International Maritime Health最新文献

Background: Maritime transportation is the lifeblood of the world's economy. However, seafarers are exposed to isolated, confined and particularly extreme environments. Maritime operations in the face of geopolitical conflicts profoundly impact seafarers' mental health, well-being and safety.

Materials and methods: The study comprises 27 seafarer interviews and 21 stakeholder interviews covering 4 maritime education and training institutions, 11 crewing agencies, 4 medical facilities and 2 maritime authorities. An online questionnaire survey of seafarers who were affected by the conflict in Ukraine and had sailed in the conflict zone in the period 24 February 2022 to 30 September 2023 yielded 319 valid responses.

Results: The study suggests that seafarers in the conflict zone are exposed to constant imminent threats to personal safety, constant stress and anxiety, prolonged lack of sleep, limited opportunities of contact with families, and high risk to mental health among other things further exacerbated by a lack of mental health support from company, and anxiety resulting from loss of access to shore-based training facilities and uncertainty in updating competency certificates.

Conclusions: The study presents rare insights on the psychological and emotional toll on seafarers who continue to serve the critical needs of the maritime transportation industry in a newly ordained role as keyworkers. This study underscores the need for improved mental health support and counselling services within the maritime industry, in particular, maritime stakeholders likely affected by geopolitical conflicts.

Highlights: From the practical perspective, this is among the first studies to focus on the mental health and well-being of seafarers arising out of the situation in Ukraine since 24 February 2022. From the theoretical perspective, this is a maiden study attempting an exploration of social conditions in three different dimensions by integrating three distinct theoretical constructs namely, UN Human Security Framework, Holmes & Rahe Social Readjustment Rating Scale and ILO Maritime Labour Convention framework.

Background: Meta-analyses show that 43-79% of international travellers develop a travel-related health problems during or after journey. The aim of the present research was to analyse travel-related morbidity in travellers hospitalized at the University Centre of Maritime and Tropical Medicine in Gdynia, Poland.

Material and methods: This retrospective study was based on the analysis of medical records of 159 Polish patients hospitalized at the Department of Tropical and Parasitic Diseases between January and December 2023. Patients' age, sex, continents and countries visited, activities undertaken during travel, and risk behaviours were analysed. The aetiology of illnesses was established for only 79 cases on the basis of reported clinical symptoms and diagnostic tests. Due to limited diagnostics, the aetiological factor could not be determined in 80 patients.

Results: Individuals with travel-related health problems accounted for only 14.6% of all patients treated at the Department of Tropical and Parasitic Diseases (159/1087) in the analysed period. Among the patients with travel-related conditions, most travelled to Africa (49.1%) and Asia (28.3%); the mean age of those patients was 41.7 years. Sunbathing (52.2%), scuba diving (17.6%), and safari (17.0%) were the most popular activities among the patients involved in the study; local food consumption (30.8%) was the most frequently reported risk behaviour. The most common causes for hospitalization included gastrointestinal (39.6%) and skin diseases (19.5%), fevers of unknown origin (13.2%), respiratory diseases (12.6%) and vector- borne diseases of established aetiology (10.1%). Due to limited diagnostic possibilities, the aetiological factor could not be determined in 74.6% patients with gastrointestinal diseases, 50% patients with genitourinary and 30% patients with respiratory diseases.

Conclusions: Despite having been granted the status of the national reference centre for tropical medicine, the University Centre for Maritime and Tropical Medicine with the Institute of Maritime and Tropical Medicine do not have the capacity for comprehensive diagnosis and treatment of ill travellers returning from tropical destinations, which is primarily associated with the dispersion of patients presenting with travel-related conditions across different infectious diseases departments in Poland.

By integrating health coaching into maritime medical clinics, we can provide tailored support to individuals at risk of developing diabetes and empower them to take control of their health.

This paper presents a case of a 77-year-old patient diagnosed with type 2 cardio-renal syndrome, who has undergone a Transcatheter Aortic Valve Implantation surgery due to aortic stenosis associated with permanent atrial fibrillation and type 2 diabetes. This patient, despite their multi-morbidity, undertook family travels to Egypt. Despite disease symptoms and plethora of medication, the patient did not seek medical advice on preventative measures or potential health risks prior to the departure. During the stay in Egypt, the patient sustained a lower limb injury, which resulted in pretibial hematoma requiring a 2-week stay in a local hospital. The patient's condition was systematically deteriorating and after returning to Poland a continued multi-specialist treatment in the field of surgery, nephrology and cardiology was required. The medical history of the described patient and the severity of heart failure and chronic kidney disease were clear contraindications to long-distance travels. Despite those risks, the patient did not seek pre-travel medical advice from specialists and did not undertake any preventative measures. As a result of an accident during travel, an elderly patient with multiple diseases suffered serious health complications that significantly and permanently worsened his general health condition. Due to the aging population and the increasing amounts of elderly patients traveling internationally, proper preparation of seniors before departure is one of the key aspects of modern travel medicine.

Background: After COVID-19 restrictions were lifted, people started to travel again. Each year, thousands of Poles travel internationally, and many travel to tropical or subtropical destinations in Asia, Africa or South America. The aim of this article was to describe the characteristics of Polish travellers based on the information from a retrospective 12-month review of the medical records of Polish patients seeking pre-travel advice at the largest diagnostic and treatment travel medicine centre in Poland in 2023.

Material and methods: The retrospective study was based on the analysis of medical records of 2,147 patients seeking pre-travel advice at the University Centre of Maritime and Tropical Medicine in Gdynia, Poland, between January and December 2023. The study focused on the analysis of the following patients' variables: age, sex, travel details (purpose of travel, length of travel, departure month, continents and countries to be visited). It also aimed to evaluate the range of prevention measures which were either recommended or administered to patients seeking pre-travel advice at the clinic (preventive vaccinations, chemoprophylaxis). In addition, it assessed the health status of the patients presenting at the travel medicine clinic; retrospective health assessments were based on the information from the interviews with the patients.

Results: Patients who sought pre-travel advice were mostly aged 36-65 years (49.5%), they were travelling for tourism purposes (78.3%), for a maximum period of 4 weeks (79.0%), mostly in November (15.2%) or in January (14.9%). Most travellers planned to visit Asia (55.5%) or Africa (29.0%); mainly Thailand (21.5%), Vietnam (8.5%), Kenya (8.3%) or India (8.2%). The most frequently administered immunoprophylaxis included vaccinations against typhoid fever and hepatitis A. Other commonly recommended/prescribed prevention measures included: insect repellents (69.3%), sunscreen (58.3%), antimalarials (35.8%), antithrombotic drugs (32.6%), and antidiarrheal drugs (25.6%). The analysis of patient interviews demonstrated that 61.8% of the travellers consulted at the clinic had no pre-existing medical conditions, while 38.2% required the use of chronic medications, mainly for allergies (14.3%), thyroid disorders (13.6%), cardiovascular diseases (9.3%), or psychiatric disorders (5.5%).

Conclusions: A large number of Polish travellers visit destinations where the risk of infectious and non-infectious diseases is high. Providing patients with professional advice during a pre-travel consultation will help protect against travel-associated health problems.

Most hyperbaric medicine reports concentrate on the patient and his morbidities. In addition to the well-known indications for hyperbaric oxygen therapy (HBOT), we cannot discount possible side effects. Among medical staff regularly exposed to hyperbaric conditions the best described so far is decompression sickness. A non-invasive and easily available way to assess cognitive functioning involves the use of the critical flicker fusion frequency (CFFF) test. In the current study, the flicker test was performed several times on 21 subjects, both under normobaric and hyperbaric conditions. The test was conducted using the device that flickering was programmed according to the method of limits. While in the hyperbaric chamber, 15 of the participants breathed oxygen to reduce the risk of decompression sickness. Flicker and fusion frequencies differed from each other in both normo- and hyperbaric conditions (p < 0.01). CFFF results were dependent on oxygen breathing during decompression.

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