The British merchant fleet has expanded in recent years but it is not known whether this expansion has led to proportionate changes in mortality.
To investigate mortality from accidents and injuries ...in British merchant shipping, to determine whether this has increased in recent years, to compare fatal accident rates across British industries and to review fatal accident rates in merchant shipping worldwide over the last 70 years.
Examinations of marine accident investigation files, death registers and death inquiry files, national mortality statistics, worldwide surveys and review methodology. The main outcome measure was the fatal accident rate per 100 000 worker-years.
Of 66 deaths in British shipping from 2003 to 2012, 49 were caused by accidents, which largely affected deck ratings. The fatal accident rate in British shipping increased by 4.7% per annum from 2003, although this was not significant (95% confidence interval: -5.1 to 15.6%). During 2003-12, the fatal accident rate in shipping (14.5 per 100 000) was 21 times that in the general British workforce, 4.7 times that in the construction industry and 13 times that in manufacturing. Of 20 merchant fleets worldwide with population-based fatal accident rates, most have shown large reductions over time.
The expansion of the British merchant fleet in recent years does not appear to have had a major impact on fatal accidents. Further preventive measures should target fatalities during mooring and towing operations. Internationally, most shipping fleets have over time experienced large decreases in fatal accident rates.
Malaria continues to have a high morbidity rate associated among European travelers. Thorough recording of epidemiological and clinical aspects of imported malaria has been helpful in the detection ...of new outbreaks and areas of developing drug resistance. Sentinel surveillance of data collected prospectively since 1999 has begun within TropNetEurop, a European network focusing on imported infectious diseases. TropNetEurop appears to cover ∼10% of all patients with malaria seen in Europe. Reports of 1659 immigrants and European patients with Plasmodium falciparum malaria were analyzed for epidemiological information and data on clinical features. Regional data were quite diverse, reflecting local patterns of immigration and international travel. By far, the most infections were imported from West Africa. Europeans had more clinical complications; consequently, all deaths occurred in this group. Compared with European standards, the mortality rate was low (0.6% in Europeans). Data from TropNetEurop member sites can contribute to our understanding of the epidemiological and clinical findings regarding imported falciparum malaria.
Previous studies have indicated that age is a risk factor for severe falciparum malaria in nonimmune patients. The objectives of this study were to reevaluate previous findings with a larger sample ...and to find out how strongly clinical outcomes for elderly patients differ from those for younger patients. Results of adjusted analyses indicated that the risks of death due to falciparum malaria, of experiencing cerebral or severe disease in general, and of hospitalization increased significantly with each decade of life. The case-fatality rate was almost 6 times greater among elderly patients than among younger patients, and cerebral complications occurred 3 times more often among elderly patients. Antimalarial chemoprophylaxis was significantly associated with a lower case-fatality rate and a lower frequency of cerebral complications. Women were more susceptible to cerebral complications than were men. Our study provides evidence that falciparum malaria is more serious in older patients and demonstrates that clinical surveillance networks are capable of providing quality data for investigation of rare events or diseases.
Plasmodium vivax is the second most common species among malaria patients diagnosed in Europe, but epidemiological and clinical data on imported P. vivax malaria are limited. The TropNetEurop ...surveillance network has monitored the importation of vivax malaria into Europe since 1999.
To present epidemiological and clinical data on imported P. vivax malaria collected at European level.
Data of primary cases of P. vivax malaria reported between January 1999 and September 2003 were analysed, focusing on disease frequency, patient characteristics, place of infection, course of disease, treatment and differences between network-member countries.
Within the surveillance period 4,801 cases of imported malaria were reported. 618 (12.9%) were attributed to P. vivax. European travellers and immigrants were the largest patient groups, but their proportion varied among the reporting countries. The main regions of infection in descending order were the Indian subcontinent, Indonesia, South America and Western and Eastern Africa, as a group accounting for more than 60% of the cases. Regular use of malaria chemoprophylaxis was reported by 118 patients. With 86 (inter-quartile range 41-158) versus 31 days (inter-quartile range 4-133) the median symptom onset was significantly delayed in patients with chemoprophylaxis (p < 0.0001). Common complaints were fever, headache, fatigue, and musculo-skeletal symptoms. All patients survived and severe clinical complications were rare. Hospitalization was provided for 60% and primaquine treatment administered to 83.8% of the patients, but frequencies varied strongly among reporting countries.
TropNetEurop data can contribute to the harmonization of European treatment policies.
Tactical data links are an essential contribution to automatic "real-time" communication, where time to decision is a key constraint. With its focus in the Navy, the Tactical Data Link 11 has been ...used and will remain in service for many years, transmitting small information entities over low data rate links. But increasing requirements - amongst others on network capabilities, throughput and robustness - have requested for an upgrade, initiating the NATO Improved Link 11 (NILE) or "Link 22", as designated by NATO. The NILE program has successfully run through a design and development phase, and now has entered the in-service support phase, where the NILE lead nations will prepare themselves for operation with Link 22 systems in combined multi-national forces. As one part of this proceeding Germany has charged Telefunken RACOMS for establishing the HF fixed frequency communication medium, which is performed by a Link 22 signal processing controller (SPC), in order first to provide interoperability and in a second step to integrate the SPC in a national German NILE reference system. The paper presents a brief overview on the NILE program, its organisation and operational approach. Setting the focus to HF fixed frequency communication as the first of four Link 22 communication media, the challenges and lessons learned of Telefunken RACOMS at implementing the waveforms and integrating the signal processing controller will be explained. Going beyond the current specification and reflecting today's state of the art HF communication capabilities, the Link 22 HF fixed frequency approach will be considered due to further potentials such as improvement in terms of more robust communication or higher data rates.
Background: Since 1963, malaria has been exclusively recognized in Poland as an imported disease, which has become increasingly frequent in recent years. When associated with performing duties in ...malaria-endemic areas, malaria is acknowledged as an occupational disease. Methods: Ninety five cases of malaria recognized as an occupational disease in Polish citizens in the years 1984-1993 were studied retrospectively in terms of working conditions, epidemiologic and clinical features, and permanent disability sequelae. Results: Among patients examined, young and professionally active persons who called at tropical ports or who worked in rural areas or in the regions of military conflict were predominant. Most infections were contracted in Africa during the first few months of the stay. The observed morbidity and recrudescence rates were mainly attributable to Plasmodium falciparum. Disregard of prevention and chemoprophylaxis of malaria were key risk factors. In 33% of the patients, severe symptoms and complications occurred and these required long-term therapy. In seven cases, disturbances of the central nervous system, hepatic, renal, or cardiac system occurred 6 months after termination of treatment, and these occurrences resulted in permanent disability and an inability to work. Conclusions: The disability and inability to work and its legal consequences, such as indemnity, demonstrate that malaria may present a serious socioeconomic problem, even in the country where it is an imported disease.
Germany and France have set up a joint program called Multiband Multirole Radio (MMR) to investigate a next generation tactical radio communication system focusing amongst others on being ...programmable and providing extended capacity. As one part of this program EADS RACOMS undertook the task to design a non-hopping VHF/UHF waveform for high data rate file transfer (HDRFT) over TCP/IP operating between 30 and 600 MHz. Target data rates are 32 and 64 kbit/s to be achieved in 25 kHz typical VHF bandwidth. Message structure needs to be flexible to adapt to actual packet size, limited by the maximum transfer unit (MTU) which defines the maximum allowed TCP/IP packet size. The overall frequency band of the MMR is defined from 2 to 600 MHz, thus requiring a multi-band front-end. Due to software defined applications different transmission bandwidths have to be handled. To keep HW constraints low, the analogue-digital border should be assigned to the highest possible IF. Analogue to digital converters (ADC) are key elements in such hardware architecture. The paper presents the HDRFT waveform approach including an extraordinary 3-PSK modulation scheme and simulation results depicting the performance potential. The content of the MMR program is briefly illustrated. The programmable multiband HW architecture is introduced.
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