When passing through a tunnel, aerodynamic effects on high-speed trains may impair passenger comfort. These variations in atmospheric pressure are accompanied by transient increases in sound pressure level. To date, it is unclear whether the latter influences the perceived discomfort associated with the variations in atmospheric pressure. In a pressure chamber of the DLR-Institute of Aerospace Medicine, 71 participants (M = 28.3 years ± 8.1 SD) rated randomised pressure changes during two conditions according to a crossover design. The pressure changes were presented together with tunnel noise such that the sound pressure level was transiently elevated by either +6 dB (low noise condition) or +12 dB (high noise condition) above background noise level (65 dB(A)). Data were combined with those of a recent study, in which identical pressure changes were presented without tunnel noise (Schwanitz et al., 2013, 'Pressure Variations on a Train - Where is the Threshold to Railway Passenger Discomfort?' Applied Ergonomics 44 (2): 200-209). Exposure-response relationships for the combined data set comprising all three noise conditions show that pressure discomfort increases with the magnitude and speed of the pressure changes but decreases with increasing tunnel noise. Practitioner Summary: In a pressure chamber, we systematically examined how pressure discomfort, as it may be experienced by railway passengers, is affected by the presence of tunnel noise during pressure changes. It is shown that across three conditions (no noise, low noise (+6 dB), high noise (+12 dB)) pressure discomfort decreases with increasing tunnel noise.

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Sleep structure is highly stable within individuals but different between individuals. The present study investigated robustness of the individual sleep structure to extended total sleep deprivation. Seventeen healthy men spent a baseline night (23:00-07:00 hours), 58 h of sleep deprivation and a 14-h recovery night (17:00-07:00 hours) in the laboratory. Intraclass correlation coefficients showed that the agreement between baseline and recovery with respect to the proportion of the different sleep stages increased as a function of recovery sleep duration. High values were reached for most of the sleep stages at the end of 14 h of recovery sleep (intraclass correlation coefficients between 0.38 and 0.76). If sleep duration of the recovery night is extended to 14 h, sleep stage distribution resembles that of a baseline night underlining the robustness of the individual sleep structure.

Helicopter emergency services (HEMS) carrying doctors trained in emergency medicine represent a well established system for primary care with increasing professionalism since their implementation in the seventies until now. However, considerable differences persist in Europe concerning the structure as well as integration of the system in the entire organisation of area-wide demands. Based on the particular geographic conditions in the alps which are highly associated with challenges for man and material a dense network of helicopter airbases has been established. Hence, this system accounts for the social, economical and touristic requirements of this region in terms of providing sufficient emergency medical treatment. In addition to statutory and professional provisions qualification requirements for emergency doctors comprehend extensive alpine training. Primarily this provides personal safety as well as security for the entire team and the patient which particularly applies for technical rope rescue. Advanced all-season training is compulsory due to seasonal differences in casualties. Well harmonized training with cross-border validity is not available to-date. Hence, the development of obligatory standard operating procedures should be the major goal of medical associations and societies.

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