scholarly journals Assessment of fatigue in personnel during sustained operations using ‘SOAP’ – Sustained Operational Assessment Profile

2020 ◽  
Vol 64 ◽  
pp. 2-7
Author(s):  
MS Butola ◽  
YS Dahiya ◽  
BK Rao
Keyword(s):  
Shift Work ◽  
Air Force ◽  
Repeated Measures ◽  
Administrative Support ◽  
Subjective Effects ◽  
Significant Risk ◽  
Sleep Cycle ◽  
Second Phase ◽  
Subjective Ratings ◽  
Sustained Operation

Introduction: Sustained operations are the future of any advanced Air Force, which involve round the clock flying operations over a prolonged period. Such operations have the potential of disrupting normal sleep cycle and may cause fatigue among aircrew and ground duty personnel. It is well known that fatigue among crew member is a significant risk to aerospace safety. The present study was hence undertaken to quantify the subjective fatigue and its effects, among the personnel involved in a simulated exercise using Sustained Operations Assessment Profile (SOAP). Material and Methods: SOAP questionnaire, a validated tool, was used for data collection. In the first phase, 1521 personnel involved in the exercise, including aircrew as well as ground duty tradesmen completed the SOAP questionnaires twice during the simulated sustained military operation. The subjective ratings were statistically analyzed using the Wilcoxon matched paired test. The two levels of repeated measures being mean SOAP scores on day 2 and that on day 5. In the second phase, to ascertain differences in the subjective ratings of SOAP among different streams of pilots, data were recorded during another simulated sustained operation after 6 months. A total of 140 aircrew responded to the SOAP questionnaire during 6 days of sustained operations. SOAP score was acquired on day 1 and day 6 of the operations in the second phase. Results: A total of 3042 completed SOAP responses were analyzed. There was a significant increase in ratings of the three cardinal dimensions of SOAP among all personnel. The aircrew rated the subjective effects higher than maintenance or administrative support group. Among the aircrew, the fighter pilots rated significantly higher as compared to transport or helicopter aircrew. Conclusion: The study revealed significant changes in the cardinal dimensions of SOAP among the aircrew who were routinely not involved in shift work (especially fighter pilots). Scientifically designed “shift work” may be an effective strategy to mitigate effects of fatigue during sustained operations, hence, needs to be practiced as a routine by combat Air Force units.

scholarly journals Serum syndecan-1 reflects organ dysfunction in critically ill patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Keiko Suzuki ◽  
Hideshi Okada ◽  
Kazuyuki Sumi ◽  
Hiroyuki Tomita ◽  
Ryo Kobayashi ◽  
...  
Keyword(s):  
Risk Factor ◽  
Critically Ill ◽  
Organ Dysfunction ◽  
Critically Ill Patients ◽  
Repeated Measures ◽  
Significant Risk ◽  
Mixed Effects ◽  
Mixed Effects Models ◽  
Endothelial Glycocalyx ◽  
Outcome Variable

AbstractSyndecan-1 (SDC-1) is found in the endothelial glycocalyx and shed into the blood during systemic inflammatory conditions. We investigated organ dysfunction associated with changing serum SDC-1 levels for early detection of organ dysfunction in critically ill patients. To evaluate the effect of SDC-1 on laboratory parameters measured the day after SDC-1 measurement with consideration for repeated measures, linear mixed effects models were constructed with each parameter as an outcome variable. A total of 94 patients were enrolled, and 831 samples were obtained. Analysis using mixed effects models for repeated measures with adjustment for age and sex showed that serum SDC-1 levels measured the day before significantly affected several outcomes, including aspartate aminotransferase (AST), alanine transaminase (ALT), creatinine (CRE), blood urea nitrogen (BUN), antithrombin III, fibrin degradation products, and D-dimer. Moreover, serum SDC-1 levels of the prior day significantly modified the effect between time and several outcomes, including AST, ALT, CRE, and BUN. Additionally, increasing serum SDC-1 level was a significant risk factor for mortality. Serum SDC-1 may be a useful biomarker for daily monitoring to detect early signs of kidney, liver and coagulation system dysfunction, and may be an important risk factor for mortality in critically ill patients.

Electromagnetic versus Electrical Coupling of Personal Frequency Modulation (FM) Receivers to Cochlear Implant Sound Processors

2013 ◽  
Vol 24 (10) ◽  
pp. 927-940 ◽  
Author(s):  
Erin C. Schafer ◽  
Denise Romine ◽  
Elizabeth Musgrave ◽  
Sadaf Momin ◽  
Christy Huynh
Keyword(s):  
Speech Recognition ◽  
Frequency Modulation ◽  
Repeated Measures ◽  
Rating Scale ◽  
Recognition Performance ◽  
Subjective Rating ◽  
Subjective Ratings ◽  
Primary Analysis ◽  
Repeated Measures Design ◽  
Sound Processor

Background: Previous research has suggested that electrically coupled frequency modulation (FM) systems substantially improved speech-recognition performance in noise in individuals with cochlear implants (CIs). However, there is limited evidence to support the use of electromagnetically coupled (neck loop) FM receivers with contemporary CI sound processors containing telecoils. Purpose: The primary goal of this study was to compare speech-recognition performance in noise and subjective ratings of adolescents and adults using one of three contemporary CI sound processors coupled to electromagnetically and electrically coupled FM receivers from Oticon. Research Design: A repeated-measures design was used to compare speech-recognition performance in noise and subjective ratings without and with the FM systems across three test sessions (Experiment 1) and to compare performance at different FM-gain settings (Experiment 2). Descriptive statistics were used in Experiment 3 to describe output differences measured through a CI sound processor. Study Sample: Experiment 1 included nine adolescents or adults with unilateral or bilateral Advanced Bionics Harmony (n = 3), Cochlear Nucleus 5 (n = 3), and MED-EL OPUS 2 (n = 3) CI sound processors. In Experiment 2, seven of the original nine participants were tested. In Experiment 3, electroacoustic output was measured from a Nucleus 5 sound processor when coupled to the electromagnetically coupled Oticon Arc neck loop and electrically coupled Oticon R2. Data Collection and Analysis: In Experiment 1, participants completed a field trial with each FM receiver and three test sessions that included speech-recognition performance in noise and a subjective rating scale. In Experiment 2, participants were tested in three receiver-gain conditions. Results in both experiments were analyzed using repeated-measures analysis of variance. Experiment 3 involved electroacoustic-test measures to determine the monitor-earphone output of the CI alone and CI coupled to the two FM receivers. Results: The results in Experiment 1 suggested that both FM receivers provided significantly better speech-recognition performance in noise than the CI alone; however, the electromagnetically coupled receiver provided significantly better speech-recognition performance in noise and better ratings in some situations than the electrically coupled receiver when set to the same gain. In Experiment 2, the primary analysis suggested significantly better speech-recognition performance in noise for the neck-loop versus electrically coupled receiver, but a second analysis, using the best performance across gain settings for each device, revealed no significant differences between the two FM receivers. Experiment 3 revealed monitor-earphone output differences in the Nucleus 5 sound processor for the two FM receivers when set to the +8 setting used in Experiment 1 but equal output when the electrically coupled device was set to a +16 gain setting and the electromagnetically coupled device was set to the +8 gain setting. Conclusions: Individuals with contemporary sound processors may show more favorable speech-recognition performance in noise electromagnetically coupled FM systems (i.e., Oticon Arc), which is most likely related to the input processing and signal processing pathway within the CI sound processor for direct input versus telecoil input. Further research is warranted to replicate these findings with a larger sample size and to develop and validate a more objective approach to fitting FM systems to CI sound processors.

The Iranian Forces’ Counterattacks

2017 ◽  
Author(s):  
Pesach Malovany ◽  
Amatzia Baram ◽  
Kevin M. Woods ◽  
Ronna Englesberg
Keyword(s):  
Air Force ◽  
Nuclear Reactor ◽  
Second Phase ◽  
War Of Attrition ◽  
West Iraq ◽  
Northern Sector

This chapter deals with the second phase of the war between Iraq and Iran—the first Iranian counter attacks to drive the Iraqi forces from their territory, and the opening of the “war of attrition”. These included two Iranian initiatives in the Khafajiya sector in central Khuzestan (January and July 1981), an initiative in the Serbil Zehab and Kolina area in the central sector of the front, and the fighting in the northern sector of the front. It deals also with the failures of the Iraqi air force to prevent the Iranian air attack on the Iraqi air base in H-3, in west Iraq, and the Israeli air attack on the Iraqi nuclear reactor south of Baghdad (April-June 1981)..

scholarly journals Acute effects of MDMA on trust, cooperative behaviour and empathy: A double-blind, placebo-controlled experiment

2020 ◽  
pp. 026988112092667
Author(s):  
Anna Borissova ◽  
Bart Ferguson ◽  
Matthew B Wall ◽  
Celia JA Morgan ◽  
Robin L Carhart-Harris ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Ultimatum Game ◽  
Subjective Effects ◽  
Plasma Concentrations ◽  
Controlled Experiment ◽  
Prosocial Behaviour ◽  
Cooperative Behaviour ◽  
Acute Effects ◽  
Double Blind ◽  
Bayesian Analyses

Background: 3,4-Methylenedioxymethamphetamine (MDMA) is being actively researched as an adjunct to psychotherapy. It may be beneficial to trust, empathy and cooperative behaviour due to its acute prosocial effects. Aim: To test (a) the acute effects of MDMA on measures of empathy, trust and cooperative behaviour, and (b) subacute changes in mood three days after MDMA administration. Methods: Twenty-five participants ( n=7 female), participated in this double-blind, repeated-measures, placebo-controlled experiment. Participants attended two acute sessions, one week apart. Each acute session was followed by a subacute session three days later. Participants received placebo (100 mg ascorbic acid) during one acute session, and MDMA (100 mg MDMA-HCl) at the other, with order counterbalanced. Participants completed the following tasks assessing prosocial behaviour: a trust investment task, a trustworthy face rating task, an empathic stories task, a public project game, a dictator game and an ultimatum game. Participants reported subjective effects. Blood was taken pre-drug, 2 and 4 hours post-drug, and tested for plasma MDMA levels. Results: MDMA acutely increased self-reported ‘closeness to others’ and ‘euphoria’ and increased plasma concentrations of MDMA. MDMA did not significantly change task-based empathy, trust or cooperative behaviour. Using Bayesian analyses, we found evidence that MDMA and placebo did not differ in their effects on empathy and cooperative behaviour. MDMA did not significantly change subacute mood and this was supported by our Bayesian analyses. Conclusion: Despite augmentation in plasma MDMA levels and subjective drug effects, we found no increase in prosocial behaviour in a laboratory setting.

scholarly journals Shift Work and Breast Cancer

2020 ◽  
Vol 17 (24) ◽  
pp. 9544
Author(s):  
Sarah Gehlert ◽  
Mark Clanton ◽  
Keyword(s):  
Breast Cancer ◽  
Shift Work ◽  
Causal Link ◽  
Sleep Cycle ◽  
Light At Night ◽  
Future Directions ◽  
Increased Risk ◽  
Part Time ◽  
Rotating Shift Work ◽  
Normal Sleep

The rates of shift work outside of daylight hours have increased in recent years, and nighttime shift work is now considered a potential carcinogenic occupational exposure. Light at night exposure, lower melatonin production, and the production of stress-related mediators disrupt normal sleep–wake cycles. Women who work lower-wage jobs and part-time workers whose shifts are determined entirely by their supervisors (rotating shifts) may be subject to stress related to efforts to align childcare and other needs with the unpredictable nature of rotating shift work. The causal link between breast cancer and the sleep cycle or circadian disruption are yet to be established; however, disruption of the circadian cycles by light at night exposure or chronic exposure to stress-related mediators have all been linked to the increased risk of breast cancer. We review the existing literature on shift work and breast cancer, identify knowledge gaps, and suggest future directions for research.

scholarly journals Novel Application of Statistical Methods to Identify New Urinary Incontinence Risk Factors

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Theophilus O. Ogunyemi ◽  
Mohammad-Reza Siadat ◽  
Suzan Arslanturk ◽  
Kim A. Killinger ◽  
Ananias C. Diokno
Keyword(s):  
Risk Factors ◽  
Urinary Incontinence ◽  
Longitudinal Data ◽  
Statistical Methods ◽  
Repeated Measures ◽  
Significant Risk ◽  
Large Data ◽  
Data Sets ◽  
Predictive Index ◽  
Urine Loss

Longitudinal data for studying urinary incontinence (UI) risk factors are rare. Data from one study, the hallmark Medical, Epidemiological, and Social Aspects of Aging (MESA), have been analyzed in the past; however, repeated measures analyses that are crucial for analyzing longitudinal data have not been applied. We tested a novel application of statistical methods to identify UI risk factors in older women. MESA data were collected at baseline and yearly from a sample of 1955 men and women in the community. Only women responding to the 762 baseline and 559 follow-up questions at one year in each respective survey were examined. To test their utility in mining large data sets, and as a preliminary step to creating a predictive index for developing UI, logistic regression, generalized estimating equations (GEEs), and proportional hazard regression (PHREG) methods were used on the existing MESA data. The GEE and PHREG combination identified 15 significant risk factors associated with developing UI out of which six of them, namely, urinary frequency, urgency, any urine loss, urine loss after emptying, subject’s anticipation, and doctor’s proactivity, are found most highly significant by both methods. These six factors are potential candidates for constructing a future UI predictive index.

Development of a Novel Rating System to Assess Lower-limb Comfort

2011 ◽  
Vol 101 (5) ◽  
pp. 371-384 ◽  
Author(s):  
Michael Kinchington ◽  
Kevin Ball ◽  
Geraldine Naughton
Keyword(s):  
Lower Limb ◽  
Repeated Measures ◽  
Intraclass Correlation ◽  
Ease Of Use ◽  
Second Phase ◽  
Comfort Index ◽  
Third Stage ◽  
High Level ◽  
Evaluation Techniques ◽  
Level Of Agreement

Background: Comfort evaluation techniques are commonplace in medicine. However, measures of lower-limb comfort are infrequently used in the sporting environment. The purpose of this study was to develop an instrument for measuring lower-limb comfort, which will extend previous work in the field of injury awareness. Methods: A lower-limb comfort index (LLCI) was developed for use in the environment of elite sport. Forty professional footballers participated in development of the index. The study had three components. A critical appraisal of the literature established the need for an LLCI. The second phase involved 20 professional footballers establishing and testing the components of the comfort index as an instrument for measuring comfort. Results: Nonparametric statistics (the McNemar test) in phase 2 indicated that the LLCI demonstrated good responsiveness to suitability (P = .019) and ease of use (P < .01). After a high level of agreement for responses, the third stage required 20 players to pilot test the reliability of the LLCI in a controlled environment. Repeated measures of difference between two periods for sum comfort (intraclass correlation coefficient = 0.99) and individual anatomical segments (κ = 0.72–1) provided confidence that the comfort index was reliable. Conclusions: The LLCI showed good trait construct to provide confidence to conduct a future study to investigate interrater consistency in a wider cohort of professional footballers under different conditions, such as match-day and training-week environments. (J Am Podiatr Med Assoc 101(5): 371–384, 2011)

Mephedrone and 3,4-methylenedioxy-methamphetamine: Comparative psychobiological effects as reported by recreational polydrug users

2016 ◽  
Vol 30 (12) ◽  
pp. 1313-1320 ◽  
Author(s):  
Lewis Jones ◽  
Phil Reed ◽  
Andrew Parrott
Keyword(s):  
Social Network ◽  
Subjective Effects ◽  
Recovery Period ◽  
Social Network Sites ◽  
Acute Effects ◽  
Subjective Ratings ◽  
Average Amount ◽  
Online Questionnaire ◽  
Nasal Irritation

Aims: The purpose of this study was to compare the effects of mephedrone and 3,4-methylenedioxy-methamphetamine (MDMA), as reported by young recreational polydrug users. Methods: 152 MDMA users and 81 mephedrone users were recruited through snowballing on social network sites. They completed a standard online questionnaire for either mephedrone or MDMA. The questions covered the average amount taken per session, the longest duration of usage in the last 12-months, subjective effects while on-drug, and recovery effects in the days afterwards. Results: Mephedrone users reported a significantly longer maximum session of use than MDMA users. Mephedrone users also reported a significantly greater average amount used per session. The majority of on-drug subjective ratings did not differ between drugs, with similar increases in entactogenic effects. Although mephedrone users did report significantly more frequent issues with sleeping, anger and anxiety. In relation to recovery, mephedrone users reported more frequent craving, nasal irritation, paranoia, and relationship difficulties. Mephedrone users also rated general recovery effects as more severe over the seven-day period following use, taking more days to feel normal. Conclusions: The acute effects of MDMA and mephedrone were broadly similar. However, the recovery period for mephedrone was more enduring, possibly due to the longer duration of acute session usage.

scholarly journals Promoting Employees’ Recovery During Shift Work: Protocol for a Workplace Intervention Study (Preprint)

2019 ◽  
Author(s):  
Irene M W Niks ◽  
Alwin van Drongelen ◽  
Elsbeth M de Korte
Keyword(s):  
Shift Work ◽  
Repeated Measures ◽  
Research Work ◽  
Workplace Intervention ◽  
Control Group ◽  
Negative Effects ◽  
Short Term ◽  
Shift Workers ◽  
Starting Point

BACKGROUND Shift work can be demanding owing to disturbances in the biological and social rhythms. This can cause short-term negative effects in employees, such as increased fatigue and reduced alertness. A potential way to counteract these negative effects is to enhance employees’ recovery from work during working hours. OBJECTIVE The aim of this study is to develop and implement an intervention that focuses on promoting “on-job” recovery of shift workers. METHODS This study is performed in 2 department units with shift workers at a multinational company in the steel industry. For each department, an intervention will be developed and implemented through an iterative process of user-centered design and evaluation. This approach consists of various sessions in which employees and a project group (ie, researchers, line managers, human resource managers, and occupational health experts) provide input on the intervention content and implementation. Intervention effects will be evaluated using pretest and posttest web-based surveys. Digital ecological momentary assessment will be performed to gain insight into the link between the intervention and daily within-person processes. The intervention process and participants’ perception of the interventions will be assessed through a process evaluation. Intervention results will be analyzed by performing mixed model repeated measures analyses and multilevel analyses. RESULTS This study is supported by the Netherlands Organization for Applied Scientific Research Work and Health Research Program, which is funded by the Ministry of Economic Affairs and supported by the Dutch Ministry of Social Affairs and Employment, program number 19.204.1-3. This study was approved by the institutional review board on February 7, 2019. From June to August 2019, baseline data were collected, and from November to December 2019, the first follow-up data were collected. The second follow-up data collection and data analysis are planned for the first two quarters of 2020. Dissemination of the results is planned for the last two quarters of 2020. CONCLUSIONS A strength of this study design is the participatory action approach to enhance the stakeholder commitments, intervention adherence, and compliance. Moreover, since the target group will be participating in the development and implementation of the intervention, the proposed impact will be high. In addition, the short-term as well as the long-term effects will be evaluated. Finally, this study uses a unique combination of quantitative and qualitative evaluation methods. A limitation of this study is that it is impossible to randomly assign participants to an intervention or control group. Furthermore, the follow-up period (6 months) might be too short to establish health-related effects. Lastly, the results of this study might be specific to the department, organization, or sector, which limits the generalizability of the findings. However, as workplace intervention research for shift workers is scarce, this study might serve as a starting point for future research on shift work interventions. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/17368

scholarly journals Development of a Core Outcome Set for Fetal MyelomenIngoCele (COSMiC): study protocol

2020 ◽  
Author(s):  
Samar Altoukhi ◽  
Clare L Whitehead ◽  
Greg Ryan ◽  
Jan Deprest ◽  
Luc Joyeux ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Systematic Reviews ◽  
Maternal Morbidity ◽  
Core Outcome Set ◽  
Significant Risk ◽  
Second Phase ◽  
Core Outcome ◽  
Outcome Reporting ◽  
Outcome Set

Abstract Background: Open spina bifida (OSB) is one of the most common congenital central nervous system defects and leads to long-term physical and cognitive disabilities. Open fetal surgery for OSB improves neurological outcomes and reduces the need for ventriculoperitoneal shunting, compared to postnatal surgery, but is associated with a significant risk of prematurity and maternal morbidity. Fetoscopic surgery comes with less maternal morbidity yet the question remains whether the procedure is neuroprotective and reduces prematurity. Comparison of outcomes between different treatment options is challenging due to inconsistent outcome reporting. We aim to develop and disseminate a core outcome set (COS) for fetal OSB, to ensure that outcomes relevant to all stakeholders are collected and reported in a standardised fashion in future studies. Methods: The COS will be developed using a validated Delphi methodology. A systematic literature review will be performed to identify outcomes previously reported for prenatally diagnosed OSB. We will assess will maternal (primary and subsequent pregnancies), fetal, neonatal and childhood outcomes until adolescence. In a second phase, we will conduct semi-structured interviews with stakeholders, to ensure representation of additional relevant outcomes that may not have been reported in the literature. We will include patients and parents, as well as health professionals involved in the care of these pregnancies and children (fetal medicine specialists, fetal surgeons, neonatologists/paediatricians, and allied health). Subsequently, an international group of key stakeholders will rate the importance of the identified outcomes using three sequential online rounds of a modified Delphi Survey. Final agreement on outcomes to be included in the COS, their definition and measurement will be achieved through a face-to-face consensus meeting with all stakeholder groups. Dissemination of the final COS will be ensured through different media and relevant societies. Discussion: Development and implementation of a COS for fetal OSB will ensure consistent outcome reporting in future clinical trials, systematic reviews, and clinical practice guidelines. This will lead to higher quality research, better evidence-based clinical practice and ultimately improved maternal, fetal and long term childhood outcomes.Trial registration: Core Outcome Measures in Effectiveness Trials (COMET): 1187. International Prospective Register of Systematic Reviews (PROSPERO): CRD42018104880.

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