Learning from triads: training undergraduates in counselling skills

Background: Research has shown that counselling skills training in undergraduate programmes is effective. However, there is potential that premature intimacy and disclosures during triad work may impact on relationships which must be maintained out-with the counselling component of the course. Little research has examined individual pedagogical practices within training. Aim: The aim of this research was to explore the experience of the practical skills training component of a counselling course for a cohort of undergraduate students, and the impact of this learning experience. The objective being an evaluation of the use of this approach for this group and of the impact of personal sharing within cohorts of undergraduates. Method: Semi-structured interviews focusing on the experience of skills training and self-disclosure during training were carried out on 12 undergraduates taking counselling skills modules as part of their BSc Psychology and Counselling degree. Thematic analysis was carried out on the interview transcripts. Results: As a result of engagement in skills training and acting as ‘clients’ for one another, individuals perceived the formation of a positive group identity with implicit ‘rules’, but also an impact of training on relationships within the group which relied on the ability to maintain boundaries and personal identities with peers, and this influenced the learning experience. The ability to manage their engagement on the programme was dependent on ongoing support and guidance from tutors. Discussion: While this pedagogical approach appears appropriate for facilitating learning and potentially provides a rich learning journey for undergraduate students, tutors must act proactively to ensure a safe learning environment.

Efficacy of a four-week uphill sprint training intervention in field hockey players

Current evidence increasingly suggests that very short, supra-maximal bouts of exercise can have significant health and performance benefits. The majority of research conducted in the area however, uses laboratory-based protocols, which can lack ecological validity. The purpose of this study was to examine the effects of a high intensity sprint-training programme on hockey related performance measures. 14 semi-professional hockey players completed either a 4-week high intensity training (HIT) intervention, consisting of a total of six sessions HIT, which progressively increased in volume (n=7), or followed their normal training programme (Con; n=7). Straight-line sprint speed with and without a hockey stick and ball, and slalom sprint speed, with and without a hockey stick and ball were used as performance indicators. Maximal sprint speed over 22.9m was also assessed. Upon completion of the four-week intervention, straight-line sprint speed improved significantly in the HIT group (~3%), with no change in performance for the Con group. Slalom sprint speed, both with and without a hockey ball was not significantly different following the training programme in either group. Maximal sprint speed improved significantly (12.1%) in the HIT group, but there was no significant performance change in the Con group. The findings of this study indicate that a short period of HIT can significantly improve hockey related performance measures, and could be beneficial to athletes and coaches in field settings.

3D Hand Pose Estimation by Finding Appearance-Based Matches in a Large Database of Training Views

Ongoing work towards appearance-based 3D hand pose estimation from a single image is presented. A large database of synthetic hand views is generated using a 3D hand model and computer graphics. The views display different hand shapes as seen from arbitrary viewpoints. Each synthetic view is automatically labeled with parameters describing its hand shape and viewing parameters. Given an input image, the system retrieves the most similar database views, and uses the shape and viewing parameters of those views as candidate estimates for the parameters of the input image. Preliminary results are presented, in which appearance-based similarity is defined in terms of the chamfer distance between edge images.

Specialized Mappings Architecture with Applications to Vision-based Estimation of Articulated Body Pose

A fundamental task of vision systems is to infer the state of the world given some form of visual observations. From a computational perspective, this often involves facing an ill-posed problem; e.g., information is lost via projection of the 3D world into a 2D image. Solution of an ill-posed problem requires additional information, usually provided as a model of the underlying process. It is important that the model be both computationally feasible as well as theoretically well-founded. In this thesis, a probabilistic, nonlinear supervised computational learning model is proposed: the Specialized Mappings Architecture (SMA). The SMA framework is demonstrated in a computer vision system that can estimate the articulated pose parameters of a human body or human hands, given images obtained via one or more uncalibrated cameras. The SMA consists of several specialized forward mapping functions that are estimated automatically from training data, and a possibly known feedback function. Each specialized function maps certain domains of the input space (e.g., image features) onto the output space (e.g., articulated body parameters). A probabilistic model for the architecture is first formalized. Solutions to key algorithmic problems are then derived: simultaneous learning of the specialized domains along with the mapping functions, as well as performing inference given inputs and a feedback function. The SMA employs a variant of the Expectation-Maximization algorithm and approximate inference. The approach allows the use of alternative conditional independence assumptions for learning and inference, which are derived from a forward model and a feedback model. Experimental validation of the proposed approach is conducted in the task of estimating articulated body pose from image silhouettes. Accuracy and stability of the SMA framework is tested using artificial data sets, as well as synthetic and real video sequences of human bodies and hands.

Multiplicative Kernels: Object Detection, Segmentation and Pose Estimation

Object detection is challenging when the object class exhibits large within-class variations. In this work, we show that foreground-background classification (detection) and within-class classification of the foreground class (pose estimation) can be jointly learned in a multiplicative form of two kernel functions. One kernel measures similarity for foreground-background classification. The other kernel accounts for latent factors that control within-class variation and implicitly enables feature sharing among foreground training samples. Detector training can be accomplished via standard SVM learning. The resulting detectors are tuned to specific variations in the foreground class. They also serve to evaluate hypotheses of the foreground state. When the foreground parameters are provided in training, the detectors can also produce parameter estimate. When the foreground object masks are provided in training, the detectors can also produce object segmentation. The advantages of our method over past methods are demonstrated on data sets of human hands and vehicles.

Learning a Family of Detectors

Object detection and recognition are important problems in computer vision. The challenges of these problems come from the presence of noise, background clutter, large within class variations of the object class and limited training data. In addition, the computational complexity in the recognition process is also a concern in practice. In this thesis, we propose one approach to handle the problem of detecting an object class that exhibits large within-class variations, and a second approach to speed up the classification processes. In the first approach, we show that foreground-background classification (detection) and within-class classification of the foreground class (pose estimation) can be jointly solved with using a multiplicative form of two kernel functions. One kernel measures similarity for foreground-background classification. The other kernel accounts for latent factors that control within-class variation and implicitly enables feature sharing among foreground training samples. For applications where explicit parameterization of the within-class states is unavailable, a nonparametric formulation of the kernel can be constructed with a proper foreground distance/similarity measure. Detector training is accomplished via standard Support Vector Machine learning. The resulting detectors are tuned to specific variations in the foreground class. They also serve to evaluate hypotheses of the foreground state. When the image masks for foreground objects are provided in training, the detectors can also produce object segmentation. Methods for generating a representative sample set of detectors are proposed that can enable efficient detection and tracking. In addition, because individual detectors verify hypotheses of foreground state, they can also be incorporated in a tracking-by-detection frame work to recover foreground state in image sequences. To run the detectors efficiently at the online stage, an input-sensitive speedup strategy is proposed to select the most relevant detectors quickly. The proposed approach is tested on data sets of human hands, vehicles and human faces. On all data sets, the proposed approach achieves improved detection accuracy over the best competing approaches. In the second part of the thesis, we formulate a filter-and-refine scheme to speed up recognition processes. The binary outputs of the weak classifiers in a boosted detector are used to identify a small number of candidate foreground state hypotheses quickly via Hamming distance or weighted Hamming distance. The approach is evaluated in three applications: face recognition on the face recognition grand challenge version 2 data set, hand shape detection and parameter estimation on a hand data set, and vehicle detection and estimation of the view angle on a multi-pose vehicle data set. On all data sets, our approach is at least five times faster than simply evaluating all foreground state hypotheses with virtually no loss in classification accuracy.

Eliminating Redundant Training Data Using Unsupervised Clustering Techniques

Training data for supervised learning neural networks can be clustered such that the input/output pairs in each cluster are redundant. Redundant training data can adversely affect training time. In this paper we apply two clustering algorithms, ART2 -A and the Generalized Equality Classifier, to identify training data clusters and thus reduce the training data and training time. The approach is demonstrated for a high dimensional nonlinear continuous time mapping. The demonstration shows six-fold decrease in training time at little or no loss of accuracy in the handling of evaluation data.

Equal citizenship for a new society? An analysis of training and employment opportunities for republican ex-prisoners in Belfast

Previous research evidence appears to suggest that while they suffer from similiar socio-economic problems to the wider nationalist community, the problems for republican ex-prisoners seem to be on a greater scale. The primary objective of this research was to investigate the current obstacles facing republication ex-prisoners in training and employment and to make proposals for change.

Training in and assessment of the procedural skills required to perform peripheral nerve blockade

The training and ongoing education of medical practitioners has undergone major changes in an incremental fashion over the past 15 years. These changes have been driven by patient safety, educational, economic and legislative/regulatory factors. In the near future, training in procedural skills will undergo a paradigm shift to proficiency based progression with associated requirements for competence-based programmes, valid, reliable assessment tools and simulation technology. Before training begins, the learning outcomes require clear definition; any form of assessment applied should include measurement of these outcomes. Currently training in a procedural skill often takes place on an ad hoc basis. The number of attempts necessary to attain a defined degree of proficiency varies from procedure to procedure. Convincing evidence exists that simulation training helps trainees to acquire skills more efficiently rather than relying on opportunities in their clinical practice. Simulation provides a safe, stress free environment for trainees for skill acquisition, generalization and transfer via deliberate practice. The work described in this thesis contributes to a greater understanding of how medical procedures can be performed more safely and effectively through education. The effect of feedback, provided to novices in a standardized setting on a bench model, based on knowledge of performance was associated with an increase in the speed of skill acquisition and a decrease in error rate during initial learning. The timing of feedback was also associated with effective learning of skill. A marked attrition of skills (independent of the type of feedback provided) was demonstrable 24 hrs after they have first been learned. Using the principles of feedback as described above, when studying the effect of an intense training program on novices of varied years of experience in anaesthesia (i.e. the present training programmes / courses of an intense training day for one or more procedures). There was a marked attrition of skill at 24 hours with a significant correlation with increasing years of experience; there also appeared to be an inverse relationship between years of experience in anaesthesia and performance. The greater the number of years of practice experience, the longer it required a learner to acquire a new skill. The findings of the studies described in this thesis may have important implications for the trainers, trainees and training bodies in the design and implementation of training courses and the formats of delivery of changing curricula. Both curricula and training modalities will need to take account of characteristics of individual learners and the dynamic nature of procedural healthcare.

Guidelines on the standards for the training of specialised health professionals dealing with breast cancer.

According to EUSOMA position paper 'The requirements of a specialist breast unit', each breast unit should have a core team made up of health professionals who have undergone specialist training in breast cancer. In this paper, on behalf of EUSOMA, authors have identified the standards of training in breast cancer, to harmonise and foster breast care training in Europe. The aim of this paper is to contribute to the increase in the level of care in a breast unit, as the input of qualified health professionals increases the quality of breast cancer patient care.

The lung cancer exercise training study: a randomized trial of aerobic training, resistance training, or both in postsurgical lung cancer patients: rationale and design.

BACKGROUND: The Lung Cancer Exercise Training Study (LUNGEVITY) is a randomized trial to investigate the efficacy of different types of exercise training on cardiorespiratory fitness (VO2peak), patient-reported outcomes, and the organ components that govern VO2peak in post-operative non-small cell lung cancer (NSCLC) patients. METHODS/DESIGN: Using a single-center, randomized design, 160 subjects (40 patients/study arm) with histologically confirmed stage I-IIIA NSCLC following curative-intent complete surgical resection at Duke University Medical Center (DUMC) will be potentially eligible for this trial. Following baseline assessments, eligible participants will be randomly assigned to one of four conditions: (1) aerobic training alone, (2) resistance training alone, (3) the combination of aerobic and resistance training, or (4) attention-control (progressive stretching). The ultimate goal for all exercise training groups will be 3 supervised exercise sessions per week an intensity above 70% of the individually determined VO2peak for aerobic training and an intensity between 60 and 80% of one-repetition maximum for resistance training, for 30-45 minutes/session. Progressive stretching will be matched to the exercise groups in terms of program length (i.e., 16 weeks), social interaction (participants will receive one-on-one instruction), and duration (30-45 mins/session). The primary study endpoint is VO2peak. Secondary endpoints include: patient-reported outcomes (PROs) (e.g., quality of life, fatigue, depression, etc.) and organ components of the oxygen cascade (i.e., pulmonary function, cardiac function, skeletal muscle function). All endpoints will be assessed at baseline and postintervention (16 weeks). Substudies will include genetic studies regarding individual responses to an exercise stimulus, theoretical determinants of exercise adherence, examination of the psychological mediators of the exercise - PRO relationship, and exercise-induced changes in gene expression. DISCUSSION: VO2peak is becoming increasingly recognized as an outcome of major importance in NSCLC. LUNGEVITY will identify the optimal form of exercise training for NSCLC survivors as well as provide insight into the physiological mechanisms underlying this effect. Overall, this study will contribute to the establishment of clinical exercise therapy rehabilitation guidelines for patients across the entire NSCLC continuum. TRIAL REGISTRATION: NCT00018255.

Rationale and design of the Exercise Intensity Trial (EXCITE): A randomized trial comparing the effects of moderate versus moderate to high-intensity aerobic training in women with operable breast cancer.

BACKGROUND: The Exercise Intensity Trial (EXcITe) is a randomized trial to compare the efficacy of supervised moderate-intensity aerobic training to moderate to high-intensity aerobic training, relative to attention control, on aerobic capacity, physiologic mechanisms, patient-reported outcomes, and biomarkers in women with operable breast cancer following the completion of definitive adjuvant therapy. METHODS/DESIGN: Using a single-center, randomized design, 174 postmenopausal women (58 patients/study arm) with histologically confirmed, operable breast cancer presenting to Duke University Medical Center (DUMC) will be enrolled in this trial following completion of primary therapy (including surgery, radiation therapy, and chemotherapy). After baseline assessments, eligible participants will be randomized to one of two supervised aerobic training interventions (moderate-intensity or moderate/high-intensity aerobic training) or an attention-control group (progressive stretching). The aerobic training interventions will include 150 mins.wk⁻¹ of supervised treadmill walking per week at an intensity of 60%-70% (moderate-intensity) or 60% to 100% (moderate to high-intensity) of the individually determined peak oxygen consumption (VO₂peak) between 20-45 minutes/session for 16 weeks. The progressive stretching program will be consistent with the exercise interventions in terms of program length (16 weeks), social interaction (participants will receive one-on-one instruction), and duration (20-45 mins/session). The primary study endpoint is VO₂peak, as measured by an incremental cardiopulmonary exercise test. Secondary endpoints include physiologic determinants that govern VO₂peak, patient-reported outcomes, and biomarkers associated with breast cancer recurrence/mortality. All endpoints will be assessed at baseline and after the intervention (16 weeks). DISCUSSION: EXCITE is designed to investigate the intensity of aerobic training required to induce optimal improvements in VO₂peak and other pertinent outcomes in women who have completed definitive adjuvant therapy for operable breast cancer. Overall, this trial will inform and refine exercise guidelines to optimize recovery in breast and other cancer survivors following the completion of primary cytotoxic therapy. TRIAL REGISTRATION: NCT01186367.

WriteSim TCExam--an open source text simulation environment for training novice researchers in scientific writing.

BACKGROUND: The ability to write clearly and effectively is of central importance to the scientific enterprise. Encouraged by the success of simulation environments in other biomedical sciences, we developed WriteSim TCExam, an open-source, Web-based, textual simulation environment for teaching effective writing techniques to novice researchers. We shortlisted and modified an existing open source application - TCExam to serve as a textual simulation environment. After testing usability internally in our team, we conducted formal field usability studies with novice researchers. These were followed by formal surveys with researchers fitting the role of administrators and users (novice researchers) RESULTS: The development process was guided by feedback from usability tests within our research team. Online surveys and formal studies, involving members of the Research on Research group and selected novice researchers, show that the application is user-friendly. Additionally it has been used to train 25 novice researchers in scientific writing to date and has generated encouraging results. CONCLUSION: WriteSim TCExam is the first Web-based, open-source textual simulation environment designed to complement traditional scientific writing instruction. While initial reviews by students and educators have been positive, a formal study is needed to measure its benefits in comparison to standard instructional methods.

Application description and policy model in collaborative environment for sharing of information on epidemiological and clinical research data sets.

BACKGROUND: Sharing of epidemiological and clinical data sets among researchers is poor at best, in detriment of science and community at large. The purpose of this paper is therefore to (1) describe a novel Web application designed to share information on study data sets focusing on epidemiological clinical research in a collaborative environment and (2) create a policy model placing this collaborative environment into the current scientific social context. METHODOLOGY: The Database of Databases application was developed based on feedback from epidemiologists and clinical researchers requiring a Web-based platform that would allow for sharing of information about epidemiological and clinical study data sets in a collaborative environment. This platform should ensure that researchers can modify the information. A Model-based predictions of number of publications and funding resulting from combinations of different policy implementation strategies (for metadata and data sharing) were generated using System Dynamics modeling. PRINCIPAL FINDINGS: The application allows researchers to easily upload information about clinical study data sets, which is searchable and modifiable by other users in a wiki environment. All modifications are filtered by the database principal investigator in order to maintain quality control. The application has been extensively tested and currently contains 130 clinical study data sets from the United States, Australia, China and Singapore. Model results indicated that any policy implementation would be better than the current strategy, that metadata sharing is better than data-sharing, and that combined policies achieve the best results in terms of publications. CONCLUSIONS: Based on our empirical observations and resulting model, the social network environment surrounding the application can assist epidemiologists and clinical researchers contribute and search for metadata in a collaborative environment, thus potentially facilitating collaboration efforts among research communities distributed around the globe.