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1.
Ann R Coll Surg Engl ; 102(2): e42-e44, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31538800

RESUMO

Erdheim-Chester disease is a rare infiltrative histiocytic disorder with around 800 cases being reported worldwide. Patients most commonly present with skeletal pain, but the condition has been shown to affect multiple other organs. We describe a rare presentation in which the disease infiltrated the sinuses and affected an ex-RAF pilot's vision. After extensive investigation of the elusive diagnosis, repeating of a molecular test using polymerase chain reaction analysis allowed for identification of a mutation (BRAF V600) ultimately leading to the diagnosis of Erdheim-Chester disease.


Assuntos
Cegueira/etiologia , Doença de Erdheim-Chester/diagnóstico , Sinusite/etiologia , Cegueira/terapia , Análise Mutacional de DNA , Diagnóstico Diferencial , Doença de Erdheim-Chester/complicações , Doença de Erdheim-Chester/genética , Doença de Erdheim-Chester/terapia , Osso Etmoide/diagnóstico por imagem , Osso Etmoide/patologia , Osso Etmoide/cirurgia , Glucocorticoides/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Osteotomia , Pilotos , Proteínas Proto-Oncogênicas B-raf/genética , Sinusite/terapia , Osso Esfenoide/diagnóstico por imagem , Osso Esfenoide/patologia , Osso Esfenoide/cirurgia , Tomografia Computadorizada por Raios X
2.
Int J Occup Saf Ergon ; 26(1): 37-45, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29570043

RESUMO

Objective. To assess the fatigue risk is an important challenge in improving flight safety in the aviation industry. The aim of this study was to develop a comprehensive fatigue risk management indicators system and a fatigue questionnaire for Chinese civil aviation pilots. Methods. Participants included 74 civil aviation pilots (all males). They finished the questionnaire in 20 min before a flight mission. Estimation of internal consistency with Cronbach's α and Student's t test as well as Pearson's correlation analysis were the main statistical methods. Results. The results revealed that the fatigue questionnaire had acceptable internal consistency reliability and construct validity; there were significant differences in fatigue scores between international and domestic flight pilots. Also, some international flight pilots, who had taken medications as a sleep aid, had worse sleep quality than those who had not. Long-endurance flights across time zones caused significant differences in circadian rhythm. Conclusions. The fatigue questionnaire can be used to measure Chinese civil aviation pilots' fatigue, which provides a reference for a fatigue risk management system for civil aviation pilots.


Assuntos
Aviação , Fadiga/diagnóstico , Pilotos , Adulto , China , Humanos , Masculino , Pessoa de Meia-Idade , Gestão de Riscos , Privação do Sono , Inquéritos e Questionários
3.
Technol Cancer Res Treat ; 18: 1533033819876899, 2019 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-31533537

RESUMO

Irreversible electroporation causes cell death through low frequency, high voltage electrical pulses and is increasingly used to treat non-resectable cancers. A recent systematic review revealed that tissue damage through irreversible electroporation is time-dependent, but the impact of time on the ablation zone size remains unknown. Irreversible electroporation ablations were performed hourly during 24 consecutive hours in the peripheral liver of 2 anaesthetized domestic pigs using clinical treatment settings. Immediately after the 24th ablation, the livers were harvested and examined for tissue response in time based on macroscopic and microscopic pathology. The impact of time on these outcomes was assessed with Spearman rank correlation test. Ablation zones were sharply demarcated as early as 1 hour after treatment. During 24 hours, the ablation zones showed a significant increase in diameter (rs = 0.493, P = .014) and total surface (rs = 0.499, P = .013), whereas the impact of time on the homogeneous ablated area was not significant (rs = 0.172, P = .421). Therefore, the increase in size could mainly be attributed to an increase in the transition zone. Microscopically, the ablation zones showed progression in cell death and inflammation. This study assessed the dynamics of irreversible electroporation on the porcine liver during 24 consecutive hours and found that the pathological response (ie, cell death/inflammation), and ablation size continue to develop for at least 24 hours. Consequently, future studies on irreversible electroporation should prolong their observation period.


Assuntos
Técnicas de Ablação , Eletroporação/métodos , Fígado , Animais , Biópsia , Imuno-Histoquímica , Modelos Animais , Pilotos , Suínos
4.
Int J Occup Med Environ Health ; 32(5): 653-662, 2019 Oct 16.
Artigo em Inglês | MEDLINE | ID: mdl-31511703

RESUMO

OBJECTIVES: The study analyzed the effectiveness of military pilots' behavior under the influence of false horizon illusion - a false perception of the real horizon. It was assumed that visual illusion tends to cause spatial disorientation (SD). The question was asked which orientation of the sloping cloud (right/left) would have a bigger impact on SD. The effectiveness of the flight profile performance under the influence of visual illusion was analyzed in the context of the field dependence (FD), field independence (FI) or field intermediate dependence (FINT) of perception, the effectiveness of attention and operational memory. MATERIAL AND METHODS: The study covered 66 pilots. A flight simulator was used as a measure of effectiveness in performing the flight profile in spatial disorientation conditions. The effectiveness of attention and working memory was diagnosed using 4 computer tasks. RESULTS: It was revealed that the right sloping cloud (compared to the left sloping cloud) had a greater impact on military pilots' behavior. The cognitive style distinguishes the accuracy of the flight profile performance from the inclined cloud pointing to the right. The comparisons showed significant differences between the FI and FD pilot groups. All the pilots demonstrated the right-sided asymmetry of the flight rate. While performing tasks on the simulator, the FI pilots were characterized by a more stable rate than the FINT pilots. CONCLUSIONS: A general conclusion is that the "correct falling cloud" had a greater impact on pilots' behavior. The presented results confirm the hypothesis that susceptibility to visual illusions is significantly increased in the pilots characterized by field dependence while the pilots with the FINT style of perception are characterized by a greater variability of the flight rate. Int J Occup Med Environ Health. 2019;32(5):653-62.


Assuntos
Cognição , Ilusões/psicologia , Pilotos/psicologia , Adulto , Medicina Aeroespacial , Simulação por Computador , Humanos , Memória de Curto Prazo , Militares/psicologia , Orientação Espacial , Campos Visuais
5.
Aerosp Med Hum Perform ; 90(10): 834-840, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31558191

RESUMO

BACKGROUND: The aim of the study was to determine the characteristics of cervical muscle activity in different head postures when using helmet-mounted display in one fighter vs. two aircraft air combat within visual range (WVR).METHODS: Cervical EMG was measured with eight F/A-18 pilots using the Joint Helmet Mounted Cueing System (JHMCS) during air combat maneuvering. In-flight Gz acceleration and continuous head position were recorded. EMG activity is divided and presented in a matrix with three-class rotation and five-class flexion-extension postures.RESULTS: The mean muscle activity in sternocleidomastoids and cervical extensors was 28.9% of maximal voluntary contraction (MVC) and 44.8% MVC, respectively. Cervical flexor and extensor muscles are subjected to loading over MVC during high Gz sorties. Cervical rotation combined with extension exceeded muscle force-producing capacity during high Gz, resulting in a decline in muscle activity.DISCUSSION: Awkward postures, especially rotational ones, are more prone to increase loading over muscles' capacity. Overloading of muscles increases the risk of muscular and ligamentous injury. In addition, the lack of muscular support potentially leads to the Gz loading being transferred to spinal structures via intervertebral discs and the vertebral column. The JHMCS helmet seems to change the pattern of most loading muscles toward the extensor (posterior) neck muscles.Sovelius R, Mäntylä M, Heini H, Oksa J, Valtonen R, Tiitola L, Leino T. Joint helmet-mounted cueing system and neck muscle activity during air combat maneuvering. Aerosp Med Hum Perform. 2019; 90(10):834-840.


Assuntos
Medicina Aeroespacial , Dispositivos de Proteção da Cabeça/efeitos adversos , Músculos do Pescoço/fisiologia , Postura/fisiologia , Entorses e Distensões/etiologia , Adulto , Aviação , Sinais (Psicologia) , Eletromiografia , Humanos , Masculino , Militares , Contração Muscular/fisiologia , Músculos do Pescoço/lesões , Pilotos , Entorses e Distensões/fisiopatologia , Guerra
6.
Aerosp Med Hum Perform ; 90(10): 851-859, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31558193

RESUMO

INTRODUCTION: Paragliding is an emerging discipline of aviation, with recreational pilots flying distances over 100 km. It remains risky. Accidents typically relate to pilot error rather than equipment failure. We measured cognition and physiological responses during simulated flight, to investigate whether errors might be due to pilot impairment, rather than misjudgment.METHODS: There were 10 male paraglider pilots (aged 19-58 yr) who undertook a simulated flight in an environmental chamber from sea level (0.209 FIo2) to 1524 m (0.174 FIo2), 2438 m (0.156 FIo2), and 3658 m (0.133 FIo2), over approximately 2 h. They experienced normobaric hypoxia, environmental cooling and headwind, completing logical reasoning, mannikin, mathematical processing, Stroop Color-Word and Tower Puzzle tasks; as well as measures of risk-taking (BART), mood (POMS), and subjective experience.RESULTS: Results were compared to ten controls, matched by age, sex, and flying experience. Physiological measures were oxygen consumption, carbon dioxide production, ventilation, heart rate, oxygen saturation, rectal and skin temperatures, blood glucose, blood lactate, and urine production. There were no significant differences between pilots and controls at any altitude. Results were heterogenous within and between individuals. As altitude increased, oxygen consumption and minute volume increased significantly, while oxygen saturations fell (98.3% [baseline] to 88.5% [peak]). Rectal temperatures fell by a statistically (but not clinically) significant amount (37.6°C to 37.3°C), while finger skin temperatures dropped steeply (32.2°C to 13.9°C).DISCUSSION: Results suggest cognitive impairment is unlikely to be a primary cause of pilot error during paragliding flights (of less than 2 h, below 3658 m), though hand protection requires improvement.Wilkes M, Long G, Massey H, Eglin C, Tipton MJ. Cognitive function in simulated paragliding flight. Aerosp Med Hum Perform. 2019; 90(10):851-859.


Assuntos
Medicina Aeroespacial , Aeronaves , Cognição , Hipóxia/psicologia , Pilotos/psicologia , Prevenção de Acidentes , Acidentes Aeronáuticos , Adulto , Altitude , Humanos , Hipóxia/etiologia , Masculino , Pessoa de Meia-Idade , Consumo de Oxigênio , Treinamento por Simulação , Adulto Jovem
7.
Aerosp Med Hum Perform ; 90(10): 867-871, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31558195

RESUMO

BACKGROUND: Preventive treatment for incidentally detected blebs or bullae is required for fast jet pilots, but their aeromedical risk is not clearly proven.METHODS: This is a retrospective study and includes 46 pilots 40 yr and older with incidentally detected emphysema-like changes (ELCs) comprising blebs or bullae in low-dose chest CT (LDCT) during health screening. Two radiologists retrospectively reviewed imaging features. Statistical analysis was done using independent t-tests and bivariate analysis.RESULTS: Among 46 pilots, 39 pilots flew fast jet aircraft and 7 pilots flew nonfast jet aircraft. The mean follow-up period was 1531 d and the LDCT follow-up interval mean period was 424.4 d. There was no evidence of rupture in incidentally detected ELCs during the follow-up period. The mean size of the ELCs was 19.15 mm. There were five cases showing changes in size. There was a statistically significant correlation between the size of ELCs and height. There were no statistically significant differences in the size or number of ELCs relating to smoking status or aircraft type, and there were no statistically significant correlations between the size or number of ELCs and multiple factors, including smoking quantity, flight time, age, BMI, and weight.CONCLUSION: This study demonstrates the aeromedical safety of incidentally detected ELCs in pilots 40 yr and older without underlying lung disease. The results indicate no need for recommending preventive treatment for ELCs in pilots 40 yr and older, even those flying fast jet aircraft, as a requisite to continue their flight duties. KEYWORDS: bleb, bulla, pilot, CT.Bang S, Yang S, Cho SW, Kim DH, Kang H. Follow-up of blebs and bullae in pilots 40 years and older using CT. Aerosp Med Hum Perform. 2019; 90(10):867-871.


Assuntos
Medicina Aeroespacial , Militares/estatística & dados numéricos , Pilotos/estatística & dados numéricos , Pneumotórax/epidemiologia , Enfisema Pulmonar/epidemiologia , Adulto , Aeronaves , Seguimentos , Humanos , Incidência , Pulmão/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Pneumotórax/etiologia , Pneumotórax/prevenção & controle , Enfisema Pulmonar/complicações , Enfisema Pulmonar/terapia , Estudos Retrospectivos , Fatores de Risco , Fumar/epidemiologia , Tomografia Computadorizada por Raios X
8.
Aerosp Med Hum Perform ; 90(10): 872-881, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31558196

RESUMO

INTRODUCTION: In this article an analysis is made of existing legal provisions and policies regarding medical confidentiality and the use of medical information on pilots, for the reporting of unfit pilots and for accident and incident investigation. An overview is given of the applicable international, European and several national legal frameworks in relation to this question. The applicable national legislation and relating policies of the Netherlands, the U.S., and Canada are compared on this subject. These three States (countries) are selected because of the differences between them in legal provisions when it comes to medical confidentiality of pilots' health information. The article will conclude with tools derived from this analysis, which can be used to find a balance between medical confidentiality vs. aviation safety.Schuite JM. Aviation safety vs. medical confidentiality: disclosure of health information for accident prevention and investigation. Aerosp Med Hum Perform. 2019; 90(10):872-881.


Assuntos
Prevenção de Acidentes/legislação & jurisprudência , Acidentes Aeronáuticos/prevenção & controle , Medicina Aeroespacial/legislação & jurisprudência , Confidencialidade/legislação & jurisprudência , Notificação de Abuso , Aviação , Canadá , Certificação , Comparação Transcultural , Humanos , Países Baixos , Pilotos , Políticas , Estados Unidos
9.
Aerosp Med Hum Perform ; 90(10): 882-890, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31558197

RESUMO

BACKGROUND: During flight, fast jet pilots frequently move their heads into extreme positions while withstanding large amounts of stress on their cervical spines. These factors are thought to contribute to episodes of neck pain.METHODS: We conducted a systematic review and meta-analysis of previous neck pain prevalence data in fast jet pilots to determine an overall pooled prevalence. Subgroup analyses were performed according to when pilots complained about their neck pain, whether these same pilots sought treatment, and if they lost time from flying. Four research databases were searched. Studies were eligible for inclusion if they were written in English, involved a group of fast jet pilots who were actively flying high performance aircraft, and reported quantitative prevalence data about neck pain in these pilots. These eligibility criteria were independently applied by two reviewers and risk of bias was evaluated. MetaXL software was used to conduct the meta-analysis.RESULTS: In total, 8003 fast jet pilots across 18 eligible studies were included in the review. The overall pooled prevalence of neck pain in fast jet pilots was 51%. It was found that 39% of subjects lost time from flying, while only 32% sought medical treatment.DISCUSSION: Neck pain in fast jet pilots adversely affects operational capabilities of defense forces. The prevalence of neck pain varies according to the definitions or thresholds of complaints used across the literature. Further research is required to standardize the definition of neck pain.Riches A, Spratford W, Witchalls J, Newman P. A systemic review and meta-analysis about the prevalence of neck pain in fast jet pilots. Aerosp Med Hum Perform. 2019; 90(10):882-890.


Assuntos
Medicina Aeroespacial/estatística & dados numéricos , Militares/estatística & dados numéricos , Cervicalgia/epidemiologia , Doenças Profissionais/epidemiologia , Pilotos/estatística & dados numéricos , Aeronaves , Humanos , Prevalência
10.
Aerosp Med Hum Perform ; 90(10): 901-907, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31558200

RESUMO

INTRODUCTION: Spatial disorientation (SD) remains a leading cause of Class A mishaps and fatalities in aviation. Motion-based flight simulators and other research devices provide the capacity to rigorously study SD in order to develop effective countermeasures. By applying mathematical models of human orientation perception, we propose an approach to improve control algorithms for motion-based flight simulators to study SD.METHODS: The Disorientation Research Device (DRD), or the Kraken™, is the Department of Defense's newest and most capable aerospace medicine motion-based research device. We implemented an "Observer" model for predicting aircrew spatial orientation perception within the DRD, and perceptions experienced in flight. Further, we propose a framework that uses the model output, in addition to pilot control inputs, to optimize multiaxis motion control including human-in-the-loop control capability.RESULTS: A case study was performed to demonstrate the functionality of the framework. Additionally, the case study highlights both how limitations of human perception are crucial to consider when designing motion algorithms, and the challenges of effective flight simulation with multiple motion axes.DISCUSSION: We implemented a mathematical model for spatial orientation perception to improve the design of control algorithms for motion-based flight simulators, using the DRD as an example application. We provide an example of predicting perceptions, producing quantitative information on the efficacy of motion control algorithms. This mathematical model based approach to validating motion control algorithms aims to improve the fidelity of ground-based SD research.Dixon JB, Etgan CA, Horning DS, Clark TK, Folga RV. Integration of a vestibular model for the Disorientation Research Device motion algorithm application. Aerosp Med Hum Perform. 2019; 90(10):901-907.


Assuntos
Acidentes Aeronáuticos/prevenção & controle , Medicina Aeroespacial/métodos , Confusão/fisiopatologia , Orientação Espacial/fisiologia , Pilotos/psicologia , Atitude , Aviação , Humanos , Militares , Modelos Biológicos , Movimento (Física) , Treinamento por Simulação/métodos , Vestíbulo do Labirinto/fisiologia
11.
Aerosp Med Hum Perform ; 90(10): 908-910, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31558201
14.
Aerosp Med Hum Perform ; 90(9): 757-763, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31426890

RESUMO

OBJECTIVE: The goal of this study was to estimate noise exposure and hearing impairments in Swedish military pilots. It also aimed to analyze possible relations between noise exposure and hearing impairments.METHODS: The study group was an open cohort of 337 male pilots. They were longitudinally followed with pure tone audiograms every fifth year from the beginning of flight service until discharge. Outcome measures were prevalence of thresholds >20 dB HL and >40 dB HL at different ages, and incidence of impairments >20 dB HL, 30 dB HL, and 40 dB HL. Exposure variables were individual flight data and noise dose measurements. The ISO 1999 Database A was used for reference data.RESULTS: At 50 yr of age, 41% of the pilots were exposed to an equivalent noise dose exceeding the EU action level of Leq 80 dB(A). We observed significant elevated prevalence values of thresholds >20 dB HL in all age classes compared to the ISO 1999 Database A. These elevations were most pronounced at ages 30 and 40 yr and at 4 and 6 kHz in the left ear. Significantly elevated prevalence values of thresholds >40 dB HL compared to the ISO 1999 Database A were observed at age 40 and 50 yr at 4 and 6 kHz. In a Cox analysis we observed elevated hazard ratios of deteriorating thresholds with longer flight time/year in fast jet pilots.DISCUSSION: Military pilots had elevated prevalence values of hearing impairment. Of the subjects, 41% had been exposed to noise exceeding the EU risk limit. Increased flight time/year and flying fast jets were associated with elevated risk of hearing deterioration.Muhr P, Johnson A-C, Selander J, Svensson E, Rosenhall U. Noise exposure and hearing impairment in air force pilots. Aerosp Med Hum Perform. 2019; 90(9):757-763.


Assuntos
Perda Auditiva Provocada por Ruído/epidemiologia , Militares/estatística & dados numéricos , Doenças Profissionais/epidemiologia , Exposição Ocupacional/efeitos adversos , Pilotos/estatística & dados numéricos , Adulto , Audiometria de Tons Puros/estatística & dados numéricos , Perda Auditiva Provocada por Ruído/diagnóstico , Perda Auditiva Provocada por Ruído/etiologia , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Doenças Profissionais/diagnóstico , Doenças Profissionais/etiologia , Sistema de Registros/estatística & dados numéricos , Estudos Retrospectivos , Fatores de Risco , Suécia/epidemiologia , Adulto Jovem
15.
Aerosp Med Hum Perform ; 90(9): 774-781, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31426892

RESUMO

INTRODUCTION: Human factors have contributed to a constant increase in the level and numbers of aviation incident involvement. The primary objective of this study is to investigate the relationships between anticipated negative emotions (ANEs) and incident involvement among Chinese civil pilots. Furthermore, this paper examines the role of risk perception and proactive coping within the relationships in order to understand the mechanisms underlying pilots' involvement in air transport incidents.METHODS: A cross-sectional regression design was used to measure ANEs (Anticipated Negative Emotions Scale), proactive coping (Proactive Coping Scale), risk perception (Pilot Risk Perception Scale), and incident involvement (Hazardous Events Scale) among 295 Chinese civil pilots from China Southern Airlines. Mediation and moderating effects were explored using regression analyses and were confirmed by the bootstrapping approach.RESULTS: The results show that ANEs are significantly correlated with risk perception (r = -0.55) and incident involvement (r = 0.28). ANEs have a direct effect on pilot involvement in incidents and have an indirect effect on pilot incident involvement through the influencing of risk perception. Proactive coping was also found to weaken the direct effect of anticipated negative emotions on incident involvement.DISCUSSION: The safety benefits of proactive coping are more pronounced among pilots with high levels of ANEs. The practical implications of the study include recommendations relating to injury prevention efforts in incident involvement. Future research directions are also discussed.Wang H, Xu Q, Yang C, You X, Ji M. Anticipated negative emotions effect on incident involvement among civil pilots. Aerosp Med Hum Perform. 2019; 90(9):774-781.


Assuntos
Acidentes Aeronáuticos/psicologia , Adaptação Psicológica , Emoções , Pilotos/psicologia , Acidentes Aeronáuticos/prevenção & controle , Adulto , China , Estudos Transversais , Humanos , Masculino , Pilotos/estatística & dados numéricos , Inquéritos e Questionários/estatística & dados numéricos , Adulto Jovem
16.
Aerosp Med Hum Perform ; 90(9): 788-791, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31426894

RESUMO

BACKGROUND: Attention deficit hyperactivity disorder (ADHD) is a chronic neurological disorder characterized by persistent patterns of inattention, impulsivity, and hyperactivity. The most common treatment for this disorder is methylphenidate, which is a disqualifying medication for flight. Candidates with previous use of methylphenidate are not necessarily disqualified from the Israeli Air Force (IAF) flight academy.METHODS: Flight cadets from 12 consecutive flight courses who have used methylphenidate at least once in the past were identified according to their medical records. The graduation ratio of cadets with previous use of methylphenidate was compared with that of the rest of the cadets. A comparison was also made with regard to the causes of disqualification from the flight course. Statistical significance was assessed using the Fischer Test.RESULTS: Among the 90 flight cadets who have used methylphenidate, only 2 (2.2%) successfully graduated from the IAF flight academy. Among the 2983 flight cadets who have no history of methylphenidate use, 461 (15.4%) successfully graduated. We found no significant differences in the disqualification causes between the two groups.CONCLUSION: The IAF flight academy graduation rate was meaningfully and significantly lower among cadets who reported previous use of methylphenidate. The study design, however, limits the inference of causal relationship.Sarfati S, Nakdimon I, Tsodyks J, Assa A, Gordon B. Success rates at an air force pilot academy and its relation to methylphenidate use. Aerosp Med Hum Perform. 2019; 90(9):788-791.


Assuntos
Sucesso Acadêmico , Estimulantes do Sistema Nervoso Central/farmacologia , Cognição/efeitos dos fármacos , Metilfenidato/farmacologia , Militares/educação , Pilotos/educação , Adolescente , Adulto , Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Estimulantes do Sistema Nervoso Central/uso terapêutico , Uso Indevido de Medicamentos , Feminino , Humanos , Israel , Masculino , Metilfenidato/uso terapêutico , Militares/estatística & dados numéricos , Pilotos/estatística & dados numéricos , Estudos Retrospectivos , Instituições Acadêmicas/estatística & dados numéricos , Adulto Jovem
17.
Aerosp Med Hum Perform ; 90(9): 792-799, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31426895

RESUMO

INTRODUCTION: Adverse weather and poor visual cues are common elements in night-time Helicopter Emergency Medical Service (HEMS) operations contributing to spatial disorientation and fatal accidents. Pilots are required to make weather-related preflight risk assessments to accept or reject a flight. This study's aim was to develop predictive risk assessment tools based on historical accident data to assist the decision-making process.METHODS: We analyzed 32 single-pilot HEMS night-time visual flight rules fatal accidents to identify contributory risk factors. Logistic regression analysis was used to develop prediction nomograms for nonvisual meteorological conditions (non-VMC), cause and nonsurvivable accidents as dependent variables. Risk factors such as temperature dew point spread, elevation difference, and years of HEMS pilot experience, were entered as continuous variables. Flight crew composition, pilot DTE (domain task experience) and flight rule capability, primary missions, and temperature dew point spread were entered as categorical variables. A point scoring matrix transposed model probability to likelihood and consequence severity.RESULTS: The nomograms correctly predicted the likelihood of entering non-VMC, accident cause, and sustaining a nonsurvivable accident in 75%, 55%, and 94% of cases, respectively. Using data from a recent nonsurvivable HEMS accident, the nomogram estimated a 92% probability (Very Likely) of nonsurvivable accident if visual cues were lost.CONCLUSION: These nomograms can provide preflight information to predict the likelihood of adverse safety outcomes occurring during a planned HEMS mission. While further development work is needed, this approach has the potential to improve HEMS operational safety.Aherne BB, Zhang C, Chen WS, Newman DG. Preflight risk assessment for improved safety in Helicopter Emergency Medical Service operations. Aerosp Med Hum Perform. 2019; 90(9):792-799.


Assuntos
Acidentes Aeronáuticos/prevenção & controle , Resgate Aéreo/organização & administração , Tomada de Decisões , Pilotos/psicologia , Gestão da Segurança/métodos , Acidentes Aeronáuticos/mortalidade , Medicina Aeroespacial , Aeronaves , Temperatura Baixa , Sinais (Psicologia) , Humanos , Nomogramas , Estudos Retrospectivos , Medição de Risco/métodos , Fatores de Risco , Fatores de Tempo , Tempo (Meteorologia)
19.
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