An education and training programme for radiological institutes: impact on the reduction of the CT radiation dose

To establish an education and training programme for the reduction of CT radiation doses and to assess this programme's efficacy.

Training in Mental Health: Evaluation of the Telephone Conference Network

The Telephone Conference Network, sponsored by The Pennsylvania State University's Coordinating Council for Health Care, is designed as a cost-effective format for providing inservice training in geriatric mental health for individuals who serve the elderly. Institutions which subscribe to the Telephone Conference Network are equipped with a conference speaker and telephone hook-up providing a two-way line of communication, and may choose from a variety of inservice programs. Mailed evaluations were completed by participants (N=73) in the "Skills to Manage Moods" program, a series of four 1-hour sessions designed to teach participants the skills needed to help patients cope with depression and to deliver the program to others. The majority of respondents reported high levels of satisfaction with the Telephone Conference Network system and the specific program in which they participated. Although 85 percent reported that they would be able to use the skills learned in the program on the job, 50 percent reported that they would not be interested in teaching these skills to others. The convenience and efficiency of the Telephone Conference Network were the most frequently mentioned strengths of the system, while the physical facilities and the program delivery format adopted by the individual institutions were the most frequently mentioned weaknesses. These data suggested several recommendations for Network subscribers and for professionals offering telephone conference programs, including ensuring optimal class enrollment and adequate physical facilities, and participant involvement in program implementation.

Effect of lifetime endurance training on left atrial mechanical function and on the risk of atrial fibrillation

Background Left atrium (LA) dilation and P-wave duration are linked to the amount of endurance training and are risk factors for atrial fibrillation (AF). The aim of this study was to evaluate the impact of LA anatomical and electrical remodeling on its conduit and pump function measured by two-dimensional speckle tracking echocardiography (STE). Method Amateur male runners > 30 years were recruited. Study participants (n = 95) were stratified in 3 groups according to lifetime training hours: low (< 1500 h, n = 33), intermediate (1500 to 4500 h, n = 32) and high training group (> 4500 h, n = 30). Results No differences were found, between the groups, in terms of age, blood pressure, and diastolic function. LA maximal volume (30 ± 5, 33 ± 5 vs. 37 ± 6 ml/m2, p < 0.001), and conduit volume index (9 ± 3, 11 ± 3 vs. 12 ± 3 ml/m2, p < 0.001) increased significantly from the low to the high training group, unlike the STE parameters: pump strain − 15.0 ± 2.8, − 14.7 ± 2.7 vs. − 14.9 ± 2.6%, p = 0.927; conduit strain 23.3 ± 3.9, 22.1 ± 5.3 vs. 23.7 ± 5.7%, p = 0.455. Independent predictors of LA strain conduit function were age, maximal early diastolic velocity of the mitral annulus, heart rate and peak early diastolic filling velocity. The signal-averaged P-wave (135 ± 11, 139 ± 10 vs. 148 ± 14 ms, p < 0.001) increased from the low to the high training group. Four episodes of non-sustained AF were recorded in one runner of the high training group. Conclusion The LA anatomical and electrical remodeling does not have a negative impact on atrial mechanical function. Hence, a possible link between these risk factors for AF and its actual, rare occurrence in this athlete population, could not be uncovered in the present study.

Effects of geriatric clinical skills training on the attitudes of medical students.

BACKGROUND Physicians' attitudes, knowledge and skills are powerful determinants of quality of care for older patients. Previous studies found that using educational interventions to improve attitude is a difficult task. No previous study sought to determine if a skills-oriented educational intervention improved student attitudes towards elderly patients. METHODS This study evaluated the effect of a geriatric clinical skills training (CST) on attitudes of University of Bern medical students in their first year of clinical training. The geriatric CST consisted of four 2.5-hour teaching sessions that covered central domains of geriatric assessment (e.g., cognition, mobility), and a textbook used by students to self-prepare. Students' attitudes were the primary outcome, and were assessed with the 14-item University of California at Los Angeles Geriatrics Attitudes Scale (UCLA-GAS) in a quasi-randomized fashion, either before or after geriatric CST. RESULTS A total of 154 medical students participated. Students evaluated before the CST had a median UCLA-GAS overall scale of 49 (interquartile range 44-53). After the CST, the scores increased slightly, to 51 (interquartile range 47-54; median difference 2, 95% confidence interval 0-4, P = 0.062). Of the four validated UCLA-GAS subscales, only the resource distribution subscale was significantly higher in students evaluated after the geriatric CST (median difference 1, 95% confidence interval 0-2, P = 0.005). CONCLUSIONS Teaching that targets specific skills may improve the attitudes of medical students towards elderly patients, though the improvement was slight. The addition of attitude-building elements may improve the effectiveness of future skills-oriented educational interventions.

Effect of standardized training on the reliability of the Cochrane risk of bias assessment tool: a study protocol

BACKGROUND The Cochrane risk of bias (RoB) tool has been widely embraced by the systematic review community, but several studies have reported that its reliability is low. We aim to investigate whether training of raters, including objective and standardized instructions on how to assess risk of bias, can improve the reliability of this tool. We describe the methods that will be used in this investigation and present an intensive standardized training package for risk of bias assessment that could be used by contributors to the Cochrane Collaboration and other reviewers. METHODS/DESIGN This is a pilot study. We will first perform a systematic literature review to identify randomized clinical trials (RCTs) that will be used for risk of bias assessment. Using the identified RCTs, we will then do a randomized experiment, where raters will be allocated to two different training schemes: minimal training and intensive standardized training. We will calculate the chance-corrected weighted Kappa with 95% confidence intervals to quantify within- and between-group Kappa agreement for each of the domains of the risk of bias tool. To calculate between-group Kappa agreement, we will use risk of bias assessments from pairs of raters after resolution of disagreements. Between-group Kappa agreement will quantify the agreement between the risk of bias assessment of raters in the training groups and the risk of bias assessment of experienced raters. To compare agreement of raters under different training conditions, we will calculate differences between Kappa values with 95% confidence intervals. DISCUSSION This study will investigate whether the reliability of the risk of bias tool can be improved by training raters using standardized instructions for risk of bias assessment. One group of inexperienced raters will receive intensive training on risk of bias assessment and the other will receive minimal training. By including a control group with minimal training, we will attempt to mimic what many review authors commonly have to do, that is-conduct risk of bias assessment in RCTs without much formal training or standardized instructions. If our results indicate that an intense standardized training does improve the reliability of the RoB tool, our study is likely to help improve the quality of risk of bias assessments, which is a central component of evidence synthesis.

Selection, training and validation process of a sensory panel for bread analysis: Influence of cultivar on the quality of breads made from common wheat and spelta wheat

A protocol of selection, training and validation of the members of the panel for bread sensory analysis is proposed to assess the influence of wheat cultivar on the sensory quality of bread. Three cultivars of bread wheat and two cultivars of spelt wheat organically-grown under the same edaphoclimatic conditions were milled and baked using the same milling and baking procedure. Through the use of triangle tests, differences were identified between the five breads. Significant differences were found between the spelt breads and those made with bread wheat for the attributes ?crumb cell homogeneity? and ?crumb elasticity?. Significant differences were also found for the odor and flavor attributes, with the bread made with ?Espelta Navarra? being the most complex, from a sensory point of view. Based on the results of this study, we propose that sensory properties should be considered as breeding criteria for future work on genetic improvement.

Influence of the training system on the agronomic behavior and grape composition of Albariño in Rías Baixas apellation

The aim of this study was to evaluate if early defoliation can be an alternative to bunch thinning in limiting yield and improving quality in grapes of the white cultivar Loureiro (Vitis vinifera L.), grafted onto 1103P. The field trial had been set up in a commercial vineyard in Vinhos Verdes Region (Northwest of Portugal, 41º 48? 53? N, 8º 24? 42? W). Treatments studied, performed five days before full bloom were: LR5 ? Leaf removal of the first five basal leaves, performed manually, LR8 ? Leave removal of the first eight basal leaves, LRM ? mechanical leaf removal and C ? the control, without defoliation. This paper reports the results of four years (2010-2013). The results presented a significant removal of main leaf area after defoliation principally in the most intensive treatment (LR8) but at harvest, the total leaf area had been compensated by lateral regrowth and no statistical differences between the treatments and the control were found. Early defoliation caused a decrease in fruit set and also a significant reduction in the diameter of the berry within the more severe defoliation treatments (LR5 and LR8). Yield factors were also significantly affected by the defoliation, causing a reduction of bunch weight and in 2013 a yield reduction in LR8 and LRM, and in 2010 in LR8. Conversely, LR5 presented a yield always similar to the control C. The reduction of cluster compactness and the substantial improvement of the microclimate at the cluster level significantly reduced bunch rot incidence in the defoliated modalities compared to control. No carry-over effects, along the four years trial were observed Early defoliation proved to be a canopy management technique that can have a strong impact in the final quality of grapes, reducing the compactness and lower the incidence and intensity of bunch rot, even if the reduction of yield observed in other papers had not been observed in all modalities.