Optimal port locations for endoscopic intracorporeal knotting

Port location is crucial for endoscopic manipulations. The aim of the study was to investigate the influence of manipulation, azimuth, and elevation angles of instruments on endoscopic intracorporeal knotting. The standard task was tying a surgeon's knot. Manipulation angles of 30°, 45°, 60°, 75°, and 90° with equal and unequal azimuth angles and elevation angles of 0°, 30°, and 60° were investigated. The endpoints were the execution time and parameters of knot analysis. The execution time was shorter with 60° than with either 90° or 30° manipulation angles (p < 0.0001 and p < 0.01). Equal azimuth angles resulted in a shorter execution time than wide unequal angles (p < 0.001). A combination of 60° manipulation angle with 60° elevation angle had the shortest execution time (p < 0.001) and highest performance quality score (p < 0.02). A range of 45°–75° manipulation angles with equal azimuth angles is recommended. As the manipulation angle increases, the elevation angle has to increase accordingly. Received: 23 July 1996/Accepted: 4 October 1996     

汽车驾驶员神经行为功能与行车事故研究

本文应用世界卫生组织神经行为核心测试组合（ＷＨＯ。ＮＣＴＢ）对１２５名汽车驾驶员（事故组８５人，无事故组４０人）及５１名对照人员进行了神经行为功能测试。结果显示：事故组驾驶员中明显存在紧张－焦虑、疲劳－惰性不良情绪状态；事故组驾驶员与无事故组及对照组相比，其六项神经行为功能，尤其是注意力、反应速度和感知－运动速度较差；但在无事故组驾驶员中尚未发现明显不良情绪和神经行为功能状态存在；汽车驾驶员的神经行为功能随年龄增大而减弱，随文化水平提高而增强，并与其造成的行车事故之间存在着显著的负性作用。结果提示：神经行为功能测试可做为汽车驾驶员行车事故研究指标并用于职业选择和培训；严格从心理－生理、文化水平和从业年限方面挑选心身健康的优秀驾驶员，以预防和减少交通事故。     

“If they had a place to live,they would be taking medication”: a qualitative study identifying strategies for engaging street-connected young people in the HIV prevention-care continuum in Kenya

Introduction

Street-connected young people (SCY) experience structural and social barriers to engaging in the HIV prevention-care continuum. We sought to elicit recommendations for interventions that may improve SCY's engagement along the HIV prevention-care continuum from healthcare providers, policymakers, community members and SCY in Kenya.

Methods

This qualitative study was conducted in Uasin Gishu, Trans Nzoia, Bungoma, Nakuru and Kitale counties in Kenya between May 2017 and September 2018 to explore and describe the public perceptions of, and proposed and existing responses to, the phenomenon of SCY. This secondary analysis focuses on a subset of data interviews that investigated SCY's healthcare needs in relation to HIV prevention and care. We conducted 41 in-depth interviews and seven focus group discussions with 100 participants, of which 43 were SCY. In total, 48 participants were women and 52 men.

Results

Our analysis resulted in four major themes corresponding to stages in the HIV prevention-care continuum for key populations. We identified the need for an array of strategies to engage SCY in HIV prevention and testing services that are patient-centred and responsive to the diversity of their circumstances. The use of pre-exposure prophylaxis was a biomedical prevention strategy that SCY and healthcare providers alike stressed the need to raise awareness around and access to for SCY. Several healthcare providers suggested peer-based approaches for engaging SCY throughout the continuum. However, SCY heavily debated the appropriateness of using peer-based methods. Structural interventions, such as the provision of food and housing, were suggested as strategies to improve antiretroviral therapy adherence.

Conclusions

This study identified contextually relevant interventions that should be adapted and piloted for use with SCY. Education and sensitization of SCY and healthcare providers alike were identified as possible strategies, along with affordable housing and anti-poverty strategies as cash transfers and provision of food. Peer-based interventions are a clear option but require SCY-specific adaptation to be implemented effectively.     

高原环境对汽车兵注意力的影响

目的 通过比较驻守不同海拔汽车兵注意力的差异,探讨高海拔组汽车兵注意力受损的主要影响因素,为客观评价高原汽车兵的注意力提供实证依据。方法 以高海拔（2 900 m）的196名汽车兵和中海拔（2 200 m）的190名汽车兵为研究对象,同时选取低海拔（100 m以下）192名汽车兵为对照组,采用华东师范大学科教仪器厂生产的注意集中测量仪（EP701C）、注意分配测量仪（EP708A）评估个体注意力。应用χ²检验、方差分析、LSD-t检验、非参数检验等统计学方法进行数据分析。结果 参与本次问卷调查和心理测量的汽车兵共600名,收回符合要求的测量表578份,有效回收率为96.33%,其中高海拔组196名、中海拔组190名、对照组192名。对3种声音选择反应测量中,高海拔组汽车兵对声音反应正确次数少于中海拔组（P<0.01）和对照组（P<0.01）;高海拔组选择声反应时长于中海拔组（P<0.05）和对照组（P<0.01）,且中海拔组选择声反应时也长于对照组（P<0.05）。注意力分配测量中,高海拔组、中海拔组注意声音正确次数均少于对照组（P<0.01,P<0.05）;高海拔组注意声反应时长于中海拔组（P<0.05）和对照组（P<0.01）,且中海拔组注意声反应时也长于对照组（P<0.05）;高海拔组注意光反应时长于中海拔组（P<0.05）和对照组（P<0.01）,且中海拔组注意光反应时也长于对照组（P<0.05）。注意集中能力测量中,高海拔组在轨时间长于对照组（P<0.01）,脱靶次数在3组之间差异无统计学意义（P>0.05）。结论 高原环境对汽车兵选择反应时、注意分配能力均有不利影响,且表现为海拔越高受损越严重;但长期的高原环境汽车驾驶训练可促进高原汽车兵的注意集中能力。     

A novel COVID-19 based truck driver syndemic? Implications for public health,safety, and vital supply chains

U.S. long-haul truck drivers traverse great distances and interact with numerous individuals, rendering them vulnerable to acquiring and transmitting coronavirus disease 2019 (COVID-19). Together, the unique co-occurrence of pronounced health disparities and known COVID-19 infection, morbidity, and mortality risks suggest the possibility of a novel COVID-19 based truck driver syndemic due to advanced driver age and endemic health issues. In turn, COVID-19 sequelae may perpetuate existing health disparities. The co-occurrence of afflictions may also result in compromised safety performance. To curb the likelihood of a COVID-19 based truck driver syndemic, several action stepsare needed. First, key COVID-19 metrics need to be established for this population. Second, relationships between long-haul trucker network attributes and COVID-19 spread need to bedelineated. Third, mutually reinforcing interactions between endemic health disparities and COVID-19 vulnerability need to be elucidated. Finally, grounded in the aforementioned steps, policies and interventions need to be identified and implemented.     

Psychosocial risk factors at work associated with the level of physical activity among motorcycle taxi drivers

Abstract

Objective: To analyze the association of psychosocial risk factors at work, sociodemographic, and occupational characteristics with the level of physical activity among motorcycle taxi drivers.

Methods: Cross-sectional study with 750 male motorcycle taxi drivers from the municipality of Jequié, Bahia, Brazil. A form containing sociodemographic and occupational characteristics was utilized. The psychosocial risk factors at work were evaluated by the Job Content Questionnaire and the level of physical activity by the International Physical Activity Questionnaire. The adjusted associations were analyzed by means of the Poisson regression with robust variance. Results: the prevalence of an insufficiently active level of physical activity was of 59.6%. The crude prevalence ratios (PR) showed an association between physical inactivity in motorcycle taxi drivers and high strain job (PR: 1.31), with 5 or more years of experience (PR: 1.67), in night shifts (PR: 1.36) and 40 or more years old (PR: 1.77). In the multivariate model, adjusted by income, work in high strain is kept associated to a situation of being insufficiently active (PR: 1.13), duration of employment of five or more years raised by 51.0% the frequency of insufficiently active physical activity (PR: 1.51) and the work in predominantly nocturnal shifts increased it by 26.0% (PR: 1.26). It is made evident that age was an effect modifier (p?<?0.001) and its interaction was evaluated by including the corresponding product term (job Demand–Control model), which shows that the association between highly straining work and being insufficiently active was observed only among the youngest (21–39?years old) (PR: 1,21).

Conclusions: the age and exposure to unfavorable working conditions, like long duration of employment, night work and work under high psychological demand and low control, have an influence on the insufficient physical activity among motorcycle taxi drivers.     

A qualitative study of migrant-related stressors,psychosocial outcomes and HIV risk behaviour among truck drivers in Zambia

Truck drivers are part of mobile populations which have been noted as a key population at risk of HIV in Zambia. This study was aimed at: (1) determining potentially traumatic events (PTEs), labour migrant-related stressors, psychosocial problems and HIV risk behaviours among truck drivers in Zambia; and (2) examining the relationship between PTEs, migrant-related stressors, psychosocial outcomes and HIV sexual risk behaviour among truck drivers in Zambia. We conducted 15 semi-structured interviews with purposively sampled male truck drivers at trucking companies in Lusaka, Zambia. Findings indicate that truck drivers experience multiple stressors and potentially traumatic incidences, including delays and long waiting hours at borders, exposure to crime and violence, poverty, stress related to resisting temptation of sexual interactions with sex workers or migrant women, and job-related safety concerns. Multiple psychosocial problems such as intimate partner violence, loneliness, anxiety and depression-like symptoms were noted. Transactional sex, coupled with inconsistent condom use, were identified as HIV sexual risk behaviours. Findings suggest the critical need to develop HIV-prevention interventions which account for mobility, potentially traumatic events, psychosocial problems, and the extreme fear of HIV testing among this key population.     

医院水、电、氧气表智能采集与管理系统的设计与实现

目的：研制开发一种适用于医院内网环境下的科室水、电、氧气表采集与管理系统,并提供与＂军卫一号＂成本核算软件的接口,做到成本录入准确、非人为化。方法：终端设备采用带有RS-485远传接口的水、电、氧气表,将每个独立核算科室的所有远传仪表接入到一个或一组串口服务器中,通过自己编写的底层通讯、数据采集软件将定期采集到的所有设备数据发送并存储到一个或多个建立于＂军卫一号＂数据库平台的专用数据表当中供访问。结果：已经实际应用到医院新住院大楼并达到预期效果。结论：通过利用串口服务器将分散的设备及数据汇合到医院局域网中,这一设备接口模式具有很广泛的应用空间和发展前景。     

Self-reported difficulty and preferences of wheeled mobility device users for simulated low-floor bus boarding,interior circulation and disembarking

Background: Low ridership of public transit buses among wheeled mobility device users suggests the need to identify vehicle design conditions that are either particularly accommodating or challenging. The objective of this study was to determine the effects of low-floor bus interior seating configuration and passenger load on wheeled mobility device user-reported difficulty, overall acceptability and design preference.

Methods: Forty-eight wheeled mobility users evaluated three interior design layouts at two levels of passenger load (high vs. low) after simulating boarding and disembarking tasks on a static full-scale low-floor bus mockup.

Results: User self-reports of task difficulty, acceptability and design preference were analyzed across the different test conditions. Ramp ascent was the most difficult task for manual wheelchair users relative to other tasks. The most difficult tasks for users of power wheelchairs and scooters were related to interior circulation, including moving to the securement area, entry and positioning in the securement area and exiting the securement area. Boarding and disembarking at the rear doorway was significantly more acceptable and preferred compared to the layouts with front doorways.

Conclusion: Understanding transit usability barriers, perceptions and preferences among wheeled mobility users is an important consideration for clinicians who recommend mobility-related device interventions to those who use public transportation.

• Implications for Rehabilitation

• In order to maximize community participation opportunities for wheeled mobility users, clinicians should consider potential public transit barriers during the processes of wheelchair device selection and skills training.

• Usability barriers experienced by wheeled mobility device users on transit vehicles differ by mobility device type and vehicle configurations.

• Full-scale environment simulations are an effective means of identifying usability barriers and design needs in people with mobility impairments and may provide an alternative model for determining readiness for using fixed route buses or eligibility for paratransit.