Assessing environmental sustainability in top Middle East travel destinations: insights on the multifaceted roles of air transport amidst other energy indicators

The Middle Eastern region is well-known for its flourishing tourism industry as the aviation sector contributes over US$213 billion to the regional GDP while air transport-related activities account for over 3.3 million jobs. Howbeit, the environmental impacts of this flourishing industry remain questionable. Hence, this study examines the tourism-emissions nexus in the Middle Eastern region from the perspective of air transportation while underscoring the multifaceted roles of major indicators like globalization, income, and energy use in the region. The empirical analysis of data spanning from 1975 to 2018 was conducted with advanced panel data analytical approach using the CS-ARDL technique. The sample selection was guided by available statistics on international tourist arrivals from the United Nations World Tourism Organization (UNWTO 2020), with a focus on the case of the five leading travel destinations in the region including Saudi Arabia, the United Arab Emirates (UAE), Egypt, Oman, and Qatar. The robustness of the evaluated outputs was checked after which result-based policy suggestions were enunciated for authorities and other regional stakeholders. The analysis indicated that air transportation although boosting tourism has constituted significant detrimental environmental impacts on the reviewed destinations with an estimated long-run elasticity of ∼1.03. Additionally, while the trio of globalization, energy utilization, and income expansion exacerbate environmental degradation, the lowest carbon-triggering magnitude was observed from the regional income expansion. Thus, while the aviation sector facilitates the growing quest to diversify from a primary sector-based economy (mainly resources exploitation) to other prospective service industries like tourism, the study posits the need for authorities to put measures in place to address the environmental side effect of air transportation.

Swedish civil air traffic control dataset

The Swedish Civil Air Traffic Control (SCAT) dataset consists of 13 weeks of data collected from the area control in Sweden flight information region. The dataset consists of detailed data from almost 170,000 flights as well as airspace data and weather forecasts. The flight data includes system updated flight plans, clearances from air traffic control, surveillance data and trajectory prediction data. Each week of data is continuous but the 13 weeks are spread over one year to provide variations in weather and seasonal traffic patterns. The dataset does only include scheduled flights not involved in any incident reports. Sensitive data such as military and private flight has been removed. The SCAT dataset can be useful for any research related to air traffic control, e.g. analysis of transportation patterns, environmental impact, optimization and automation/AI.

The state of Africa's air transport market amid COVID-19, and forecasts for recovery

The COVID-19 pandemic has raised air transport stakeholders' concerns about the state of the market, the potential timing of recovery, and recouping long-haul traffic. Passengers' travel confidence must be restored, and air travel safety awareness raised. This paper estimates the immediate and long-term effects of COVID-19 on air transport markets and forecasts timescales for recovery of the markets for domestic and international flights in nine African countries. Intervention analysis and SARIMAX are employed for the analysis, using monthly time-series data from August 2003 to December 2021. The empirical results show that air transport is significantly elastic to the pandemic. It is forecast that air transport recovery may take around 28 months for domestic flights and 34 months for international flights, starting from 2020. The simulation analysis suggests that passenger flights may rebound to pre-crisis levels between 2022 and 2023. In general, the pandemic-induced fluctuations in the aviation market and the nature of the rebound may be considered to be part of a cyclical process rather than a structural change.

Asymmetric impact of transportation on carbon emissions influencing SDGs of climate change

Transportation facilities have expanded globally because of rapid industrialization and economic growth. Transportation involves substantial use of energy therefore strongly linked with environmental pollution. This study intends to explore linkages among transport from air mode, combustible renewable energy and waste, GDP, energy use, oil prices, trade expansion, and carbon releases from airline transport. The data covered in the study ranged from 1971 to 2021. For the empirical analysis, the non-linear autoregressive distributed lag (NARDL) methodology has been applied in order to explore the asymmetric impact of the variables of interest. Prior to this, the augmented Dickey-Fuller (ADF) unit root test is applied whose results demonstrate that variables included in the model contain mixed order of integration. The NARDL estimates show that the "positive shock to air transport and positive and negative shock to energy usage results in the increase of CO₂ emissions per capita in the long run. While, a "positive (negative) shock" to renewable energy use and trade expansion reduces (increases) transport-related carbon discharge. The Error Correction Term (ECT) carries a negative sign implying a stability adjustment in the long run. These asymmetric components in our study can be employed in cost-benefit analysis and encompass the environmental repercussions (asymmetric) of government and management actions. The study suggests that the government of Pakistan should promote financing for renewable energy consumption and clean trade expansion to achieve the sustainable development goals (SDGs) objective 13.

Effect of prevailing winds and land use on Alternaria airborne spore load

Alternaria spores are a common component of the bioaerosol. Many Alternaria species are plant pathogens, and their conidia are catalogued as important aeroallergens. Several aerobiological studies showing a strong relationship between concentrations of airborne spore and meteorological parameters have consequently been developed. However, the Alternaria airborne load variation has not been thoroughly investigated because it is difficult to assess their sources, as they are a very common and widely established phytopathogen. The objective of this study is to estimate the impact of vegetation and land uses as potential sources on airborne spore load and to know their influence, particularly, in cases of long-medium distance transport. The daily airborne spore concentration was studied over a 5-year period in León and Valladolid, two localities of Castilla y León (Spain), with differences in their bioclimatic and land use aspects. Moreover, the land use analysis carried out within a 30 km radius of each monitoring station was combined with air mass data in order to search for potential emission sources. The results showed a great spatial variation between the two areas, which are relatively close to each other. The fact that the spore concentrations recorded in Valladolid were higher than those in León was owing to prevailing winds originating from large areas covered by cereal crops, especially during the harvest period. However, the prevailing winds in León came from areas dominated by forest and shrubland, which explains the low airborne spore load, since the main Alternaria sources were the grasslands located next to the trap. Furthermore, the risk days in this location presented an unusual wind direction. This study reveals the importance of land cover and wind speed and direction data for establishing potential airborne routes of spore transport in order to improve the Alternaria forecasting models. The importance of conducting Alternaria aerobiological studies at a local level is also highlighted.

Pilot Study on Annual Horse Movements by Air and the Possible Effect of the Covid-19 Pandemic

There is a lack of information on the number of horses shipped globally by air annually, the purpose of air travel and the routes of their journeys. This pilot study aimed to collect retrospective data on the international movements of horses by air from 2018 to 2021, describe their routes, and identify the possible effects of the coronavirus SARS-CoV-2 (COVID-19) pandemic. Equine transport data was gathered from 7 of 15 international shipping companies (ISCs) and 5 of 8 airlines contacted by email. The seven ISCs performed a median of 10,401 horse movements annually, ranging from a few hundred to several thousand movements per company, most frequently in Europe (Western and Northern Europe), Middle East/Africa (Middle East, Southern Africa), Asia Pacific (Australia), and the Americas (North and South America). The five airlines performed a median of 10,656 horse movements annually, importing and exporting horses to and from Europe, North America, Australasia, and the Middle East. For all but one airline, the number of horse movements decreased in 2020. The number and journey characteristics of horses transported by air require further scientific studies focused on the epidemiological and welfare risks unique to this type of transport to enable the development and implementation of best practices and regulations based on objective evidence.

[«Management of nurses specialized in the aero-evacuation of highly infectious critical patients, during the COVID-19 pandemic. Systematic review»]

Introduction

Aeromedical evacuation missions to transport highly infectious critical COVID-19 patients involve multiple factors, therefore planning is essential in their preparation. The management of specialist nurses is cross-cutting, as they participate in the planning, organisation and implementation of aero-evacuation protocols, delivery of care and operational safety procedures throughout the operation, with an integrated aeromedical crew working as a team alongside the air crew.

Objective

To study the management of nurses specialised in the aero-evacuation of highly infectious critical patients during the COVID-19 pandemic.

Design

Through a systematic search of the biomedical literature, this study was conducted according to the standards of the Cochrane Handbook for Systematic Reviews of Interventions and PRISMA. The literature search included articles published from 2019 to August 2020 and meta-search engines, yielding a total of 142 articles, and a triangulation of information was performed. A total of 11 articles were eventually included in the review, and the validity of each article was determined according to the guidelines of the Joanna Briggs Institute level of evidence.

Results and discussion

The systematic review identified 11 studies that use different methodological considerations for conducting an aeromedical evacuation and covering key aspects for a successful operation.

Conclusion

The management of specialist nurses has a direct impact on the aeromedical evacuation of the critical patient. It covers planning, organisation, and operational safety, applied in the instruction, training, execution and strict monitoring of the work of the aeromedical crew as a solid team. This contributes to the success of the aero-evacuation mission and the infectious patient's high likelihood of survival during the COVID-19 pandemic.

«Management of nurses specialized in the aero-evacuation of highly infectious critical patients, during the COVID-19 pandemic. Systematic review»

INTRODUCTION

Aeromedical evacuation missions to transport highly infectious critical COVID-19 patients involve multiple factors, therefore planning is essential in their preparation. The management of specialist nurses is cross-cutting, as they participate in the planning, organisation and implementation of aero-evacuation protocols, delivery of care and operational safety procedures throughout the operation, with an integrated aeromedical crew working as a team alongside the air crew.

OBJECTIVE

To study the management of nurses specialised in the aero-evacuation of highly infectious critical patients during the COVID-19 pandemic.

DESIGN

Through a systematic search of the biomedical literature, this study was conducted according to the standards of the Cochrane Handbook for Systematic Reviews of Interventions and PRISMA. The literature search included articles published from 2019 to August 2020 and meta-search engines, yielding a total of 142 articles, and a triangulation of information was performed. A total of 11 articles were eventually included in the review, and the validity of each article was determined according to the guidelines of the Joanna Briggs Institute level of evidence.

RESULTS AND DISCUSSION

The systematic review identified 11 studies that use different methodological considerations for conducting an aeromedical evacuation and covering key aspects for a successful operation.

CONCLUSION

The management of specialist nurses has a direct impact on the aeromedical evacuation of the critical patient. It covers planning, organisation, and operational safety, applied in the instruction, training, execution and strict monitoring of the work of the aeromedical crew as a solid team. This contributes to the success of the aero-evacuation mission and the infectious patient's high likelihood of survival during the COVID-19 pandemic.

Prevention of pressure injuries during military aeromedical evacuation or prolonged field care: A randomized trial

BACKGROUND

During military aeromedical evacuation (AE) and prolonged field care (PFC), casualties are at increased pressure injury (PI) risk. Operational PI mitigation strategies research is limited.

PURPOSE

Using multiple factors, this study examined Mepilex/LiquiCell effects on PI risk under simulated AE/PFC.

METHODS

Healthy adults were stratified by body fat (%) and randomized to six groups on three surfaces. Set A: Warrior Evacuation Litter Pad (WELP) with/without Mepilex; Set B: Vacuum Spine Board (VSB) with/without Mepilex; Set C: Talon litter with/without LiquiCell. Two hours supine (loaded) was needed.

OUTCOMES

Sacral skin transcutaneous tissue oxygen (TcPO2), temperature, moisture, interface pressure, interleukin-1α/Total Protein.

FINDINGS

54 participants. Sets A/B: No Mepilex effects; temperature increased 2.5°C. Set C: No LiquiCell effects. Significant ΔTcPO2 (unloaded-loaded), with 100% impaired perfusion; temperature increased 1.2°C.

DISCUSSION

Multiple risk factors for PI mitigating strategies must consider. Talon with increased pressure/impaired perfusion but smaller temperature/moisture changes; WELP/VSB with increased temperature/moisture but lower pressure/adequate perfusion.

The dynamic nexus between air transport, technological innovation, FDI, and economic growth: evidence from BRICS-MT countries

This study examines the endogenous growth theory for technological innovation and economic growth with the role of foreign direct investment (FDI) and air transport freight in seven emerging BRICS-MT economies. In the existing literature, there is no significant empirical evidence on the dynamic relationship among technological innovation, air transport freight, FDI, and economic growth in BRICS-MT countries. Thus, the current study contributes to the growing literature regarding the role of technological Innovation, air transport, and FDI on economic growth. To this end, we explore the dynamic nexus between technological innovation, air transport, FDI, and economic growth in 7 selected emerging BRICS-MT countries, including Brazil, Russia, India, China, South Africa, Mexico, and Turkey. This study covers the most recent updated period for panel data from 2000 to 2019. We applied panel cointegration, dynamic ordinary least square (DOLS), fully modified ordinary least square (FMOLS), and Granger causality tests to draw empirical inferences. The Pedroni panel and Kao residual cointegration tests confirm the long-run relationships among the variables. The DOLS results indicate that air transport freight, technological innovation, and FDI significantly positively impact economic growth. This study's findings confirmed the endogenous growth model in BRICS-MT countries. Furthermore, the Granger causality test results show the feedback effect of FDI on economic growth. The outcomes of this study also show the unidirectional causal relationship between air transport freight and economic growth. Moreover, the results provide support to economic policymakers in their decision-making. These results fill the gaps that assist policymakers of BRICS-MT countries in removing barriers to air transport freight, technological innovation, and foreign direct investment, thereby achieving sustainable economic development.

Air transport and mood in younger generations: The role of travel significance and COVID-19

The purpose of this paper is to investigate the relationship between mood and air travel choices, considering the role of travel significance and the influence that COVID-19 may have on younger generations' choices. Using a mixed-methods sequential exploratory design, a sample of 1,111 Italian respondents, belonging to younger generations is investigated. The data are analysed using a quantile regression with group effects considering attitudes towards COVID-19. The study demonstrates that there is a positive and significant relationship between mood and the number of journeys by air to destinations outside Europe, highlighting the positive moderating effect of the air travel experience and the negative moderating effect of COVID-19. This may have important implications for air transport managers interested in luring younger people to fly in the post-COVID19 era.

Testing the differentiated impact of the COVID-19 pandemic on air travel demand considering social inclusion

The economic downturn and the air travel crisis triggered by the recent coronavirus pandemic pose a substantial threat to the new consumer class of many emerging economies. In Brazil, considerable improvements in social inclusion have fostered the emergence of hundreds of thousands of first-time fliers over the past decades. We apply a two-step regression methodology in which the first step consists of identifying air transport markets characterized by greater social inclusion, using indicators of the local economies' income distribution, credit availability, and access to the Internet. In the second step, we inspect the drivers of the plunge in air travel demand since the pandemic began, differentiating markets by their predicted social inclusion intensity. After controlling for potential endogeneity stemming from the spread of COVID-19 through air travel, our results suggest that short and low-density routes are among the most impacted airline markets and that business-oriented routes are more impacted than leisure ones. Finally, we estimate that a market with 1% higher social inclusion is associated with a 0.153%-0.166% more pronounced decline in demand during the pandemic. Therefore, markets that have benefited from greater social inclusion in the country may be the most vulnerable to the current crisis.

Recovery preparedness of global air transport influenced by COVID-19 pandemic: Policy intervention analysis

The outbreak of COVID-19 constitutes an unprecedented disruption globally, in which risk management framework is on top priority in many countries. Travel restriction and home/office quarantine are some frequently utilized non-pharmaceutical interventions, which bring the worst crisis of airline industry compared with other transport modes. Therefore, the post-recovery of global air transport is extremely important, which is full of uncertainty but rare to be studied. The explicit/implicit interacted factors generate difficulties in drawing insights into the complicated relationship and policy intervention assessment. In this paper, a Causal Bayesian Network (CBN) is utilized for the modelling of the post-recovery behaviour, in which parameters are synthesized from expert knowledge, open-source information and interviews from travellers. The tendency of public policy in reaction to COVID-19 is analyzed, whilst sensitivity analysis and forward/backward belief propagation analysis are conducted. Results show the feasibility and scalability of this model. On condition that no effective health intervention method (vaccine, medicine) will be available soon, it is predicted that nearly 120 days from May 22, 2020, would be spent for the number of commercial flights to recover back to 58.52%-60.39% on different interventions. This intervention analysis framework is of high potential in the decision making of recovery preparedness and risk management for building the new normal of global air transport.

Geographical trend analysis of COVID-19 pandemic onset in Africa

Little has been documented in literature concerning the manner of occurrence and spread of COVID-19 in Africa. Understanding the geographic nature of the corona virus pandemic may offer critical response signals for Africa. This paper employed analysis of variance (ANOVA) to show that significant variations exist among African countries’, particularly total population as well as those using basic drinking water services, gross national income, expenditure on health, number of physicians and air transport passengers. Although we have only considered the number of confirmed corona virus infections noting that the fatality may be too early to discuss, we have relied on data from the European Centre for Disease Prevention and Control (ECDC) to establish a significant association between international mobility based on average annual air passenger carried (r ​= ​0.6) which also successfully predicted (R 2 ​= ​0.501) the number of COVID-19 cases reported in each country along with the population density (R 2 ​= ​0.418). We also detected that COVID-19 cases report y geometrically increased daily x (R 2 ​= ​0.860) with a 2nd order polynomial equation in the form of y ​= ​0.3993 ​× ​2–8.7569 x and a clustered spatial pattern with a nearest neighbour ratio of 0.025 significant at 0.05 α-level. African countries have responded to the pandemic in different ways including partial lockdown, closure of borders and airports as well as providing test centres. We concluded that 40% of Africa are categorized as emerging hot spots while responses differ significantly across regions.

Efficiency evaluation of Brazilian airlines operations considering the Covid-19 outbreak

In this paper we evaluate the operational efficiency of the Brazilian airlines considering the novel coronavirus Covid-19 outbreak. This novel coronavirus was first reported end of 2019 in Wuhan, China, however the powerful contamination spread among people forced the World Health Organization to characterize the Covid-19 as a pandemic in March of 2020. Here we analyze the main Brazilian airlines operations response due to lower demand because Covid-19 outbreak in first quarter of 2020 comparing with first quarter of 2019. The analysis here aims to verify the efficiency of airlines in domestic air transport market in Brazil through Multicriteria Data Envelopment Analysis (MCDEA) model. We used MCDEA to avoid limitations of classical DEA models for the case, especially the numbers of decision units and variable. In this paper we used an improvement of the MCDEA model to seek benchmarks considering a dual model all objective functions of MCDEA. The results highlight the challenges for the airlines, due to flight restriction and demand dropping. And also, the evaluation exposes the different company configuration of aircrafts age and network reconfiguration which was reflected by the efficiency difference on the period. The assessment shows the company with a better mix of aircraft models has a leverage on efficiency response due to unpredictable period as the pandemic Covid-19 outbreak.

Pandemics and environmental shocks: What aviation managers should learn from COVID-19 for long-term planning

This article gives guidance to aviation managers being struck by environmental shocks. The introduced frameworks support aviation managers to think strategically during times of shocks and help them to prepare for future shocks by developing more resilient and learning organizations. Practical, short-term recommendations include strategically orienting or reorienting and not exaggerating the current, short-term developments due to unproductive uncertainty. Further, and to prepare for future shocks, the results of this study suggest that aviation managers should develop a common strategy language, introduce uncertainty as a standard factor for long-term planning, manage uncertainty proactively and make long-term plans accordingly by fostering a dialogue with various stake- and shareholders, being aware of the strategy tools in use, making the board a co-creating team and introducing a three-step process in sensing, seizing and transforming the organization accordingly.

Factors affecting environmental practice adoption at small European airports: An investigation

The majority of the world's 3759 commercial airports handle under 5 million passengers a year and these small airports rarely employ practices to address their environmental externalities. The aim of this research is to investigate the range of environmental practices (EPs) that are employed at small European airports and identify the factors which affect their adoption. The findings of an online survey of 413 small airports in the European Common Aviation Area reveal that the EPs most commonly adopted concern waste management and noise reduction. Privately owned airports were generally more engaged with EPs than publicly owned ones. Consumer pressure, regulatory intervention, and airport size positively affected the adoption of environmental practices whereas complexity, perceived relative advantage and human resource constraints acted as barriers to adoption. The paper concludes with recommendations for policy and practice to support EP engagement and reduce the environmental impact of small airport operations worldwide.

The effects of air transportation, energy, ICT and FDI on economic growth in the industry 4.0 era: Evidence from the United States

This study analyses the causal and long-run linkage between air transport and economic growth. It was conducted to validate the tourism-led growth hypothesis for the United States (US) during the period 1981-2017 and includes Information and Communication Technologies (ICTs) alongside coal rents in the tourism-led growth hypothesis. This study presents a new direction for future studies by considering the relevance of the fourth industrial revolution (Industry 4.0), particularly in the US. To achieve the stated claim, this study considers as additional explanatory variables how ICTs moderate the impact of Foreign Direct Investment (FDI) on GDP. The empirical result confirms a connection between the Industry 4.0 era and the role of ICTs, which promotes substantial changes in the way of life and productivity. This has led to a vast technological advancement, which is in line with but at a faster pace than the technological advancement of previous revolutions. From empirical results, the study provides relevant policy recommendations related to the role of natural resources, new technologies and tourism on US GDP, while it also provides evidence of the positive effect of ICTs over FDI under the Industry 4.0 era.

Government support to airlines in the aftermath of the COVID-19 pandemic

This paper assesses government support measures to the air transport sector following the outbreak of the coronavirus disease (COVID-19) pandemic from two points of view. First, it explores the factors that shape governments' willingness to support airlines. This is followed by a discussion on the various types of support that may be provided and how country-specific parameters influence the choice of measures. Second, it analyses the implications of government support in three dimensions relevant to air transport policy: competition and liberalisation, airline ownership and control, and environmental sustainability. The analysis suggests that most governments give a high priority to maintaining air transport connectivity in order to protect economic activity and jobs, in aviation itself and in related sectors such as tourism. The trade-off between ensuring connectivity and maintaining competition after the COVID-19 pandemic is a challenge with several political and economic dimensions. The re-orientation of public policy in the aftermath of the pandemic may limit the relative importance of the policy priorities that shaped the evolution of the air transport sector before the crisis, especially those related to climate change and the environment. The role of government and public authorities at all levels - especially the type and duration of measures affecting transport operations - will be crucial for the future development of the aviation industry.

Exploring the roles of high-speed train, air and coach services in the spread of COVID-19 in China

To understand the roles of different transport modes in the spread of COVID-19 pandemic across Chinese cities, this paper looks at the factors influencing the number of imported cases from Wuhan and the spread speed and pattern of the pandemic. We find that frequencies of air flights and high-speed train (HST) services out of Wuhan are significantly associated with the number of COVID-19 cases in the destination cities. The presence of an airport or HST station at a city is significantly related to the speed of the pandemic spread, but its link with the total number of confirmed cases is weak. The farther the distance from Wuhan, the lower number of cases in a city and the slower the dissemination of the pandemic. The longitude and latitude coordinates do not have a significant relationship with the number of total cases but can increase the speed of the COVID-19 spread. Specifically, cities in the higher longitudinal region tended to record a COVID-19 case earlier than their counterparties in the west. Cities in the north were more likely to report the first case later than those in the south. The pandemic may emerge in large cities earlier than in small cities as GDP is a factor positively associated with the spread speed.

Passengers waste production during flights

We assume that during flights the amount of waste that is produced is limited. However, daily, approximately 8000 commercial airplanes fly above Europe's airspace while at the same time, more than 17,000 commercial flights exist in the entire world. Using primary data from airlines, which use the Larnaca's International Airport (LIA) in Cyprus, we have tried to understand why wastes are produced during a typical flight such as food waste, paper, and plastics, as well as how passengers affect the production of those wastes. The compositional analysis took place on 27 flights of 4 different airlines which used LIA as final destination. The evaluation indicated that the passenger's habits and ethics, and the policy of each airline produced different kinds of waste during the flights and especially food waste (FW). Furthermore, it was observed that the only waste management strategy that exists in place in the airport is the collection and the transportation of all those wastes from aircrafts and from the airport in the central unit for further treatment. Hence, this research indicated extremely difficulties to implement any specific waste minimization, or prevention practice or other sorting methods during the flights due to the limited time of the most flights (less than 3 h), the limited available space within the aircrafts, and the strictly safety roles that exist during the flights.

Body temperature change and outcomes in patients undergoing long-distance air medical transport

BACKGROUND

Short-distance air medical transport for adult emergency patients does not significantly affect patients' body temperature and outcomes. This study aimed to examine the influence of long-distance air medical transport on patients' body temperatures and the relationship between body temperature change and mortality.

METHODS

We retrospectively enrolled consecutive patients transferred via helicopter or plane from isolated islands to an emergency medical center in Tokyo, Japan between April 2010 and December 2016. Patients' average body temperature was compared before and after air transport using a paired t-test, and corrections between body temperature change and flight duration were calculated using Pearson's correlation coefficient. Multivariable logistic regression models were then used to examine the association between body temperature change and in-hospital mortality.

RESULTS

Of 1253 patients, the median age was 72 years (interquartile range, 60-82 years) and median flight duration was 71 min (interquartile range, 54-93 min). In-hospital mortality was 8.5%, and average body temperature was significantly different before and after air transport (36.7 °C versus 36.3 °C; difference: -0.36 °C; 95% confidence interval, -0.30 to -0.42; p < 0.001). There was no correlation between body temperature change and flight duration (r = 0.025, p = 0.371). In-hospital death was significantly associated with (i) hyperthermia (>38.0 °C) or normothermia (36.0-37.9 °C) before air transport and hypothermia after air transport (odds ratio, 2.08; 95% confidence interval, 1.20-3.63; p = 0.009), and (ii) winter season (odds ratio, 2.15; 95% confidence interval, 1.08-4.27; p = 0.030).

CONCLUSION

Physicians should consider body temperature change during long-distance air transport in patients with not only hypothermia but also normothermia or hyperthermia before air transport, especially in winter.

Inter-hospital and intra-hospital patient transfer: Recent concepts

The intra- and inter-hospital patient transfer is an important aspect of patient care which is often undertaken to improve upon the existing management of the patient. It may involve transfer of patient within the same facility for any diagnostic procedure or transfer to another facility with more advanced care. The main aim in all such transfers is maintaining the continuity of medical care. As the transfer of sick patient may induce various physiological alterations which may adversely affect the prognosis of the patient, it should be initiated systematically and according to the evidence-based guidelines. The key elements of safe transfer involve decision to transfer and communication, pre-transfer stabilisation and preparation, choosing the appropriate mode of transfer, i.e., land transport or air transport, personnel accompanying the patient, equipment and monitoring required during the transfer, and finally, the documentation and handover of the patient at the receiving facility. These key elements should be followed in each transfer to prevent any adverse events which may severely affect the patient prognosis. The existing international guidelines are evidence based from various professional bodies in developed countries. However, in developing countries like India, with limited infrastructure, these guidelines can be modified accordingly. The most important aspect is implementation of these guidelines in Indian scenario with periodical quality assessments to improve the standard of care.

Occurrence and dry deposition of organophosphate esters in atmospheric particles over the northern South China Sea

Nine organophosphate esters (OPEs) in airborne particles were measured during a cruise campaign over the northern South China Sea (SCS) from September to October 2013. The concentration of the total OPEs (∑OPEs) was 47.1-160.9 pg m(-3), which are lower than previous measurements in marine atmosphere environments. Higher OPE concentrations were observed in terrestrially influenced samples, suggesting that OPE concentrations were significantly influenced by air mass transport. Chlorinated OPEs were the dominant OPEs, accounting for 65.8-83.7% of the ∑OPEs. Tris-(2-chloroethyl) phosphate (TCEP) was the predominant OPE compound in the samples (45.0±12.1%), followed by tris-(1-chloro-2-propyl) phosphates (TCPPs) (28.8±8.9%). Dry particle-bound deposition fluxes ranged from 8.2 to 27.8 ng m(-2) d(-1) for the ∑OPEs. Moreover, the dry deposition input of the ∑OPEs was estimated to be 4.98 ton y(-1) in 2013 in a vast area of northern SCS. About half of the input was found to relate to air masses originating from China.

Helicopter versus ground emergency medical services for the transportation of traumatically injured children

BACKGROUND

Helicopter emergency medical services (HEMS) are a common mode of transportation for pediatric trauma patients. We hypothesized that HEMS improve outcomes for traumatically injured children compared to ground emergency medical services (GEMS).

METHODS

We queried trauma registries of two level 1 pediatric trauma centers for children 0-17 years, treated from 2003 to 2013, transported by HEMS or GEMS, with known transport starting location and outcome. A geocoding service estimated travel distance and time. Multivariate regression analyses were performed to adjust for injury severity variables and travel distance/time.

RESULTS

We identified 14,405 traumatically injured children; 3870 (26.9%) transported by HEMS and 10,535 (73.1%) transported by GEMS. Transport type was not significantly associated with survival, ICU length of stay, or discharge disposition. Transport by GEMS was associated with a 68.6%-53.1% decrease in hospital length of stay, depending on adjustment for distance/time. Results were similar for children with severe injuries, and with propensity score matched cohorts. Of note, 862/3850 (22.3%) of HEMS transports had an ISS<10 and hospitalization<1 day.

CONCLUSIONS

HEMS do not independently improve outcomes for traumatically injured children, and 22.3% of children transported by HEMS are not significantly injured. These factors should be considered when requesting HEMS for transport of traumatically injured children.

Usefulness and applicability of infectious disease control measures in air travel: a review

BACKGROUND

Air travel has opened up opportunities for world transportation, but has also increased infectious disease transmission and public health risks. To control disease spread, airlines and governments are able to implement control measures in air travel. This study inventories experiences and applicability of infectious disease control measures.

METHODS

A literature search was performed in PubMed, including studies between 1990 and 2013. Search terms included air travel terms and intervention terms. Interventions were scored according outcome, required resources, preparation, passenger inconvenience and passenger compliance.

RESULTS

Provision of information to travelers, isolation, health monitoring, hygiene measures and vector control reportedly prevent disease spread and are well applicable. Contact tracing can be supportive in controlling disease spread but depend on disease characteristics. Exit and entry screening, quarantine and travel restrictions are unlikely to be very effective in preventing disease spread, while implementation requires extensive resources or travel implications.

CONCLUSIONS

Control measures should focus on providing information towards travelers, isolation, health monitoring and hygiene measures. Appropriateness of measures depends on disease characteristics, and the required resources. As most studies analyze one type of measure in a particular situation, further research comparing the effectiveness of measures is recommended.

Fast resuscitation and care of the burn patients by telemedicine: A review

BACKGROUND

In Iran, burns are the second most common cause of death, after traffic accidents in individuals under the age of 15 years. Many burned patients die or suffer injury due to lack of immediate care, so we need to use an alternative resuscitations to cure them immediately. Telemedicine describes the use of medical information exchanged from one site to another via electronic communications to improve patients' health status and care. The aim of this study was to express the advantages of Telemedicine to resuscitate and care burn patients.

MATERIALS AND METHODS

This study was a narrative review. The literature was searched on fast resuscitation and care of the patients' burn by telemedicine with the help of libraries, databases, and also searches engines available at Google, Google scholar, books and conference proceedings. In our searches, we employed the following keywords and their combinations: Telemedicine, Telecare, Burn, Burn patient, Air transport, Triage and Health Information Management in the searching areas of titles, keywords, abstracts and full texts.

RESULTS

In this study, more than 78 articles and reports were collected and 30 of them were selected based on their relevancy.

CONCLUSION

Acute evaluation of burn patients can be performed by the telemedicine and it plays an important role in improving access to the required expertise, and raises physician confidence in treating burn patients. This can reduce under-triage or over-triage for air transport and finally lead to saving time and cost.

Air transport globalization, liberalization and sustainability: post-2001 policy dynamics in the United States and Europe

Against a context of international crisis in the air transport industry, this paper examines the implications of the ways in which strategies developed by key air transport stakeholders, as well as the contemporary dynamics of the globalized, liberalized market place, impact directly on sustainability issues. More specifically, the paper has two objectives. First, it discusses the policy ramifications of the interrelationships between the concepts of globalization, liberalization, and sustainability within the air transport industry. Second, the paper explores the import of these interrelationships as they interconnect with stakeholder strategies in the differing geopolitical contexts of the US and EU. Particular attention is given to airline network and frequency strategies. The paper concludes that while the financial sustainability of the airline industry is the overwhelming concern today, if this is essentially the short-term crisis that the airline industry claims it to be, the longer-term predictions of air transport growth will again bring environmental sustainability issues to the fore.