Risk of bias and reporting practices in studies comparing VO2max responses to sprint interval vs.continuous training:A systematic review and meta-analysis

Background:It remains unclear whether studies comparing _(max)imal oxygen uptake(VO_(2max))response to sprint interval training(SIT)vs.moderate-intensity continuous training(MICT)are associated with a high risk of bias and poor reporting quality.The purpose of this study was to evaluate the risk of bias and quality of reporting in studies comparing changes in VO_(2max) between SIT and MICT.Methods:We conducted a comprehensive literature search of 4 major databases:AMED,CINAHL,EMBASE,and MEDLINE.Studies were excluded if participants were not healthy adult humans or if training protocols were unsupervised,lasted less than 2 weeks,or utilized mixed exercise modalities.We used the Cochrane Collaboration tool and the CONSORT checklist for non-pharmacological trials to evaluate the risk of bias and reporting quality,respectively.Results:Twenty-eight studies with 30 comparisons(3 studies included 2 SIT groups)were included in our meta-analysis(n=360 SIT participants:body mass index(BMI)=25.9±3.7 kg/m^(2),baseline VO_(2max)=37.9±8.0 mL/kg/min;n=359 MICT participants:BMI=25.5±3.8 kg/m^(2),baseline VO_(2max)=38.3±8.0 mL/kg/min;all mean±SD).All studies had an unclear risk of bias and poor reporting quality.Conclusion:Although we observed a lack of superiority between SIT and MICT for improving VO_(2max)(weighted Hedge’s g=0.004,95%con-fidence interval(95%CI):-0.08 to 0.07),the overall unclear risk of bias calls the validity of this conclusion into question.Future studies using robust study designs are needed to interrogate the possibility that SIT and MICT result in similar changes in VO_(2max).

Evaluation of Clinician Training in Autism Screening, Care Management, and Patient Education

Objective: The demand for pediatric developmental evaluations has far exceeded the workforce available to perform them, which creates long significant wait times for services. A year-long clinician training using the Extension for Community Healthcare Outcomes (ECHO®) model with monthly meetings was conducted and evaluated for its impact on primary care clinicians’ self-reported self-efficacy, ability to administer autism screening and counsel families, professional fulfillment, and burnout. Methods: Participants represented six community health centers and a hospital-based practice. Data collection was informed by participant feedback and the Normalization Process Theory via online surveys and focus groups/interviews. Twelve virtual monthly trainings were delivered between November 2020 and October 2021. Results: 30 clinicians participated in data collection. Matched analyses (n = 9) indicated statistically significant increase in self-rated ability to counsel families about autism (Pre-test Mean = 3.00, Post-test Mean = 3.89, p = 0.0313), manage autistic patients’ care (Pre-test Mean = 2.56, Post-test Mean = 4.11, p = 0.0078), empathy toward patients (Pre-test Mean = 2.11, Post-test Mean = 1.22, p = 0.0156) and colleagues (Pre-test Mean = 2.33, Post-test Mean = 1.22, respectively, p = 0.0391). Unmatched analysis revealed increases in participants confident about educating patients about autism (70.59%, post-test n = 12 vs. 3.33%, pre-test n = 1, p = 0.0019). Focus groups found increased confidence in using the term “autism”. Conclusion: Participants reported increases in ability and confidence to care for autistic patients, as well as empathy toward patients and colleagues. Future research should explore long-term outcomes in participants’ knowledge retention, confidence in practice, and improvements to autism evaluations and care.

Research on Training Needs,Training Transfer,and Training Effectiveness of In-Service Teachers in Local Normal Colleges

This study aims to understand the in-service training needs,training transfer,and training effectiveness of teachers in local normal universities in China,while also proposing a continuous professional development plan for teachers.Descriptive research methods were employed,with questionnaires serving as the primary data collection tool.The survey revealed that the educational background of teachers in local normal universities is characterized by an unreasonable distribution of academic qualifications,with a shortage of teachers holding postgraduate and higher degrees.Additionally,the training effectiveness for female teachers was found to be lower than that of male teachers.There is a lack of personalization in training needs,which tends to be more generalized.The transfer effect of training is moderate,and there is a need for further enhancement at the behavioral level of training effectiveness.A continuous professional development plan for teachers has been formulated to improve training effectiveness and promote professional development.

Timing theory continuous nursing,resistance training:Rehabilitation and mental health of caregivers and stroke patients with traumatic fractures

BACKGROUND Stroke is the leading cause of adult lifelong disability worldwide.A stroke is an acute cerebrovascular disease with a variety of causes and corresponding clinical symptoms.Around 75%of surviving stroke patients experience impaired nerve function,and some suffer from traumatic fractures,which can lead to special care needs.AIM To determine the effect of timing theory continuous care,with resistance training,on the rehabilitation and mental health of caregivers and stroke patients with traumatic fractures.METHODS Between January 2017 to March 2021,we selected 100 hospital admissions with post-stroke hemiplegia complicated with a traumatic fracture.Two participant groups were created:(1)Control group:given resistance training;and(2)Observation group:given timing theory continuous care combined with resistance training.The degree of satisfaction and differences in bone and phosphorus metabolism indexes between the two groups were compared.The self-perceived burden scale(SPBS)and caregiver burden questionnaire were used to evaluate the psychological health of patients and caregivers.The Harris hip function score,ability of daily living(ADL)scale,and global quality of life questionnaire(GQOL-74)were used to evaluate hip function,ability of daily living,and quality of life.RESULTS Data were collected prior to and after intervention.Alkaline phosphatase(ALP),osteocalcin,and vitamin D3 in the observation group and control group increased after intervention(P<0.05),and carboxy-terminal peptide of type I collagenβSpecial sequence(β-CTX)decreased(P<0.05).ALP and osteocalcin in the observation group were higher than in the control group(P<0.05).There was no significant difference inβ-CTX and vitamin D3 between the two groups(P>0.05).The SPBS score of the observation group was lower and the ADL score was higher than the control group.The burden score was lower and the Harris hip function and GQOL-74 scores were higher than that of the control group(P<0.05).The observation group’s satisfaction rating was 94.00%,which was higher than the rating from the control group(P<0.05).CONCLUSION Timing theory continuous nursing with resistance training can reduce hip dysfunction in stroke patients with a traumatic fracture and enhance quality of life and mental health of patients and caregivers.

Efficiency Evaluation of Continuously Variable Transmissions Including a Planetary Gear Train

With their advantages, continuously variable transmissions have gained more popularity in the last decade by their use in mechanical transmission systems. The present paper aims to analysis the efficiency of the transmission based on the mechanical efficiency of the planetary gear train integrated in such transmission. In this analysis, we consider the mechanical efficiency of the transmission has been determined considering how the efficiency of the CVT members changes as a function of the operating conditions. The efficiency of the planetary gear train as a function of the configuration, speeds in his three input/output shafts, and also with respect to the power flow type. Results are compared with those obtained from other methods performance evaluation of the transmission, available in the literature.

Roles of Training Materials in Continuing Education of EFL Teachers

In the continuing education of EFL teachers, a set of standardized and systematic training materials is vitally needed. And such a set of training materials will be distinctive for the multi-dimensions and the inter-activities. When taking into account the two aspects, we argue that the training materials should consist of four features classified as: an instrument of skill-training, a conveyor for theory-inputting, a guide to methodology-practising and a motivator of interactivity-promoting. And the four will be integrated in an organic whole so as to accomplish the mission in refreshing school teachers’ English skills, renewing their concepts, and developing their teaching potential and their awareness in research-based teaching.

Exercise training in heart transplantation

Heart transplantation remains the gold standard in the treatment of end-stage heart failure(HF).Heart transplantation patients present lower exercise capacity due to cardiovascular and musculoskeletal alterations leading thus to poor quality of life and reduction in the ability of daily self-service.Impaired vascular function and diastolic dysfunction cause lower cardiac output while decreased skeletal muscle oxidative fibers,enzymes and capillarity cause arteriovenous oxygen difference,leading thus to decreased peak oxygen uptake in heart transplant recipients.Exercise training improves exercise capacity,cardiac and vascular endothelial function in heart transplant recipients.Pre-rehabilitation regular aerobic or combined exercise is beneficial for patients with end-stage HF awaiting heart transplantation in order to maintain a higher fitness level and reduce complications afterwards like intensive care unit acquired weakness or cardiac cachexia.All hospitalized patients after heart transplantation should be referred to early mobilization of skeletal muscles through kinesiotherapy of the upper and lower limbs and respiratory physiotherapy in order to prevent infections of the respiratory system prior to hospital discharge.Moreover,all heart transplant recipients after hospital discharge who have not already participated in an early cardiac rehabilitation program should be referred to a rehabilitation center by their health care provider.Although high intensity interval training seems to have more benefits than moderate intensity continuous training,especially in stable transplant patients,individualized training based on the abilities and needs of each patient still remains the most appropriate approach.Cardiac rehabilitation appears to be safe in heart transplant patients.However,long-term follow-up data is incomplete and,therefore,further high quality and adequately-powered studies are needed to demonstrate the long-term benefits of exercise training in this population.

The need analysis of backbone civilian nurses post-oriented education training in China

To learn about the need of post-oriented education training of backbone civilian nurses,and to provide scientific evidence for the promotion of training. Methods The convenience sampling method was performed,and an anonymous survey on 324 nurses who participated in the "backbone civilian nurses training program"from September 2013 to October 2015 was carried out by using self-made questionnaire.Results(1)Among the 324 nurses,12. 04% of them volunteered to participate in the training and 87. 96%were sent by their departments.(2)More than 90% of training contents met their needs.(3)The training methods in demand included theoretical classroom teaching,clinical observation and probation,seminars,clinical management practice,clinical problem discussion and clinical nursing practice(4)The training period suggested by most nurses was about 2 to 4 weeks. Conclusion It is important to strengthen the significance of post-oriented education training and to improve the quality and capacity of civilian through scientific education design and practical training programs.

Health Training Needs at Primary Care Level Health Facilities in Rural Western Uganda

Introduction: Continual education is recognized worldwide as a tool for the professional development of health care practitioners. It is however effective when the training targets the appropriate needs of the target beneficiaries. This study was therefore aimed at identifying priority training needs of Primary Care Level health professionals in rural Western Uganda. Methods: This was a descriptive cross-sectional survey among 35 rural community health facilities represented by their managers in rural Western Uganda. Participants were invited to Mbarara University of Science and Technology and responded to a self-administered questionnaire and also participated in qualitative group discussions guided by Facilitators from the Community Based Education and Research Services unit within the Community Health Department of Mbarara University of Science and Technology. Priority health training needs were determined based on the computed weighted scores. Results: The majority of managers of rural primary care level health facilities were medical officers by the level of training (51.43%) and male by gender (68.57%). Priority health training needs identified were child health and maternal health with total weighted scores of 12.0 and 10.9 respectively. Qualitatively, emerging themes included;leadership and management, and supervisory roles during student field attachments. Conclusion: Priority health training needs at rural Primary Care level health facilities were child health, maternal health, leadership and management, and supervisory skills. There is dire need to train rural primary care level, health professionals. In-service training based on identified needs should be offered by MUST in partnership with regional stakeholders. This is likely to enhance the quality of services provided by rural primary care level health facilities.

基于结构性问题培养全科医生深度思考能力的方法研究

背景住院医师规范化培训的全科学员在各临床专科轮转时间短暂,学习内容宽泛,需要增强学习自主性。全科师资会面临不同背景学员,如5+3、转岗、专业硕士,或3+2助理全科、实习医生、公共卫生学员等,如何在培训中,使不同培训对象能各取所需,达到应有培训效果,需要认真研究。目的探索基于结构性问题的培训方式,提高学员学习主动性,培养其深度思考能力的作用。方法选取2020年江苏省全科/助理全科骨干师资培训班(骨干师资班)和基层卫生人才能力提升培训班(基层人才班)的学员作为研究对象。在每次学习活动结束,即刻组织学员讨论,要求依次回答“通过学习1.你学到了什么?2.还有哪些疑问?3.既往有什么相同或者类似的经验与大家分享?4.对今后工作的启发?”根据上述问题思路自行设计调查问卷调查培训学员对结构性问题培训方式的认同度,分为第1部分一般资料,包括性别、学历、职称、工作单位、岗位、工作年限、参与培训的项目等;第2部分是对“问题1、问题2、问题3、问题4和培训形式5”的解释性问题,5个维度共计20个条目,备选项是四等级,赋值为“1=非常同意,2=同意,3=不太同意,4=完全不同意”。结果培训对象对所有条目选择同意与非常同意的百分比均大于95%。不同性别、年龄、职称、岗位、工作年限培训学员等对结构性问题培训方法的认同程度比较,差异无统计学意义(P>0.05);不同学历、工作单位和培训项目培训学员对结构性问题培训方法的认同程度比较,差异有统计学意义(P<0.05)。相较于研究生及以上学历,本科培训对象对问题3、问题4的认同程度更高(P<0.05)。相较于三级医院,城市社区卫生服务中心(乡镇卫生院)和二级医院的培训对象对于问题1~4认同程度更高(P<0.05)。相较于骨干师资班,基层人才班的培训对象对于问题1~4及培训形式5认同程度更高(P<0.05)。结论培训实践中总结出的四个开放式问题,内容简单,含义递进,具有内在联系。运用结构性问题培训全科学员,形式灵活,能够激发被培训者的深度思考,该方法在基层卫生人才培训班获得更高的认可程度,表明适用于全科医生的培养。

5A教学模式在普通外科住院医师规范化培训中的应用

目的探讨5A教学模式在普通外科住院医师规范化培训中的应用效果。方法采用随机对照研究方法,以2020年1月至2022年12月在解放军总医院第一医学中心普通外科医学部接受住院医师规范化培训并进入本研究团队主诊组轮转学习的学员为研究对象,随机分为试验组和对照组。试验组20名,采用5A教学模式;对照组20名,采用传统教学模式。对2组学员进行理论考核、临床技能考核和综合能力考核,记录考核成绩,并比较2组的教学效果。结果相对于对照组,试验组学员在消毒铺巾、切开缝合和腔镜技能考核3个方面的成绩得到提高,差异有统计学意义(P<0.05);试验组学员在团队协作和科学研究2个方面的成绩高于对照组,差异有统计学意义(P<0.05);试验组学员带教满意度高于对照组,差异有统计学意义(P<0.05)。结论5A教学模式可以显著提高学员的临床实践操作、团队协作和科学研究能力,可作为普通外科住院医师规范化培训的有效教学方法。

肌骨超声进修医师的教学实践探索

继续教育是提高超声医师亚专业技术能力的重要途径和手段,肌骨超声发展迅速,临床应用范围不断拓展,已成为临床多学科重要的影像学评估手段,但目前我国肌骨超声尚未得到普遍推广,很多基层医院的医师对肌骨超声一知半解。肌骨超声有自身的特殊性,集解剖、病理、临床及超声为一体,除对解剖结构进行诊断外,还涉及功能评估,因此教学难度大。进修学习是快速掌握肌骨超声的重要手段。文章结合多年肌骨进修医师的带教经验,将肌骨进修医师培训分4个阶段:相关理论知识学习、规范化操作学习、临床常见疾病学习和临床观摩及患者检查。文章分别总结了每一阶段的教学特点、侧重点和带教方法,兼顾基础知识、技能操作和临床思维培养,以更好地提升进修医师的继续教育质量。

PBL教学法联合思维导图在外科护士疼痛培训中的应用

目的探讨采用以问题为基础教学法(problembased learning,PBL)联合思维导图教学模式对外科护士疼痛培训的效果研究。方法2021年6月—2022年3月,对上海中医药大学附属市中医医院外科87名临床护士采用PBL教学法联合思维导图教学模式进行疼痛管理知识培训,并采用《护理人员的疼痛知识和态度评估问卷》(the nurses’knowledge and attitude survey,NKAS)于培训前后对参训护士进行疼痛知识和态度评估,以及培训后进行疼痛知识理论考核和教学满意度调查。结果87名外科护士NKAS培训前得分为(15.07±3.45)分,正确率为47.09%,培训后得分为(21.95±5.96)分,正确率为68.61%,差异有统计学意义(P<0.001)。NKAS疼痛一般知识维度分数培训后(5.90±1.81)分高于培训前(4.72±1.72)分,疼痛评估知识维度分数培训后(1.82±0.39)分高于培训前(1.68±0.52)分,药物镇痛知识维度分数培训后(11.95±3.33)分高于培训前(7.72±2.14)分,情景案例分析测试维度分数培训后[2.00(1.00,4.00)分]高于培训前[0(0,1.00)分],差异具有统计学意义(P<0.05)。结论PBL教学法联合思维导图教学模式能有效提高外科护士的疼痛知识水平及疼痛综合应用能力,且充分发挥二者的教学优势,值得在临床继续教育中运用。

核医学科进修护士个性化培养体系构建的思考

进修教育是提升护士业务水平的重要途径。四川大学华西医院核医学科承担着来自不同等级医院的进修教学任务,为进修护士提供优质的培训服务。考虑到进修护士的背景、经验和基础的差异,科室构建了以个性化为核心的进修护士培养体系,旨在提高进修护士的理论水平、操作技能和临床思维能力。在培训方法上,科室综合运用了多种教学法,包括以授课为导向的教学法(lecture-based learning,LBL)、以问题为导向的教学法(problem-based learning,PBL)和以案例为基础的教学法(case-based learning,CBL);在评估方面,采用柯氏四级培训评估模式对进修护士的培训效果进行全面评估,并通过建立沟通反馈机制,持续优化和改进培训体系。核医学科进修培训的总体情况、带教师资、岗前培训、专业培训、考核和反馈沟通等方面都得到了规范。

高强度间歇运动和中等强度持续运动对抑制功能影响的元分析

目的:使用元分析方法探讨高强度间歇运动(HIIT)对抑制功能的影响及其影响因素,以及与中等强度持续运动(MICT)相比的效果差异,为不同锻炼人群选择合适的锻炼方式提供依据。方法:依据PRISMA原则,在国内外的一些检索平台检索相关文献,检索时间为2010年1月1日—2022年8月30日。运用软件“Stata 15.0”和软件“Review Manager 5.3”进行效应量分析。结果:1)HIIT能够显著提高运动者的抑制功能,为中等效应量。2)HIIT能够显著提高10~24岁人群的抑制功能,而对25岁以上人群的抑制功能未见显著影响;90%~100%最大心率运动强度的HIIT能够显著提高运动者的抑制功能,且合并效应量较大,70%~90%最大心率运动强度的HIIT能够显著提高运动者的抑制功能;10~30 min和30~60 min的HIIT均能显著提高运动者的抑制功能;功率自行车、篮球、爬楼梯等方式的HIIT能显著提高运动者的抑制功能,跑步机上跑步的HIIT对运动者的抑制功能未见显著影响;HIIT结束30 min后仍对运动者的抑制功能有积极影响。3)HIIT与MICT对抑制功能的影响未见显著性差异。结论:HIIT能够提高运动者的抑制功能,为中等效应量,HIIT与MICT对抑制功能的积极影响没有差异;HIIT与抑制功能的关系受到年龄、运动强度、运动时间、运动方式等调节变量的影响,HIIT的认知促进效益可以持续30 min以上。

“互联网+”延续性康复训练综合干预模式的构建及在抑郁症患者中的实证研究

目的:探讨“互联网+”延续性康复训练综合干预模式的构建对抑郁症患者干预效果。方法:采用随机对照试验研究,以2022年6月至2023年6月选取符合诊断抑郁症患者110例,随机分为试验组和等待对照组,等待对照组采用药物治疗、每月复查和电话随访,试验组在等待对照组的基础上采用“互联网+”药物自我管理训练、舞动训练和社交技能训练。采用汉密顿抑郁量表(HAMD)、抑郁自评量表(SDS)、社交技能评定目录(SSC)社会适应功能评估量表(SAFE)比较干预前及干预2、4、6月后两组患者抑郁程度、社交能力和社会适应的差异。采用重复测量方差分析对不同时间点两组患者进行干预效果比较。结果:干预前两组HAMD、SDS、SSC、SAFE评分比较,差异无统计学意义(P>0.05);干预后组间与时间对HAMD、SDS、SSC、SAFE评分有交互作用(F=4.400,13.085,23.841,41.777;P<0.001),组间对HAMD、SDS、SSC、SAFE评分主效应显著(F=4040.373,3522.972,16452.039,151.544;P<0.001),时间对HAMD、SDS、SSC、SAFE评分主效应显著(F=69.345,100.620,69.874,221.385;P<0.001)。简单效应分析显示,试验组、等待对照组组内前后HAMD、SDS、SSC、SAFE评分比较,差异有统计学意义(t=-4.142,-6.313,-7.811,-18.903;P<0.008)。结论:“互联网+”延续性康复训练综合干预模式能减轻抑郁症患者抑郁程度,增强患者的社交能力,提高患者的社会适应水平。

湖南省2020年度儿科医师转岗培训学员结业后转归特点分析

目的 调查2020年度湖南省儿科医师转岗培训学员结业后转归特点,探讨转岗培训成功率的影响因素。方法 2020年11月—2021年11月通过问卷调查收集湖南省2020年儿科医师转岗培训学员结业后相关信息,比较转岗成功与不成功的学员特点。结果 81名完成转岗培训,100%完成了本次调查。81名学员中,中位年龄33岁。男性18名,女性63名,男女比例0.29:1。58人(71.6%)来自二级医院,行政区域划分以县级为主。54人(66.7%)来自非儿科专业。2020年度儿科医师转岗培训的转岗成功率为77.8%(42/54)。儿科医师转岗结业后转岗成功与否在性别、年龄、医院等级、转岗前专业、单位设立儿科、单位变动、薪酬变化方面差异无统计学意义(P> 0.05)。转岗成功学员较转岗失败学员培训后工作量的变化以及所属医院重视程度差异有统计学意义(P=0.007,P=0.002),52.4%的学员认为转岗后工作量较转岗前增加。结论 在政府支持下的儿科转岗培训已有一定成效,对健全儿童疾病分级诊疗体系具有重要意义,但从根源上解决儿科医师工作量大、县级医院儿科重视度不够等问题仍是一个挑战。

以胜任力为导向的医学教育在眼科住院医师规范化培训中的应用

住院医师规范化培训是医学生毕业后继续教育的重要组成部分,以胜任力为导向的医学教育是现今医学教育改革的重要风向标,我国住院医师规范化培训核心胜任力框架共识的形成为住培工作的改进与优化提供了新的指引。眼科学由于自身专科特征使得其对住培质量的专业性要求更高,而目前为止,以胜任力为导向的医学教育在眼科住院医师规范化培训工作中的实际应用及具体的实施办法尚未形成。文章针对此现状,在总结既往眼科住培过程中经验与不足的基础上,聚焦以胜任力为导向的医学教育在眼科住培中的实践,分别阐述了包括职业素养、专业能力、患者管理、沟通合作、教学能力和学习提升在内的六大核心胜任力的培养在眼科住培工作中的内涵和具体实施办法,为我国眼科住培工作的开展和完善提供了一定的有益参考。

儿童口腔专业继续教育改革的启示

随着我国对儿童牙医的需求量越来越大,面对更新快速的医学知识,为了保持理论知识和临床技能与时俱进,继续医学教育已然成为儿童口腔专科医师的首选。新疆维吾尔自治区人民医院作为一所省级三级甲等综合医院,每年承担着全疆各地基层医生的继续教育工作,同时也会派遣医生前往国内顶尖医院进修学习。通过在北京大学口腔医院儿童口腔科进修学习过程,归纳总结北大口腔儿科进修生培养模式和特点及其与儿童口腔专业发展趋势相适应的转变。这种以能力为导向的个性化培养模式、多种教学方法相结合运用,加强临床实践规范,注重科研与临床相结合的进修生训练模式,值得借鉴。同时北大口腔儿科营造的良好学习氛围深深影响着进修生,从被动学习到主动学习的转变也值得思考与借鉴。