Research priorities in light of current trends in microsurgical training: revalidation, simulation, cross-training, and standardisation.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/ licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly citedPlastic surgery training worldwide has seen a thorough restructuring over the past decade, with the introduction of formal training curricula and work-based assessment tools. Part of this process has been the introduction of revalidation and a greater use of simulation in training delivery. Simulation is an increasingly important tool for educators because it provides a way to reduce risks to both trainees and patients, whilst facilitating improved technical proficiency. Current microsurgery training interventions are often predicated on theories of skill acquisition and development that follow a 'practice makes perfect' model. Given the changing landscape of surgical training and advances in educational theories related to skill development, research is needed to assess the potential benefits of alternative models, particularly cross-training, a model now widely used in non-medical areas with significant benefits. Furthermore, with the proliferation of microsurgery training interventions and therefore diversity in length, cost, content and models used, appropriate standardisation will be an important factor to ensure that courses deliver consistent and effective training that achieves appropriate levels of competency. Key research requirements should be gathered and used in directing further research in these areas to achieve on-going improvement of microsurgery training

Modified Pilates as an adjunct to standardphysiotherapy care for urinaryincontinence: a mixed methods pilot for arandomised controlled trial

Background Urinary incontinence (UI) is a distressing condition affecting at least 5 million women in England and Wales. Traditionally, physiotherapy for UI comprises pelvic floor muscle training, but although evidence suggests this can be effective it is also recognised that benefits are often compromised by patient motivation and commitment. In addition, there is increasing recognition that physical symptoms alone are poor indicators of the impact of incontinence on individuals’ lives. Consequently, more holistic approaches to the treatment of UI, such as Modified Pilates (MP) have been recommended. This study aimed to provide preliminary findings about the effectiveness of a 6-week course of MP classes as an adjunct to standard physiotherapy care for UI, and to test the feasibility of a randomised controlled trial (RCT) design. Methods The study design was a single centre pilot RCT, plus qualitative interviews. 73 women referred to Women’s Health Physiotherapy Services for UI at Colchester Hospital University NHS Foundation Trust were randomly assigned to two groups: a 6-week course of MP classes in addition to standard physiotherapy care (intervention) or standard physiotherapy care only (control). Main outcome measures were self-reported UI, quality of life and self-esteem at baseline (T1), completion of treatment (T2), and 5 months after randomisation (T3). Qualitative interviews were conducted with a subgroup at T2 and T3. Due to the nature of the intervention blinding of participants, physiotherapists and researchers was not feasible. Results Post-intervention data revealed a range of benefits for women who attended MP classes and who had lower symptom severity at baseline: improved self-esteem (p = 0.032), decreased social embarrassment (p = 0.026) and lower impact on normal daily activities (p = 0.025). In contrast, women with higher symptom severity showed improvement in their personal relationships (p = 0.017). Qualitative analysis supported these findings and also indicated that MP classes could positively influence attitudes to exercise, diet and wellbeing. Conclusions A definitive RCT is feasible but will require a large sample size to inform clinical practice. Trial registration ISRCTN74075972 Registered 12/12/12 (Retrospectively registered)

A Systematic Review of the Effects of Pilates Method of Exercise in Healthy People

Objective: To evaluate evidence for the effectiveness of the Pilates method of exercise (PME) in healthy people. Data Sources: Published research was identified by searching Science Direct, MEDLINE, PubMed, SPORTDiscus, PEDro, Cochrane Central Register of Controlled Trials, CINAHL, and Web of Science. Study Selection: Research studies published from inception to May 7, 2011 were selected for evaluation. Two reviewers independently applied the inclusion criteria to selected potential studies. Studies were included if they were published in a peer-reviewed journal, written in the English language, conducted as a randomized controlled trial (RCT) or quasi-RCT in healthy people, had an inactive and/or exercise control group(s), included key study outcomes, and used the PME as the study intervention in at least 1 study arm. Data Extraction: Two reviewers independently extracted data (study, design, subjects, intervention, key outcomes results), applied the Physiotherapy Evidence Database (PEDro) scale to assess the method quality of selected studies, and determined the strength of the evidence using the best evidence synthesis grading system. Data Synthesis: Sixteen studies met the inclusion criteria. PEDro scale values ranged from 3 to 7 (mean, 4.1), indicating a low level of scientific rigor. The outcomes studied most often were flexibility, muscular endurance, strength, and postural alignment. The PME appears to be effective in improving flexibility (strong evidence), dynamic balance (strong evidence), and muscular endurance (moderate evidence) in healthy people. Conclusions: There was strong evidence to support the use of the PME at least to the end of training to improve flexibility and dynamic balance and moderate evidence to enhance muscular endurance. Future RCTs should focus on the components of blinding, concealed allocation, subject adherence, intention- to-treat analysis, and follow-up designs

Richard Kloubec papers, 1972-1993

The collection is divided into four series; Personal, Political, Newspapers, and Publications. The Personal Series contains certificates for Kloubec’s nominations and elections, personal correspondence, and documents from his activity in the First Presbyterian Church in his community. The Political Series contains correspondence from other legislators and constituents, documents from his participation in committees, house bills and resolutions he represented, journals of legislative assemblies, political interest topics, and campaign materials, as well as ephemera and photographs. The Newspapers Series includes clippings from newspapers all around North Dakota and political newsletters. The Publications Series contains government reports, government manuals and directories, and Oversized Publications, which includes reports, presentations, and government books

Pilates: how does it work and who needs it?

Pilates uses a combination of approximately 50 simple, repetitive exercises to create muscular exertion. Advocates of this system of exercise claim that exercises can be adapted to provide either gentle strength training for rehabilitation or a strenuous workout vigorous enough to challenge skilled athletes. The exercises are designed to increase muscle strength and endurance, as well as flexibility and to improve posture and balance. There is cautious support for the effectiveness of Pilates in improving flexibility, abdominal and lumbo-pelvic stability and muscular activity. Stronger support cannot be given at this point in time primarily due to the limited number of studies and the lack of sound methodology in the published research. However, current research does indicate that there may be applications for this type of intervention in certain clinical populations that are worthy of continued investigation

AN OBSERVATIONAL STUDY OF THE METABOLIC COST OF THE YOGA SEQUENCE SURYA NAMASKAR B

AN OBSERVATIONAL STUDY OF THE METABOLIC COST OF THE YOGA SEQUENCE SURYA NAMASKAR B JA Kloubec Bastyr University, Kenmore, WA, Gustavus Adolphus College, St. Peter, MN PURPOSE: Questions around the usefulness of yoga in cardiovascular conditioning and weight loss of are particular interest to western societies today. The purpose of this study was to determine the metabolic cost of a popular sequence of yoga postures (Surya Namaskar B in the Asthanga tradition). METHODS: Twenty female subjects (mean age = 40.75±13) who had familiarity with the sequence and had at least five years of yoga experience were recruited. Subjects followed a 22 minute DVD to ensure consistency of movement and timing of postures. RESULTS: Subjects mean heart rate (HRmean) at rest was recorded as 76.05±14 b.min-1. After the initial five minutes of the sequence subjects were able to achieve and maintain 71% average of their age predicted HR max (126±20 b.min-1.) throughout the remainder of the sequence. Mean maximal VO2 was 16.8 ±2.43ml.kg-1.min-1 or approximately 4.85 METS; peak caloric expenditure was 5.38± 1.26 Kcal.min-1. CONCLUSION: Heart rate response indicated that Surya Namaskar B may elicit a training effect on the cardiorespiratory system, however direct measure of VO2 failed to reflect this intensity of exercise. Results indicate that yoga practiced in this manner is of low to moderate intensity and may be sufficient to induce moderate training effects if performed for longer durations (i.e., 30-60 minutes)

Electricity Market in the Czech Republic, its definition

Tato bakalářská práce se zabývá charakteristikou trhu s elektřinou v České republice a jeho definováním. Hlavní část práce je systematicky rozdělena do tří kapitol, přičemž první kapitola je věnována teoretické rovině definování trhu a zvláštnostem marketingu v elektroenergetickém odvětví. Ve druhé kapitole práce přechází z teoretické roviny do praktické a je v ní teorie definování trhu aplikována na trh s elektřinou v České republice. Přitom dochází mimo jiné k podrobnému definování jednotlivých účastníků trhu s elektřinou stejně tak, jako jednotlivých typů obchodů s elektřinou. Předmětem třetí kapitoly je definování elektrické energie a jejích marketingových specifik.This bachelor thesis deals with the characterization of the Electricity Market in the Czech Republic and its definition. The main part of the thesis is systematically divided into three chapters, where the first chapter addresses the theoretic framework of market definition and marketing distinctiveness in the Electrical Power Engineering Industry. The second chapter approaches the practical part of the thesis wherein the theory of market definition is applied to the Electricity Market in the Czech Republic. In the process, an in-depth definition of individual market participants, as well as of individual types of electricity deals, is -- among many others -- carried out as well. The third chapter focuses on the definition of the market product, i.e. electricity, and its marketing specifics

DIRECT DIGITAL CONTROL OF SYSTEMS SUBJECT TO STOCHASTIC DISTURBANCES AND CONTROL EFFORT CONSTRAINTS

Abstract not availabl