Experience from the selection and nutritional preparation for Expedition ICE MAIDEN: the first successful all-female unassisted Antarctic traverse.

INTRODUCTION: Expedition ICE MAIDEN (Ex IM) was the first all-female unsupported crossing of Antarctica. We describe the prerequisite selection and training, comparing those who formed the final team with other participants, and discuss how the expedition diet was established. METHODS: All women serving in the British Army were invited to participate. Following initial assessments, successful women completed three training/selection ski expeditions. Between expeditions 1 and 2, participants completed 6 months rigorous UK-based training. Weight was measured before and after the 6 months UK-based training, expeditions 2 and 3, and body composition by skinfold before and after expedition 2. Participant feedback, body composition and weight changes were applied to modify the expedition diet and provide weight gain targets prior to Ex IM. RESULTS: Following 250 applications, 50 women were assessed and 22, 12 and seven women attended training expeditions 1, 2 and 3, respectively. The final team of six women lost more weight than other participants during UK-based training (mean (SD) change -1.3 (1.5) kg vs -0.5 (1.6) kg, respectively, p=0.046) and during training expedition 2 (-2.8 (0.8) kg vs -1.7 (0.4) kg, respectively, p=0.048), when they also gained more lean mass (+2.1 (0.8) kg vs +0.4 (0.7) kg, respectively, p=0.004). The Ex IM diet provided 5000 kCal/day, comprising approximately 45% carbohydrate, 45% fat and 10% protein. Median (range) weight change between expedition 3 and Ex IM was +8.7 (-1.9 to +14.3) kg. CONCLUSIONS: The selected Ex IM team demonstrated favourable training-associated body composition changes. Training-associated weight loss informed the expeditionary diet design.

Cardiovascular system parameters in participants of Arctic expeditions.

OBJECTIVES: A method of continuous heart rate (HR) and blood pressure (BP) recording was used for the evaluation of the cardiovascular system parameters in participants of short-term (<1 month) high-latitude expeditions, in comparison with the parameters of residents of Central Russia and the Arctic region. MATERIAL AND METHODS: A dynamic examination of participants of Arctic expeditions (30 men, residents of middle-latitude regions, aged 46.7±1.7 years), workers permanently living in Central Russia (the Moscow region, 44 men, aged 46.7±1.0 years) and residents of the North (the Murmansk region, 35 men, aged 46.6±1.3 years) was performed. The authors used a spiroartheriocardiorythmograph allowing the parallel recording of HR, BP, spectral characteristics of HR variability (HRV) and the variability of systolic BP (sBP) and diastolic BP (dBP), cardiac performance parameters, and spontaneous baroreflex sensitivity (BRS). The parameters were recorded at rest, in a sitting position, over 2 min. RESULTS: The basic clinical parameters (HR, BP and cardiac performance) did not differ in the workers living in different climatic zones. However, the residents of the North demonstrated a lower total power (TP) of the dBP variability spectrum and a lower relative power of the high-frequency (HF) range in both the sBP and dBP variability spectra. The participants of expeditions to the North had a lower TP of the HRV spectrum (in comparison with both control groups) that did not change during the expeditions; BRS was reduced, while the TP of the sBP spectrum was increased in comparison with the corresponding parameters obtained from the residents of circumpolar regions, and decreased during the expedition in parallel with a decrease in the sBP values. The TP of both the sBP and dBP variability spectra, as well as the power of the HF range in these spectra, were similar in the participants of expeditions to those obtained from the residents of Central Russia, and they considerably surpassed the corresponding parameters in the northerners surveyed. CONCLUSIONS: The revealed peculiarities of the cardiovascular system in the participants of high-latitude expeditions can be considered as correlates of positive, and adequate in terms of the physiological value, adaptive shifts in the autonomous regulation of the cardiovascular system. Int J Occup Med Environ Health. 2020;33(6):819-28.

Disease and injury statistics of Japanese Antarctic research expeditions during the wintering period: evaluation of 6837 cases in the 1st-56th parties - Antarctic health report in 1956-2016.

This study aimed to evaluate disease and injury trends among wintering members of the Japanese Antarctic Research Expedition. Obtained information is indispensable to the advancement of medical system and research. Summation was performed based on medical records of reports prepared by each expedition over the period 1956-2016. The clinical department's classification methods of the names of injuries and diseases varied among expeditions, but the names were integrated following the same classification. Of 1734 members (29 women), 6837 disease or injury cases (4 cases/person) were recorded. The rates of cases were as follows: surgical-orthopaedic (45.3%), internal medical (21.7%), dental (11.6%), dermatological (8.4%), ophthalmological (5.8%), otorhinolaryngological (5.3%), psychiatric (1.6%), and urological (0.1%) cases. There was no major change in rates by type of medical case in each expedition. This analysis made it possible to prepare medical facilities, content of physical examinations to select members, training of physicians before departure, preventive hygiene at sites, and medical research themes.

Medical Incidents and Evacuations on Wilderness Expeditions for the Northwest Outward Bound School.

INTRODUCTION: Outdoor education (OE) expeditions travel far from definitive care and have unique epidemiology. Most OE expedition studies have examined a single organization and results may not generalize. This study examines the injuries, illnesses, medical evacuations, and nonmedical incidents of the Northwest Outward Bound School (NWOBS) to broaden our understanding and demonstrate commonalities within the field. METHODS: This retrospective database review examined incidents and evacuations on NWOBS expeditions from June 1, 2014 through October 31, 2016. Incident rates, evacuation rates, and incident type frequencies were calculated. Frequencies of incidents during different expedition time periods were compared with a 1-sample χ2 test. The odds ratio that each type of incident would require evacuation was calculated and compared with other incident types using Fisher exact test. RESULTS: The study period included 59,058 program days, 277 incidents, 143 medical incidents, 75 medical evacuations, and no fatalities. Injuries occurred at a rate of 1.64 per 1000 program days and illnesses at a rate of 0.78 per 1000 program days. The most common injuries were strains, sprains, and trauma or infection of the skin and soft tissue. Most injuries occurred while backpacking, hiking, or moving around camp. The most common illnesses were nausea, vomiting, diarrhea, abdominal pain, asthma, respiratory infections, and urinary tract infections. The medical incidents with the highest odds of evacuation were fractures, urinary tract infections, abdominal pain, and asthma. CONCLUSIONS: Results from the NWOBS database are consistent with those from other expeditionary OE programs. These findings should guide risk-management strategies and staff medical training.

Trends in Skin and Soft Tissue-Related Injuries in NOLS Wilderness Expeditions from 1984 to 2012.

OBJECTIVE: Wilderness expeditions inevitably involve risk to participants. Understanding of expedition-related illnesses and injuries allows institutions and individuals to develop strategies to mitigate risk. We describe findings and trends in soft tissue injuries, the second-most common type of injury, among participants in the National Outdoor Leadership School expeditions from 1984 to 2012. METHODS: Injuries and illnesses sustained by students and staff have been recorded continuously since 1984 in the extensive National Outdoor Leadership School database. We performed a retrospective analysis of incidence of soft tissue injuries in this population. Data before 1996 were standardized in order to make use of the entire dataset. RESULTS: Of 9734 total reported incidents, 2151 (22%) were soft tissue related, 707 (33%) of which required evacuation. The sex distribution of incidents was similar to the sex distribution of participants. The largest incidence of soft tissue injuries occurred independent of activity (711 incidents, 33%). The most commonly associated activities were hiking (528 incidents, 25%), camping (301 incidents, 14%), and cooking (205 incidents, 10%). Over the study period, rates of injury declined overall and in every individual category except cooking. CONCLUSIONS: Over this 28-year period, the incidence of soft tissue injuries associated with the most common activities decreased. Incidence of activity-independent injuries did not change significantly, but reported severity decreased. These data provide unique insights to help improve wilderness risk management for institutions and individuals and suggest areas in which educational efforts may further reduce risk.

Prolonged Exposure Dermatosis: Reporting High Incidence of an Undiagnosed Facial Dermatosis on a Winter Wilderness Expedition.

OBJECTIVE: Previously unclassified inflammatory skin lesions referred to as sun bumps have been observed throughout the year on participants of wilderness trips; however, the underlying cause and diagnosis remain unclear. The purpose of this prospective observational study was to document the incidence, characteristics, and risk factors associated with these skin lesions as they occurred on a winter wilderness expedition. METHODS: For this study, the lesions were defined as pruritic or erythematous skin lesions occurring while in the wilderness. Seventy-four participants in a wilderness ski touring course in Wyoming fully completed a 44-question written survey concerning occurrence and risk factors for these lesions. Weather information and photographs were collected. RESULTS: Twenty-six percent of participants had similar lesions. The lesions were described as edematous pale papules and plaques with erosions and crusts on an erythematous background. The face was involved in 90% of affected persons. Lesions occurred after an average of 8.7 days in the wilderness and resolved 10.6 days later. Skin that was less prone to sunburn was associated with a decreased incidence (odds ratio 0.44). No association could be found between lesion incidence and history of polymorphous light eruption, sun exposure, ambient temperature, affected contacts, sex, or body mass index. CONCLUSIONS: Overall, the lesions were common among study participants but occurred only after prolonged exposure to wilderness conditions. It was not possible to classify the skin condition as an example of any known diagnosis. We propose the name "prolonged exposure dermatosis" for this condition until further studies better define its etiology, prevention, and treatment.

Impact of Antarctica winters on vital parameters and anthropometric variables.

INTRODUCTION: We studied the variations in vital parameters and anthropometric variables in Antarctica to identify the effect of extreme weather and isolation on the vital parameters and adipose tissue distribution in humans. METHODS: A descriptive observational cohort study on three vital parameters and nine anthropometric measurements was conducted among the 26 winter team members of the 27th Indian Scientific Expedition to Antarctica. The parameters were evaluated in March, May and July 2008. The data was analyzed for: (1) undivided team, (2) groups based on physical activity levels, and (3) groups based on age. Intergroup variations were analyzed. RESULTS: The diastolic blood pressure of the undivided team fell significantly during the study. The systolic and diastolic blood pressure of non-convoy team decreased but the systolic blood pressure of the convoy team increased. The pulse rate of the two physical activity groups increased. No significant changes were observed in rest of the vital parameters and any of the anthropometric variables. CONCLUSION: The blood pressure of the expedition members may show unpredictable changes. But in a modern day Antarctic station, no significant variations in body fat are observed. Though the stress factors have been mitigated in Antarctica to a large extent, they might still be substantial. Quantification of the impact of such factors is difficult.

Reasons for medical consultation among members of the Indian Scientific Expeditions to Antarctica.

The article attempts to analyze the disease burden in a healthy, pre-screened population subjected to prolonged residence in the hostile environment of Antarctica. This retrospective epidemiological study was conducted utilizing data from medical consultation room on board the Indian Antarctic expedition vessels and at Indian Antarctic station, Maitri from seven Indian Scientific Expeditions to Antarctica (ISEA). The study group (n=327) consisted of 325 men and two women. The total number of medical room consultations was 1989. Maximum consultations were for injuries (27.25%); 14.68% were musculoskeletal and 10.31% were bruises and lacerations. Disturbances of gastrointestinal tract (19.66%) were the second most common disorders. Psychological disturbances accounted for 2.66% consultations. Cold injuries constituted 2.01% consultations and photophthalmia accounted for 1.06% consultations.

Morbidity pattern of the 27th Indian Indian Scientific Expedition to Antarctica.

OBJECTIVE: To evaluate morbidity prototype of 27th Indian Scientific Expedition to Antarctica (ISEA). METHODS: Twenty-six team members of 27th ISEA wintered over at the Indian Antarctic Station, Maitri, from February 2008 to January 2009. The morbidity pattern was sourced from the medical records. Preexisting illnesses were also considered in this analysis. RESULTS: The team consisted of men between 27 and 59 years of age (mean age, 43 years). Nine team members had preexisting illnesses. A total of 93 illness incidents were recorded during the stay in Antarctica. Most of these (27) were musculoskeletal injuries, bruises, and lacerations. Thirty-two (34%) incidents of illness were noted under the purview of medicine; 26 (28%), surgery; 15 (16%), orthopedics; 9 (10%), otorhinolaryngology; 8 (9%), ophthalmology; 2 (2%), dentistry; and 3 (3%), psychiatry. Oral ulcers were noted in 8 (8%) participants primarily during early wintering. CONCLUSIONS: Injuries continue to be the most common cause of morbidity in Antarctica. Nutritional deficiencies and cold-related injuries are relatively less common.

Fatal accidents among elite mountaineers: A historical perspective from the European Alps.

The lifetime risk of a fatal mountain accident among elite European alpine mountaineers and its time trends are determined by studying a fixed cohort of 390 elite mountaineers listed in the Encyclopaedia of the Alps (Hiebler, 1977). At publication of the encyclopaedia, 158 individuals were still living and were followed up until the end of 2008. The crude lifetime risk of a fatal accident for elite mountaineers is 0.203 [95% confidence interval (CI), 0.165 to 0.246). The difference in mortality between male (0.207; 95% CI: 0.168 to 0.251) and female mountaineers (0.118; 95% CI: 0.033 to 0.343) is not statistically significant. No fatal accidents occurred among elite mountaineers born before 1820. For the birth cohort from 1820 to 1949, the lifetime risk of a fatal accident (male mountaineers only) increased with time from 0.069 (95% CI, 0.019 to 0.220) to 0.375 (95% CI, 0.212 to 0.573). For all time strata, the highest risk of a fatal mountain accident was observed at an age of 30 to 39 yr. The high mortality among elite mountaineers clearly demonstrates that the limits of human performance are reached by these activities. The high risks should be communicated and should motivate risk-reduction efforts for this highly exposed subgroup of mountaineers.

Puerto del Pendulo, doubtful sound: la visita de la expedición Malaspina a Nueva Zelanda en busca de la verdadera forma de la tierra / Puerto del Pendulo, doubtful sound: the Malaspina expedition's visit to New Zealand in quest of the true figure of the earth

The Malaspina expedition was assigned the task of conducting a series of experiments using the pendulum to measure the strength of gravity at different locations during the course of its voyage.The immediate objective was to establish the length of a pendulum beating at seconds at latitude 45º as the basic unit of a new universal system of measures. Although the new unit, the metre, was eventually established on a different principle, the gravity experiments carried out by the expedition resulted in useful geodesic information and incidentally led to the first charting of Doubtful Soundin New Zealand (AU)

La expedición Malaspina tuvo por misión realizar una serie de experimentos utilizando un péndulo para medir la fuerza de la gravedad en los diferentes lugares recorridos durante el viaje. El objetivo inmediato consistió en establecer la longitud de un péndulo oscilando durante unos segundos a una latitud de 45º como unidad básica de un nuevo sistema métrico universal. Aunque la nueva unidad, el metro, fue finalmente establecida por otro principio diferente, los experimentos que llevó a cabo la expedición sobre la gravedad proporcionaron una información geodésica muy útil y por casualidad dieron lugar al primer trazado de mapa de Doubtful Sound, en Nueva Zelanda (AU)

Robert Musil frente a Ernst Mach / Robert Musil versus a Ernst Mach

Sobre las teorías de Mach (TD de R. Musil) rebate que la representación científica tienda a construir un claro y completo inventario de hechos. Pues Mach se ve obligado a presuponer relaciones constantes en la naturaleza; pero esta regularidad de los fenómenos implica que la ley es algo más que cierto «cuadro», que las meras dependencias que defiende están en un segundo plano y que una relación teórica en física es mucho más que una relación de orden. Su concepción de laeconomía científica como «adaptación natural» significa un monismo biológico opuesto a las dualidades propias de un empirista (AU)

On Mach’s Theories (DT of R. Musil) rejects that the scientific representation tends to build a clear and complete inventory of facts. Mach finds himself obliged to presuppose constant relationshipsin nature; but this regularity of phenomena implies that the law is something more than a «table», that its mere dependencies are pushed into the background, and that a theoretical relationship in Physics is much more than an order relationship. His conception of scientific economy as a «natural adaptation» implies a biological monism opposed to the characteristic dualities of an empiricist (AU)

Morbidity and determinants of health on youth expeditions.

OBJECTIVE: To document the prevalence of illness and injury on youth expeditions and analyze specific determinants of health. METHODS: Two thousand nine hundred fifteen people, aged 15 to 18 years, traveled with a commercial company, World Challenge Expeditions Ltd, between June and September 2001. Adult team leaders were required to keep medical cards for each person. This study is a retrospective analysis of these medical cards. RESULTS: Completed medical cards were available for 2402 people (82%). There were no medical problems in 36% of people. Illness or injury was reported by 64% (mean, 2.0 medical problems per person). Of the medical problems, 6% were defined as serious, and 1% were admitted to the hospital. One fatality occurred. The five most prevalent medical problems were diarrhea (22%), nausea and vomiting (20%), cold or sore throat (11%), headache (11%), and trauma (10%). Girls reported 19% more medical problems than the boys reported. Gastrointestinal illness was significantly increased at high altitude. Illness and injury were most prevalent in South America and least prevalent in Australasia. CONCLUSIONS: Our results demonstrate that in young people traveling to remote parts of the world, illness and injury are common. Serious incidents are rare; however, the death of one person does highlight the dangers present. This study may help risk assessment for young people considering taking part in an expedition.

Team climate at Antarctic research stations 1996-2000: leadership matters.

INTRODUCTION: The popular assumption is that extreme environments induce a climate of hostility, incompatibility, and tension by intensifying differences and disagreements among team members. Team members' perceptions of team climate are likely to change over time in an extreme environment, and thus team climate should be considered as a dynamic outcome variable resulting from multiple factors. In order to explore team climate as a dynamic outcome, we explored whether variables at multiple levels of analysis contributed to team climate over time for teams living and working in Antarctica. METHOD: Data for this study were collected from volunteers involved in Australian National Antarctic Research Expeditions conducted from 1996 to 2000. Multilevel analysis was used to partition and estimate the variance in team climate and to explore factors explaining variance at the group/team, individual, and weekly levels. RESULTS: Most of the variance in perceptions of team climate was at the individual level (57%). Team climate had less variance at the group level (16%) and at the weekly level (26%). Results indicated that perceived leadership effectiveness was significantly related to team climate. Perceived leadership effectiveness accounted for an estimated 77% of the group level variance, which equated to 14% of the overall variance in team climate. DISCUSSION: Our results suggest that exploring the characteristics and behaviors that constitute effective leadership would contribute to a more complete and useful picture of team climate, as well as guide selection research.

The incidence of injury with the British Antarctic Survey, 1986-1995.

Medical consultations recorded by the British Antarctic Survey between 1986-1995 were analysed. A total of 3683 new consultations were recorded, an incidence of 2193.7/1000/year, with a significantly higher incidence on the bases compared to the ships. Injuries comprised 30.2% of consultations, an incidence of 661.7/1000/year. The bases had a significantly higher incidence of injuries. Work accounted for 47.0% and recreation 30.6% of all injuries.

Expedition health and safety: a risk assessment.

Little has been published on the risks of participating in an expedition. A questionnaire survey was conducted to quantify those risks and to determine how expedition organizers plan for medical mishaps. 246 expeditions, taking 2381 participants to more than one hundred countries, were studied retrospectively. 65 expeditions (26%) reported no medical incidents; the remaining 181 reported 835 in 130,000 man-days (6.4 per 1000 man-days). 59% of the medical incidents seen on expeditions were preventable, one-third of these being due to gastrointestinal upsets. 78% of medical incidents were classified as minor and only 5% (40) as serious. There was no excess of serious incidents in any particular organizational group or environment. The findings of this survey suggest that the health risks of participating in a well-planned expedition are similar to those encountered during normal active life.

The epidemiology of cold injury in Antarctica.

METHOD: A retrospective study was performed of 10 yr of medical records to determine the type, severity, etiological factors and treatment of cold injury experienced by members of the British Antarctic Survey between 1986-95. RESULTS: There were 61 new consultations for cold injury. These comprised 2.5% of all new consultations with an incidence of 65.6 per 1000 per year. Cold injuries seen were frostbite (95%), hypothermia (3%) and trench foot (2%). Superficial frostbite was the most common injury (74% of cases) with the face the most frequently affected area (47% of injuries). No cases of frostbite severe enough to cause permanent tissue loss were seen. The prevalence of cold injury increased with falling temperature to a maximum between -25 and -35 degrees C, despite these temperatures occurring infrequently. The relationship with windchill is not as clear cut with frequency of injury tending to follow the frequency of windchill values except at higher windchill values. Neither temperature nor windchill were found to significantly influence the severity of frostbite. Prior cold injury was shown to be significantly (chi2 p < 0.001) associated with further cold injury. Most injuries (78%) occurred during recreation; skiing and snowmobile driving were often implicated. CONCLUSIONS: Cold injury is uncommon in Antarctica. Despite this, it warrants a continued high profile as under most circumstances it may be regarded as an entirely preventable occurrence.

Oswaldo Cruz monumenta histórica: campanhas e inquéritos sanitários

Apresenta um conjunto de dados sobre o pesquisador e sanitarista Oswaldo Cruz. Descreve as campanhas sanitárias de erradicação das doenças infecto-contagiosas, tais como: malária, varíola, peste bubônica, tuberculose. Apresenta relatórios do Dr. Oswaldo Cruz sobre as condições medico-sanitárias do Vale do Amazonas e do Rio Madeira.Inclui ainda um trabalho de autoria do Dr. Theophilo Torres que contem pequena biografia de Oswaldo Cruz, comentários sobre as leis sanitárias promulgadas após a Proclamação da Republica, as epidemias ocorridas no Rio de Janeiro e as medidas utilizadas para combatê-las. Por fim, descreve as diversas seções que constituíram a Diretoria Geral da Saúde Publica.(PPB)