CPR on board the Metro.
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Attitude of Health Personnel↗
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Psychological evaluation of the emotional effects of a community toxic exposure.
OBJECTIVE: We sought to assess the emotional effects of a major community toxic release while controlling the potential effects of response bias associated with litigation. METHODS: Participants included 152 exposed adult litigants and a matched unexposed comparison group (n = 76). Psychological assessment methods included: (1) Minnesota Multiphasic Personality Inventory-2; (2) Symptom Checklist-90-Revised; and (3) Impact of Event Scale-Revised. RESULTS: Ten to 40% of the exposed group demonstrated emotional distress (compared with a 5% comparison baseline) depending on indicator and cutoff score used. CONCLUSIONS: The psychological consequences of a community toxic exposure were present even when exaggeration was carefully controlled. Accounting for exaggeration in the assessment of subjective psychological complaints provides a more accurate view of the subjective emotional state of persons who have experienced toxic exposure thereby facilitating appropriate clinical management of their mental health needs.
Accidents↗
What are the current guidelines on the use of implantable defibrillators in transportation safety critical work?
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Automobile Driving↗
Empiric determination of corrected visual acuity standards for train crews.
PURPOSE: Probably the most common visual standard for employment in the transportation industry is best-corrected, high-contrast visual acuity. Because such standards were often established absent empiric linkage to job performance, it is possible that a job applicant or employee who has visual acuity less than the standard may be able to satisfactorily perform the required job activities. For the transportation system that we examined, the train crew is required to inspect visually the length of the train before and during the time it leaves the station. The purpose of the inspection is to determine if an individual is in a hazardous position with respect to the train. In this article, we determine the extent to which high-contrast visual acuity can predict performance on a simulated task. METHODS: Performance at discriminating hazardous from safe conditions, as depicted in projected photographic slides, was determined as a function of visual acuity. For different levels of visual acuity, which was varied through the use of optical defocus, a subject was required to label scenes as hazardous or safe. RESULTS: Task performance was highly correlated with visual acuity as measured under conditions normally used for vision screenings (high-illumination and high-contrast): as the acuity decreases, performance at discriminating hazardous from safe scenes worsens. CONCLUSIONS: This empirically based methodology can be used to establish a corrected high-contrast visual acuity standard for safety-sensitive work in transportation that is linked to the performance of a job-critical task.
Adult↗
Four major disasters in Aquitaine, France: use of odontologic techniques for identification.
The 4 mass disasters that have affected the Aquitaine region (France) in the previous 15 years are related through the specificity and the efficiency of dental methodology in identifying the victims. The results point to the decisive influence and the efficiency of dental methodology for identification of bodies that are burned or disfigured after an accident or a prolonged period in water.
Accidents, Traffic↗
Ipsilateral replantation of foot with crossover segmental transfer in bilateral leg amputation.
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Accidents↗
A multiple-indicator multiple-cause model for posttraumatic stress reactions: personality, coping, and maladjustment.
OBJECTIVE: This study aimed to develop a multiple-indicator multiple-cause model (MIMIC) to describe the relationship among posttraumatic stress (PTSD) responses, general health problems, death anxiety, personality factors, and coping strategies among community residents exposed to the technological disasters of aircraft and train crashes. MATERIALS AND METHODS: One hundred forty-eight community residents, after exposure to the aircraft or train crash, were assessed using the Impact of Event Scale, the General Health Questionnaire-28, the Death Anxiety Scale, the Eysenck Personality Questionnaire, and the Ways of Coping Checklist. The control group (n = 90) comprised members of the general public, who had not been exposed to the disasters, from another city. RESULTS: The model showed significant associations between the impact of the disaster and general health problems, which varied depending on where community residents lived in relation to the disaster site, whether they were present when the disaster occurred, and the type of disaster. The model also suggested that death anxiety was associated with type of disaster and neuroticism. The model supported the interactive model in that personality factors interacted with coping strategies in maintaining or generating PTSD and general health problems. CONCLUSIONS: After exposure to technological disasters, community residents could develop PTSD and general health problems; however, increased death anxiety was a separate psychological reaction. The interaction between certain personality traits and coping strategies was one reason for PTSD and general health problems.
Accidents↗
Management of a circumferential lower extremity degloving injury with the use of vacuum-assisted closure.
A 58-year-old male presented with a large circumferential degloving injury and was immediately taken to the operating room for further assessment of his wound. At that time, a plastic surgeon was consulted to manage the wound due to its size and significant soft tissue loss. The decision was made to manage the patient's wound with the vacuum-assisted closure (VAC) device to prepare the wound bed for grafting. After three weeks of VAC therapy, the wound bed was revascularized with granulation tissue and was ready for grafting. The patient underwent a successful split thickness skin graft on hospital Day 23 and was discharged home. Follow-up visits revealed no scar contracture or functional limitations.
Accidents, Occupational↗
Railyard amputations in children.
Railyard or train-related accidents are a common cause of traumatic amputations in children. Four consecutive children with traumatic lower extremity amputations due to railyard amputation seen between 1975 and 1980 demonstrated: a common mechanism of injury--all were attempting to obtain rides on slow-moving trains near their homes or school; similar lower extremity amputation patterns--four right below knee and two left Syme's amputations; and distinctively abnormal psychosocial backgrounds. The psychosocial abnormalities have been demonstrated to be unique in children sustaining traumatic railyard amputations and are probably contributory. Awareness of these factors is important when considering surgical intervention and in planning for long-term rehabilitation.
Accidents↗
Bioinspired laser-operated molecular locomotive.
Biomotors kinesin and dynein show us that robust track-walking is possible down to molecular scale. Here I design a laser-powered molecular locomotive that is able to do that on an easily constructed track. The core of the machine is its work cycle that periodically converts optical energy into mechanical work, which is further rectified into processive, directional motion. Thus the molecular locomotive is essentially beyond the famous design of molecular shuttles. Under automated laser operation, the locomotive can move a few mum per second comparable to its biological counterparts. However, this artificial motor is capable of conveniently switchable, dual directional motion in contrast to common unidirectionality of biomotors. The locomotive is also different from the big category of Brownian motors in the sense that move of the locomotive is not a result of biasing pre-existing fluctuations, rather it is directly and decisively driven by optomechanical strokes of the work cycle, generating a pulling force ten times greater than those of biomotors. Being a novel type of molecular motor as well as a powerful molecular engine, this machine will potentially enable automatic, forceful delivery of molecular building blocks with nanometer accuracy. Well within reach of established techniques, its implementation will be a significant advance in nanoscience and nanotechnology.
Biomimetic Materials↗
The wreck of Amtrak's Sunset Limited: news coverage of a mass transport disaster.
Using the 1993 crash of Amtrak's Sunset Limited in Mobile, Alabama, this study examines the safety education provided by seven newspapers. A total of 117 news stories were analysed for five primary themes: overall story category, passenger safety theme, train personnel safety theme, train safety theme and rescue safety. Sixty-three per cent were found to contain at least one safety theme paragraph within the larger story. A total of 631 paragraphs were identified as safety theme paragraphs, 32 per cent of which were passenger safety themes, 8 per cent were train personnel safety, 31 per cent were train safety and 29 per cent were rescue safety themes. As in previous research, safety themes rarely appeared alone; more often than not, a story contained a mixture of all themes. Some safety themes appeared more frequently than others, but overall, the safety themes present a complete view of the safety issues surrounding the crash. Safety themes are embedded within a story framework which reflects the three stages of disaster news work. Images of normalcy tragically disrupted by the crash abound as do images of passengers escaping and aiding others. Disaster relief personnel and aviation officials are shown working to restore order and solve the mystery of the crash. Within this framework we can learn what to expect when a train crashes and what we might have to do in a similar situation.
Accidents, Occupational↗
Isolation of keratinophilic fungi from the dust of ferry boats and trains in Italy.
The occurrence of fungi of the genera Epidermophyton, Microsporum, Trichophyton and Chrysosporium in dust collected from 10 ferry boats and 11 railway cars in Italy was studied. Ferry boats: 101 colonies of fungi were isolated. Of the dermatophytes, E. floccosum represented 2.0% of all the colonies isolated, M. canis 3.0%, M. gypseum 5.0% and Tr. mentagrophytes represented 2.0%. E. floccosum was isolated from 2 ferry boats, M. canis from 3, M. gypseum from 4 and Tr. mentagrophytes from 2. Only two ferry boats appeared to be free of pathogenic fungi. Of all the species isolated, Chr. pannorum was the most numerous (45.4%). In all five species of Chrysosporium were isolated. Railway cars: The final destination of the trains, coming from various cities, was Rome's Termini Station. 336 strains were isolated. The following species were found: E. floccosum 3%, Tr. mentagrophytes 4.8%, Tr. tonsurans 0.3%, Tr. ajelloi 0.6%, Trichophyton spp. 3%, M. canis 5% and M. gypseum 1.5%. Seven different species of Chrysosporium were isolated. Chr. pannorum was the most numerous one (71% of all). Regarding the occurrence of dermatophytes, E. floccosum was isolated from 8 of the 11 trains examined, M. canis from 10, M. gypseum from 4, Tr. mentagrophytes from 8 and Tr. tonsurans from only 1 of the trains. All of the trains were positive for pathogenic fungi, ranging from a minimum of 2 species to a maximum of 4.
Animals↗
Factor structure of Zung self-rating depression scale for workers.
The Zung self-rating depression scale (SDS) was applied to workers of a railway company. A total of 1,784 night-shift workers responded to the questionnaire and 1,394 daytime workers were set as the control group. The average age of the subjects was 39.9. The SDS index decreased with age. A factor analysis was conducted and two factors were obtained having an initial eigen value over 2.0. Factor 1 was the group of 8 positive items, accounting for 18.2%. Factor 2 was the group of 8 depressive items, accounting for 18.1%. Four items including "loss of weight," "constipation," "good appetite," and "partner coping" did not construct a distinct factor. The factor structure of SDS items of the night-shift workers was similar to those of the control group.
Adult↗
The Aum Cult leader Asahara's mental deviation and its social relations.
This paper is a further discussion of the author's previous reports on the crimes committed by the Asahara-Aum Cult. First, the motivations of Asahara-Aum crimes, in particular those of murders, and their abnormality beyond the realm of criminology are ascertained. Second, psychopathology of the leader, Asahara, was considered, and it was assumed that Asahara was affected with the syndrome of pseudologia phantastica which was confirmed by his strange attitude during his trials. Third, the mental status of Asahara after the first trial was investigated, and some evidence was found that his mental status was so severe as to be 'unfit to plead' that psychiatric evaluation and treatment would be necessary. Fourth, the reasons for making people, in particular scientific elites, fascinated with Asahara and the Aum Cult were scrutinized and some clues were described. Finally, the problem that Aum has survived under the name of Aleph, how heavy capital punishment for Leader Asahara is appropriate, and that reparations for victims of Asahara-Aum crimes are urgent from the standpoint of social psychiatry, are discussed.
Antisocial Personality Disorder↗
A note on the influence of rail defects on the risk associated with shipping hazardous materials by rail.
Existing approaches to routing hazardous material shipments by rail recognize that track condition is an important influence, but have not included it in the risk assessment and routing models. This note explores the influence of track condition based on predictions of internal defects in the rail. The method developed predicts the expected frequency of accidents and subsequent consequences in terms of the expected number of fatalities accounting for one aspect of track condition-internal defects. It is intended to indicate the magnitude and impact of track condition. The formulation integrates models of consequences and the risk of a hazardous spill found in the literature with the frequency of accidents as a function of the number of defects. The number of defects may be based on observations or predicted as a function of the cumulative traffic. The models are used to calculate the expected number of fatalities per year for a particular route. Application of the methodology to a hypothetical route shows that the risk associated with the transportation of hazardous material shipments varies significantly with the expected number of defects in the track. Therefore, risk not only varies from route to route but over time for any section of track as the condition deteriorates.
Accident Prevention↗
Train suicide in the county of Fyn 1979-82.
The phenomenon of suicide by train in the county of Fyn is examined for the period 1979-82. The reference population comprised all suicides in the county, minus suicide by train, for the period 1979-82, totalling 505 events. The data is based on the death certificates and the relevant psychiatric journals in the region for the period under study. Sixteen suicides by train took place in the investigation period and these differed significantly from the reference population on the following points: distribution by age: 44% of the suicide by train population belong to the age group 15-29 years, whereas in the reference population only 11% were found in this age group; psychiatric or non-psychiatric patient: in the group of train suicides 81% were classifiable as psychiatric patients (inpatient, outpatient, former inpatient), in the reference population 38% were thus classifiable. Of the 13 "psychiatric" suicides by train, nine (69%) had a psychosis diagnosis. As in other international investigations a correlation was demonstrated between increasing proportion of mentally ill and degree of violence and deliberateness of the suicide act. From the aspect of prophylaxis, suicide by train is more a problem for the psychiatrist than for Danish Rail, just as coverage of these events by the daily press is believed to act as an incentive to this group of potential suicides.
Adolescent↗
Suicidal acts on metro systems: an international perspective.
Suicide is a problem experienced by railway networks worldwide. The epidemiology of this method of suicide has not been described in any detail. To investigate the characteristic features of railway suicide, data were gathered from 23 metro systems around the world. The similarities in the nature of this problem across systems were striking. Universally the victims were young (aged less than 40 years); most incidents involved men; case fatality was generally less than 60%; there was no consistent seasonal variation in incidence; the peak time of day for incidents was 1000-1200; proximity to psychiatric institutions was possibly a risk factor. This method of suicide may be prevented by environmental modification of the railway system. Strategies for reducing the opportunities for suicide on railways are discussed.
Adolescent↗
Contact dermatitis and its relationship to atopy in workers on the Polish State Railways.
Clinical examinations, patch tests and prick tests were carried out in a group of railwaymen. Only 3 had both eczema and atopy. Prick tests were positive in a high proportion of subjects, including both those with eczema and controls.
Adolescent↗