Crew resource management: a simulator study comparing fixed versus formed aircrews.

BACKGROUND: Most airline and military transport planes are flown by crews that have been teamed together for a short amount of time before disbanding and becoming part of a different crew (formed crew concept). Some military operations use a fixed crew concept, pairing crewmembers together for an indefinite period. This research investigated the effect of crew formation policy on aircrew performance during missions in U.S. Air Force KC-135 (tanker) simulators. METHOD: The performance of fixed aircrews is compared to formed aircrews flying the same simulator mission scenario, which included an in-flight emergency. Cockpit resource management (CRM) behavioral data and error data were collected by trained observers for 17 crews (9 fixed and 8 formed). RESULTS: The results show that fixed crews committed more minor errors (4.4 per mission) than formed crews (2.6 per mission), t(14) = 2.32, p = 0.036. No differences were found concerning major errors or CRM behavioral indicators. CONCLUSIONS: The results suggest the possibility of a "familiarity decline," where aircrew performance declines when crewmembers become too familiar with each other and may affect flight safety.

Present-day principles in weaning babies.

For parents, the principles of weaning are to be flexible, offer variety, keep calm and show tolerance. Weaning is usually begun between three and six months old. Premature introduction of solids is inadvisable, as is delaying beyond six months. A wide range of home-prepared and/or manufactured baby foods broadens the experience of taste and smell at a receptive age. Foods during weaning should be given without added salt or added sugar. A low-fat diet is not appropriate for babies. Skimmed or semi-skimmed milk are not suitable. Fibre need not be excluded but should be given only in small amounts. Current Department of Health guidelines are that breast or complete formula milk should preferably be continued throughout the first year of life. Follow-on milk or whole cow's milk may be given from six months onwards Follow-on milk is preferable to cow's milk because it is a more reliable source of iron and vitamin D. The need for fluid increases with the intake of solids. Watch the sugar content in fruit juices and give well diluted. Children's vitamin drops should be given from six months up to two years, and preferably up to five years.

Comparison of fixed versus formed aircrews in military transport.

Historically, transport crews are formed to fly a brief series of sorties together. But what would be the effect of keeping crews together longer? This research investigates the effect of crewing policies on accident rates. We compare the crew coordination performance of fixed teams that work together indefinitely with that of formed teams that work together for shorter periods. We researched 74 accident investigation records of two jet transport aircraft of the U.S. Air Force over 20-year periods. These aircraft used both fixed and formed crews. The "ineffective crew coordination" accident rates for formed crews were significantly safer (z = 12.5 for one aircraft and 2.1 for another p < 0.05). This may imply that airlines and military commands could enhance flight safety by following a formed crew policy. However, further study is needed to identify more completely the effects of crew policies on sortie effectiveness.

Is diet in diabetes important?

Theoretical recommendations for dietary prescriptions with the aim of providing optimum nutrition for diabetic control have been made. What are the practical implications of some of these recommendations for diabetic children? Children should be encouraged to select most of their carbohydrate allowance from unrefined carbohydrate, this will increase their fibre intake. The policy to discourage the use of refined carbohydrate on a regular basis is generally accepted although practically this is not always possible. Excessive amounts of dietary fat are to be discouraged and this happens naturally if sufficient carbohydrate is prescribed since it limits the intake of "fillers" such as meat, eggs and cheese. Whilst these principles are generally accepted analysis of sample low fat, high fibre menus for children show these to be low in calories which could be detrimental since normal growth and development is the cornerstone of paediatric dietetics. In addition it should be remembered that diabetes places much stress on a child and too rigid management increases this. Whilst recognising the need for improved nutrition theoretical principles should not be overemphasized. A dietary regimen must be practical and acceptable as well as theoretically sound.

Galactosaemia workshop. Report of a workshop held at Alder Hey Children's Hospital, Liverpool, on 30 April, 1982.

A workshop on galactosaemia was held in 1982 in Liverpool, UK. The purpose of the meeting was twofold; to establish guidelines for dietary management and to consider the clinical data of affected children. Findings are reported here.

Binocular reflexes in the first 6 months of life: preliminary results of a study of normal infants.

The development of the binocular reflexes during the first 6 months of life was studied in 38 normal infants. Preliminary results indicate that the following reflex is well established by 2 months, convergence by 3 months and the corrective fusion reflex by the age of 5 months.