Wilderness & Environmental Medicine最新文献

Cardiac Autonomic Dysfunction in Diabetic Highlander and Lowlander Populations of Nepal Assessed by Heart Rate Variability. 通过心率变异性评估尼泊尔高原和低地糖尿病人群的心脏自主神经功能障碍。

IF 1.6 4区医学

Wilderness & Environmental Medicine Pub Date : 2026-11-05 DOI: 10.1177/10806032261504752

Santosh Kumar Deo, Sanjay Kumar, Kopila Agrawal, Bibhushan Dhungyal, Ram Babu Joshi

{"title":"Cardiac Autonomic Dysfunction in Diabetic Highlander and Lowlander Populations of Nepal Assessed by Heart Rate Variability.","authors":"Santosh Kumar Deo, Sanjay Kumar, Kopila Agrawal, Bibhushan Dhungyal, Ram Babu Joshi","doi":"10.1177/10806032261504752","DOIUrl":"https://doi.org/10.1177/10806032261504752","url":null,"abstract":"IntroductionDiabetes mellitus is associated with cardiac autonomic dysfunction (CAD) and enhanced cardiovascular risk. High-altitude dwellers exhibit physiological adaptations that may regulate autonomic function. The present study aims to compare cardiac autonomic function in diabetic highlanders vs diabetic lowlanders of Nepal using heart rate variability (HRV).MethodsA cross-sectional study was performed on a total of 128 patients with type 2 diabetes mellitus (T2DM), including 64 native highlanders residing above 2500 m (Phaplu, Solukhumbu district, Nepal) and 64 native lowlanders below 500 m (Biratnagar, Morang District, Nepal). HRV was measured using standard electrocardiography (ECG) under baseline resting state. Time- and frequency-domain HRV indices including age, gender, duration of diabetes, and HbA1c were recorded and analyzed. Comparative statistical analysis was conducted using independent t tests and Mann-Whitney U tests.ResultsIn time-domain HRV parameters, diabetic highlanders showed significantly higher SDNN (88.9 [48.5-97.2] ms vs 28.7 [20.2-43.1] ms; P < .001) and increased RMSSD (64.9 [35.1-92.3] ms vs 21.6 [14.3-38.3] ms; P < .001) compared to lowlanders. Likewise, in frequency-domain HRV analysis, as compared to diabetic lowlanders, diabetic highlanders revealed significantly increased HF power (317.6 [96.5-869.2] ms2 vs 86.1 [29.7-314.0] ms2; P < .001) and lower LF/HF ratio (0.4 [0.2-1.1] vs 1.2 [0.9-3.4]; P < .001) demonstrating relatively better autonomic balance.ConclusionHighlanders with T2DM exhibit relatively preserved cardiac autonomic balance compared to diabetic lowlanders, indicating that chronic exposure to high altitude influences diabetes-related autonomic dysfunction. These findings highlight the importance of considering geographical and environmental factors during management and risk assessment of diabetic individuals in Nepal.","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":" ","pages":"10806032261504752"},"PeriodicalIF":1.6,"publicationDate":"2026-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149335836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Personality Traits and Professional Quality of Life in Volunteer Ski Patrollers. 志愿滑雪巡警的人格特质与职业生活品质。

IF 1.6 4区医学

Wilderness & Environmental Medicine Pub Date : 2026-11-04 DOI: 10.1177/10806032261501926

Katie M Stubbers, Lisa R Christiansen

{"title":"Personality Traits and Professional Quality of Life in Volunteer Ski Patrollers.","authors":"Katie M Stubbers, Lisa R Christiansen","doi":"10.1177/10806032261501926","DOIUrl":"https://doi.org/10.1177/10806032261501926","url":null,"abstract":"IntroductionSki patrollers, as outdoor emergency first responders, face unique occupational trauma exposure that impacts their professional quality of life. Despite these exposures, this population has been largely understudied in trauma research. Personality traits have been associated with outcomes from occupational trauma exposure in other populations. This study investigates associations between personality traits and outcomes including compassion fatigue and satisfaction in volunteer ski patrollers.MethodsVolunteers from a ski patrol in the Pacific Northwest (n = 82) completed a cross-sectional online survey measuring trauma exposure, the 5-factor model personality traits (neuroticism, extraversion, agreeableness, openness, and conscientiousness), and professional quality of life variables of compassion fatigue (comprising burnout and secondary traumatic stress [STS]) and compassion satisfaction.ResultsThose who reported trauma exposure while patrolling endorsed higher compassion satisfaction and lower burnout. Extraversion, agreeableness, and conscientiousness correlated negatively with burnout and positively with compassion satisfaction. Extraversion and conscientiousness negatively correlated with STS, while neuroticism positively correlated with burnout and STS but negatively correlated with compassion satisfaction.ConclusionsOur findings highlight the association between personality traits and professional quality of life outcomes. Organizations could use this data to design tailored interventions to support ski patrollers in managing occupational trauma exposure. Individuals high in neuroticism endorsed more negative outcomes and could potentially benefit most from preventative measures and intervention compared to those high in extraversion, agreeableness, and conscientiousness.","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":" ","pages":"10806032261501926"},"PeriodicalIF":1.6,"publicationDate":"2026-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149335838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

No Woman Left Un-Kitted: Is the Traditional Expedition Medical Kit Really Fit for Women? 没有女人不带：传统的远征医疗包真的适合女人吗？

IF 1.6 4区医学

Wilderness & Environmental Medicine Pub Date : 2026-11-04 DOI: 10.1177/10806032261505808

M Oliver, S Broughton, K E Joyce

引用次数: 0

Should Esophageal Temperature Probes Be Used within UK Search and Rescue Helicopter Services? 食管温度探头应该在英国搜救直升机服务中使用吗？

IF 1.6 4区医学

Wilderness & Environmental Medicine Pub Date : 2026-11-03 DOI: 10.1177/10806032261503287

Emma Atkinson, Els S Freshwater, James S Brogan

引用次数: 0

Beyond Dialysis Independence: The Importance of Longitudinal Renal Follow-Up after Severe Acute Kidney Injury. 超越透析独立性：严重急性肾损伤后纵向肾脏随访的重要性。

IF 1.6 4区医学

Wilderness & Environmental Medicine Pub Date : 2026-11-03 DOI: 10.1177/10806032261504755

Thotanolla Surya Prakash

引用次数: 0

Cloudbursts in the Fragile Indian Himalaya: Ecological, Societal, and Health Consequences. 脆弱的印度喜马拉雅地区的暴雨：生态、社会和健康后果。

IF 1.6 4区医学

Wilderness & Environmental Medicine Pub Date : 2026-11-03 DOI: 10.1177/10806032261444342

Vikas Vaibhav, Raviprakash Meshram, Varun Chandran, Gitanjali Khorwal, Kshitiza Sharma

引用次数: 0

Biphasic Biochemical Pattern Suggestive of Second-Wave Muscle Injury in Exertional Rhabdomyolysis. 力竭性横纹肌溶解中提示第二波肌肉损伤的双相生化模式。

IF 1.6 4区医学

Wilderness & Environmental Medicine Pub Date : 2026-11-01 DOI: 10.1177/10806032261503477

Thotanolla Surya Prakash

{"title":"Biphasic Biochemical Pattern Suggestive of Second-Wave Muscle Injury in Exertional Rhabdomyolysis.","authors":"Thotanolla Surya Prakash","doi":"10.1177/10806032261503477","DOIUrl":"https://doi.org/10.1177/10806032261503477","url":null,"abstract":"BackgroundExertional rhabdomyolysis is an important cause of acute kidney injury (AKI) in otherwise healthy individuals following strenuous physical activity. Serum creatine kinase (CK) typically peaks within 24 to 72 h and progressively declines with appropriate supportive management. A secondary biochemical rise after initial improvement is uncommon and may reflect ongoing skeletal muscle injury.Case PresentationA 21-year-old previously healthy man presented with severe generalized myalgia, dark-colored urine, and progressive oliguria progressing to anuria following a prolonged trekking expedition. Initial investigations revealed severe rhabdomyolysis with a CK of 18,500 U/L, dialysis-requiring AKI (serum creatinine 9.0 mg/dL), hyperkalemia, hyperphosphatemia, hypocalcemia, metabolic acidosis, and myoglobinuria. Intermittent hemodialysis was initiated because of severe AKI with persistent anuria and metabolic complications. Serial biochemical monitoring initially demonstrated improvement; however, on the fourth hospital day, an unexpected secondary rise in CK (14,900-22,600 U/L) occurred, accompanied by recurrent hyperkalemia, hyperphosphatemia, worsening metabolic acidosis, and increased AST and LDH, despite ongoing renal replacement therapy. This biphasic biochemical pattern was considered suggestive of delayed or \"second-wave\" skeletal muscle injury. The patient received a total of 5 hemodialysis sessions with continued supportive care, following which urine output progressively improved, biochemical abnormalities resolved, and renal function recovered completely.ConclusionThis case highlights a rare biphasic biochemical pattern in severe exertional rhabdomyolysis, characterized by a secondary surge in muscle injury markers and metabolic abnormalities after initial improvement. Recognition of this potential \"second-wave\" phenomenon emphasizes the importance of continued serial CK and biochemical monitoring in patients with severe rhabdomyolysis.","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":" ","pages":"10806032261503477"},"PeriodicalIF":1.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149326738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Effect of Rescuer Position on Chest Compression Quality and Rescuer Stability during CPR on a Sloped Surface: A Simulation Study. 斜面CPR中施救者体位对胸部按压质量和施救者稳定性的影响：一项模拟研究。

IF 1.6 4区医学

Wilderness & Environmental Medicine Pub Date : 2026-11-01 DOI: 10.1177/10806032261501927

Eva Dolenc Šparovec, Jakob Praznik, Žiga Metelko, Damjan Slabe

{"title":"Effect of Rescuer Position on Chest Compression Quality and Rescuer Stability during CPR on a Sloped Surface: A Simulation Study.","authors":"Eva Dolenc Šparovec, Jakob Praznik, Žiga Metelko, Damjan Slabe","doi":"10.1177/10806032261501927","DOIUrl":"https://doi.org/10.1177/10806032261501927","url":null,"abstract":"IntroductionHigh-quality chest compressions (CCs) are essential for survival after cardiac arrest. Current cardiopulmonary resuscitation (CPR) guidelines recommend performing CCs on a firm and flat surface; however, cardiac arrest may also occur in austere environments such as mountainous or sloped terrain where such conditions cannot be achieved. This study aimed to evaluate the impact of rescuer positioning on CC quality during CPR on a slope.MethodsA repeated-measures simulation study was conducted with 50 basic life support-trained volunteers. Participants performed uninterrupted CCs for 2 min in 3 different positions relative to the victim on a natural slope: uphill, downhill, and parallel. CC quality was assessed using a Resusci Anne QCPR manikin and the Laerdal QCPR application.ResultsRescuer position significantly affected CC quality and subjective ratings (P < 0.05). The downhill position achieved the highest proportion of time within the recommended compression rate range (median 90% vs 30% in the uphill position; P < 0.001) and deeper compressions (71 mm vs 67 mm; P < 0.001). In contrast, the uphill position was associated with higher compression rates and reduced chest recoil quality. Subjective assessments also differed significantly between positions. Compared with the downhill position, the uphill position was associated with greater physical demand, poorer stability, increased hand slipping, and greater fear of falling (all P < 0.001).ConclusionsRescuer position significantly influences CC quality and perceived rescuer safety during CCs on sloped terrain. Performing CCs from a downhill position may improve CC performance in austere and mountainous environments.","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":" ","pages":"10806032261501927"},"PeriodicalIF":1.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149326740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Field Medical Observations from a Remote High-Altitude Community on the Route to K2 (Askole Study I). 在通往K2的路上，一个偏远的高海拔社区的野外医学观察（Askole研究I）。

IF 1.6 4区医学

Wilderness & Environmental Medicine Pub Date : 2026-10-30 DOI: 10.1177/10806032261502775

P Sossai, P Tosoni, E Polisseni, C D'Angelo, L M Colombo, M A Lenotti

{"title":"Field Medical Observations from a Remote High-Altitude Community on the Route to K2 (Askole Study I).","authors":"P Sossai, P Tosoni, E Polisseni, C D'Angelo, L M Colombo, M A Lenotti","doi":"10.1177/10806032261502775","DOIUrl":"https://doi.org/10.1177/10806032261502775","url":null,"abstract":"BackgroundAskole (9843 ft [≈3000 m], Gilgit-Baltistan, Pakistan), the last village on the route to K2 Base Camp, is a remote high-altitude community with limited healthcare access, unsafe water, and infrastructural constraints. No systematic data describe its health burden, although such information is needed to plan future medical expeditions.MethodsFrom September 8 to 18, 2025 (11 working days), 2 Italian Alpine Club physicians provided medical care and health education at the Lorenzo Mazzoleni Dispensary. Clinical evaluation was supplemented by electrocardiography, ultrasonography, pulse oximetry, blood pressure measurement, and point-of-care glucometer and urine dipstick testing. School-based vision screening with the Lang stereotest was performed in Korphe.Results and DiscussionA total of 171 patients (174 visits; mean age 23.6 years) were evaluated. Gastrointestinal infectious diseases were most frequent, likely related to unsafe water and poor hygiene, followed by musculoskeletal disorders, chiefly lumbosacral radiculopathy, in adults. Skin, genitourinary, oral, ear, and ocular conditions were also common. Respiratory and cardiovascular symptoms occurred in relatively young individuals, without electrocardiographic evidence of ischemia, structural abnormality, or infarction; chronic mountain sickness was not systematically assessed. Vision screening identified stereoacuity deficits in 1.9% of children examined, all referred for ophthalmological evaluation. One new case of diabetes mellitus was diagnosed.ConclusionsInfectious disease is the main health burden in this setting. Improvements in water safety and infrastructure are essential, as health education alone is insufficient. These observations, limited by a small sample and short observation period, can nonetheless inform the planning of future medical expeditions.","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":" ","pages":"10806032261502775"},"PeriodicalIF":1.6,"publicationDate":"2026-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149301418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Backcountry Risk-Taking (BRiT)-An Instrument to Evaluate an Individual's Overall Risk-Taking Behavior Within the Backcountry Avalanche Environment. 野外冒险(BRiT)-在野外雪崩环境中评估个人整体冒险行为的工具。

IF 1.6 4区医学

Wilderness & Environmental Medicine Pub Date : 2026-10-28 DOI: 10.1177/10806032261498049

Sarah Petelinsek, Olivia Pearson, Rowan Kelner, Boomer Olsen, Nikki Champion, Kailey Mahoney, Peilu Zhang, Scott E McIntosh, Patrick G Hughes

{"title":"Backcountry Risk-Taking (BRiT)-An Instrument to Evaluate an Individual's Overall Risk-Taking Behavior Within the Backcountry Avalanche Environment.","authors":"Sarah Petelinsek, Olivia Pearson, Rowan Kelner, Boomer Olsen, Nikki Champion, Kailey Mahoney, Peilu Zhang, Scott E McIntosh, Patrick G Hughes","doi":"10.1177/10806032261498049","DOIUrl":"https://doi.org/10.1177/10806032261498049","url":null,"abstract":"Study HypothesisThe primary objective of this study was to develop and evaluate a novel instrument called the Backcountry Risk-Taking Instrument (BRiT) to measure risk-taking behavior among backcountry users. We aimed to create an instrument that is content-valid, grounded in theory, and psychometrically sound.MethodsWe conducted a cross-sectional study to evaluate the psychometric properties of the instrument. Participants completed the newly developed 13-item instrument along with established measures of risk-taking behavior and risk preference to assess convergent validity.ResultsA total of 361 participants completed the survey. After listwise deletion, n = 280 were retained for factor analysis and n = 354 for convergent validity. The resulting instrument provides a concise, empirically supported framework for measuring backcountry risk behavior and establishes a foundation for prospective validation in future cohorts.ConclusionsThe BRiT instrument significantly advances avalanche risk assessment. BRiT demonstrates a clear and stable foundation built upon 3 domains: Core Gear, Avalanche History, and Terrain Choice. Continued validation and refinement across broader populations will strengthen its utility as a foundational tool for both research and applied avalanche risk management.","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":" ","pages":"10806032261498049"},"PeriodicalIF":1.6,"publicationDate":"2026-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149289605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0