intake, quality of life, fitness, well-being, anxiety, depression and interpersonal problems...

Pilates based core stability training in ambulant individuals with multiple sclerosis: protocol for a multi-centre randomised controlled trial

OpenAIRE

Freeman, Jennifer; Fox, Esther; Gear, Margaret; Hough, Alan

2012-01-01

Abstract Background People with Multiple Sclerosis (MS) frequently experience balance and mobility impairments, including reduced trunk stability. Pilates-based core stability training, which is aimed at improving control of the body's stabilising muscles, is popular as a form of exercise with people with MS and therapists. A replicated single case series study facilitated by the Therapists in MS Group in the United Kingdom (UK) provides preliminary evidence that this approach can improve bal...

Preliminary Analysis and Selection of Mooring Solution Candidates

DEFF Research Database (Denmark)

Thomsen, Jonas Bjerg; Delaney, Martin

This report covers a preliminary analysis of mooring solutions candidates for four large floating wave energy converters. The work is part of the EUDP project “Mooring Solutions for Large Wave Energy Converters” and is the outcome of "Work Package 3: Preliminary Analysis". The report further...... compose the "Milestone 4: Report on results of preliminary analysis and selection of final candidates. The report is produced by Aalborg University with input from the partner WECs Floating Power Plant, KNSwing, LEANCON and Wave Dragon. Tension Technology International (TTI) has provided a significant...

A novel approach to training attention and gaze in ASD: A feasibility and efficacy pilot study.

Science.gov (United States)

Chukoskie, Leanne; Westerfield, Marissa; Townsend, Jeanne

2018-05-01

In addition to the social, communicative and behavioral symptoms that define the disorder, individuals with ASD have difficulty re-orienting attention quickly and accurately. Similarly, fast re-orienting saccadic eye movements are also inaccurate and more variable in both endpoint and timing. Atypical gaze and attention are among the earliest symptoms observed in ASD. Disruption of these foundation skills critically affects the development of higher level cognitive and social behavior. We propose that interventions aimed at these early deficits that support social and cognitive skills will be broadly effective. We conducted a pilot clinical trial designed to demonstrate the feasibility and preliminary efficacy of using gaze-contingent video games for low-cost in-home training of attention and eye movement. Eight adolescents with ASD participated in an 8-week training, with pre-, mid- and post-testing of eye movement and attention control. Six of the eight adolescents completed the 8 weeks of training and all six showed improvement in attention (orienting, disengagement) and eye movement control or both. All game systems remained intact for the duration of training and all participants could use the system independently. We delivered a robust, low-cost, gaze-contingent game system for home use that, in our pilot training sample, improved the attention orienting and eye movement performance of adolescent participants in 8 weeks of training. We are currently conducting a clinical trial to replicate these results and to examine what, if any, aspects of training transfer to more real-world tasks. © 2017 Wiley Periodicals, Inc. Develop Neurobiol 78: 546-554, 2018. © 2017 Wiley Periodicals, Inc.

A brain-computer interface based cognitive training system for healthy elderly: a randomized control pilot study for usability and preliminary efficacy.

Directory of Open Access Journals (Sweden)

Tih-Shih Lee

Full Text Available Cognitive decline in aging is a pressing issue associated with significant healthcare costs and deterioration in quality of life. Previously, we reported the successful use of a novel brain-computer interface (BCI training system in improving symptoms of attention deficit hyperactivity disorder. Here, we examine the feasibility of the BCI system with a new game that incorporates memory training in improving memory and attention in a pilot sample of healthy elderly. This study investigates the safety, usability and acceptability of our BCI system to elderly, and obtains an efficacy estimate to warrant a phase III trial. Thirty-one healthy elderly were randomized into intervention (n = 15 and waitlist control arms (n = 16. Intervention consisted of an 8-week training comprising 24 half-hour sessions. A usability and acceptability questionnaire was administered at the end of training. Safety was investigated by querying users about adverse events after every session. Efficacy of the system was measured by the change of total score from the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS before and after training. Feedback on the usability and acceptability questionnaire was positive. No adverse events were reported for all participants across all sessions. Though the median difference in the RBANS change scores between arms was not statistically significant, an effect size of 0.6SD was obtained, which reflects potential clinical utility according to Simon's randomized phase II trial design. Pooled data from both arms also showed that the median change in total scores pre and post-training was statistically significant (Mdn = 4.0; p<0.001. Specifically, there were significant improvements in immediate memory (p = 0.038, visuospatial/constructional (p = 0.014, attention (p = 0.039, and delayed memory (p<0.001 scores. Our BCI-based system shows promise in improving memory and attention in healthy

FAO/IAEA - interregional training course on the use of 15N in soil science and plant nutrition

International Nuclear Information System (INIS)

Faust, H.

1981-03-01

This training manual provides an introduction for the basic methodology and principles of application of the stable isotope 15 N. After preliminary remarks on stable isotope terminology fundamentals, experimental problems and methods of quantitative nitrogen determination in soil and plant studies are reported in the main part of the manual. An appendix with a compilation of different parameters such as natural abundance of stable isotopes, selected atomic weights and multiples of them conversion factors of chemical compounds, and much more concludes the manual

The development of a myoelectric training tool for above-elbow amputees.

Science.gov (United States)

Dawson, Michael R; Fahimi, Farbod; Carey, Jason P

2012-01-01

The objective of above-elbow myoelectric prostheses is to reestablish the functionality of missing limbs and increase the quality of life of amputees. By using electromyography (EMG) electrodes attached to the surface of the skin, amputees are able to control motors in myoelectric prostheses by voluntarily contracting the muscles of their residual limb. This work describes the development of an inexpensive myoelectric training tool (MTT) designed to help upper limb amputees learn how to use myoelectric technology in advance of receiving their actual myoelectric prosthesis. The training tool consists of a physical and simulated robotic arm, signal acquisition hardware, controller software, and a graphical user interface. The MTT improves over earlier training systems by allowing a targeted muscle reinnervation (TMR) patient to control up to two degrees of freedom simultaneously. The training tool has also been designed to function as a research prototype for novel myoelectric controllers. A preliminary experiment was performed in order to evaluate the effectiveness of the MTT as a learning tool and to identify any issues with the system. Five able-bodied participants performed a motor-learning task using the EMG controlled robotic arm with the goal of moving five balls from one box to another as quickly as possible. The results indicate that the subjects improved their skill in myoelectric control over the course of the trials. A usability survey was administered to the subjects after their trials. Results from the survey showed that the shoulder degree of freedom was the most difficult to control.

A Preliminary Study of the Effectiveness of Different Recitation Teaching Methods

Science.gov (United States)

Endorf, Robert J.; Koenig, Kathleen M.; Braun, Gregory A.

2006-02-01

We present preliminary results from a comparative study of student understanding for students who attended recitation classes which used different teaching methods. Student volunteers from our introductory calculus-based physics course attended a special recitation class that was taught using one of four different teaching methods. A total of 272 students were divided into approximately equal groups for each method. Students in each class were taught the same topic, "Changes in energy and momentum," from Tutorials in Introductory Physics. The different teaching methods varied in the amount of student and teacher engagement. Student understanding was evaluated through pretests and posttests given at the recitation class. Our results demonstrate the importance of the instructor's role in teaching recitation classes. The most effective teaching method was for students working in cooperative learning groups with the instructors questioning the groups using Socratic dialogue. These results provide guidance and evidence for the teaching methods which should be emphasized in training future teachers and faculty members.

Preliminary assessment of an S.G.H.W. type research reactor

International Nuclear Information System (INIS)

Bicevskis, A.; Chapman, A.G.; Hesse, E.W.

1970-08-01

A preliminary design study has been made of a research reactor, based on the enriched S.G.H.W.R. concept, to be used for power reactor fuel irradiation, isotope production, basic research, and training in nuclear technology. A reactor physics assessment established a core size which would allow uninterrupted operation for the required irradiation period consistent with low capital and operating costs. A design was selected with 24 channels, a D 2 O calandria diameter of 2.7 m and an overall core height of 4.0 m. The capital cost was estimated as $750,000 for the fuel and $1,600,000 for the moderator, the refuelling cost being $340,000 per annum. A thermal design study showed that the fission heat of 65 MW could be transmitted to pressurised light water at 200 lb/in 2 abs. and rejected to sea water in two conventional U-tube heat exchangers. The basic design is flexible and can be adapted to meet many special requirements. (author)

Preliminary Analysis of Severe Accident Progression Initiated from Small Break LOCA of a SMART Reactor

International Nuclear Information System (INIS)

Jin, Young Ho; Park, Jong Hwa; Kim, Dong Ha; Cho, Seong Won

2010-01-01

SMART (System integrated Modular Advanced ReacTor), is under the development at Korea Atomic Energy Research Institute (KAERI). SMART is an integral type pressurized water reactor which contains a pressurizer, 4 reactor coolant pumps (RCPs), and 8 steam generator cassettes(S/Gs) in a single reactor vessel. This reactor has substantially enhanced its safety with an integral layout of its major components, 4 trains of safety injection systems (SISs), and an adoption of 4 trains of passive residual heat removal systems (PRHRS) instead of an active auxiliary feedwater system . The thermal power is 330 MWth. During the conceptual design stage, a preliminary PSA was performed. PSA results identified that a small break loss of coolant accident (SLOCA) with all safety injections unavailable is one of important severe core damage sequences. Clear understanding of this sequence helps in the developing accident mitigation strategies. MIDAS/SMR computer code is used to simulate the severe accident progression initiated from a small break LOCA in SMART reactor. This code has capability to model a helical steam generator which is adopted in SMART reactor. The important accident progression results for SMART reactor are then compared with the typical pressurized water reactor (PWR) result

Augmented Reality Cubes for Cognitive Gaming: Preliminary Usability and Game Experience Testing

Directory of Open Access Journals (Sweden)

Costas Boletsis

2016-03-01

Full Text Available Early detection is important in dementia care; however, cognitive impairment is still under-recognised and under-diagnosed. Cognitive screening and training are two important preventative treatments, which can lead to early detection of cognitive decline. In this work, the “Cognitive Augmented Reality Cubes” (CogARC system is presented, i.e. a serious game for cognitive training and screening, utilising an interaction technique based on Augmented Reality and the manipulation of tangible, physical objects (cubes. The game is a collection of cognitive mini-games of preventative nature and is, primarily, targeting elderly players (≥60 years old. A preliminary testing was conducted focusing on the game experience that CogARC offers (utilising the In-Game Experience Questionnaire, the usability of the system (using the System Usability Scale, and the specific user observations and remarks, as documented by open, semi-structured interviews.  Overall, CogARC demonstrated satisfying positive responses, however, the negative reactions indicated that there are specific problems with aspects of the interaction technique and a number of mini-games. The open interview shed more light on the specific issues of each mini-game and further interpretation of user interactions. The current study managed to provide interesting insights into the game design elements, integration of Augmented Reality, tangible interaction of the system, and on how elderly players perceive and use those interaction components.