Combining hypoxic methods for peak performance.

New methods and devices for pursuing performance enhancement through altitude training were developed in Scandinavia and the USA in the early 1990s. At present, several forms of hypoxic training and/or altitude exposure exist: traditional 'live high-train high' (LHTH), contemporary 'live high-train low' (LHTL), intermittent hypoxic exposure during rest (IHE) and intermittent hypoxic exposure during continuous session (IHT). Although substantial differences exist between these methods of hypoxic training and/or exposure, all have the same goal: to induce an improvement in athletic performance at sea level. They are also used for preparation for competition at altitude and/or for the acclimatization of mountaineers. The underlying mechanisms behind the effects of hypoxic training are widely debated. Although the popular view is that altitude training may lead to an increase in haematological capacity, this may not be the main, or the only, factor involved in the improvement of performance. Other central (such as ventilatory, haemodynamic or neural adaptation) or peripheral (such as muscle buffering capacity or economy) factors play an important role. LHTL was shown to be an efficient method. The optimal altitude for living high has been defined as being 2200-2500 m to provide an optimal erythropoietic effect and up to 3100 m for non-haematological parameters. The optimal duration at altitude appears to be 4 weeks for inducing accelerated erythropoiesis whereas <3 weeks (i.e. 18 days) are long enough for beneficial changes in economy, muscle buffering capacity, the hypoxic ventilatory response or Na(+)/K(+)-ATPase activity. One critical point is the daily dose of altitude. A natural altitude of 2500 m for 20-22 h/day (in fact, travelling down to the valley only for training) appears sufficient to increase erythropoiesis and improve sea-level performance. 'Longer is better' as regards haematological changes since additional benefits have been shown as hypoxic exposure increases beyond 16 h/day. The minimum daily dose for stimulating erythropoiesis seems to be 12 h/day. For non-haematological changes, the implementation of a much shorter duration of exposure seems possible. Athletes could take advantage of IHT, which seems more beneficial than IHE in performance enhancement. The intensity of hypoxic exercise might play a role on adaptations at the molecular level in skeletal muscle tissue. There is clear evidence that intense exercise at high altitude stimulates to a greater extent muscle adaptations for both aerobic and anaerobic exercises and limits the decrease in power. So although IHT induces no increase in VO(2max) due to the low 'altitude dose', improvement in athletic performance is likely to happen with high-intensity exercise (i.e. above the ventilatory threshold) due to an increase in mitochondrial efficiency and pH/lactate regulation. We propose a new combination of hypoxic method (which we suggest naming Living High-Training Low and High, interspersed; LHTLHi) combining LHTL (five nights at 3000 m and two nights at sea level) with training at sea level except for a few (2.3 per week) IHT sessions of supra-threshold training. This review also provides a rationale on how to combine the different hypoxic methods and suggests advances in both their implementation and their periodization during the yearly training programme of athletes competing in endurance, glycolytic or intermittent sports.

Enzymes musculaires et exercice physique [Muscle enzyme activity and exercise]

Exercise is classically associated with muscular soreness, presenting one to two days later, delayed onset muscular soreness. Blood muscle enzymes and protein elevations are characteristic, and may cause renal failure. Creatin phosphokinase peak appears on the fourth day and depends on exercise type and individual parameters. This effect is attenuated with repeated bouts, by habituation. Metabolic complications are rare. The knowledge of this reaction, even with common exercises, allows to postpone investigations for a complex metabolic disorder, or to avoid stopping a medication for fear of a side effect, as with statins. Indeed, it is necessary to wait for seven days without any exercise before interpreting an elevated CK result.

Blood transfusion in sports.

Blood transfusion is an effective and unmediated means of increasing the number of red blood cells in the circulation in order to enhance athletic performance. Blood transfusion became popular in the 1970s among elite endurance athletes and declined at the end of the 1980s with the introduction of recombinant erythropoietin. The successive implementation in 2001 of a direct test to detect exogenous erythropoietin and in 2004 of a test to detect allogeneic blood transfusion forced cheating athletes to reinfuse fully immunologically compatible blood. The implementation of indirect markers of blood doping stored in an Athlete's Biological Passport provides a powerful means to deter any form of blood transfusion.

Muuttuvien ammattitaitovaatimusten mukaisen koulutuksen käyttöönotto toisen asteen koulutuksessa

Yritykset tarvitsevat nopealla toimitusajalla uudenlaista osaamista omaavia työntekijöitä. Tämän vuoksi kouluttajien täytyy pystyä reagoimaan nopeasti työelämän esittämiin haasteisiin Kehittämällä uusi toimintamalli muuttuvien ammattitaitovaatimusten mukaisen koulutuksen käynnistämiseksi voidaan saavuttaa mittavia taloudellisia ja ajallisia säästöjä uusien osaajien koulutuksessa. Mallin avulla tapauskohtaisesti oikeat henkilöt tekevät oikea aikaisesti juuri oikeita toimenpiteitä ja näin toimien päästään mahdollisimman lyhyeen koulutusaikaan koulutustarvesignaalien vastaanottamisesta hetkeen, jolloin opiskelijat ovat valmiita siirtymään työelämään. Mikäli koulutuksen käynnistämiseen liittyvien tehtävien kanssa työskentelevät henkilöt, joilla ei ole kokonaisnäkemystä tai heiltä puuttuu päätösvalta päätösten tekemiseksi, niin tärkeää aikaa ja energiaa kuluu hukkaan. Samoin jos signaalien oikeita kulkuväyliä työelämästä oppilaitokselle ei tunnisteta tai ei osata hyödyntää, koulutusten aloittaminen viivästyy tai koulutusjää kokonaan toteutumatta.Tiiviissä yhteistyössä metallialan yritystoiminnan jakoulutuksen järjestäjän kanssa kehitetty robotisoitu laserhitsauskoulutus mahdollistaa juuri oikeanlaista osaamista omaavien työtekijöiden tuottamisen mahdollisimman tehokkaasti. Tehokkuus on todettavissa koulutuksen käynnistämiseen ja kouluttamiseen tarvittavan ajan lyhenemisenä sekä koulutuksesta syntyvien kustannusten vähenemisenä.

Oppimistehtaan toimintamallin kehittäminen

Educaworks Oy on toiminut viisi vuotta oppimistehtaana, jonka omistajia ovat olleet yritykset ja oppilaitokset. Yrityksen pääasiallisia työntekijöitä ovat tähän mennessä olleet ammattiopiston työssäoppijat ja parina viimeisenä vuotena on yrityksellä ollut palkkalistoillaan omia työntekijöitä. Tässä työssä luotiin vaihtoehtoja Educaworks Oy:n tulevalle toiminnalle lähtien siitä, että tämä nykyinen toimintamalli on tullut tiensä päähän ja tarvitaan uusi malli toiminnan jatkamiselle.Työssä haettiin hyviä käytäntöjä Suomesta benchmarkingin avulla. Näiden mallienvahvuuksia hyödyntämällä pystyttiin kehittämään vaihtoehto Educaworks Oy:n tulevalle toiminnalle. Tämä malli, oppimistehdas osana osaamiskeskittymää, valittiin toteutettavaksi kolmesta eri vaihtoehdosta, joista kaksi muuta olivat oppimistehdas yrityksenä ja oppimistehdas osana koulutusorganisaatiota. Valitussa vaihtoehdossa hyödynnetään Savonia-ammattikorkeakoulun suunnitteilla olevaa EducaTech Center-hanketta, jossa on tarkoitus luoda Iisalmeen teknologiateollisuuden osaamiskeskittymä seuraavan EU-kauden 2007-2013 aikana. Valitussa mallissa Educaworks Oy hyödyntää tulevassa toiminnassaan tämän osaamiskeskittymän uutta kone- ja laitekantaa sekä tekee yhteistyötä keskittymän tutkimus- ja tuotekehityshenkilökunnan kanssa. Yritykset pääsevät parhaiten osallisiksi Educa Tech Center osaamiskeskittymän tuottamista palveluista hankkimalla Educaworks Oy:n osakkeita ja pääsemällä täten keskittymän ytimeen sen tuotannollisen toimijan, Educaworks Oy:n, avulla. Educaworks Oy toimii tässä keskittymässä komponenttitoimittajan roolissa ollen malli komponenttitoimittajasta muillealueella oleville vastaaville verkostoissa toimiville yrityksille. Educaworks Oy:n toiminnan toisena periaatteena tulee olemaan työssäoppiminen. Työssäoppiminen on tänä päivänä osa ammatillista koulutusta ja sen merkityskorostuu yhä enemmän, koska oppilaat tulevat opiskelemaan tänä päivänä monesti lähtökohdista, joissa heillä ei ole ollut mahdollisuutta harjoittaa käytännön taitojaan ennen ammatillisten opiskelujen aloittamista. Työpaikoilla ei ole vielä kovin hyvää valmiutta toteuttaa sitä opetushallituksen tavoitetta, että oppilaatoppisivat työssäoppimisjaksoilla uusia asioita ohjatusti. Työpaikoilta puuttuu työssäoppimisen ohjaajat ja oppilaiden tekemät harjoitteet ovat liian monta kertaa ammatillisesti kovin vaatimattomia jäysteenpoisto- tai kappaleenvaihtotöitä koneistuksesta puhuttaessa. Tässä työssä luodaan mallia oppilaiden ohjatulle työssäoppimiselle tehtyjen tieteellisten tutkimusten pohjalta. Tavoitteena on, että Educaworks Oy:ssä pystyttäisiin jatkossa kouluttamaan myös muiden alueen teknologiateollisuuden yritysten työntekijöitä toimimaan työssäoppimisen ohjaajina.

Business competence and training needs in Finnish companies operating in the Leningrad Region

Tässä pro gradu -työssä tutkitaan Leningradin alueella, Venäjällä, toimivien suomalaisyritysten liiketoimintaosaamisen koulutustarpeita. Tavoitteena on ollut tutkia, millaisia yritysten koulutustarpeet ovat, sekä lisäksi selvittää yleisemmällä tasolla, miten liiketoimintaosaaminen määritellään. Useat tutkimusta varten haastatellut johtajat pitävät liiketoimintaosaamista erityisesti markkinoilla toimimiseen liittyvänä osaamisena. Myös johtaminen, sekä tuotteet ja teknologia nähdään liiketoimintaosaamisen tärkeinä osina. Yrityksillä on koulutustarpeita seuraavilla alueilla: johtaminen; myynti, markkinat ja asiakkaat; yrityksen sisäinen yhteistyö; kielet, sekä juridiikka ja laskentatoimi. Haastateltavien mukaan markkinoiden nopea kehitys sekä yrityksen kasvu luovat yrityksille koulutustarpeita. Yllättäen myös Venäjän koulutusjärjestelmää itsessään pidetään koulutustarpeiden syynä. Tutkimuksessa mukana olleiden yritysten koulutuskäytännöt ovat keskenään melko erilaisia: koulutusbudjetti, koulutuspäivien määrä ja koulutusorganisaation valintakriteerit vaihtelevatyrityksestä riippuen. Joka tapauksessa yleisin koulutusmuoto näyttää olevan yrityksen sisäinen koulutus. Monet haastateltavat painottavat suuresti uusien työntekijöiden kouluttamista. Selvästikin rekrytointi ja uusien työntekijöiden koulutus vievät suuren osan tutkimusta varten haastateltujen johtajien ajasta. Tärkeä huomio koulutusmarkkinoihin liittyen on se, että lyhyiden, kaikille avoimien koulutusten kohdalla markkinat ovat Pietarissa täynnä. Suurimpana uhkana nähdään alalla vallitseva kouluttajapula.

Structured running program for health and performance promotion in hospital employees.

Introduction Our institution (University hospital) is encouraging physical activities for health through various popular sporting events in the city of Lausanne, the biggest of which is a road race of 2, 4, 10 and 20km. Objective To create an efficient and sustainable training program in preparation of the race for a group of motivated hospital employees without any prior experience with structured training and to identifying the benefits and limitations encountered.. Methods Subjects of various fitness levels were recruited by add and agreed to undergo lab and field testing before a 12-week 3 times/week running program, based on maximal aerobic speed (MAS-30/30 sec intervals), running technique exercises and endurance training. The interval session was the only one supervised. Their goal was the 10km (11 subjects) and the 20km (6 subjects). Results A group of 17 subjects (7 male and 10 female), mean age 36.6±7.3 years, VO2max 44.0±5.5 ml/kg/min, filed test interval MAS 15.1±2.4 km/h started the program. 2 were lost because of injury (while skiing). Adherence to interval sessions was excellent, although 3 weekly training sessions proved to be difficult for most of the subjects. Performance in the race was satisfying for all of them, 6/7 subjects having improved their running time from the previous year, the others participated for the first time and 7/8 completed the race satisfyingly, one DNF-ed because of sinusitis. Repeat MAS field test was available for 6 subjects, who improved by 5.9% (p<0.01). Subjectively, all of the participants were very satisfied with improvement, interaction with colleagues from various professions, and with self achievement and confidence. Conclusions Implementation of a structured training program for recreational or non-athletes can be very successful in creating a better self-confidence, a better working environment inside a hospital facility and obviously in improvement of physical fitness and athletic performance. Above all, it can only encourage health institutions to promote the health of their own employees through physical activity, which can allow people to connect through sports. As a result, subjects in this study tend to encourage other employees to be more active and are hungry for more advice and continued offers for physical activities benefiting both them and the institution through better efficiency at work and less absenteeism common to more active people.

La figura del mediador intercultural en Cataluña: la visión del colectivo formador

La aproximación al tipo de mediación intercultural que se está llevando a cabo en Cataluña en este momento en el ámbito educativo -y su desarrollo futuro- se concreta y se dibuja en la diversidad de respuestas y de enfoques que aparecen del mismo término. Hemos intentado poner en común la reflexión y el debate sobre cuál sería la figura ideal y real del mediador intercultural. Con esta finalidad se han realizado 17 entrevistas a todos los coordinadores y formadores en ejercicio.

Exercise efficiency relates with mitochondrial content and function in older adults.

Chronic aerobic exercise has been shown to increase exercise efficiency, thus allowing less energy expenditure for a similar amount of work. The extent to which skeletal muscle mitochondria play a role in this is not fully understood, particularly in an elderly population. The purpose of this study was to determine the relationship of exercise efficiency with mitochondrial content and function. We hypothesized that the greater the mitochondrial content and/or function, the greater would be the efficiencies. Thirty-eight sedentary (S, n = 23, 10F/13M) or athletic (A, n = 15, 6F/9M) older adults (66.8 ± 0.8 years) participated in this cross sectional study. V˙O2peak was measured with a cycle ergometer graded exercise protocol (GXT). Gross efficiency (GE, %) and net efficiency (NE, %) were estimated during a 1-h submaximal test (55% V˙O2peak). Delta efficiency (DE, %) was calculated from the GXT. Mitochondrial function was measured as ATPmax (mmol/L/s) during a PCr recovery protocol with (31)P-MR spectroscopy. Muscle biopsies were acquired for determination of mitochondrial volume density (MitoVd, %). Efficiencies were 17% (GE), 14% (NE), and 16% (DE) higher in A than S. MitoVD was 29% higher in A and ATPmax was 24% higher in A than in S. All efficiencies positively correlated with both ATPmax and MitoVd. Chronically trained older individuals had greater mitochondrial content and function, as well as greater exercise efficiencies. GE, NE, and DE were related to both mitochondrial content and function. This suggests a possible role of mitochondria in improving exercise efficiency in elderly athletic populations and allowing conservation of energy at moderate workloads.

Investigating Neuroanatomical Features in Top Athletes at the Single Subject Level.

In sport events like Olympic Games or World Championships competitive athletes keep pushing the boundaries of human performance. Compared to team sports, high achievements in many athletic disciplines depend solely on the individual's performance. Contrasting previous research looking for expertise-related differences in brain anatomy at the group level, we aim to demonstrate changes in individual top athlete's brain, which would be averaged out in a group analysis. We compared structural magnetic resonance images (MRI) of three professional track-and-field athletes to age-, gender- and education-matched control subjects. To determine brain features specific to these top athletes, we tested for significant deviations in structural grey matter density between each of the three top athletes and a carefully matched control sample. While total brain volumes were comparable between athletes and controls, we show regional grey matter differences in striatum and thalamus. The demonstrated brain anatomy patterns remained stable and were detected after 2 years with Olympic Games in between. We also found differences in the fusiform gyrus in two top long jumpers. We interpret our findings in reward-related areas as correlates of top athletes' persistency to reach top-level skill performance over years.

The Effect of Two Speed Endurance Training Regimes on Performance of Soccer Players.

In order to better understand the specificity of training adaptations, we compared the effects of two different anaerobic training regimes on various types of soccer-related exercise performances. During the last 3 weeks of the competitive season, thirteen young male professional soccer players (age 18.5±1 yr, height 179.5±6.5 cm, body mass 74.3±6.5 kg) reduced the training volume by ~20% and replaced their habitual fitness conditioning work with either speed endurance production (SEP; n = 6) or speed endurance maintenance (SEM; n = 7) training, three times per wk. SEP training consisted of 6-8 reps of 20-s all-out running bouts followed by 2 min of passive recovery, whereas SEM training was characterized by 6-8 x 20-s all-out efforts interspersed with 40 s of passive recovery. SEP training reduced (p<0.01) the total time in a repeated sprint ability test (RSAt) by 2.5%. SEM training improved the 200-m sprint performance (from 26.59±0.70 to 26.02±0.62 s, p<0.01) and had a likely beneficial impact on the percentage decrement score of the RSA test (from 4.07±1.28 to 3.55±1.01%) but induced a very likely impairment in RSAt (from 83.81±2.37 to 84.65±2.27 s). The distance covered in the Yo-Yo Intermittent Recovery test level 2 was 10.1% (p<0.001) and 3.8% (p<0.05) higher after SEP and SEM training, respectively, with possibly greater improvements following SEP compared to SEM. No differences were observed in the 20- and 40-m sprint performances. In conclusion, these two training strategies target different determinants of soccer-related physical performance. SEP improved repeated sprint and high-intensity intermittent exercise performance, whereas SEM increased muscles' ability to maximize fatigue tolerance and maintain speed development during both repeated all-out and continuous short-duration maximal exercises. These results provide new insight into the precise nature of a stimulus necessary to improve specific types of athletic performance in trained young soccer players.

The new final Clinical Skills examination in human medicine in Switzerland: Essential steps of exam development, implementation and evaluation, and central insights from the perspective of the national Working Group.

OBJECTIVE: Since 2011, the new national final examination in human medicine has been implemented in Switzerland, with a structured clinical-practical part in the OSCE format. From the perspective of the national Working Group, the current article describes the essential steps in the development, implementation and evaluation of the Federal Licensing Examination Clinical Skills (FLE CS) as well as the applied quality assurance measures. Finally, central insights gained from the last years are presented. METHODS: Based on the principles of action research, the FLE CS is in a constant state of further development. On the foundation of systematically documented experiences from previous years, in the Working Group, unresolved questions are discussed and resulting solution approaches are substantiated (planning), implemented in the examination (implementation) and subsequently evaluated (reflection). The presented results are the product of this iterative procedure. RESULTS: The FLE CS is created by experts from all faculties and subject areas in a multistage process. The examination is administered in German and French on a decentralised basis and consists of twelve interdisciplinary stations per candidate. As important quality assurance measures, the national Review Board (content validation) and the meetings of the standardised patient trainers (standardisation) have proven worthwhile. The statistical analyses show good measurement reliability and support the construct validity of the examination. Among the central insights of the past years, it has been established that the consistent implementation of the principles of action research contributes to the successful further development of the examination. CONCLUSION: The centrally coordinated, collaborative-iterative process, incorporating experts from all faculties, makes a fundamental contribution to the quality of the FLE CS. The processes and insights presented here can be useful for others planning a similar undertaking.