Air Transport Environment Research Articles

Identifying and Reducing Insulin Errors in the Simulated Military Critical Care Air Transport Environment: A Human Factors Approach.

During high-fidelity simulations in the Critical Care Air Transport (CCAT) Advanced course, we identified a high frequency of insulin medication errors and sought strategies to reduce them using a human factors approach. Of 169 eligible CCAT simulations, 22 were randomly selected for retrospective audio-video review to establish a baseline frequency of insulin medication errors. Using the Human Factors Analysis Classification System, dosing errors, defined as a physician ordering an inappropriate dose, were categorized as decision-based; administration errors, defined as a clinician preparing and administering a dose different than ordered, were categorized as skill-based. Next, 3 a priori interventions were developed to decrease the frequency of insulin medication errors, and these were grouped into 2 study arms. Arm 1 included a didactic session reviewing a sliding-scale insulin (SSI) dosing protocol and a hands-on exercise requiring all CCAT teams to practice preparing 10 units of insulin including a 2-person check. Arm 2 contained arm 1 interventions and added an SSI cognitive aid available to students during simulation. Frequency and type of insulin medication errors were collected for both arms with 93 simulations for arm 1 (January-August 2021) and 139 for arm 2 (August 2021-July 2022). The frequency of decision-based and skill-based errors was compared across control and intervention arms. Baseline insulin medication error rates were as follows: decision-based error occurred in 6/22 (27.3%) simulations and skill-based error occurred in 6/22 (27.3%). Five of the 6 skill-based errors resulted in administration of a 10-fold higher dose than ordered. The post-intervention decision-based error rates were 9/93 (9.7%) and 23/139 (2.2%), respectively, for arms 1 and 2. Compared to baseline error rates, both arm 1 (P = .04) and arm 2 (P < .001) had a significantly lower rate of decision-based errors. Additionally, arm 2 had a significantly lower decision-based error rate compared to arm 1 (P = .015). For skill-based preparation errors, 1/93 (1.1%) occurred in arm 1 and 4/139 (2.9%) occurred in arm 2. Compared to baseline, this represents a significant decrease in skill-based error in both arm 1 (P < .001) and arm 2 (P < .001). There were no significant differences in skill-based error between arms 1 and 2. This study demonstrates the value of descriptive error analysis during high-fidelity simulation using audio-video review and effective risk mitigation using training and cognitive aids to reduce medication errors in CCAT. As demonstrated by post-intervention observations, a human factors approach successfully reduced decision-based error by using didactic training and cognitive aids and reduced skill-based error using hands-on training. We recommend the development of a Clinical Practice Guideline including an SSI protocol, guidelines for a 2-person check, and a cognitive aid for implementation with deployed CCAT teams. Furthermore, hands-on training for insulin preparation and administration should be incorporated into home station sustainment training to reduced medication errors in the operational environment.

Evaluation of agile attributes for low-cost carriers to achieve sustainable development using an integrated MCDM approach

PurposeSince conducting agile strategies provides sustainable passenger satisfaction and revenue by replacing applied policies with more profitable ones rapidly, the focus of this study is to evaluate agile attributes for managing low-cost carriers (LCCs) operations by means of resources and competences based on dynamic capabilities built on resource-based view (RBV) theory and to achieve sustainable competitive advantage in a volatile and dynamic air transport environment. LCCs in Turkey are also evaluated in this study since the competition among LCCs is high to gain market share and they can adapt quickly to all kinds of circumstances.Design/methodology/approachTwo well-known Multi-Criteria Decision-Making Methods (MCDM) named as the Stepwise Weight Assessment Ratio Analysis (SWARA) and multi-attributive border approximation area comparison (MABAC) methods by employing Picture fuzzy sets (PiFS) are employed to determine weight of agile attributes and superiority of LCCs based on agile attributes in the market, respectively. To check the consistency and robustness of the results for the proposed approach, comparative and sensitivity analysis are performed at the end of the study.FindingsWhile the ranking orders of agile attributes are Strategic Responsiveness (AG1), Financial Management (AG4), Quality (AG2), Digital integration (AG3) and Reliability (AG5), respectively, LCC2 is selected as the best agile airline company in Turkey with respect to agile attributes. SWARA and MABAC method based on PiFS is appropriate and effective method to evaluate agile attributes that has important reference value for the airline companies in aviation industry.Practical implicationsThe findings of this study will support managers in the airline industry to conduct airline operations more flexibly and effectively to take sustainable competitive advantage in unexpected and dynamic environment.Originality/valueTo the author' best knowledge, this study is the first developed to identify the attributes necessary to increase agility in LCCs. Thus, as a systematic tool, a framework is developed for the implementation of agile attributes to achieve sustainable competitive advantage in the airline industry and presented a roadmap for airline managers to deal with crises and challenging situations by satisfying customer and increasing competitiveness.

Vibration Test Spectrum Simulating the In-Flight Jet Aircraft Transport Environment of Parcel and Unit Load Shipments

Abstract The measurement and analysis of the hazards occurring during the distribution environment are critical to developing test simulations that can be used to challenge packaged products and quantify their performance. One increasingly utilized vehicle is jet aircraft to move packaged product systems through the distribution network. As a result, there is a need to ensure that the vibration test levels used to qualify packaged product systems reflect the hazard levels observed in the air transport environment. This study utilized a field data recorder that separated ground and in-flight vibration events to capture a series of jet aircraft flights. The measured acceleration-time data were analyzed in terms of power spectral density (PSD) and statistically examined to understand the variability of the vibration intensity of this transport mode. The PSD profiles computed from the field measured events were significantly lower in vibration intensity than current test methods for air transport. Statistical analysis showed that the measured events were non-Gaussian and right-skewed. Additionally, a composite jet aircraft PSD test profile, reflective of the field-collected events, was developed, which could drive vibration test systems to evaluate packaged product systems during the in-flight segment of this distribution channel.

Cooperation between the Slovak Armed Forces and Movement Coordination Centre Europe Project: Air Transportation Improvement Opportunities

The air transport environment is very complex, and in its nature everThe air transport environment is very complex, and in its nature everchanging and evolving. Capabilities and capacities in transport are dynamicand dependent on many factors including the world happenings andsituation. It’s as well crucial to note that characteristics of the transportconditions are subject to compliance with the national and internationalagreements, laws, and other regulations.On the top of that, most of the militaries around the world have limitedoperational budget, so there is a notable need in finding cost-effectivesolutions for transportation. That’s one of the main reasons whyinternational military transportation projects, such as MovementCoordination Centre Europe project, are progressively growing andexpanding their scope.

Service Quality of domestic airlines in the face of COVID-19 in Nepal

The coronavirus pandemic has turned the aviation industry on its head, transforming the passenger experience drastically. The airlines have faced significant challenges due to both the Covid-19 pandemic, the sequence of lockdowns and the provisions of safety and security legislation. There is more concern about the growing feeling that passengers are aware of the level of service. Airlines not only need to focus on service quality in today's highly competitive air transport environment, but also need to focus more on safety and security issues, especially at the time of the Covid-19 pandemic. The research related to these dimensional studies becomes more important in the COVID-19 scenario. Therefore, the objective of this study was to examine the impact of service quality dimensions on the overall quality of service of domestic airlines in Nepal in the midst of the Covid-19 pandemic. A quantitative methodology with a descriptive and explanatory research design was adopted in the study. A sample of 200 passengers recently travelling after the lockdown and reopening of the domestic airline service has been contacted. Out of which 160 responded to the questionnaire. In the sense of COVID-19 post lockdown operations, the service quality of domestic airlines is affected by various factors. All the likely factors that influence the quality of airlines need to be considered by airlines. Reliability, assurance, tangibility, empathy, and responsiveness are the variables. All these aspects play an important role in providing passengers with a reliable service. The dimensions of reliability, tangibility and responsiveness need to concentrate more on having the standard of service as desired in the sense of COVID-19 by domestic airlines in Nepal. It means that during COVID-19 and similar situations, tangibility must concentrate on the highest level of operation.&#x0D;

Enteral Nutrition in the Deployed Critical Care Ground and Air Transport Environment: A Narrative Review.

Early and adequate administration of enteral nutrition (EN) improves outcomes in critical care patients. However, the environment where Critical Care Air Transport teams provide patient care poses particular challenges to achieving the same standard of nutritional support readily administered in civilian intensive care units. Providing the highest standard of nutritional care in austere military environments remains the goal for all patients despite inherent challenges. Enteral nutrition, specifically, is not currently a standard of practice in-flight because of concerns for microaspiration and the associated risk of developing ventilator-associated pneumonia. Clinical concern for aspiration combines with the lack of an EN pump approved for use through Safe-to-Fly testing to further decrease the likelihood of initiating EN in trauma patients. Early EN significantly reduces morbidity and mortality risks; therefore, the lack of nutritional support is contrary to established standards of care in civilian intensive care units. Hence, this literature review proposes to provide a clearer understanding of current EN practices as well as any associated risks within the En Route Care system. A narrative review of literature related to EN in military and civilian flight settings using the PRISMA methodology. A search using the key terms of critical care, air ambulance, EN, nutritional status, and aspiration returned a total of 51,990 articles. A title review followed by a more targeted abstract analysis by the research team generated 39 articles for full-text review. The full-text review then yielded a total of 10 relevant articles for inclusion in the final synthesis table. Overall, the consensus of the literature supports that early evaluation and initiation of standard EN feeding protocols on the ground and during transport improves patient outcomes and enhances injury recovery. However, additional research will determine the current number of patients fed in-flight along with the actual risks and benefits of EN in this population.

Evaluate The Relationship Between the Air Transport Environment and The Quality Services Provided to Tourists in The Kurdistan Region

The research aims to study the evaluation of the relationship between the air transport environment and the quality of services provided to tourists in the Kurdistan Region of Iraq for the period 2018-2019, which is an exploratory study in a sample of airlines in the city of Erbil. The independent variable is represented in four axes: (the role of aviation organizations, the role of air safety and security, the role of human resources training and the role of quality awards) that affect the quality of services provided to tourists by airlines. The research relies on the first two descriptive approaches, that is, it seeks to describe the various economic phenomena and study the factors that led to their emergence. The number of airlines was (52) companies, the questionnaire was distributed to them as a tool to collect data and information, and then we developed a hypothetical model based on a set of assumptions, including: 1- There is a statistically significant moral relationship between aviation and the quality of services provided by airlines.2- There is a significant statistical relationship between air safety and the quality of services provided by airlines.3- There is a significant statistical relationship between the training of human resources and the quality of services provided by airlines.4- There is a statistically significant moral relationship between the quality awards and the quality of services provided by airlines.5- Each of the four axes has an impact on the quality of services provided by airlines.The second approach adopts the analytical approach to analyze the data or information collected quantitatively, which is digital analysis by adopting mathematical and statistical relationships and equations and using them to analyze the results.

Music and Medicine Come Together Over Pain in the Air Medical Transport Environment

ObjectiveThis study aimed to determine if noise-canceling headphones (NCHs) with music supersedes pain reduction of other hearing protection for patients transported by Guardian Air Transport via rotor or fixed wing aircraft from 2017 to 2019. MethodsWe designed a randomized pilot study in which patients who received NCHs with or without music were compared with controls who received non-NCH hearing protection alone. Four hundred fifty-four adults 19 to 64 years of age and 36 pediatric patients 4 to 18 years old who received ≥ 1 dose of opioids were included. ResultsIn the aggregate population, opioid use was reduced by 31% from 14.3 to 10.0 morphine milligram equivalent/h transport (P = .131) with music compared with controls. The mean total pain reduction in the aggregate population from −2.5 (standard deviation [SD] = 3.2) to −4.0 (SD = 2.9) was 1.6-fold more than controls compared with NCH and music (P = .008). This effect was most profound in the pediatric population where the mean total pain reduction with NCHs and music (−5.4, SD = 3.1) was 3.4-fold more than controls (−1.6, SD = 2.7, P = .021). ConclusionsMusic may provide greater subjective pain relief when combined with NCHs in the air transport environment; further research is required.

Educational Model for Evaluation of Airport NIS Security for Safe and Sustainable Air Transport

One of the praxeological problems of safe and sustainable air transport (airfreight transport/air cargo, and air passenger transport) is the prevention and management of risks by competent staff, with the support of modern information and communication technologies. This paper presents an educational information model and software for the airport network and information systems risk assessment, primarily intended for aviation education and training of professionals for ensuring safe and sustainable air transport. The solution to the problem is based on the application of the fuzzy logic method in the air transport environment. Based on a fuzzy expert model, the selected scenario, and the input data established separately for airport assets by a group of 23 experts from aviation practice and a university, the following three assessments of airport network information system assets were constructed: Asset A2 (meteorological information systems) has an insignificant risk with an estimated 0.1162, and assets A1 (air traffic control and management (ATM), navigational aids and approach) and A3 (runway monitoring system) received a low risk of airport network and information systems (NIS) security with ratings of 0.2623 and 0.2915, respectively. An airport NIS risk assessment was aggregated (0.2288), indicating a low degree of security risk to the airport’s network and information systems. The aggregated risk assessment of airport NIS, including financial loss data, was calculated as 0.1438, representing a low degree of security risk to the airport’s network and information systems. Scenarios for evaluating airport assets are changing for students during education. The results of the developed model and its software will be part of the Simulation Center of the Faculty of Aeronautics.

Impact of coronavirus ( COVID ‐19) pandemic on air transport mobility, energy, and environment: A case study

The recent pandemic caused by COVID-19 has globally affected air transport mobility as well as the airline industry in general. Numerous restrictions have been implemented in airline transport, which is potentially leading toward severe long-term impacts on the global airline industry. In this paper, air transport mobility was analyzed regarding Europe (EU) based on the available data from the relevant sources associated with the airline industry. Data were analyzed in specific periods from January to April of 2020, which corresponded with the initialization of the pandemic in the EU and later in its full development. Specifically, two airports were selected in Croatia as case studies to analyze the impact of COVID-19 more thoroughly on mobility together with the estimation of carbon footprint during the pandemic and the year before the pandemic state. The results revealed that COVID-19 gradually affected air transport mobility in the EU where a peak was reached in April with a reduction in the number of flights in the EU region reaching more than 89%. Cargo traffic was not significantly affected by the pandemic, and was even increased in some cases due to the supply of medical equipment in the fight against the disease. The analyzed case study revealed the reduction in air transport mobility for selected airports to be more than 96%, which directly affected the reduction of CO2 emissions to factor 1.81 for the commercial airport of Zagreb and 3.49 for the seasonal airport of Split. A normalization of air transport mobility is expected to be reached through a 1-year period with a continued reduction in the number of flights ranging from 15% to 25%, based on the projections and expectations from relevant EU associations.

Fuzzy Model for Quantitative Assessment of Environmental Start-up Projects in Air Transport

The purpose of this paper is to develop an applied fuzzy model of information technology to obtain quantitative estimates of environmental start-up projects in air transport. The developed model will become a useful tool for venture funds, business angels, or crowdfunding platforms for the development of innovative air transport businesses. Obtaining a quantitative estimate of the environmental start-up projects will increase the sustainability of the decision making on the security of financing of such projects by investors. This article develops a fuzzy evaluation model of project start-ups in air transport as an application of our neuro-fuzzy model in a specific air transport environment. The applied model provides output ranking of start-up project teams in air transport based on a four-layer neuro-fuzzy network. The presented model declares the possibilities of the application to solve these economic problems and offers the space for subsequent research focused on its usability in several areas of start-up development, in sectors and processes differentiated. The benefits are also visible for several types of policies, with an emphasis on decision-making processes in regulatory mechanisms to support the state funding in Slovakia, the EU etc.

Low Cost Carriers in the Middle East and North Africa: Prospects and Strategies

We examine the ‘low cost’ airline sector in the Middle East and North Africa (MENA) and develop a number of indicators of growth potential for the sector. We also discuss the role of ‘open skies’ air service agreements and examine the characteristics and business models of MENA-based airlines that are commonly referred to as ‘low cost carriers’ (LCCs). Utilizing a bench marking methodology, we compare the business strategy of Air Arabia Group with those of dominant European LCCs easyJet and Ryanair. We find that while Air Arabia adheres most closely (of all current MENA-based airlines) to the traditionally defined LCC business model, its current strategy differs significantly from those of Ryanair and easyJet. We conclude that the air transport environment in the MENA region has influenced the strategies of current carriers in ways that may be detrimental in a more liberalized future environment.

Would competition between air transport and high-speed rail benefit environment and social welfare?

We develop a duopoly model to analyze the impact of air transport and high-speed rail (HSR) competition on the environment and social welfare. We show that the introduction of HSR may have a net negative effect on the environment, since it may result in additional demand, i.e., there is a trade-off between the substitution effect and the traffic generation effect. Furthermore, if environmental externalities are taken into account when assessing social welfare, the surplus measure may be higher when only air transport serves the market than when the two modes compete. When the airline and the HSR operator decide frequencies, the airline reduces the aircraft size in order to keep load factors high while offering lower frequency and carrying fewer passengers. In these circumstances, the introduction of HSR may be beneficial to the environment on a per seat basis only if the market size is large enough. When the HSR operator decides speed, it has incentive to keep it at the maximum level in order to reduce travel time. When the increase in the emissions of HSR due to the increase in the speed of the train is sufficiently high, the overall level of emissions grows after the introduction of HSR. Therefore, there can be a trade-off between the attractiveness of the service due to reduced travel time and the effects on the environment.

Analysis of in‐flight vibration of a twin‐engine turbo propeller aircraft

AbstractA data recorder was utilized to record in‐flight vibration of a twin engine turbo propeller (feeder) aircraft. The data recorded produced power spectral density (PSD) profiles which are currently used in laboratory settings to drive vibration tables in order to simulate a particular vehicle type. Overall Grms values were averaged and compared to previous research studies.The data collected from this research study could be utilized for packaging research when developing products and packages that will pass through a distribution cycle which includes transportation via a feeder aircraft. One example of this type of distribution cycle is the small parcel shipping environment. The PSD profiles which were analyzed from this research could simulate in‐flight aircraft vibration of the aircraft chassis in a laboratory environment. This will enable further research in the air transport environment. Copyright © 2009 John Wiley &amp; Sons, Ltd.

Effects of reduced pressure and vibration on haz-mat packages for liquids

Eleven different bottle/closure systems used to package dangerous goods for transportation by air were tested for leakage. The bottles were filled with water and subjected to the combined effects of random vibration and external pressure equivalent to an altitude of 14000ft (4267m) for up to an hour. The bottles were placed in the vertical, horizontal and inverted orientations and observed for leaks. The differences in bottle weights before and after the tests were used to quantify leakage. The results show that of the 11 package types tested, six leaked when subjected to simulation of the air transport environment. Those systems utilizing ‘stretch tape’ around the closure did not leak. Copyright © 2006 John Wiley & Sons, Ltd.

Air transport of the IABP patient

The intra-aortic balloon pump (IABP) has evolved into an easily transported, computer-driven device for invasively assisting circulation. This article reviews the use of the IABP during interfacility patient transport by air. Air transport of the IABP-dependent patient creates unique clinical, logistical, and technical challenges. We review the function and clinical application of IABP in various air transport conditions. We also identify the complications of intra-aortic balloon pumping, such as hemorrhage, loss of trigger signals, cardiac arrest, and atmospheric pressure changes, and offer solutions. The effective clinical use of IABP in the air transport environment involves more than familiarity with the device and implications for its use; rapid identification of problems and implementation of solutions are required for successful transport and patient outcomes.

Human factors in multi-crew flight operations

AbstractThis paper discusses selected aviation human factors challenges in the air transport environment. Because of the authors’ background, much of this paper will be based upon the growth of human factors and airline training in transport aviation in the United States. However, parallel growth and advancements have been made in other parts of the world from the beginning of air transport and are being made in many parts of the world today. This is certainly true of Great Britain. One should never forget that air transport is a world enterprise and has been since its beginning. While it is important to recognise that cultural and other differences should be considered if they are relevant, it is equally important in air transport to recognise that common problems are solved by common solutions and can be addressed by, but are not limited to, common approaches.It is recognised that the behavioral aspect of aviation human factors deserves considerable attention, particularly in the area of training and evaluation. We have also learned that previous training criteria are not satisfactory for operation with increasingly complex aircraft being operated in an increasingly complex environment. Human errors occur with greater frequency than is often believed and can be made by anyone — even an airline captain. An inevitable consequence of this entirely human characteristic is that the role of the co-pilot has been considerably enhanced. Furthermore, the monitoring function of the pilot-not-flying, whether he/she is the captain or co-pilot, is now recognised as a critical safety function by virtually all serious operational experts.

Human Factors in Multi-crew Flight Operations

This paper discusses selected aviation human factors challenges in the air transport environment. Because of the authors' background, much of this paper will be based upon the growth of human factors and airline training in transport aviation in the United States. However, parallel growth and advancements have been made in other parts of the world from the beginning of air transport and are being made in many parts of the world today. This is certainly true of Great Britain. One should never forget that air transport is a world enterprise and has been since its beginning. While it is important to recognise that cultural and other differences should be considered if they are relevant, it is equally important in air transport to recognise that common problems are solved by common solutions and can be addressed by, but are not limited to, common approaches. It is recognised that the behavioral aspect of aviation human factors deserves considerable attention, particularly in the area of training and evaluation. We have also learned that previous training criteria are not satisfactory for operation with increasingly complex aircraft being operated in an increasingly complex environment. Human errors occur with greater frequency than is often believed and can be made by anyone - even an airline captain. An inevitable consequence of this entirely human characteristic is that the role of the co-pilot has been considerably enhanced. Furthermore, the monitoring function of the pilot-not-flying, whether he/she is the captain or co-pilot, is now recognised as a critical safety function by virtually all serious operational experts. Language: en

Decline and growth, privatization and protectionism in the Middle East airline industry

The changing international air transport environment creates challenges for the management of the national airlines in the Middle East. The rapid development of this area's civil aviation market in the last decade and the liberalization of the European civil aviation industry embody risks but also enormous opportunities for Middle Eastern airlines. The international airline industry has, during the early 1990s, suffered financial losses that may very quickly force it into accepting fundamental changes. These changes may result in a largely unregulated, competitive oligopoly. In such an environment a new approach is required by Middle Eastern airlines. The authors suggest that the long-term prospects for Middle East air transport are improving, and that the Middle East is likely to become an aviation junction again. This paper emphasizes recent changes in Middle Eastern airlines and government policy, which are expected to help develop a more efficient and coherent air industry, and, as result, expedite industry growth. However, when and to what extent a free market in aviation ensues still remains to be seen.

Airline Simulation for Analysis of Commercial Airplane Markets

The Lockheed Airline System Simulation is discussed as a step-by-step evaluation of the economics of different ways of routing passenger travel demand. Interacting items that are discussed include forecast passenger traffic demand, persistence of demand, purpose of travel, passenger preferences toward fare and speed, aircraft characteristics, flight frequency, route interaction, and competitive and regulatory influences. Also discussed are specific uses of the simulation program during the design of the supersonic transport. The first use is in determining the optimum SST size, speed, and sonic boom characteristics. The impact of a refined SST on the air transport environment is then discussed. This latter subject is presented in terms of airplane requirements, load factors, airline earnings, and airline return on investment.