Totally Percutaneus Veno-Venous ECMO Therapy for COVID 19 Patients. Bridge to Recovery or Lung Transplantation?

Objective: Multiple major health organisations recommend the use of extracorporeal membrane oxygenation (ECMO) support for COVID-19-related acute hypoxaemic respiratory failure. Method(s): From march 2020 to november 2021 we done 108 veno-venous ECMO therapies. 35 patients required implantation immediately in intensive care unit in place of call by mobile ECMO team. Depend from distance of call it was used medical ambulance, rescue helicopter or medical plane. Result(s): In the first analyzed period (March-December 2020), 90-day mortality was 41%. 8 (7.6%) patients were discharged from the Intensive Care Unit. The remaining 3 (4.2%) were discharged home. 7 patients (6.6%) had both lung transplants. 7 patients (6.6%) required conversion to VV-A ECMO therapy due to the development of acute heart failure. Conclusion(s): In the analyzed period of March-December 2020, the mortality was 41%. As a result, the lower effect of regression of consolidation and inflammatory lesions of lung tissue indicates that ECMO therapy remains the treatment method in high-risk patients as a bridge therapy to lung transplantation.

Emergency Air Transport of Patients with Acute Chest Pain in the Adriatic Islands of Croatia: A Four-Year Analysis.

BACKGROUND: An efficient first-aid system usually supports ground services with a helicopter emergency medical service (HEMS). An HEMS is important for patients with acute chest pain on remote islands. The current study sought to identify the characteristics of HEMS in acute chest pain cases on the Croatian Adriatic islands over a four-year period. METHODS: We conducted a four-year observational study to investigate HEMS from Adriatic islands. The study population consisted of all patients with acute coronary syndrome or pulmonary embolisms who were urgently transferred by HEMS to the University Hospital in Split 1 June 2018-1 June 2022. RESULTS: During the observation period, 222 adult patients (67 females, or 30.2%) were urgently transferred. The mean age was 71.81 ± 13.42 years. The most common diagnosis was ST-elevated myocardial infarction (113, 50.9%). Most of the HEMS cases were from Hvar (91, 41.0%). The mean call-to-flight time was 19.10 ± 10.94 min, and the total time from call to hospital was 68.50 ± 22.29 min. The total time from call to hospital was significantly correlated with call-to-flight time (r = 0.761, P < 0.001). Of the 222 participants, 5 (2.25%) were transported for more than 120 min, and 35 (15.8%) were transported for more than 90 min. CONCLUSION: This study provided a detailed insight into HEMS in the area of the Croatian Adriatic islands. The average time from the call to the helicopter taking off was 19.10 min. An increase in dispatching time has a significant impact on the prolongation of the total time for the hospital admission. Shortening the response time is critical to reducing hospital arrival time.

Retour d'expérience sur le centre médical de coordination et d'évacuation aérien Covid — Paris-Orly

Après la décision de réaliser des évacuations aériennes de patients Covid vers les régions françaises ouest et sud avec des vecteurs civils et des vecteurs militaires, le Samu 94, en collaboration avec les services de l'aéroport Paris-Orly, a ouvert un centre médical d'évacuation (CME) au niveau du service médical de l'aéroport (SMU). Le CME établi sous tente, équipé des ressources en matériel médical et en médicaments, permettait d'accueillir temporairement 16 patients. Le Samu 94 a établi un centre de coordination des opérations au niveau du SMU. Ce centre de coordination était constitué de l'ensemble des ressources nécessaires à l'accomplissement de la mission. Le centre de coordination recevait du Samu zonal l'information des patients à transférer. Le rôle du centre de coordination était d'assurer l'enchaînement logistique depuis la prise en charge du patient dans l'hôpital d'origine, vers l'établissement de destination en région. Le centre de coordination s'assurait de la mobilisation des équipes médicales pour la prise en charge des patients soit directe par moyen héliporté posé sur la dropping zone de l'hôpital, soit par la mise en œuvre d'un préacheminement terrestre et d'un embarquement dans un moyen aérien civil ou militaire au niveau du hub de Paris-Orly.Alternate : After the decision to transport by medical air evacuation COVID patients to the western and southern French regions with civilian air vectors and military air vectors, the Samu 94, in collaboration with the services of Paris-Orly airport, opened a medical center of evacuation (CME) at the airport medical service (SMU). The CME under tent, equipped with medical equipment and drug resources, was able to temporarily accommodate 16 patients. The Samu 94 has also established an operational medial coordination center at the level of the SMU. The coordination center was composed of all human resources necessary for the accomplishment of the mission. The coordination center received information from the zonal SAMU about patients to be transferred. The role of the coordination center was to ensure all the logistical chain from the pic-up of the patient at the hospital of origin, to the destination hospital. The coordination center ensures the mobilization of the medical team who take care of the patient either directly by helicopter placed on the DZ of the hospital, or by implementation a land transportation before boarding in a civilian, military plane or helicopter at the Paris-Orly hub.

Retour d'expérience des transferts en HéliSmur de patients Covid-19

L'augmentation du nombre d'hospitalisations en réanimation de patients graves atteints de la Covid-19 a nécessité le transfert d'un certain nombre d'entre eux vers des régions moins touchées que le Grand Est et l'Île-de-France afin de ne pas dégrader la qualité des soins. Les HéliSmur ont fait partie intégrante du dispositif d'évacuation de ces patients. Utilisés au quotidien, ils ont confirmé leur utilisation en cas de crise où la problématique des élongations est une difficulté. Cependant, le recours aux HéliSmur a nécessité une adaptation de tous à de nouvelles modalités opérationnelles. Le transport de patients critiques, le port d'un équipement de protection individuelle par l'équipe médicale et les membres d'équipage ainsi que les procédures renforcées de bionettoyage ont impacté les temps d'intervention mais aussi la charge mentale des personnes à bord. La mise en place d'équipes médicales dédiées et rompues aux transferts héliportés a permis d'optimiser la prise en charge complexe de ces patients tant sur le plan médical qu'aéronautique. Nous présentons notre retour d'expérience des transferts en HéliSmur que nous avons réalisés au départ de la région francilienne.Alternate : The increase in the number of hospitalizations in intensive care units of serious patients with COVID-19 has required the transfer of many of them to regions less affected than the Grand Est and Ile-de-France in order to not degrade the quality of care. The Helicopter Emergency Medical Service was an integral part of the evacuation system for these patients. Used on a daily basis, they have confirmed their use in the event of a crisis where the problem of elongations is difficulty. However, the use of Helicopter Emergency Medical Service requires everyone to adapt to new operational methods. The transport of critical patients, the wearing of personal protective equipment by the medical team and crew members as well as the reinforced bio-cleaning procedures have impacted the intervention times but also the mental load of the people on board. The establishment of dedicated medical teams experienced in helicopter transfers has made it possible to optimize the complex care of these patients, both medically and aeronautically. We present our feedback from the Helicopter Emergency Medical Service transfers that we carried out from the Ile-de-France region.

(Special Issue) Perceived Helicopter Parenting Related to Vocational Senior High School Students' Academic Achievement and Smartphone Addiction

Background and Purpose of Research Adolescents use their smartphones for various purposes, for example, following distance/online learning, especially during the COVID-19 pandemic, staying in touch with friends, having fun using social media tools. According to the social ecological model, risk behaviors, like substance consumption, are regarded as behavior problems. Relatively, etiology is derived of youths' embeddedness surrounded by their social networks, mainly throughout sensitive development periods (Bishop et al., 2020). Given the prevalence of smartphone addiction among young students, previous studies have explored the relationships between smartphone addiction and students' learning and indicated there is negative outcomes of smartphone resulting from overuse of mobile phones, including poor sleep quality. However, there some antecedents of smartphone addiction which has not extendedly studied, for example, parenting style, thus, the present study aimed to explore the correlates between parenting styles, academic achievement and smartphone addiction. Parenting that reflects a combination of support and behavioral control has been linked to numerous indices of academic well-being and live functioning from early childhood through adolescence. In regarding the term helicopter parenting indicated that parents involve hovering behaviors and are potentially over-involved in the lives of their child or in their academic work (Padilla-Walker & Nelson, 2012). But empirical research has not adequately used these two construct from other controlling parenting practices to predict children's smartphone addiction, thus, the present study applied two types of helicopter parenting: live hovering and academic hovering of parenting for of emerging adults, to explain the prediction of children's smartphone addiction. According to Bronfenbrenner (1979) micro ecological system that discusses the association between person-process-content (PPC), who described "person-process-context model” (PPCM) that occurs variability in development procedure as considered in this paper as a functional context (mobile phone usage), person (parenting styles) and process (academic achievement). Not only has cultural ecology be likely to pursue its complications in issues originating from social and cultural topics, but intricate schools of understanding of culture-nature relationship have developed for certain risk behavior. For example, helicopter parenting is more obvious in Chinese families than Western ones, even though the parents want their children to grow up to be independent and think for themselves. Particularly, Chinese parents are more concerned about their children's schoolwork when they are teenagers, which leads to increased helicopter parenting problems, exacerbating issues such as lack of independence, lack of control, and not knowing how to self-manage smartphone use, which can in turn lead to smartphone addiction. If parents are in constant hovering of their children's lives or schoolwork, children develop dependent behaviors. Some studies have indicated that a child's dependent behaviors result in lower motivation to learn and reduced academic achievement. In line with this, drawn on PPCM to understanding the role of academic hovering and live hovering affect participants' smartphone addiction mediated by academic achievement, hypotheses are proposed as follows. Hypotheses (1) Live hovering has a negative effect on academic achievement. (2) Academic hovering has a negative effect on academic achievement. (3) Academic achievement has a negative effect on smartphone addiction. (4) Live hovering has a positive effect on smartphone addiction. (5) Academic hovering has a positive effect on smartphone addiction. Methodology Questionnaire was designed by adapting and translated from previous researched and gave to domain experts to ensure the content validity. Afterward, a purposive sampling was adapted in this study, a total of 400 questionnaires were distributed to 4 vocational senior high schools located in Taipei City. 354 of which were collected, resulting in a questionnaire collection rate of 88.5%. After 64 invalid questionnaires were excluded, 290 valid questionnaires remained, resulting in a valid questionnaire collection rate of 81.92%. Factor analysis was conducted on the valid questionnaires. Results First, helicopter parenting, live and academic hovering had a negative association with academic achievement, with an explanatory power of 20.8%. Second, academic achievement had a negative association with smartphone addiction, with an explanatory power of 38.6%. Third, helicopter parenting had a negative association with smartphone addiction. Fourth, academic hovering had a negative association with smartphone addiction mediated by academic achievement, with an explanatory power of 20.8%. The results of the study thus indicate that young people who are not independent in life or schoolwork tend to rely on their parents, are less able to control their smartphone use, and are more likely to develop smartphone addiction. By contrast, young people who are independent in life and schoolwork and do not need to rely on their parents have control over their smartphone use and are less likely to develop smartphone addiction. Conclusions and Recommendations The results of this study demonstrate that if vocational senior high school students are overly dependent on their parents in life or schoolwork, they may have lower academic achievement and therefore, they are not motivated to achieve strong academic results and will not restrain their desire to spend time on using smartphone, resulting in a tendency toward smartphone addiction. However, when vocational senior high school students do not have to rely on their parents to a great extent in life or schoolwork, they are able to act independently, attain high academic achievement, determine what they want to achieve, and arrange how they will accomplish their goals. Therefore, they have the ability to control the time they spend using their phones and will not develop smartphone addiction. This study suggests that parents should let their children learn to be independent and autonomous, which should help to effectively reduce the problem of smartphone addiction. Finally, conducting this study highlighted possibilities for future research. Some studies suggest that fathers and mothers do not necessarily share the same parenting style, and hence, it is suggested that in a questionnaire survey, the hovering styles of fathers and mothers could be differentiated and then analyzed through a differential analysis. In addition, some smartphone use can be designed with time of use to control using time (e.g., Chinese government limited the hours for children to use smartphone). However, how is the effect of the regulation to students' smartphone addiction should be further studied.Alternate : 隨著行動網路普及，人與人之間的通訊變得更加便利，也造成人們高度依賴手機。然而，手機使用失去控制已對健康造成嚴重危害，如成癮等。孩子的行為控制經常依賴於父母教養方式，尤其是華人父母在教養孩子方面與歐美國家的父母相比，會更加關注地自己的子女。這代表華人父母更關注於孩子的學業和生活，並形成更多按照父母親意志且欠缺獨立思考的媽寶，這將可能激起或停止孩子的手機成癮問題。本研究針對技術型高中學生進行問卷調查，有效問卷共290份，並對數據進行結構方程模式的驗證性因素分析。本研究採用生態系統理論，由AMOS 20建模，並從數據分析的結果進行分析。本研究發現：一、生活媽寶覺知與課業媽寶覺知對學業成就動機呈現負向影響；二、學業成就動機對手機成癮呈現負向影響；三、生活媽寶覺知與課業媽寶覺知對手機成癮呈現正向影響；四、生活媽寶覺知與課業媽寶覺知經由學業成就動機對手機成癮有正向的間接影響。研究結果證明，過分依賴父母的技術型高中學生有較低的學業成就動機，並無法控制手機的使用，因此造成手機成癮。換言之，父母應避免過多的日常生活與學業控制，以減少孩子手機使用的需求性。

Parental Support during the COVID-19 Pandemic: Friend or Foe? A Moderation Analysis of the Association between Maternal Anxiety and Children's Stress in Italian Dyads.

There is evidence that parental psychological disorders in stressful situations increase the risk of disturbance in child development. This has been investigated in disasters but not in pandemics, which are sensibly different from other types of traumatic events. We investigated the relationship between mothers' anxiety and their children's (self-reported) stress and the boundary conditions of this association during the first full COVID-19 lockdown in Italy. During the COVID-19 pandemic, mothers might have increased their protective attitudes to secure and support their children; we tested whether the relationship between mothers' anxiety and children's stress was weaker (buffer effect) or stronger (over-protection effect) when perceived parental support was high. We measured mothers' anxiety, children's perceived parental support, and children's stress in a sample of 414 8- to 11-year-old primary school children (229 females, Mage = 9.44) and 395 mothers (Mage = 42.84). Results supported the over-protection scenario and provided the first evidence for the "helicopter-parent effect" during the COVID-19 pandemic: mothers' anxiety was positively associated with children's stress only when perceived support was high. Our finding highlights the importance of educating parents (for example, via emotional training) to prevent the worst consequences of adverse events in children and promote their mental health.

Emergency Service Assistance for Injuries on Alpine Ski Slopes: A Cross-Sectional Study.

OBJECTIVES: Injuries on alpine ski slopes have been described in cohorts of a reasonable sample size, but constant improvements in safety gear, increased use of airborne rescue, and safety measures during the coronavirus disease 2019 (COVID-19) pandemic mandate re-evaluation. Therefore, the purpose of this study was to evaluate skiing and snowboarding injuries, effectiveness of airborne rescue, and impact of the COVID-19 pandemic on a large sample size. METHODS: Data on alpine injuries were prospectively collected from the state emergency services dispatch center in the state of Tyrol (Austria). A total of 10,143 patients were identified, with an average age of 33.5 years (SD = 20.36). The ski patrol was involved in 8,606 cases (84.9%) and some patients (n = 1,536; 15.1%) required helicopter rescue. RESULTS: A total of 10,143 patients were identified from the dataset of the emergency dispatch center. The most frequently injured region was the knee (30.2%), and it was followed by the shoulder (12.9%), the lower leg (9.5%), and the head/skull (9.5%). CONCLUSION: The present findings indicate that the most frequent site of injuries on alpine slopes is the knee, and life-threatening injuries are rare. Airborne rescue is very time-effective, however clinical studies with patient follow-up should be emphasized to determine the impact of airborne rescue on patient outcome. The present findings indicate that the duration of all rescue operations has been prolonged as a result of the introduction of safety measures during the COVID-19 pandemic.

Pre-hospital care & interfacility transport of 385 COVID-19 emergency patients: an air ambulance perspective.

BACKGROUND: COVID-19, the pandemic caused by the severe acute respiratory syndrome coronavirus-2, is challenging healthcare systems worldwide. Little is known about problems faced by emergency medical services-particularly helicopter services-caring for suspected or confirmed COVID-19 patients. We aimed to describe the issues faced by air ambulance services in Europe as they transport potential COVID-19 patients. METHODS: Nine different HEMS providers in seven different countries across Europe were invited to share their experiences and to report their data regarding the care, transport, and safety measures in suspected or confirmed COVID-19 missions. Six air ambulance providers in six countries agreed and reported their data regarding development of special procedures and safety instructions in preparation for the COVID-19 pandemic. Four providers agreed to provide mission related data. Three hundred eighty-five COVID-19-related missions were analysed, including 119 primary transport missions and 266 interfacility transport missions. RESULTS: All providers had developed special procedures and safety instructions in preparation for COVID-19. Ground transport was the preferred mode of transport in primary missions, whereas air transport was preferred for interfacility transport. In some countries the transport of COVID-19 patients by regular air ambulance services was avoided. Patients in interfacility transport missions had a significantly higher median (range) NACA Score 4 (2-5) compared with 3 (1-7), needed significantly more medical interventions, were significantly younger (59.6 ± 16 vs 65 ± 21 years), and were significantly more often male (73% vs 60.5%). CONCLUSIONS: All participating air ambulance providers were prepared for COVID-19. Safe care and transport of suspected or confirmed COVID-19 patients is achievable. Most patients on primary missions were transported by ground. These patients were less sick than interfacility transport patients, for whom air transport was the preferred method.

Safety during interhospital helicopter transfer of ventilated COVID-19 patients. No clinical relevant changes in vital signs including non-invasive cardiac output.

BACKGROUND: During the COVID-19 pandemic in The Netherlands, critically ill ventilated COVID-19 patients were transferred not only between hospitals by ambulance but also by the Helicopter Emergency Medical Service (HEMS). To date, little is known about the physiological impact of helicopter transport on critically ill patients and COVID-19 patients in particular. This study was conducted to explore the impact of inter-hospital helicopter transfer on vital signs of mechanically ventilated patients with severe COVID-19, with special focus on take-off, midflight, and landing. METHODS: All ventilated critically ill COVID-19 patients who were transported between April 2020 and June 2021 by the Dutch 'Lifeliner 5' HEMS team and who were fully monitored, including noninvasive cardiac output, were included in this study. Three 10-min timeframes (take-off, midflight and landing) were defined for analysis. Continuous data on the vital parameters heart rate, peripheral oxygen saturation, arterial blood pressure, end-tidal CO2 and noninvasive cardiac output using electrical cardiometry were collected and stored at 1-min intervals. Data were analyzed for differences over time within the timeframes using one-way analysis of variance. Significant differences were checked for clinical relevance. RESULTS: Ninety-eight patients were included in the analysis. During take-off, an increase was noticed in cardiac output (from 6.7 to 8.2 L min-1; P < 0.0001), which was determined by a decrease in systemic vascular resistance (from 1071 to 739 dyne·s·cm-5, P < 0.0001) accompanied by an increase in stroke volume (from 88.8 to 113.7 mL, P < 0.0001). Other parameters were unchanged during take-off and mid-flight. During landing, cardiac output and stroke volume slightly decreased (from 8.0 to 6.8 L min-1, P < 0.0001 and from 110.1 to 84.4 mL, P < 0.0001, respectively), and total systemic vascular resistance increased (P < 0.0001). Though statistically significant, the found changes were small and not clinically relevant to the medical status of the patients as judged by the attending physicians. CONCLUSIONS: Interhospital helicopter transfer of ventilated intensive care patients with COVID-19 can be performed safely and does not result in clinically relevant changes in vital signs.

Economic Stimulus and Financial Instability: Recent Case of the U.S. Household

The effectiveness of government policies and economic stimuli during the 2007 financial crisis and the COVID-19 pandemic are compared in this study. While the 2007 financial crisis started in the real estate market and spread through the contagion effect to other sectors, the pandemic halted the all sectors of the global economy simultaneously. In the United States, where the social safety net is not as strong as other advanced economies, the unemployment rate skyrocketed and many families lost income. The federal government countered with various relief packages, which have been, unlike the rounds of quantitative easing prevalent after the 2007 financial crisis, direct payments to households and businesses. The Agent Instability Indicator and default elasticity coefficient are used to quantitatively assess the financial instability and default risk of subgroups of United States households classified by percentile of income and net worth. It turns out that the financial instability level of the United States household during the pandemic has not been as high as that during the 2007 crisis and the Great Recession. It is concluded that the direct handout of cash-so called helicopter money-is more effective at preventing financial collapse and stabilizing the economy than quantitative easing through asset purchase.

Integration of aeromedicine in the response to the COVID-19 pandemic.

There is limited guidance on the use of helicopter medical personnel to facilitate care of critically ill COVID-19 patients. This manuscript describes the emergence of this novel virus, its mode of transmission, and the potential impacts on patient care in the unique environment of rotor wing aircraft. It details the development of clinical and operational guidelines for flight crew members. This allows other out-of-hospital clinicians to utilize our framework to augment or supplement their own for the current response effort to COVID-19. It further serves as a road map for future response to the care of high consequence infectious disease patients.

Helicopter Money and Basic Income, or a Work-Based Society?

Following the coronavirus outbreak, and especially before inflation became a key factor in this period, several crisis management proposals raised the possibility of a universal basic income, which could be hacked by the central bank's money creation. The following paper is an essay that seeks to grasp the political economic meaning and implications of the propositions related to helicopter money and basic income. We cannot avoid observing the essence of these proposals, presented fundamentally as a distribution-related issue, in the historical context of value, work and money creation. Helicopter money appears in this light as a new paradigm of extensive growth, which at first glance comes off as a financial innovation, but paradoxically rather hears a relationship with a pre-capitalist conception of value. Moreover, helicopter money is a wage-substitute transfer that does not respond to the social and symbolic void that has replaced work. It appears to be a welfare instrument, while it can only rest on the separation of production and consumption on a global scale. Helicopter money is an extension of quantitative easing by other means, which unveils the motives for money creation. It is an overture to the thought experiments of 'value without work' and 'economy without people'.(1)

Perceived Helicopter Parenting Related to Vocational Senior High School Students’ Academic Achievement and Smartphone Addiction

Background and Purpose of Research Adolescents use their smartphones for various purposes, for example, following distance/online learning, especially during the COVID-19 pandemic, staying in touch with friends, having fun using social media tools. According to the social ecological model, risk behaviors, like substance consumption, are regarded as behavior problems. Relatively, etiology is derived of youths’ embeddedness surrounded by their social networks, mainly throughout sensitive development periods (Bishop et al., 2020). Given the prevalence of smartphone addiction among young students, previous studies have explored the relationships between smartphone addiction and students’ learning and indicated there is negative outcomes of smartphone resulting from overuse of mobile phones, including poor sleep quality. However, there some antecedents of smartphone addiction which has not extendedly studied, for example, parenting style, thus, the present study aimed to explore the correlates between parenting styles, academic achievement and smartphone addiction. Parenting that reflects a combination of support and behavioral control has been linked to numerous indices of academic well-being and live functioning from early childhood through adolescence. In regarding the term helicopter parenting indicated that parents involve hovering behaviors and are potentially over-involved in the lives of their child or in their academic work (Padilla-Walker & Nelson, 2012). But empirical research has not adequately used these two construct from other controlling parenting practices to predict children’s smartphone addiction, thus, the present study applied two types of helicopter parenting: Live hovering and academic hovering of parenting for of emerging adults, to explain the prediction of children’s smartphone addiction. According to Bronfenbrenner (1979) micro ecological system that discusses the association between person-process-content (PPC), who described “person-process-context model” (PPCM) that occurs variability in development procedure as considered in this paper as a functional context (mobile phone usage), person (parenting styles) and process (academic achievement). Not only has cultural ecology be likely to pursue its complications in issues originating from social and cultural topics, but intricate schools of understanding of culture-nature relationship have developed for certain risk behavior. For example, helicopter parenting is more obvious in Chinese families than Western ones, even though the parents want their children to grow up to be independent and think for themselves. Particularly, Chinese parents are more concerned about their children’s schoolwork when they are teenagers, which leads to increased helicopter parenting problems, exacerbating issues such as lack of independence, lack of control, and not knowing how to self-manage smartphone use, which can in turn lead to smartphone addiction. If parents are in constant hovering of their children’s lives or schoolwork, children develop dependent behaviors. Some studies have indicated that a child’s dependent behaviors result in lower motivation to learn and reduced academic achievement. In line with this, drawn on PPCM to understanding the role of academic hovering and live hovering affect participants’ smartphone addiction mediated by academic achievement, hypotheses are proposed as follows. Hypotheses (1) Live hovering has a negative effect on academic achievement. (2) Academic hovering has a negative effect on academic achievement. (3) Academic achievement has a negative effect on smartphone addiction. (4) Live hovering has a positive effect on smartphone addiction. (5) Academic hovering has a positive effect on smartphone addiction. Methodology Questionnaire was designed by adapting and translated from previous researched and gave to domain experts to ensure the content validity. Afterward, a purposive sampling was adapted in this study, a total of 400 questionnaires were distributed to 4 vocational senior high schools located in Taipei City. 354 of which were collected, resulting in a questionnaire collection rate of 88.5%. After 64 invalid questionnaires were excluded, 290 valid questionnaires remained, resulting in a valid questionnaire collection rate of 81.92%. Factor analysis was conducted on the valid questionnaires. Results First, helicopter parenting, live and academic hovering had a negative association with academic achievement, with an explanatory power of 20.8%. Second, academic achievement had a negative association with smartphone addiction, with an explanatory power of 38.6%. Third, helicopter parenting had a negative association with smartphone addiction. Fourth, academic hovering had a negative association with smartphone addiction mediated by academic achievement, with an explanatory power of 20.8%. The results of the study thus indicate that young people who are not independent in life or schoolwork tend to rely on their parents, are less able to control their smartphone use, and are more likely to develop smartphone addiction. By contrast, young people who are independent in life and schoolwork and do not need to rely on their parents have control over their smartphone use and are less likely to develop smartphone addiction. Conclusions and Recommendations The results of this study demonstrate that if vocational senior high school students are overly dependent on their parents in life or schoolwork, they may have lower academic achievement and therefore, they are not motivated to achieve strong academic results and will not restrain their desire to spend time on using smartphone, resulting in a tendency toward smartphone addiction. However, when vocational senior high school students do not have to rely on their parents to a great extent in life or schoolwork, they are able to act independently, attain high academic achievement, determine what they want to achieve, and arrange how they will accomplish their goals. Therefore, they have the ability to control the time they spend using their phones and will not develop smartphone addiction. This study suggests that parents should let their children learn to be independent and autonomous, which should help to effectively reduce the problem of smartphone addiction. Finally, conducting this study highlighted possibilities for future research. Some studies suggest that fathers and mothers do not necessarily share the same parenting style, and hence, it is suggested that in a questionnaire survey, the hovering styles of fathers and mothers could be differentiated and then analyzed through a differential analysis. In addition, some smartphone use can be designed with time of use to control using time (e.g., Chinese government limited the hours for children to use smartphone). However, how is the effect of the regulation to students’ smartphone addiction should be further studied. © 2021, National Taiwan Normal University. All rights reserved.

The Helicopter Transports of Patients Critically ill with COVID-19.

Objective: The aim of our study was to describe specialist nurses' experiences with the helicopter transport of patients critically ill with COVID-19. Method: Our study followed a descriptive qualitative design anchored in the naturalistic paradigm and was based on qualitative content analysis. The study followed the consolidated criteria for reporting qualitative research. Results: Six semi-structured interviews were conducted with specialist nurses who have cared for patients critically ill with COVID-19 during helicopter transport. The analysis of the interviews resulted in three themes-designing new routines before transport, working under new conditions and post-transport and reflections-with 11 categories. The goal of the intensive care transport of patients with COVID-19 was twofold: to prevent the spread of infection by using personal protective equipment and to prevent the contamination of the helicopter. Conclusion: For the nurses, working in personal protective equipment created a feeling of distance from patients that compromised patient-nurse intimacy. Our results suggest that ensuring the sufficiency of equipment required in the event of major accidents and pandemics is critical.

Guest editorial

[...]the following 13 conference papers have been selected for publication in this peer-reviewed special issue: Topczewski S., Żugaj M.;Bibik P., “Impact of Actuators Backlash on the Helicopter Control During Landing on the Moving Vessel Deck” Kopecki G., “Aircraft Control With the Use of Model Reference Adaptive Control” Rodzewicz M., “Comparative fatigue properties estimation of composite structural nodes” Kowalski M., Goraj Z.;Goliszek B., “The use of FEA and semi-empirical equations for weight estimation of a passenger aircraft” Olejnik A., Dziubiński, A.: Kiszkowiak. Ł., “CFD simulation of engine nacelle cooling on pusher configuration aircraft” Goraj Z., Kowalski M., Kiszkowiak Ł.;Olejnik A., “Simulation of a passenger aircraft flight with the wing tip cut” Bridel G., Goraj Z.;Kiszkowiak Ł., Brevot Jean-G. and Devaux J., Szczepański C., Vrchota P., “Air combat training - high energy at lowest cost” Kwiek A., Galiński C., Bogdański K., Hajduk J.;Tarnowski A., “Results of Simulation and Scaled Flight Tests Performed on a Rocket-Plane at High Angles of Attack” Rogalski T., Rzucidło P., Noga St.;Prusik J., “Unmanned Aircraft Automatic Flight Control Algorithm in an Immelmann Manoeuvre” Kretov A., “Sensitivity Factors of Aircraft Mass for the Conceptual Design” Noga St., Maciejowska K.;Rogalski T., “Vibration Analysis of an Aviation Engine Turbine Shaft Shield” Samolej S., Dec G., Rzońca D., Majka A.;Rogalski T., “Regular Graph-based Free Route Flight Planning Approach” Pieniążek J.;Cieciński P., “Safety analysis of the optionally-piloted airplane landing” The articles deal with different solutions for future aerospace challenges in the areas of novel configuration, aerodynamics, design methods, multidisciplinary optimization, UAV and stress analysis. [...]I would like to thank the Editor-in-Chief of the AEAT, Prof. Philip Webb, for his agreement, and support of all editorial team of AEAT in making this issue possible.

Auto-Tuning of Attitude Control System for Heterogeneous Multirotor UAS

This paper presents a heterogeneous configuration of the multirotor unmanned aerial system (UAS) that features the combined characteristics of the helicopter and quadrotor in a single multirotor design, featuring the endurance and energy efficiency similar to a helicopter, while keeping the mechanical simplicity, control, and manoeuvrability of the standard quadrotor. Power needed for a rotorcraft to hover has the inverse relation with the rotor disc. Therefore, multiple small rotors of the quadrotor are energetically outperformed by a large rotor of the helicopter, for a similar size. Designing the stable control system for such a dynamically complex multirotor configuration remains the main challenge as the studies previously carried out on these designs have successfully demonstrated energy efficiency but at the cost of degraded attitude control. Advancements in the energetics of the multirotor results in enhanced endurance and range that could be highly effective in remote operation applications. However, a stable control system is required for accurate positioning. In this paper, a cascaded PID control approach is proposed to provide the control solution for this heterogeneous multirotor. Automatic tuning is proposed to design the PID controller for each loop of the cascade structure. A relay feedback experiment is conducted in a controlled environment, followed by identification of the open-loop frequency response and estimation of dynamics. Subsequently, PID controllers are tuned through approximated models with the help of tuning rules. A custom-designed flight controller is used to experimentally implement the proposed control structure. Presented experimental results demonstrate the efficacy of the proposed control strategy for heterogeneous multirotor UAS.

POSC44 Extra Regional COVID-19 Patients Transfers: A Retrospective Analysis of Distance, Time and Cost for Train, Helicopter and Fixed-Wing Ambulances

Objectives: The COVID-19 pandemic presents unique challenges to the transportation of critically ill patients. In France, between mid-March and mid-April 2020, 660 COVID-19 patients were safely transported from four regions towards six other regions and four neighboring countries using various modes of transport (plane, helicopter, train, boat). The study aimed to assess costs for these transfers and compare the different transport options. Methods: A cost analysis was conducted including the operating costs for a specific transport distance and time, as well as associated personnel costs. We measured costs for each type of transport system, and costs for specific distances or time in operation, in order to perform comparisons for short, moderate, and long transport distances. Results: Our preliminary findings indicated that using fixed-wing transport for patients was cheaper and more time-effective. For a reference distance of 500 km, which corresponds to the average distance traveled for such transfers, the cost of fixed-wing transport was around 1 625 € per patient. On the opposite, helicopters appeared to be the worst option (7 327 € per patient) whereas the train accounted for 5 136 euros per patient. In average, personnel costs represented around 13% of total costs. Conclusions: To our knowledge, few studies have investigated the costs of patient transfers during the sanitary crisis. This study includes the first comprehensive cohort of transferred patients during COVID-19 pandemic, in France, between mid-March and mid-April 2020. The mode of transport conditions the number of patients transferred and the associated operating costs. Because there is potentially inconsistent data collection for some modes of transport, our study carries several limitations. We were also unable to measure specific time intervals for the preparatory and system disinfection phases. Further research should be conducted to better inform decision makers.

Pandemic recession and helicopter money: Venice, 1629–1631

We analyse the money-financed fiscal stimulus implemented in Venice during the famine and plague of 1629–31, which was equivalent to a ‘net-worth helicopter money’ strategy – a monetary expansion generating losses to the issuer. We argue that the strategy aimed at reconciling the need to subsidize inhabitants suffering from containment policies with the desire to prevent an increase in long-term government debt, but it generated much monetary instability and had to be quickly reversed. This episode highlights the redistributive implications of the design of macroeconomic policies and the role of political economy factors in determining such designs.

Lessons learned from the first 50 COVID-19 critical care transfer missions conducted by a civilian UK Helicopter Emergency Medical Service team.

BACKGROUND: The COVID-19 pandemic has placed exceptional demand on Intensive Care Units, necessitating the critical care transfer of patients on a regional and national scale. Performing these transfers required specialist expertise and involved moving patients over significant distances. Air Ambulance Kent Surrey Sussex created a designated critical care transfer team and was one of the first civilian air ambulances in the United Kingdom to move ventilated COVID-19 patients by air. We describe the practical set up of such a service and the key lessons learned from the first 50 transfers. METHODS: Retrospective review of air critical care transfer service set up and case review of first 50 transfers. RESULTS: We describe key elements of the critical care transfer service, including coordination and activation; case interrogation; workforce; training; equipment; aircraft modifications; human factors and clinical governance. A total of 50 missions are described between 18 December 2020 and 1 February 2021. 94% of the transfer missions were conducted by road. The mean age of these patients was 58 years (29-83). 30 (60%) were male and 20 (40%) were female. The mean total mission cycle (time of referral until the time team declared free at receiving hospital) was 264 min (range 149-440 min). The mean time spent at the referring hospital prior to leaving for the receiving unit was 72 min (31-158). The mean transfer transit time between referring and receiving units was 72 min (9-182). CONCLUSION: Critically ill COVID-19 patients have highly complex medical needs during transport. Critical care transfer of COVID-19-positive patients by civilian HEMS services, including air transfer, can be achieved safely with specific planning, protocols and precautions. Regional planning of COVID-19 critical care transfers is required to optimise the time available of critical care transfer teams.