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In this paper, benchmark results are presented on the calculation of vertical electronic excitation energies using a long-range second-order polarization propagator approximation (SOPPA) description with a short-range density functional theory description based on the Perdew-Burke-Ernzerhof (PBE) functional. The excitation energies are investigated for 132 singlet states and 71 triplet states across 28 medium-sized organic molecules. The results show that overall SOPPA-srPBE always performs better than PBE and that SOPPA-srPBE performs better than SOPPA for singlet states, but slightly worse than SOPPA for triplet states when CC3 results are the reference values.
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OBJECTIVE: To compare the effect of early meniscal surgery versus exercise and education with the option of later surgery on pain, function, and quality of life in young patients with a meniscal tear, taking symptom onset into account. DESIGN: Randomized controlled trial. METHODS: In a randomized controlled trial (the "Danish RCT on Exercise versus Arthroscopic Meniscal surgery for young adults" [DREAM] trial), 121 patients aged 18-40 years with a magnetic resonance imaging-verified meniscal tear were randomized to surgery or 12 weeks of supervised exercise and patient education. For this exploratory study, the analyses were stratified by symptom onset (traumatic/nontraumatic). The main outcome was the difference in change after 12 months in the mean score of 4 Knee injury and Osteoarthritis Outcome Score subscales (KOOS4) covering pain, symptoms, function in sport and recreation, and quality of life. RESULTS: Forty-two patients (69%) in the exercise therapy group and 47 (78%) in the surgery group were categorized as having a traumatic tear. We observed no difference in change in the KOOS4 after 12 months between the 2 treatment groups for either traumatic tears (18.8 versus 16.0 in the surgery versus exercise therapy groups; adjusted mean difference, 4.8 [95% confidence interval, -1.7 to 11.2]) or nontraumatic tears (20.6 versus 17.3 in the surgery versus exercise therapy groups; adjusted mean difference, 7.0 [95% confidence interval, -3.7 to 17.7]). CONCLUSION: In patients with traumatic and nontraumatic meniscus tears, early meniscal surgery did not appear superior to exercise and education in improving pain, function, and quality of life after 12 months. Further research is needed to confirm the clinical applicability of these findings. J Orthop Sports Phys Ther 2024;54(5):1-10. Epub 22 February 2024. doi:10.2519/jospt.2024.12245.
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Terapia por Exercício , Educação de Pacientes como Assunto , Qualidade de Vida , Lesões do Menisco Tibial , Humanos , Lesões do Menisco Tibial/terapia , Lesões do Menisco Tibial/cirurgia , Lesões do Menisco Tibial/reabilitação , Adulto , Masculino , Terapia por Exercício/métodos , Feminino , Adulto Jovem , Adolescente , Artroscopia , Meniscectomia , Tempo para o TratamentoRESUMO
Shipping is considered a demanding environment that can significantly impact seafarers' well-being and mental health. This review aims to examine existing literature on the resilience of seafarers, with a focus on the measurement methods used. Furthermore, this study intends to gain a comprehensive understanding of the current state of research in the field of seafarers' resilience, examining the variations in defining and conceptualizing resilience across different studies and contexts. The review identified 99 studies published between 2003 and 2023, with ten studies being included in the final analysis. These studies employed various measurement methods and provided definitions of resilience. Five questionnaires were identified, with the Dispositional Resilience Scale-15 (DRS-15) being the most commonly used. Two of the selected studies had a longitudinal follow-up, while eight were cross-sectional. Four studies related to tankers, and an additional four studies focused on naval vessels, while two studies did not specify the vessel type. The publications were distributed in the period between 2003 and 2013 (two papers) and between 2013 and 2023 (eight papers). The identified themes encompassed shipboard stressors (three papers), sleep problems (two papers), occupational groups or attitudes (two papers), experiences in war (two papers), and intervention measures (one paper), highlighting the multidimensional nature of resilience within the maritime field. This review suggests a research gap, as it reveals that the topic of resilience in seafaring has been sparsely represented. Despite an increasing interest in recent years, research remains limited, particularly in the civilian maritime sector. Therefore, this review highlights the importance of understanding and promoting resilience among seafarers. While the variety of questionnaires used was limited, achieving consensus and standardization in resilience measurement is essential for more comparable and consistent research findings. Recognizing resilience as a crucial resource can promote the development of targeted interventions and support systems, enhancing seafarers' well-being and mental health.
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Saúde Ocupacional , Resiliência Psicológica , Humanos , Saúde Mental , Navios , Inquéritos e QuestionáriosRESUMO
In this paper, we present the theory and implementation of nuclear magnetic resonance shielding constants with gauge-including atomic orbitals for the hybrid multiconfigurational short-range density functional theory model. As a special case, this implementation also includes Hartree-Fock srDFT (HF-srDFT). Choosing a complete-active space (CAS) wave function as the multiconfigurational parameterization of the wave function, we investigate how well CAS-srDFT reproduces experimental trends of nuclear shielding constants compared to DFT and complete active space self-consistent field (CASSCF). Calculations on the nucleobases adenine and thymine show that CAS-srDFT performs on average the best of the tested methods, much better than CASSCF but only marginally better than HF-srDFT. The performance, compared to regular DFT, is similar when functionals containing exact exchange are used. We generally find that the inclusion of exact exchange is important for an accurate description of the shielding constants. In cases where no exact exchange is included, we observe that the HF- and CAS-srDFT often outperform regular DFT. For calculations on transition metal nuclei in organometallic compounds with significant static correlation, the CAS-srDFT method again outperforms CASSCF compared to experimental shielding constants, and the change from HF-srDFT is substantial. In conclusion, the static correlation posed by the metal complexes seems to be captured by CAS-srDFT, which is promising since this type of correlation is not well described by regular DFT.
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Compostos Organometálicos , Teoria Quântica , Teoria da Densidade Funcional , Espectroscopia de Ressonância Magnética , Imageamento por Ressonância MagnéticaRESUMO
In this paper, the history, present status, and future of density-functional theory (DFT) is informally reviewed and discussed by 70 workers in the field, including molecular scientists, materials scientists, method developers and practitioners. The format of the paper is that of a roundtable discussion, in which the participants express and exchange views on DFT in the form of 302 individual contributions, formulated as responses to a preset list of 26 questions. Supported by a bibliography of 777 entries, the paper represents a broad snapshot of DFT, anno 2022.
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Ciência dos Materiais , HumanosRESUMO
The polarizable density embedding model is combined with the multiconfigurational self-consistent field and MC-srDFT electronic structure methods to calculate solvatochromic shifts of the n-π* absorption of acrolein and the π-π* absorption of the para-nitrophenolate anion in aqueous solution. Differences between linear-response (LR) and state-specific (SS) solvent shifts are analyzed by assessing the contributions of different terms in the solvent potential. This comparison shows that the differences are not only due to the intrinsically different response of LR and SS excitation energies to the polarizability of the environment but also due to a different response to the static part of the environment potential. These observations show that even in nonpolarizable environments, LR and SS calculations based on SCF (orbital optimization) methods do not necessarily agree on the spectral shift. The difference can be as large as, or even dominate, the difference due to dynamical polarization.
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Teoria Quântica , Água , Acroleína , Solventes/química , Água/químicaRESUMO
Based on self-consistent field (SCF) atomic mean-field (amf) quantities, we present two simple yet computationally efficient and numerically accurate matrix-algebraic approaches to correct both scalar-relativistic and spin-orbit two-electron picture-change effects (PCEs) arising within an exact two-component (X2C) Hamiltonian framework. Both approaches, dubbed amfX2C and e(xtended)amfX2C, allow us to uniquely tailor PCE corrections to mean-field models, viz. Hartree-Fock or Kohn-Sham DFT, in the latter case also avoiding the need for a point-wise calculation of exchange-correlation PCE corrections. We assess the numerical performance of these PCE correction models on spinor energies of group 18 (closed-shell) and group 16 (open-shell) diatomic molecules, achieving a consistent ≈10-5 Hartree accuracy compared to reference four-component data. Additional tests include SCF calculations of molecular properties such as absolute contact density and contact density shifts in copernicium fluoride compounds (CnFn, n = 2,4,6), as well as equation-of-motion coupled-cluster calculations of x-ray core-ionization energies of 5d- and 6d-containing molecules, where we observe an excellent agreement with reference data. To conclude, we are confident that our (e)amfX2C PCE correction models constitute a fundamental milestone toward a universal and reliable relativistic two-component quantum-chemical approach, maintaining the accuracy of the parent four-component one at a fraction of its computational cost.
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Skin grafting involves covering an area of missing skin with healthy skin tissue harvested from another part of the body. The aim of this clinical overview is to give a short introduction to the procedure.
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Transplante de Pele , Cicatrização , Humanos , Pele , Transplante de Pele/métodosRESUMO
We present an implementation of time-dependent linear-response equations for strongly orthogonal geminal wave function models: the time-dependent generalized valence bond (TD-GVB) perfect-pairing theory and the antisymmetrized product of strongly orthogonal geminals. The geminal wave functions are optimized using a restricted-step second-order algorithm suitable for handling many geminals, and the linear-response equations are solved in an efficient way using a direct iterative approach. The wave function optimization algorithm features an original scheme to create initial orbitals for the geminal functions in a black-box fashion. The implementation is employed to examine the accuracy of the geminal linear response for singlet excitation energies of small and medium-sized molecules. In systems dominated by dynamic correlation, geminal models constitute only a minor improvement with respect to time-dependent Hartree-Fock. Compared to the linear-response complete active space self-consistent field, TD-GVB either misses or gives large errors for states dominated by double excitations.
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In situ burning (ISB) is an oil spill response technique including ignition and burning to remove oil on the water surface. The technique rapidly and effectively removes large portions of the oil. However, the combustion process causes a large smoke plume and leaves a viscous residue in the water. During six large-scale experimental burns in the North Sea in 2018 and 2019, the smoke plume, released oil and contained residues were analysed. The objectives were to document the content of particles and gases in the smoke plume, properties of both the released oils and residues, and the effectiveness of the burns. Oseberg crude oil, Ultra Low Sulphur Fuel Oil (ULSFO), Intermediate Fuel Oil (IFO180) and Marine Gas Oil (MGO) were released into a fire-boom and ignited. Particles and gases in the smoke plume were monitored using drones with several sensors. Soot particle monitoring indicated that more than 90% of the particles produced during the burns were <1 µm. Soot fallout was mainly limited to visible smoke, and the particle concentration was highest directly under the smoke plume and declined with distance from the burn. Gas monitoring in the smoke indicated low concentrations of SO2 and NOX (<2 ppm), and the concentrations of CO2 and CO were within air quality standards. Black Carbon produced relative to the amount of oil burned was 10-18%. The burn efficiency varied and were estimated to 80-91% for Oseberg, >90% for MGO, and <60% for both ULSFO and IFO180. The present paper addresses the results of the smoke plume monitoring, properties of the ISB residues and the burn efficiency.
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Poluentes Atmosféricos , Poluição do Ar , Queimaduras , Poluição por Petróleo , Petróleo , Poluentes Atmosféricos/análise , Poluição do Ar/análise , Humanos , Óleos/análise , Petróleo/análise , Poluição por Petróleo/análiseRESUMO
OBJECTIVES: The character and duration of cognitive adverse effects of electroconvulsive therapy (ECT) are unclear. This study investigated (1) the sensitivity of a short cognitive test battery to cognitive adverse effects of ECT, (2) the relation between subjective and objective cognitive adverse effects, and (3) patient characteristics associated with more subjective than objective adverse effects. METHODS: Forty-one patients with unipolar or bipolar depression referred to ECT underwent assessments at baseline, 5 to 7 days post-ECT, and 3 months post-ECT. Patients rated their fear of various aspects of ECT on a visual analog scale. At each assessment, patients were evaluated for depressive symptoms, completed the Screen for Cognitive Impairment in Psychiatry (SCIP) and Trail Making Test-Part B (TMT-B), and rated their cognitive difficulties. RESULTS: Patients feared cognitive adverse effects and lack of treatment efficacy more than other aspects of ECT. The SCIP and TMT-B revealed transient decline in objective cognition after ECT, which was reversed after 3 months. Patients presented with more subjective than objective cognitive difficulties at baseline and more subjective than objective cognitive adverse effects of ECT. This discrepancy was significantly reduced at follow-up. Younger age and poorer objective cognition pretreatment were associated with more subjective than objective cognitive adverse effects 5 to 7 days after ECT. CONCLUSIONS: The SCIP and TMT-B are sensitive to cognitive adverse effects of ECT. Patients show more subjective than objective cognitive adverse effects of ECT. These insights can be used clinically to inform patients of treatment choice and expected cognitive consequences.
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Transtorno Bipolar , Transtornos Cognitivos , Eletroconvulsoterapia , Transtorno Bipolar/terapia , Cognição , Transtornos Cognitivos/psicologia , Eletroconvulsoterapia/efeitos adversos , Humanos , Testes Neuropsicológicos , Resultado do TratamentoRESUMO
PURPOSE: Today, measures to economise in the operation of ships can cause either an effort-reward imbalance or health impairments. The goal of this study was to assess the risk of effort-reward imbalance including overcommitment among officers and ratings on merchant vessels during their assignments and to evaluate lifestyle factors of seafarers as well as the health-promoting conditions on board. METHODS: A study sample of 308 male seafarers was examined during a total of 20 sea voyages on German container ships (participation rate 91.9%). RESULTS: Only 11 seafarers were identified as having an increased health risk of an effort-reward imbalance (ER ratio > 1). Officers tended to have a higher risk of an elevated ratio than ratings (4.4% vs. 3.1%) and also showed a significantly higher risk of an ER ratio above the median (58.8% vs. 41.8%; p = 0.022). Compared to land-based populations, the average overcommitment score of seafarers was high (17.9)-particularly among officers (20.3 vs. 16.5; p = 0.031). This corresponded to an elevated risk of overcommitment among officers compared to ratings (OR 2.14; 95% CI 1.78-2.37). This elevated risk remained significant after adjustment for age (OR 2.11; 95% CI 1.76-2.35) and job-related stressors. CONCLUSION: Although an elevated risk of effort-reward imbalance was only observed in few seafarers, this study revealed a high prevalence of overcommitment particularly among officers. In the course of time, overcommitment can lead to mental exhaustion. Therefore, shipboard health-promoting conditions need to be optimised.
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Navios , Estresse Psicológico , Estudos Transversais , Humanos , Estilo de Vida , Masculino , Recompensa , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Surgery is commonly used to treat meniscal tears; however, to our knowledge, no randomized controlled trials (RCTs) have compared surgery with nonsurgical alternatives in young adults. We hypothesized that early meniscal surgery would be superior to a strategy of exercise and education with the option of surgery later if needed. METHODS: In this pragmatic parallel-group RCT, we enrolled young adults (18-40 years of age) with magnetic resonance imagingverified meniscal tears eligible for surgery from seven Danish hospitals. Patients were randomly assigned (1:1) to surgery (partial meniscectomy or meniscal repair) or 12-week supervised exercise therapy and education with the option of surgery later if needed. The primary outcome was the difference in change from baseline to 12 months in the mean score of four Knee Injury and Osteoarthritis Outcome Score (KOOS4) subscales covering pain, symptoms, function in sport and recreation, and quality of life, ranging from 0 (worst) to 100 (best). RESULTS: We enrolled 121 young adults (mean age, 29.7 years; 28% were female). In total, 107 participants (88%) completed the 12-month follow-up; 16 participants (26%) from the exercise group crossed over to surgery, while 8 (13%) from the surgery group did not undergo surgery. Intention-to-treat analysis showed no statistically significant difference in change between groups from baseline to 12 months in KOOS4 scores (19.2 vs. 16.4 in the surgery vs. exercise groups; adjusted mean difference, 5.4 [95% confidence interval, −0.7 to 11.4]). No difference in serious adverse events was observed (four vs. seven in the surgery and exercise groups, respectively; P=0.40). Per-protocol and as-treated analyses yielded similar results. CONCLUSIONS: Our results suggest that among young, active adults with meniscal tears, a strategy of early meniscal surgery is not superior to a strategy of exercise and education with the option of later surgery. Both groups experienced clinically relevant improvements in pain, function, and quality of life at 12 months, and one of four from the exercise group eventually had surgery. (Funded by the Danish Council for Independent Research, IMK Almene Fond, Lundbeck Foundation, Spar Nord Foundation, Danish Rheumatism Association, Association of Danish Physiotherapists Research Fund, Research Council at Næstved-Slagelse-Ringsted Hospitals, and Region Zealand; ClinicalTrials.gov number, NCT02995551.)
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Terapia por Exercício , Meniscectomia , Lesões do Menisco Tibial , Humanos , Feminino , Masculino , Adulto , Lesões do Menisco Tibial/cirurgia , Lesões do Menisco Tibial/terapia , Lesões do Menisco Tibial/diagnóstico por imagem , Terapia por Exercício/métodos , Adulto Jovem , Adolescente , Qualidade de Vida , Educação de Pacientes como Assunto , Resultado do Tratamento , Dinamarca , Traumatismos do Joelho/cirurgia , Imageamento por Ressonância MagnéticaRESUMO
The multi-configurational short-range (sr) density functional theory has been extended to the calculation of indirect spin-spin coupling constants (SSCCs) for nuclear magnetic resonance spectroscopy. The performance of the new method is compared to Kohn-Sham density functional theory and the ab initio complete active space self-consistent field for a selected set of molecules with good reference values. Two density functionals have been considered, the local density approximation srLDA and srPBE from the GGA class of functionals. All srDFT calculations are of Hartree-Fock-type HF-srDFT or complete active space-type CAS-srDFT. In all cases, the calculated SSCC values are of the same quality for srLDA and srPBE functionals, suggesting that one should use the computationally cost-effective srLDA functionals in applications. For all the calculated SSCCs in organic compounds, the best choice is HF-srDFT; the more expensive CAS-srDFT does not provide better values for these single-reference molecules. Fluorine is a challenge; in particular, the FF, FC, and FO couplings have much higher statistical errors than the rest. For SSCCs involving fluorine and a metal atom CAS-srDFT with singlet, generalized Tamm-Dancoff approximation is needed to get good SSCC values although the reference ground state is not a multi-reference case. For VF6 -1, all other considered models fail blatantly.
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In this paper, we report reimplementation of the core algorithms of relativistic coupled cluster theory aimed at modern heterogeneous high-performance computational infrastructures. The code is designed for parallel execution on many compute nodes with optional GPU coprocessing, accomplished via the new ExaTENSOR back end. The resulting ExaCorr module is primarily intended for calculations of molecules with one or more heavy elements, as relativistic effects on the electronic structure are included from the outset. In the current work, we thereby focus on exact two-component methods and demonstrate the accuracy and performance of the software. The module can be used as a stand-alone program requiring a set of molecular orbital coefficients as the starting point, but it is also interfaced to the DIRAC program that can be used to generate these. We therefore also briefly discuss an improvement of the parallel computing aspects of the relativistic self-consistent field algorithm of the DIRAC program.
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BACKGROUND: Maritime pilots often navigate ships through challenging waterways. The required 24 h standby rotation system (ROS) poses a stressful working situation. This study aims to describe the current job-related stress and strain among maritime pilots and the effects on their work ability, taking into account the different rotation systems. METHODS: Within a cross-sectional survey, pilots of all German pilots' associations were asked to complete an online questionnaire. The 1-week ROS (port pilots) was compared with the 4-month ROS (sea and canal pilots). The pilots' subjective perception of stress and strain was assessed using an established ship-specific questionnaire. Daily sleepiness and work ability were examined respectively using the Epworth Sleepiness Scale (ESS) and the Work Ability Index (WAI). RESULTS: The study group consisted of 401 male German pilots with an average age of 48.5 years (participation rate 46.9%). More than 50% of the pilots evaluated irregular working hours as the main stressor in their job. 79.8% of the pilots (especially 4-month ROS) experienced high psychological demands in their workplace. 83.3% stated having regularly neglected their private obligations due to job assignments. Pilots from the 4-month ROS experienced insufficiently predictable free time and long operation times at a stretch as stressors (p < 0.001 and p = 0.037). Elevated daily sleepiness was found in 41.9% of the pilots. The overall evaluation of the WAI questionnaire showed good to very good work ability at 77.3%. Additionally, no significant differences in the daily sleepiness or the work ability were observed between the pilots of the different two ROS. CONCLUSIONS: Due to their subjectively higher job-related mental demands, their disturbed work-life balance, and their long operation times at a stretch, it is likely that pilots from the 4-month ROS have significantly higher job stress compared to those in the 1-week ROS. However, this does not lead to more sleepiness or reduced work ability, which suggests that the pilots of this ROS are highly adapted to their working situation. Nevertheless, intervention measures with shortened ROS amongst sea and canal pilots' associations should be tested in respect of benefit, practicability and acceptance by the pilots.
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The confined environment of a ship promotes the transmission of the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) due to close contact among the population on board. The study aims to provide an overview of outbreaks of SARS-CoV-2 on board of cruise, navy or cargo ships, to identify relevant outbreak management techniques, related problems and to derive recommendations for prevention. Four databases were searched. The study selection included reports about seroprevalences or clinically/laboratory confirmed infections of SARS-CoV-2 on board ships between the first of January, 2020 and the end of July, 2020. A total of 37 studies were included of whom 33 reported outbreaks of SARS-CoV-2 on cruise ships (27 studies referred to the Diamond Princess). Two studies considered outbreaks on the Grand Princess, three studies informed about Nile River cruises and one study about the MS Westerdam (mention of multiple outbreaks possible in one study). Additionally, three studies reported outbreaks of SARS-CoV-2 on navy vessels and one study referred to a cargo ship. Problems in handling outbreaks resulted from a high number of asymptomatic infections, transportation issues, challenges in communication or limited access to health care. Responsible operators need to implement infection control measures which should be described in outbreak management plans for ships to prevent transmission risks, including, e.g., education, testing strategies, communication lines, social distancing and hygiene regulations.
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COVID-19 , Navios , Surtos de Doenças , Órgãos Governamentais , Humanos , SARS-CoV-2RESUMO
BACKGROUND: Working and living on board merchant vessels often constitute high psychophysical stress for the crews. In this study, the current stress of seafarers is examined by using observation-based and subjective measures. MATERIALS AND METHODS: The workplaces of 70 crew members on board 11 container ships were analysed and evaluated using the objective instrument for the situational screening of mental workload (SMW-S). In addition, standardised interviews were carried out with 198 seafarers about their subjectively experienced stress. RESULTS: According to SMW-S, nautical and technical officers experience psychological strain due to their limited decision latitude, risky work situations and the physical and psychosocial working conditions. Among the ratings, psychological distress is more likely due to the limited decision latitude, physical and psychosocial working conditions and low qualification requirements (and, for the engine room ratings, given the low complexity and variability in their work). The interview results show that the irregular work is stressful for 79% of seafarers, the long working periods for 77%, the long working hours per day for 69% and working under time pressure for 62%. Additional psychosocial burdens are present for 95% of seafarers due to family separation and for 65% due to existing social differences in a multicultural occupation. CONCLUSIONS: Considering the stressful work on board, particular attention must be paid to shipping-specific conditions such as long working times, family and socio-cultural separation and living together in a heterogeneous crew.
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Medicina Naval , Estresse Ocupacional , Humanos , Navios , Estresse Psicológico/diagnóstico , Carga de Trabalho , Local de TrabalhoRESUMO
INTRODUCTION: Tibial intercondylar eminence fracture is a rare fracture and is commonly treated with suture, screw or bio-absorbable nail. Current literature includes little information regarding outcome of surgically treatment with bio-absorbable nails. The purpose of this study was to report the clinical and functional outcomes in patients with tibial intercondylar eminence fractures arthroscopically treated with bio-absorbable nails. METHODS: The study design was retrospective follow-up. Sixteen patients, age 11-16 years, were surgically treated with bio-absorbable nail following an intercondylar eminence fracture. Thirteen patients participate in the present follow-up study. The median follow-up time was 6.5 years. The main outcome measurement was the Knee Injury and Osteoarthritis Outcome Score (KOOS). Secondary outcome measurements consisted of: Eq5d-5L questionnaire, knee pain, knee laxity, range of motion (ROM), muscle strength, gait analyses, radiological outcomes, activity and level. RESULTS: The median KOOS scores for the five subscales were: pain 98.5 (19-100), symptoms 90.5 (54-100), ADL 100 (22-100), sport 87.5, (0-100) and QOL 88.0 (13-100), indication satisfactory outcome. Low level of gait asymmetry was observed. Almost balanced muscle strength between the injured and non-injured leg for knee extension and knee flexion strength was observed. Measurement of anterior knee laxity showed 12 patients with a knee laxity between - 1 and 2 mm. The examination of intercondylar eminence displacement at the time of follow-up showed that 12 patients had a displacement of 2 mm or less. CONCLUSION: This case series demonstrates satisfactory patient-reported and functional outcomes in the treatment of intercondylar eminence fractures in children and adolescents with bio-absorbable nails.
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Implantes Absorvíveis , Fraturas da Tíbia , Adolescente , Artroscopia , Criança , Seguimentos , Fixação Interna de Fraturas , Humanos , Unhas , Qualidade de Vida , Estudos Retrospectivos , Fraturas da Tíbia/diagnóstico por imagem , Fraturas da Tíbia/cirurgia , Resultado do TratamentoRESUMO
BACKGROUND: The present study describes the intercultural differences in the perception of stress and the preparation of seafarers. MATERIALS AND METHODS: Three hundred twenty-three seafarers (156 [48.3%] Europeans and 167 [51.7%] Southeast Asians) were interviewed about their subjective stress on board. RESULTS: According to the interviews with ship's officers, mostly represented by Europeans, mental stress was most often due to high responsibilities (82.0%), extensive administrative tasks (81.1%) and lack of qualification of seafarers (64.8%). Subjectively, the Europeans questioned were significantly more likely to experience mental stress on board than the Southeast Asians (74.2% vs. 56.3%), whereas the latter were more prone to being physically stressed. 43.1% of the Southeast Asian seafarers often felt lonely on board compared with 26.2% of the Europeans. Preparation for maritime-specific stress in the form of specific training units is only provided in 1 of the 5 universities surveyed. The most important reason for this is a lack of time. Intercultural leadership training was also only offered at one university. CONCLUSIONS: In view of the many psychophysical stressors in daily life on a ship and the lacking respective education, it is recommended to integrate stress management and diversity training in intercultural communication in the higher education of future superiors on board.