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OBJECTIVE: This study investigated the effect of the spatial disorientation (SD) events on an attentive blank stare in the cockpit scene and demonstrated how much the flight task and visual delayed discrimination task were competing for the pilots' attention. BACKGROUND: SD in flight is the leading cause of human error-related aircraft accidents in the military, general and commercial aviation, and has been an unsolved problem since the inception of flight. In-flight safety research, visually scanning cockpit instruments, and detecting changes are critical countermeasures against SD. METHOD: Thirty male military pilots were performing a dual task involving piloting a flight simulator and visual change detection, while eye movements were obtained using an eye tracker. RESULTS: Pilots made more flight errors and spent less time gazing at the area of change in SD-conflict than in non-conflict flights. The vestibular origin SD-conflict led not only to deteriorated piloting and visual scanning but also to problems coordinating overt and covert attention, resulting in lower noticeability of visual changes despite gazing at them. CONCLUSION: Our study shows that looking at a given area in space is not a sufficient condition for effective covert attention allocation and the correct response to a visual stimulus. It seems to be important to make pilots aware of this during SD training. APPLICATION: To reduce change blindness, some strategies, such as reducing the number of secondary tasks is extremely valuable. Particular efforts should also be focused on improving the design of the aircraft cockpit by increasing the conspicuousness of critical information.

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BACKGROUND: The aim of the study was to evaluate overweight, obesity and the level of physical activity in the study group of 100 cadets of the Air Force Military Academy in Deblin (WSOSP). MATERIAL AND METHODS: Evaluation of overweight and obesity was based on body mass index (BMI) and body fat content. An accelerometer AiperMotion 500TM was used to measure the level of physical activity. There were marked such parameters as the average daily energy consumption, the average distance covered during the day and the whole week and the indicator of physical activity level (PAL). RESULTS: Based on BMI indicators, 71.3% of the cadets had normal body weight, 25.3% were overweight and 3.4% were obese. Assessment of nutritional status showed significant differences between the 1st and 2nd vs. the 4th and 5th years of study. Normal BMI values showed 88% of the 1st and 2nd year students, while of the 4th and 5th years - only 48.6% (p < 0.05). Based on the body fat content, obesity was found only in a group of older students (16.2%) and overweight was 10 times higher in the 4th and 5th years (21.6%) in comparison to younger students (2%). The average distance covered during the day or during the whole week was significantly higher in the 1st and 2nd year students. CONCLUSIONS: It is necessary to implement appropriate measures in the field of nutrition and physical activity to prevent the development of excessive body weight during studies among the military cadets of the Air Force Military Academy in Deblin.

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INTRODUCTION: The main aim of this study was to differentiate the magnitude of a pilot's heart rate variability (HRV) when performing assisted and unassisted flights, as well as simple and complex flight tasks. METHODS: Cardiac monitoring in flights was carried out using a compact, mobile ECG recorder. A frequency analysis of the heart rate (HR) signal was performed to determine the ratio of low-frequency spectral power (LF) to high-frequency spectral power (HF). RESULTS: The LF/HF ratio observed in the zone (M=1.047, SD=0.059) was significantly different than the LF/HF calculated preflight (M=0.877, SD=0.043) and postflight (M=0.793, SD=0.037). There was no main effect of the flight type (unassisted zone flight vs. zone flight with an instructor) on the LF/HF parameter. However, greater psychophysiological load of a pilot was observed in the training zone flights when compared to simple circle flights (main effect of the flight type). CONCLUSIONS: As the LF/HF ratio turned out to be significantly higher in the zone than pre- and postflight, this parameter can be useful for predicting the risk of excessive stress and arousal of pilots during flights. Based on the LF/HF ratio we can also estimate difficulty level of flight tasks, because our research has shown higher values of this parameter in the training zone flights than in simple circle flights.

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INTRODUCTION: An important problem for pilots is visual disturbances occurring under +Gz acceleration. Assessment of the degree of intensification of these disturbances is generally accepted as the acceleration tolerance level (ATL) criterion determined in human centrifuges. The aim of this research was to evaluate the visual-motor responses of pilots during rapidly increasing acceleration contained in cyclic intervals of +6 Gz to the maximum ATL. METHODS: The study involved 40 male pilots ages 32-41 yr. The task was a quick and faultless response to the light stimuli presented on a light bar during exposure to acceleration until reaching the ATL. Simple response time (SRT) measurements were performed using a visual-motor analysis system throughout the exposures which allowed assessment of a pilot's ATL. RESULTS: There were 29 pilots who tolerated the initial phase of interval acceleration and achieved +6 Gz, completing the test at ATL. Relative to the control measurements, the obtained results indicate a significant effect of the applied acceleration on response time. SRT during +6 Gz exposure was not significantly longer compared with the reaction time between each of the intervals. SRT and erroneous reactions indicated no statistically significant differences between the "lower" and "higher" ATL groups. CONCLUSION: SRT measurements over the +6-Gz exposure intervals did not vary between "lower" and "higher" ATL groups and, therefore, are not useful in predicting pilot performance. The gradual exposure to the maximum value of +6 Gz with exposure to the first three intervals on the +6-Gz plateau effectively differentiated pilots.

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INTRODUCTION: Hard work in farming may lead to lumbar spinal stenosis, and consequently, to pain. The pain and neurological disorders may lead to disability and postural disorders. OBJECTIVE: The aim of the presented study was to analyse postural stability and its correlation with functional disability of patients with lumbar spinal stenosis living in rural areas. MATERIALS AND METHODS: The study population consisted of 30 rural patients with lumbar spinal stenosis; mean age: 51.40 (±12.92); mean BMI: 28.60 (±3.77). The control group consisted of 30 rural inhabitants without spinal disorders. Postural stability was tested on the Biodex Balance System. The patients were also evaluated according to the ODI, the Rolland- Morris disability questionnaire, and VAS. RESULTS: The mean results of the patients studied were as follows: 49.37 (±17.39) according to ODI, 15 (±6.19) according to the Rolland-Morris disability scale, and pain intensity of 7 (±1.93) according to the VAS. The following statistically significant differences were found: the mean balance index result was 1.8 (±1.88) and 0.64 (±0.41) in the control group. The mean centre of mass deviation in the A/P plane was 1.39 (±1.88) and 0.46 (±0.41) in the control group. The mean centre of mass deviation in the M/L plane was 0.8 (±0.51) and 0.32 (±0.22) in the control group. The balance in the studied population correlated significantly with the Rolland-Morris disability questionnaire and the VAS. CONCLUSIONS: 1) Serious disability was found in rural patients with spinal stenosis. There was a statistically significant correlation between the disability and postural stability disorders. 2) Most of the patients (84%) were overweight. 3) Postural stability disorders were statistically significant for both the stability index and the A/P plane deviation.

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INTRODUCTION: Surgical treatment of obesity is currently the only effective treatment option for patients with excess body weight, especially morbid obesity and diseases caused by it. There are no studies evaluating the knowledge of surgeons in the field of bariatric surgery. AIM: To assess the knowledge of surgeons regarding bariatric surgery. MATERIAL AND METHODS: An anonymous questionnaire was conducted among 143 surgeons in 2010-2011 during local educational conferences. The survey consisted of 10 questions dedicated to the fundamental problems of the surgical treatment of obesity. RESULTS: Theoretical and practical knowledge connected to the so-called "epidemiological awareness" in the surgical treatment of obesity was possessed by 25% of the respondents. Knowledge of surgical techniques is known to most surgeons. Reducing the "oncological risk" after bariatric surgery is known to only 27% of surgeons. Almost 80% of surgeons indicated a necessity of their further education regarding the surgical treatment of obesity. CONCLUSIONS: Knowledge of Polish general surgeons in the surgical treatment of obesity is not high, with a high number of surgeons who possess knowledge of the operating technique, whereas only a quarter have a basic knowledge of the indication for surgical treatment. Most surgeons who participated in our study are awaiting educational programmes focused on this issue.

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OBJECTIVES: Back pain in Air Force fast jet pilots has been studied by several air forces and found to be relatively common. The objective of the study was to determine the prevalence and degree of the pain intensity in the cervical, thoracic and lumbar spine, subjective risk factors and their effect on the pilots' performance while flying high maneuver aircrafts and the consequences for cognitive deficiencies. MATERIAL AND METHODS: The study was designed as a retrospective, anonymous questionnaire survey, collecting data on the age, aircraft type, flying hours, pain characteristics, physical activity, etc. The study was participated by 94 pilots aged 28-45 years (mean age: 35.9 ± 3.3 years), actively flying fast jet aircrafts Su-22, Mig-29 and F-16. The estimates regarding the level of the subjective back pain were established using visual analogue scales (VAS). RESULTS: The values of the Cochran and Cox T-test for heterogeneous variances are as follows: for the total number of flying hours: F = 2.53, p = 0.0145, for the pilot's age: F = 3.15, p = 0.003, and for the BMI factor F = 2.73, p = 0.008. CONCLUSIONS: Our questionnaire survey showed a significant problem regarding spinal conditions in high performance aircraft pilots. The determination of the risk factors may lead to solving this problem and help eliminate the effect of the unfavorable environment on piloting jet aircrafts. Experiencing back pain during the flight might influence the mission performance and flight safety. The costs of pilots education are enormous and inability to fly, or even disability, leads to considerable economic loss. More research on specific prevention strategies is warranted in order to improve the in-flight working environment of fighter pilots.

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In the study, we checked: 1) how the simulator test conditions affect the severity of simulator sickness symptoms; 2) how the severity of simulator sickness symptoms changes over time; and 3) whether the conditions of the simulator test affect the severity of these symptoms in different ways, depending on the time that has elapsed since the performance of the task in the simulator. We studied 12 men aged 24-33 years (M = 28.8, SD = 3.26) using a truck simulator. The SSQ questionnaire was used to assess the severity of the symptoms of simulator sickness. Each of the subjects performed three 30-minute tasks running along the same route in a driving simulator. Each of these tasks was carried out in a different simulator configuration: A) fixed base platform with poor visibility; B) fixed base platform with good visibility; and C) motion base platform with good visibility. The measurement of the severity of the simulator sickness symptoms took place in five consecutive intervals. The results of the analysis showed that the simulator test conditions affect in different ways the severity of the simulator sickness symptoms, depending on the time which has elapsed since performing the task on the simulator. The simulator sickness symptoms persisted at the highest level for the test conditions involving the motion base platform. Also, when performing the tasks on the motion base platform, the severity of the simulator sickness symptoms varied depending on the time that had elapsed since performing the task. Specifically, the addition of motion to the simulation increased the oculomotor and disorientation symptoms reported as well as the duration of the after-effects.

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INTRODUCTION: Pilots flying at very high speed are exposed to the effects of prolonged accelerations while changing their flight path. The aim of this research was to assess the impact of sustained accelerations on the visual-motor response times of pilots and the acceleration tolerance level (ATL) as a measure of pilots' endurance to applied +G(z). METHOD: The study involved 18 young pilots, 23-25 yr of age. The subjects' task was to quickly and accurately respond to the light stimuli presented on a light bar during exposure to acceleration at +4.5 G(z) and until reaching the ATL. Simple response time (SRT) measurements were performed using a visual-motor analysis system throughout the exposures, which allowed the assessment of a pilot's ATL. RESULTS: The pilots' ATL ranged from 270 to 366 s (Mean = 317.7 +/- 26.15 SD). The analysis of the SRT indicated a significant effect of duration of acceleration on the visual response time. The results of the post hoc comparisons showed that SRT increased with longer durations of the same level of +G(z) load and then decreased, reaching values similar to the controls. CONCLUSION: Exposure to prolonged acceleration of +4.5 G(z) significantly increases SRT. There was no statistically significant difference in SRT between the pilots with "short" and "long" time exposures. A pilot's SRT during a prolonged +4.5 G(z) exposure could be a reliable indicator of pilot G performance in the fast jet. Deterioration of SRT may be used to predict imminent +G(z) endurance limits between pilots with widely varying endurance abilities.

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INTRODUCTION: The return to work of patients who undergo spinal surgery poses important medical and social challenge. OBJECTIVES: 1) To establish whether patients who undergo spinal stenosis surgery later return to work. 2) To establish the patient's attitude towards employment. 3) To assess the quality of life of the patients and its influence on their attitude to work. MATERIALS AND METHODS: The study population consisted of 58 patients aged from 21 to 80 years (the mean age was 52.33±14.12). There were 29 women (50%) and 29 men (50%) in the group. The patients' quality of life was measured by the use of the WHOQOL-BREF instrument. Individual interviews were conducted 3 to 8 months (a mean of 5.72 months ±1.6) after the surgery. RESULTS: 1) Although 13 patients (22.3%) returned to work, 44 (75.9%) did not, these being manual workers of vocational secondary education. 2) Almost half of the patients (27 patients, i.e. 44%) intend to apply for disability pension, 16 patients (27.6%) consider themselves unfit to work, 22 patients (37.9%) do not feel like working again. 3) The quality of life of the patients decreased. Domain scores for the WHOQOL-BREF are transformed to a 0-100 scale. The mean physical health amounted to 60.67 (±16.31), the mean psychological health was 58.78 (±16.01), while the mean social relations with family and friends were 59.91 (±20.69), and the mean environment 59.62 (±12.48). CONCLUSIONS: 1) A total of 75% of the patients operated for lumbar spinal stenosis do not return to their preoperative work. Difficulties in returning to work and decreased quality of life are associated with female sex, lower-level education, hard physical work and low income. 2) Physical health, psychological health, social relations and environment decreased to the mean of approximately 60. 3) The quality of life of the patients who did return to work was similar to that of healthy people.

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UNLABELLED: Bariatric surgery is currently the only effective treatment option for morbidly obese patients. There has been observed a considerable disproportion between the number of procedures conducted in Poland and the number of patients requiring such treatment. There are no studies assessing bariatric knowledge among general practitioners who play crucial role in polish health care system. The aim of the study was to assess the knowledge of general practitioners regarding bariatric surgery. MATERIAL AND METHODS: An anonymous questionnaire conducted among 282 general practitioners in 2010-2011 during local educational conferences. The questionnaire consisted of 10 questions relating to fundamental issues of bariatric surgery. RESULTS: Only one twelfth (8.1%) of the general practitioners questioned knows the indications for bariatric surgery, can apply them, and has epidemiological awareness. 61.5% of general practitioners know the surgical procedures used for the treatment of obesity, whereas 58% of them show the knowledge of surgical technique in which they are performed. Only 23% of general practitioners were aware that bariatric surgery decreases cancer risk. 92% of the participants noticed a necessity of education regarding the surgical treatment of obesity. CONCLUSIONS: Bariatric knowledge among general practitioners is not adequate to scientific research results published during the last years. Most general practitioners who participated in our study are aware of that and are awaiting for educational programmes focused on this issue.

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OBJECTIVES: Low back pain in pilots of military helicopters is widely discussed in the world literature. Vibrations and improper seat configuration cause that cervical, thoracic and lumbar spine might be exposed to overloading. The aim of the study was to determine the incidence and intensity of pain in the spine as well as to identify subjective risk factors of back pain and its effect on the pilot's actions while flying a helicopter. MATERIALS AND METHODS: 112 pilots, aged 25-56 years (mean age: 34.8 ± 6.3 years), actively flying helicopters, participated in the questionnaire survey. The questionnaire containing five groups of questions, elaborated by the authors, was used. RESULTS: 70% of the pilots reported pain complaints. Pain was localized in different parts of the spine. Uncomfortable body posture during prolonged flights resulting from the lack of lumbar support exerted the highest effect on pain provocation. CONCLUSIONS: This questionnaire survey enabled to determine the prevalence of pain, its type and intensity. Knowledge on low back pain imposes the necessity to eliminate the negative environmental effect on helicopter pilotage. Elimination of risk factors is possible through appropriate physical exercises and adjustment of pilots' seats. The authors plan to conduct--in the future--detailed annual examinations among pilots with back pain and, based on the results, to elaborate a prophylactic program containing simple forms of isometric and isotonic training involving paravertebral and deep abdominal muscles designed specifically for pilots of military helicopters.

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BACKGROUND: The development of diagnostic imaging facilitates evaluation of spinal anatomy, but there is no full correspondence between morphologic and pathologic changes observed in radiographic studies and clinical findings. The aim of the study was to: 1. Evaluate the degree of signal intensity and degenerative changes of intervertebral discs in the lumbar spine on MRI. 2. Estimate interrater reliability of classification of pathology between experienced and inexperienced medical doctors. MATERIAL AND METHOD: The sample consisted of 89 persons aged between 18 and 21 years. MRI scans of the lumbar spine were evaluated by the use of a console for digital analysis by three medical doctors with different levels of experience. RESULTS: Evidence of dehydration of intervertebral disc was found in 3.37%-4.49% at the L4-L5 level, and in 13.48%-15.73% of cases at the L5-S1 level. Interrater reliability ranged from full agreement at levels where degenerative changes are rarely observed to fair and poor agreement at L4-L5 and L5-S1. Intrarater reliability showed full agreement on higher levels to good and very good at l4-l5 and l5-S1 levels. Interrater reliability concerning the degree of degenerative changes was 0.6 for Th12 to L4, but was poor at L4-L5 and L5-S1. Intrarater reliability ranged from full agreement at higher levels to poor at L3-L4-L5 and moderate at L5-S1. CONCLUSIONS: 1. Asymptomatic intervertebral disk changes were found in 30% of the study participants. 2. Evaluation of the degree of degenerative changes of intervertebral discs requires specialist training and experience.

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OBJECTIVES: Human reactions to environmental changes have been the subject of numerous investigations related to pathophysiology, aviation psychology, aviation, and sports. The present study aimed at evaluating the perception of light stimulus via the Critical Flicker Fusion threshold (CFF) measurements among aviation pilots. MATERIALS AND METHODS: The study was carried out under hypoxic conditions corresponding to 5000 m altitude, for a period of 30 min, without the use of supplemental oxygen. Fourteen volunteer pilots, 23-30 years of age, were examined in the hypobaric chamber (HC). The measurements were performed at normobaria and at the initial and final phase of hypoxia. Heart rate (HR) and blood oxygen saturation (SaO2) were monitored. RESULTS: The high altitude hypoxia was found to produce a decrease in the CFF threshold F(3.39) = 3.207, p < 0.05, and SaO2 F(3.39) = 52.651, p < 0.001, as well as HR increase F(3.39) = 7.356, p < 0.001. The results indicate that the higher the decrease in SaO2 under hypoxic conditions, the higher the decrease in CFF r = .567 p < 0.05. Likewise, the higher the increase in HR, the higher the decrease in CFF r = -0.491 p < 0.05. CONCLUSIONS: Under hypoxic conditions, the perceptual ability of the pilots is gradually decreasing. This has been confirmed by the findings of the physiological examinations. The authors express an opinion that it would be advisable to introduce CFF measurement into the hypobaric chamber tests as it allows individual assessment of the pilot's perceptual ability under conditions of incomplete physiological compensation of the high altitude hypoxia.

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OBJECTIVES: Visual disturbances are commonly accepted criteria for acceleration tolerance assessment. Researchers during centrifuge experiments use them as a safe criterion for cessation of acceleration exposure. Visual disturbances analysis is a non-invasive method of assessing retinal blood flow. Limitation of visual stimuli perception is a measure of physiological state of the experiment participants before hemodynamic changes, which reach a critical level manifested by G-induced loss of consciousness. Detection of these disturbances play an important role during the acceleration tolerance assessment. In this study, an attempt was made to answer the question on how many mistakes or incorrect reactions had to be identified to classify the ability of the pilot to fly on military jets. MATERIALS AND METHODS: A new computer-aided research apparatus of our own design was used to assess visual disturbances, being a criterion of +Gz tolerance. In the center of monitor screen, a line of 3 light points was projected. During the centrifuge test, green lateral lights randomly changed their shapes from circles to squares while central light, being a point of vision fixation, remained unchanged. To assess its efficacy, 14 volunteers participated in the tests with various stimuli exposure. The authors aimed at selecting parameters of stimuli and exposure so that the division of reactions presented in the table would correspond with the score scale appropriate for our goals. RESULTS: Preliminary tests showed that appropriately selected light intensity of the exposed stimuli enables the use of test results to assess the number of erroneous reactions, and consequently the level of pilots' concentration during centrifuge tests. CONCLUSIONS: It has been found that the chosen luminance range of the projected light points is correct as it allows to evaluate the reactions, which should be considered erroneous. Additionally, prolongation of the correct reaction time to the mean value of about 400 ms facilitates better differentiation of results. Proper results evaluation, depending on the number of errors, lack of reactions or prolonged reactions made the assessment easier with computer-aided methods.

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