Changes in physical performance during British Army Junior Entry, British Army Standard Entry and Royal Air Force Basic Training.

INTRODUCTION: The purpose was to quantify physical performance in men and women during British Army Junior Entry (Army-JE), British Army Standard Entry (Army-SE) and Royal Air Force (RAF) basic training (BT). DESIGN: Prospective longitudinal study. METHODS: 381 participants ((339 men and 42 women) n=141 Army-JE, n=132 Army-SE, n=108 RAF) completed a 2 km run, medicine ball throw (MBT) and isometric mid-thigh pull (MTP), pre-BT and post-BT. To examine changes in pre-BT to post-BT physical test performance, for each course, paired Student t-test and Wilcoxon test were applied to normally and non-normally distributed data, respectively, with effect sizes reported as Cohen's D and with rank biserial correlations, respectively. A one-way between-subjects analysis of variance (ANOVA) (or Welch ANOVA for non-normally distributed data) compared performance between quartiles based on test performance pre-BT. Where the main tests statistic, p value and effect sizes identified likely effect of quartile, post hoc comparisons were made using Games-Howell tests with Tukey's p value. Data are presented as mean±SD, with statistical significance set at p<0.05. RESULTS: During BT, 2 km run time improved by 13±46 s (-2.1%±8.1%), 30±64 s (-4.8%±12.3%) and 24±27 s (-4.5%±5.1%) for Army-JE, Army-SE and RAF, respectively (all p<0.005). MBT distance increased by 0.27±0.28 m (6.8%±7.0%) for Army-JE (p<0.001) and 0.07±0.46 m (2.3%±10.9%) for Army-SE (p=0.040), but decreased by 0.08±0.27 m (-1.4%±6.0%) for RAF (p=0.002). MTP force increased by 80±281 n (10.8%±27.6%) for Army-JE (p<0.001) and did not change for Army-SE (-36±295 n, -0.7%±20.6%, p=0.144) or RAF (-9±208 n, 1.0±17.0, p=0.603). For all tests and cohorts, participants in the lowest quartile of pre-BT performance scores demonstrated greater improvements, compared with participants in the highest quartile (except Army-JE MBT, ∆% change similar between all quartiles). CONCLUSIONS: Changes in physical performance were observed for the three fitness tests following the different BT courses, and recruits with the lowest strength and aerobic fitness experienced greatest improvements.

Implementing nitrous oxide cracking technology in the labour ward to reduce occupational exposure and environmental emissions: a quality improvement study.

Nitrous oxide, a potent greenhouse gas, is a common labour analgesic. One method which may reduce its carbon footprint is to 'crack' the exhaled gas into nitrogen and oxygen using catalytic destruction. In this quality improvement project, based on environmental monitoring and staff feedback, we assessed the impact of nitrous oxide cracking technology in the maternity setting. Mean ambient nitrous oxide levels were recorded during the final 30 minutes of uncomplicated labour in 36 cases and plotted on a run chart. Interventions were implemented in four stages, comprising: stage 1, baseline (12 cases); stage 2, cracking with nitrous oxide delivered and scavenged via a mouthpiece (eight cases); stage 3, cracking with nitrous oxide via a facemask with an air-filled cushion (eight cases); stage 4, cracking with nitrous oxide via a low-profile facemask, and enhanced coaching on the use of the technology (eight cases). The median ambient nitrous oxide levels were 71% lower than baseline in stage 2 and 81% lower in stage 4. Staff feedback was generally positive, though some found the technology to be cumbersome; successful implementation relies on effective staff engagement. Our results indicate that cracking technology can reduce ambient nitrous oxide levels in the obstetric setting, with potential for reductions in environmental impacts and occupational exposure.

'Summer of Sport': the development of a 6-week programme in increasing physical activity to improve public health outcomes.

OBJECTIVES: A population-based physical activity (PA) programme was implemented to increase PA levels and encourage individuals to join the local council leisure facility. STUDY DESIGN: This is a cross-sectional design. METHODS: The 6-week programme Summer of Sport (SOS) involved a total of 487 individuals registered for PA sessions. The sessions were held at three local council leisure facilities included badminton, swimming, table tennis, squash and group cycle. The programme was assessed using a survey based on the Theory of Planned Behaviour. Individuals were asked for their current fitness levels, whether the programme encouraged them to be more active and for their intentions to join the leisure centre after the programme. RESULTS: Of the 487 who originally registered for the programme, there were 161 users of SOS, with 112 not already members of the leisure facility. After the programme, 83% considered themselves already being active, with 78% stating that they partook in at least 30 min of exercise, 3 times per week. Although a large proportion of individuals were already physically active, 78% stated that taking part encouraged them to become more active. More than half suggested that they would not join the leisure facility, 30% said that they had joined after the programme and 17% stated their intention to join. Many individuals highlighted that the programme provided an opportunity to be active with their family. CONCLUSIONS: Public health teams should work with partner organisations to embed robust processes for measuring outcomes that impact on population health.