Training pharmacists to deliver a complex information technology intervention (PINCER) using the principles of educational outreach and root cause analysis

Objective: To describe the training undertaken by pharmacists employed in a pharmacist-led information technology-based intervention study to reduce medication errors in primary care (PINCER Trial), evaluate pharmacists’ assessment of the training, and the time implications of undertaking the training. Methods: Six pharmacists received training, which included training on root cause analysis and educational outreach, to enable them to deliver the PINCER Trial intervention. This was evaluated using self-report questionnaires at the end of each training session. The time taken to complete each session was recorded. Data from the evaluation forms were entered onto a Microsoft Excel spreadsheet, independently checked and the summary of results further verified. Frequencies were calculated for responses to the three-point Likert scale questions. Free-text comments from the evaluation forms and pharmacists’ diaries were analysed thematically. Key findings: All six pharmacists received 22 hours of training over five sessions. In four out of the five sessions, the pharmacists who completed an evaluation form (27 out of 30 were completed) stated they were satisfied or very satisfied with the various elements of the training package. Analysis of free-text comments and the pharmacists’ diaries showed that the principles of root cause analysis and educational outreach were viewed as useful tools to help pharmacists conduct pharmaceutical interventions in both the study and other pharmacy roles that they undertook. The opportunity to undertake role play was a valuable part of the training received. Conclusions: Findings presented in this paper suggest that providing the PINCER pharmacists with training in root cause analysis and educational outreach contributed to the successful delivery of PINCER interventions and could potentially be utilised by other pharmacists based in general practice to deliver pharmaceutical interventions to improve patient safety.

Youth unemployment and vocational training

This paper focuses on the determinants of the labor market situation of young people in developed countries and the developing world, with a particular emphasis on the role of vocational training and education policies. We highlight the role of demographic factors, economic growth and labor market institutions in explaining young people's transition into work. Subsequently, we assess differences between the setup and functioning of the vocational education and training policies across major world regions as an important driver of differential labor market situation of youth. Based on our analysis, we argue in favor of vocational education and training systems combining work experience and general education and provide some policy recommendations regarding the implementation of education and training systems adapted to a country's economic and institutional context.

Chronic low frequency/low volume resistance training reduces pro-inflammatory cytokine protein levels and TLR4 mRNA in rat skeletal muscle

Skeletal muscle is the source of pro- and anti-inflammatory cytokines, and recently, it has been recognized as an important source of interleukin 6 (IL-6), a cytokine that exerts inhibitory effects on several pro-inflammatory cytokines. Although dynamic chronic resistance training has been shown to produce the known ""repeated bout effect"", which abolishes the acute muscle damage, performing of high-intensity resistance training has been regarded highly advisable, at least from the hypertrophy perspective. On the other hand, a more therapeutic, ""non-damaging"" resistance training program, mainly composed of concentric forces, low frequency/low volume of training, and the same exercise, could theoretically benefit the muscle when the main issue is to avoid muscle inflammation (as in the treatment of several ""low-grade"" inflammatory diseases) because the acute effect of each resistance exercise session could be diminished/avoided, at the same time that the muscle is still being overloaded in a concentric manner. However, the benefits of such ""less demanding"" resistance training schedule on the muscle inflammatory profile have never been investigated. Therefore, we assessed the protein expression of IL-6, TNF-alpha, IL-10, IL-10/TNF-alpha ratio, and HSP70 levels and mRNA expression of SCF(beta-TrCP), IL-15, and TLR-4 in the skeletal muscle of rats submitted to resistance training. Briefly, animals were randomly assigned to either a control group (S, n = 8) or a resistance-trained group (T, n = 7). Trained rats were exercised over a duration of 12 weeks (two times per day, two times per week). Detection of IL-6, TNF-alpha, IL-10, and HSP70 protein expression was carried out by western blotting and SCF(beta-TrCP) (SKP Cullin F-Box Protein Ligases), a class of enzymes involved in the ubiquitination of protein substrates to proteasomal degradation, IL-15, and TLR-4 by RT-PCR. Our results show a decreased expression of TNF-alpha and TLR4 mRNA (40 and 60%, respectively; p < 0.05) in the plantar muscle from trained, when compared with control rats. In conclusion, exercise training induced decreased TNF-alpha and TLR-4 expressions, resulting in a modified IL-10/TNF-alpha ratio in the skeletal muscle. These data show that, in healthy rats, 12-week resistance training, predominantly composed of concentric stimuli and low frequency/low volume schedule, down regulates skeletal muscle production of cytokines involved in the onset, maintenance, and regulation of inXammation.

Training New Acquisitions and Collection Development Librarians: Some Technical and Philosophical Guideposts

This article covers key competencies for success as acquisitions and collection development librarians, delineates between collection development's intellectual facets of curricular support and acquisitions' business functions and shows how the two interrelated. Also provided are best practices for training and mentoring and professional development information for new librarians entering acquisitions and collection development.

Exercise training prevents hyperinsulinemia, muscular glycogen loss and muscle atrophy induced by dexamethasone treatment

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Relationship between green management and environmental training in companies located in Brazil: A theoretical framework and case studies

The main objective of this study is to understand the relationship between green management and environmental training in Brazilian companies, underscoring how this relationship takes place and its most important factors. For such, 9 case studies were conducted at large ISO 14001 certified companies, leaders in their market segments. Several interviews were conducted for each case, documents were collected and visits were made for direct observation. The main contributions and results of this study were: (a) a proposal for a theoretical framework relating the evolutionary stages of green management and the characteristics of environmental training; (b) it was ascertained, as per the proposed theoretical framework, that organizational culture and teamwork, top management support and more technical green management practices are the factors that seem to connect and convert environmental training into more proactive green management, especially for companies in the proactive green management stage; (c) the identification of the co-evolution between the companies' stage of green management and their environmental training level, which is the identified relationship mechanism between environmental training and green management. In other words, the higher the level of adoption of activities recommended for green management, the more evolved the green management practiced at the companies tends to be; and (d) identification that the proposed theoretical framework tends to be useful, mainly because it can explain the relationship between green management and environmental training at the company in the proactive stage. (C) 2012 Elsevier B.V. All rights reserved.

Productivity of cherry tomatoes under protected cultivation carried out with different types of pruning and spacing

The aim of the study was to evaluate production and determine the level of total soluble solids for cherry tomatoes, under protected cultivation carried out with different types of spacing and pruning. The experiment was performed according to a randomized block design in a 2×2 factorial scheme, with two types of spacing between plants and two types of pruning, and with five repetitions. The cultivar 'Sindy' (De Ruiter) was utilized. Each experimental parcel contained seven plants, and fruits were collected from the five central plants. The seedlings were produced in Styrofoam trays of 128 cells and transplanted at 33 days after planting using two types of spacing between plants (0.3 and 0.5 m) and 1 m spacing between rows. The plants were grown as single-or double-stem form and staked individually. The parameters evaluated were the number of fruit per plant, fresh weight of fruit and the level of total soluble solids expressed in °Brix. There was no evidence of significant interaction between the treatments. For fresh weight of fruit per plant, there was a significant effect when the plants were grown with a spacing of 1 × 0.5 m, with 4.12 kg per plant, compared to a production of 3.00 kg per plant with a spacing of 1 × 0.3 m. With regard to the number of fruit per plant, a significant difference was seen between the two types of spacing, where a spacing of 1 × 0.3 m yielded a lower number of fruit per plant (188.8), compared to that observed with a spacing of 1 × 0.5 m (238.1). With regard to the two types of pruning, there was a significant effect for only the number of fruit per plant, where the mean number of fruit was 188.4 with one stem and 238.4 with two stems. No significant difference was observed between the treatments for the level of total soluble solids. It is concluded that for the cultivar 'Sindy', under protected cultivation, production is better with a spacing of 0.5 m between plants and the use of two stems per plant.

Managing environmental training in organizations: Theoretical review and proposal of a model

Purpose: The aim of this work is to address the issue of environmental training in organizations, presenting a theoretical review on the subject and proposing a model that highlights the importance of this type of training for organizations. Design/methodology/approach: The paper presents a thorough, updated literature review, discusses typology and the best practices of environmental training, and presents a framework integrating environmental training and organizational results. Findings: A careful consideration allows identifying a significant theoretical gap related to the lack of theoretical references, best practices, and an alignment between environmental training and organizational results. To overcome this gap, a model was proposed that helps to manage the environmental training process in organizations. Research limitations/implications: The paper needs to be complemented with empirical research on the topic. Originality/value: Environmental training is considered to be an essential element for organizations seeking to mitigate their environmental impacts. ISO 14001 states that environmental management is a duty of certified organizations. However, there have been few published articles that suggest models and insights to improve the environmental training in organizations. © Emerald Group Publishing Limited.

Histochemical and ultrastructural analysis of hepatic glycogen and collagen fibers in alloxan-induced diabetic rats submitted to long-term physical training

Alterations in liver functions are common among diabetic patients, and many symptoms in the liver have been reported, including changes in glycogen stores and in the amount of collagen fibers. The practice of physical training and its morphological effects in this organ, however, are scarcely studied. In order to observe the morphological effects of alloxan-induced diabetes and the alterations arising from the practice of long-term chronic physical training in the liver, samples were collected and processed, and then analyzed by means of the histochemical techniques Periodic Acid-Schiff and Picrosirius-Hematoxylin, and ultrastructural cytochemical test of Afzelius. Through evaluation of the tissue, it was observed a drastic reduction in hepatic glycogen stores of sedentary diabetics, recovered in trained diabetic rats. Furthermore, it was detected a decrease in the content of perisinusoidal collagen fibers in the diabetic liver, also recovered due to the development of a training protocol. On ultrastructural level, cytochemical analysis confirmed the loss of glycogen and the recovery obtained by training. In conclusion, the practice of a long-term chronic physical training protocol may be considered an important assistant in the treatment of diabetes, mitigating the occurrence of possible damages to liver tissue. © 2011 Elsevier Ltd.

Optimum-Path Forest pruning parameter estimation through Harmony Search

Pattern recognition in large amount of data has been paramount in the last decade, since that is not straightforward to design interactive and real time classification systems. Very recently, the Optimum-Path Forest classifier was proposed to overcome such limitations, together with its training set pruning algorithm, which requires a parameter that has been empirically set up to date. In this paper, we propose a Harmony Search-based algorithm that can find near optimal values for that. The experimental results have showed that our algorithm is able to find proper values for the OPF pruning algorithm parameter. © 2011 IEEE.

Education in basic skills and training for productive work

Includes bibliography

Influence of a preventive training program on lower limb kinematics and vertical jump height of male volleyball athletes

Objective: To examine the influence of a preventative training program (PTP) on sagittal plane kinematics during different landing tasks and vertical jump height (VJH) in males. Design: Six weeks prospective exercise intervention. Participants: Fifteen male volleyball athletes (13 ± 0.7 years, 1.70 ± 0.12 m, 60 ± 12 kg). Interventions: PTP consisting of plyometric, balance and core stability exercises three times per week for six weeks. Bilateral vertical jumps with double leg (DL) and single leg (SL) landings were performed to measure the effects of training. Main outcome measurements: Kinematics of the knee and hip before and after training and VJH attained during both tasks after training. The hypothesis was that the PTP would produce improvements in VJH, but would not generate great changes in biomechanical behavior. Results: The only change identified for the SL was the longest duration of landing, which represents the time spent from initial ground contact to maximum knee flexion, after training, while increased angular displacement of the knee was observed during DL. The training did not significantly alter the VJH in either the SL (difference: 2.7 cm) or the DL conditions (difference: 3.5 cm). Conclusions: Despite the PTP's effectiveness in inducing some changes in kinematics, the changes were specific for each task, which highlights the importance of the specificity and individuality in selecting prevention injury exercises. Despite the absence of significant increases in the VJH, the absolute differences after training showed increases corroborating with the findings of statistically powerful studies that compared the results with control groups. The results suggest that short-term PTPs in low risk young male volleyball athletes may enhance performance and induce changes in some kinematic parameters. © 2012 Elsevier Ltd.

The effects of combined aerobic and resistance training on heart rate variability in postmenopausal women

Model of the study: Controlled clinical trial. Objective: To verify the effects of 16 weeks of combined aerobic and resistance training on cardiac autonomic modulation in menopausal women. Methods: 17 menopausal women were divided into two groups: the training group (TG: n=11) and control group (CG: n=6). The body composition variables were estimated using dual-energy X-ray absorptiometry. The cardiac autonomic modulation was evaluated by heart rate variability using linear indexes. The training protocol consisted of 16 weeks of 50 minutes of resistance training and 30 minutes of aerobic training. Results: For the TG there was an increase in the rMSSD(ms) index (pre:17,4±3,7 and post:24,8±13,1, p<0,045), an increase in the duration of the intervals between the cardiac beats(ms) (pre:891,2±80,2 and post:974,1±71,4, p<0,003) and in the values of heart rate(bpm) (pre:68,1±6,4 and post:62,0±4,7, p<0,003), additionally for the spectral indexes in normalized units, changes for LF (pre:52,2±13,1 and post:44,5±12,4, p<0,025) and HF (pre:47,8±13,3 and post:55,5±12,4, p<0,025) were noticed, demonstrating increased parasympathetic and reduced sympathetic. There were no significant differences to CG. Conclusion: combined aerobic and resistance training promoted benefits to the autonomic modulation in menopausal women.

Weight Training, Aerobic Physical Activities, and Long-Term Waist Circumference Change in Men

ObjectiveFindings on weight training and waist circumference (WC) change are controversial. This study examined prospectively whether weight training, moderate to vigorous aerobic activity (MVAA), and replacement of one activity for another were associated with favorable changes in WC and body weight (BW).MethodsPhysical activity, WC, and BW were reported in 1996 and 2008 in a cohort of 10,500 healthy U.S. men in the Health Professionals Follow-up Study. Multiple linear regression models (partition/substitution) to assess these associations were used.ResultsAfter adjusting for potential confounders, a significant inverse dose-response relationship between weight training and WC change (P-trend<0.001) was observed. Less age-associated WC increase was seen with a 20-min/day activity increase; this benefit was significantly stronger for weight training (-0.67 cm, 95% CI -0.93, -0.41) than for MVAA (-0.33 cm, 95% CI -0.40, -0.27), other activities (-0.16 cm, 95% CI -0.28, -0.03), or TV watching (0.08 cm, 95% CI 0.05, 0.12). Substituting 20 min/day of weight training for any other discretionary activity had the strongest inverse association with WC change. MVAA had the strongest inverse association with BW change (-0.23 kg, 95% CI -0.29, -0.17).ConclusionsAmong various activities, weight training had the strongest association with less WC increase. Studies on frequency/volume of weight training and WC change are warranted.

Effects of high and low volume of strength training on muscle strength, muscle volume and lipid profile in postmenopausal women

Changes in lipid profile are considered a risk factor for cardiovascular disease (CVD), especially in postmenopausal woman who have been associated with age-related loss of muscle mass. The beneficial role of aerobic exercise in the prevention of CVD has been well documented. However, the effect of strength training has not been established. The purpose of this study was to determine the changes of lipoprotein levels after 12 weeks of different volumes of strength training and its correlation with strength and muscle volume in postmenopausal women. The participants were randomized into three groups: low volume (LVST; n = 12, 1 set) and high volume of strength training (HVST; n = 11, 3 sets), or control group (n = 12). Training groups performed 12 weeks of supervised strength exercises, 15 maximum repetitions, five times a week, 20 minutes for LVST and 40 minutes for HVST for each training session. Measurements included body composition, strength and muscle volume, as well as blood analysis (glucose, total cholesterol, triglycerides, low-density lipoprotein, and high-density lipoprotein) pre- and post-training. The HVST and LVST improved the one-repetition maximum knee extension strength (p < 0.001), maximal dynamic strength (p < 0.001), and muscle volume (p = 0.048). Post-training triglyceride was lower in HVST when compared to LVST and the control group (p = 0.047). Even though they present the same neuromuscular and morphological adaptations in postmenopausal women, the HVST is more effective than LVST in improving the lipid profile of postmenopausal woman, and can be considered as an ideal program of intervention to reverse changes in lipid metabolism commonly found in this group. Copyright (C) 2014, The Society of Chinese Scholars on Exercise Physiology and Fitness. Published by Elsevier (Singapore) Pte Ltd. All rights reserved.