Review of Apprenticeship Training in Ireland

On 19 May 2013, Ruairi Quinn T.D, Minister for Education and Skills, announced a review of apprenticeship training in Ireland. The terms of reference of the review were “to determine whether the current model of apprenticeship should be retained, adapted or replaced by an alternative model of vocational education and training for apprentices –taking into account the needs of learners, the needs of employers, the needs of the economy and the need for cost effectiveness into the future.” The Review Group was asked to complete its work before the end of 2013. A Technical Group was also established to provide background evaluative data for the review. To provide a context for the review, a Background Issues Paper 1 was prepared by the Department of Education and Skills and published at www.education.ie in May 2013 .

Enseignement prégradué de la médecine ambulatoire a la PMU: quelques repères [Pregraduate training in ambulatory care: a Swiss perspective].

The current lack of general practitioners in Switzerland is the result of health care policy which aimed in the past years to reduce the number of medical students and physicians in private practice. Furthermore, during the past decades, the Swiss Medical Schools emphasized on the transmission of medical care by specialists and neglected primary care medicine. The Faculty of medicine at the University of Lausanne recently decided to renew the curriculum. The Department of ambulatory care and community medicine (Policlinique Médicale Universitaire) of Lausanne is committed to the elaboration of this move. The biomedical model, essential to the acquisition of clinical competence, is still taught to the students. Nevertheless, from the beginning to the end of the curriculum, an emphasis is now put on the clinical skills and the clinical reasoning.

Maximal lipid oxidation during exercise: a target for individualizing endurance training in obesity and diabetes?

This review summarizes the rationale for personalized exercise training in obesity and diabetes, targeted at the level of maximal lipid oxidation as can be determined by exercise calorimetry. This measurement is reproducible and reflects muscles' ability to oxidize lipids. Targeted training at this level is well tolerated, increases the ability to oxidize lipids during exercise and improves body composition, lipid and inflammatory status, and glycated hemoglobin, thus representing a possible future strategy for exercise prescription in patients suffering from obesity and diabetes.

Adherence and perceptions regarding simulation training in undergraduate health Sciences

BACKGROUND: Simulation techniques are spreading rapidly in medicine. Suc h resources are increasingly concentrated in Simulation Laboratories. The MSRP-USP is structuring such a laboratory and is interested in the prevalence of individual initiatives that could be centralized there. The MSRP-USP currently has five full-curriculum courses in the health sciences: Medicine, Speech Therapy, Physical Therapy, Nutrition, and Occupational Therapy, all consisting of core disciplines. GOAL: To determine the prevalence of simulation techniques in the regular courses at MSRP-USP. METHODS: Coordinators of disciplines in the various courses were interviewed using a specifically designed semi-structured questionnaire, and all the collected data were stored in a dedicated database. The disciplines were grouped according to whether they used (GI) or did not use (GII) simulation resources. RESULTS AND DISCUSSION: 256 disciplines were analyzed, of which only 18.3% used simulation techniques, varying according to course: Medicine (24.7.3%), Occupational Therapy (23.0%), Nutrition (15.9%), Physical Therapy (9.8%), and Speech Therapy (9.1%). Computer simulation programs predominated (42.5%) in all five courses. The resources were provided mainly by MSRP-USP (56.3%), with additional funding coming from other sources based on individual initiatives. The same pattern was observed for maintenance. There was great interest in centralizing the resources in the new Simulation Laboratory in order to facilitate maintenance, but there was concern about training and access to the material. CONCLUSIONS: 1) The MSRP-USP simulation resources show low complexity and are mainly limited to computer programs; 2) Use of simulation varies according to course, and is most prevalent in Medicine; 3) Resources are scattered across several locations, and their acquisition and maintenance depend on individual initiatives rather than central coordination or curricular guidelines

Device model for training of laparoscopic surgical skills

The authors present a especially constructed, lightweight, collapsible, portable and low cost model device for skills training in laparoscopic.

Group cognitive behavior therapy for bipolar disorder can improve the quality of life

Bipolar disorder (BD) can have an impact on psychosocial functioning and quality of life (QoL). Several studies have shown that structured psychotherapy in conjunction with pharmacotherapy may modify the course of some disorders; however, few studies have investigated the results of group cognitive behavior therapy (G-CBT) for BD. Our objective was to evaluate the effectiveness of 14 sessions of G-CBT for BD patients, comparing this intervention plus pharmacotherapy to treatment as usual (TAU; only pharmacotherapy). Forty-one patients with BD I and II participated in this study and were randomly allocated to each group (G-CBT: N = 27; TAU: N = 14). Thirty-seven participants completed the treatment (women: N = 66.67%; mean age = 41.5 years). QoL and mood symptoms were assessed in all participants. Scores changed significantly by the end of treatment in favor of the G-CBT group. The G-CBT group presented significantly better QoL in seven of the eight sub-items assessed with the Medical Outcomes Survey SF-36 scale. At the end of treatment, the G-CBT group exhibited lower scores for mania (not statistically significant) and depression (statistically significant) as well as a reduction in the frequency and duration of mood episodes (P < 0.01). The group variable was significant for the reduction of depression scores over time. This clinical change may explain the improvement in six of the eight subscales of QoL (P < 0.05). The G-CBT group showed better QoL in absolute values in all aspects and significant improvements in nearly all subscales. These results were not observed in the TAU control group.

Effectiveness of Self-Instructional Mediator Training in Applied Behaviour Analysis

Interventions using applied behaviour analysis (ABA) are widely used with children with autism spectrum disorders (ASD). Individuals who work with this population are important to target for ABA education. This study evaluated the efficacy of a self-directed program in increasing parent and student ABA knowledge and skills, self-efficacy, and new skill development in children with ASD. Study 1 was a pilot study of the newly developed evaluation materials. Study 2 tested the self-instructional package with three parents of children with ASD, three university students, and eight children diagnosed with ASD. Parents and students were given the Simple Steps ABA training package to use independently and were measured using a multiple baseline across participants and/or skills design. After training, ABA knowledge scores and self-efficacy showed variable improvement as did children’s appropriate behaviours. These results suggest that more research is needed to determine the efficacy of a self-instructional ABA package.

Marine Engineering Training in India -A Pedagogic Introspection

Indian marine engineers are renowned for employment globally due to their knowledge, skill and reliability. This praiseworthy status has been achieved mainly due to the systematic training imparted to marine engineering cadets. However, in an era of advancing technology, marine engineering training has to remain dynamic to imbibe latest technology as well as to meet the demands of the shipping industry. New subjects of studies have to be included in the curriculum in a timely manner taking into consideration the industry requirements and best practices in shipping. Technical competence of marine engineers also has to be subjected to changes depending upon the needs of the ever growing and over regulated shipping industry. Besides. certain soft skills are to be developed and improved amongst the marine engineers in order to alter or amend the personality traits leading to their career success.If timely corrective action is taken. Indian marine engineers can be in still greater demand for employment in global maritime field. In order to enhance the employability of our mmine engineers by improving their quality, a study of marine engineers in general and class IV marine engineers in particular was conducted based on three distinct surveys, viz., survey among senior marine engineers, survey among employers of marine engineers and survey of class IV marine engineers themselves.The surveys have been planned and questionnaires have been designed to focus the study of marine engineer officer class IV from the point of view of the three distinct groups of maritime personnels. As a result of this, the strength and weakness of class IV marine engineers are identified with regard to their performance on board ships, acquisition of necessary technical skills. employability and career success. The criteria of essential qualities of a marine engineer are classified as academic, technical, social, psychological. physical, mental, emergency responsive, communicative and leadership, and have been assessed for a practicing marine engineer by statistical analysis of data collected from surveys. These are assessed for class IV marine engineers from the point of view of senior marine engineers and employers separately. The Endings are delineated and graphically depicted in this thesis.Besides. six pertinent personality traits of a marine engineer viz. self esteem. learning style. decision making. motivation. team work and listening self inventory have been subjected to study and their correlation with career success have been established wherever possible. This is carried out to develop a theoretical framework to understand what leads a marine engineer to his career attainment. This enables the author to estimate the personality strengths and weaknesses of a serving marine engineer and eventually to deduce possible corrective measures or modifications in marine engineering training in India.Maritime training is largely based on International Conventions on Standard of Training. Certification and Watch keeping for Seafarers 1995. its associated Code and Merchant Shipping (STCW for Seafarers) Rules 1998. Further, Maritime Education, Training and Assessment (META) Manual was subjected to a critical scrutiny and relevant Endings of thc surveys arc superimposed on the existing rule requirement and curriculum. Views of senior marine engineers and executives of various shipping companies are taken into account before arriving at the revision of syllabus of marine engineering courses. Modifications in the pattern of workshop and sea service for graduate mechanical engineering trainees are recommended. Desirable age brackets of junior engineers and chief engineers. use of Training and Assessment Record book (TAR Book) during training etc. have also been evaluated.As a result of the pedagogic introspection of the existing system of marine engineering training in India. in this thesis, a revised pattern of workshop training of six months duration for graduate mechanical engineers. revised pattern of sea service training of one year duration and modified now diagram incorporating the above have been arrived at. Effects of various personality traits on career success have been established along with certain findings for improvement of desirable personality traits of marine engineers.

Cognitive-behavior therapy for low self-esteem: a case example

Low self-esteem is a common, disabling, and distressing problem that has been shown to be involved in the etiology and maintenance of range of Axis I disorders. Hence, it is a priority to develop effective treatments for low self-esteem. A cognitive-behavioral conceptualization of low self-esteem has been proposed and a cognitive-behavioral treatment (CBT) program described (Fennell, 1997, 1999). As yet there has been no systematic evaluation of this treatment with routine clinical populations. The current case report describes the assessment, formulation, and treatment of a patient with low self-esteem, depression, and anxiety symptoms. At the end of treatment (12 sessions over 6 months), and at 1-year follow-up, the treatment showed large effect sizes on measures of depression, anxiety, and self-esteem. The patient no longer met diagnostic criteria for any psychiatric disorder, and showed reliable and clinically significant change on all measures. As far as we are aware, there are no other published case studies of CBT for low self-esteem that report pre- and posttreatment evaluations, or follow-up data. Hence, this case provides an initial contribution to the evidence base for the efficacy of CBT for low self-esteem. However, further research is needed to confirm the efficacy of CBT for low self-esteem and to compare its efficacy and effectiveness to alternative treatments, including diagnosis-specific CBT protocols.

Radically open-dialectical behavior therapy for adult anorexia nervosa: feasibility and outcomes from an inpatient program

Background Anorexia Nervosa (AN) is a highly life-threatening disorder that is extremely difficult to treat. There is evidence that family-based therapies are effective for adolescent AN, but no treatment has been proven to be clearly effective for adult AN. The methodological challenges associated with studying the disorder have resulted in recommendations that new treatments undergo preliminary testing prior to being evaluated in a randomized clinical trial. The aim of this study was to provide preliminary evidence on the effectiveness of a treatment program based on a novel adaptation of Dialectical Behavior Therapy (DBT) for adult Anorexia Nervosa (Radically Open-DBT; RO-DBT) that conceptualizes AN as a disorder of overcontrol. Methods Forty-seven individuals diagnosed with Anorexia Nervosa-restrictive type (AN-R; mean admission body mass index = 14.43) received the adapted DBT inpatient program (mean length of treatment = 21.7 weeks). Results Seventy-two percent completed the treatment program demonstrating substantial increases in body mass index (BMI; mean change in BMI = 3.57) corresponding to a large effect size (d = 1.91). Thirty-five percent of treatment completers were in full remission, and an additional 55% were in partial remission resulting in an overall response rate of 90%. These same individuals demonstrated significant and large improvements in eating-disorder related psychopathology symptoms (d = 1.17), eating disorder-related quality of life (d = 1.03), and reductions in psychological distress (d = 1.34). Conclusions RO-DBT was associated with significant improvements in weight gain, reductions in eating disorder symptoms, decreases in eating-disorder related psychopathology and increases in eating disorder-related quality of life in a severely underweight sample. These findings provide preliminary support for RO-DBT in treating AN-R suggesting the importance of further evaluation examining long-term outcomes using randomized controlled trial methodology.

Facilitation of learning in specialist nursing training in the PICU : the supervisors´ concerns in the learning situation

With the aim to unfold nurses’ concerns of the supervision of the student in the clinical caring situation of the vulnerable child, clinical nurses situated supervision of postgraduate nursing students in the Pediatric Intensive Care Unit (PICU) are explored. A qualitative approach, interpretive phenomenology, with participant observations and narrative interviews, was used. Two qualitative variations of patterns of meaning for the nurses’ clinical facilitation were disclosed in this study. Learning by doing theme supports the students learning by doing through performing skills and embracing routines. The reflecting theme supports thinking and awareness of the situation. As the supervisor often serves as a role model for the student this might have an immediate impact on how the student applies nursing care in the beginning of his or her career. If the clinical supervisor narrows the perspective and hinders room for learning the student will bring less knowledge from the clinical education than expected, which might result in reduced nursing quality.

PRODUCTION of FREE RADICALS and CATALASE ACTIVITY DURING ACUTE EXERCISE TRAINING IN YOUNG MEN

Reactive oxygen species (ROS) are constantly produced by cells that promote cellular oxidative damage and are neutralized by an antioxidant system including superoxide dismutase, glutathione, peroxidase and catalase. Male volunteers were exercised for 20 minutes, three days (60, 70 and 80% of maximum heart rate). Catalase activity and plasma malondialdehyde concentration were measured. The mean age of the volunteers was 25 +/- 7 years, with body mass index 2 of 24.03 +/- 4.32 kg/m(2). Acute exercise training produced an increase of malondialdehyde concentration that was exercise intensity-dependent in young volunteers. However, catalase activity shows a great variability at baseline and the percentual of reduction was exercise intensity-independent in this particular population. Therefore, our study shows that acute cycling exercise promotes an increase of oxidative stress that was exercise intensity-dependent in young volunteers. Furthermore, the antioxidant system measured by catalase activity was effective to counterbalance the ROS production showing a saturation behavior at an intensity of 70% of maximum heart rate.

The effects of elastic tubing-based resistance training compared with conventional resistance training in patients with moderate chronic obstructive pulmonary disease: a randomized clinical trial

Objective: To investigate the effects of elastic tubing training compared with conventional resistance training on the improvement of functional exercise capacity, muscle strength, fat-free mass, and systemic inflammation in patients with chronic obstructive pulmonary disease.Design: A prospective, randomized, eight-week clinical trial.Setting: The study was conducted in a university-based, outpatient, physical therapy clinic.Subjects: A total of 49 patients with moderate chronic obstructive pulmonary disease.Interventions: Participants were randomly assigned to perform elastic tubing training or conventional resistance training three times per week for eight weeks.Main measures: The primary outcome measure was functional exercise capacity. The secondary outcome measures were peripheral muscle strength, health-related quality of life assessed by the Chronic Respiratory Disease Questionnaire (CRDQ), fat-free mass, and cytokine profile.Results: After eight weeks, the mean distance covered during six minutes increased by 73 meters (69) in the elastic tubing group and by 42 meters (+/- 59) in the conventional group (p < 0.05). The muscle strength and quality of life improved in both groups (P < 0.05), with no significant differences between the groups. There was a trend toward an improved fat-free mass in both groups (P = 0.05). After the first and last sessions, there was an increase in interleukin 1 (IL-1) and interleukin 10 (IL-10) in both groups, while tumour necrosis factor alpha (TNF-) was stimulated only in the conventional training group.Conclusion: Elastic tubing training had a greater effect on functional exercise capacity than conventional resistance training. Both interventions were equally effective in improving muscle strength and quality of life.

Multidisciplinary approach in the teaching of dental sculpture and anatomy

The purpose of the Dental Sculpture and Anatomy discipline is to introduce undergraduate students to the study of the anatomic and morphological characteristics of permanent and primary human dentition, through classes, books and cognitive and psychomotor activities. This discipline supports the teaching of specific knowledge necessary for a more extensive education, involving interdisciplinarity as a means of knowledge exchange among several areas of dentistry, to achieve comprehensive professional education. Students must recognize the dental morphology from samples of preserved teeth, and reproduce the morphology through three-dimensional models made of stone or wax blocks. In this article, the authors describe the process for producing teeth collars and macro dental models made of stone, their importance and benefits of utilization. The purpose of the study was to encourage the teaching of Dental Sculpture and Anatomy toundergraduate students of the Bauru School of Dentistry, University of Sao Paulo, through activities that would associate theory, practice and the development of manual skills.