Development and evaluation of an allocation committee to distribute community placements on an equitable basis between universities: Our experience with the University Placement Allocation Committee

The present paper outlines the development and evaluation of an allocation committee to distribute community placements on an equitable basis between universities. Although based on our experience in South Australia with the University Placement Allocation Committee (UPAC), the primary goal is to outline the steps that would be useful if placement coordinators at other universities in Australia decided to establish and maintain an allocation committee. A survey of field supervisors was also conducted and field supervisors endorsed UPAC as a constructive mechanism for allocating community placements.     

Effect of Psoas Training on Postmenopausal Lumbar Bone Loss: A 3-Year Follow-Up Study

The present study completed a previous randomized trial that demonstrated the protective effect of 1-year psoas training on lumbar bone loss in postmenopausal women. Computerized tomography had been carried out at the beginning (CT1) and at the end (CT2) of this trial. In the present study, 67 women having completed the first trial were asked to practice psoas exercises (60 hip flexions in sitting position with a 5 kg weight on the knee) for 2 additional years with a third CT control at the end of this period (CT3). The aim of this complementary study was to assess the compliance rate and long-term effect on bone of daily psoas muscle training over a longer period. Twenty-one women performed this daily psoas training for 3 years from CT1 to CT3, and 14 acted as controls during the same period. Fourteen women were controls during the first year (from CT1 to CT2) but practiced psoas training during the following 2 years (from CT2 to CT3). Four women were psoas trained during the first year (from CT1 to CT2) and subsequently crossed over to the control group for the last 2 years. The compliance rate was 42%, with an attendance rate of 88%. The lumbar bone loss was lower in the 21 women trained over the 3 years (−3.26 ± 28.45 mg/cm³) than in the 14 untrained women (−16.79 ± 8.51 mg/cm³) (P= 0.02). The bone loss was not significantly reduced between the two periods of the study in the 12 women having been controls from CT1 to CT2 and having crossed over to the active training group from CT2 to CT3. Psoas training may be effective against lumbar bone loss. We conclude that specific training may play a contributing role in the preventive strategy to avoid osteoporosis. Received: 23 February 1996 / Accepted: 25 October 1996     

运动训练对雄性大鼠垂体─性腺轴功能的影响

本研究通过使用自己制造的大鼠流动水游泳池，对雄性大鼠进行了６周递增负荷的游泳训练，以此来探讨运动训练对大鼠垂体－性腺轴功能的影响，结果显示：与安静对照大鼠相比，训练大鼠的一般状态较差，血清睾酮水平显著降低（Ｐ＜０．０５），血清睾酮／皮质酮比值平均降低了３０％以上；而血清ＬＨ和ＦＳＨ水平未见明显变化。通过对大鼠睾丸组织ＬＨ／ＣＧ受体的测定，显示运动训练虽未引起其最大结合量的改变，却能使其解离常数显著升高（Ｐ＜０．０５）。提示此种训练可能通过降低睾丸ＬＨ／ＣＧ受体对垂体分泌ＬＨ的亲和力，从而影响睾酮的合成。     

Laparoscopic colorectal surgery in Great Britain and Ireland – Where are we now?

OBJECTIVE: We aimed to gather information from the members of the Association of Coloproctology of Great Britain and Ireland (ACPGBI) to assess trends in the current practice of laparoscopic colorectal surgery. METHODS: A postal questionnaire survey of the members of ACPGBI. RESULTS: The response rate was 37% (200/540). Only 45 surgeons currently perform laparoscopic colorectal work in Great Britain and Ireland mainly right hemicolectomy and laparoscopic stoma formation, of these about one third practiced laparoscopy for benign colorectal conditions only. The majority (68%) of surgeons had enough resources at their place of work, but further training seemed to be a major issue. Nearly 22% of surgeons had not had any formal training. Only 50% of surgeons trained their specialist registrars. The incidence of conversion rate was not different for benign or malignant conditions and also did not appear to be related to the duration of experience. Only four surgeons had noted port a site recurrence during the past 10 years. Seventy-five percent (150/200) felt that laparoscopic colorectal work could be carried out safely in a District General Hospital. CONCLUSION: Laparoscopic colorectal surgery was being performed by a small minority of members of the ACPGBI although more surgeons had started to work in this field in recent years. The main areas of concern appeared to be a wide variation in the range of experience as indicated by the number of operations performed and limited formal training for consultants.     

Getting to Dissemination

The combination of a stage model of psychotherapy and treatment manualization has been a major step forward in treatment development and efficacy testing, but not in dissemination. I argue that the technological model of treatment development makes research on the practical application of these technologies difficult. If we continue on our present course, research on dissemination will be uncommon, expensive, and largely irrelevant to the practical issues that need to be faced. It makes more sense to proceed directly to dissemination research. Alternative methods, including manipulated training designs, will permit this, but these fundamentally challenge the implicit assumptions of the stage model.     

腭裂儿童三位一体语音训练模式的构建

目的：评价家庭语音训练模式对腭裂术后患者语音康复的干预效果。方法：对16例患儿运用家庭-学校-医院三位一体的训练模式进行为期1年的家庭语音训练，通过语音清晰度评价疗效。结果：患儿语音清晰度平均提高36．06％，代偿性发音等腭裂音质明显改善。结论：家庭-学校-医院三位一体的训练模式对于校正腭裂术后患者的不良代偿性发音习惯有良好的效果。     

Activities of creatine kinase isoenzymes in single skeletal muscle fibres of trained and untrained rats

Biochemical changes in the creatine kinase isoenzyme compositions in single muscle fibres of different types in rats were induced by endurance running training. Single muscle fibres were dissected from the soleus and extensor digitorum longus muscles of Wistarstrain male rats trained on a motor-driven treadmill for 16 weeks. Each fibre was typed histochemically (SO, slow-twitch oxidative; FOG, fast-twitch oxidative glycolytic; FG, fast-twitch glycolytic), and the activities of total creatine kinase and its four isoenzymes (CK-MM, -MB,-BB, and mitochondrial creatine kinase) were measured. The endurance training did not affect the total creatine kinase activity, but resulted in significantly increased activities of CK-MB and CK-BB in SO and FOG fibres, and the mitochondrial enzyme activity in FOG and FG fibres. Endurance training induced biochemical changes in the isoenzyme compositions, specifically in FOG fibres. These results suggest that changes in creatine kinase isoenzymes with endurance training reflect changes in the energy metabolism in the different muscle fibres, supporting the hypothesis that the different isoenzymes play different roles in energy transduction.     

Recognition and management of patients with high-risk vesicovaginal fistulas: Implications for teaching and research

Vesicovaginal fistulas (VVFs) occurring as a result of obstetric trauma are a vast problem in Nigeria and Ghana, where at least 20 000 women await repair, and fewer than 50 physicians have the necessary expertise. Through a series of conferences those VVFs that are at high risk and those at low-risk for repair failure, were identified. A clinic was established where repair of low-risk VVFs was done on an ongoing basis in a remote region of Ghana. A visiting surgical team was utilized to repair the difficult, or high-risk, VVFs, which included 4–6 cm VVFs (3), recurrent VVF (1), combined VVF and RVF (rectovaginal fistula), a large 5 cm juxtacervical VVF (1), and a vesicouterine fistula (1). Management of these patients and others with VVF repair complications is discussed.     

Skeletal Muscle Adaptations to Physical Training in Type II (Non-insulin-dependent) Diabetes Mellitus

Seven middle-aged men with manifest type II diabetes mellitus underwent an endurance training programme for 10–15 weeks. The maximal aerobic capacity, as well as the endurance capacity, was improved by 10% (p<0.05). The intramuscular glycogen store increased by more than 80% (p<0.05) from 350 μmol/g dw (dry weight), and the activities of citrate synthase and 3-hydroxy-acyl-CoA dehydrogenase increased by more than 50% (p<0.05) and 30% (p<0.05). The activity of glycogen synthase was decreased by approximately 20% (p<0.05), whereas lactate dehydrogenase remained unchanged. Capillaries/fibre and fibre area increased by more than 50% (p<0.05) and 30% (p<0.05) leaving the area of supply constant. Training did not influence fasting blood lipids and glucose, glycosylated hemoglobin, oral glucose tolerance, and insulin response to an oral glucose load measured 72 hours post-exercise. It is concluded that patients with manifest type II diabetes, as normoglycaemic individuals, adapt to physical training. However, no persistent effect on glucohomeostasis and lipaemia is produced by short-term training in the diabetic patients.