Flight Crew Members Research Articles

A Complex Mathematical Model for Evaluating the Functional Reliability of Flight Crew Members

A Complex Mathematical Model for Evaluating the Functional Reliability of Flight Crew Members

FLIGHT HOURS AND BMI AGAINST TUC IN HYPOBARIC CHAMBER ALTITUDE 25.000 FEET

Background: Time of Useful Consciousness (TUC) is the time interval a person can survive carrying out flight duties due to a decrease in oxygen pressure and the point at which there is a decrease in the level of consciousness. The TUC time interval is influenced by various factors including Body Mass Index (BMI) and flying hours which affect the increase in the duration of the body's exposure to hypoxic conditions in pilots. Purpose: This research was conducted to determine the relationship between total flight hours and BMI on TUC. Method: This research employed observational analytic research with a cross-sectional method. Sampling was taken by simple random sampling technique. The sample for this research included active flight crew members from Lakespra dr. Saryanto 202 who met the inclusion criteria. Result: There were 53 research subjects, with the results showing that 48 subjects (90.6%) had a TUC <4 minutes, and 5 subjects had a TUC >4 minutes. There were 47 subjects (88.7%) with total flight hours >1000 hours and 6 subjects (11.3%) with total flight hours <1000 hours. In BMI, 37 subjects (69.8%) had an overweight BMI, and 16 subjects (30.2%) had a normal BMI. Conclusion: After examining 53 subjects, it was found that there was no relationship between total flight hours and TUC (p-value = 1.000) or BMI and TUC( p-value = 0.307) in the hypobaric chamber at an altitude of 25.000 feet.

Navigating the Skies: Unraveling Communication Challenges in Diverse Aviation Accidents

Effective communication is the lifeline of aviation safety, serving as the cornerstone for preventing accidents, mitigating crises, and ensuring seamless coordination among diverse stakeholders within the complex and dynamic aviation environment. The aim of this study is to provide a qualitative analysis of the 10 fatal accidents in aviation history and incidents and accidents that occurred in the past 10 years registered by the National Transportation Safety Board (NTSB). The content analysis of the reports of the fatal accidents and reports of the 48 events identified in the accident database search revealed themes such as miscommunication between flight crew members, challenges in emergent situations, and communication breakdowns with ATC. These findings align with existing literature, emphasizing the pivotal role of communication in aviation safety. The study offers recommendations to invest in CRM training, standardized phraseology, and advanced communication technologies for aviation safety. Future research directions include exploring human-machine interaction, artificial intelligence, and communication in Unmanned Aerial Systems. Moreover, grounded in these findings, airline companies can infer practical implications such as improved safety, operational efficiency, stress reduction, cost savings, regulatory compliance, and trust-building, thereby emphasizing the industry's commitment to continuous improvement in navigating the complexities of aviation communication.

Delayed Pressure Urticaria Associated With Altitude Chamber Training Responsive to Cyclosporine and Omalizumab.

Delayed pressure urticaria (DPU) is a subset of chronic inducible urticaria. It is characterized by the formation of wheals anytime between 30 minutes and 24 hours after stimulus exposure of localized pressure application. In this case report, we discuss a military flight crew member with no significant past medical history who developed DPU following rapid decompression in an altitude chamber. The chamber training included an uneventful ascent to 45,000 feet, higher than he had been previously, and a rapid decompression. About 16 hours later, he developed pruritic swelling of his hands and feet, along with diffuse deep nodular swelling, erythematous plaques, and erythematous nodules. His DPU was refractory to monotherapy treatment with antihistamines, and he continued to develop lesions in weight-bearing areas. Control of symptoms was achieved through combination treatment of a second-generation antihistamine, a leukotriene receptor antagonist, and an immunosuppressant (cyclosporine). His waiver to return to flight status was denied while on cyclosporine. He was transitioned to a monoclonal antibody that binds free immunoglobin E (omalizumab) with resolution of symptoms and was cleared to return to active duty.

Correlations among Fatigue Indicators, Subjective Perception of Fatigue, and Workload Settings in Flight Operations

Conducting flight operations at the pace of air traffic relies on shift work, overtime work, work at night, work in different and numerous time zones, and unbalanced flight crew schedules. Such working hours and workload settings can cause disturbances of the circadian rhythm and sleep disorders among flight crew members; this can result in fatigue and can have an impact on the safety of flight operations. Fatigue impacts many cognitive abilities such as vigilance, memory, spatial orientation, learning, problem solving, and decision making. In aviation, fatigue has been identified as a hazard to the safety of flight operations. This paper describes objectivation methods for data collecting processes regarding flight crew fatigue, using an electronic system of standardized chronometric cognitive tests and subjective self-assessment surveys on the subjective perception of fatigue. The data collected were analyzed using statistical methods to identify and quantify elements that affect the appearance of fatigue. Finally, causal modeling methods were used to determine correlations among the measured flight crew fatigue indicators, the subjective perception of fatigue, and the defined workload settings. The results of this research reveal which elements strongly impact flight crew fatigue. The detected correlations can help define improved measures for the mitigation of fatigue risk in future flight operations.

0184 Can Subjective Sleepiness Pre-flight Predict the Use of Controlled Rest on the Flight Deck?

Abstract Introduction Pilot sleepiness in flight continues to be an issue in aviation due to irregular and extended working hours. In some regions of the world, pilots are allowed to use an in-flight countermeasure called controlled rest, which involves taking a short nap on the flight deck. The use of this countermeasure in practice is understudied. We aimed to investigate whether subjective sleepiness ratings taken pre-flight are predictive of controlled rest use. Methods Data from 94 long (> 6 hours flight duration), non-augmented (two flight crewmembers) flights were analyzed (n = 30 pilots). Mixed-effects logistic regression was used to assess the likelihood of controlled rest based on a Karolinska Sleepiness Scale rating (KSS) taken at pre-flight. Results Controlled rest was taken on 62.77% (n = 59) of the analyzed flights. Pilots with higher KSS ratings (i.e., subjectively sleepier) pre-flight were more likely to take controlled rest during the subsequent flight (b ± SE: 1.03 ± 0.33; OR = 2.81, 95% CI [1.47, 5.37]; p = .002; R2 (Marginal): .28, R2 (Conditional): .51). That is, for every one-unit increase in KSS ratings, there was a near three-fold increase in the odds of taking controlled rest in flight. Conclusion Our results suggest that subjective sleepiness prior to a flight may be predictive of the decision to take controlled rest later in the flight. Further research is needed to understand the influence of other scheduling factors and individual differences. Support (if any) NASA Airspace Operations and Safety Program, System-Wide Safety Project.

Crush Injury and Simulated Flight Effects on Muscle Gene Expression in Female Mice.

Aeromedical evacuation provides critical care during long-distance transport of injured victims between medical facilities. Often, these victims sustain muscle trauma related to mechanical insults, such as crush. Understanding the effects of flight on injured muscle is important because the aircraft cabin represents an external environment with mild hypoxia-the cabin's altitude is 2,438 m instead of sea level. Because mild hypobaric hypoxia can alter gene expression in normal muscle and affect recovery patterns, it is beneficial to examine whether this type of hypoxia may also alter injury-related genes. The objective of this study was to verify the hypothesis that differential gene expression occurs in response to mild hypobaric hypoxia exposure in crush-injured muscle during two early recovery (preregeneration stage) time points. Twenty-four female mice were anesthetized, and the right gastrocnemius muscle underwent crush injury. Approximately 24 hours later, mice were exposed to normobaric normoxia or hypobaric hypoxia for 8-9 hours. After 32 or 48 hours of recovery, the mice were euthanized, and the right and left lateral gastrocnemius muscles were collected for microarray and bioinformatics analyses. The study hypothesis was verified. There were 353 highly upregulated, differentially expressed genes identified in the injured muscle compared to the uninjured muscle. Mid1 was upregulated in both pressure conditions regardless of injury status. There were 52 and 15 differentially expressed genes at 32 and 48 hours postinjury, respectively, in the hypobaric hypoxia-exposed, injured muscle compared to the normobaric normoxia-exposed, injured muscle. The macrophage gene Cd68 correlated with other leukocyte-related genes. These findings expand our understanding of the genetic changes that occur in muscle in response to a crush injury, including those related to the macrophage protein CD68. Nursing interventions addressing adequate functioning after crush muscle injury may need to consider the effects on Cd68 and its closely related genes. In addition, our results suggest a responsiveness of the gene Mid1 to flight-relevant hypobaric hypoxia. Changes in the expression of Mid1 may be appropriate in assessing the long-term health of flight crew members.

SYNBIO® Probiotic and Antioxidant Dietary Supplementation: Clinical Trial Evaluation of Potential Effects on Airline Flight Crew Members' Well-Being.

The irregular lifestyle of airline crew members, wide/adverse job-related exposures, and the impact of temporary hypoxia on gut microbiota well-being have increased concern about the daily recommended dose of certain nutrients among flight crew. The aim of this study was to determine if daily consumption of a SYNBIO® probiotics-elderberry extract supplement (ACTIVE) may contribute to the well-being of flight attendants. Forty healthy crew members enrolled in a double-blind, randomized, placebo-controlled study consumed one ACTIVE capsule/day or placebo for 30 days. Bowel well-being, health-related quality of life, and gastrointestinal tolerance were assessed by validated questionnaires. Saliva and fecal samples were analyzed to determine secretory immunoglobulin-A (sIgA) levels and to characterize gut microbiota composition, respectively. ACTIVE subjects presented a physiological improvement and a statistically significant higher Psychological General Well-Being Index (PGWBI) global score compared to PLACEBO subjects. The ACTIVE subjects showed significantly increased levels of lactobacilli and bifidobacteria compared to the PLACEBO group, while a significant increase in lactobacilli and a significant reduction in Enterobacteriaceae were registered when compared with the beginning of supplementation, confirming the persistence of probiotics in the gastrointestinal tract and the direct antagonism and competitive exclusion effects. Additionally, sIgA levels were significantly higher in the ACTIVE group compared to the baseline and to the PLACEBO group at the end of supplementation. The ACTIVE supplementation might be beneficial to airline crew members, improving their physiological state, their immune defenses, and the strength and efficiency of their gastrointestinal tract when responding to stressful conditions.

Development of a theoretical model of pilot decision making with conflicting information

AbstractThe advancement of technology on the modern commercial flight deck has allowed flight crew members to utilise multiple sources of information to maintain the safety of their flight. Having multiple sources of flight deck information, capable of displaying the same type of information, can lead to a situation in which a pilot encounters conflicting information. Understanding how a pilot makes a decision when faced with an information conflict on the flight deck is important to ensure appropriate design of flight-deck information systems and effective pilot training. This effort utilised data collected from 25 airline pilots who experienced information conflicts on a simulated B-737 flight deck, in conjunction with a theoretical review of how information conflicts impact decision making, to develop a theoretical model of pilot decision-making in the presence of an information conflict. This manuscript describes the model, along with the theory-driven and data-driven approaches utilised to develop the model.

Problems of hygienic regulation of working conditions in civil aviation and ways to solve them (literature review)

The analysis of the current and cancelled documents concerning the regulation of working conditions in civil aviation (CA) is carried out. There have been established significant factors of working environment and workload, their relationship with indicators of the health status of flight personnel, the development of fatigue and the risks of aviation accidents (AA) has been proved. The design of the study included a multifactorial analysis of the impact of working conditions on the functional state, occupational morbidity and accident rate of CA pilots with the establishment of a list of mandatory factors for rationing and control of the production environment and the labour process. The analysis of sanitary and hygienic characteristics of working conditions, health data was carried out based on the results of retrospective studies of the clinic of the Federal State Budgetary Scientific Institution “Izmerov Research Institute of Occupational Health”, publications indexed in the databases Scopus, Web of Science, RSCI and official statistical collections. Own experimental studies were conducted among one hundred twenty pilots of the case-control type, including the analysis of 10324 standard operating procedures for aircraft management, 59670 studies within the framework of psychophysiological testing, as well as the analysis of 83 AA. The necessity of adjusting the regulatory framework with the expansion of indicators for the normalization of working conditions in terms of the intensity of the labour process is proved. New criteria are proposed to be used for assessing information, intellectual, emotional loads, expanding the boundaries of sensory loads with the allocation of class 3.3 - according factors working load. Proposals have been developed to make additions to SP 2.5.3650-20 for flight crew members and air traffic controllers concerning requirements for all missed and obligatory factors of working conditions; a list of production factors obligatory for control during a special assessment of working conditions at the workplaces of aircraft crew members; new methodological documents relating to the assessment of indicators of the intensity of the labour process, the assessment of the personal risk of fatigue in pilots, conducting psychophysiological studies using a video oculograph, the procedure for conducting special assessment of working conditions, a general assessment of professional risks intended for the implementation of regulatory requirements.

How airline business models impact working conditions of flight crew members

This literature research investigates the working conditions, fatigue, mental health, and working conditions of pilots of network carriers (NWCs) and low-cost carriers (LCCs). According to the McKinsey 7S model, different management strategies entail different HRM practices and working conditions. This research paper provides a holistic overview of previous research by investigating the working conditions, actual rosters, stress levels, sleep problems, fatigue, ad mental health of LCC and NWC flight crew members. Basically, LCC pilots have lower income, younger age, less flight experience, more demanding rosters, more sleep difficulties, and experience more fatigue. Moreover, it seems that LCC working conditions are more related with anxiety due to insecure and atypical contractual conditions. Consequently, the research paper confirms that different management strategies result in different working conditions (e.g., atypical contracts, higher work-related stress, more job insecurity, different levels of fatigue, sleep problems, and potential impairment of mental health), consistently to the detriment of LCC pilots. Lastly, LCC pilots reported more safety issues and more fatigue-related incidents compared with NWC pilots.

Актуальные проблемы экспертизы профессиональной нейросенсорной тугоухости у пилотов гражданской авиации

Occupational hearing loss in the civilian flight crew members prevails in the structure of occupational hearing loss. The study was aimed to assess errors made in forensic evaluation of flight personnel with hearing loss. A total of 213 definitive diagnoses of occupational hearing loss established in 2015–2021 were assessed. Expert errors were found in 73% of cases. The most common, typical errors were reported that were evident in 12 cases submitted for forensic evaluation. The main errors were as follows: incorrect assessment of the parameters of noise inside the aircraft cabin, lack of knowledge about the clinical and audiological features of noise-induced hearing loss, incorrect assessment of audiological indicators, underestimation of the role of comorbidities, etc. The findings showed that high proportion of occupational hearing loss in the civilian flight crew members was in large part due to imperfection of expert solutions resulting from the lack of knowledge about the basic criteria of the diagnosis and the relationship between the noise-induced hearing loss and profession. The major requirements for evaluation of the relationship between the noise-induced hearing loss and profession and the issues related to professional suitability set out in the current regulatory documents issued by the Ministry of Health of the Russian Federation and seminal publications were not taken into account. The cornerstones of expert work on the issues of the relationship between the hearing organ disorder and profession in the civilian flight crew members were underestimated. This resulted in unsubstantiated professional unsuitability, disability among working-age people, and economic losses.

Social Network Analysis on the Mobility of Three Vulnerable Population Subgroups: Domestic Workers, Flight Crews, and Sailors during the COVID-19 Pandemic in Hong Kong.

Background: Domestic workers, flight crews, and sailors are three vulnerable population subgroups who were required to travel due to occupational demand in Hong Kong during the COVID-19 pandemic. Objective: The aim of this study was to explore the social networks among three vulnerable population subgroups and capture temporal changes in their probability of being exposed to SARS-CoV-2 via mobility. Methods: We included 652 COVID-19 cases and utilized Exponential Random Graph Models to build six social networks: one for the cross-sectional cohort, and five for the temporal wave cohorts, respectively. Vertices were the three vulnerable population subgroups. Edges were shared scenarios where vertices were exposed to SARS-CoV-2. Results: The probability of being exposed to a COVID-19 case in Hong Kong among the three vulnerable population subgroups increased from 3.38% in early 2020 to 5.78% in early 2022. While domestic workers were less mobile intercontinentally compared to flight crews and sailors, domestic workers were 1.81-times in general more likely to be exposed to SARS-CoV-2. Conclusions: Vulnerable populations with similar ages and occupations, especially younger domestic workers and flight crew members, were more likely to be exposed to SARS-CoV-2. Social network analysis can be used to provide critical information on the health risks of infectious diseases to vulnerable populations.

비행 임무에 따른 조종사 스트레스 차이에 대한 연구

This study is a study to analyze the stress difference of pilots according to the category of aircraft. According to previous studies, pilot stress is affected by several factors such as flight time, fatigue regulation, and operating environment, and it is known that stress also affects cardiac variability. In this paper, we analyzed that there is a difference in stress according to the operating environment through airline pilots and pilots of educational institutions, and then tested the difference in stress between airplane pilots and helicopter pilots. This study differs in that it is a study that has almost no empirical research on pilot fatigue and stress considering the role of flight crew members and operational conditions for each mission. If we expand and verify the sample of the results for the stress difference in the future, it will be a great contribution to practical aviation safety research in connection with the fatigue risk management system in the future.

Optimization of work and rest modes of flight crew members in order to improve flight safety in civil aviation

Introduction. The researchers carried out the analysis of work and rest modes (WRM) according to the survey data of 667 pilots and the results of investigations of 83 aviation accidents (AA) that occurred in the Russian Federation with heavy aircraft (HA) weighing more than 5,700 kg for the period 2010-2021. We also considered the data of official statistics for the period from 2005 to September 2021. The obtained results indicate the facts of non-compliance with the work and rest modes (WRM), which may be one of the causes of aviation accidents (AA). In this regard, it is relevant to optimize the work and rest modes in order to improve flight safety in civil aviation and organize their stricter control. The study aims to assess the impact of the actual compliance with the WRM of the crew members of the Civil Aviation Aircraft (CAA) on the occurrence of aviation accidents and to develop proposals for their optimization and control. Materials and methods. The authors studied a compliance of work and rest modes based on the results of 667 online questionnaires developed on the basis of recommendations of the International Civil Aviation Organization (ICAO) on the introduction of a risk management system in airlines related to pilot fatigue, and data from 83 aviation accidents (AA) for the period from 2010 to 2020, presented in the reports of the Interstate Aviation Committee (IAC) on the results of the investigation the causes of their occurrence. When assessing the relevance of the topic, we considered the data of official statistics. Results. The data of the study indicate that in 18% of cases, one of the main causes of AA was non-compliance with WRM. Among the causes of aviation accidents, the following are important: exceeding the norms of flight time for a month (detected in 10% of cases) and for a year (up to 30%); insufficient preflight rest (46.5% of aircraft commanders and 7.4% of co-pilots); lack of full-fledged vacation for a year (32% of cases). In many cases the Researchers revealed several facts of different violations of work and res modes simultaneously. Data of online questionnaire survey confirm the high prevalence of severe fatigue among pilots: 44% rarely have time to rest between flights, 86% go on a night flight shift without having a full day's sleep. We determined the interrelations between the frequency of fatigue of pilots associated with various types of violations of WRM and the risk of air crashes: the prevalence of fatigue and the frequency of disasters increased with a decrease in the duration of pre-flight rest, an increase in vacation arrears and other factors from 1.2 to 2.1 times. Conclusion. The results of the study confirm the high significance of WRM disorders in the occurrence of aviation accidents (AA). The researchers compiled a comprehensive program to reduce accidents in air transport associated with violations of WRM and the development of fatigue among crew members. We have provided proposals to amend the current Regulations on WRM. Ethics. Authors carried out the study in accordance with the International Code of Medical Ethics (1949) and the provisions of the Helsinki Declaration adopted by the World Medical Association (1964). When conducting an online questionnaire survey, before the start of the study, we have introduced all participants with the methodology of its conduct, associated risks and signed an informed voluntary consent.

A Survey of the Operational Environment and Regulations of Hospital Owned Helipads at Level I Trauma Centers

<h3>Introduction</h3> The Association of Air Medical Services (AAMS) estimates that 400,000 patients per year are transported by rotor wing aircraft. Despite the frequent utilization of air medical transport, little is known about the operational environment and regulations of hospital owned helipads. We sought to understand the environment and regulations of hospital helipads, hypothesizing that the majority of these facilities have strict rules regarding who may use their facilities and how aircraft approach and depart. <h3>Methods</h3> We developed a 23-item survey to explore the operational environment and regulations surrounding the use of helipads at level I trauma centers in the United States. Flight crew members and administration, as well as hospital administrators, were invited to complete a multiple choice and free text survey hosted by a secure online data collection tool. The survey was publicized through relevant professional organizations, social media, and individual invitation. Descriptive statistics were calculated. <h3>Results</h3> We received 138 responses and analyzed survey data for 87 adult and pediatric level I trauma centers representing 34 states after excluding surveys that did not name a specific center, level II trauma centers, and duplicates for a facility already enrolled. The mean (SD) number of helipads controlled by a center is 2 (1) with the majority (84%) being rooftop helipads. 17/87 (20%) of facilities require a formal agreement with a transport program prior to use of their helipad. Of that group, 8/17 (47%) indicate pre-specified consequences for violation of the agreement and 7/8 (88%) of those consequences include loss of landing privileges. A minority of facilities (9%) require CAMTS accreditation as a prerequisite for helipad use, and the most common restrictions in place are specific approach paths (67%), specific departure paths (64%) and aircraft type and weight restrictions (64%). 74/87 (85%) of facilities require 10-15 minute notification prior to arrival, while only 13/87 (15%) require notification prior to departure. <h3>Conclusion</h3> There is significant variation in the operational environment and regulations surrounding the use of hospital owned helipads at level I trauma centers, with a minority requiring formal agreement for use of the helipad or specifying repercussions for violation of the agreement.

Psychological features of emotional stability as a safety factor of air traffic specialists

The article presents the empirical study on emotional stability and other personal cognitive, emotional and volitional factors affecting flight activities performed by transport aviation personnel. Emotional stability mobilizes body functions for the successful performance of a particular activity; it correlates closely with patterns of behavior, strong-willed efforts aimed at this activity, i.e. it provides different emotional changes for the most adequate mobilization of air traffic specialists. That is, the reliability of air traffic specialists’ professional work depends on indicators of their emotional stability. The article purpose is to investigate empirically transport aviation personnel’ emotional stability depending on the indicators: thinking flexibility, neuroticism, behavioural patterns in a stressful situation, personal anxiety, resilience (psychological hardiness). In order to study air traffic control specialists’ emotional stability, we used the psychological examining techniques determining the characteristics of thinking flexibility, personal anxiety, behavioural patterns in stressful situations (behavioural types, adaptive strategies at stress, internal control in stress situations). Our study involved civil flight crew members and air traffic controllers. The obtained results allowed us to perform correlation analysis and comparative analysis using SPSS software package. The performed correlation analysis showed that emotional stability correlated with behavioural patterns in a stressful situation (r = 0.396, at p≤0.05) and personal anxiety (r = 0.404, at p≤0.05), which indicated the balance preservation in difficult situations, the ability to reconcile emotional experiences without suppressing them. The comparative analysis helped outline further research and prospects for aviation psychologists’ work to maintain air traffic control specialists psychological health.

English

BACKGROUND The flyers tooth or the tooth squeeze is the toothache during air travel, termed as Barodontalgia / Aerodontalgia by researchers. It was first identified as an in-flight physiologic and pathologic phenomenon at the start of the 20th century. With the introduction of the scuba in the 1940s, many in-flight manifestations caused by barometric variations were discovered to be synonymous with diving as well. Scuba diving is a type of underwater diving where the diver breathes underwater using equipment independent of the surface supply. It can be performed for fun or a living in various settings, including the scientific, army, and public security responsibilities. However, most commercial diving employs surface-supplied diving equipment wherever possible. Battle divers and assault swimmers are all terms for scuba divers who participate in clandestine military operations. Most cases of barodontalgia occur during ascent. The origin of the discomfort is also affected by the underlying pathology. In general, pain on the rise is associated with essential pulp disease, i.e., pulpitis and pain on descent with pulp necrosis. The pain subsides typically as the patient returns to the onset stage or the ground ambient level, although it can last longer if exacerbated by periapical infection. The Fédération dentaire internationale FDI advises that pilots, divers, and other professionals undergo yearly exams, as well as appropriate dental hygiene education from dentists, after a dental procedure that necessitates an anaesthetic or seven days after a dental procedure until travelling, teeth with pre-existing substantial restorations should have a cold-test examination or periapical radiographs taken to rule out occult pulp necrosis. It is appropriate to arrange outpatient dental appointments for a suitable period until the next scheduled flight. The possible treatment modalities vary from immediate relief to the control of infection and further subsequent treatment procedures. In recent years, the airline industry and scuba diving have grown in popularity, but little is known about the oral issues linked with high altitude. It is entirely the obligation of dental health experts to give the finest dental care to aviators as well as raise knowledge of the risks of dental treatments at higher altitudes. Dentists and flight crew members should both have appropriate awareness of barodontalgia and its role in its prevention. Particular attention should be given by the otolaryngologist and must be aware of the issues and hazards associated with scuba diving. KEY WORDS Aerodontalgia, Barodontalgia, Flyer's Tooth, Pulpitis; Scuba, Tooth Squeeze

Noncompliance and Decision-Making of Airline Pilots: An Analysis of Narratives From the Aviation Safety Reporting System

The purpose of this study was to identify self-reported flight deck noncompliance in aviation safety reports and explore the relationship between adaptive expertise, deliberate vs. non-deliberate actions (errors), and intentional vs. unintentional noncompliance. The heuristics for assessing adaptive thinking and behavior were based on subscales of the Adaptive Expertise Survey (AES; Fisher &amp; Peterson, 2001). We analyzed a random sample of 200 ASRS reports from 2019 and coded them with respect to (a) whether they described intentional or unintentional noncompliance by one or more flightcrew members, (b) whether the decision making was deliberate, and (c) whether the decision-making process involved correlates of adaptive or routine (non-adaptive) expertise. We found that unintentional noncompliance was associated most frequently with non-deliberate actions and non-adaptive behaviors. Adaptive behaviors were strongly associated with deliberate actions and intentional noncompliance. Our on-going research to investigate adaptive expertise and its relationship with predictors of noncompliance is discussed.

Medical Issues Associated with Winter Survival Training.

INTRODUCTION: During active phases of manned spaceflight there is a possibility of a spacecraft landing at any point traversed by its orbital path on the Earth. Survival training after emergency landing is an important and vital part of pre-mission preparations. In this paper we analyze medical issues associated with winter survival training in marshy and forested terrain.METHODS: From 2011 to 2019, 50 International Space Station crews participated in winter survival training. Crewmembers included Roscosmos, NASA, CSA, ESA, and JAXA astronauts, spaceflight participants, and instructors. Medical protocols and training final reports were analyzed for conditions and medical events.RESULTS: The health status of crewmembers during training was nominal. Temperature sensation was reported as comfortable or moderately cold during daytime and moderately cold or cold during nighttime. SpO₂ (blood oxygen saturation) and heart rate recorded during training did not exceed normal values. SpCO (blood carbon monoxide saturation) generally was within normal limits. All participating crewmembers lost some bodyweight, from 0.15.5 kg (average 2.1 kg). Over the course of winter survival training there were 32 medical and environmental events requiring medical intervention. For two of the crewmembers requiring medical intervention, training was subsequently canceled.DISCUSSION: Winter survival training has successfully prepared spaceflight crews for the possibility of off-nominal landings in challenging terrain under adverse conditions. As this training involves high fidelity flight-like survival equipment and assigned flight crewmembers, the medical problems described here should closely reflect type and prevalence of events during an actual contingency scenario.Kireev KS, Grishin AP, Dowell GL. Medical issues associated with winter survival training. Aerosp Med Hum Perform. 2021; 92(8):676680.