Evaluation of two longitudinal faculty leadership training programs: behavioral change and institutional impact.

PURPOSE: Building leadership skills among faculty in academic medicine is essential, yet professional development programs focused on leadership are not always attentive to the needs of faculty on diverse career pathways or at differing career stages-nor are they often rigorously assessed. Evaluations commonly focus on participant satisfaction and short-term learning but not behavior change and institutional impact, which are difficult to assess but arguably more meaningful. Given the substantial time and money invested in these programs, more rigorous evaluation is critical. DESIGN/METHODOLOGY/APPROACH: The authors evaluated an intensive, shared leadership-focused training program for early-career and mid-career faculty, offered by the University of Pittsburgh's School of Medicine over the course of a year. They administered a pre/post-program assessment of confidence in key skill areas, and conducted semi-structured interviews with 21 participants between 1-4 years after program completion. FINDINGS: Participants in both programs showed statistically significant improvement (p < 0.001) on every item measured in the pre/post-test. Analysis of the interviews revealed indications of substantial behavior change as well as institutional impact. The evaluation also suggested particular benefits for female professionals. ORIGINALITY/VALUE: The authors conducted a long-term assessment of leadership training focused on career pathway and career stage and found that it (a) prompted both positive behavioral change and institutional impact and (b) suggested benefits for female faculty in particular, which could potentially help to eliminate gender-based disparities in leadership in academic medical centers.

Drivers of adolescent adiposity: Evidence from the Australian LOOK study.

OBJECTIVES: To contribute to our understanding of the drivers of body composition during adolescence we sought to employ valid and reliable measures to investigate cross-sectional and longitudinal relationships between percentage body fat (%BF) and physical activity (PA), moderate and vigorous PA (MVPA), sedentary time (ST), total energy, sugar and fat intake. DESIGN: Longitudinal cohort study. METHODS: We measured 556 (289 male) participants at age 12.4 (SD 0.4) years, and 269 (123 males) at 16.3 (SD 0.4) years, for %BF (dual energy X-ray absorptiometry); habitual PA, MVPA, ST (accelerometry); and dietary intake ('multi-pass' weekday and weekend 24-h recall). Accounting for likely under-reporting of energy intake (Goldberg cut-off), general linear mixed modelling was used to generate relationships with %BF. RESULTS: Cross-sectional analyses indicated that 10min more MVPA per day was associated with 0.6 lower %BF (95%CI 0.4-0.9, p<0.001), and 10min less ST/day with 0.07 lower %BF (95%CI 0.00-0.15, p<0.001), independently of PA. In contrast, %BF was unrelated to total energy (p=0.4), sugar intake (p=0.2) or fat intake (p=0.9). Longitudinal analysis showed that if PA was increased by 3% (10,000 counts/day) over the 4 years, then %BF was reduced by 0.08 (95%CI 0.05-0.12, p=0.06). CONCLUSIONS: The independent relationships of %BF with PA and ST, but absence of relationships with energy, sugar or fat intake, suggest that general community campaigns in a developed country directed at reducing adolescent obesity through modifications to energy intake and output would benefit from a more concerted focus on the latter.

Voluntary food intake by elite female cyclists during training and racing: influence of daily energy expenditure and body composition.

We estimated self-reported energy intake (EI) and cycling energy expenditure (CEE) during racing and training over 26 days (9 days recovery [REC], 9 days training [TRN], and 8 days racing [RACE], which included a 5-day stage race) for 8 members of the Australian National Training Squad [mean SD; 25.1 4.0 years, 59.2 4.4 kg, 3.74 0.24 L min-1 VO 2 peak, 13.6 4.5 % Body fat (% B fat)]. After 70 days of training and racing, average body mass increased by 1.1 kg (95%CI 0.5 to 1.7 kg; p <.01) and average % B fat decreased by 0.9% (95%CI 1.7 to 0.1%; p <.05). These minor changes, however, were not considered clinically significant. CEE was different between RACE, TRN, and REC (2.15 0.18 vs. 1.73 0.25 vs. 0.72 0.15 MJ d-1, p <.05). Reported EI for RACE and TRN were higher than REC (14.87 3.03, 13.70 4.04 vs. 11.98 3.57 MJ d-1, p <.05). Reported intake of carbohydrate for RACE and TRN were also higher than REC (588 122, 536 130 vs. 448 138 g d-1, p <.05). Reported intake of fat (59 21 68 21 g d-1) was similar during RACE, TRN, and REC, whereas protein intake tended to be higher during TRN (158 49 g d-1) compared to RACE and REC (136 33; 130 33 g d-1). There was a relationship between average CEE and average EI over the 26 days (r = 0.77, p <.05), but correlations between CEE and EI for each of the women varied (r = 0.02 to 0.67). There was a strong trend for an inverse relationship between average EI and % Bf at (r = -.68, p =.06, n = 8). In this study, increases in reported EI during heavy training and racing were the result of an increase in carbohydrate intake. Most but not all cyclists modulated EI based on CEE. Research is required to determine whether physiological or psychological factors are primarily responsible for the observed relationship between CEE and EI and also the inverse correlation between % B fat and EI.