Wilderness & Environmental Medicine最新文献

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.

The rising occurrence of natural disasters linked to climate change has drawn the attention of disaster response leaders to the significance of addressing operational stress injuries among disaster response personnel. We define and describe operational stress injuries in this workforce and explore theoretical frameworks that can inform the development of programs and interventions to mitigate these effects. We aim to establish a conceptual framework for understanding an operational stress injury by introducing a model specific to disaster responders. We also emphasize strategies that can be employed within a stress injury awareness framework to promote the mental well-being of those who respond to climate-related disasters.

The imminent climate crisis has been labeled as the biggest health threat humanity must deal with. Vector-borne disease distribution and transmission as well as the population at risk are influenced to a great degree by environmental and climactic factors affecting both the vectors themselves and the causative pathogens. Paired with an increase in worldwide travel, urbanization, and globalization, along with population displacements and migration, elucidating the effects of anthropogenic climate change on these illnesses is therefore of the essence to stave off potential negative sequelae. Outcomes on different vector-borne diseases will be diverse, but for many of them, these developments will result in a distribution shift or expansion with the possibility of (re-)introduction of vector and pathogen species in previously nonendemic areas. The consequence will be a growing likelihood for novel human, vector, and pathogen interactions with an increased risk for infection, morbidity, and mortality. Wilderness medicine professionals commonly work in close relationship to the natural environment and therefore will experience these alterations most strongly in their practice. Hence, this article attempts to bring awareness to the subject at hand in a wilderness medicine context, with a focus on malaria, the most burdensome of arthropod-borne diseases. For prevention of the potentially dire consequences on human health induced by climate change, concerted and intensified efforts to reduce the burning of fossil fuels and thus greenhouse gas emissions will be imperative on a global scale.

In Hawaii, impacts from climate change, such as sea-level rise and flooding, increased hurricanes and wildfires, and warmer temperatures, intersect with aging infrastructure, toxicities from the built environment, and pathogens to threaten the health of recreational ocean users via reduced water quality, severe weather and flooding, environmental degradation, and food systems impacts. An examination of climate-driven threats to water safety is a pertinent review of threats to coastal residents globally.

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.

In 1911, Mabel Purefoy FitzGerald (1872-1973) conducted a study in the mountains of Colorado that offered invaluable insights into how the body responds to chronic hypoxia. Researchers awarded the Nobel Prize for Physiology or Medicine 2019 cited her work as critical in unravelling the hypoxia sensing system. The astounding career situation in which FitzGerald found herself while conducting this study offers important insights into the challenges faced by women in science at the turn of the twentieth century. Like Ginger Rogers dancing with Fred Astaire, FitzGerald did the equivalent of everything her male colleagues did, only backward and in high heels. Although it is tempting to believe that such inequities for women are relegated to history, the career challenges faced by 2023 Nobel Laureate Katalin Karikó highlight evidence that the struggle for equality of women in science remains a significant problem.