Certain issues for medical evacuation and support after traumatic brain injury at high altitude / 中华创伤杂志

Traumatic brain injury (TBI) is much more complex considering the unique pathophysiological changes under high-altitude hypoxic environment. Moreover, because of limited source of medical transportation and facilities at high altitude, TBI patients often lack urgent and standard treatment and have to be transported to the district medical center at high altitude or even the neurotrauma center at plain region as soon as possible. The transportation has high risk and takes serious effect on lives and prognosis of the TBI patients. Up to date, the evacuation and support process for TBI patients in the western plateau region of China has been improved through years of practice, but there are still deficiencies compared to the Critical Care Air Transport Team (CCATT). The authors sought to discuss certain issues related to medical evacuation and support after TBI at high altitude from aspects of early damage control operation and timely safety medical transportation, aiming to improve the survival rate, neurological outcomes and life quality for these patients.

Sleeping quality in civil aviation pilots and associated influence factors / 环境与职业医学

Background Civil aviation pilots are actual operators of civil aircraft. Their job operations are directly associated with passenger safety and flight safety. Unsafe aviation operations are related to fatigue caused by poor sleep quality. Recently, with the promotion of China's air transportation business, irregular working hours of civil aviation pilots rise gradually. However, there is still a lack of relevant research on the influence of working conditions on sleep quality in this group. Objective To explore potential impact factors of sleep quality among civil aviation pilots, for the purposes of improving sleep quality and health level of this group and ensuring aviation flight safety by formulating health management suggestions in a targeted manner. Methods All pilots of an aviation company were approached when they visited the Shanghai Hospital of Civil Aviation Administration of China for their health examinations. After informed consent, an online questionnaire survey was conducted. Self-made questionnaires were used to collect information on general conditions, lifestyle, and subjective work stress levels. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. A total of 1204 valid questionnaires were recovered. Statistical analysis was conducted using SPSS 26.0 software. Results There were 410 pilots (16.8%) who reported sleep disorders, including insufficient sleep time, difficulty falling asleep, and poor sleep quality, and 894 pilots (74.3%) who reported moderate to severe work stress. Associations were identified between sleep quality of pilots and work stress or lifestyle indicators (P<0.05), while work stress showed the strongest association (r=0.28). Further multiple-factor analysis results showed that severe work stress (OR=4.25, 95%CI: 2.89, 6.30) and alcohol use (OR=1.72, 95%CI: 1.31, 2.27) associated with an increased risk of sleep disorders. Regular breakfast (OR=0.62, 95%CI: 0.42, 0.91) and physical exercise (OR=0.68, 95%CI: 0.45, 1.03) associated with a lower risk of sleep disorders. Conclusion A certain degree of sleep disturbance is reported in the civil aviation pilot group, which is closely related to work stress and lifestyle indicators. Targeted measures must be taken to effectively improve the quality of their sleep.

Outcomes of patients with decompression illness transported by physician-staffed helicopter according to Japanese Registry data (2015–2020) / Journal of Rural Medicine

Objective: No nationwide reports have focused on patients with decompression illness (DCI) transported by doctor helicopter (DH) in Japan. We performed this retrospective study to examine this population using data from the Japan DH registry system (JDRS).Patients and Methods: Patients were initially selected from the JDRS database. They were divided into two groups: those transported by the Eastern Shizuoka DH (ES-DH) and those transported by other DHs. Variables were compared between the two groups.Results: There were 44 patients who had DCI out of 41,592 patients in the JDRS. The majority of cases (70%) were transported by the ES-DH. In the ES-DH group, age, rate of request type using key words, and rate of instrumental intervention to secure an airway were significantly greater, and the median Glasgow Coma Scale score was significantly lower than that of the other DH group. However, there was no statistically significant difference in the rate of cases with fatal outcomes between the two groups.Conclusions: This is the first report regarding the current status of patients with DCI transported by DH in Japan. Most patients were transported by ES-DH to the Izu Peninsula. In addition, the patients transported by ES-DH due to decompression illness tended to be severely ill; however, the outcomes of the ES-DH and other DH groups did not differ to a statistically significant extent and therefore effective recompression therapy could be successfully performed at suitable hospitals owing to timely transportation.

Barotrauma y barodontalgia en la aviación / Barotrauma and barodontalgia in Aviation / Barotrauma e barodontalgia na aviação

Introducción: se ha estudiado ampliamente la importancia de los cambios de presión y sus consecuencias en el cuerpo humano. De esto se desprenden dos conceptos importantes: el barotrauma que se define como el daño producido por cambios en la presión atmosférica; y la barodontalgia que se define como el dolor dentario producido por variaciones de presión barométrica, por ejemplo cuando existen gases atrapados en restauraciones o en la cámara pulpar y/o conducto radicular. Estos conceptos se fundamentan en las leyes de los gases: la Ley de Difusión Gaseosa, la Ley de Dalton, la Ley de Boyle, la Ley de Charles y la Ley de Henry. Discusión: el estudio y prevención de la barodontalgia es de suma importancia, ya que aunque no tiene alta prevalencia entre los aviadores, su aparición es súbita y de alta intensidad, lo que puede provocar en el piloto una incapacidad física y mental, que aumenta el riesgo de accidentes. Conclusiones: en esta revisión, se reúnen las estrategias recomendadas para prevenir su aparición.

Introduction: the importance of pressure changes and their consequences on the human body has been widely studied. Two important concepts arise from this: barotrauma, which is defined as the damage produced by changes in atmospheric pressure; and barodontalgia, which is defined as dental pain produced by variations in barometric pressure, for example when gases are trapped in restorations or in the pulp chamber and/or root canal. These concepts are based on the gas laws: the Law of Gaseous Diffusion, Dalton's Law, Boyle's Law, Charles' Law and Henry's Law. Discusion: the study and prevention of barodontalgia is of utmost importance, since although it is not highly prevalent among aviators, its onset is sudden and of high intensity, which can cause physical and mental incapacity in the pilot, increasing the risk of accidents. Conclusions: this review brings together the recommended strategies to prevent its occurrence.

Introducão: a importância das mudanças de pressão e suas conseqüências sobre o corpo humano têm sido amplamente estudadas. Dois conceitos importantes podem ser derivados disto: barotrauma, que é definido como o dano produzido por mudanças na pressão atmosférica; e barodontalgia, que é definida como a dor dental produzida por variações na pressão barométrica, por exemplo, quando os gases estão presos em restaurações ou na câmara de polpa e/ou canal radicular. Estes conceitos são baseados nas leis do gás: a Lei de Difusão Gasosa, a Lei de Dalton, a Lei de Boyle, a Lei de Charles e a Lei de Henry. Discusion: o estudo e prevenção da barodontia é de suma importância, pois embora não seja muito prevalente entre os aviadores, seu início é repentino e de alta intensidade, o que pode causar incapacidade física e mental no piloto, aumentando o risco de acidentes. Conclusões: esta revisão reúne as estratégias recomendadas para evitar sua ocorrência.

Aviation flight and neurological diseases / 中国医师杂志

In the air flight, individuals rise rapidly to the environment of low-pressure hypoxia, low humidity and high noise. If we can't adapt to the change of the environment, we may suffer headache, stroke, epilepsy and other common nervous system diseases. With the increasing popularity of aviation, more and more in-flight medical emergencies are reported. Aviation medical is gradually concerned and studied by social people, medical internists and scientific research workers. This article will summarize the clinical characteristics and pathogenesis of common paroxysmal nervous system diseases in flight, and discuss the prospect of early warning and prevention of in-flight medical emergencies.

Hematoma subperiosteal orbitário secundário a barotrauma em aviação civil / Orbital subperiosteal hematoma secondary to barotrauma in civil aviation

RESUMO Os diagnósticos diferenciais que compõem as proptoses agudas são, muitas vezes, desafiadores. A anamnese e o exame clínico exigem do oftalmologista atenção especial aos detalhes que permitem diferenciar quadros relativamente benignos e autolimitados de quadros que evoluirão com incapacidades permanentes. Relatamos o caso de uma paciente de 49 anos que, durante viagem de avião, apresentou dor ocular, hematoma periorbitário e proptose do olho esquerdo súbitos. Referia diplopia aguda incapacitante. Exames de tomografia e angiorressonância magnética confirmaram diagnóstico de sinusopatia do seio etmoidal esquerdo e hematoma subperiosteal da órbita esquerda, associado ao barotrauma. Apesar de raro, o diagnóstico de hematoma subperiosteal não traumático deve ser considerado diferencial em relação a proptoses agudas, sendo a anamnese fundamental para essa elucidação diagnóstica.

ABSTRACT Differential diagnoses of acute proptosis are often challenging. History and clinical examination require from ophthalmologists special attention to details, which make it possible to differentiate relatively benign and self-limited conditions from those that will progress to permanent disabilities. We report a 49-year-old female patient who had sudden eye pain, periorbital hematoma and proptosis of the left eye during a commercial flight. She also complained of disabling acute diplopia. Computed tomography and magnetic resonance angiography imaging confirmed the diagnosis of subperiosteal hematoma of the left orbit, associated with left ethmoid sinus disease. Although rare, non-traumatic subperiosteal hematoma should be considered in differential diagnoses of acute proptosis, and history taking is fundamental to elucidate the picture.

Sazonalidade de indicadores de fadiga nas escalas de trabalho dos aeronautas da aviação regular brasileira / Seasonal variation in fatigue indicators in Brazilian civil aviation crew rosters

Introdução: Métodos de análise, compreensão e gerenciamento do risco da fadiga na aviação representam tópicos de interesse para a segurança de voo e mitigação de falhas humanas. Objetivo: Avaliar o provável nível de fadiga em uma amostra de conveniência de pilotos e comissários de voo da aviação regular brasileira, propondo metodologia e indicadores apropriados para a quantificação da potencial exposição ao risco da fadiga durante as fases críticas de voo (pousos e decolagens). Métodos: Os dados foram obtidos por envio espontâneo e anônimo das escalas de voo para uma plataforma, sendo estas analisadas com o software Sleep, Activity, Fatigue, and Task Effectiveness / Fatigue Avoidance Scheduling Tool (SAFTE-FAST), que leva em conta o processo homeostático, os ritmos circadianos associados à atenção e vigília e a inércia do sono. Resultados: As escalas dos meses de janeiro (n=248), maio (n=259) e julho (n=261) de 2018 tiveram incidência de 77, 54 e 77% de ao menos um evento com efetividade mínima nas fases críticas abaixo de 77%, respectivamente. As distribuições de efetividades mínimas e áreas de risco nas fases críticas apresentaram oscilação sazonal significativa, comparando os meses de janeiro ou julho com maio de 2018 (p<0,001). Conclusões: O estudo apontou probabilidade relativa elevada de fadiga nas escalas dos aeronautas, assim como oscilações sazonais significativas nas distribuições de efetividade mínima e aérea de risco nas fases críticas. Esses resultados indicam a necessidade de um melhor gerenciamento das escalas, visto que os limites prescritivos vigentes à época não foram suficientes para a mitigação dos riscos.

Background: Analyzing, understanding and managing fatigue risk in aviation is relevant for flight safety and to reduce human error. Objective: To analyze probable levels of fatigue among a convenience sample of Brazilian civil aviation pilots and flight attendants and to develop appropriate methods and indicators to quantify potential fatigue risk in critical phases of flight (landings and takeoffs). Methods: Data were obtained from flight rosters voluntarily and anonymously fed to a digital platform. Rosters were analyzed with software SAFTEFAST, which considers homeostatic process and circadian cycles related to attention and wakefulness and sleep inertia. Results: The rosters for January (n=248), May (n=259) and July (n=261) 2018 were associated with incidence of 77, 54 and 77% respectively of least one event of minimal effectiveness (<77%) during critical phases of flight. The distribution of minimal effectiveness and hazard area during critical phases of flight exhibited significant seasonal oscillation upon comparing the results for January and July relative to May 2018 (p<0.001). Conclusion: Relative likelihood of fatigue was high in the crew rosters, with significant seasonal oscillation of minimal effectiveness and hazard area in critical phases of flight. These results point to the need for improved roster management since prescriptive rules were insufficient to mitigate risk.

The objective assessment of the effects on cognition functioning among military personnel exposed to hypobaric-hypoxia: A pilot fMRI study

@#Objective: To identify regions of the brain affected during cognitive working memory during tasks to assess attention, planning and decision making among military aviation personnel who have chronic intermittent exposure to high altitude environment. Method: A case-control study was conducted in the Universiti Putra Malaysia among eight military personnel, four of whom had chronic intermittent exposure to high altitude training. They were divided into two groups, chronic intermittent exposure group (CE) (n=4) and a control group (n=4). They underwent a task-based functional magnetic resonance imaging (fMRI) that utilised spatial working memory task to objectively evaluate the neural activation in response to the Tower of London paradigm. Each correct answer was given a score of one and the maximum achievable score was 100%. Results: A consecutive dichotomised group of CE (4/8) and control (4/8) of age-matched military aviation personnel with a mean age of 37.23±5.52 years; showed significant activation in the right middle frontal gyrus (MFG). This in turn was positively correlated with response accuracy. A significant difference in the response accuracy was noted among both the groups at p<0.05. Conclusion: At the minimum results of power analysis of this preliminary fMRI study, our group of aviation personnel who had chronic intermittent exposure to hypobaric hypoxic environment, did not have any significant decrease in cognitive function namely attention, decision-making and problem solving compared to controls during a working memory task

Health protection guideline of passenger transport stations and transportation facilities during novel coronavirus pneumonia (NCP) outbreak / 中华预防医学杂志

During the coronavirus pneumonia (NCP) outbreak, the transportation industries are faced with the more burdensome tasks of outbreak prevention and control as well as ensuring smooth transportation. It is important to organize transportation in order to restore the order of production and life, ensure the normal economic and social operation, and control the outbreak in the whole society. From the perspective of health, this guideline puts forward technical requirements on the operation management, personnel requirements and health protection of passenger transportation places such as aviation, railway, subway, bus, taxi, ship, etc., which reduces the impact of the NCP outbreak on the transportation industry and personal health risks.

Health protection guideline of passenger transport stations and transportation facilities during novel coronavirus pneumonia (NCP) outbreak / 中华预防医学杂志

@#During the coronavirus pneumonia (NCP) outbreak, the transportation industries are faced with the more burdensome tasks of outbreak prevention and control as well as ensuring smooth transportation. It is important to organize transportation in order to restore the order of production and life, ensure the normal economic and social operation, and control the outbreak in the whole society. From the perspective of health, this guideline puts forward technical requirements on the operation management, personnel requirements and health protection of passenger transportation places such as aviation, railway, subway, bus, taxi, ship, etc., which reduces the impact of the NCP outbreak on the transportation industry and personal health risks.

Pesquisas em psicologia da aviação na América Latina: revisão integrativa / Research about aviation psychology in Latin America: integrative review

Resumo Entre os diferentes sistemas geradores de transformações, incluem-se aqueles engajados em atividades relacionadas ao comportamento humano no ambiente aéreo-espacial. Esta revisão integrativa da literatura teve por objetivo analisar em uma perspectiva sistémica os estudos relacionados à área da psicologia da aviação na América Latina. Os artigos foram pesquisados nas bases de dados BVSPSI e Scielo, entre 2005 e 2017, utilizando os descritores: aviação e medicina aeroespacial. Cinco artigos foram analisados e agrupados nos núcleos sistémicos saúde, família e organização e os seus respectivos subnúcleos. Os resultados das pesquisas foram discutidos à luz das perspectivas sistémicas no contexto da América Latina. Ademais, a literatura sobre o tema é emergente e demanda aprofundamentos sobre as estruturas e dinâmicas familiares, a rede social e lazer dos indivíduos no contexto do voo. Espera-se que os resultados deste trabalho deem suporte às pesquisas sobre a aviação na área da psicologia.

Abstract Among different systems of transformations, there are those engaged to the human behavior in air-space environments. This integrative literature review aimed to analyze in a systematic perspective the research about the psychology of aviation in Latin America. The articles were obtained in the data bases BVSPSI and Scielo between 2005 and 2017, using the descriptors: aviation and aeroespacial medicine. Five articles were analyzed and grouped as health, family and organization in systematic cores and its respectives under cores. The results from the studies were discussed across systemic research developed in the main categories in latin america context. Furthermore, the literature on the topic is emerging and demand of deeper investigations about family's dynamics and structure, social network and leisure of those in the context of flight. We hope the results from this article gives support to the research about aviation.

Quality of Life Assessment Post Refractive Surgery in Aviators

To measure QoL outcome in post LASIK Aviators using the Quality of Life Impact of Refractive Correction (QIRC) questionnaire. Methods: A prospective, non-randomized, cross-sectional study was carried out from Oct 2016 to Dec 2017. . The study included actively flying Indian pilots of both sexes, reporting for the annual medical fitness certification. QIRC which consists of 20 questions scored on 5 category response scale, is self-administered. Aviators were asked to rate on 5 point scale of agreement. Response was converted to Rasch weighted scores to give a true measure of refractive error related QoL. Results: This hospital based study was conducted on 39 Pilots who were administered Quality of Life Impact of Refractive Correction (QIRC) questionnaire. 20 pilots were from civil airline pilots and 7 were Army Aviation and 2 were IAF pilot of transport stream. There were 3 female pilots all from the civil transport stream. Mean age 27.2 yrs ± 4.5 (21 to 37 yrs) who had myopia of more than- 0.50 D, ranging from -.75D TO 6.5 D before undergoing the refractive surgery procedure. Prior to surgery predominantly i.e.26 patients (66.6%) were spectacle wearer, 10 (25.6%) were contact lens wearer, 3 patients (7.69%) were not using any means of correction. All the patients were Post Lasik status of more than 1 year. This study showed a large improvement in QoL in the majority of patients after refractive surgery (PRK & LASIK). These large improvements are consistent with results in conventionally validated previous reports of refractive error related QoL as a result of surgery. In the POST LASIK study group spectacle correction was being used by 36% of patients with power ranging from –0.50D to – 1.50 D SE. Conclusion: LASIK is an excellent alternative to glasses or contact lens use, being associated with high degree of patient’s satisfaction. While LASIK is not without risks, these results are quite reassuring for all pilots thinking of this procedure. Laser system for vision correction like aircraft are continually being enhanced, improved and upgraded. We should embrace the technology and offer the best currently available to the aviators.

Study on the status and influencing factors of hypertension in civil aviation pilots / 中国职业医学

OBJECTIVE: To investigate the incidence and influencing factors of hypertension among civil aviation pilots. METHODS: A total of 1 169 civil aviation pilots in Northern China were selected into the study by the method of convenient sampling. Physical examination, laboratory test and questionnaire survey were conducted. RESULTS: The prevalence of hypertension in Northern China was 4.7%(55/1 169). Multivariate regression analysis showed that the relative risk factors ranking from high to low were, age over 30 years [odds ratio(OR)=6.81, 95% confidence interval(95%CI) 3.57-12.98)], total flight hours over 1 000 hours(OR=4.24, 95%CI 2.14-8.41), flight hours over 500 hours in the past year(OR=2.91, 95%CI 1.57-5.40), obesity(OR=2.50, 95%CI 1.08-5.81), fasting blood glucose(OR=2.24, 95%CI 1.21-4.13), and frequent long-distance flight(OR=2.38, 95%CI 1.24-4.58). These factors were the risk factors of hypertension in civil aviation pilots(P<0.05). CONCLUSION: Age, total flight hours, flight hours in the past year, obesity, fasting blood glucose, frequent long-distance flight are related to the prevalence of hypertension in civil aviation pilots.

Structured Debriefings in Aviation Simulations: A Qualitative Study on Basic Life Support Training for Cabin Crews in Malaysia

Abstract@#Introduction: To develop quality cabin crews, trainings involve simulation-based education (SBE) with structured debriefings – a significant component which plays a critical role in optimising learning outcomes. Previous studies have empirically tested the efficacy of the DIAMOND-structured debriefing model and found significant improvement and retention of the cabin crews’ knowledge and skills. This study was aimed to explore the elements of the DIAMOND-structured debriefing model that have been known to promote the acquisition and retention of knowledge and skills in basic life support (BLS). Methods: A qualitative study was conducted with a random sample of 16 individual cabin crew members who participated in an in-depth interview with 13 open-ended questions for 45 – 60 minutes. The interviews were transcribed and independently analysed using inductive thematic analysis. Results: The codes which have emerged during data analysis were clustered into three themes: (1) Cognitive, with three subthemes: engagement, learning environment, and ability to reflect; (2) Methodology, with three sub-themes: concept of debriefing, techniques of questioning, and additional elements; as well as (3) Psychosocial, with five sub-themes: attitude, self-awareness, relationships, self-confidence, and work culture. Several suggestions have emerged, such as the implementation of the model. Conclusion: The DIAMOND-structured debriefing model was a method to reduce cognitive load, which in turn allowed individuals to organise their knowledge, reflect individually and collectively, as well as structure their ideas. It has showed that the elements has a positive impact on the cabin crews’ acquisition and retention of knowledge and skills which will improve the performance and patient safety

Epidemiological character of retina white without pressure in healthy adolescents in the air force cadets' medical selection / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the epidemiological character of white without pressure(WWOP)in the healthy adolescents by fundus examination and provide theoretical support for air force recruitment and health examination. <p>METHODS:A total of 461 middle school graduates and 71 junior middle school graduates, who participate in the air force cadets' medical selection, were selected as subjects. The ultra-wide-angle laser fundus scanning system, direct ophthalmoscopy and three-sided mirror were used to check the fundus. The χ² test was used to analyze the incidence and distribution of fundus abnormalities.<p>RESULTS: The prevalence of WWOP in healthy adolescents was as high as 2.63%. There was no significant difference in the prevalence of WWOP among junior middle school graduates(<i>P</i>>0.05). The lesion was more common in the temporal quadrant, especially the lower temporal quadrant. In the eyes with WWOP in high school graduates, the proportion of retinal degeneration was as high as 18.18%, which was significantly higher than that without WWOP. <p>CONCLUSION:WWOP is not uncommon in adolescents and is more common in the temporal quadrant. The proportion of retinal degeneration in eyes with WWOP is significantly higher. Thus, in order to avoid missed diagnosis, the surrounding retina should be carefully examined if WWOP was founded in aviation physical examination.

Analysis on the intervention of dry eye disease in aircrew members / 中国职业医学

OBJECTIVE: To evaluate the effectiveness of using artificial tears and eye exercise for intervention of dry eye disease in aircrew members. METHODS: A accidental sampling method was used and 86 patients diagnosed with dry eye disease were selected as study subjects. Artificial tears or artificial tears plus eye exercise were used in patients. Symptoms of dry eye disease were investigated. RESULTS: of break up time( BUT) and schirmer I test( SIT) were recorded.RESULTS: The main symptoms of these 86 aviators diagnosed with dry eye disease were visual fatigue( 82. 6%),dry feeling( 60. 5%),and itchy eyes( 29. 1%). Among them,28 patients( 32. 6%) were treated with artificial tears only( artificial tears group) and 58 patients( 67. 4%) were treated with artificial tears plus eye exercise( combined treatment group). The duration of treatment of less than 4 weeks,4-weeks,and 6-9 weeks were 25,36 and 25 cases,respectively.After treatment,the symptoms improved in 71 patients( 82. 6%). All patients of these two groups showed improved SIT and BUT compared with the same group before treatment( P < 0. 01). There was no significant difference in the change of SIT and BUT between the artificial tears group and the combined treatment group after treatment( P > 0. 05). There was statistical significance in the change of SIT in the main effect of treatment time( P < 0. 01),but no significant difference in the main effect of treatment measures and the interaction effect( P > 0. 05). There was no statistical significance in the change of BUT in the main effect of treatment measures,treatment time and the interaction effect( P > 0. 05).CONCLUSION: The intervention using artificial tears or artificial tears combined with eye exercise improved the subjective symptoms of dry eye disease in aircrew members. The SIT and BUT also improved after intervention.

Vision distribution and its influencing factors of two teenager aviation schools in Western China / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To analyze the vision distribution and its related risk factors of two teenager aviation schools in Western China. <p>METHODS: The study was a cross-sectional survey. A total of 233 participants were randomly selected from two teenager aviation schools in Western China in November and December of 2017, which were all qualified through the standard of physical examination by Air Force. Distance visual acuity of students was checked and questionnaires about influencing factors of vision were filled voluntarily. Mann-Whitney <i>U</i> rank-sum test and chi-square test were applied for single factor analysis, and Multiple factor Logistic regression analysis was used for the main influence factors of the vision difference. <p>RESULTS: The proportion of students with less than 0.8 eyesight in school B of Grade 2 and Grade 3 were 18.6% and 45.9%, which was significantly higher than that of 2.6% and 20% of school A. The well-vision distribution in school B of Grade 2 and Grade 3 were lower than that of school A(<i>P</i><0.05). Single factor analysis showed that school reading and writing time in school B of Grade 2(360min, average: 180-535min)and Grade 3(470min, average: 440-500min)were higher than that of school A(Greade 2: 200min, average: 180-315min; Grade 3: 440min, average: 400-480min; <i>P</i><0.05); and outdoor activity time of the two grades(Grade 2: 420min, average: 325-516min and Grade 3: 378min, average: 265-515min)were lower than that of school A(Grade 2: 510min, average: 439-681min and Grade 3: 440min, average: 370-601min; <i>P</i><0.05), and the proportion of students whose mother had a senior high school degree or above in school B was lower than that of school A(<i>P</i>=0.032). Multiple factor Logistic regression analysis showed that reading and writing time was a risk factor for vision loss(<i>OR</i>=1.109, <i>P</i>=0.010)and outdoor activity time was a protective factor(<i>OR</i>=0.986, <i>P</i>=0.001). Mothers' education background, father's educational background, parents' myopia, primary school enrollment age, class time and electronic product using time were not the main factors affecting the vision. <p>CONCLUSION: More reading and writing time and less outdoor activity time are the main factors for loss of vision, the key point of school myopia prevention needs to coordinate the time between reading, writing and outdoor activity.

Forward and maneuver: how to save life and injuries in an air rescue room or intensive care unit? / 中华危重病急救医学

Aviation medicine is being recognized as a rising star and an indispensable part of the "trinity"medical emergency network composed of land, water and air. The unparalleled mobility and traffic advantages of aircraft, especially rotorcraft (helicopter), are playing an increasingly important role in rescuing the dying and wounded, especially the critical patients, and thus derive a new medical operation mode. How to adapt to the development of the situation and the progress of the times, give full play to the advantages of aviation medical care? The key factors are improvement of the level of service efficiency, strength of learning, practice courage, innovation, and good at summing up to keep pace with the times.

Simulation training of aeromedical evacuation under international perspective / 医疗卫生装备

The history of aeromedical evacuation was reviewed in the world.Database inquiry was executed to explore the present situation of aeromedical evacuation simulation training from the aspects of the contents, tools and environmental design.The problems were summarized in aeromedical evacuation simulation training in China,and some suggestions were put forward accordingly.It's pointed out that the researches on simulation training is of great significance for the development of aeromedical evacuation in war or non-war conditions.

La ergonomía de la persona. la medicina del trabajo en la aviación y en el trabajo médico / Work medicine and the ergonomics of the person

La Organización Internacional de Trabajo (OIT) señala que la magnitud de las lesiones, enfermedades y muertes ocasionadas por el trabajo indica la necesidad imperiosa de los Estados de proseguir la acción para reducirlas. Medicina del trabajo y ergonomía de la persona. Importancia de los exámenes médicos en la prevención de accidentes y enfermedades laborales.

The International Labour Organization (ILO) indicates that the magnitude of work-related injuries, illnesses and deaths caused by work, indicates the imperative need for States to continue to reduce them. Medicine the work and ergonomics of the person, importance of medical examinations in prevention of accidents and labor diseases.