Exercise-Induced Cardiac Fatigue in Soldiers Assessed by Echocardiography

Background: Echocardiographic signs of exercise-induced cardiac fatigue (EICF) have been described after strenuous endurance exercise. Nevertheless, few data are available on the effects of repeated strenuous exercise, especially when associated with other constraints as sleep deprivation or mental stress which occur during military selection boot camps. Furthermore, we aimed to study the influence of experience and training level on potential EICF signs.Methods: Two groups of trained soldiers were included, elite soldiers from the French Navy Special Forces (elite; n = 20) and non-elite officer cadets from a French military academy (non-elite; n = 38). All underwent echocardiography before and immediately after exposure to several days of uninterrupted intense exercise during their selection boot camps. Changes in myocardial morphology and function of the 4 cardiac chambers were assessed.Results: Exercise-induced decrease in right and left atrial and ventricular functions were demonstrated with 2D-strain parameters in both groups. Indeed, both atrial reservoir strain, RV and LV longitudinal strain and LV global constructive work were altered. Increase in LV mechanical dispersion assessed by 2D-strain and alteration of conventional parameters of diastolic function (increase in E/e' and decrease in e') were solely observed in the non-elite group. Conventional parameters of LV and RV systolic function (LVEF, RVFAC, TAPSE, s mitral, and tricuspid waves) were not modified.Conclusions: Alterations of myocardial functions are observed in soldiers after uninterrupted prolonged intense exercise performed during selection boot camps. These alterations occur both in elite and non-elite soldiers. 2D-strain is more sensitive to detect EICF than conventional echocardiographic parameters.

New Zealand’s recent experiences with Military Activity Camps under the new youth justice system

<p>This research paper discusses the recent New Zealand experience of Military Activity Camps (MACs) through the implementation of the Children, Young Persons, and Their Families (Youth Courts Jurisdictions and Orders) Amendment Act 2010. The paper will address the fundamental principles of the youth justice system under the Children, Young Persons, and Their Families Act 1989 and how the Amendment Act 2010 has created new possibilities of dealing with New Zealand’s most persistent group of young offenders. It will furthermore address the historic background of boot camps and aims to analyse how effective the introduction of MACs has been so far. Finally it will look at what alternative measures may exist in order to fight youth offending and recidivism.</p>

New Zealand’s recent experiences with Military Activity Camps under the new youth justice system

<p>This research paper discusses the recent New Zealand experience of Military Activity Camps (MACs) through the implementation of the Children, Young Persons, and Their Families (Youth Courts Jurisdictions and Orders) Amendment Act 2010. The paper will address the fundamental principles of the youth justice system under the Children, Young Persons, and Their Families Act 1989 and how the Amendment Act 2010 has created new possibilities of dealing with New Zealand’s most persistent group of young offenders. It will furthermore address the historic background of boot camps and aims to analyse how effective the introduction of MACs has been so far. Finally it will look at what alternative measures may exist in order to fight youth offending and recidivism.</p>

Prognostic significance of drivers at work and learning styles in surgical training

Purpose of the studyDrivers at work (DW) and Learning Styles (LS) refer to contentious theories that aim to account for differential career development yet seldom feature in assessment. This study aimed to quantify the influence of core surgical trainees’ (CST) DW and LS on career progress.Study designDW questionnaires and Kolb LS inventories were distributed to 168 CSTs during five consecutive induction boot camps in a single-statutory education body. Primary outcome measures were membership of the Royal College of Surgeons (MRCS) examination and national training number (NTN) success.ResultsOf 108 responses received (response rate 64.3%), 64.8% were male and 35.2% female (p=0.003). DW spectrum was: please people (25.0%), be perfect (21.3%), hurry up (18.5%), be strong (13.9%) and try hard (0%, p<0.001). DW was either equivocal (n=14) or not provided (n=9) by 21.3% of CSTs. LS were: converging (34.3%), accommodating (28.7%), diverging (23.1%) and assimilating (13.9%, p=0.021). Men were more likely to be convergers (29/70, 41.4%), and women divergers (15/38, 39.5%, p=0.018) also preferring team-based LS (accommodating/diverging, 26/38 (68.4%) vs 30/70 (42.9%), p=0.010). MRCS success was not associated with DW (p=0.329) or LS (p=0.459). On multivariable analysis, NTN success was associated with LS (accommodators 64.5%, divergers 32.0%, OR 10.90, p=0.014), scholarly activity (OR 1.71, p=0.001), improving surgical training programme (OR 36.22, p=0.019) and universal ARCP 1 outcome (OR 183.77, p<0.001).ConclusionsLS are associated with important differences in career progress with accommodator twofold more likely than diverger to achieve NTN.

SP2.1.16Prognostic significance of Drivers at Work and Learning Styles in surgical training

Aims Drivers at Work (DW) and Learning Styles (LS) refer to a range of contentious theories that aim to account for differences in career progression, yet seldom feature in training assessment. This study aimed to quantify the influence of Core Surgical Trainees’ (CST) DW and LS on career progression. Methods Kolb LS inventories were distributed to 168 CSTs during five consecutive induction boot camps in a single Statutory Education Body. Primary outcome measures were MRCS and National Training Number (NTN) success. Results Of 108 responses received (response rate 64.3%), 64.8% were male and 35.2% female (p = 0.003). The spectrum of DW was: Please People (25%), Be Perfect (21.3%), Hurry Up (18.5%), Be Strong (13.9%), and Try Hard (0%, p &lt; 0.001). DW was either unequivocal or not provided by 23 CSTs (21.3%). The spectrum of LS was: Converging (34.3%), Accommodating (28.7%), Diverging (23.1%), and Assimilating (13.9%, p = 0.021). MRCS success was not associated with DW (p = 0.703) or LS (p = 0.598). Men were more likely to have Converging LS (29/70, 41.4%), and women Diverging LS (15/38, 39.5%, p = 0.018) and to have team-based LS (Accommodating / Diverging, 26/38 vs. 30/70, p = 0.010). NTN success was associated with LS (p = 0.038) with Convergers achieving most NTNs (65.4%). Conclusions LS are associated with important differences in career progression with Converging LS three-fold more likely to achieve NTNs than Diverging LS.

Simulation-based Boot-camp Improves the Self-efficacy of Newly Inducted Hospital Residents and Interns

IntroductionExpectation of competence from interns and residents from outset stresses the need for bridging the gap between undergraduate and post-graduate worlds, in terms of clinical skills. Worldwide, simulation-based boot camps ease this transition and equip novice trainees with essential foundation knowledge, technical skills, and effective communication. This study describes the introduction, change management process, and analyzes effectiveness of first-ever boot camp in Pakistan aimed at improving self-efficacy of PGME interns and residents. A boot camp of 4 days duration was conducted in December 2018 at The Aga Khan University Hospital (AKUH) for newly inducted PGME interns and residents. 40 residents and 68 interns completed a self-administered self-efficacy questionnaire after boot camp.ResultsThere was a significant overall improvement in self-efficacy of trainees across all skills. Self-efficacy improved most in CVC insertion, hospital management software) and communication, while, least gain was seen in infection control post-boot camp. Boot camp approach has proven to be an efficient, safe, forgiving, experiential learning environment for healthcare professionals and prepares them to thrive in a new hospital setting. Analysis supports effectiveness of boot camp in improving the self-efficacy of new trainees and provides direction for future planning of boot camps.

Coding Boot Camps

College-educated women in the workforce are discovering a latent interest in and aptitude for computing motivated by the prevalence of computing as an integral part of jobs in many fields as well as continued headlines about the number of unfilled, highly paid computing jobs. One of these women's choices for retraining are the so-called coding boot camps that teach programming skills through intensive multi-week courses. This article reports on a qualitative research study focused on the Silicon Valley area of California. We used social cognitive career theory (SCCT) to investigate the larger context surrounding women entering computing professions through boot camp learning sites, including: the environment of a booming technology workforce, boot camps as learning settings , the characteristics of women who attend boot camps, how retraining at a coding boot camp influence women's computing self-efficacy and outcome expectations , and the performance attainments of women at boot camps. Interview data was collected from 14 women who had attended boot camps—first before graduating from the boot camp and again after six months in the workforce. To contextualize the computing ecosystem, we conducted single interviews with 6 boot camp organizers/curriculum developers, 7 industry hiring managers, and 14 university computer science faculty. To provide a contrast with women at boot camps, we interviewed 5 women who majored in computer science at the university and with 17 men who had attended boot camps. Structural data coding and analysis was done focused on the SCCT mechanisms of environment, person inputs, learning experiences, self-efficacy, outcome expectations, and performance attainments. Findings here demonstrate that training at a boot camp can be the catalyst for college-educated women to attain computing jobs and careers, although these entry-level jobs may be a compromise to the goal of a software development job and are unlikely to lead to a job at large, well-known, established technology companies.