Progetto e realizzazione del sistema di gestione autonoma del volo e controllo in remoto per un velivolo UAV ad ala rotante

This PhD thesis presents the results, achieved at the Aerospace Engineering Department Laboratories of the University of Bologna, concerning the development of a small scale Rotary wing UAVs (RUAVs). In the first part of the work, a mission simulation environment for rotary wing UAVs was developed, as main outcome of the University of Bologna partnership in the CAPECON program (an EU funded research program aimed at studying the UAVs civil applications and economic effectiveness of the potential configuration solutions). The results achieved in cooperation with DLR (German Aerospace Centre) and with an helicopter industrial partners will be described. In the second part of the work, the set-up of a real small scale rotary wing platform was performed. The work was carried out following a series of subsequent logical steps from hardware selection and set-up to final autonomous flight tests. This thesis will focus mainly on the RUAV avionics package set-up, on the onboard software development and final experimental tests. The setup of the electronic package allowed recording of helicopter responses to pilot commands and provided deep insight into the small scale rotorcraft dynamics, facilitating the development of helicopter models and control systems in a Hardware In the Loop (HIL) simulator. A neested PI velocity controller1 was implemented on the onboard computer and autonomous flight tests were performed. Comparison between HIL simulation and experimental results showed good agreement.

Therapeutisches Drug Monitoring in der ambulanten Psychopharmakotherapie

Während Therapeutisches Drug Monitoring (TDM) im klinischen Alltag der stationären Behandlung in der Psychiatrie bereits fest etabliert ist, kommt es in der ambulanten Betreuung von psychisch Kranken bislang noch selten zum Einsatz. Ziel dieser Arbeit war es zu klären, wie TDM im ambulanten Bereich eingesetzt wird, wann seine Anwendung sinnvoll ist und ob es Hinweise gibt, dass TDM zu einer besseren Psychopharmakotherapie beitragen kann. rnEine Grundvoraussetzung für den Einsatz von TDM ist die Messbarkeit des Arzneistoffes. Am Beispiel des Antipsychotikums Flupentixol wurde eine Quantifizierungsmethode entwickelt, validiert und in die Laborroutine integriert. Die neue Methode erfüllte alle nach Richtlinien vorgegebenen Anforderungen für quantitative Laboruntersuchungen. Die Anwendbarkeit in der Laborroutine wurde anhand von Untersuchungen an Patienten gezeigt. rnEine weitere Voraussetzung für eine TDM-geleitete Dosisanpassung ist die Kenntnis des therapeutischen Referenzbereiches. In dieser Arbeit wurde exemplarisch ein Referenzbereich für das Antipsychotikum Quetiapin ermittelt. Die Untersuchung verglich darüber hinaus die neu eingeführten Arzneiformulierung Quetiapin retard mit schnell freisetzendem Quetiapin. Es zeigte sich, dass die therapiebegleitenden Blutspiegelkontrollen beider Formulierungen mit der Einstellung des Blutspiegels auf den therapeutischen Bereich von 100 - 500 ng/ml die Wahrscheinlichkeit des Therapieansprechens erhöhen. Bei den verschiedenen Formulierungen musste unbedingt auf den Zeitpunkt der Blutentnahmen nach Einnahme geachtet werden.rnEs wurde eine multizentrische Querschnittsuntersuchung zur Analyse von TDM unter naturalistischen Bedingungen an ambulanten Patienten durchgeführt, und zwar in Ambulanzen, in denen TDM als fester Bestandteil der Therapieüberwachung genutzt wurde und in Ambulanzen, in denen TDM sporadisch engesetzt, bzw. neu eingeführt wurde. Nach dieser Erhebung schien die Anwendung von TDM zu einer besseren Versorgung der Patienten beizutragen. Es wurde festgestellt, dass in den Ambulanzen mit bewusster Anwendung von TDM mehr Patienten mit Blutspiegeln im therapeutischen Bereich vorkamen als in den Ambulanzen mit nur sporadisch durchgeführten Blutspiegelmessungen. Bei Letzteren betrug die mittlere Anzahl an Medikamenten pro Patient 2,8 gegenüber 2,2 in den anderen Ambulanzen, was mit höheren Nebenwirkungsraten einherging. Die Schlussfolgerung, dass das Einstellen der Blutspiegel auf den therapeutischen Bereich auch tatsächlich zu besseren Therapieeffekten führte, konnte mit der Studie nicht valide überprüft werden, da die Psychopathologie nicht adäquat abgebildet werden konnte. Eine weitere Erkenntnis war, dass das reine Messen des Blutspiegels nicht zu einer Verbesserung der Therapie führte. Eine Verbesserung der Anwendung von TDM durch die Behandler wurde nach einer Schulung festgestellt, die das Ziel hatte, die Interpretation der Blutspiegelbefunde im Kontext mit patienten- und substanzspezifischen Informationen zu verbessern. Basierend auf dieser Erfahrung wurden Arzneistoffdatenblätter für die häufigsten angewandten Antipsychotika und Antidepressiva entwickelt, um damit die ambulanten Ärzte für eine eigenständige Befundinterpretation zu unterstützen. rnEin weiterer Schwerpunkt der Untersuchungen an ambulanten Patienten war die Aufdeckung von Non-Compliance durch TDM. Ein neu entwickeltes Verfahren, durch Berechnung der Streuung der mittleren Blutspiegel, erwies sich als geeignetes Instrument zur Compliance-Kontrolle in der Clozapin-Langzeittherapie. Es war etablierten anderen Verfahren überlegen. Demnach hatten Patienten ein erhöhtes Rückfallrisiko, wenn der Variationskoeffizient von nur drei nacheinander gemessenen Blutspiegeln größer als 20 % war. Da für die Beurteilung des Variationskoeffizienten das Messen von nur drei aufeinander folgenden Blutspiegeln notwendig war, kann diese Methode leicht in den ambulanten Alltag integriert werden. Der behandelnde Arzt hat so die Möglichkeit, einen rückfallgefährdeten Patienten noch vor seiner psychopathologischen Verschlechterung zu erkennen und ihn beispielsweise durch engmaschigeres Supervidieren vor einem Rückfall zu bewahren.rnAlles in allem konnte durch die eigenen Untersuchungen an psychiatrischen Patienten, die unter naturalistischen Bedingungen behandelt wurden, gezeigt werden, wie die Voraussetzungen für die Anwendung von TDM geschaffen werden, nämlich durch die Etablierung und Validierung einer Messmethode und durch die Evaluierung eines therapeutischen Referenzbereiches und wie TDM bei adäquatem Einsatz, nach Verbesserung der Compliance und des Kenntnisstandes der behandelnden Ärzte im praktischen und theoretischen Umgang mit TDM, die Versorgung ambulanter psychiatrischer Patienten unterstützen kann.

Waldbrandprognose und Waldbrandbekämpfung in Deutschland

Ist Deutschland auf Waldbrandkatastrophen vorbereitet? Dies ist die zentrale Frage dieser wissenschaftlichen Arbeit. Zahlreiche Großwaldbrände der Vergangenheit zeigen ein deutliches Waldbrandpotential für die bundesdeutschen Areale, speziell in Ostdeutschland. Als eine der Folgen des global warming ist zukünftig mit einem Anstieg der Gefahrensituation zu rechnen. Anhand der Untersuchung zweier Katastrophenwaldbrände wurden Schwachstellen bei der Bekämpfung dieser Waldbrände aufgezeigt, aber auch positive Aspekte herausgestellt. Die wichtigste Erkenntnis ist hierbei die große Bedeutung der Brandbekämpfung aus der Luft. Sie spielt die Schlüsselrolle bei der Bekämpfung von Großwaldbränden. Daher untersucht diese Arbeit die aktuelle Situation in Deutschland und erstellt erstmals ein bundesweites Kataster der Hubschrauberaußenlastbehälter sowie den dazugehörigen Trägerfahrzeugen (Hubschrauber). Aufgrund dieses Katasters sowie einer Auflistung der Systeme zur Branddetektion (Feuerwachtürme und kameragestützte Systeme) kommt diese Arbeit zu dem Ergebnis, dass man in Deutschland gut auf Waldbrandkatastrophen vorbereitet ist. Gleichzeitig liefert diese Arbeit aber auch Optimierungsmöglichkeiten in Form eines Maßnahmenkatalogs. So ist beispielsweise das System der Waldbrandprognose nach M-68 zu überarbeiten, da es die tatsächliche Gefährdungslage teilweise unterschätzt, Simulationsprogramme zur Ausbreitung von Waldbränden sind zu entwickeln, Sicherheitsregeln sind einzuführen. Weiterhin ist die indirekte Brandbekämpfung durch die Aufstellung von task-forces in Deutschland erstmalig zu ermöglichen.

Night Vision Imaging System (NVIS) certification requirements analysis of an Airbus Helicopters H135

The safe operation of nighttime flight missions would be enhanced using Night Vision Imaging Systems (NVIS) equipment. This has been clear to the military since 1970s and to the civil helicopters since 1990s. In these last months, even Italian Emergency Medical Service (EMS) operators require Night Vision Goggles (NVG) devices that therefore amplify the ambient light. In order to fly with this technology, helicopters have to be NVIS-approved. The author have supported a company, to quantify the potentiality of undertaking the certification activity, through a feasibility study. Even before, NVG description and working principles have been done, then specifications analysis about the processes to make a helicopter NVIS-approved has been addressed. The noteworthy difference between military specifications and the civilian ones highlights non-irrevelant lacks in the latter. The activity of NVIS certification could be a good investment because the following targets have been achieved: Reductions of the certification cost, of the operating time and of the number of non-compliance.

Prehospital ultrasound in emergency medicine: incidence, feasibility, indications and diagnoses

Sonography is an established diagnostic procedure in hospitals, but is not routinely used in prehospital emergency medicine. Several studies have addressed the use of ultrasound during helicopter flights and in emergency rooms, few in prehospital settings, but most focused on abdominal blunt trauma. Several case reports describe crucial decisions distinguished by ultrasound.

A feasibility study for the provision of electronic healthcare tools and services in areas of Greece, Cyprus and Italy

Background Through this paper, we present the initial steps for the creation of an integrated platform for the provision of a series of eHealth tools and services to both citizens and travelers in isolated areas of thesoutheast Mediterranean, and on board ships travelling across it. The platform was created through an INTERREG IIIB ARCHIMED project called INTERMED. Methods The support of primary healthcare, home care and the continuous education of physicians are the three major issues that the proposed platform is trying to facilitate. The proposed system is based on state-of-the-art telemedicine systems and is able to provide the following healthcare services: i) Telecollaboration and teleconsultation services between remotely located healthcare providers, ii) telemedicine services in emergencies, iii) home telecare services for "at risk" citizens such as the elderly and patients with chronic diseases, and iv) eLearning services for the continuous training through seminars of both healthcare personnel (physicians, nurses etc) and persons supporting "at risk" citizens. These systems support data transmission over simple phone lines, internet connections, integrated services digital network/digital subscriber lines, satellite links, mobile networks (GPRS/3G), and wireless local area networks. The data corresponds, among others, to voice, vital biosignals, still medical images, video, and data used by eLearning applications. The proposed platform comprises several systems, each supporting different services. These were integrated using a common data storage and exchange scheme in order to achieve system interoperability in terms of software, language and national characteristics. Results The platform has been installed and evaluated in different rural and urban sites in Greece, Cyprus and Italy. The evaluation was mainly related to technical issues and user satisfaction. The selected sites are, among others, rural health centers, ambulances, homes of "at-risk" citizens, and a ferry. Conclusions The results proved the functionality and utilization of the platform in various rural places in Greece, Cyprus and Italy. However, further actions are needed to enable the local healthcare systems and the different population groups to be familiarized with, and use in their everyday lives, mature technological solutions for the provision of healthcare services.

Same Same but Different: Returning to Vietnam after 40 Years

Dan Cornell returned to Vietnam in 2012, more than 40 years after he was stationed there. From 1970-1971, Dan spent time flying around Vietnam and the neighboring countries in a large, CH-47 helicopter. There was not much time to think about what he was doing or why. In spite of this, Dan managed to become enticed bu this country so different from his own. This presentation features videos and photos from his 8-week trip.

Traditionen, Utopien, Dekonstruktionen - die Sozialstaatskonzepte des 'Ostblocks' (1945-1990)

The welfare state concepts in Eastern Europe under state socialism (1945-1990) were based on the conviction that only the state was responsible for solving all social problems. The 'bourgeois' manners of individual care were substituted by general measures in the field of labour- and family politics, as well as urban development. The experience showed however that this way of substitution was an illusion, because certain target groups were still in need of help (for example ill or handicapped children and adults, elderly people etc). Nevertheless, most of the Eastern European countries - with the exception of Yugoslavia - decided to abolish the existing forms of professional social work and the training for social workers. Instead, they invented 'surrogate structures' to manage the care for the 'needy': Various institutions and occupational groups (schools, hospitals and ambulances, employees groups etc.) took over the tasks of social workers and were trained to fulfil this as a kind of 'social practice'. Therefore, it is wrong to claim that social work was completely abolished under state socialism, But: as social work 'as such' did not exist any longer, it is more reasonable to speak of welfare state concepts, including social policy on one hand, and non- or paraprofessional social practice on the other. To characterize the effect of these welfare state concepts three parameter of interpretation seem to be useful: 'traditions', 'visions', and 'deconstructions' - embedded in a system of repression as well as incentives. Traditions: The huge 'social laboratory' that was installed was not a totally new one - it still carried on the heritage of the bygone: some bourgeois traces as well as elements out of the fascist heritage and -last but not least - the traditions of their own socialist movement. Visions: The socialist traditions included visions of social justice, the creation of a 'new mankind', a classless society, the end of exploitation and a peaceful living together of all people. Although the 'real existing socialism' has destroyed most of these visions, the power of these utopian ideas has outshined a lot of the every day’s misfortune and injustice for quite a long time. Deconstructions: The term of 'deconstruction' has a threefold meaning: the deconstruction of professional welfare, the deconstruction - in the sense of reinterpretation - of the socialist ideals such as social justice and social security, making an instrument of inclusion and exclusion out of it. And the deconstruction that is necessary to free the history of social work under state socialism from the prejudices and distorting practices, from both sides, the east and the west. In the contribution these three parameter of interpretation are applied on the following issues: The gaps in the 'overall system' of social security; working morale and education for work; mass organisations as an instrument of egalitarianism and general prevention; de-professionalisation by 'surrogating' social work; the 'transparent client'; church as refuge or 'state organ'; women’s politics as bio-politics.

From Matterhorn to Mt Everest: empowering rescuers and improving medical care in Nepal.

This article describes a private initiative in which professional Swiss rescuers, based at the foot of the Matterhorn, trained Nepalese colleagues in advanced high altitude helicopter rescue and medical care techniques. What started as a limited program focused on mountain safety has rapidly developed into a comprehensive project to improve rescue and medical care in the Mt Everest area for both foreign travelers and the local Nepalese people.

Repatriations and 28-day mortality of ill and injured travellers: 12 years of experience in a Swiss emergency department

QUESTIONS UNDER STUDY Many persons are travelling all over the world; the elderly with pre-existing diseases also travel to places with less developed health systems. Reportedly, fewer than 0.5% of all travellers need repatriation. We aimed to analyse and examine people who are injured or ill while abroad, where they travelled to and by what means they were repatriated. METHODS Retrospective cross-sectional study with adult patients repatriated to a single level 1 trauma centre in Switzerland (2000-2011). RESULTS A total of 372 patients were repatriated, with an increasing trend per year. Of these, 67% were male; the median age was 56 years. Forty-nine percent sustained an injury, and 13% had surgical and 38% medical pathologies. Patients with medical conditions were older than those with injuries or surgical emergencies (p <0.001). Seventy-three percent were repatriated from Europe. For repatriation from Africa trauma was slightly more frequent (53%, n = 17) than illnesses, whereas for most other countries illnesses and trauma were equally distributed. Injured patients had a median Injury Severity Score of 8. The majority of illnesses involved the nervous system (38%), mainly stroke. Forty-five percent were repatriated by Swiss Air Ambulance, 26% by ground ambulance, 18% by scheduled flights with or without medical assistance and two patients injured near the Swiss boarder by helicopter. The 28-day mortality was 4%. CONCLUSIONS The numbers of travellers repatriated increased from 2000 to 2011. About half were due to illnesses and half due to injuries. The largest group were elderly Swiss nationals repatriated from European countries. As mortality is relatively high, special consideration to this group of patients is warranted.

Penetrating injuries of the thorax and abdomen: Type of medical-care institution and case fatality

The purpose of this study was to determine, for penetrating injuries (gunshot, stab) of the chest/abdomen, the impact on fatality of treatment in trauma centers and shock trauma units compared with general hospitals. Medical records of all cases of penetrating injury limited to chest/abdomen and admitted to and discharged from 7 study facilities in Baltimore city 1979-1980 (n = 581) were studied: 4 general hospitals (n = 241), 2 area-wide trauma centers (n = 298), and a shock trauma unit (n = 42). Emergency center and transferred cases were not studied. Anatomical injury severity, measured by modified Injury Severity Score (mISS), was a significant prognostic factor for death, as were cardiovascular shock (SBP $\le$ 70), injury type (gunshot vs stab), and ambulance/helicopter (vs other) transport. All deaths occurred in cases with two or more prognostic factors. Unadjusted relative risks of death compared with general hospitals were 4.3 (95% confidence interval = 2.2, 8.4) for shock trauma and 0.8 (0.4, 1.7) for trauma centers. Controlling for prognostic factors by logistic regression resulted in these relative risks: shock trauma 4.0 (0.7, 22.2), and trauma centers 0.8 (0.2, 3.2). Factors significantly associated with increased risk had the following relative risks by multiple logistic regression: SBP $\le$ 70 (RR = 40.7 (11.0, 148.7)), highest mISS (42 (7.7, 227)), gunshot (8.4 (2.1, 32.6)), and ambulance/helicopter transport (17.2 (1.3, 228.1)). Controlling for age, race, and gender did not alter results significantly. Actual deaths compared with deaths predicted from a multivariable model of general-hospital cases showed 3.7 more than predicted deaths in shock trauma (SMR = 1.6 (0.8, 2.9)) and 0.7 more than predicted deaths in area-wide trauma centers (SMR = 1.05 (0.6, 1.7)). Selection bias due to exclusion of transfers and emergency center cases, and residual confounding due to insufficient injury information, may account for persistence of adjusted high case fatality in shock trauma. Studying all cases prospectively, including emergency center and transferred cases, is needed. ^

SEVERE HEAD TRAUMA, EMERGENCY TRANSPORT, AND PATIENT OUTCOME

Trauma and severe head injuries are important issues because they are prevalent, because they occur predominantly in the young, and because variations in clinical management may matter. Trauma is the leading cause of death for those under age 40. The focus of this head injury study is to determine if variations in time from the scene of accident to a trauma center hospital makes a difference in patient outcomes.^ A trauma registry is maintained in the Houston-Galveston area and includes all patients admitted to any one of three trauma center hospitals with mild or severe head injuries. A study cohort, derived from the Registry, includes 254 severe head injury cases, for 1980, with a Glasgow Coma Score of 8 or less.^ Multiple influences relate to patient outcomes from severe head injury. Two primary variables and four confounding variables are identified, including time to emergency room, time to intubation, patient age, severity of injury, type of injury and mode of transport to the emergency room. Regression analysis, analysis of variance, and chi-square analysis were the principal statistical methods utilized.^ Analysis indicates that within an urban setting, with a four-hour time span, variations in time to emergency room do not provide any strong influence or predictive value to patient outcome. However, data are suggestive that at longer time periods there is a negative influence on outcomes. Age is influential only when the older group (55-64) is included. Mode of transport (helicopter or ambulance) did not indicate any significant difference in outcome.^ In a multivariate regression model, outcomes are influenced primarily by severity of injury and age which explain 36% (R('2)) of variance. Inclusion of time to emergency room, time to intubation, transport mode and type injury add only 4% (R('2)) additional contribution to explaining variation in patient outcome.^ The research concludes that since the group most at risk to head trauma is the young adult male involved in automobile/motorcycle accidents, more may be gained by modifying driving habits and other preventive measures. Continuous clinical and evaluative research are required to provide updated clinical wisdom in patient management and trauma treatment protocols. A National Institute of Trauma may be required to develop a national public policy and evaluate the many medical, behavioral and social changes required to cope with the country's number 3 killer and the primary killer of young adults.^

Changes in 911 call volume and type during Hurricane Ike and the implementation and usefulness of the TeleHealth Nurse system for the Houston Fire Department

This study examined both changing call volume and type with resulting effect of TeleHealth Nurse, the Houston Fire Department's (HFD) telephone nurse line, on call burden during Hurricane Ike. On September 13, 2008, Hurricane Ike made landfall in the Galveston area and continued north through Houston resulting in catastrophic damages in infrastructure and posing a public health threat. The overall goal of this study looked at data from Houston Fire Department to obtain a better understanding of the needs of citizens before, during, and after a hurricane. This study looked at four aspects of emergency response from HFD. The first section looked at call volumes surrounding the time of Hurricane Ike in 2008 compared to the same time period in 2007. The data showed a 12% increase in calls surrounding Hurricane Ike compared to previous years with a p value <.001. Next, the study evaluated the types of calls prevalent during Hurricane Ike compared to the same time period in 2007. The data showed a statistically significant increase in chronic health problems such as diabetes and cardiac events, Obstetric calls and an increase in breathing problems, falls, and lacerations during the days following Hurricane Ike. There was also a statistically significant increase in auto med alerts and check patients surrounding Hurricane Ike's landfall. The third section analyzed the change in call volume sent to HFD's Telephone Nurse Line during Hurricane Ike and compares this to earlier time periods while the fourth and final section looks at the types of calls sent to the nurse line during Hurricane Ike. The data showed limited use of the TeleHealth Nurse line before Hurricane Ike, but when the winds were at their strongest and ambulances were unable to leave the station, the nurse line was the only functioning medical help some people were able to receive. These studies bring a better understanding to the number and types of calls that a city might experience during a natural disaster, such as a hurricane. This study also shows the usefulness of an EMS Telephone Nurse Line during a natural disaster.^