Wilderness & Environmental Medicine最新文献_第2页

Graduate Medical Education Fellowships Versus Specialty Society Curriculum: A Comparative Study on Alumni Outcomes and Academic Pursuits in Wilderness Medicine. 研究生医学教育奖学金与专业学会课程：荒野医学校友成果与学术追求的比较研究。

IF 1.4 4区医学

Wilderness & Environmental Medicine Pub Date : 2025-06-12 DOI: 10.1177/10806032251345770

Stephanie Lareau, Pavel Diaz, Alec M Chan-Golston, Susanne Spano

{"title":"Graduate Medical Education Fellowships Versus Specialty Society Curriculum: A Comparative Study on Alumni Outcomes and Academic Pursuits in Wilderness Medicine.","authors":"Stephanie Lareau, Pavel Diaz, Alec M Chan-Golston, Susanne Spano","doi":"10.1177/10806032251345770","DOIUrl":"https://doi.org/10.1177/10806032251345770","url":null,"abstract":"Introduction-Wilderness medicine (WM) is a growing field offering advanced training and recognition through graduate medical education (GME) WM fellowships and the Fellow of the Academy of Wilderness Medicine (FAWM) professional designation. GME fellowships, introduced in 2004, provide immersive, structured training and experiential learning opportunities. The FAWM designation, established in 2005, is earned through approved educational activities. This study compared alumni outcomes between these pathways.Methods-A cross-sectional survey was conducted among GME fellowship graduates and FAWM recipients. Inclusion criteria were GME fellowship alumni or individuals with FAWM recognition. Exclusion criteria included incomplete surveys. Respondents were surveyed on demographics, academic output, and satisfaction with their training. Data analysis included χ2 tests for categorical data, analysis of variance for publication comparisons, and ordinal Likert scales for satisfaction.Results-Of 321 responses, 281 were included. GME alumni expressed greater satisfaction with mentorship and research opportunities; 95% of FAWM-only respondents reported exposure to career opportunities unknown prior to fellowship. There was no detectable difference (P=0.523) between FAWM-only respondents' number of WM-related publications. Overall, 93% of FAWM-only respondents and 76% of GME alumni would repeat their fellowship. Both groups demonstrated high proficiency in WM, with 89% feeling proficient.Conclusion-Both GME and FAWM pathways support WM education and career development. However, GME fellowships provide enhanced academic involvement, mentorship, and performance of relevant clinical skills. FAWM introduced new wilderness careers and had higher alumni satisfaction. These findings highlight the complementary roles of GME fellowships and FAWM recognition in advancing proficiency and professional growth.","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":" ","pages":"10806032251345770"},"PeriodicalIF":1.4,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286973","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

Women, Iron, and Altitude-Path to the Peak. 女人、铁和海拔——通往顶峰之路。

IF 1.4 4区医学

Wilderness & Environmental Medicine Pub Date : 2025-06-11 DOI: 10.1177/10806032251346664

Emma P DeLoughery, Thomas G DeLoughery

引用次数: 0

Cardiopulmonary Resuscitation Techniques on the Dragon Spacecraft: A Polaris Dawn Mission Study. 龙飞船上的心肺复苏技术：北极星黎明任务研究。

IF 1.4 4区医学

Wilderness & Environmental Medicine Pub Date : 2025-06-11 DOI: 10.1177/10806032251346746

Anna Menon, David Mampre, Jared Isaacman, Scott Poteet, Sarah Gillis, Jaime Mateus, Marissa Rosenberg

{"title":"Cardiopulmonary Resuscitation Techniques on the Dragon Spacecraft: A Polaris Dawn Mission Study.","authors":"Anna Menon, David Mampre, Jared Isaacman, Scott Poteet, Sarah Gillis, Jaime Mateus, Marissa Rosenberg","doi":"10.1177/10806032251346746","DOIUrl":"https://doi.org/10.1177/10806032251346746","url":null,"abstract":"Introduction-Performing cardiopulmonary resuscitation (CPR) in microgravity is challenging due to reciprocal motion between the patient and operator, requiring unique methods of stabilization for chest compressions. In this study, the Polaris Dawn mission crew evaluated optimal methods of CPR administration in the Dragon spacecraft during spaceflight as well as the impact of CPR tasks to the vehicle.Methods-CPR was simulated by compressing a CPR Adult Manikin Bellows Piston with Clicker against different surfaces of the vehicle. Crew members performed compressions at 3 different locations to select the optimal worksite. All 4 crew members then performed a 2-min round of compressions at the optimal worksite. Workload was measured using the Bedford workload and Borg rating of perceived exertion scales, where lower scores are desirable for both scales. Vehicle impacts were monitored with navigation and carbon dioxide sensors.Results-The outboard seat was selected as the optimal worksite. When performing a full 2 min of chest compressions at this location, average Bedford workload and Borg rating of perceived exertion scores among all 4 crew members were 4.75 and 16, respectively. All 4 crew members achieved the target-frequency range (mean, 1.8 Hz; range 1.7-1.9 Hz). Vehicle accelerations were observed in all axes, and cabin carbon dioxide increased to a peak level of >3.6 mm Hg, triggering a carbon dioxide caution limit.Conclusions-Outboard seat location provided the best ergonomics for administration of CPR on the Dragon spacecraft, although task performance had high difficulty ratings. CPR also was associated with elevated cabin carbon dioxide and vehicle accelerations, as measured by the navigation system.","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":" ","pages":"10806032251346746"},"PeriodicalIF":1.4,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267796","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

Comparing Single-Site Fractures with Multisite Injuries in Pediatric Skiers and Snowboarders. 儿童滑雪和单板滑雪运动员单部位骨折与多部位损伤的比较。

IF 1.4 4区医学

Wilderness & Environmental Medicine Pub Date : 2025-06-11 DOI: 10.1177/10806032251345771

Ruikang Kong Kong Liu, Michael Lieu, David R Howell, Lauren A Pierpoint, Morteza Khodaee, Aaron Provance

{"title":"Comparing Single-Site Fractures with Multisite Injuries in Pediatric Skiers and Snowboarders.","authors":"Ruikang Kong Kong Liu, Michael Lieu, David R Howell, Lauren A Pierpoint, Morteza Khodaee, Aaron Provance","doi":"10.1177/10806032251345771","DOIUrl":"https://doi.org/10.1177/10806032251345771","url":null,"abstract":"Introduction-The purpose of this study was to evaluate pediatric skiing and snowboarding fracture injuries at a large ski resort, comparing injury patterns in those who sustained fracture injuries at a single site against those with injuries in multiple sites. Given the more serious nature of multisite injuries, this information may give healthcare providers insight into injury patterns when assessing a patient in snow sport settings.Methods-Radiographs of 797 patients aged 3 to 17 y diagnosed with at least 1 skiing- or snowboarding-related fracture at a large ski resort were reviewed by a sports medicine fellowship-trained physician. Descriptive information about regions of injury was provided, and Bonferroni-corrected multivariable logistic regression modeling and χ2 tests were used.Results-Of the total, 756 patients had single-site fractures, whereas 41 patients had fractures with a secondary injury. Upper extremity fractures were the most common primary injury site in both groups at 61%. The head/neck was the most common location of a second injury, with concussions being the most common injury type. Collision with an object or person and being transferred to a local hospital were independently associated with higher odds of a multisite injury. No significant differences were found when comparing age, sex, self-rated ability, or terrain.Conclusions-One must maintain a high index of suspicion for concussions/head injuries following any fracture injury and have a low threshold for working up internal organ injuries with fractures in the torso.","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":" ","pages":"10806032251345771"},"PeriodicalIF":1.4,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267744","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

10, 14, 19 Essentials? 10、14、19个要点？

IF 1.4 4区医学

Wilderness & Environmental Medicine Pub Date : 2025-06-10 DOI: 10.1177/10806032251342116

Thomas G DeLoughery, Emma P DeLoughery

引用次数: 0

Medical Student Training for a Wilderness Rotation at the Philmont Scout Ranch: Validation of a Skills Curriculum. 医学院学生在菲尔蒙特童子军牧场野外轮换训练：技能课程的验证。

IF 1.4 4区医学

Wilderness & Environmental Medicine Pub Date : 2025-06-09 DOI: 10.1177/10806032251346692

Kathleen S White, Stasha B Beermann, Tanya Z Filardi, David G Naylor

{"title":"Medical Student Training for a Wilderness Rotation at the Philmont Scout Ranch: Validation of a Skills Curriculum.","authors":"Kathleen S White, Stasha B Beermann, Tanya Z Filardi, David G Naylor","doi":"10.1177/10806032251346692","DOIUrl":"https://doi.org/10.1177/10806032251346692","url":null,"abstract":"Introduction-Fourth-year medical students from the University of Kansas School of Medicine have the opportunity to complete a rotation at the Philmont Scout Ranch. To be prepared for this rotation, the students need to be taught a set of skills so that they are capable of evaluating and initiating treatment of patients in the infirmary and backcountry. We aimed to demonstrate that the training provided to the medical students improved confidence in the required skills.Methods-The training curriculum was developed by three Philmont physicians involved in medical student education and included skills videos, virtual training sessions, and an in-person training weekend. The necessary skills were identified by these physicians. Surveys on the confidence in these skills were administered to the medical students before training, after training, and after rotation. Paired t-tests were done to compare the confidence levels before and after training as well as before training and after rotation.Results-A total of 23 responses were gathered from the pre-training survey, 21 responses from the post-training survey, and 20 responses from the post-rotation survey. There was a statistically significant increase in the confidence level of all the skills from pre-training to post-training and of all the skills except suturing from pre-training to post-rotation.Conclusion-The training curriculum successfully improved the confidence of third-year medical students with unfamiliar skills and helped prepare them for their rotation at Philmont. Further refinement is needed to improve complex mastery of all the skills and standardize the training.","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":" ","pages":"10806032251346692"},"PeriodicalIF":1.4,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259217","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

Outbreaks Associated with Ingesting Water from Freshwater Sources in Outdoor Settings-United States, 2000-2022. 与室外环境中饮用淡水水源有关的暴发——美国，2000-2022。

IF 1.4 4区医学

Wilderness & Environmental Medicine Pub Date : 2025-06-04 DOI: 10.1177/10806032251344070

Muhammad Thuneibat, Allison D Miller, Shanna Miko, Michelle E Gleason, Hannah Lawinger, Jonathan S Yoder, Vincent R Hill, Virginia A Roberts

{"title":"Outbreaks Associated with Ingesting Water from Freshwater Sources in Outdoor Settings-United States, 2000-2022.","authors":"Muhammad Thuneibat, Allison D Miller, Shanna Miko, Michelle E Gleason, Hannah Lawinger, Jonathan S Yoder, Vincent R Hill, Virginia A Roberts","doi":"10.1177/10806032251344070","DOIUrl":"https://doi.org/10.1177/10806032251344070","url":null,"abstract":"IntroductionFreshwater sources (eg, lakes, ponds, rivers, or streams) can be contaminated by pathogens. Ingesting water from these sources can cause illness if the water is insufficiently treated.MethodThe Waterborne Disease and Outbreak Surveillance System (WBDOSS) collects data on waterborne disease outbreaks associated with drinking water, recreational water, other nonrecreational water, and undetermined exposures to water. We analyzed outbreaks reported to WBDOSS that involved ingesting water from freshwater sources in outdoor settings.ResultFrom 2000 through 2022, public health officials in 16 jurisdictions reported 32 outbreaks associated with ingesting water from insufficiently treated freshwater sources. These outbreaks resulted in 437 illnesses, 4 hospitalizations, and no reported deaths. Giardia was implicated in 69% of outbreaks, and Campylobacter was implicated in 28% of total cases. Water from rivers or streams was implicated in 75% of outbreaks. In half the reported outbreaks, water treatment was not attempted. Individuals were primarily exposed in outdoor recreational areas (eg, public outdoor areas, state parks, campgrounds), with most illnesses occurring in those aged 10-19 years.ConclusionThis is the first summary dedicated to outbreaks associated with ingesting freshwater. These outbreaks can be mitigated using potable water sources, when available, or appropriate water treatment. Public health and provider efforts could include engaging the public-especially those who spend time in the backcountry-regarding health risks and encouraging hygiene, safe disposal of feces, and recommended water treatment methods. Healthcare providers should be encouraged to ask individuals about potential exposure to water from outdoor freshwater sources when presenting with gastrointestinal illness.","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":" ","pages":"10806032251344070"},"PeriodicalIF":1.4,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217371","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

Evaluation of Physiologic Responses to Woodsmoke Inhalation During Exercise in Blood Pressure-Sensitive/Chronotype-Stratified Individuals. 评估血压敏感/时间型分层个体运动时吸入木材烟雾的生理反应。

IF 1.4 4区医学

Wilderness & Environmental Medicine Pub Date : 2025-06-03 DOI: 10.1177/10806032251343803

Joseph A Sol, Amanda Alafaro-Chevarri, Burke McGowan, Basil Coutinho, Elias M Malek, Graham R McGinnis, John C Quindry

{"title":"Evaluation of Physiologic Responses to Woodsmoke Inhalation During Exercise in Blood Pressure-Sensitive/Chronotype-Stratified Individuals.","authors":"Joseph A Sol, Amanda Alafaro-Chevarri, Burke McGowan, Basil Coutinho, Elias M Malek, Graham R McGinnis, John C Quindry","doi":"10.1177/10806032251343803","DOIUrl":"https://doi.org/10.1177/10806032251343803","url":null,"abstract":"IntroductionWe examined the physiologic alterations in respiratory and cardiovascular parameters during and after acute exercise under controlled woodsmoke inhalation conditions.MethodsThis study involved 20 recreationally active participants (10 males and 10 females) divided into groups based on their sensitivity to the cold pressor test (CPT+ vs CPT-) and their chronotype, as assessed by the Morningness-Eveningness Questionnaire. Participants completed a 120-min stationary cycling session at 50% VO2max while exposed to woodsmoke at a concentration of 250 μg·m-3. Assessments of heart rate variability, pulse wave velocity, blood pressure, pulmonary function testing, and oxidative stress were performed before, immediately after, and 24 h after exercise.ResultsIn the CPT+ group, significant alterations were noted in the pulse wave velocity variable, augmentation index, and heart rate variability metrics of logarithmic transformation of high- and low-frequency powers of heart rate variability immediately following exercise, whereas no such changes were observed in the CPT- group.ConclusionClassification of participants indicated a potentially susceptible subpopulation when exposed to a single acute exercise session in the presence of woodsmoke.","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":" ","pages":"10806032251343803"},"PeriodicalIF":1.4,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210058","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

Envenoming by King Cobra (Ophiophagus hannah s str) with Cardiopulmonary Arrest in Yunnan, China. 在中国云南，呼吸骤停的眼镜王蛇（Ophiophagus hannah s str）。

IF 1.4 4区医学

Wilderness & Environmental Medicine Pub Date : 2025-06-03 DOI: 10.1177/10806032251345769

Huating Zhao, Bin Han, Chengwei Ao, Dangbo Bao, Ruanxian Dai

引用次数: 0

An Unusual Case of Epistaxis: Intranasal Bipalium Pseudoparasite. 鼻出血的罕见病例：鼻内假寄生物。

IF 1.4 4区医学

Wilderness & Environmental Medicine Pub Date : 2025-06-02 DOI: 10.1177/10806032251343594

Brandon Watkins, David Cabaniss, Paul Bracey

{"title":"An Unusual Case of Epistaxis: Intranasal Bipalium Pseudoparasite.","authors":"Brandon Watkins, David Cabaniss, Paul Bracey","doi":"10.1177/10806032251343594","DOIUrl":"https://doi.org/10.1177/10806032251343594","url":null,"abstract":"Hammerhead worms are becoming increasingly common in the southeastern United States as the invasive species continues to spread. Limited data exist on this species acting as a pseudoparasite, with only 3 documented cases found on literature review of Bipalidae species living inside human hosts. We present one such case from Shreveport, Louisiana, of a patient who arrived at the emergency department after a hammerhead worm was expelled from his sinus passage. A 13-y-old male with a history of autism and developmental delay had been complaining of headache for 2 to 3 d. He had a spontaneous nosebleed from his right nostril on the morning of presentation to the emergency department. On blowing his nose, a large hammerhead worm was evacuated from his sinuses. Imaging studies and direct visualization did not reveal any significant damage or remaining helminths in the sinus passages. Due to patient risk factors for parasitic infection, while definitive identification of the worm species was still pending, a course of albendazole was prescribed. The patient was discharged from the emergency department in good condition. As this invasive species becomes more common in warm and humid areas of the United States, infection with these pseudoparasites may become more prevalent as well. Fortunately, this appears to be a rare occurrence, and clinical sequelae appear to be minimal after removal of the organism.","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":" ","pages":"10806032251343594"},"PeriodicalIF":1.4,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200620","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