Young Trainees Research Articles

Intangibles, Inequality and Stagnation

We examine how aggregate output and income distribution interact with accumulation of intangible capital over time and across individuals. We consider an overlapping generations economy in which managerial skill (intangible capital) is essential for production, and it is acquired by young workers through on-the-job training by old managers. We show that, when young trainees are not committed to staying in the same firms and repaying their debt, a small difference in initial endowment and ability of young workers leads to a large inequality in accumulation of intangibles and lifetime income. A negative shock to endowment or the degree of commitment generates a persistent stagnation and a rise in inequality.

European Network of Trainees in Obstetrics and Gynaecology—ENTOG Exchange 2017: an experience report from Slovenia outlining the different trainee situations around Europe

The European Network of Trainees in Obstetrics and Gynaecology (ENTOG) is a non-profit, independent organisation that represents young trainees in obstetrics and gynaecology around Europe. At present, ENTOG has 32 member countries. The organisation was founded in 1997 and shall assure the exchange of experiences between young physicians all over Europe. The aim is to improve the quality of traineeship in all participating countries and consequently enhance the standards for women's healthcare. This article reports about the experiences of trainees during the ENTOG Exchange 2017 in Slovenia and gives an overview of the trainee situations in different ENTOG member countries. The ENTOG exchange in Slovenia was a unique opportunity to get insights to the Slovenian medical system. Reflecting about their training situations, the participants found considerable differences in the training of young gynaecologists throughout Europe. Working on the ENTOG goal of raising the quality of training is still highly relevant. The ENTOG exchange is an excellent way to build a network among trainees and stimulate their commitment to improve women's healthcare in their home countries and beyond.

Training Young Maxillofacial Surgeons or Trainees Using Additive Manufacturing

Cranio-maxillofacial surgery requires high precision to obtain the desired results. However, to perform such surgeries a surgeon has to go-through intense training. Earlier surgeon was solely dependent on the data obtained from conventional X-ray films which would give only the 2 dimensional depictions. There existed a need for a depiction of the third dimension. The virtual models were obtained by 3 d Scans but the real time performing surgery was the next step. The virtual imaging can be made physical with help of additive manufacturing (AM). AM or 3D-printed models to train new surgeons before they perform complex surgery resolves a dire need for proper training and practice. Additive manufacturing is the perfect technique to create hyper realistic training replicas of complex or rare pathologies which gives a life like feel over which a trainee can practice the art of surgery without the risk of losing an actual patient. The opportunity to use 3D Printing technology in hospitals creates a valuable learning opportunity for new surgeons. The 3D CT images are converted into lifelike, soft, 3D-printed models which can be cut, sewn and operated on. This is just a much more rapid way of expanding the circle of competence of budding surgeons. Apart from regular training, 3D-printed models can also be used in trial runs before an actual surgery is performed.

Report and Abstracts of the 14th Meeting of IIM, the Interuniversity Institute of Myology, - Assisi (Italy), October 12-15, 2017

The 14th Meeting of the Interuniversity Institute of Myology (IIM), October 12-15, 2017 - Assisi, Italy gathered together researchers from Italy, European and North-American countries to discuss recent results on muscle research. The program showcased keynote lectures from world-renowned international speakers presenting advances in muscle physiology, bioengineering, metabolism and therapeutics. Based on selection from submitted abstracts, participants presented their novel, unpublished results in seven oral communication and two poster sessions. Particular emphasis was devoted to young trainees. For example, trainees where directly involved in organizing a scientific session and three round tables tailored to the interests of their peers. The meeting attracted a broad audience from Italy, various European countries and from North America. It offered a unique opportunity to all researchers involved in the field of muscle biology to exchange ideas and foster scientific collaborations to better understand the causative mechanisms of muscular diseases and to improve the design of more efficient therapeutic strategies. The friendly and inclusive atmosphere promoted the active participation of junior scientists to exciting discussions, which allowed to identify emerging areas of myology research and encouraged scientific cross-fertilization to facilitate exchanges between different laboratories in different countries. The meeting was a success and this community will continue to deliver major contributions to our understanding of muscle development and function, the pathogenesis of muscle diseases and the development of novel therapeutic approaches. Here, we report abstracts of the meeting discussing recent results of basic, translational and early clinical studies confirming that the field of Myology is strong and articulated, maturing toward clinical development for the treatment of muscle diseases.

Effect of Adventure Based Counselling on Resilience among National Service Trainee

This study aims to look at the effects of Adventure Based Counselling (ABC) against the resilient (RES) and resilient subconstructs which are optimistic (RES-OPT), self-control (RES-KAD) and facing challenges (RES-CAB) among young trainees at the National Service Training Programme (NS). A total of 60 (N = 60) National service trainees are involved in this quasi-experimental study. They were divided into 2 groups of treatment group and control group. ABC is operated by the 6 facilitators (3 counsellors and 3 NS trainers). Data were collected by self-report through Resilience Scale Instrument (RES) and were analysed with mean difference, T-test, ANCOVA and MANCOVA at a significant level of 0.05. The results showed that ABC has increased the resilience among the subjects of NS trainees. It is suggested that the ABC approach to be used as an alternative counselling treatment in improving the level of resilience among young National Service trainees.

PP.21.02] MENTAL STRESS, PH AND PCO2 AND SYSTOLIC HYPERTENSION

Objective: Resilence is known to be a major risk factor for the development of primary hypertension. Persisting overcompensation during mental irritation increases pH values and oxygen binding in blood samples by respiratory overcompensation. Is this metabolic effect dependent on blood pressure values? Design and method: 23 healthy young officer trainees were tested for pCO2, O2 saturation, pH values (PhOX-M, TECOM, Austria) and blood pressure values (Beurer, Ulm, Germany) during the sympatho-adrenal anticipation phase before their first parachute jump. Both, the entire group as well as two subgroups, consisting of systolic blood pressure values above average and below average (normal values) have been investigated. Results: The relation pH/pCO2, indicative of breathing frequency and acid management shows a rather weak negative linear correlation in the entire group (r = 0.329). The normal systolic blood pressure group shows no correlation at all, the high systolic blood pressure group developed a highly significant negative correlation of pH/CO2 (r = 0.656, p < 0.001). At the same time, O2 saturation increases with increasingly alkaline blood and decreasing pCO2 (p < 0.05). Conclusions: Mental stimulation increases blood pH by respiratory overcompensation and thereby increases O2 binding. Consequently, less O2 reaches e.g. heart tissue at higher demand during a sympatho-adrenal anticipation phase, which is by no means uncommom during day-to-day exertions. This symptom is much less significant at normal blood pressure values, but highly significant at higher systolic blood pressure values. Therefore, increased systolic blood pressure values institute an integral part of significantly negative metabolic effects upon the heart during even commonplace mental stimulation or irritation.

Antenne sociali per la formazione iniziale: un approccio strutturale per la rilevazione dei bisogni

Good territorial policy planning needs preliminary considerations about local needs. The present case study intends to reflect on the importance of policy reference context, starting from the identification of initial trainees’ needs in a vocational training centre in Piedmont. This research experience designs a detection system (social antenna) aiming at identifying systemic needs of students and their families, in order to provide appropriate policy making tools. The multi-dimensionality of trainees’ social disadvantage is addressed by structural equation modeling. The present social antenna is specifically designed to detect the changing needs of young trainees, but the systematization of this methodological approach can guarantee the use of social antennas in different areas and contexts. The fil rouge is the ability to provide policy indications on-the-fly, so that the policy makers can instantaneously (re)orient interventions, depending on environmental changes.

Piloting an injury awareness and education program for reducing alcohol-related harm in Navy Trainees

ABSTRACTObjectives: Alcohol consumption and associated risk-taking behaviors, are known issues among trainees in the Australian Defence Force. We evaluated the impact and feasibility of a 1 day injury awareness program designed to reduce alcohol-related risk-taking behavior and associated harms in young naval trainees in this pilot study. Method: One hundred eight naval trainees participated in the 1 day Prevent Alcohol and Risk related Trauma in Youth (P.A.R.T.Y.) program at a hospital in Melbourne, Australia between November 2011 and March 2013. Participants completed pre- and postprogram questionnaires, on the day of the program, that included questions on perceptions of the program and their own risk-taking behavior. Alcohol-related incidents reported on their military record were collected at 12 months postprogram. Pre- and postprogram questionnaire responses were compared using descriptive statistics. Survival analysis was used to assess the association between pre-program alcohol-related incidents and the rate of reporting of alcohol-related incidents in the 12 months after the program. Results: Fifty of the 108 (46%) participants were reported for ≥1 alcohol-related incident prior to study participation. Fifteen (14%) were reported for an alcohol-related incident within 12 months of completing the program. Participants perceived the program positively with 92% reporting that the program would definitely influence their behavior after program completion compared to 82% suggesting so before. The rate of reported alcohol-related incidents following the program was higher for participants who had a preprogram incident on record than those who did not. Conclusion: Our findings suggest that PARTY participation was associated with a change in participants’ perceptions of risk-taking behavior. We found that alcohol-related incidents after attending the P.A.R.T.Y. program occurred more frequently among participants who had prior alcohol-related incidents suggesting the program may have less impact on this group. Further work is required to establish effectiveness of the P.A.R.T.Y. program in the military setting.

The organisation and needs of young sections belonging to UEG National Societies: Results of a Europe-wide survey.

One of the aims of the Young Talent Group (YTG) is to make United European Gastroenterology (UEG) more attractive for young fellows interested in gastroenterology, and to involve them actively in UEG activities, by collaborating with young GI sections (YGIS) across Europe. Therefore, the YTG launched a survey to collect up-to-date information on YGISs belonging to UEG National Societies. The Friends of YTG were chosen as the target population and received a web-based questionnaire concerning their personal information, the structure of YGIS in their respective country, the YGIS' support mechanisms for young trainees, and ideas on how to improve them. Overall, 24 of 29 Friends answered the survey (83%). Among the Societies surveyed, only half have a young section. Typically, YGIS are supported, but not influenced, by National Societies through several initiatives. Results of the survey suggest that a lack of funding, of harmonised education, and of active roles available within National Societies, were the concerns most prevalent among young fellows. Our survey shows that the development of YGIS is being hindered by organisational, financial, and political issues. The YTG believes that a close collaboration between National Societies, UEG, and the YTG is necessary in order to offer young fellows the most productive and professionally satisfying future possible.

Psychiatrist Teams With Elyn Saks on Opera Depicting Psychosis

Psychiatrist Teams With Elyn Saks on Opera Depicting Psychosis

Commercial competence: comparing test results of paper-and-pencil versus computer-based assessments

BackgroundVocational education and training (VET) aims to enable young adults or trainees to participate in the workplace, and to promote their vocational capacities. In order to examine trainees’ competencies at the end of VET, appropriate instruments are needed. This contribution aims: (1) to give an outline of such an instrument, one that has been designed to evaluate vocational competencies in the field of economics, and (2) to present the results of an empirical comparison of two possible test modes: computer-based assessment (CBA) versus paper-based assessment (PBA). The use of new technologies offers various opportunities for competence measurement: in particular, the computer as an assessment tool presents an authentic work tool drawn from professional life and promises novel ways of designing assessments. However, the current assessment practice in Germany is dominated by the use of traditional PBA, and there is less evidence about the possible effects of CBA. This study addresses the question of whether there are significant differences in the various ways of representing and measuring commercial competence with respect to specific content, item format, and, finally, motivational aspects.MethodsA sample of 387 trainees from the German VET system was used to compare these two kinds of assessment. The analyses were realized using Item Response Theory and, particularly, Differential Item Functioning to detect differences between PBA and CBA at the item level. In addition to the performance data, motivational aspects, such as emotional state and test attractiveness, were also taken into account by a pre-/post-questionnaire.ResultsThe study demonstrates that both test formats (CBA and PBA) can represent commercial competence in a valid and reliable way, but differences were found for certain items in the number of correct responses. The PBA shows a slight advantage in respect of overall item and model fit. Another key finding of our comparative study, at item level, is important from an instructive viewpoint: (domain) specific items are easier to solve in CBA than in PBA, whereas more general items are answered correctly more frequently in the latter. Contrary to expectations, we could not confirm the overall dominance of CBA against PBA on the basis of test takers’ motivation, but values from CBA were more stable over time.ConclusionsThe study facilitated making the strengths and weaknesses of both test formats evident, and this implies the possibility of identifying opportunities for further development in assessment practice and in designing tests. Selected design criteria and aspects of test administration are discussed, with the aim of seeking to optimize test development in order to create the best possible estimates for young adults’ competence and capacity to participate in the world of work.

Burden of Influenza-like Illness Among Military Personnel Receiving Advanced Training at Ft. Sam Houston, TX

BackgroundInfluenza-like illness (ILI) places a significant burden on operational readiness in the U.S. military, particularly in trainees who live and work in congregated settings. ILI incidence rates for the trainees are based on passive surveillance of those presenting to medical clinics. Such clinic-based surveillance may under-estimate the true ILI burden because trainees with ILI may not seek health care due to mild symptoms or fear of missing training. We aimed to estimate the hidden ILI burden among trainees and behaviors related to healthcare seeking for ILI.MethodsA 1-page voluntary, anonymous ILI survey was administered during the end of program sessions for military medical trainees at Fort Sam Houston (JBSA-FSH), TX. The survey was started in January 2017 and is ongoing.ResultsBetween January and April 2017, 724 surveys were returned: respondents were aged 17–42 years (median 20 yo), 299 (41%) were female, and 442 (62%) white. The trainees maintained a healthy and active life style: 94% exercised at least 3 times a week; 79% never smoked and only 3% were obese. Overall, 68% trainees reported ILI symptoms during training: the proportion decreased from 75% in January to 46% in April (P-for-trend <0.01). History of travel and self-reported contact to people with ILI were associated with reporting having ILI. Of those reporting ILI, only 36% sought health care, and the proportion did not change over the four month period. Females were more likely to seek health care if they developed ILI: 43% of females vs. 31% of males (P = 0.02). While the majority of trainees washed their hands or used hand sanitizer at least 4 times a day, only 60% of trainees washed their hands after covering their mouth/nose for a sneeze, which may facilitate ILI circulation in the population.ConclusionAmong young and healthy medical trainees at JBSA-FSH, ILI was reported frequently during winter and decreased in spring. Trainees often did not seek health care for mild symptoms. The high prevalence of self-reported ILI among trainees despite their healthy life styles and good daily hand hygiene warrants further study. A better understanding of the impact of self-reported ILI on performance and of factors associated with health-care seeking are needed.Disclosures All authors: No reported disclosures.

Cruising through the journey without getting drowned: The saga of a PhD student in the Netherlands

Young medical trainees all over the world are encouraged to investigate unknown areas of medicine that need clarification. This often leads them to undertake a PhD (Doctor of Philosophy). Being curious, critical, and creative are necessary competences which enable us to engender scientific research within acute (internal) medicine. Worldwide, huge numbers of professionals are pursuing a PhD, with the aim of receiving a ‘Doctor’-title. These PhD trajectories vary distinctly between countries. Since the distances in the scientific world are getting smaller and it is becoming more easy to work with each other across borders, it might be interesting to know what it requires to become an academic ‘doctor’ overseas. Hereby, we provide a concise insight in to the differences between doing PhD in (acute) medicine in the Netherlands and in the UK

SC30.03 E-Learning in Thoracic Oncology

Advances in modern technologies allows for an increasing opportunities in surgical and medical education. The main advantages for e-learning process are: accessibility and flexibility. A range of platforms offers educational programs accessible at work or home with total temporal and spatial freedom. Trainees are allowed to access their learning environment at a convenient time and relevant to their own training needs. Several techniques are available: web-based data, interactive online modules, and virtual reality. This is especially true within surgical training where the development of new techniques constantly evolves. The rapid and constant evolution in oncology knowledge’s makes it relevant for e-leaning process. E learning allows trainees to apply and be assessed on the new information in a safe setting. In addition, all contents can be discussed and debated around the medical world without any limits. The level of trainees recall can be significantly increased by e-learning techniques because it stimulates multi-sensory experiences. E learning offers also large possibilities for decision making based on available information and interactive decision-making process. Surgical e-learning programs include the development of knowledge, technical skills, non-technical skills and decision-making process. The content of all the e-learning modules should be relevant; best available, up to date and critically appraised evidence should supports the information contained within the modules. E-learning surgical programs should be based on an understanding of educational principles, peer review resources associated to creativity. It could be highly interactive. Immersive questions and answers for clinical setting permit to trainee to progress through scenarios and makes the relevant decisions and choices. Trainees have to evolve with their decisions and receive feedback as to the choices they have made. These interactive models can be created with text on the page or with simulators. E-learning modules should be used as a complementary tool to traditional learning methods. Authors will present their e-learning thoracic platform created at September 2013: “Tenon Thoracic Institute“ (www.tenon-thoracic-institute).This e-leaning thoracic platform develops several e-learning tools: live from OR with interactive discussion with faculty, round table with exerts, didactic session for young trainees. All the aspects around thoracic pathology are treated: oncology, surgery, anesthesiology, radiology, etc. Authors will discuss the relevance of such a platform, the lack of its content and future e-leaning projects. thoracic oncologic surgery, oncology, e-learning, education

Insufficient global health education in European neurological post-graduate training: a European Association of Young Neurologists and Trainees survey.

The awareness of and demand for neurological expertise in global health (GH) have emerged over recent years and have become more relevant due to the increasing numbers of refugees from developing countries arriving in Europe. This study aimed to assess the provision of GH education and opportunities for international exchange during neurology post-graduate training with a focus on Europe. We developed a questionnaire covering different aspects of and interest in GH education on behalf of the European Association of Young Neurologists and Trainees. Residents in neurology and junior neurologists (RJN) were approached to complete this survey. Completed questionnaires were returned by 131 RJNs, of whom 65.7% were women and 84.0% were between 26 and 35 years old. In total, almost one-third (29.0%) of RJNs reported that their residency programs offered training in GH. Limited education was reported for women's or children's health and neurological disorders of immigrants and refugees, as only 22.1%, 25.2% and 22.1% of RJNs reported that such training was offered, respectively. The curriculum rarely included coverage of the global impact of neurological disorders. Definite plans to volunteer in a developing country were reported by 7.6%. The majority of the participants acknowledged the importance of GH training and international exchange during post-graduate education. This survey corroborates the interest in and appreciation of GH education by European RJNs. However, there are shortcomings in training and opportunities for international exchange. Academic neurology and international bodies, including the European Academy of Neurology, are requested to address this.

Centenary of the death of Elie Metchnikoff: a visionary and an outstanding team leader

Elie Metchnikoff passed away on July 15th, 1916. He is considered to be the father of phagocytes, cellular innate immunity, probiotics, and gerontology. In all of these fields, he was a visionary. To achieve such a notability and produce so many masterpieces, Metchnikoff used more than 30 animal species to support his findings, and his pasteurian laboratory published more than 200 papers in the Annales de l’Institut Pasteur. As a wonderful team leader and a great mentor, during his 28 years at Institut Pasteur, he welcomed and supervised more than 100 young trainees. Trained as an embryologist, he contributed to the birth of immunology and to the understanding of physiology and pathology. Indeed, Metchnikoff and his team investigated inflammation in guinea pigs, rats, frogs; studied infectious diseases in monkeys, caimans, geese; investigated aging in parrots, dogs, humans; proposed hypotheses to understand age-associated senility using rabbits and humans; developed germ free tadpoles, flies, chicks; studied the gut flora in bats, horses, birds, humans; and popularized the use of probiotics as a tool to delay the deleterious effects of toxic compounds derived from putrefactive gut bacteria. He was also a philosopher and penned essays on human disharmony and on pessimism and optimism.

Override ship maneuvering simulator using AR toolkit

AbstractThis paper proposes an override ship maneuvering simulator using an actual training ship for young pilot trainees. In this new simulator, augmented reality toolkit was used to reproduce scenery from the bridge of a large vessel on the actual training ship. Moreover, the system reproduced the large vessel’s maneuverability under wind disturbance on the training ship. The effectiveness of the developed system was indicated with results of an actual ship experiment.

Effects of vocational training on unemployed youths' work motivation and work engagement: Mediating roles of training adequacy and self-actualization

This study investigated work motivation and work engagement, along with their associated factors, among unemployed young people participating in vocational training schemes in Tianjin, China. Derived from a sample of 209 young trainees (mean age=22.67, SD=1.93), the results supported the hypotheses that training adequacy and self-actualization showed positive effects on work motivation and work engagement. Furthermore, training variables (the number of training courses attended and duration of workplace training) did not present any significant direct effect on either work motivation or work engagement; however, they predicted the two outcome variables indirectly through the mediating effects of training adequacy and self-actualization. The study implied that power, skills, and other resources gained during the training provided fuel for motivation and performance. The study also advanced the human capital development approach by unraveling the mechanism through which hard skills and soft skills contribute to youth empowerment and employment. The implications of these present findings for theory, practice, and policy were also discussed.

Voice of young neurologists around the world.

At the 67th annual meeting of the American Academy of Neurology (AAN), there was a roundtable discussion with representatives from the International Working Group of Young Neurologist and Trainees–World Federation of Neurology (IWGYNT-WFN), Asia and Oceanian Association of Neurology, Association of South East Asian Nations Neurological Association, European Association of Young Neurologists and Trainees (EAYNT), and the AAN's Consortium of Neurology Residents and Fellows (AAN-CNRF). The purpose of the meeting was to provide updates on the developments affecting young neurologists throughout the world, as well as to discuss current initiatives focused on the improvement of neurology training on the international stage.

Study the Impact of Diabetes Camps on Adherence to Medication and Glycaemic Control in Uttarakhand.

Diabetes is a major public health problem which needs to be addressed with outmost planning in resource poor settings. Good glycaemic control and medication adherence patterns can play an important role in reducing disease related complications thereby reducing morbidity and mortality among diabetics. Disease specific camps can act as a stepping stone in providing limited care to the patients. The study was planned to study the impact of diabetes camp on glycaemic control and adherence to antidiabetic medication among diabetic patients at a Government Teaching Hospital, Srinagar, Garhwal, Uttarakhand, India. A cross-sectional study using a medication adherence questionnaire collected from the patients participating in diabetic camps and measuring their HbA1C levels before and after the camps along with spreading awareness about the disease. Two diabetes awareness camps were organized, three month apart and the participants were imparted knowledge about the disease. A total of 50 patients with type 2 DM who had self reported history of diabetes and were on some form of oral anti diabetics confirmed by their prescriptions. The patients were called for monthly follow up in outpatient department. A six question preformed questionnaire - the Girerd's instrument was used to assess the level of adherence to the prescribed anti-diabetic drugs in 50 patients with type 2 diabetes mellitus, their HbA1C levels were estimated and the results were analysed using standard statistical methods. A total of 50 type 2 diabetic, 48 were studied comprising 23 (47.9%) women and 25 (52.1%) men with a mean age of 57.43 years. The average duration of diabetes among participants was 7.02 years. Poor medication adherence score was recorded in 27 participants and only 7 participants had good adherence to medication before the camp. After the camp, 19 participants had good adherence and 7 had poor medication adherence scores. As a result of improved adherence, improvement in glycaemic control was noticed by a decrease of 0.5 units in the mean HbA1C value by the end of the study. The results clearly showed that group intervention in the form of camp combined with monthly follow-ups could improve adherence as well as glycaemic control at a government teaching hospital in a resource poor setting. This could also involve and encourage society as well as young trainees to participate collectively in the care of diabetics.