Wilderness & Environmental Medicine最新文献_第5页

Klebsiella pneumoniae Lung Abscess Due to Aspiration of Seawater During Recreational Free Diving. 休闲自由潜水时吸入海水致肺炎克雷伯菌肺脓肿。

IF 1.4 4区医学

Wilderness & Environmental Medicine Pub Date : 2025-06-01 Epub Date: 2025-02-26 DOI: 10.1177/10806032251314741

Carisa Mariella Paraz, Mark Anthony Sandoval, Enrick Joshua Cruz

引用次数: 0

Survey of Pathologic Microorganisms in the Streams Along the Tahoe Rim Trail. 太浩湖沿岸小径溪流中病理微生物的调查。

IF 1.4 4区医学

Wilderness & Environmental Medicine Pub Date : 2025-06-01 Epub Date: 2025-03-11 DOI: 10.1177/10806032251318228

Hannah A Miller, Robby S Boparai, Joshua J Warner, Stephen F Mowery, Anna C Smith, Anthony P Cummins, Jennifer L Wittmann, David C Fiore

{"title":"Survey of Pathologic Microorganisms in the Streams Along the Tahoe Rim Trail.","authors":"Hannah A Miller, Robby S Boparai, Joshua J Warner, Stephen F Mowery, Anna C Smith, Anthony P Cummins, Jennifer L Wittmann, David C Fiore","doi":"10.1177/10806032251318228","DOIUrl":"10.1177/10806032251318228","url":null,"abstract":"IntroductionThis study aimed to estimate the contamination of water sources along the Tahoe Rim Trail (TRT) through evaluation of the presence and concentration of Escherichia coli, Giardia, and Cryptosporidium spp.MethodsSample sites were selected from 6 of the 8 sections of the TRT. Each stream was sampled 3 or 4 times during the summer and early fall of 2023. Samples were collected and analyzed for E. coli using Standard Methods 9223B and Giardia and Cryptosporidium spp. using EPA Method 1623.ResultsE. coli counts ranged from <1 to 29.2 most probable number (MPN)/100 mL. There was no difference in contamination with E. coli between streams (P=0.287) or sampling rounds (P=0.413). Giardia counts ranged from 0 to 7 count/10 L. There was a difference in contamination with Giardia between the highest and lowest concentration streams (P=0.028) but no difference in contamination between other streams or between sampling rounds (P=0.924). Cryptosporidium counts ranged from 0 to 1 count/10 L. There was no difference in contamination with Cryptosporidium between streams (P=0.589) or between sampling rounds (P=0.888).ConclusionsE. coli, Giardia, and Cryptosporidium are present in the streams along the TRT. Results from this study show that the risk of illness from occasional direct consumption of water from the streams sampled is low; however, it is always advisable to filter or treat water from any backcountry source prior to consumption. More extensive studies are recommended to evaluate backcountry water sources in the Tahoe Basin to further evaluate the risk to human health from direct consumption.","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":" ","pages":"194-200"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606906","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

Recreational Outdoor Injury and Mortality in Texas State Parks Between 2012 and 2021. 2012年至2021年期间德克萨斯州州立公园的休闲户外伤害和死亡率。

IF 1.4 4区医学

Wilderness & Environmental Medicine Pub Date : 2025-06-01 Epub Date: 2025-03-25 DOI: 10.1177/10806032251323500

Mohammad I Hirzallah, Ebubechi K Adindu, Julliet C Ogu, Tania Allison, May Kamleh

{"title":"Recreational Outdoor Injury and Mortality in Texas State Parks Between 2012 and 2021.","authors":"Mohammad I Hirzallah, Ebubechi K Adindu, Julliet C Ogu, Tania Allison, May Kamleh","doi":"10.1177/10806032251323500","DOIUrl":"10.1177/10806032251323500","url":null,"abstract":"IntroductionThe outdoor recreation industry in Texas has witnessed a large growth. There are no publications about the epidemiology of outdoor recreation injury and mortality in Texas. This work analyzes the Texas Parks and Wildlife Department (TPWD) outdoor injury reports to address this gap.MethodsWe analyzed TPWD injury incident reports filed from July 2012 to April 2021. Statistical analysis included descriptive statistics, Wilcoxon Rank Sum test for continuous data, χ2 analysis for categorical data, Fisher exact test for small sample cross tables, and two multivariable logistic regression models for the effects of season, activity, and location on morbidity and mortality.ResultsThere were 4882 outdoor recreational events, including injuries (n = 4401, 90.1%), mortalities (n = 124, 2.5%), and search and rescue operations (n = 357, 6.4%). The injury and mortality rates were 5.20 and 0.15 per 100 000 visits, respectively. Activities preceding injury included hiking (n = 1112, 24.3%), walking/running (n = 1078, n = 23.6%), water sports (n = 533, 11.6%), biking (n = 393, 8.6%), and climbing (n = 260, 5.7%). The most common injuries were skin-related (n = 1194, 27.1%), musculoskeletal (n = 804, 18.3%), and heat injuries (n = 393, 8.9%). Activities preceding mortality included water sports (n = 52, 42.6%) and hiking (n = 20, 16.4%). Injuries contributing to mortality included respiratory events and drowning (n = 46, 37.41%), cardiac events (n = 13, 10.5%), and heat injury (n = 9, 7.3%). Most incidents occurred in Hill Country (n = 1170, 24.01%) and Prairies and Lakes (n = 1144, 23.48%) areas.ConclusionThis study evaluates outdoor recreational injuries in the state of Texas. It uncovers and summarizes important trends that may inform the development of prevention and education efforts.","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":" ","pages":"223-233"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701840","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

Shelters in Alpine Rescue: Can They Create a Comfortable Zone at the Deployment Site? 高山救援中的避难所：他们能在部署地点创造一个舒适的区域吗？

IF 1.4 4区医学

Wilderness & Environmental Medicine Pub Date : 2025-06-01 Epub Date: 2024-12-20 DOI: 10.1177/10806032241300132

Willi Troeger, Manuel Winkler, Markus Isser, Wolfgang Lederer

{"title":"Shelters in Alpine Rescue: Can They Create a Comfortable Zone at the Deployment Site?","authors":"Willi Troeger, Manuel Winkler, Markus Isser, Wolfgang Lederer","doi":"10.1177/10806032241300132","DOIUrl":"10.1177/10806032241300132","url":null,"abstract":"IntroductionLightweight shelters made of water- and windproof polyester are frequently used by mountain rescue, but information on physical and psychological stress during their use is scarce.MethodsA prospective observational study was conducted with 48 experienced rescuers who performed cardiopulmonary resuscitation training on a manikin in a shelter in alpine terrain. The objective parameters of air temperature, moisture, and concentrations of carbon dioxide and oxygen were measured inside the shelter. The subjective experience of the rescuers regarding stress, moisture, noise, air draft, convenience, spatial confinement, brightness, room temperature, and air quality was assessed using a questionnaire.ResultsDuring 15 min of cardiopulmonary resuscitation, the median temperature in the shelter rose by >15°C (Δt, 15.9°C; interquartile range, 14.3-16.5°C; P=0.018). Carbon dioxide concentrations increased to 0.97 vol% maximum. Bag valve mask ventilation was established with and without the use of supplemental oxygen, which showed significantly different oxygen shelter concentrations (21.1 vol% with oxygen, 20.6 vol% without oxygen; P<0.001). Most participants rated the physical comfort and spatial conditions inside the shelter as convenient.ConclusionsIn this study, the use of shelters in alpine terrain improved physical comfort while carrying out a rescue. Most participants gave high ratings for the working conditions in the shelter.","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":" ","pages":"159-165"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866052","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

Fishhook Injuries and Antibiotic Prescribing Patterns: A Retrospective Analysis. 鱼钩伤与抗生素处方模式：回顾性分析。

IF 1.4 4区医学

Wilderness & Environmental Medicine Pub Date : 2025-06-01 Epub Date: 2025-01-17 DOI: 10.1177/10806032241308834

Alan A Lazzara, Jacob S Sinkoff, Robert Thompson, Khader Zahdan, Jonathan Baptiste

{"title":"Fishhook Injuries and Antibiotic Prescribing Patterns: A Retrospective Analysis.","authors":"Alan A Lazzara, Jacob S Sinkoff, Robert Thompson, Khader Zahdan, Jonathan Baptiste","doi":"10.1177/10806032241308834","DOIUrl":"10.1177/10806032241308834","url":null,"abstract":"IntroductionFishhook injuries are a common occurrence among anglers. There are no guidelines for prophylactic antibiotic use after fishhook removal. This study analyzed the management of embedded fishhooks, prophylactic antibiotic use, and complication rate at a Michigan county emergency department to observe whether antibiotic use changes patient outcome. Commentary on a freshwater pathogen (Aeromonas hydrophila) is also included.MethodsCases were obtained through a retrospective chart review of patients seen for fishhook injury between 2016 and 2022. We analyzed age, sex, relevant medical history, type of fishhook, site preparation, removal technique, antibiotic use, return visit within 30 days, and complications.ResultsFifty-one patients with fishhooks injuries were identified. Mean age was 48±17 y. Forty-three patients were male (84%), and 8 were female (16%). Hook site varied, with most occurring in the finger/thumb (78.4%) and scalp (5.9%). One case involved the ear cartilage. The most common removal technique was the advance and cut method (52.9%). Four patients had an immunocompromising condition (eg, diabetes). Oral antibiotics were prescribed to 26 patients (51%) on discharge. Prophylactic antibiotic choice varied-cephalexin predominated (61.5%). There were no wound infections or complications in cases where the fishhook was removed during the emergency department encounter (50 of 51). One case involved a delayed presentation, abscess formation, and outpatient hand surgery referral.ConclusionsIn this small observational study, antibiotic prophylaxis for freshwater-associated fishhook injury did not change outcome regardless of fishhook location or presence of an immunocompromising condition. Further controlled studies are needed to determine the validity of these findings.","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":" ","pages":"166-170"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014696","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

Management of Fasciitis in a Mariner on a Disabled Sailboat in the Middle of the Pacific. 太平洋中一艘伤残帆船上一名水手筋膜炎的处理。

IF 1.4 4区医学

Wilderness & Environmental Medicine Pub Date : 2025-06-01 Epub Date: 2025-03-31 DOI: 10.1177/10806032251321469

Catherine V Levitt, Kate Larsen, John E Lafleur

引用次数: 0

Evaluating Large Language Models on Aerospace Medicine Principles: Comment. 评价航空航天医学原理的大型语言模型：评论。

IF 1.4 4区医学

Wilderness & Environmental Medicine Pub Date : 2025-05-30 DOI: 10.1177/10806032251344073

Hinpetch Daungsupawong, Viroj Wiwanitkit

引用次数: 0

Two Cases of Fatal Leopard Attacks from Botswana. 两起来自博茨瓦纳的致命豹子袭击事件。

IF 1.4 4区医学

Wilderness & Environmental Medicine Pub Date : 2025-05-22 DOI: 10.1177/10806032251342115

Nale Mvula, Arthur Saniotis, Martinson Danquah, Thato M Patlakwe

引用次数: 0

What Is the Purpose, Nature, and Challenge of Student Assessment in the Diploma in Mountain Medicine: A Qualitative Study Exploring the Opinions of Senior Policymakers. 山地医学文凭学生评估的目的、性质与挑战：一项探讨高层决策者意见的质性研究。

IF 1.4 4区医学

Wilderness & Environmental Medicine Pub Date : 2025-05-21 DOI: 10.1177/10806032251340977

Michael Greene

{"title":"What Is the Purpose, Nature, and Challenge of Student Assessment in the Diploma in Mountain Medicine: A Qualitative Study Exploring the Opinions of Senior Policymakers.","authors":"Michael Greene","doi":"10.1177/10806032251340977","DOIUrl":"https://doi.org/10.1177/10806032251340977","url":null,"abstract":"BackgroundThe Diploma in Mountain Medicine (DiMM) is an educational program designed to enable healthcare professionals to adapt their practice to the mountain environment. The purpose and nature of student assessment are not explained in the regulations. Understanding the intentions of the administrators who wrote the assessment regulations would enable students to be assessed more consistently and in keeping with the objectives of the program.MethodThis study used qualitative methods. Interviews were used to collect the opinions of members of the DiMM program administrative group. Thematic analysis was used to identify themes in the data and to produce a narrative description concerning the purpose, nature, and challenges of assessment.ResultsThe major themes identified included the importance of using assessment to measure student progress and outcome, the intention to assess competency, the importance of standardization in assessment, and the identification of core knowledge and skills. The need to be sensitive to cultural differences in education was a complex issue that limited the development of learning outcomes and the definition of a level of learning for the program.ConclusionsThere is variation in the content, level of learning, and outcomes assessed on DiMM courses. Cultural and educational diversity of the courses were complex issues that confounded consistent student assessment. In the future, clear statements about the aims of assessment, the academic level of study, and the content of learning would enhance the educational rigor and value of the program. The use of consensus methodology would be beneficial in achieving these objectives.","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":" ","pages":"10806032251340977"},"PeriodicalIF":1.4,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121088","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

Simulated Avalanche vs Tree-Well Burial Effects on Human Physiology. 模拟雪崩与树井掩埋对人体生理的影响。

IF 1.4 4区医学

Wilderness & Environmental Medicine Pub Date : 2025-05-15 DOI: 10.1177/10806032251337476

Nicholas C Kanaan, Jibreel Abdul Cader, Joseph Krakker, Heather Beasley, Colin K Grissom, Scott E McIntosh

{"title":"Simulated Avalanche vs Tree-Well Burial Effects on Human Physiology.","authors":"Nicholas C Kanaan, Jibreel Abdul Cader, Joseph Krakker, Heather Beasley, Colin K Grissom, Scott E McIntosh","doi":"10.1177/10806032251337476","DOIUrl":"https://doi.org/10.1177/10806032251337476","url":null,"abstract":"IntroductionAvalanches and tree-wells (TW) are causes of snow immersion death in skiers and snowboarders. TW burials may have different victim physiology profiles and rescue considerations than avalanche-related burials due to snow density, burial position, and compensatory physiologic responses. This study aimed to compare the physiological responses between avalanche and TW burials through a prospective controlled trial of simulated avalanche burial to simulated TW burial.MethodsEleven volunteers participated in two paired 60-min snow burials: Avalanche and TW simulations, controlling for position and snowpack densities. We monitored core temperature, respiratory rate, minute ventilation, end-tidal carbon dioxide, oxygen saturation, partial pressure of inspired carbon dioxide, and heart rate.ResultsThe average cooling rate for the avalanche simulation was -0.017(Δ°C/min) versus -0.012(Δ°C/min) for the TW simulation (p = 0.014*), 1.42 times faster cooling rate than TW burial. SpO2 decreased 10.9 times faster on average in TW burial than in avalanche conditions when normalized by burial time as a rate (avalanche -0.011 vs TW -0.12 (Δ%/min), p = 0.033*). More participants requested early study termination in the TW scenario.DiscussionSimulated TW burial resulted in a statistically significant slower rate of core temperature cooling and earlier hypoxemia. Inverted body position in TW burials may lead to increased physiologic distress and contribute to earlier hypoxia. These findings may have important implications for search and rescue as well as resuscitation efforts for snow burial victims.","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":" ","pages":"10806032251337476"},"PeriodicalIF":1.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081609","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