The Influence Of Transfer System Factors And Training Elapsed Time On Transfer In A Healthcare Organization

Organizations and other sponsors of training face increasing pressure to demonstrate the value or impact of their training programs on individual and organizational performance. A critical element in the validation of training effectiveness is the permanent transfer of learned knowledge, skills, and behaviors to the workplace. The generalization of learned material to the job and maintenance of trained skills, are greatly influenced by training design, trainee characteristics, and work environmental factors. Using a multidimensional approach to identify all factors that promote or inhibit transfer could provide performance technologists and instructional designers with the insight necessary to design and develop strategic interventions that may enhance transfer and sustained workplace performance. Much of the empiric research has examined evidence of transfer soon after training while studies assessing the generalization or maintenance of skills and knowledge are few; yet, the majority of training transfer models specify a change in performance or behavior at the individual or organizational level following training as the primary measure of transfer. The purpose of this study was to examine trainee perceptions of transfer system factors that influence the transfer process on a continuum in a multi-center healthcare organization 9 to 24 months following a management training program using the validated Learning Transfer System Inventory (LTSI) survey instrument. In addition, the study examined the influence of time elapsed since completion of training on stage of transfer achieved. Results showed that trainees who perceived a more supportive work environment had a greater likelihood of progressing to maintenance of the skills and knowledge learned in training. Individuals who achieved the maintenance stage of transfer specifically, perceived motivation to transfer learning, performance self-efficacy, and transfer design as strong catalysts for transfer in this study while mean scores for trainees who achieved only partial transfer or no transfer of skills indicated a perception of a weak transfer climate overall. Time since completion of training was not found to be a significant influence on the stage of transfer achieved. Previous studies have suggested that the transfer climate in organizations is complex and unique to specific types of organizations and training programs. These study results support previous findings and contribute to the understanding of transfer as a process. These and other findings are discussed as well as implications for instructional designers, performance technologists, and the business of healthcare. Limitations related to the study and recommendations for future research are also presented

Homeowner garden design series: Elements and principles of design

The Oklahoma Cooperative Extension Service periodically issues revisions to its publications. The most current edition is made available. For access to an earlier edition, if available for this title, please contact the Oklahoma State University Library Archives by email at [email protected] or by phone at 405-744-6311

Homeowner garden design series: Pre-design planning worksheet

The Oklahoma Cooperative Extension Service periodically issues revisions to its publications. The most current edition is made available. For access to an earlier edition, if available for this title, please contact the Oklahoma State University Library Archives by email at [email protected] or by phone at 405-744-6311

Augmentation of patellar tendon repair with autologous semitendinosus graft - Porto technique

"Article in press" ; "Published online: November 27, 2017"Patellar tendon ruptures can lead to significant functional deficiency of the extensor mechanism of the knee. These injuries, because of their inherent nature and associated complications, may require a complex treatment and remains a challenge for orthopaedic surgeons. Current surgical techniques present significant complications, including patellar fracture, damage to patellar articular cartilage, and abnormal patella height. This note describes a surgical technique to provide an additional reinforcement to the patellar tendon repair with a semitendinous autograft, without the necessity to perform any transosseous tunnels at the patella bone. First, the patellar tendon is repaired with an end-to-end technique and the semitendinous tendon is harvested. A transosseous tunnel at the tibial tubercle is drilled and 2 rents are made, both medial and lateral to the retinaculum at the level of the intermedial segment of the patella close to the patellar margin. The graft is passed through the tunnel and rents in a U-shaped form. The graft is sutured along the length of the patellar tendon on both margins in tension at 30 of knee flexion. Fluoroscopy imaging is performed to assess the patella height. This technique provides a significant augmentation of patellar tendon, avoiding the potential patella bone tunnel complications.info:eu-repo/semantics/publishedVersio

Homeowner garden design series: Creating outdoor rooms

The Oklahoma Cooperative Extension Service periodically issues revisions to its publications. The most current edition is made available. For access to an earlier edition, if available for this title, please contact the Oklahoma State University Library Archives by email at [email protected] or by phone at 405-744-6311

Relationship of Objectively-Measured Habitual Physical Activity to Chronic Inflammation and Fatigue in Middle-Aged and Older Adults

Habitual (non-exercise) physical activity (PA) declines with age, and aging-related increases in inflammation and fatigue may be important contributors to variability in PA

Increasing Trunk Mass Evokes Lower Extremity Biomechanical Plasticity during Stair Descent

International Journal of Exercise Science 16(1): 942-953, 2023. The purpose of this study was to investigate the influence of simulated changes in body mass on lower extremity joint work and relative joint contributions during stair descent. Ten healthy recreationally active college-age participants performed five stair descent trials in each of five loading conditions: no added load and with an additional 5%, 10%, 15% and 20% of their body weight. Three-dimensional ankle, knee and hip joint powers were calculated using a six degree-of-freedom model in Visual3D (C-Motion Inc., Germantown, MD, USA). Sagittal plane joint work was calculated as the joint power curve integrated with respect to time during the period between initial contact and toe off. Prism 9.0 (GraphPad Inc., San Diego, CA) was used to perform univariate 1 x 5 repeated measures analyses of variance to determine the effect of added mass on absolute and relative joint work values for total and for each lower extremity joint independently. Increasing added mass was associated with greater total lower extremity negative work during the stair descent task (p \u3c 0.001). At the ankle, increasing added mass was associated with increasing magnitudes of negative joint work. Increasing added mass was associated with greater relative contributions of the ankle and reduced knee contributions to total negative lower extremity joint work (p = 0.014 and p = 0.006). The current findings demonstrated increases in ankle joint contributions to total lower extremity work while knee joint contributions to total lower extremity work were reduced in response to increasing added mass

Effects of total and regional fat loss on plasma CRP and IL-6 in overweight and obese, older adults with knee osteoarthritis

SummaryObjectiveTo describe associations between total and regional body fat mass loss and reduction of systemic levels of inflammation (C-reactive protein (CRP) and interleukin-6 (IL-6)) in obese, older adults with osteoarthritis (OA), undergoing intentional weight loss.DesignData come from a single-blind, 18-month, randomized controlled trial in adults (age: 65.6 ± 6.2; Body mass index (BMI): 33.6 ± 3.7) with knee OA. Participants were randomized to diet-induced weight loss plus exercise (D + E; n = 150), diet-induced weight loss-only (D; n = 149), or exercise-only (E; n = 151). Total body and region-specific (abdomen and thigh) fat mass were measured at baseline and 18 months. High-sensitivity CRP and IL-6 were measured at baseline, six and 18 months. Intervention effects were assessed using mixed models and associations between inflammation and adiposity were compared using logistic and mixed linear regression models.ResultsIntentional total body fat mass reduction was associated with significant reductions in log-adjusted CRP (β = 0.06 (95% CI = 0.04, 0.08) mg/L) and IL-6 (β = 0.02 (95% CI = 0.01, 0.04) pg/mL). Loss of abdominal fat volume was also associated with reduced inflammation, independent of total body fat mass; although models containing measures of total adiposity yielded the best fit. The odds of achieving clinically desirable levels of CRP (<3.0 mg/L) and IL-6 (<2.5 pg/mL) were 3.8 (95% CI = 1.6, 8.9) and 2.2 (95% CI = 1.1, 4.6), respectively, with 5% total weight and fat mass loss.ConclusionsAchievement of clinically desirable levels of CRP and IL-6 more than double with intentional 5% loss of total body weight and fat mass. Global, rather than regional, measures of adiposity are better predictors of change in inflammatory burden.Clinical Trial Registration NumberNCT00381290

The infected hip: A treatment algorithm

The management of periprosthetic joint infection following total joint arthroplasty is presently a major challenge to orthopedic surgeons. Despite various treatment options available, the two-stage revision procedure is most often chosen in North America because of a high success rate, especially in cases involving resistant organisms. Sometimes the use of antibiotics alone, irrigation with debridement, or a one-stage exchange may be a more appropriate treatment option. Various factors such as the status of a patient’s immune system, time of onset of the infection, as well as susceptibility of causative microorganism should be considered as they play an important role in effectiveness of treatment. When surgery presents a great risk to patients due to their level of health, and infection is caused by a low-virulent antimicrobial susceptible pathogen, antibiotic suppression alone may be the best treatment option. If the patient can successfully undergo surgery then an irrigation and debridement procedure may be preferred, especially with an acute onset of symptoms. If onset of symptoms is much later as in chronic cases, or irrigation and debridement procedure is unsuccessful, then resection of all components and reimplantation is necessary. In a two-stage revision, placement of an antibiotic-loaded spacer is needed to eradicate the infection before reimplantation takes place. There are rare cases in which salvage procedures, such as arthrodesis or amputation, are necessary to completely eradicate an uncontrollable infection in immunocompromised patients