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Nakdimon I, Gordon B, Assa A, Ben-Ari O. Simulator sickness among helicopter pilots: Incidence, threshold and severity using the SSQ. J Vestib Res 2024:VES230111. [PMID: 39150839 DOI: 10.3233/ves-230111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/18/2024]
Abstract
BACKGROUND Flight simulators have an essential role in aircrew training. Occasionally, symptoms of motion sickness, defined as simulator sickness, develop during training sessions. The reported incidence of simulator sickness ranged widely in different studies. OBJECTIVE The aims of this study were to calculate the incidence of and to define a threshold value for simulator sickness among rotary-wing pilots using the validated Simulator Sickness Questionnaire (SSQ). METHODS CH-53 and UH-60 helicopter pilots, who trained in helicopter simulators in the Israeli Air Force, were asked to fulfill SSQ. A score of 20 in the SSQ was defined as the threshold for simulator sickness. Simulator sickness incidence and average SSQ were calculated. Correlations between age and simulator training hours to SSQ scores were analyzed. RESULTS A total of 207 rotary-wing aircrew participated in the study. Simulator sickness was experienced by 51.7% of trainees. The average SSQ score was 32.7. A significant negative correlation was found between age and SSQ score. CONCLUSIONS Simulator sickness was experienced by more than half of helicopter pilots. A score of 20 in the SSQ was found to be suitable as the threshold for this condition.
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Affiliation(s)
- Idan Nakdimon
- The Israeli Air Force Aeromedical Center, Tel-Hashomer, Ramat Gan, Israel
| | - Barak Gordon
- The Israeli Air Force Aeromedical Center, Tel-Hashomer, Ramat Gan, Israel
- Department of Military Medicine, Faculty of Medicine, The Hebrew University, Jerusalem, Israel
- Israeli Defense Forces Medical Corps, Tel-Hashomer, Ramat Gan, Israel
| | - Amit Assa
- The Juliet Keidan Institute of Pediatric Gastroenterology and Nutrition, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Oded Ben-Ari
- The Israeli Air Force Aeromedical Center, Tel-Hashomer, Ramat Gan, Israel
- Department of Military Medicine, Faculty of Medicine, The Hebrew University, Jerusalem, Israel
- Israeli Defense Forces Medical Corps, Tel-Hashomer, Ramat Gan, Israel
- The Adelson School of Medicine, Ariel University, Ariel, Israel
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Lorincz D, Drury HR, Smith DW, Lim R, Brichta AM. Aged mice are less susceptible to motion sickness and show decreased efferent vestibular activity compared to young adults. Brain Behav 2023; 13:e3064. [PMID: 37401009 PMCID: PMC10454360 DOI: 10.1002/brb3.3064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 04/13/2023] [Accepted: 05/03/2023] [Indexed: 07/05/2023] Open
Abstract
INTRODUCTION The efferent vestibular system (EVS) is a feedback circuit thought to modulate vestibular afferent activity by inhibiting type II hair cells and exciting calyx-bearing afferents in the peripheral vestibular organs. In a previous study, we suggested EVS activity may contribute to the effects of motion sickness. To determine an association between motion sickness and EVS activity, we examined the effects of provocative motion (PM) on c-Fos expression in brainstem efferent vestibular nucleus (EVN) neurons that are the source of efferent innervation in the peripheral vestibular organs. METHODS c-Fos is an immediate early gene product expressed in stimulated neurons and is a well-established marker of neuronal activation. To study the effects of PM, young adult C57/BL6 wild-type (WT), aged WT, and young adult transgenic Chat-gCaMP6f mice were exposed to PM, and tail temperature (Ttail ) was monitored using infrared imaging. After PM, we used immunohistochemistry to label EVN neurons to determine any changes in c-Fos expression. All tissue was imaged using laser scanning confocal microscopy. RESULTS Infrared recording of Ttail during PM indicated that young adult WT and transgenic mice displayed a typical motion sickness response (tail warming), but not in aged WT mice. Similarly, brainstem EVN neurons showed increased expression of c-Fos protein after PM in young adult WT and transgenic mice but not in aged cohorts. CONCLUSION We present evidence that motion sickness symptoms and increased activation of EVN neurons occur in young adult WT and transgenic mice in response to PM. In contrast, aged WT mice showed no signs of motion sickness and no change in c-Fos expression when exposed to the same provocative stimulus.
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Affiliation(s)
- David Lorincz
- School of Biomedical Sciences and PharmacyThe University of NewcastleCallaghanNew South WalesAustralia
| | - Hannah R. Drury
- School of Biomedical Sciences and PharmacyThe University of NewcastleCallaghanNew South WalesAustralia
| | - Doug W. Smith
- School of Biomedical Sciences and PharmacyThe University of NewcastleCallaghanNew South WalesAustralia
| | - Rebecca Lim
- School of Biomedical Sciences and PharmacyThe University of NewcastleCallaghanNew South WalesAustralia
| | - Alan M. Brichta
- School of Biomedical Sciences and PharmacyThe University of NewcastleCallaghanNew South WalesAustralia
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Parnell KJ, Pope KA, Hart S, Sturgess E, Hayward R, Leonard P, Madeira-Revell K. 'It's a man's world': a gender-equitable scoping review of gender, transportation, and work. ERGONOMICS 2022; 65:1537-1553. [PMID: 35467471 DOI: 10.1080/00140139.2022.2070662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 04/20/2022] [Indexed: 06/14/2023]
Abstract
The deeply embedded inequalities in gender which mark most contemporary societies have led to a world shaped by male perspectives. This world fails to accommodate adequately the needs and experiences of women: no more evident than in the transport sector, where a 'default male' perspective dominates the planning and policies that shape our roads, railways, airlines, and shipping. This paper argues that the ways in which masculinity infuses transport systems mean they are integral to debates on gender and work. They impact both the way women experience travel and their access to places of work. A multi-transport domain scoping study has been conducted to review the literature for key gender factors that influence the use of road, rail, aviation, and maritime transport modes. A multi-disciplinary approach is proposed which incorporates perspectives and methods from the social sciences that can help to foster Gender-Equitable Human Factors (GE-HF).Practitioner summary: This paper seeks to identify the gender issues related to transport and work. A scoping review provides key factors that detail how women are disadvantaged by current transport systems. It presents gaps in knowledge that future research needs to fill. Women must be included in key decisions within the transport sector.
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Affiliation(s)
- Katie J Parnell
- Human Factors Engineering, Transportation Research Group, Faculty of Engineering and Physical Sciences, University of Southampton, Southampton, UK
| | - Kiome A Pope
- Human Factors Engineering, Transportation Research Group, Faculty of Engineering and Physical Sciences, University of Southampton, Southampton, UK
| | - Sophie Hart
- Human Factors Engineering, Transportation Research Group, Faculty of Engineering and Physical Sciences, University of Southampton, Southampton, UK
| | - Erinn Sturgess
- Human Factors Engineering, Transportation Research Group, Faculty of Engineering and Physical Sciences, University of Southampton, Southampton, UK
| | - Rachel Hayward
- School of Electronics and Computer Science, University of Southampton, Southampton, UK
| | - Pauline Leonard
- School of Economic, Social and Political Sciences, University of Southampton, Southampton, UK
| | - Kirsten Madeira-Revell
- Human Factors Engineering, Transportation Research Group, Faculty of Engineering and Physical Sciences, University of Southampton, Southampton, UK
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Besnard S, Bois J, Hitier M, Vogt J, Laforet P, Golding JF. Motion Sickness Lessons from the Southern Ocean. Aerosp Med Hum Perform 2021; 92:720-727. [PMID: 34645552 DOI: 10.3357/amhp.5696.2021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND: The objectives were to assess the prevalence, severity, and medication taken, and to look for predictive factors in order to better identify characteristics of passengers at risk of motion sickness during transport from Hobart in Tasmania to the French polar stations in Antarctica. METHODS: There were 239 passengers who were surveyed over 4 yr with 4 round trips per year using the Motion Sickness Susceptibility Questionnaire (MSSQ), Simulator Sickness Questionnaire (SSQ), state-trait anxiety test (STAI-Trait and STAI-State), and general parameters (age, gender, number of trips, jet-lag, direction of the trip), medication, calculation of the distance of each passengers cabin to the center of gravity (CoG). RESULTS: While the passengers had a low intrinsic sensitivity to motion sickness (MSSQ), 94 reported at least one SSQ symptom of motion sickness, and 38 vomited. Five associated factors were discovered: greater initial sensitivity (MSSQ), anticipation of being ill, younger age, higher level of anxiety at midtrip, and greater distance from the CoG. Of the passengers, there were 54 who took anti-motion sickness medication at different times of the trip, however, these passengers experienced more nausea. This could be due to self-selection since they were more sensitive to motion sickness. CONCLUSION: We identified three predictive factors of motion sickness (greater intrinsic susceptibility, younger age, and greater cabin distance from the CoG). For preventive purposes, two associated factors of MS (anticipation of being ill, MSSQ score) were determined to classify three groups of risk of MS to improve passenger care during the trip. Besnard S, Bois J, Hitier M, Vogt J, Laforet P, Golding JF. Motion sickness lessons from the Southern Ocean. Aerosp Med Hum Perform. 2021; 92(9):720727.
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Cha YH, Golding J, Keshavarz B, Furman J, Kim JS, Lopez-Escamez JA, Magnusson M, Yates BJ, Lawson BD, Staab J, Bisdorff A. Motion sickness diagnostic criteria: Consensus document of the classification committee of the Bárány society. J Vestib Res 2021; 31:327-344. [PMID: 33646187 PMCID: PMC9249300 DOI: 10.3233/ves-200005] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We present diagnostic criteria for motion sickness, visually induced motion sickness (VIMS), motion sickness disorder (MSD), and VIMS disorder (VIMSD) to be included in the International Classification of Vestibular Disorders. Motion sickness and VIMS are normal physiological responses that can be elicited in almost all people, but susceptibility and severity can be high enough for the response to be considered a disorder in some cases. This report provides guidelines for evaluating signs and symptoms caused by physical motion or visual motion and for diagnosing an individual as having a response that is severe enough to constitute a disorder. The diagnostic criteria for motion sickness and VIMS include adverse reactions elicited during exposure to physical motion or visual motion leading to observable signs or symptoms of greater than minimal severity in the following domains: nausea and/or gastrointestinal disturbance, thermoregulatory disruption, alterations in arousal, dizziness and/or vertigo, headache and/or ocular strain. These signs and/or symptoms occur during the motion exposure, build as the exposure is prolonged, and eventually stop after the motion ends. Motion sickness disorder and VIMSD are diagnosed when recurrent episodes of motion sickness or VIMS are reliably triggered by the same or similar stimuli, severity does not significantly decrease after repeated exposure, and signs/symptoms lead to activity modification, avoidance behavior, or aversive emotional responses. Motion sickness/MSD and VIMS/VIMSD can occur separately or together. Severity of symptoms in reaction to physical motion or visual motion stimuli varies widely and can change within an individual due to aging, adaptation, and comorbid disorders. We discuss the main methods for measuring motion sickness symptoms, the situations conducive to motion sickness and VIMS, and the individual traits associated with increased susceptibility. These additional considerations will improve diagnosis by fostering accurate measurement and understanding of the situational and personal factors associated with MSD and VIMSD.
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Affiliation(s)
- Yoon-Hee Cha
- Department of Neurology, University of Minnesota, Minneapolis, MN, USA
| | - John Golding
- Psychology, School for Social Sciences, University of Westminster, London UK
| | - Behrang Keshavarz
- Toronto Rehabilitation Institute - University Health Network, Toronto, ON, Canada; Department of Psychology, Ryerson University, Toronto, ON, Canada
| | - Joseph Furman
- Department of Otolaryngology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Ji-Soo Kim
- Department of Neurology Seoul National University, Seoul, Republic of Korea
| | - Jose A Lopez-Escamez
- Department of Surgery, Division of Otolaryngology, Universidad de Granada, Granada, Spain.,Otology and Neurotology Group CTS495, Department of Genomic Medicine, Centre for Genomics and Oncology Research - Pfizer/Univ. de Granada/Junta de Andalucía (GENyO), PTS, Granada, Spain.,Department of Otolaryngology, Instituto de Investigación Biosanitaria ibs. GRANADA Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Måns Magnusson
- Department of Otorhinolaryngology, Lund University, Lund, Sweden
| | - Bill J Yates
- Department of Otolaryngology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Ben D Lawson
- Naval Submarine Medical Research Laboratory, Naval Submarine Base New London, Groton CT, USA
| | - Jeffrey Staab
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Alexandre Bisdorff
- Department of Neurology, Centre Hospitalier Emile Mayrisch, L-4005 Esch-sur-Alzette, Luxembourg
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Kitajima N, Sugita-Kitajima A. Ocular counter-rolling in scuba divers with motion sickness. Auris Nasus Larynx 2020; 48:214-220. [PMID: 32828593 DOI: 10.1016/j.anl.2020.08.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 07/29/2020] [Accepted: 08/03/2020] [Indexed: 01/10/2023]
Abstract
OBJECTIVE Motion sickness (MS) is a familiar condition to scuba divers. The purpose of this study was to compare otolith organ function of scuba divers who have MS to those without MS. METHOD Video-oculography (VOG) goggles were used to measure video ocular counter-roll (vOCR) in 50 healthy scuba divers with no vestibular pathology. Divers with MS (n = 30) had Graybiel motion sickness (GMS) scores of ≥1 point, and divers without MS (n = 20) had GMS scores of 0. Divers with MS also completed the Motion Sickness Susceptibility Questionnaire short form (MSSQs). For all divers, otolith-ocular function of both ears was tested separately via vOCR testing, which was performed during 30° head tilt. An R-L side asymmetry ratio for vOCR values (%OCRA) was compared to divers' static OCR. RESULTS MSSQs and %OCRA scores differed significantly (p<0.01and p<0.001, respectively) between divers with MS and divers without MS. Their %OCRA scores and severity of MS were significantly correlated. Female divers were more susceptible to MS. ROC analysis for %OCRA revealed that the AUC for divers with MS and divers without MS was 0.8967 (95% CI, 0.8114 to 0.9819), the specificity was 1.000, and the sensitivity was 0.700, with a cutoff value of 45.946. CONCLUSION Physiological differences between R-L otolith organ function could affect the severity and susceptibility to MS. Female hormones may also increase susceptibility to MS. Thus, MS may be a physiological phenomenon induced by functional ear differences in the absence of pathology. As MS is caused by multiple factors, otolaryngologists need to consider various causative factors beyond those related to otolith organ function in scuba divers with MS.
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Affiliation(s)
- Naoharu Kitajima
- Kitajima ENT Clinic, 1-15-15 Tagara Nerima-ku, Tokyo 179-0073, Japan; Department of Otolaryngology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan.
| | - Akemi Sugita-Kitajima
- Kitajima ENT Clinic, 1-15-15 Tagara Nerima-ku, Tokyo 179-0073, Japan; Department of Otolaryngology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa 216-8511, Japan
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Livingstone DM, Smith KA, Lange B. Scuba diving and otology: a systematic review with recommendations on diagnosis, treatment and post-operative care. Diving Hyperb Med 2017. [PMID: 28641322 DOI: 10.28920/dhm47.2.97-109] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Scuba diving is a popular recreational and professional activity with inherent risks. Complications related to barotrauma and decompression illness can pose significant morbidity to a diver's hearing and balance systems. The majority of dive-related injuries affect the head and neck, particularly the outer, middle and inner ear. Given the high incidence of otologic complications from diving, an evidence-based approach to the diagnosis and treatment of otic pathology is a necessity. We performed a systematic and comprehensive literature review including the pathophysiology, diagnosis, and treatment of otologic pathology related to diving. This included inner, middle, and outer ear anatomic subsites, as well as facial nerve complications, mal de debarquement syndrome, sea sickness and fitness to dive recommendations following otologic surgery. Sixty-two papers on diving and otologic pathology were included in the final analysis. We created a set of succinct evidence-based recommendations on each topic that should inform clinical decisions by otolaryngologists, dive medicine specialists and primary care providers when faced with diving-related patient pathology.
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Affiliation(s)
- Devon M Livingstone
- Division of Otolaryngology - Head and Neck Surgery, Department of Surgery, University of Calgary, 7th floor, 4448 Front Street SE, Calgary, Alberta, Canada, T3M 1M4,
| | - Kristine A Smith
- Division of Otolaryngology - Head and Neck Surgery, Department of Surgery, University of Calgary, Alberta, Canada
| | - Beth Lange
- Division of Otolaryngology - Head and Neck Surgery, Department of Surgery, University of Calgary, Alberta, Canada
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Zhou W, Wang J, Pan L, Qi R, Liu P, Liu J, Cai Y. Sex and Age Differences in Motion Sickness in Rats: The Correlation with Blood Hormone Responses and Neuronal Activation in the Vestibular and Autonomic Nuclei. Front Aging Neurosci 2017; 9:29. [PMID: 28261089 PMCID: PMC5309225 DOI: 10.3389/fnagi.2017.00029] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 02/03/2017] [Indexed: 11/13/2022] Open
Abstract
Many studies have demonstrated sex and age differences in motion sickness, but the underlying physiological basis is still in controversy. In the present study, we tried to investigate the potential correlates of endocrine and/or neuronal activity with sex and age differences in rats with motion sickness. LiCl-induced nausea symptom was evaluated by conditioned gaping. Motion sickness was assessed by measurement of autonomic responses (i.e., conditioned gaping and defecation responses), motor impairments (i.e., hypoactivity and balance disturbance) after Ferris wheel-like rotation, and blood hormone levels and central Fos protein expression was also observed. We found that rotation-induced conditioned gaping, defecation responses and motor disorders were significantly attenuated in middle-aged animals (13- and 14-month-age) compared with adolescents (1- and 2-month-age) and young-adults (4- and/or 5-month-age). LiCl-induced conditioned gapings were also decreased with age, but was less pronounced than rotation-induced ones. Females showed greater responses in defecation and spontaneous locomotor activity during adolescents and/or young-adult period. Blood adrenocorticotropic hormone and corticosterone significantly increased in 4-month-old males after rotation compared with static controls. No significant effect of rotation was observed in norepinephrine, epinephrine, β-endorphin and arginine-vasopressin levels. The middle-aged animals (13-month-age) also had higher number of rotation-induced Fos-labeled neurons in the spinal vestibular nucleus, the parabrachial nucleus (PBN), the central and medial nucleus of amygdala (CeA and MeA) compared with adolescents (1-month-age) and young-adults (4-month-age) and in the nucleus of solitary tract (NTS) compared with adolescents (1-month-age). Sex difference in rotation-induced Fos-labeling was observed in the PBN, the NTS, the locus ceruleus and the paraventricular hypothalamus nucleus at 4 and/or 13 months of age. These results suggested that the sex and age differences in motion sickness may not correlate with stress hormone responses and habituation. The age-dependent decline in motion sickness susceptibility might be mainly attributed to the neuronal activity changes in vestibulo-autonomic pathways contributing to homeostasis regulation during motion sickness.
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Affiliation(s)
- Wei Zhou
- Department of Nautical Injury Prevention, Faculty of Navy Medicine, Second Military Medical University, Shanghai China
| | - Junqin Wang
- Department of Nautical Injury Prevention, Faculty of Navy Medicine, Second Military Medical University, Shanghai China
| | - Leilei Pan
- Department of Nautical Injury Prevention, Faculty of Navy Medicine, Second Military Medical University, Shanghai China
| | - Ruirui Qi
- Department of Nautical Injury Prevention, Faculty of Navy Medicine, Second Military Medical University, Shanghai China
| | - Peng Liu
- Department of Nautical Injury Prevention, Faculty of Navy Medicine, Second Military Medical University, Shanghai China
| | - Jiluo Liu
- Department of Nautical Injury Prevention, Faculty of Navy Medicine, Second Military Medical University, Shanghai China
| | - Yiling Cai
- Department of Nautical Injury Prevention, Faculty of Navy Medicine, Second Military Medical University, Shanghai China
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Krueger WWO. Controlling motion sickness and spatial disorientation and enhancing vestibular rehabilitation with a user-worn see-through display. Laryngoscope 2011; 121 Suppl 2:S17-35. [PMID: 21181963 DOI: 10.1002/lary.21373] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVES/HYPOTHESES An eyewear mounted visual display ("User-worn see-through display") projecting an artificial horizon aligned with the user's head and body position in space can prevent or lessen motion sickness in susceptible individuals when in a motion provocative environment as well as aid patients undergoing vestibular rehabilitation. In this project, a wearable display device, including software technology and hardware, was developed and a phase I feasibility study and phase II clinical trial for safety and efficacy were performed. STUDY DESIGN Both phase I and phase II were prospective studies funded by the NIH. The phase II study used repeated measures for motion intolerant subjects and a randomized control group (display device/no display device) pre-posttest design for patients in vestibular rehabilitation. METHODS Following technology and display device development, 75 patients were evaluated by test and rating scales in the phase II study; 25 subjects with motion intolerance used the technology in the display device in provocative environments and completed subjective rating scales, whereas 50 patients were evaluated before and after vestibular rehabilitation (25 using the display device and 25 in a control group) using established test measures. RESULTS All patients with motion intolerance rated the technology as helpful for nine symptoms assessed, and 96% rated the display device as simple and easy to use. Duration of symptoms significantly decreased with use of the technology displayed. In patients undergoing vestibular rehabilitation, there were no significant differences in amount of change from pre- to posttherapy on objective balance tests between display device users and controls. However, those using the technology required significantly fewer rehabilitation sessions to achieve those outcomes than the control group. CONCLUSIONS A user-worn see-through display, utilizing a visual fixation target coupled with a stable artificial horizon and aligned with user movement, has demonstrated substantial benefit for individuals susceptible to motion intolerance and spatial disorientation and those undergoing vestibular rehabilitation. The technology developed has applications in any environment where motion sensitivity affects human performance.
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Kuhn S, Hui C. STATEMENT ON PEDIATRIC TRAVELLERS: Committee to Advise on Tropical Medicine and Travel. CANADA COMMUNICABLE DISEASE REPORT = RELEVE DES MALADIES TRANSMISSIBLES AU CANADA 2010; 36:1-31. [PMID: 31701957 PMCID: PMC6802455 DOI: 10.14745/ccdr.v36i00a03] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Abstract
With focused pretravel counseling and intervention, travelers can be prepared to avoid many risks of in-flight problems. Travel medicine practitioners can include appropriate guidance for in-flight health and safety in discussions during pretravel visits.
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Affiliation(s)
- Muhammad R Sohail
- Division of Infectious Disease, Department of Medicine, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN 55905, USA
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Affiliation(s)
- Craig R Sherman
- Medical Director, Hope Pharmaceuticals, Scottsdale, Arizona 85260, USA
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