Wilderness & Environmental Medicine最新文献_第10页

Biopsychosocial Health Considerations for Astronauts in Long-Duration Spaceflight: A Narrative Review. 长期太空飞行中宇航员的生物心理社会健康考虑因素：叙述性评论。

IF 1.4 4区医学

Wilderness & Environmental Medicine Pub Date : 2024-10-29 DOI: 10.1177/10806032241289106

Bradley N Barbour, Karolina Twardowska, Nicolò Favero, Payam Ghoddousi, Peter Hodkinson

{"title":"Biopsychosocial Health Considerations for Astronauts in Long-Duration Spaceflight: A Narrative Review.","authors":"Bradley N Barbour, Karolina Twardowska, Nicolò Favero, Payam Ghoddousi, Peter Hodkinson","doi":"10.1177/10806032241289106","DOIUrl":"10.1177/10806032241289106","url":null,"abstract":"Long-duration spaceflights beyond low-Earth orbit, including missions to the Moon and Mars, pose significant health risks. Although biomedical approaches commonly appear in the literature, considering psychological and social factors alongside physiologic health offers a more holistic approach to astronaut care. Integrating the biopsychosocial (BPS) framework into medical planning addresses complex spaceflight challenges and aids in developing mitigation strategies. This review examined health risks associated with long-duration spaceflight within a BPS framework. Sources included governmental space agencies, academic textbooks, and relevant publications from multiple databases. Considering the National Aeronautics and Space Administration's Human Research Program's 5 main hazards, a conceptual model was developed to highlight the multifactorial BPS effects of spaceflight. In space, astronauts face unique environments and biological adaptations, including fluid shift, plasma volume loss, bone density loss, and muscle atrophy. Noise and the absence of natural light disrupt circadian rhythms, causing sleep disturbances and fatigue, which affect physical and mental health. Studies on crews in isolated and confined extreme environments reveal psychosocial challenges, including impaired mood and cognition, interpersonal tension, and miscommunication. International collaboration in spaceflight introduces differences in communication, problem solving, and social customs due to diverse cultural backgrounds. Upcoming long-distance missions likely will amplify these challenges. This review emphasizes BPS health considerations in long-duration spaceflight. It highlights the interplay among psychological, social, and biological factors, advocating for multidisciplinary teams and a holistic approach to astronaut health and mission planning and the potential added value of BPS perspectives in considering countermeasures.","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":" ","pages":"10806032241289106"},"PeriodicalIF":1.4,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523464","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

Wilderness Medicine Curricula in US Multidisciplinary Training Courses. 美国多学科培训课程中的野外医学课程。

IF 1.4 4区医学

Wilderness & Environmental Medicine Pub Date : 2024-10-26 DOI: 10.1177/10806032241289315

Maria Holstrom-Mercader, Avram Flamm

{"title":"Wilderness Medicine Curricula in US Multidisciplinary Training Courses.","authors":"Maria Holstrom-Mercader, Avram Flamm","doi":"10.1177/10806032241289315","DOIUrl":"https://doi.org/10.1177/10806032241289315","url":null,"abstract":"Introduction: Wilderness medicine (WM) is the study of medicine in austere environments. There are several US multidisciplinary courses that teach WM to people from varying medical backgrounds. However, WM topics are covered to different extents. This study's purpose was to compare WM components among US multidisciplinary training courses.Methods: The American College of Emergency Physicians WM fellowship curriculum's 19 components and the Fellowship of the Academy of Wilderness Medicine's 12 core and 16 elective competencies and their credits were used as two control lists. Curricula from 10 US multidisciplinary courses were analyzed for WM components. Using descriptive analysis, each course curriculum was compared with the controls.Results: This study examines WM components in 10 courses. The greatest number of American College of Emergency Physicians WM fellowship topics (14 of 19) was covered by the Paramedic course and the fewest number (4 of 19) by the Tactical Combat Casualty Care-Combat Lifesaver course. The greatest number of Fellowship of the Academy of Wilderness Medicine core credits (56) was offered by the Paramedic course and the fewest number (24) by the Tactical Combat Casualty Care-Medical Personnel course. The greatest number of Fellowship of the Academy of Wilderness Medicine elective credits (83) was offered by the Paramedic course and the fewest number (25) by the Tactical Combat Casualty Care-Combat Lifesaver course.Conclusion: This research analyzed WM components in US multidisciplinary courses and demonstrated that each covers WM topics to varying extents. This shows an opportunity for these courses to expand their WM education within their scope. It also demonstrates competencies offered by different courses for interested trainees.","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":" ","pages":"10806032241289315"},"PeriodicalIF":1.4,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511611","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

Space Radiology: Emerging Nonsonographic Medical Imaging Techniques and the Potential Applications for Human Spaceflight. 太空放射学：新兴的 Nonsonographic 医学成像技术及其在载人航天飞行中的潜在应用。

IF 1.4 4区医学

Wilderness & Environmental Medicine Pub Date : 2024-10-03 DOI: 10.1177/10806032241283380

Michael Pohlen

{"title":"Space Radiology: Emerging Nonsonographic Medical Imaging Techniques and the Potential Applications for Human Spaceflight.","authors":"Michael Pohlen","doi":"10.1177/10806032241283380","DOIUrl":"https://doi.org/10.1177/10806032241283380","url":null,"abstract":"Space medicine is a multidisciplinary field that requires the integration of medical imaging techniques and expertise in diagnosing and treating a wide range of acute and chronic conditions to maintain astronaut health. Medical imaging within this domain has been viewed historically through the lens of inflight point-of-care ultrasound and predominantly research uses of cross-sectional imaging before and after flight. However, space radiology, a subfield defined here as the applications of imaging before, during, and after spaceflight, will grow to necessitate the involvement of more advanced imaging techniques and subspecialist expertise as missions increase in length and complexity. While the performance of imaging in spaceflight is limited by equipment mass and volume, power supply, radiation exposure, communication delays, and personnel training, recent developments in nonsonographic modalities have opened the door to their potential for in-mission use. Additionally, improved exam protocols and scanner technology in combination with artificial intelligence algorithms have greatly advanced the utility of possible pre- and postflight studies. This article reviews the past and present of space radiology and discusses possible use cases, knowledge gaps, and future research directions for radiography, fluoroscopy, computed tomography, and magnetic resonance imaging within space medicine, including both the performance of new exam types for new indications and the increased extraction of information from exams already routinely obtained. Through thoughtfully augmenting the use of these tools, medical mission risk may be reduced substantially through preflight screening, inflight diagnosis and management, and inflight and postflight surveillance.","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":" ","pages":"10806032241283380"},"PeriodicalIF":1.4,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367182","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

Creation of an Emergency Care Capacity Assessment Tool for Facilities in Austere Environments. 为环境恶劣的设施创建紧急救护能力评估工具。

IF 1.4 4区医学

Wilderness & Environmental Medicine Pub Date : 2024-09-12 DOI: 10.1177/10806032241278982

Vijay Christopher Kannan,Geoff Comp,Stephanie Lareau

{"title":"Creation of an Emergency Care Capacity Assessment Tool for Facilities in Austere Environments.","authors":"Vijay Christopher Kannan,Geoff Comp,Stephanie Lareau","doi":"10.1177/10806032241278982","DOIUrl":"https://doi.org/10.1177/10806032241278982","url":null,"abstract":"INTRODUCTIONFacilities in austere environments may consider emergency care beyond their scope. Often patients with high-acuity conditions have no other choice than to present to these facilities. The disconnect between the intent of health systems planners and the reality faced by providers manifests as facilities unable to manage such cases.The Indian Health Service, with a range of stakeholders, developed an emergency care delivery assessment tool for facilities in austere environments, designed to identify deficiencies in facility readiness for emergency care delivery across four areas: 1. Procedural2. Human resources3. Non-pharmacologic material resources4. Pharmacologic material resources.METHODSThe tool's underlying architecture is a resource matrix similar to hospital-based tools, using the \"Facility\" component of the WHO Emergency Care Systems Framework as the Y-axis and undifferentiated presentations taught by the WHO basic emergency care course, advanced trauma life support, and advanced life support in obstetrics as the X-axis. The tool was piloted at a remote frontier clinic.RESULTSWe found 48 deficiencies: 7 procedural, 1 human resources, 31 non-pharmacologic materials, and 9 pharmacologic materials. We aggregated deficiencies by facility function to assess the capacity to perform each. We also aggregated deficiencies by clinical presentation to identify targets for educational interventions.CONCLUSIONWe successfully created a novel emergency care capacity assessment tool for use in austere environments using materials with broad international consensus. The successful pilot found deficiencies across all 4 areas. This tool may be useful in many other remote domestic facilities and rural health posts in low- and middle-income countries.","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":"70 1","pages":"10806032241278982"},"PeriodicalIF":1.4,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142204075","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

Catfish Puncture Wound and Retained Spine Management in the ED Setting: A Case Report. 急诊室中的鲶鱼刺伤和脊柱留置治疗：病例报告。

IF 1.4 4区医学

Wilderness & Environmental Medicine Pub Date : 2024-09-10 DOI: 10.1177/10806032241273505

Spencer J Carbone,Jennifer L Jozefick,Adam P Sigal,Robert H Nordell

引用次数: 0

Backward and in Heels . . . Mabel Purefoy FitzGerald's Extraordinary Journey to Discovery at High Altitudes. 后退并穿着高跟鞋 . .梅布尔-普尔福伊-菲茨杰拉德在高海拔地区的非凡发现之旅.

IF 1.4 4区医学

Wilderness & Environmental Medicine Pub Date : 2024-09-02 DOI: 10.1177/10806032241272125

Martha Tissot van Patot

引用次数: 0

A Comprehensive Pathophysiologic, Histologic, and Biochemical Analysis of Buthus paris (C. L. Koch, 1839) Venom. Buthus paris（C. L. Koch，1839 年）毒液的病理生理学、组织学和生化综合分析。

IF 1.4 4区医学

Wilderness & Environmental Medicine Pub Date : 2024-09-01 Epub Date: 2024-05-07 DOI: 10.1177/10806032241249748

Abdessamad Elmourid, My Abdelmonaim Elhidan, Samia Boussaa, Mehdi Ait Laaradia, Btissam Bouimeja, Omar Amahmid, Mohamed Merzouki, Oulaid Touloun

{"title":"A Comprehensive Pathophysiologic, Histologic, and Biochemical Analysis of Buthus paris (C. L. Koch, 1839) Venom.","authors":"Abdessamad Elmourid, My Abdelmonaim Elhidan, Samia Boussaa, Mehdi Ait Laaradia, Btissam Bouimeja, Omar Amahmid, Mohamed Merzouki, Oulaid Touloun","doi":"10.1177/10806032241249748","DOIUrl":"10.1177/10806032241249748","url":null,"abstract":"Introduction: Buthus species, including B paris, are classified as one of the most dangerous scorpion genera in Morocco, implicated in several cases of human death. Our objective is to characterize, for the first time, the toxicity and histopathologic and biochemical impacts of B paris venom.Methods: We investigated the experimental pathophysiology of B paris venom by examining histologic changes in vital organs (heart, kidneys, liver, and lungs) and assessing biochemical enzymatic markers (alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, creatine phosphokinase, urea, and creatinine) in mice injected subcutaneously with 2 doses of 400 and 450 mg·kg-1.Results: Our results showed that the subcutaneous median lethal dose of B paris venom was around 0.52 mg·kg-1. Histologic findings revealed significant tissue damage in the previously mentioned vital organs, confirmed through biochemical analysis indicating impaired heart and liver functions. Additionally, an increase in urea, creatinine, and glucose levels occurred following B paris venom injection.Conclusion: Our findings show that B paris venom exhibits a high level of experimental toxicity. These results highlight the potentially lethal nature of this venom and emphasize the potential medical importance of this species.","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":" ","pages":"271-277"},"PeriodicalIF":1.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140877801","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

In Reply to Dr Gupta et al. 答复古普塔博士等人

IF 1.4 4区医学

Wilderness & Environmental Medicine Pub Date : 2024-09-01 Epub Date: 2024-06-05 DOI: 10.1177/10806032241260347

Stefan Cowtan, Jonathon Broughton, Sarvesh Logsetty

引用次数: 0

A Qualitative Review of the Air Rescue One Rural Search and Rescue Program in British Columbia, Canada. 加拿大不列颠哥伦比亚省 "空中救援一号 "农村搜救计划定性审查。

IF 1.4 4区医学

Wilderness & Environmental Medicine Pub Date : 2024-09-01 Epub Date: 2024-06-11 DOI: 10.1177/10806032241258425

Raphael Nowak, Jeremy N Vandekerkhove, Deena D Wasserman

{"title":"A Qualitative Review of the Air Rescue One Rural Search and Rescue Program in British Columbia, Canada.","authors":"Raphael Nowak, Jeremy N Vandekerkhove, Deena D Wasserman","doi":"10.1177/10806032241258425","DOIUrl":"10.1177/10806032241258425","url":null,"abstract":"Introduction: Rural emergency prehospital care in British Columbia is conducted primarily by the British Columbia Ambulance Services or ground search and rescue volunteers. Since 2014, the volunteer Air Rescue One (AR1) program has provided helicopter emergency winch rescue services to rural British Columbia. The aim of this research was to describe the activity of the AR1 program and to make recommendations to improve future operations.Methods: Data were collected retrospectively from September 2014 to May 2021, and parameters of emergency callout statistics from the organization's standard operating guidelines, rescue reports, and interviews were summarized and reviewed.Results: Of 152 missions within the study period, 105 were medically related rescues involving trauma or cardiac events. Snowmobiling, mountain biking, and hiking were the most common activities requiring rescue. The 38 medical callouts that were not completed by AR1 were reviewed for contributing factors. Response time varied due to the vast service area, but median time from request to takeoff was 55 min (interquartile range 47-69 min), and median on-scene time was 21 min (interquartile range 11-33 min).Conclusions: AR1 provides advanced medical care into British Columbia's remote and difficult-to-access areas, minimizing delays in treatment and risk to patients and responders. Callout procedures should be streamlined enabling efficient AR1 activation. Collection of medical and flight information should be improved with standardized documentation, aiding in internal education and future research into the program's impact on emergency prehospital care. Future directions for improvement of care include the possibility of introducing portable ultrasound technology.","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":" ","pages":"287-294"},"PeriodicalIF":1.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141301923","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

Cold-Induced Vasodilation, Rewarming, and Dexterity Impairment Following Second-Degree Frostbite. 病例报告：二度冻伤后冷引起的血管扩张、复温和灵活性受损。

IF 1.4 4区医学

Wilderness & Environmental Medicine Pub Date : 2024-09-01 Epub Date: 2024-07-23 DOI: 10.1177/10806032241262986

Rebecca S Weller, Tony Duong, Rebecca J McClintock, Alice LaGoy, Matthew Peterson, Douglas M Jones

{"title":"Cold-Induced Vasodilation, Rewarming, and Dexterity Impairment Following Second-Degree Frostbite.","authors":"Rebecca S Weller, Tony Duong, Rebecca J McClintock, Alice LaGoy, Matthew Peterson, Douglas M Jones","doi":"10.1177/10806032241262986","DOIUrl":"10.1177/10806032241262986","url":null,"abstract":"Frostbite, a severe cold injury resulting from exposure to subfreezing temperatures, damages the skin and underlying tissues of the affected area and ranges in severity from first to fourth degree. This case report investigates the impact of second-degree frostbite suffered by a marine during winter training on cold-induced vasodilation (CIVD). Comparisons of CIVD before and after the injury revealed significant alterations in CIVD responses. CIVD, a physiological mechanism characterized by blood vessel dilation in response to cold exposure, plays a crucial role in operating in cold-weather environments and enhancing dexterity. The marine exhibited prolonged CIVD onset time, lower finger temperatures, increased pain sensations, and diminished dexterity after the frostbite injury during follow-up CIVD testing. The findings suggest that the frostbite-induced damage possibly compromised the microvascular function, contributing to the observed changes in CIVD. The marine reported persistent cold sensitivity and difficulty in maintaining hand warmth when assessed postinjury. This case underscores the potential long-term consequences of frostbite on CIVD and manual dexterity, emphasizing the importance of understanding these physiological changes for individuals engaged in cold-weather activities, particularly for military and occupational personnel.","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":" ","pages":"351-355"},"PeriodicalIF":1.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753147","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