RESUMEN
The challenges of practicing medicine in small ships on remote sites involve limited resources, lack of specialized support, and longer interactions with a patient in an isolated environment. This report describes the successful management of a patient who suffered a major injury after fell from the stairs in an expedition ship in the Southern Ocean in the Antarctic route. The patient was managed by the onboard physician for four days until the medical evacuation was possible.
Los desafíos de practicar la medicina en barcos pequeños en sitios remotos implican recursos limitados, falta de apoyo especializado e interacciones más prolongadas con el paciente en un entorno aislado. Este manuscrito describe el manejo exitoso de un paciente quien sufrió un trauma mayor producto de una caída en un barco de expedición en el Océano Austral en la ruta Antártica. El paciente fue manejado por el médico de a bordo durante cuatro días hasta que fue posible realizar la evacuación médica.
Asunto(s)
Humanos , Expediciones , Navíos , MedicinaRESUMEN
A standardized neurocognitive test battery is needed to study the effects of military isolated and confined environments on the cognitive functions of personnel. The cognitive tests currently in use have the following problems: inconsistency among different studies, no clear psychological processes, the presence of practice effect, absence of related normative data, and insufficiency in sensitivity, difficulty, and comprehensiveness. Therefore it is proposed that the neurocognitive tests for military isolated and confined environments should meet the following requirements: (1) easy to carry and easy to carry out the test; (2) the test time should be as short as possible (≤30 min); (3) suitable for repeated measuring, and the subjects can reach a stable level quickly; (4) preferably a complete set of test, the cognitive function should be comprehensively and should be closely related to specific tasks; (5) the test should be based on the norm of military isolated and confined environments and the changing curve with time, which can be used as controls; (6) the reliability and validity of the cognitive test should have been tested; (7) with high sensitivity and appropriate test difficulty; (8) the psychological process involved in the cognitive test is clear and simple, making it easy for result interpretation; and (9) the brain areas activated by cognitive test should be clear, which is convenient for further neuropsychological research. Cognition, American National Aeronautics and Space Administration (NASA) neurocognitive test battery for spaceflight, almost perfectly fits the above nine requirements. In the future when our army develops the neurocognitive test tools based on NASA Cognition, we should emphasize the following four focuses: improving the portability of the cognitive test device, developing computerized adaptive cognitive tests, clarifying the inclusion criteria of cognitive tests, and developing parallel tests with consistent psychometrics characteristics.
RESUMEN
Long-term stays in extreme environments, such as Polar Regions, may cause significant changes in the health and well-being of individuals. A systematic overview aimed to map studies about the psychological effects on Antarctic expeditioners. The reviewed data were categorized and divided into two thematic axes: Negative Effects, resulting from harmful psychophysiological variations caused by exposure to the polar stressors, which may present seasonal symptom patterns, altering cognitive performance, mood and interpersonal relationships; and Positive Effects, such as salutogenic results arising from successful adaption to environmental adversities. Due to the great deal of evidence, it is suggested that protection factors should be promoted through preventive approaches, such as psychological training and support in order to reduce symptoms and generate satisfactory adaptation to Antarctica...
A permanência em ambientes de condições extremas, como regiões polares, pode provocar alterações significativas na saúde e no bem-estar dos indivíduos. Por meio de uma revisão sistemática, objetivou-se mapear pesquisas sobre efeitos psicológicos em expedicionários antárticos. Os dados revisados foram categorizados e divididos em dois eixos temáticos: Efeitos Negativos, que resultam de variações psicofisiológicas nocivas causadas pela exposição aos estressores polares, podendo apresentar padrões sazonais nos sintomas, alterando o funcionamento cognitivo, estado de humor e relações interpessoais; e Efeitos Positivos, resultados salutogênicos, decorrentes da adaptação bem sucedida às adversidades ambientais. Devido ao número de evidências, sugere-se que fatores de proteção sejam promovidos por abordagens preventivas, como treinamento e suporte psicológico, a fim de reduzir sintomas e gerar uma adaptação satisfatória à Antártica...