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A second set of studies evaluates the social effects of training programs in Latin America.
Although recent empirical studies reveal that fostering patients' perception of meaning in their lives is an essential task for palliative care clinicians, few studies have reported the effects of training programs for nurses specifically aimed at improving these skills.
A variety of intervention studies have shown positive, but only temporary, effects of training programs.
Further studies are necessary to determine the effects of training programs on outcome in patients with PH.
Clearly, more research is needed about the different effects of training programs on cardiopulmonary function, skeletal muscle microcirculation, oxidative capacity, and fiber-type composition in these different conditions.
While several studies have evaluated the effects of training programs for nurses and care-aides aimed at improving oral care support, e.g. [ 79- 82], or have documented barriers to oral care provision for this group, e.g.[ 83- 88], one major barrier to accurate oral care support from nurses remains largely unaddressed.
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In a systematic review of the effect of training programs for parents of children 0 7 years, Kaminski et al. (2008) included 48 controlled studies.
Three RCT's [ 21, 34, 35] and a controlled study [ 25], found an effect of training programs for nurses regarding challenging behavior on the behavior of the residents.
Although much of the research into training nursing staff shows methodological limitations, several studies find some effect of training programs on knowledge about and on management of challenging behavior.
Future trials are necessary to contrast different approaches to CART, considering the effect on order of training program in the T2D population.
The few studies that did study the effects of such training programs, reported some effects [ 19, 20] but they combined their training programs with alterations in work schedules, so that it was impossible to address the measured fatigue reduction and performance improvement to the training program alone.
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