The application of full-crew stratified teaching combined with PBL teaching in nursing practice teaching in emergency department / 中华医学教育探索杂志

Objective:To explore the application of full-crew stratified teaching combined with PBL teaching in nursing practice teaching in emergency department.Methods:A total of 86 intern nursing students in the Emergency Department of The First Affiliated Hospital of Air Force Medical University from February 2019 to August 2020 were randomly divided into the control group ( n=43) and the observation group ( n=43). The control group used full-crew stratified teaching, and the observation group adopted full-crew stratified teaching combined with PBL teaching. The learning interest, subjective initiative, and recognition of teaching were compared between the two groups, and the theoretical scores, operational skills, and comprehensive ability were assessed among them. Meanwhile, the nursing quality of the intern nursing students was evaluated. SPSS 22.0 was used for Chi-square test and t-test. Results:The incidence of total learning interest and total subjective initiative of nursing students in the observation group were better than those in the control group ( P<0.05). The scores of the four dimensions of case analysis, theoretical total score, quality, and operation score in the observation group were higher than those in the control group ( P<0.05). There was no significant difference between the two groups in the scores of the three dimensions of short answer, choice, and skills ( P>0.05). The scores of the four dimensions of reasoning ability, information management ability, goal completion ability, and communication ability in the observation were higher than those in the control group ( P<0.05). The total recognition of teaching in the observation group was 95.35% (41/43), which was higher than that in the control group (79.07%, 34/43). Conclusion:Full-crew stratified teaching combined with PBL teaching in emergency department in nursing teaching can fully stimulate the learning interest of the intern nursing students, improve their subjective initiative, enhance their recognition degree of the nursing teaching, and finally improve the nursing quality.

The effect of Pit-Crew cardiopulmonary resuscitation on the quality of chest compression / 中华急诊医学杂志

Objective:To observe the effect of team resuscitation with Pit-Crew cardiopulmonary resuscitation (CPR) mode on improving the quality of chest compression.Methods:A control method was conducted in this study. Sixty-four medical staffs in ICU and Emergency departments were divided into the role division group and non-role division group according to the ratio of doctors to nurses, with 8 teams in each group and 4 staffs in each team. A team leader was appointed in each team of the role division group to organize and coordinate the whole CPR process, and the non-role division group was not appointed. Each team performed chest compression for 8 min according to the recommendations of the 2020 AHA CPR Guideline under the monitoring of the CPR quality tracking system using a resuscitation manikin. CPR time, chest compression fraction (CCF), times of pressing interruption, times of pressing exceeding standard interruption (>10 s), pressing frequency, chest full recoil rate and other parameters were observed and recorded. The computer system recorded the above parameters, Student's t test and Mann-Whitney U test were used to compare the differences of indexes between the two groups. Results:After the training, the role division group achieved higher CCF [(69.13±1.55)% vs. (59.13 ± 6.08)%, P<0.05], and the total time was significantly shorter and times of overshoot interruptions was significantly less in the role division group compared with the non-role division group [(79.88±28.76) s vs. (135.25±32.99) s; 4 (3, 5) times vs. 2 (1, 2) times respectively; P<0.01]. There were no statistical differences in the total time of CPR and interruption numbers ( P>0.05). In addition, there were also no statistically significant differences in the pressing total numbers, correct times, pressing frequency, pressing depth, and the full rebound times of compression, as well as the substandard indicators of compression such as pressing too fast, too slow, too deep and insufficient rebound times of compression (all P>0.05). Conclusions:Pit-Crew CPR mode with designated team leader contributes to the implementation of high quality CPR, and the monitoring of CPR quality parameters and the applying of real-time feedback system can effectively improve the quality of chest compression.

Analysis of visual fatigue of naval crew in continuous voyage / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate and analyze the status of visual fatigue of naval crew on continuous voyage, explore the risk factors related to visual fatigue, and build a decision tree model for visual fatigue prediction.<p>METHODS:A total of 373 naval fleet members were selected by stratified random sampling method from July to October 2016. By asking the medical history and basic personal information of the subjects, the naked eye visual acuity, the best corrected visual acuity, slit lamp examination including: eyelid, eyelid margin, meibomian gland changes, cornea and conjunctiva signs of ocular surface damage, and corneal fluorescein staining to determine the tear breakup time(BUT). The Ocular Surface Disease Analysis Scale(OSDI)and ocular fatigue questionnaire were filled in, the incidence and severity of ocular fatigue were counted, and the risk factors of ocular fatigue were analyzed.<p>RESULTS: Totally 63.0%(235)of the crew members had different degrees of visual fatigue. There was no correlation between asthenopia and gender, age and previous corneal refractive surgery(<i>P</i>>0.05); Dry eyes and exposure time of electronic screen were the risk factors(<i>P</i><0.01). The overall prediction accuracy was 76.9%.<p>CONCLUSION: The exposure time of dry eye and electronic screen is the risk factor of visual fatigue in continuous navigation crew.

Interprofessional work in health in the context of the COVID-19 pandemic: a scoping review / Trabajo interprofesional en salud en el contexto de la pandemia del COVID-19: revisión del alcance / O trabalho interprofissional em saúde no contexto da pandemia de COVID-19: revisão de escopo

ABSTRACT Objective: to map the scientific production on interprofessional relationships in health in the first year of the COVID-19 pandemic. Method: this is a scoping review performed in PubMed, Scopus, LILACS, CINAHL, Web of Science, Google Scholar and Science Direct databases, covering the period of publication in 2020, using the acronym PCC (Population = health professionals; Concept = interprofessional relationships; Context = health services) and respective search strategies. Results: fourteen scientific articles were selected and the content discussed in the manuscripts was standardized, analyzed and organized into categories of affinities and similarities of their results: 1 - Interprofessional collaboration; 2 - Collaborative practice; 3 - Interprofessional work; 4 - Interactive and interprofessional learning. Conclusion: the pandemic demanded quick and effective responses that were only possible through collaboration and interprofessionalism dimensions. Interprofessional work in health during the first year of the COVID-19 pandemic confirms the importance of interprofessional work and its dimensions for the provision of more comprehensive, resolute and safer health services.

RESUMEN Objetivo: mapear la producción científica sobre las relaciones interprofesionales en salud en el primer año de la pandemia del COVID-19. Método: revisión del alcance, realizada en las bases de datos PubMed, Scopus, LILACS, CINAHL, Web of Science, Google Scholar y Science Direct, cubriendo el período de publicación 2020, utilizando las siglas del PCC (Población = profesionales de la salud; Concepto = relaciones interprofesionales; Contexto = salud servicios) y las respectivas estrategias de búsqueda. Resultados: se seleccionaron 14 artículos científicos y el contenido discutido en los manuscritos fue estandarizado, analizado y organizado en categorías de afinidades y similitudes de sus resultados: 1 - Colaboración interprofesional; 2 - Práctica colaborativa; 3 - Trabajo interprofesional; 4 - Aprendizaje interactivo e interprofesional. Conclusión: la pandemia exigía respuestas rápidas y eficaces que solo eran posibles a través de las dimensiones de la colaboración y la interprofesionalidad. El trabajo interprofesional en salud durante el primer año de la pandemia COVID-19 confirma la importancia del trabajo interprofesional y sus dimensiones para la prestación de servicios de salud más integrales, decididos y seguros.

RESUMO Objetivo: mapear a produção científica sobre relações interprofissionais em saúde no primeiro ano da pandemia de COVID-19. Método: revisão de escopo, realizada nas bases PubMed, Scopus, LILACS, CINAHL, Web of Science, Google Scholar e Science Direct, abrangendo o período de publicação do ano de 2020, utilizando o acrônimo PCC (População = profissionais de saúde; Conceito = relações interprofissionais; Contexto = serviços de saúde) e respectivas estratégias de busca. Resultados: foram selecionados 14 artigos científicos e o conteúdo discutido nos manuscritos foi uniformizado, analisado e organizado em categorias de afinidades e semelhanças de seus resultados: 1 - Colaboração interprofissional; 2 - Prática colaborativa; 3 - Trabalho interprofissional; 4 - Aprendizagem interativa e interprofissional. Conclusão: a pandemia demandou respostas rápidas e eficazes que só foram possíveis através das dimensões da colaboração e da interprofissionalidade. O trabalho interprofissional em saúde durante o primeiro ano de pandemia de COVID-19 confirma a importância do trabalho interprofissional e suas dimensões para a oferta de serviços de saúde mais integrais, resolutivos e seguros.

Centro cirúrgico: recomendações para o atendimento de pacientes com suspeita ou portadores de COVID-19 / Surgical Center: recommendations for the care of patients with suspected or confirmed COVID-19 / Centro quirúrgico: recomendaciones para el cuidado de pacientes con COVID-19 sospechado o confirmado

Objetivo: Apresentar as recomendações para reorganização do centro cirúrgico no atendimento a pacientes com suspeita ou confirmação de COVID-19. Método: Revisão crítica da literatura, com publicações dos anos de 2019 e 2020 relacionadas à produção científica, a normas técnicas, às diretrizes e recomendações de sociedades, para o gerenciamento do centro cirúrgico na assistência a pacientes durante a pandemia do novo coronavírus. Resultados: A gestão dos recursos humanos e materiais é primordial para: atender à demanda assistencial perioperatória; reorganizar os procedimentos cirúrgicos; garantir a segurança dos profissionais de saúde; organizar a sala cirúrgica com materiais necessários; planejar a recuperação pós-anestésica do paciente; e realizar limpeza e desinfecção da sala cirúrgica. Conclusão: As recomendações apresentadas direcionam os enfermeiros a aplicar as melhores práticas no atendimento aos pacientes, em consonância com evidências científicas recomendadas por instituições de referência, para promoção de assistência segura e de qualidade aos pacientes e profissionais.

Objective: To present the recommendations to reorganize surgical center in the care of patients with suspected or confirmed COVID-19. Method: Critical literature review of the literature, with publications from 2019 and 2020 related to scientific production, technical standards, guidelines and recommendations of societies for managing the surgical center in the care of patients during the new coronavirus pandemic. Results: The management of human and material resources is essential to meet the perioperative care demand; reorganize surgical procedures; ensure the safety of health professionals; organize an operating room with required materials; plan the patient's post-anesthetic recovery; and perform cleaning and disinfection of the operating room. Conclusion: The recommendations direct nurses to apply best practices in patient care, in line with scientific evidence recommended by reference institutions, to promote safe and quality care for patients and professionals.

Objetivo: presentar las recomendaciones para la reorganización del Centro Quirúrgico en la atención de pacientes con COVID-19 sospechado o confirmado. Método: Revisión crítica de la literatura, con publicaciones de los años 2019 y 2020, relacionadas con producción científica, estándares técnicos, Guías y Recomendaciones de Sociedades, para el manejo del CQ en la asistencia a pacientes durante la pandemia del nuevo coronavirus. Resultados: La gestión de los recursos humanos y materiales es fundamental para atender la demanda de cuidados perioperatorios, reorganizar los procedimientos quirúrgicos; garantizar la seguridad de los profesionales de la salud; organizar el quirófano con los materiales necesarios; planificar la recuperación postanestésica del paciente y realizar la limpieza y desinfección del quirófano. Conclusión: Las recomendaciones presentadas a enfermeras directas para aplicar las mejores prácticas en la atención al paciente, en línea con la evidencia científica recomendada por las instituciones de referencia, para promover una atención segura y de calidad a pacientes y profesionales.

Conflictos del cirujano: ¿La vocación quirúrgica está en crisis? / Conflicts of surgeons: is surgical vocation in crisis?

RESUMEN Introducción: En los últimos años vemos un aumento de bibliografía que se refiere a problemas perso nales y psicológicos del cirujano, a la deserción en residencias de cirugía y a la falta de especialización de individuos jóvenes. Este aumento se observa sobre todo en revistas de jerarquía como Lancet o JAMA. ¿Pero cuál es la situación en la Argentina? ¿Consideramos que nos están pagando adecua damente por nuestra práctica? ¿Pensamos en abandonar nuestra especialidad? ¿Cuántos conflictos tenemos con pacientes por mes? Estimamos necesaria la realización de un trabajo regional que lo plasme. Objetivo: conocer la situación socioeconómica actual de los cirujanos. Material y métodos: estudio de corte transversal. Resultados: de 73 cirujanos encuestados de la provincia de Santa Fe, se recibió respuesta en un 57,5 %. El 87,8 % fueron hombres y 56,1% estaba dentro del grupo de edad adulto intermedio/mayor al momento del estudio. El 97,6 % de los cirujanos concordó en que sus ingresos no se corresponden con el tiempo invertido en la práctica. Consideraron abandonar su práctica diaria en el último año en un 26,2 %; la causa económica es el principal problema para el 72,7%. Discusión: la incomodidad del cirujano frente a su salario (97,6 %), la discrepancia de porcentajes en tre cirujanos y cirujanas (87,8% vs. 12,2%), la falta de cirujanos jóvenes (43,9%) y la alarmante cifra de cirujanos graduados por año (35 por año) son cuatro puntos clave que consideramos deberían abordar de manera urgente los entes políticos y, sobre todo, las Asociaciones de Cirugía.

ABSTRACT Background: In recent years we have witnessed more publications about personal and psychological issues affecting surgeons, residents quitting surgery residencies, and lack of specialization of young in dividuals. This growth can be observed especially in high-impact journals such as The Lancet or JAMA. But what is the situation in Argentina? Do we think that we are receiving adequate payment for our practice? Do we consider quitting our specialty? How many conflicts do we have with patients each month? We think that a regional work is necessary to reflect this situation. Objective: The aim of this study is to determine the current socioeconomic situation of surgeons. Material and methods: We conducted a cross-sectional study. Results: A total of 73 surgeons from the province of Santa Fe were contacted and 42 answers were received (response rate 57.5%): 87.8% were men and 56.1% corresponded to middle/older adulthood. Almost all surgeons (97.6%) agreed that their income did not reflect the time spent in practice. Up to 26.2% of survey respondents considered quitting their daily practice in the last year due to eco nomic reasons, which is the main problem for 72.7% of them. Discussion: Surgeons' discomfort with their salaries (97.6%), the discrepancy in percentages between male and female surgeons (87.8% vs. 12.2%), the lack of young surgeons (43.9%) and the alarming number of surgeons graduated per year (35 per year) are 4 key issues which we believe should be urgently addressed by political bodies and, especially, by surgery associations.

Intervention with thumbtack needling on spinal low back pain in Air Force crew: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the clinical effect on spinal low back pain (SLBP) in Air Force crew treated with novel thumbtack needling therapy and to analyze the relevant factors of the therapeutic effect.@*METHODS@#A total of 120 Air Force crew with SLBP were randomized into a thumbtack needling group (40 cases), an external treatment group (40 cases, 1 case dropped off ) and a combined treatment group (40 cases, 1 case dropped off ). In the thumbtack needling group, the thumbtack needling therapy was adopted. The novel thumbtack needles were inserted at the lower No.6 region of the wrist-ankle acupuncture, Yaotongdian (EX-UE 7), Yaoyangguan (GV 3), etc. Each point was pressed and kneaded for 1 min each time, 3 or 4 times a day. The treatment for 3 days was taken as one course. At the interval of 2 days, 3 courses were required totally. In the external treatment group, @*RESULTS@#Compared with the values before treatment, McGill scores and ODI scores were reduced (@*CONCLUSION@#The thumbtack needling therapy is significantly effective on spinal low back pain in Air Force crew and is of the safety. Hence, this therapy is applicable to be promoted in the primary care army hospital.

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

Cirurgia abdominal de alta complexidade: classificação e escolha dos equipamentos pela equipe multiprofissional / High-complexity abdominal surgery: classification and choice of equipment by the multi-professional team / Cirugía abdominal de alta complejidad: clasificación y elección del equipo quirúrgico por el equipo multiprofesional

Introdução: Os procedimentos de alta complexidade são caracterizados pelo uso da alta tecnologia. A classificação e a escolha dos equipamentos são um desafio para os profissionais envolvidos. Objetivo: Comparar a classificação das cirurgias abdominais de alta complexidade e a escolha dos equipamentos pela equipe multiprofissional entre duas instituições hospitalares. Método: Pesquisa descritiva, quantitativa, transversal e comparativa, com questionários estruturados sobre a opinião dos cirurgiões, anestesiologistas e enfermeiros. Resultado: A classificação dos procedimentos é semelhante quando levados em conta equipamentos (P<1,0) e estrutura física (P=0,172) diferenciados. Discussão: A classificação dos procedimentos mais complexos tem concordância entre os profissionais comparado à legislação, mesmo não englobando o porte anestésico, tipo de procedimento e condições clínicas na sua classificação; a escolha dos equipamentos é do profissional que os utiliza, incluindo amplas salas de operações, sendo a cirurgia robótica dispensável aos cirurgiões. Conclusão: Há diferenças entre instituições de saúde em relação à escolha, à disponibilidade de equipamentos e aos tipos de cirurgias abdominais.

Introduction: High-complexity procedures are characterized by the use of high-technology. The classification and choice of equipment are challenging for the professionals involved. Objective: To compare the classification of high-complexity abdominal surgeries and the choice of equipment by the multi-professional team between two hospital institutions. Method: Descriptive, quantitative, transversal and comparative research, with structured questionnaires on the opinion of surgeons, anesthesiologists and nurses. Results: The classification of procedures is similar when considering differentiated equipment (P<1.0) and physical structure (P=0.172). Discussion: The classification of more complex procedures is in agreement between professionals when compared to the legislation, even if not encompassing anesthetic dimensions, type of procedure or clinical conditions in their classification; the equipment is chosen by the professional who uses them, including operating rooms, with robotic surgeries being expendable to surgeons. Conclusion: There are differences between the choices made by health institutions, the availability of equipment and the types of abdominal surgeries.

Introducción: procedimientos de alta complejidad se caracterizan por el uso de alta tecnología. La clasificación y elección de los equipos son un desafío para los profesionales. Objetivo: comparar la clasificación de cirugías abdominales de alta complejidad y la elección del equipo por parte del equipo multiprofesional entre dos instituciones hospitalarias. Método: investigación descriptiva, cuantitativa, transversal y comparativa, con cuestionarios estructurados sobre la opinión de cirujanos, anestesiólogos y enfermeras. Resultados: la clasificación de los procedimientos es similar cuando se consideran equipos diferenciados (P<1,0) y estructura física (P=0,172). Discusión: la clasificación de procedimientos más complejos está de acuerdo entre los profesionales en comparación con la legislación, incluso si no abarca dimensiones anestésicas, tipo de procedimiento o condiciones clínicas en su clasificación; el equipo es elegido por el profesional que los utiliza, incluidos los quirófanos, y las cirugías robóticas son dispensables para los cirujanos. Conclusión: hay diferencias entre las elecciones realizadas por las instituciones de salud, la disponibilidad de equipos y los tipos de cirugías abdominales.

Noise Exposure Among Maintenance Crews Of C130h Aircraft Lead To The Hearing Impairment

@#The objectives of the research are to identify the noise sources and noise level exposure inside C130H aircraft’s hangar; to produce noise mapping; to identify hearing status of C130H aircraft maintenance crews (MC); and suggesting the noise control measure that can be applied. A field survey on noise level by using a digital sound level meter and producing noise mapping. A hearing testing among 63 MC was carried out in Institute of Aviation Medicine, Royal Malaysian Air Force (RMAF). Reviewing the literature and analyzing some control measures to be taken. Hearing test result shown 41.2% of the MC are having hearing impairment. The highest noise level at the central of the hangar is 92.2 dBA (day-time) and 94.2 dBA (night-time) when there is a C130H aircraft starting its engine at 50 meters from the central of the hangar, 95.3 dBA (day-time) and 97.3 dBA (night-time) when there is a C130H aircraft Engine Ground Run at 150 meters from the central of the hangar. Besides, Auxiliary Power Unit is producing the highest noise level which is 125.7 dBA (day-time) and 127.7 dBA (night-time). The application of Personal Protective Equipment (PPE) is the very likely control measure to be taken while engineering control is very costly but can be considered. Since noise is recognized as a hazard, hearing protection as PPE will not be the ultimate solution as a control measure. Hence, the Engineering Control must be identified and studied to be implemented as an ultimate solution to control the noise hazard in long term duration.

Survey on the job satisfaction among the staff in the dilution situation of the hospital staffing management / 国际中医中药杂志

To explore the status of the job satisfaction of the authorized and contract staff in a university affiliated hospital in the dilution situation of the hospital staffing management, and to discuss the key factors and reasons affecting the satisfaction difference. The questionnaire was developed based on Minnesota Satisfaction short form with extra items covering “the comprehensive satisfaction evaluation”. According to the hospital population of staff, the cluster random sampling method was used, and survey was conducted on the spot. Both authorized staff and the contract staff showed high degree of satisfaction. But the contract staff showed higher degree of satisfaction of leadership and their own responsibility sense than the authorized staff. The contract female staff showed higher degree of overall satisfaction than the authorized female staff. The discussion based on the results showed that new human resource management mode, new mechanism of flexible management of staff, targeted staff with targeted management.

Noise exposure Among Maintenance Crews Of C130H Air-Craft Lead To The Hearing Impairment

The objective s of the research are t o identify the noise sources and noise level exposure inside C130H aircraft ’s hangar ; to produce nois e mapp ing ; to identify hearing status of C 130H aircraft maintenance crews (MC) ; and suggesting the noise control measure that can be applied. A field survey on noise level by using a digital s ound level m eter and producin g noise mapping . A h earing test ing among 63 MC was carried out in Institute of Aviation Me dicine , Royal Malaysian Air Force ( RMAF ) . Reviewing the literature and a nalyzing some control measure s to be taken. Hearing test result shown 41.2% of the MC are having hearing impairment. The highest noise level at the central of the hanga r is 92.2 dB A ( day - time) and 94.2 dBA (night - time) when there is a C130H aircraft starting its engine at 50 meter s from the centr al of the hanga r, 95.3 dBA (day - time) and 97.3 dBA (night - time) when there is a C130H a ircraft Engine Ground Run at 150 meter s fr om the centra l of the hanga r. Besides, Auxiliary Power Unit is producing the highest nois e level which is 125.7 dBA (day - time) and 127.7 dBA (night - time) . The application of Personal Protective Equipment (PPE) is the very likely control measure to be taken while engin eering control is ve ry costly but can be considered. Since noise is recognized as a hazard, hearing protection as PPE will not be the ultimate solution as a control measure. Hence, the Engineering Control must be identified and studied to be implemented as an ultimate solution to control the noise hazard in long term duration.

The utility of live video capture to enhance debriefing following transcatheter aortic valve replacement.

Background: The surgical and procedural specialties are continually evolving their methods to include more complex and technically difficult cases. These cases can be longer and incorporate multiple teams in a different model of operating room synergy. Patients are frequently older, with comorbidities adding to the complexity of these cases. Recording of this environment has become more feasible recently with advancement in video and audio capture systems often used in the simulation realm. Aims: We began using live capture to record a new procedure shortly after starting these cases in our institution. This has provided continued assessment and evaluation of live procedures. The goal of this was to improve human factors and situational challenges by review and debriefing. Setting and Design: B‑Line Medical’s LiveCapture video system was used to record successive transcatheter aortic valve replacement (TAVR) procedures in our cardiac catheterization/laboratory. An illustrative case is used to discuss analysis and debriefing of the case using this system. Results and Conclusions: An illustrative case is presented that resulted in long‑term changes to our approach of these cases. The video capture documented rare events during one of our TAVR procedures. Analysis and debriefing led to definitive changes in our practice. While there are hurdles to the use of this technology in every institution, the role for the ongoing use of video capture, analysis, and debriefing may play an important role in the future of patient safety and human factors analysis in the operating environment.

Análise dos acidentes de trabalho na equipe de enfermagem: uma revisão integrativa / Analysis of the accidents at work in the nursing staff: an integrative review / Análisis de los accidentes de trabajo en el equipo de enfermería: una revisión integrativa

Objective: To analyze work-related injuries in nursing staff. Method: Integrative review in which the sample was obtained by articles of national and international journals that were available on the SciELO and LILACS databases, between 2007-2011. Results: We found 212 publications, of which 18 were selected after applying the inclusion criteria. A large number of publications were found in SciELO (61%) and there was equality in the number of publications in the years 2007-2009 and 2011 (22.2%). After examination, it was noticed that the nursing staff is very struck by accidents, and that the sharps are the main villains in this sense, and biological material is also very present. Conclusion: It is concluded that not only the workers should have care knowledge in their workplace, but also the health institutions have to meet their obligations in order to protect the workers.

Objetivo: Analisar os acidentes de trabalho na equipe de enfermagem. Métodos: Revisão integrativa na qual a amostra de artigos captados estava disponível em periódicos nacionais e internacionais e se encontravam nas bases do SCIELO e LILACS, durante os anos de 2007-2011. Resultados: Encontrou-se 212 publicações, sendo que 18 foram selecionados após aplicação dos critérios de inclusão. Encontrou-se um maior número de publicações na SCIELO (61%) e houve igualdade no número de publicações nos anos de 2007-2009 e 2011 (22,2%). Após a análise, percebeu-se que a equipe de enfermagem é bastante atingida pelos acidentes de trabalho, e que os materiais perfurocortantes são os principais vilões nesse sentido, e o material biológico se faz bastante presente. Conclusão: Conclui-se que não somente os trabalhadores devem ter a ciência dos cuidados em seu local de trabalho, mas também as instituições de saúde em cumprir suas obrigações visando à proteção do trabalhador.

Objetivo: Analizar las lesiones relacionadas con el trabajo del personal de enfermería. Método: Revisión integradora en la que se obtuvo la muestra de artículos disponibles en revistas nacionales e internacionales en las bases SciELO y LILACS, durante los años 2007-2011. Resultados: Se encontraron 212 publicaciones, de las cuales 18 fueron seleccionadas después de aplicar los criterios de inclusión. Se reunió un gran número de publicaciones en SciELO (61%) y hubo igualdad en el número de publicaciones en los años 2007-2009 y 2011 (22,2%). Después del examen, se observó que el personal de enfermería es muy atingido por los accidentes, y que los objetos punzantes son los principales villanos en este sentido, el material biológico está muy presente. Conclusión: Se concluye que no sólo los trabajadores deben tener la ciencia del cuidado en su lugar de trabajo, sino también las instituciones de salud para cumplir con sus obligaciones con el fin de proteger al trabajador.

Relationship between psychological quality and performance capacity among armored crew / 军事医学

Objective To investigate the relationship between psychological quality and performance capacity of the crew in armored equipment so as to provide scientific evidence for the training of crew .Methods The psychological quality of 82 crew members of armored cavalry was tested and analyzed by neurobehavioral testers and questionnaires .Results and Conclusion The education level and age had no significant effect on the performance capacity among the armored crew . The test results of psychological quality parameters showed the same trend as the performance capacity of the crew , but their psychological health status had obvious effect on the performance capacity .The psychological quality of the crew had great influence on their performance capacity ,so we should pay attention to mental intervention ,enhance psychological protection ability of the crew , and improve their combat effectiveness continuously .

Medical identification of lumbar spondylolysis among flight crew between PLAAF and USAF:an empirical study / 军事医学

Objective To improve the selection of flying cadets of the Air Force of People′s Liberation Army of China ( PLAAF) by analyzing the differences of medical identification of lumbar spondylolysis between PLAAF and the US Air Force ( USAF) .Methods Flight crew who had been checked for lumbar spondylolysis during hospitalization at the Air Force General Hospital between 2013 and 2015 were chosen.The results of their medical identification were compaired according to PLAAF and USAF Medical Standards Directory, and their differences and possible reasons were analyzed accordingly.Results The qualified rate of PLAAF was about 85%, which was very close to the standards of USAF, but the difference was not of any statistical significance(P>0.05).Conclusion The standards of our medical identification of lumbar spondylolysis was similar to those of USAF, suggesting that the selection of flying cadets can be improved.

Design of an operative gesture measuring system used for crew in armored vehicles / 军事医学

Objective To design a measuring system for operative gestures used for the crew in armored vehicles. Methods The MEMS sensor was used to collect gesture parameters of important parts of four crew members,such as the head, neck,trunk,arms,legs.The infrared tracking auxiliary measurement was used to calibrate the gesture parameters of arms of drivers.The wireless transceiver was used to transmit data to the control unit for preprocessing and then send the data to the collector for storage, before being transmitted to the back-end computers.A software system was used to process and display the body posture parameters.Results and Conclusion The system can mesure the operative gestures of the crew and provide means by which to analyze the kinematics for the crew in armored vehicles.

Dolor musculoesquelético en tripulantes de tanques petroleros venezolanos / Musculoskeletal pain in Venezuelan oil tanker crews

El objetivo de esta investigación fue analizar la prevalencia de dolor musculoesquelético (DoME) en 155 tripulantes de tanqueros petroleros venezolanos. Se realizó un estudio descriptivo y transversal, aplicando el cuestionario Estandarizado Nórdico. La prevalencia de DoME (n=127) fue de 82%. La edad en los tripulantes que refirieron DoME fue 39,29 ± 10,16 años, rango 24-60 años y los que lo negaron fue de 34,93 ± 9,76 años, rango 24-58 años (p<0,05); el IMC del grupo con DoME fue de 29,94 ± 4,31 Kg/m², mientras que el otro fue de 30,02 ± 4,96 Kg/m². El 83% de los tripulantes con DoME tenían una antigüedad laboral de 10 años o menos (4,31 ± 2,44 años). La ocurrencia de DoME para los tripulantes de sala de máquinas y de cubierta fue similar (50%) y su frecuencia por región anatómica fue: 57% en espalda inferior, 32% en rodillas, 24% en cuello, 24% en espalda superior y 19% hombros. Se demostró asociación directa significativa (p<0,05) entre el DoME de espalda baja y antigüedad, así como entre edad e IMC (p<0,01); cargo con el área de trabajo; y una asociación inversa significativa (p<0,01) entre lumbalgia y DoME de rodillas, edad y dolor de cuello y antigüedad laboral en el tanquero con el cargo. Los tripulantes en área de cubierta mostraron una ocurrencia más alta de DoME en cuello (33%) que los de máquinas (15%) (p<0,01). Estos hallazgos sugieren la necesidad de implementar programas de salud para reducir la ocurrencia de DoME en el lugar de trabajo.

The objective of this investigation was to analyze the prevalence of musculoskeletal pain (MSP) in oil tanker crew members in Venezuela. A descriptive cross-sectional study was implemented, using a modified version of the Standardized Nordic Questionnaires. The prevalence of MSP in 127 men was 82%. The mean age was statistically different (p < 0.05) between the MSP group (39.29 ± 10.16 years, range 24-60) and the no-MSP group (34.9 ± 9.76 years, range 24-58 years). There was no significant difference between the body mass indexes (BMI) of the MSP group (29.94 ± 4.31 kg/m²) and the no-MSP group (30.02 ± 4.96 km/m²). The majority of the crew members with MSP (83%) had ≤ 10 years seniority, mean value of 4.31 ± 2.44 years. MSP occurrence was the same (50%) for crew members located in engine rooms and decks. The MSP frequency for anatomical region was 57% in lower back, 32% knees, 24% in neck and upper back and 19% shoulders. There was a significant association between lower back pain and seniority (p < 0.05), also between age and BMI (p < 0.01); and an inverse significant correlation (p < 0.01) between lower back pain and knee pain, age and neck pain and seniority in the job. The crew members in the deck area showed a higher occurrence of neck pain (33%) than the engine crew (16%) (p< 0.01). Our findings suggest the need to implement health programs to reduce the occurrence of MSP in the workplace.

D(e)scolar de casa: dilemas contemporâneos dos casais de aeronautas / Take off home: contemporary dilemmas for crew members couples / Despegar de casa: conflictos contemporáneos de parejas de aeronautas

Este estudo examina a questão de gênero na divisão de tarefas domésticas e responsabilidades familiares entre membros de casais de aeronautas (comissários e pilotos). Homens e mulheres se veem divididos diante de propostas igualitárias de relacionamento, em contraposição a práticas mais tradicionais. A lacuna deixada pelas mulheres na vida privada, com sua entrada maciça no mercado de trabalho, não foi ocupada por outros, senão por elas próprias, para poder conciliar família e profissão. Foi possível perceber que, nos quatro casais de aeronautas entrevistados, as mulheres despendem mais tempo com o trabalho doméstico e com as responsabilidades familiares do que seus maridos, produzindo, com isso, um cenário desfavorável para a ascensão profissional das mulheres e para um maior envolvimento dos homens com a vida familiar.

The main subject of this study is the gender issue in the division of housework and child care between spouses who work as crew members in civil aviation. This study reports an investigation of the relationships of nonstanda rd work schedules and family balance. Women and men are confronted with an egalitarian social discourse and traditional patterns of behavior. Women started working outside the home dealing with multiple roles to balance housework and career. Interviews with four couples were made and the results were that these women still do much more routine housework than their husbands. The gender segregation of tasks associated with the traditional gender ideologies contribute to difficult women to grow in their careers as well as the father’s role to expand.

El presente trabajo examina la question de género en la división de tareas domésticas y responsabilidades familiares entre miembros de parejas de profesionales azafatas/comisários y pilotos. Hombres y mujeres se encuentran divididos frente a propuestas igualitárias de relación en contraposición a las práticas más tradicionales. El espacio vacío dejado por las mujeres en la vida privada, con su entrada en el mercado laboral, no fue ocupado por otros, sino por ellas mismas, para poder conciliar familia y profesión. Según las entrevistas con cuatro parejas de aeronautas, las mujeres entrevistadas dedican más tiempo a las tareas domésticas y responsabilidades familiares que sus maridos, produciendo com esto un escenario desfavorable a la ascención profesional de las mujeres y para una mayor responsabilidad de los hombres con la vida familiar.

Research on the shock protection of surface ship crew subjected to underwater explosion / 医用生物力学

Objective To study the methods of reducing the shock response of surface ship crew by under water explosion. Method The shock response lumped parameter models were established to study the influence on surface ship crew with different structure parameters in standing, sitting and walking posture. Results For ship crew with sitting posture, the shock response of the pelvis could be reduced by enlarging the damping ratio and stiffness ratio between the deck and the chair. For ship crew with both standing posture and walking posture, the shock response of the limb could be reduced by enlarging the damping coefficient of the deck. Conclusions By adding anti shock chairs or laying anti-shock material on the deck, the damping ratio and stiffness ratio between the deck and the chair, or the damping coefficient of the deck could be enlarged, and the shock response of the surface ship crew could be reduced.