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Physiotherapists interested in the profession's future have turned in recent years to historical evidence to understand how the physical therapies were practiced before the advent of modern healthcare. However, studies to date suggest that their practice was largely confined to social elites, and those from working-class or poor populations rarely, if ever, experienced them. To test this theory further, this study focuses on British sailors during the Napoleonic wars (1803–1815). Utilizing historical and semi-fictional accounts, this study shows that healthcare on board naval fighting ships concentrated almost entirely on the prevention of disease, and the medical and surgical management of acute trauma. Even though sailors experienced shocking levels of traumatic injury, none appear to have experienced any form of physical therapy. This study supports the argument that prior to the 20th century, the physical therapies were luxuries available primarily to those with surplus time and money, and that widespread access to physiotherapy has relied on state-sponsored universal health coverage. It follows, then, that the decline of universalized healthcare may have profound implications for many marginal groups in society, as well as the physiotherapy profession itself. [ABSTRACT FROM AUTHOR]

Plusieurs études ont démontré l'existence de pathologies psychiques et de risques psychosociaux chez les marins, notamment les officiers de la marine marchande. Les principaux facteurs de risque notifiés sont la fonction d'officier, l'accroissement de la durée de travail et en corollaire la diminution du temps de sommeil, la solitude, l'éloignement familial et plus récemment l'impact de la pandémie de COVID-19 (peur pour sa santé, celle de sa famille, allongement des durées d'embarquement). La faible latitude décisionnelle des membres d'équipage comparativement aux officiers a également été mis en exergue. À ce jour, il n'existe pas d'étude chez les élèves officiers de la marine marchande. Un groupe de travail comprenant des membres des écoles supérieurs de la marine marchande et du CHU de Brest a été constitué. Un questionnaire comprenant des données démographiques et des navigations auquel nous avons adjoint le questionnaire GHQ-12, HAD et le questionnaire de Karasek a été élaboré. L'ensemble des élèves a été sollicité et a rempli le questionnaire de manière anonyme par voie électronique. Les résultats des différents questionnaires ont ensuite été analysés en utilisant les modalités de cotation reconnues au niveau international. Une phase d'analyse descriptive puis une analyse selon les catégories du score de Karasek a été menée. Cent soixante-dix questionnaires ont pu être inclus. La population est majoritairement masculine (76,4 %), et l'âge moyen des élèves est de 21,7 ans. Près de 20 % des élèves déclarent avoir vécu un événement traumatisant au cours d'un stage embarqué. Nous observons que la moyenne du GHQ-12 est à 13,3 et donc supérieure à 12. Les moyennes du HAD anxiété et HAD dépression sont respectivement 6,9 et 5,37, avec respectivement 18,2 % et 7,6 % des élèves inclus présentant des signes d'anxiété et de dépression. Selon la classification de Karasek, nous notons que la classe « actif » est la plus représentée avec 29,4 % des élèves, puis viennent à égalité les classes « tendu » et « détendu » avec 27,6 %. La classe « passif » est la moins représentée avec 15,3 %. Cette étude montre que les élèves de l'école officiers de la marine marchande française ont une évaluation moyenne de leur santé globale et que nous retrouvons une prédominance de troubles anxieux mais peu de signes de dépression. Des signes de « work strain » selon Karasek sont retrouvés pour 1/4 de la population de ces jeunes officiers. La proportion d'élèves officiers présentant des signes d'anxiété et dépression selon le questionnaire HAD est similaire aux études chez les officiers français et européens. Par contre, la proposition d'élèves classés comme « tendus » est plus importante. Concernant les événements traumatisants, dans une analyse semi-dirigée sur les premiers embarquements des étudiants, les principaux facteurs de stress déclarés étaient la conduite du navire, les avaries, la piraterie puis les conditions météorologiques. La période des études au sein des ENSM est une période d'apprentissage théorique mais également de mise en situation lors des stages. Dans ce milieu très spécifique de la marine marchande, l'impact des contraintes psychosociales semble important. Ces données nous interrogent également sur l'impact de la profession mais également celui de la période de pandémie de SARS CoV-2. Cela soulève aussi la problématique de l'aptitude à la navigation de certains élèves présentant des signes anxieux et dépressifs lors de l'enquête, et d'autres à risque de développer ce type de pathologies entrant dans la liste des inaptitudes à la navigation. Several studies have demonstrated the existence of mental disorders and psychosocial risks among sailors, particularly merchant navy officers. The main risk factors reported are assuming the status of an officer, longer working hours and the consequent reduction in sleep time, loneliness, separation from family, and, more recently, the impact of the COVID-19 pandemic (fear for one's own health and that of one's family, and longer embarkation times). The low decision latitude of crew members compared to that of officers has also been highlighted. To date, no studies have been carried out among merchant navy officer cadets. A working group including members of the Merchant Navy school and the hospital of the University of Brest was set up. A questionnaire was devised that included demographic and navigational data to which we added the GHQ-12, HAD and Karasek questionnaires. All the students were asked to complete the questionnaire anonymously and submit it electronically. The results of the questionnaires were then analyzed using internationally recognized scoring procedures. A descriptive analysis phase was conducted which was followed by an analysis according to the Karasek scoring categories. In all, 170 questionnaires were submitted. The participant population was predominantly male (76.4%), and the average age of the students was 21.7 years. Nearly 20% of the students stated that they had experienced a traumatic event during an on-board training course. We note that the average GHQ-12 is 13.3 and therefore higher than 12. The HAD anxiety and HAD depression averages are 6.9 and 5.37 respectively, with 18.2% and 7.6% of the students included showing signs of anxiety and depression. According to Karasek's classification, we note that the "active" class is the most represented with 29.4% of students, followed by the "tense" and "relaxed" classes with 27.6%. The "passive" class is the least represented with 15.3%. This study demonstrates that the students of the French Merchant Navy Officer Training School evaluated their overall health as average, with a predominance of anxiety disorders but few signs of depression. Signs of "work strain" according to the Karasek questionnaire were found in 1/4 of these young officers. The proportion of cadets showing signs of anxiety and depression according to the HAD questionnaire is similar to that shown in studies among French and European officers. On the other hand, the proportion of cadets classified as "tense" is higher. Concerning traumatic events, in a semi-structured analysis of the students' first deployments at sea, the main stress factors reported were how the ship was managed, damaged, piracy and then weather conditions. The period of study within the ENSM involves both a period of theoretical learning but also one of practical training. In the highly specific environment of the merchant navy, the impact of psychosocial constraints seems to be significant. These data also raise questions about the impact of the profession as well as that of the SARS CoV-2 pandemic period. This also raises the issue of the fitness of certain students to sail where they showed signs of anxiety and depression at the time of the survey, and of others who are at risk of developing this type of pathology, which is included in the list of criteria for unfitness for sea duty. [ABSTRACT FROM AUTHOR]

The Ifni Sahara War (1957-1958) was eminently a land conflict however, Spanish Navy had an important logistical role. Navy medical officers provided medical support to both the ships' crews and the Marine Corps detachment on El Aaiún beach, in a satisfactory way in the authors' point of view. Peninsular naval hospitals such as San Carlos (Cádiz) or the tuberculosis sanatorium in Madrid were some of the health centers in the rearguard. [ABSTRACT FROM AUTHOR]

Improper ballasting can lead to severe damage, potentially resulting in loss of life, vessel damage, and environmental disasters. This paper systematically assesses system failures in ballast pump operation related to human errors that contribute to operational risks. Considering this objective, we developed a hybrid approach that combines the Cognitive Reliability and Error Analysis Method (CREAM) with Hazard and Operability (HAZOP). Within this study's context, HAZOP analysis is harnessed to pinpoint the risks inherent in intricate ballast operations, a crucial component of maritime safety. By integrating CREAM analysis, a comprehensive understanding of the role of human factors in systematic failures and operational risks is achieved. The research emphasizes the critical role of cognitive activities, including monitoring, planning, diagnosing, and maintaining, in ensuring the safe and efficient operation of ballast pump systems. This study highlights the importance of cognitive functions such as observation, planning, interpretation, and execution in addressing these issues. The HAZOP analysis successfully identifies various potential deviations and failures within the system, providing insights into the complex nature of ballast operations and the significance of human factors. The analysis method effectively pinpoints vulnerabilities and weaknesses, underlining the necessity of meticulous planning and proper execution to mitigate identified failures. By not only delineating the fundamental causal factors behind ballast system failures and the potential consequences of these failures but also aiming to elevate safety control measures, this paper strives to mitigate prospective losses in critical shipboard operations. [ABSTRACT FROM AUTHOR]

Introduction: Living aboard submarines has a potential negative effect on health. Although studies have evaluated specific health hazards and short-term outcomes, long-term health effects have not been investigated in this population. Methods: Veteran submariners were contacted through the veterans' society and administered a World Health Organisation validated questionnaire (SF-36) assessing their physical, emotional, and social functioning. Scores were compared with those of the general (reference) population and scores in veteran submariners were differentiated by rank, time at sea and time in service. Statistical analyses were performed using the Wilcoxon signed rank and Kruskal-Wallis tests. Results: Of the 1,025 submariners approached in December 2019, 742 (72.4%) completed and returned the questionnaire before July 2020. All 742 were men, of median age 68 (interquartile range [IQR] 59-76) years (range 34-99 years). Of these subjects, 10.3% were current smokers, 64.4% were former smokers and 23.7% had never smoked. Submariners scored significantly better (P < 0.001) than the general population on all eight domains of the SF-36. Except for 'pain' and 'change in health status over the last year', scores for all domains decreased with age. Scores were not significantly affected by smoking status, rank, service, and time at sea. Conclusions: Dutch veteran submariners have better self-reported vitality and health status than the general Dutch population. Rank, service, and time at sea did not significantly affect scores of Dutch submariners. [ABSTRACT FROM AUTHOR]

The Philippines is one of the single largest nationality groups in the maritime and shipping sectors; as a result, the nation's efforts to modernize the skills of the engine cadets are significant. This study aimed to assess the engine cadets' skill level in relation to the requisite 21st-century skills while they were receiving shipboard training at TORM Shipping Philippines Inc. It used a sequential explanatory mixed-methods design. The paper used mean, standard deviation, and Mann-Whitney for comparing differences between two independent groups for the statistical treatment analyses of the quantitative data. Thematic analysis of the descriptive data provided by the interviewees involved coding and identifying common themes, patterns, and responses. The findings revealed that the engine cadets were competent in three (3) areas but needed to be more competent in the remaining area (inventive thinking). This signified that the engine cadets need supplemental training in the areas where they are less apt to improve their skills in all variables, especially 21st-century skills. The management of maritime schools and policymakers must address the common factors that prevent engine cadets from acquiring 21st-century skills, according to the study. [ABSTRACT FROM AUTHOR]

Overview: Juan Sebastián de Elcano training ship is a brigantine-school of the Spanish Navy. Due to its characteristics and navigation type, health care (provided by a Role 1 on-board and occasionally enhanced by a surgical team that includes a general surgeon medical officer and an anesthesiologist medical officer), is considered an essential resource. Material and methods: Retrospective descriptive study of medical care provided on board, grouped by medical specialty, complementary tests, blood products consumption, reason of medical assistance in port, number of evacuations to national territory and type of consultations performed by telemedicine to Role 4 during twelve sailing cruises between 2010 and 2020. Results: The most prevalent healthcare services were traumatology (n=1.982, 22.04%), followed by otorhinolaryngology (n=1.234, 13.72%) and the third was internal medicine (n=1.125, 12.50%). 112 internal medicine consultations were conducted in port (dental first and traumatology second) and 24 evacuations to national territory. The most often requested complementary tests were drug control and X-rays. There were 37 telemedicine consultations and no unit of blood components were transfused during the analyzed period. Conclusions: The study of health care on the navy training ship has shown that traumatology is the most frequent cause of medical consultations on board, followed by internal medicine consultations in port, telemedicine consultations and evacuations to national territory. Thanks to the work of the Military Health on board, it is possible to sail, teach and be ambassador on the seas. [ABSTRACT FROM AUTHOR]

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Throughout the nineteenth century, U.S. Navy medical men, believing that airborne filth--miasmata--caused many of the diseases afflicting sailors and that humid air carries more filth than dry, sought to curtail the cleaning of the decks of warships with wet swabs. They met resistance to this reform from line officers who, from a variety of motives, were committed to keeping their ships clean. The medical reform movement attained its greatest intensity in the 1870s but quickly dissipated at the end of the century when steel hulls replaced wooden ones and the germ theory of disease replaced the theory of miasmata. [ABSTRACT FROM AUTHOR]

The aim is to assess the prevalence and knowledge on acute occupational exposure to phosphine in the shipping industry. We followed PRISMA guidelines for scoping review. We searched in 4 databases without language and date restrictions for scientific articles in peer-reviewed and gray literature. We found 13 peer-reviewed articles and 63 articles in gray literature. These covered 56 incidents from 1963 to 2019 for a total of 254 victims and 22 fatalities. There is an increase in the number of reported cases over the last 20 years. Neurologic and gastrointestinal symptoms are predominant, and hospitalization is needed in 80% of cases. Our review underlined the principal risk as gas exposure through leaks between holds and the ventilation system. Further studies on the knowledge and the prevention in order to improve good practices onboard, prevent the risk of fire explosion, and a global reporting system of new cases are recommended. [ABSTRACT FROM AUTHOR]

Seen as a crucial historical step in the development of 'modern' institutional healthcare, eighteenth-century British naval medicine has traditionally been studied from the point of view of the state and of physicians and surgeons: naval sailors' attitudes towards health, medicine and their own bodies remain virtually unexplored. Using official and personal sources, this article sketches a 'patient's history' of late-eighteenth- and early-nineteenth-century British ratings. Aiming to counterbalance Foucauldian interpretations, it highlights some of the ways in which individuals, even when apparently most powerless, confined in ships far from home, and controlled by rigidly disciplined institutions, could take responsibility for their health, successfully or otherwise, within, against or alongside the system. If the unprecedented administrative requirements of the French Wars strengthened and standardised top-down medical authority, they also brought opportunities for evasion and negotiation. This complicates established narratives of the relationship between modern medicine, the armed forces and power. [ABSTRACT FROM AUTHOR]

Background: Seafarers are at an increased risk of developing cardiovascular diseases (CVDs), potentially due to a stressful working environment and behavioral risk factors. To develop better prevention strategies, it is important to elucidate the extent of this risk. Therefore, we conducted a systematic literature review on CVD in seafarers., Method: We conducted systematic searches in five databases. All studies investigating CVDs among occupational seafarers, published in articles or conference papers, were eligible for inclusion. The identified records were screened and reviewed by two independent researchers, who also evaluated the methodological quality of the included studies., Results: Three thousand nine hundred and seventeen records qualified for screening, and 55 were eligible for inclusion. Most of the studies were observational, including cohort, frequency, incidence or prevalence studies, and review of case records. Around half were assessed at risk of biased findings. Participants in the studies were primarily from North America or the European continent and work onboard transportation vessels. Many studies investigated CVDs as a cause of death, focusing on conditions such as CVD, ischemic heart disease, and myocardial infarction. Frequency of CVD conditions varied but indicate that seafarers face a greater risk compared to the reference populations or control groups. Environmental factors were mainly investigated as risk factors., Conclusion: Our results indicate a higher risk of CVDs among seafarers compared to reference or control groups. However, due to the variable quality of the evidence, well-designed studies are needed to establish the causes of cardiovascular mortality and morbidity in seafarers and to investigate behavioral aspects of cardiovascular risk., (© 2024 The Authors. Journal of Cellular Physiology published by Wiley Periodicals LLC.)

Thresholds that guide diagnoses of probable and acceptable seasickness levels on board ships are scarcely reported in literature. Motion sickness incidence and motion sickness dose value thresholds exist, but are defined for specific environments, such as naval, or offered merely as optional criteria for ship performance metrics. The presented work communicates a novel means of developing seasickness diagnostic criteria during ship operation, based on observations from shipboard measurement systems and seafarers using an innovative platform. The innovative platform provides personalised seasickness criteria that are accessible during ship operation to estimate the probable level of seasickness on board. Results are compared to that from a traditional method of data acquisition and analyses, post operation, revealing a similar trend in diagnostic threshold magnitudes (13-85 m/s 1.5 ) that can be applicable to voyages with different durations (0.5-6 hr) considering desired levels of seasickness (10-50 %). The seasickness criteria are envisioned to be pertinent for the prediction of probable seasickness levels based on sea state forecasts and ship motion estimation., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. s., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Divers are regularly exposed to a unique and changing environment that dentists must consider when treating such patients. This review focuses around two case studies encountered in naval dentistry: (i) diving barotrauma (pressure-induced injury related to an air space); and (ii) scuba diving mouthpiece-related oral conditions. Each condition is described by its effect on the oral cavity and in particular the teeth. Then we generally review the latest literature on the different effects of scuba diving on the diver's head, face and oral regions and emphasize methods of dental disease prevention, diagnostic tools and treatment guidelines. [ABSTRACT FROM AUTHOR]

In conclusion, with coordinated work and communication between cruise medical staff, port agency and port and public health authorities, >100 000 cruise passengers were safely mobilized with few COVID-19 cases and no significantly large outbreaks. Although vaccination was not widely available at the analysed period and by the end of May 2021, <20% of EU citizen were fully vaccinated, the green passport for vaccinated passengers on cruise would be an additional relevant preventive measure, and several international cruise companies require all crew and passengers be vaccinated. Description of outbreaks on cruise ships Two COVID-19 outbreaks were detected and notified to the Canary public health authorities on two ships, namely "cruise number 1" and "cruise number 2". Keywords: COVID-19; Disease Outbreaks; Quarantine; Ships; Naval Medicine; Travel EN COVID-19 Disease Outbreaks Quarantine Ships Naval Medicine Travel 1 4 4 06/08/22 20220401 NES 220401 Background The coronavirus disease 2019 (COVID-19) pandemic has a severe impact on cruise activity ([1]). [Extracted from the article]

In 2016, the French Navy acquired a new high-speed boat, called ECUME. It exposes crewmembers to significant Whole Body Vibrations. This work explores the musculoskeletal diseases among this population. We conducted a retrospective declarative epidemiologic study using anonymous questionnaires. Eighty-four sailors were included. Fifty-six (66.7%) report acute traumas during a nautical raid during the 12 months study period. Sixty (71.4%) report chronic pains, which they associate with their nautical activity. Among them, only 16 (26.7%) have consulted a doctor, but 32 (53.3%) report consuming medication, including 18 through selfmedication. More than half rely to alternatives medicine, especially osteopathy. The traumatic risk of ECUME riding is obvious. Many crewmembers minimize their symptoms, and consult rarely a physician. They give preference to selfmedication and alternative medicines. [ABSTRACT FROM AUTHOR]

Background In the 1960s, the International Labour Organization passed a convention under which all countries with national shipping were obliged to create a 24-h telemedicine center for ships. In accordance with the convention, Telemedical Assistance Service centers were to provide permanent access to medical advice given by qualified doctors and to create an international platform for the exchange of information and experience. In Poland, the Telemedical Maritime Assistance Service (TMAS) was established in 2012, and its duties in a 24-h system are carried out by doctors from the University Center of Maritime and Tropical Medicine (UCMTM) in Gdynia. The aim of this work was to determine the reasons for medical officers reporting for help from the TMAS doctor on duty and to create a database of the most common diagnoses and actions undertaken, and in particular evacuation. Material and Methods In the presented work, the authors analyzed TMAS telephony and e-mail advice provided by doctors of the UCMTM in Gdynia, in the period from October 2012 to the end of 2018. Results In the 6-year period, UCMTM doctors provided TMAS advice 225 times, recommending evacuation in over 20% of these cases. Infectious diseases were the most common cause of contact in the entire period under analysis – 61 cases were recorded, accounting for as many as 27% of all applications. Injuries were the second most frequent reason for seeking help from TMAS, and 20% of TMAS applications (44 cases) were related to trauma. Conclusions The obtained data show that TMAS doctors face various medical problems; therefore, providing proper medical assistance to patients requires a close multidisciplinary cooperation between medical officers, TMAS doctors and emergency services. Med Pr. 2020;71(2):121–5

We analysed all proven cases of SARS-CoV-2 on sea-going vessels entering or present in the Port of Rotterdam to illustrate the burden of the corona pandemic on commercial shipping. We calculated the notification rate (NR) per arrival and attack rate per vessel and correlated outbreak sizes by vessel type over time during the pandemic using routinely gathered data from the port and public health (PH) authorities.

During distributed maritime operations, individual components of the naval force are more geographically dispersed. As the U.S. Navy further develops this concept, smaller vessels may be operating at a significant time and distance away from more advanced medical capabilities. Therefore, during both current and future contested Distributed Maritime Operations, Role 1 maritime caregivers such as Independent Duty Corpsman will have to manage patients for prolonged periods of time. This manuscript presents an innovative approach to teaching complex operational medicine concepts (including Prolonged Casualty Care [PCC]) to austere Role 1 maritime caregivers using a hypothetical scenario involving a patient with sepsis and septic shock. The scenario incorporates the Joint Trauma System PCC Clinical Practice Guidelines (CPG) and other standard references. The scenario includes a stem clinical vignette, expected clinical changes for the affected patient at specific time points (e.g., time 0, 1, 2, and 48h), and expected interventions based on the PCC CPG and available shipboard equipment. Epidemiology of sepsis in the deployed environment is also reviewed. This process also identifies opportunities to improve training, clinical skills sustainment, and standard shipboard medical supplies., (2024.)

According to the International Labor Organization, health protection and access to medical treatment are to be guaranteed to seamen in the same way as to people working ashore. However, in practice, formal measures and mechanisms do not always make it possible to provide medical care to crew members of civil vessels due to peculiarities of legal systems of the States in whose territorial waters the vessel is located, remoteness of the vessel from coastline and objective situation that permits to receiving medical care from the shore. As far as possible these problems are resolved by non-profit organizations of seamen. The overview of their activities is presented in this article.