Aerospace Environmental Health: Considerations and Countermeasures to Sustain Crew Health Through Vastly Reduced Transit Time to/From Mars.

The concept of implementation of environmental health protection and sustainment in aerospace environments by definition implies a One Health systems approach. One Health indicates an inherently complex, contextually interrelated system with consideration of human, animal, plant, systems engineering, and environmental health, their interrelationships, and networks. One Health implies seamless integration of subsystem co-dependencies to achieve an outcome of overall health protection for the individual. One of the most challenging aspects of space travel involves prevention, mitigation and protection from radiation injuries. While avoidance altogether is the best approach, these authors will focus on minimized exposure through limiting time in the space radiation environment in the transit to Mars and back. Implementation of the pillars of time, distance and shielding comprise ALARA, "As Low as Reasonably Achievable" (www.cdc.gov/nceh/radiation/alara.html) and is stressed in this strategy. This general overview will briefly describe the critical components of space environmental health in anticipation of increasing duration and interaction of human, animal, and plant habitation of aerospace and extreme environments into the future. Of the many considerations that could be addressed, precision medicine, and bioinformatics are the most rapidly evolving. Complex interdependencies will emerge from macro- and micro-environmental ecosystems data analysis, not yet fully comprehended or understood in the context of space health. We will conclude this contribution with suggested new countermeasure strategies gleaned through big data analytics that may protect space crew through mitigation of radiation exposure in flight.

Warfighter nutrition: current opportunities and advanced technologies report from a Department of Defense workshop.

The Uniformed Services University hosted a conference in July 2008 entitled "Warfighter Nutrition: Advanced Technologies and Opportunities" with Health Affairs and the Defense Advanced Research Projects Agency to develop strategic and tactical plans that could enhance Force Health Protection (FHP) by optimizing warfighter nutrition within the Department of Defense (DoD). The conference focused on three aspects of military nutrition: (1) fueling the forces, or garrison feeding; (2) performance optimization or operational feeding during deployment; and (3) nutritional interventions to support health reset and healing. Presentations by speakers addressed practical interventions (i.e., ready for implementation now) and advanced technologies (i.e., approaches meriting prioritized research and development efforts to transition into application). The conference concluded that nutritional optimization represents an integral and proactive approach to prevent illness, injury, and performance degradation throughout all phases of military service. The overarching consensus achieved was that warfighter nutrition, as a cornerstone of FHP, warrants the critical attention of both medical and line leadership to move quickly to support current initiatives and future advanced technologies.

Social Media Technology and Public Health in Ontario: Findings from a Planning Meeting Exploring Current Practices and Future Research Directions.

In the province of Ontario, many of the public health units (PHUs) now possess and use social media as part of their daily health promotion and communication operations. To explore this topic, a planning meeting was held to generate deeper insights toward the use of these forms of technology for preventative services delivery. The planning meeting was held with 50 participants, comprising representatives from 20 of the 36 PHUs in Ontario, interested academics, students and government representatives. A nominal group technique (NGT) was used to build consensus related to future research needs, as related to public health and social media. Participants generated a range of insights around the use of social media, including the need for: leadership buy-in and resource allocation; social media policy and governance structure; performance measurement and evaluation; practices related to engagement with program recipients and addressing the lack of resources faced by many health units. Future research priorities were also generated, related to evaluating the cost-benefit of social media activities and understanding behaviour change implications. Further research is needed to evaluate the functionality, leadership and competency requirements and impact(s) of these new forms of health communication technology within public health service delivery.

Long-term Death Rates, West Nile virus epidemic, Israel, 2000.

We studied the 2-year death rate of 246 adults discharged from hospital after experiencing acute West Nile Virus infection in Israel during 2000. The age- and sex-adjusted death rates were significantly higher than in the general population. This excess was greater for men. Significant adverse prognostic factors were age, male sex, diabetes mellitus, and dementia.