Trainee-therapists are not all equal: Examination of therapeutic efficiency, effectiveness and early client dropout after 12 months of clinical training

Objective Contemporary research demonstrates the feasibility of assessing therapeutic performance of trainee-therapists through the use of objective measures of client treatment outcome. Further, significant variation between individual therapists based on their client treatment outcomes has been demonstrated. This study sets out to determine whether a reliable composite measure of therapeutic efficiency, effectiveness and early dropout can be developed and used to objectively compare trainee-therapists against each other. Design and methods Treatment outcomes of 611 clients receiving treatment from 58 trainee-therapists enrolled in a professional training programme were tracked with the OQ-45.2 over a 6-year period to assess therapeutic efficiency, therapeutic effectiveness and early client dropout. Results Significant variation between trainee-therapists was observed for each index. Findings of a moderately strong correlation between therapeutic efficiency and effectiveness enabled the ranking of trainee-therapists based upon a composite measure of these indexes. A non-significant correlation was found between early client dropout and measures of therapeutic effectiveness and efficiency. Conclusions The findings stress the importance of utilizing objective measures to track the treatment outcomes. Despite all trainee-therapists being enrolled in the same training programme, significant variation between trainee-therapists' therapeutic efficiency and effectiveness was found to exist. Practitioner points Developing of potential benchmarking tools that enable trainee-therapists, supervisors and educational institutions to quickly assess therapeutic performance can become part of a holistic assessment of a trainee-therapist's clinical development. Despite an inherent optimistic belief that therapists do not cause harm, there appears to be a small and significant proportion of trainee-therapists who consistently evidence little therapeutic change. Considerable variability in trainee-therapists' therapeutic efficiency and effectiveness can exist in the one training programme. Early client dropout may not be associated with therapists' therapeutic effectiveness and efficiency.

Child protection training for professionals to improve reporting of child abuse and neglect (Protocol)

Child abuse and neglect results in significant costs for children and communities. As a core public health strategy, diverse professional groups are required by law and policy in many jurisdictions to report suspected cases. Numerous different training initiatives appear to have been developed and implemented for professionals but there is little evidence regarding the precise training components and mechanisms that improve reporting of child abuse and neglect both generally, for specific professions, and for distinct types of child abuse and neglect. To enhance reporting practice, designers of training programmes require detailed information about what programme features will offer greatest benefit. A systematic review which identifies the effectiveness of different training approaches will advance the evidence base and develop a clearer understanding of optimal training content and methods. In addition, it will provide policymakers with a means by which to assess whether current training interventions are congruent with what is demonstrated to be effective. It will also inform future research, public policy, and professional practice in this field.

A virtual radiation therapy workflow training simulation

Aim Simulation forms an increasingly vital component of clinical skills development in a wide range of professional disciplines. Simulation of clinical techniques and equipment is designed to better prepare students for placement by providing an opportunity to learn technical skills in a “safe” academic environment. In radiotherapy training over the last decade or so this has predominantly comprised treatment planning software and small ancillary equipment such as mould room apparatus. Recent virtual reality developments have dramatically changed this approach. Innovative new simulation applications and file processing and interrogation software have helped to fill in the gaps to provide a streamlined virtual workflow solution. This paper outlines the innovations that have enabled this, along with an evaluation of the impact on students and educators. Method Virtual reality software and workflow applications have been developed to enable the following steps of radiation therapy to be simulated in an academic environment: CT scanning using a 3D virtual CT scanner simulation; batch CT duplication; treatment planning; 3D plan evaluation using a virtual linear accelerator; quantitative plan assessment, patient setup with lasers; and image guided radiotherapy software. Results Evaluation of the impact of the virtual reality workflow system highlighted substantial time saving for academic staff as well as positive feedback from students relating to preparation for clinical placements. Students valued practice in the “safe” environment and the opportunity to understand the clinical workflow ahead of clinical department experience. Conclusion Simulation of most of the radiation therapy workflow and tasks is feasible using a raft of virtual reality simulation applications and supporting software. Benefits of this approach include time-saving, embedding of a case-study based approach, increased student confidence, and optimal use of the clinical environment. Ongoing work seeks to determine the impact of simulation on clinical skills.

A novel experimental method to assess industrial aerosol deposition in idealized porous channels

A novel and economical experimental technique has been developed to assess industrial aerosol deposition in various idealized porous channel configurations. This judicious examination on aerosol penetration in porous channels will assist engineers to better optimize designs for various engineering applications. Deposition patterns differ with porosity due to geometric configurations of the channel and superficial inlet velocities. Interestingly, it is found that two configurations of similar porosity exhibit significantly higher deposition fractions. Inertial impaction is profound at the leading edge of all obstacles, whereas particle build-up is observed at the trailing edge of the obstructions. A qualitative analysis shows that the numerical results are in good agreement with experimental results.

Interval training intensity affects energy intake compensation in obese men

Abstract PURPOSE: Compensatory responses may attenuate the effectiveness of exercise training in weight management. The aim of this study was to compare the effect of moderate- and high-intensity interval training on eating behavior compensation. METHODS: Using a crossover design, 10 overweight and obese men participated in 4-week moderate (MIIT) and high (HIIT) intensity interval training. MIIT consisted of 5-min cycling stages at ± 20% of mechanical work at 45%VO(2)peak, and HIIT consisted of alternate 30-s work at 90%VO(2)peak and 30-s rests, for 30 to 45 min. Assessments included a constant-load exercise test at 45%VO(2)peak for 45 min followed by 60-min recovery. Appetite sensations were measured during the exercise test using a Visual Analog Scale. Food preferences (liking and wanting) were assessed using a computer-based paradigm, and this paradigm uses 20 photographic food stimuli varying along two dimensions, fat (high or low) and taste (sweet or nonsweet). An ad libitum test meal was provided after the constant-load exercise test. RESULTS: Exercise-induced hunger and desire to eat decreased after HIIT, and the difference between MIIT and HIIT in desire to eat approached significance (p = .07). Exercise-induced liking for high-fat nonsweet food tended to increase after MIIT and decreased after HIIT (p = .09). Fat intake decreased by 16% after HIIT, and increased by 38% after MIIT, with the difference between MIIT and HIIT approaching significance (p = .07). CONCLUSIONS: This study provides evidence that energy intake compensation differs between MIIT and HIIT.

Comparing fat oxidation in an exercise test with moderate-intensity interval training

This study compared fat oxidation rate from a graded exercise test (GXT) with a moderate-intensity interval training session (MIIT) in obese men. Twelve sedentary obese males (age 29 ± 4.1 years; BMI 29.1 ± 2.4 kg·m-2; fat mass 31.7 ± 4.4 %body mass) completed two exercise sessions: GXT to determine maximal fat oxidation (MFO) and maximal aerobic power (VO2max), and an interval cycling session during which respiratory gases were measured. The 30-min MIIT involved 5-min repetitions of workloads 20% below and 20% above the MFO intensity. VO2max was 31.8 ± 5.5 ml·kg-1·min-1 and all participants achieved ≥ 3 of the designated VO2max test criteria. The MFO identified during the GXT was not significantly different compared with the average fat oxidation rate in the MIIT session. During the MIIT session, fat oxidation rate increased with time; the highest rate (0.18 ± 0.11 g·min- 1) in minute 25 was significantly higher than the rate at minute 5 and 15 (p ≤ 0.01 and 0.05 respectively). In this cohort with low aerobic fitness, fat oxidation during the MIIT session was comparable with the MFO determined during a GXT. Future research may consider if the varying workload in moderate-intensity interval training helps adherence to exercise without compromising fat oxidation.

Performance enhancement: A whole of person approach to first year dance students’ transition into tertiary training

The transition into university presents very particular challenges for students. The First Year Experience (FYE) is a transitional liminal phase, fraught with uncertainty, ripe with potential. The complexity inherent in this initial phase of tertiary education is well documented and continues to be interrogated. Providing timely and effective support and interventions for potentially at-risk first year students as they transition into tertiary study is a key priority for universities across the globe (Gale et al., 2015). This article outlines the evolution of an established and highly successful Transitional Training Program (TTP) for first year tertiary dance students, with particular reference to the 2015 iteration of the program. TTP design embraces three dimensions: physical training in transition, learning in transition, and teaching for transition, with an emphasis on developing and encouraging a mindset that enables information to be transferred into alternative settings for practice and learning throughout life. The aim of the 2015 TTP was to drive substantial change in first year Dance students’ satisfaction, connectedness, and overall performance within the Bachelor of Fine Arts (BFA) Dance course, through the development and delivery of innovative curriculum and pedagogical practices that promote the successful transition of dance students into their first year of university. The program targeted first year BFA Dance students through the integration of specific career guidance; performance psychology; academic skills support; practical dance skills support; and specialized curricula and pedagogy.

Architectural changes of the biceps femoris after concentric or eccentric training

Purpose To determine i) the architectural adaptations of the biceps femoris long head (BFlf) following concentric or eccentric strength training interventions; ii) the time course of adaptation during training and detraining. Methods Participants in this randomized controlled trial (control [n=28], concentric training group [n=14], eccentric training group [n=14], males) completed a 4-week control period, followed by 6 weeks of either concentric- or eccentric-only knee flexor training on an isokinetic dynamometer and finished with 28 days of detraining. Architectural characteristics of BFlf were assessed at rest and during graded isometric contractions utilizing two-dimensional ultrasonography at 28 days pre-baseline, baseline, days 14, 21 and 42 of the intervention and then again following 28 days of detraining. Results BFlf fascicle length was significantly longer in the eccentric training group (p<0.05, d range: 2.65 to 2.98) and shorter in the concentric training group (p<0.05, d range: -1.62 to -0.96) after 42 days of training compared to baseline at all isometric contraction intensities. Following the 28-day detraining period, BFlf fascicle length was significantly reduced in the eccentric training group at all contraction intensities compared to the end of the intervention (p<0.05, d range: -1.73 to -1.55). There was no significant change in fascicle length of the concentric training group following the detraining period. Conclusions These results provide evidence that short term resistance training can lead to architectural alterations in the BFlf. In addition, the eccentric training-induced lengthening of BFlf fascicle length was reversed and returned to baseline values following 28 days of detraining. The contraction mode specific adaptations in this study may have implications for injury prevention and rehabilitation.

Leveraging coherent distributed space-time codes for noncoherent communication in relay networks via training

For point to point multiple input multiple output systems, Dayal-Brehler-Varanasi have proved that training codes achieve the same diversity order as that of the underlying coherent space time block code (STBC) if a simple minimum mean squared error estimate of the channel formed using the training part is employed for coherent detection of the underlying STBC. In this letter, a similar strategy involving a combination of training, channel estimation and detection in conjunction with existing coherent distributed STBCs is proposed for noncoherent communication in Amplify-and-Forward (AF) relay networks. Simulation results show that the proposed simple strategy outperforms distributed differential space-time coding for AF relay networks. Finally, the proposed strategy is extended to asynchronous relay networks using orthogonal frequency division multiplexing.

Supporting the development and deployment of sustainable energy technologies through targeted scientific training

Sustainable energy technologies rely heavily on advanced materials and modern engineering controls. These promising new technologies cannot be reliably deployed without ensuring that there is a sufficient “capacity,” i.e., trained technical personnel with the expertise to implement, monitor, and maintain the energy infrastructure. This same capacity is critical to the local development of new technologies, especially those that respond directly to regional priorities, strengths, and needs. One way to build capacity is through targeted programs that integrate the training and development of locals at an advanced technical level. In practical terms, these programs usually produce a small number of highly educated individuals with skills in science and engineering. The goal of Part VI of this book is to highlight contributing factors in successfully operating capacity building programs.

From vision to actions: Towards adaptive and autonomous humanoid robots

Although robotics research has seen advances over the last decades robots are still not in widespread use outside industrial applications. Yet a range of proposed scenarios have robots working together, helping and coexisting with humans in daily life. In all these a clear need to deal with a more unstructured, changing environment arises. I herein present a system that aims to overcome the limitations of highly complex robotic systems, in terms of autonomy and adaptation. The main focus of research is to investigate the use of visual feedback for improving reaching and grasping capabilities of complex robots. To facilitate this a combined integration of computer vision and machine learning techniques is employed. From a robot vision point of view the combination of domain knowledge from both imaging processing and machine learning techniques, can expand the capabilities of robots. I present a novel framework called Cartesian Genetic Programming for Image Processing (CGP-IP). CGP-IP can be trained to detect objects in the incoming camera streams and successfully demonstrated on many different problem domains. The approach requires only a few training images (it was tested with 5 to 10 images per experiment) is fast, scalable and robust yet requires very small training sets. Additionally, it can generate human readable programs that can be further customized and tuned. While CGP-IP is a supervised-learning technique, I show an integration on the iCub, that allows for the autonomous learning of object detection and identification. Finally this dissertation includes two proof-of-concepts that integrate the motion and action sides. First, reactive reaching and grasping is shown. It allows the robot to avoid obstacles detected in the visual stream, while reaching for the intended target object. Furthermore the integration enables us to use the robot in non-static environments, i.e. the reaching is adapted on-the- fly from the visual feedback received, e.g. when an obstacle is moved into the trajectory. The second integration highlights the capabilities of these frameworks, by improving the visual detection by performing object manipulation actions.

Effects of the sensorimotor training volume on sensorimotor function in patients following lower limb arthroplasty

Background Sensorimotor function is degraded in patients after lower limb arthroplasty. Sensorimotor training is thought to improve sensorimotor skills, however, the optimal training stimulus with regard to volume, frequency, duration, and intensity is still unknown. The aim of this study, therefore, was to firstly quantify the progression of sensorimotor function after total hip (THA) or knee (TKA) arthroplasty and, as second step, to evaluate effects of different sensorimotor training volumes. Methods 58 in-patients during their rehabilitation after THA or TKA participated in this prospective cohort study. Sensorimotor function was assessed using a test battery including measures of stabilization capacity, static balance, proprioception, and gait, along with a self-reported pain and function. All participants were randomly assigned to one of three intervention groups performing sensorimotor training two, four, or six times per week. Outcome measures were taken at three instances, at baseline (pre), after 1.5 weeks (mid) and at the conclusion of the 3 week program (post). Results All measurements showed significant improvements over time, with the exception of proprioception and static balance during quiet bipedal stance which showed no significant main effects for time or intervention. There was no significant effect of sensorimotor training volume on any of the outcome measures. Conclusion We were able to quantify improvements in measures of dynamic, but not static, sensorimotor function during the initial three weeks of rehabilitation following TKA/THA. Although sensorimotor improvements were independent of the training volume applied in the current study, long-term effects of sensorimotor training volume need to be investigated to optimize training stimulus recommendations.

Murtuva säätyvalta, kestävä eliitti : Senaattori Lennart Gripenbergin sukupiiri ja sääty-yhteiskunnan muodonmuutos

This study examines the transformation of the society of estates in the Finnish Grand Duchy through the case study of Senator Lennart Gripenberg and his family circle. While national borders and state structures changed, the connections between old ruling elite families remained intact as invisible family networks, ownership relations, economic collaboration and power of military families. These were the cornerstones of trust, which helped to strengthen positions gained in society. Also, these connections often had a central if unperceivable impact on social development and modernization. Broadly speaking, the intergenerational social reproduction made it possible for this network of connections to remain in power and, as an imperceptible factor, also influenced short-term developments in the long run. Decisions which in the short term appeared unproductive, would in the long run produce cumulative immaterial and material capital across generations as long-term investments. Social mobility, then, is a process which clearly takes several generations to become manifest. The study explores long-term strategies of reproducing and transferring the capital accumulated in multinational elite networks. Also, what was the relationship of these strategies to social change? For the representatives of the military estate the nobility and for those men of the highest estates who had benefited from military training, this very education of a technical-military nature was the key to steering, controlling and dealing with the challenges following the industrial breakthrough. The disintegration of the society of estates and the rising educational standards also increased the influence of those professionals previously excluded, which served to intensify competition for positions of power. The family connections highlighted in this study overlapped in many ways, working side by side and in tandem to manage the economic and political life in Finland, Russia and Sweden. The analysis of these ties has opened up a new angle to economic co-operation, for example, as seen in the position of such family networks not only in Finnish, but also Swedish and Russian corporations and in the long historical background of the collaboration. This also highlights in a new way the role of women in transferring the cumulative social capital and as silent business partners. The marriage strategies evident in business life clearly had an impact on the economic life. The collaborative networks which transcended generations, national boundaries and structures also uncover, as far as the elites are concerned, serious problems in comparative studies conducted from purely national premises. As the same influential families and persons in effect held several leading positions in society, the line would blur between public and invisible uses of power. The power networks thus aimed to build monopolies to secure their key positions at the helm. This study therefore examines the roles of Lennart Gripenberg senator, business executive, superintendent of the Department of Industry, factory inspector, and founding member of industrial interest groups as part of the reproduction strategies of the elite. The family and other networks of the powerful leaders of society, distinguished by social, economic and cultural capital, provided a solid backdrop for the so-called old elites in their quest for strategies to reproducing power in a changing world. Crucially, it was easier for the elites to gain expertise to steer the modernization process and thereby secure for the next generation a leading position in society, something that they traditionally, too, had had the greatest interest in.

Male nursing students in training: A comparative analysis of hidden advantage and discrimination

Aim The aim of this study was to examine the lived experience of men training to be registered nurses within a regional New Zealand context. Design This study draws upon the key principles of descriptive phenomenology. Sample Five male students enrolled from the 1st and 3rd year of the BN programme. Findings - A Career with Prospects - Gender inequality by superiors; - Developing professional boundaries with female colleagues; - Being unique has its advantages.

Post-industrial Intervention : An Activity-Theoretical Expedition Tracing the Proximal Development of Forms of Conducting Interventions

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