International Maritime Health最新文献

Background: This work performs two-dimensional Computational Fluid Dynamics (CFD) simulations of pulsatile bubbly flow in a column resembling the flow inside human vena cava during Decompression Sickness (DCS), aiming to illustrate the effect of certain parameters in bubbly blood flow and so facilitate the design of the: a) corresponding in-vitro bubbly flow experiments under pulsatile flow conditions inside a flow loop and b) in-vivo trials on swines for assessing a novel electrical impedance spectroscopy technique on the detection of bubbles (as those found during DCS) in their bloodstream.

Materials and methods: The commercially available ANSYS 2019-R3 CFD code was employed to simulate the pulsatile bubbly flow that resembled DCS. Simulations were validated against experiments conducted in a vertical co-current upward pulsatile bubbly flow provided by a flow loop equipped with electrical, optical and pressure diagnostics.

Results: CFD simulations under pulsatile conditions were initially validated by oscillatory in-vitro bubbly flow experiments. Then, the influence of pulsation parameters on void fraction, α, and flow velocity, U, profiles was computationally investigated. Intense periodic fluctuations of void fraction were observed along the column and their intensity increases with pulsation amplitude. Moreover, U and α radial profiles were uniform for bubbles 30 μm but showed a core-peaking profile for bubbles 300 μm.

Conclusions: CFD simulations of pulsatile bubbly flow resembling DCS provided unconventional information about the influence of different-sized sub-millimetre bubbles on the flow velocity and void fraction profiles, which are expected to improve the design of in-vitro and in-vivo trials for the detection of bubbles such as those found in DCS.

Background: A descriptive study was designed to determine the relationship between the anxiety levels of offshore workers participating in the Basic Offshore Safety Induction and Emergency Training (BOSIET) and their success in the training and to examine the potential factors affecting anxiety.

Materials and methods: The trainees' state-anxiety values were determined using the State-Trait Anxiety Inventory (STAI) Form TX-1 before and after each exercise, and trait-anxiety values were determined using TX-2 after all exercises had been completed.

Results: Among 276 trainees, female (n = 17), non-swimmers (n = 22) and younger trainees (median age: 35 [32-41]) had higher state-anxiety levels. The most anxiety-provoking and the most unsuccessful parts of the training were helicopter escape, the use of Compressed Air Emergency Breathing System (CA-EBS), and sea survival, respectively. After the CA-EBS exercise, where failure was seen for the first time, the anxiety level of those who failed increased.

Conclusions: The post-exercise state-anxiety scores of the unsuccessful ones were higher than those of the successful ones.

Background: The aim of this survey was to assess the health status, sleep habits and dyssomnia of coastal fishermen.

Materials and methods: This cross-sectional survey involved a representative sample of 948 coastal fishermen. All participants were men and had a regular activity for at least 2 years. We used an individual questionnaire inspired by those of Morphée network, the National Institute for Research and Security of France, and of the Karasek's Job Content Questionnaire.

Results: The prevalence of sociodemographic and individual parameters was similar in rotating shiftwork (RW) and in nocturnal work (NW). The average age of the total population was 38.8 ± 8.1 years. The prevalence of sleep habits and alertness disorders was similar in RW and in NW. The average daily sleep time of the total population was 5.5 ± 0.9 hours during the week, and 8.7 ± 0.8 hours during the holidays, Fridays and recovery days. Upon waking, 49.7% of the subjects felt tired and sleepy, 43.2% fit and 7.1% had a headache. 47.2% reported being chronic insomniac. The index of severity of insomnia was moderate to severe in 29.6%. The prevalence of excessive daytime sleepiness (Epworth > 10) was 16.2%. Fatigue, iso-strain and socio-economic concerns were associated with a higher risk of chronic insomnia.

Conclusions: Coastal fishermen were at a high risk of chronic dyssomnia and alertness disorders. Education initiatives should be conducted to raise fishermen's awareness on their health and safety consequences.

Background: An innovative medical simulation course was offered to seafarers during their statutory medical education refresher course. During the coronavirus disease 2019 (COVID-19) pandemic, they experienced difficulties dealing with mariners' mental health problems.

Materials and methods: One hundred and fifty-three seafarers underwent training at the C3S medical training centre in Lorient Hospital. At the end of the module they were asked to fill in a questionnaire.

Results: Ninety-seven per cent of them were satisfied with their training. They felt that their training had given them confidence to deal with these problems when returning to sea. On this occasion, we tested their feelings on the psychological consequences of the COVID-19 pandemic on board and compared their answers with the data available in our telemedical assistance service (TMAS) and in the literature.

Conclusions: Simulation training is an appreciated and effective educational tool for raising awareness and training medical managers in psychological or psychiatric situations.

An increasing presence on many beaches worldwide, jellyfish are a diverse group of Cnidarians equipped with stinging cells termed cnidocytes. Though few of the over 10,000 species are dangerous to humans, and most that are produce no more than a painful sting, some jellyfish can produce systemic symptoms and even death. Chironex fleckeri, the Australian box jellyfish, has a venom potent enough to kill in less than 10 minutes, and for which there is an antivenom of debatable efficacy. Stings from Carukia barnesi can cause Irukandji syndrome, characterised by severe pain and hypertension. Jellyfish stings have also been associated with Guillain-Barre syndrome and anaphylaxis. Though optimal treatment of stings remains controversial, after removal from the water and addressing any immediate life threats, the tentacles should be removed and the area washed, with seawater being the best choice due to its low likelihood of inducing further cnidocyte discharge. Hot water immersion may be beneficial for pain control for non-tropical jellyfish stings, and cold packs for tropical stings. In general, there is no consensus for the optimal treatment of jellyfish stings, and so further research is needed into species-specific guidelines and whether there are any overarching rules.

Background: Marine fishermen experience high levels of environmental and relationship stress and anxiety. The current study explored the role of stress in the relationship between neuroticism and anxiety symptoms among marine fishermen.

Materials and methods: Participants (fishermen from Tanmen in Qionghai city, Hainan Province) completed three questionnaires: the NEO-Five-Factor Inventory-Neuroticism Subscale (NEO-FFI-N); the Mental Stressor Investigation Questionnaire (MSIQ); and the Mood and Anxiety Symptoms Questionnaire-30-item-Anxious Arousal Subscale (MASQ-D30-AA) within 1 week before embarking on a fishing trip and then again within 1 week after their return to port. The data were subjected to correlational analyses and structural equation modelling.

Results: Positive correlations were found between NEO-FF-N (neuroticism) score, MSIQ score (total stress), MSIQ work-relationship score, ship environmental stress score, and MASQ score (anxiety symptoms). Regression analyses showed environmental stress had a significant moderating effect on the relationship between neuroticism and anxiety symptoms, and further analysis showed a mediating effect of work-relationship stress on the relationship between neuroticism and anxiety symptoms.

Conclusions: Marine fishermen with high environmental stress had greater anxiety symptoms than those with low environmental stress. Neuroticism in marine fishermen further affects anxiety symptoms by affecting the level of work-relationship stress.

Background: The onset of the coronavirus disease 2019 (COVID-19) pandemic has greatly impacted maritime telemedicine services. The aim of this study is to describe the impact of the pandemic, both quantitatively and qualitatively, by analysing the teleconsultations by doctors from the French Tele-Medical Assistance Service (TMAS).

Materials and methods: We carried out a descriptive observational study of retrospective data from the TMAS files. The main inclusion criterion for the files was a diagnosis of "influenza due to an unidentified virus". We extracted the following data: type of ship, gender, age, nationality, role on board, reason for the call and symptoms, number of calls, navigation zone, severity, medical decision, whether or not a COVID-19 test had been carried out, and treatments prescribed on board.

Results: One hundred and ninety-nine files were included of which 39 (20%) were clusters. We were able to analyse data from 384 patients. The study population comprised 376 suspected COVID-19 patients, of whom 334 (87%) were symptomatic and 42 (10.9%) asymptomatic. Eight (2.1%) patients were not thought to have COVID-19 but their call was related to the pandemic. Of the symptoms presented by the patients, fever was the most frequent (n = 196; 59%), while 129 (39%) presented a cough, 60 (18%) a headache, 41 (12%) non-specific ear, nose, throat signs, and 40 (12%) dyspnoea. Two hundred fifty-two (75%) patients stayed on board, 55 (17%) were disembarked, for 14 (4%) a ship diversion was arranged, and 13 were evacuated including 4 medical evacuations.

Conclusions: The most important problem encountered related to managing asymptomatic or pauci-symptomatic patients at sea, which was the subject of the majority of calls. The TMAS doctors played an important role in managing the pandemic by emphasising the need for social distancing and quarantine procedures at sea to limit the spread of the virus, while adapting to the sometimes difficult implementation conditions and logistics for medical decision and quarantine.