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Background: Mandatory training is considered fundamental to establishing and maintaining high standards of professional practice. There is little evidence however, of the training either achieving its required learning outcomes, or delivering improvement in outcomes for patients. Whist organisations may be hitting their compliance target for mandatory training, is the purpose missing the point? This systematic review aims to synthesize and evaluate the efficacy of statutory and mandatory training. Methods: PubMed, EMBASE, CNAHL, ERIC and Cochrane Central registers were searched on 23rd May 2023. All research designs were included and reported training had to specify an organisational mandate within a healthcare setting. Data was coded using a modified Kirkpatrick (KP) rating system. Critical appraisal was undertaken using the Modified Medical Education Research Study Quality Instrument, Critical Appraisal Skills Programme Qualitative Studies checklist and Mixed Methods Assessment Tool. Results: Twenty-five studies were included, featuring 9132 participants and 1348 patient cases audited. Studies described evaluation of mandatory training according to Kirkpatrick's outcomes levels 1–4b, with the majority (68%) undertaken in the UK and within acute settings. Training duration varied from 5 min to 3 days. There is a lack of consensus regarding mandatory training rationale, core topics, duration, and optimum refresher training period. Currently, mandatory training does not consistently translate to widescale improvements in safe practice or improved patient outcomes. Conclusions: Due to the lack of international consensus regarding the need for mandated training, most papers originated from countries with centrally administered national health care systems. The rationale for mandating training programmes remains undefined. The assumption that mandatory training is delivering safe practice outcomes is not supported by studies included in this review. The findings of this review offer a basis for further research to be undertaken to assist with the design, facilitation, and impact of mandatory training. [ABSTRACT FROM AUTHOR]

Background and Objectives: Physical activity (PA) environments at micro- (eg, home) and macro-levels (eg, built) may be associated with rural children's PA, an underrepresented population in research. A secondary data analysis of New Ulm at HOME, a family-based childhood obesity prevention RCT, examined which environmental supports explain variation in moderate-to-vigorous PA (MVPA), vigorous PA (VPA), and total PA. Methods: Gold standard measurement tools (geospatial analysis; accelerometry) and surveys were used to assess children's (N = 105, age 7-10) PA environments and behaviors. Environmental supports were evaluated in a block-wise manner. Each variable was placed into 1 block (ie, sociodemographic characteristics, physical supports, or social supports). Blocks were added in a sequential manner to multiple linear regression models, controlling for sociodemographic variables, and analyzed for their groupwise ability to explain variation in MVPA, VPA, and total PA. Results: At micro- and macro-levels, differences in MVPA were explained by physical supports (ΔR2 = 0.06, P = .03; ΔR2 = 0.13, P = .04). Explained variance in VPA was improved by neither physical nor social supports at either level. Physical supports explained differences in total PA at the micro- (ΔR2 = 0.09, P = .01) and macro-levels (ΔR2 = 0.17, P = .01). Conclusions: Further research is warranted to explore if expanding access to PA equipment and infrastructure supports mitigates inactivity in rural youth. [ABSTRACT FROM AUTHOR]

The scale of plastic pollution boggles the mind. Nearly 400 megatons of virgin plastics are produced annually, with an environmental release rate of 80%, and plastic waste, including microplastics and nanoplastics, is associated with a plethora of problems. The naturally evolved abilities of plastic-degrading microbes offer a starting point for generating sustainable and eco-centric solutions to plastic pollution-a field of endeavor we term eco-microbiology. Here, we developed an iterative discovery procedure coupling faster polyethylene terephthalate (PET)-dependent bioactivity screens with longer-term PET biodegradation assays to find biochemical boosters of PET consumption by the bacterium Piscinibacter sakaiensis . We discovered multiple hits supporting the enhancement of PET biodegradation, with a 0.39% dilution of growth medium #802, a rich medium similar to Luria-Bertani broth, on average more than doubling the rate of PET biodegradation both alone and in combination with 0.125% ethylene glycol. In addition, we identified other chemical species (sodium phosphate, L-serine, GABA) worth further exploring, especially in combination with growth medium #802, for enhanced PET biodegradation by P. sakaiensis . This work represents an important step toward the creation of a low-cost PET fermentation process needed to help solve PET plastic pollution., Importance: Plastic pollution is an urgent issue. Adding to the well-known problems of bulk plastic litter, shed microplastics and nanoplastics are globally distributed, found in diverse organisms including human foodstuffs and tissues, and increasingly associated with chronic disease. Solutions are needed and the microbial world offers abundant help via naturally evolved consumers of plastic waste. We are working to accelerate polyethylene terephthalate (PET) plastic biodegradation by Piscinibacter sakaiensis , a recently described bacterium that evolved to slowly but completely consume PET, one of the most common types of plastic pollution. We used a combination of PET-dependent bioactivity screens and biodegradation tests to find stimulators of PET biodegradation. Out of hundreds, we found a small number of biochemical conditions that more than double the PET biodegradation rate. Our work provides a foundation for further studies to realize a fermentation process needed to help solve PET plastic pollution.