Intraoperative temperature regulation in children using a liquid-warming garment.

PURPOSE: Children undergoing operative intervention while induced under general anesthesia are at risk for experiencing a significant decrease in core body temperature that can lead to adverse systemic effects. Given that the head contributes an estimated 18% of a child's body surface area, we theorized that a liquid-warming garment applied to the head could control a pediatric patient's core body temperature during surgical procedures. METHODS: Patients undergoing elective, non-cranial, general surgical procedures were enrolled in the study. A head garment with an embedded network of tubing was placed on the patient. The garment connected to a computer-controlled water bath that managed the temperature of the water in the tubing through a feedback mechanism. RESULTS: Ten patients with ages ranging from 1 day to 3 years (mean age 10.5 months) were enrolled in this study. The average procedure length was 82.5 min. The mean core body temperature throughout the procedure for all-comers was 36.5 ± 0.9 °C with an overall mean difference in maximum and minimum temperatures of 1.32 ± 1.1 °C. CONCLUSION: A liquid-warming garment applied to the head of pediatric surgical patients is an innovative and relatively low-cost means to regulate and to maintain the ideal core body temperature of patients undergoing surgical procedures.

The psychological process of reintegration following a nine month/260 day solo sailboat circumnavigation of the globe.

The focus of this case report is on the psychological reintegration process following the achievement of a highly challenging long-duration and solitary endeavor. The participant was a 29 year old male who successfully circumnavigated the globe during a 260 day solo sailing expedition. We assessed the psychological aftermath in terms of stability and change in personality characteristics and personal beliefs prior to, and at 180 and 360 days after the completion of the journey. Overall, the personality configuration reflected adaptive personality functioning. A belief in an internal locus of control was consistent throughout, as were perceptions of personal growth as a result of the circumnavigation experience. NEO PI-R Neuroticism, Extraversion, Openness, and Triarchic Psychopathy Measure (Tri-PM) Boldness scores remained stable. Positive personality change was reflected by an elevation in Conscientiousness; negative change by a decline in Agreeableness and an increase in Tri-PM Disinhibition. While overall the participant exhibited positive change as a result of his journey, there were also some negative aspects of the reintegration phase in regard to interactions with other persons. This latter change may be related to the effects of isolation from usual social contacts over an extended period.

Relationship of locus of control, psychological distress, and trauma exposure in groups impacted by intense political conflict in Egypt.

INTRODUCTION: Social and political instability have become common situations in many parts of the world. Exposure to different types of traumatic circumstances may differentially affect psychological status. OBJECTIVE: The aim of this study was to compare the relationship between personal perceptions of control over the events happening in one's life and psychological distress in two groups who experienced physical trauma but differed as to whether the trauma was a result of political upheaval and violence. Views on the extent to which the state was interested in the individual were also assessed. METHODS: The sample consisted of 120 patients who were injured in the Cairo epicenter and 120 matched controls from the greater Cairo area whose injuries were from other causes. The Brown Locus of Control Scale and the Symptom Checklist-90-Revised (SCL 90-R) were administered approximately three months after the January 2011 start of the demonstrations and subsequent overthrow of the government. RESULTS: The groups did not differ on locus of control. For both groups, externality was associated with greater distress, suggesting a relationship between perceived helplessness in controlling one's life and distress. The Cairo group scored significantly higher than the control group on the SCL 90-R Global Severity Index (GSI) and Positive Symptom Total (PST). Perceptions of state interest in the population were low; overall, 78% viewed the state as having little or no interest in them. Discussion The relationship between exposure intensity and psychological distress is examined. In addition, differences in findings in populations experiencing political chaos compared with other types of disasters are considered. CONCLUSION: Beliefs regarding personal control over one's life circumstances are more closely associated with psychological distress than the circumstances in which the trauma occurred.

Team Effectiveness and Person-Environment Adaptation in an Analog Lunar Habitat.

BACKGROUND: Maintaining psychologically adaptive relationships among team members operating in an isolated, confined, and extreme (ICE) environment for an extended period continues to be a challenge, with relevance for long-duration missions to the Moon and beyond.METHODS: Two male architects were studied who lived and worked over a 60-d period in a polar ICE environment in a lunar analog habitat they designed and helped construct. Psychological measures were completed at different points of the mission, including a post-mission debriefing interview.RESULTS: Team members were highly different from each other on a number of personality traits, personal values, and stress and coping factors. Marked differences were noted on NEO-PI-3 Agreeableness and Extraversion personality traits, and Portrait Values Questionnaire (PVQ) Stimulation, Power, and Achievement values. Team Effectiveness Questionnaire (TEQ) findings showed consistency between team members with high ratings on the Passion and Commitment and Purpose and Goals scales, and low ratings on the Roles scale. The leveling influence of decision authority and its deleterious effect on interpersonal interactions and work performance was evident. The interior design with attention to materials that made it more Earth-like and the circadian lighting system were associated with ease of work performance and promotion of relaxation and privacy.DISCUSSION: The study findings demonstrated the impact of incompatibility in personality traits and values on team performance, challenges regarding decision authority in a long-term dyadic relationship, and highlighted the human factors components of the habitat that facilitated effective individual and team functioning.Kjærgaard A, Leon GR, Chterev K. Team effectiveness and person-environment adaptation in an analog lunar habitat. Aerosp Med Hum Perform. 2022; 93(2):70-78.

Surveying the ashes: experience from the 2007 Peloponnese wildfires six months after the disaster.

INTRODUCTION: Major disasters disrupt the infrastructure of communities and have lasting psychological, economic, and environmental effects on the affected areas. The psychological status and community effects of the devastating 2007 wildfires on the Peloponnese Peninsula of Greece were assessed six months following the disaster. METHODS: Adult inhabitants, 18-65 years of age, living in villages affected by the wildfires were selected randomly and compared with a demographically similar group living in neighboring villages that were unaffected by the fires. Regions were chosen based on the extent of fire damage in that area. There were 409 participants in the fire group, and 391 in the control group. Participants completed a questionnaire that included the SCL-90-R symptom checklist, a subjective perception of health status, and a series of items assessing views about current problems, personal values, and trust in different institutions. RESULTS: The fire group scored significantly higher on psychological distress compared to the control group. Both groups viewed their health status in the previous year as better than at the present time. There were few significant differences between groups in the designation of regional problems, attitudes, and values. In the total sample, 41.6% listed unemployment, and 15.0% listed poverty as the most important problem in their region. The Church was indicated as the most trusted institution by 36.7% of the group and the Government by 13.3%. A total of 30.2% did not have a trusted institution. CONCLUSIONS: The hardiness and resilience of the fire-impacted group was evident. However, an improvement in economic conditions is needed to maintain the health and enhance the quality of life of the population living in the Peloponnese region. This improvement likely would have a positive effect on the attitude of trust in government institutions.

Individual Attributes, Values, and Goals of an All-Military Women Antarctic Expedition.

BACKGROUND: While participation of women in the military has increased, research on performance of female teams engaged in arduous physical activity in isolated, confined, and extreme (ICE) environments remains sparse.METHODS: A team of six British military women completed the Multidimensional Personality Questionnaire-Brief Form, Triarchic Psychopathy Measure, and Personal Values Questionnaire (PVQ) prior to embarking on an expedition that traversed the Antarctic continent. Questionnaires were completed weekly on the ice; repeat of the PVQ and individual semistructured debriefing interviews were carried out within 9 d post-expedition.RESULTS: Personality findings indicated a generally well-adjusted group with notable individual differences in personality and personal values. Positive affect and camaraderie among teammates was evident throughout, although pace vs. distance in the strategy of the daily trek was a continuing point of tension. Honesty in communication was viewed as key to team effectiveness. A significant post-expedition decline in the tradition value (Pre M = -0.55, SD = 0.99; Post M = -0.82, SD = 1.12) and an increase in the conformity value (Pre M = -0.26, SD = 0.46; Post M = 0.18, SD = 0.27) was found.DISCUSSION: Congruence in personal and team goals among group members engaged in highly challenging activities is crucial for optimal team performance. Presence of two highly dominant individuals has a negative effect on team dynamics. Application of study findings to space exploration is considered.Blackadder-Weinstein J, Leon GR, Norris RC, Venables NC, Smith M. Individual attributes, values, and goals of an all-military women Antarctic expedition. Aerosp Med Hum Perform. 2019; 90(1):18-25.

Visual analog scales for assessment of thermal perception in different environments.

INTRODUCTION: Subjective thermal perception in stable and dynamic environments has been measured primarily by categorical rating scales. At present, there is an increasing use of visual analog scales (VAS) to assess whole body and body region thermal perceptions in laboratory and other thermal environments. DISCUSSION: The rationale behind the use of VAS is that individuals are more accurate in conveying their subjective experience if they are not forced to make ratings according to numbers or categories. Unipolar scales have the advantage of focusing on a single subjective perception, such as the amount of cold the subject experiences. With bipolar scales (e.g., cold to hot), the sensitivity in measuring the extent of a specific thermal experience may be diminished because the subject needs to make a discontinuous change from one thermal perception to another. CONCLUSIONS: The robust psychometric properties of VAS indicate their usefulness in measuring thermal experience. Unipolar VAS with a large equal interval scoring range will enable the investigator to measure small gradients of change in perceptual experience. However, the subjective perception of thermal status is not highly accurate at thermal extremes, and caution is needed in sole reliance on subjective report in these conditions.

Personality influences on a two-man Arctic expedition, impact on spouse, and the return home.

INTRODUCTION: Two men engaged in a kayak/sled Arctic expedition and their wives were evaluated. This report focuses on personality factors and decisions on the ice, psychosocial effects on those left behind, and the family re-integration process. METHOD: Pre-expedition measures included the Multidimensional Personality Inventory (MPQ) and the Personal Assessment of Intimacy in Relationships (PAIR). Semi-structured interviews were conducted post-expedition and at a 4-mo follow-up. The PAIR was re-administered at the 4-mo follow-up. RESULTS: Significant tension and lack of communication between the two expeditioners was reported in response to the leader's decision to terminate the expedition because of weather conditions and poor progress. The incompatibility of the personality traits and goals of the two expeditioners contributed to this tension. The wives provided positive social support to each other, although the support and concern of their community became stressful. For each couple, both positive and negative changes in partner relationship intimacy were evident at the 4-mo follow-up. There was little consistency between each spouse on the types of changes that occurred. DISCUSSION: Greater attention to and planning for the re-integration process is suggested, with application for the return from other types of challenging endeavors.

Individual Traits, Personal Values, and Conflict Resolution in an Isolated, Confined, Extreme Environment.

BACKGROUND: The study of personality traits, personal values, and the emergence of conflicts within groups performing in an isolated, confined, and extreme environment (ICE) may provide insights helpful for the composition and support of space crews for long duration missions. METHODS: Studied pre/post and over the 2-yr period of the investigation were 10 Danish military personnel deployed to stations in Greenland on a 26-mo staggered rotation. Subjects completed the NEO PI-R, Triarchic Psychopathy Measure, and Portrait Values Questionnaire, and participated in structured interviews. During deployment, questionnaires were completed biweekly and a cognitive function test once a month. RESULTS: Personality findings indicated a generally well-adjusted group, above average in positive personality traits [Conscientiousness T-score = 59.4 (11.41); Agreeableness T-score = 54.4 (9.36)] and boldness. Personal values of benevolence and self-direction were highly rated. The decision when to "pick sides" and intervene during disagreements between group members was viewed as an important component of conflict resolution. There were no changes in positive/negative affect or cognitive function over the annual light/dark cycle. DISCUSSION: The personal values of group members appear highly compatible for living in a small group ICE environment for an extended period. Disagreements between group members impact the functioning of the entire group, particularly in regard to decisions whether to support one of the individuals or let the argument run its course. Extended training in strategies for conflict resolution are needed in planning for future long duration missions to avoid fault lines forming within the group.Corneliussen JG, Leon GR, Kjærgaard A, Fink BA, Venables NC. Individual traits, personal values, and conflict resolution in an isolated, confined, extreme environment. Aerosp Med Hum Perform. 2017; 88(6):535-543.

Men and women in space.

The influence of gender on the social context in which work performance takes place is considered. Women in single and mixed-gender polar expedition groups reported concern for the welfare of a teammate as a significant stressor. All-male teams exhibited higher levels of competitiveness and a lesser tendency to talk about their feelings. Excerpts from expedition debriefing interviews illustrate gender-related patterns noted in extreme environments. Application of these findings for the better selection, training, and performance of mixed-gender space crews is examined. A case study approach to conducting research on crew performance is recommended, and strategies for dealing with confidentiality are discussed.

Redirection of biological heat from head to hands to support finger comfort in the cold.

INTRODUCTION: Maintaining hand comfort in the cold while sustaining optimal performance is still a challenge. There has been little research on the efficacy of transporting biological heat from the head to the hands to stabilize finger comfort, although there are notable temperature differences between these two areas in the cold. METHOD: A tubing bypass between the head and the hands was designed as an independent component in a liquid cooling/warming garment (LCWG). Seven subjects (four men, three women) were studied, comparing finger temperature (Tfing) change in two conditions: LCWG with additional bypass; and LCWG without bypass. The protocol consisted of three stages: 1) comfort stabilization, LCWG inlet water temperature 33 degrees C, water in loop in bypass condition 23 degrees C; 2) body cooling, LCWG inlet water temperature 20 degrees C; and 3) rewarming, LCWG inlet water temperature 45 degrees C. RESULTS: The time to reach the 25 degrees C Tfing discomfort criterion was significantly longer in the bypass condition (p < 0.01); Tfing was significantly higher at the same time point when Tfing of 25 degrees C was reached in the control condition (p < 0.01). CONCLUSION: The incorporation of a bypass transferring biological heat from a high to a low skin temperature area has potential to improve local finger comfort and thus increase the time personnel can work in cold environments.

Finger heat flux/temperature as an indicator of thermal imbalance with application for extravehicular activity.

The designation of a simple, non-invasive, and highly precise method to monitor the thermal status of astronauts is important to enhance safety during extravehicular activities (EVA) and onboard emergencies. Finger temperature (Tfing), finger heat flux, and indices of core temperature (Tc) [rectal (Tre), ear canal (Tec)] were assessed in 3 studies involving different patterns of heat removal/insertion from/to the body by a multi-compartment liquid cooling/warming garment (LCWG). Under both uniform and nonuniform temperature conditions on the body surface, Tfing and finger heat flux were highly correlated with garment heat flux, and also highly correlated with each other. Tc responses did not adequately reflect changes in thermal balance during the ongoing process of heat insertion/removal from the body. Overall, Tfing/finger heat flux adequately reflected the initial destabilization of thermal balance, and therefore appears to have significant potential as a useful index for monitoring and maintaining thermal balance and comfort in extreme conditions in space as well as on Earth.

Fearless Temperament and Overconfidence in an Unsuccessful Special Forces Polar Expedition.

BACKGROUND: Assessment of the influence of personality and decision processes on the performance of two-person expedition teams has application for the composition of small teams for planetary exploration and potentially responding to off-nominal situations. CASE REPORT: We studied a two-man Special Forces team with a goal of reaching the North Pole in the shortest amount of time. Both subjects had high scores on measures of leadership/dominance, fearlessness, and achievement, and low scores on harm avoidance (high risk-taking). Differences were noted on scales measuring empathy, agreeableness, extraversion, emotional regulation, and callousness. Individual differences in the primacy of personal values of tradition vs. pleasure-seeking were evident. DISCUSSION: High dominance traits of both team members, incompatibility in other characteristics and values, and minimal pretraining had a significant impact on the decision to abort the trek because of severe frostbite suffered by one subject. Implications for dyads exploring the Mars surface are discussed.

Overview of the psychosocial impact of disasters.

The psychosocial sequelae can be intense and of long duration in the aftermath of natural and technological disasters, as well as terrorist attacks. Post-traumatic stress symptoms and full syndrome disorder, depression, anxiety, somatic complaints, and excessive alcohol use have been demonstrated consistently, particularly following large-scale disasters. This paper examines the psychological research conducted at various intervals after extensive natural disasters, the Three Mile Island and Chernobyl technological accidents, and recent terrorist events in the United States. Factors predictive of the emergence of emotional distress and psychological and physical problems following a disaster also are discussed.

Conscientiousness and work performance while suffering from acute mountain sickness: a case report.

A 52-yr-old male scientist who participated in a geophysical survey in Antarctica from a field camp located at 3538 m (11,600 ft) experienced specific symptoms of acute mountain sickness (AMS) by Mission Day 9, and full syndrome AMS by Mission Day 12. He was treated at the field camp and evacuated to sea level on the next available flight (Mission Day 15). The concerns of this highly conscientious individual that initial signs of illness, such as fatigue with exertion, could be misinterpreted by others as poor work performance are described. The report focuses on individual personality and group processes that could lead to nondisclosure of symptoms, and the need, particularly in long-duration missions in which evacuation is difficult or impossible, to sensitize personnel to the importance of recognizing and reporting potential health problems.

Enhancing circulation to lower limbs during head-down tilt by warming upper body and thighs.

BACKGROUND: Long-duration spaceflight results in deconditioning of the cardiovascular system, loss of fluid volume, bone demineralization, and atrophy of skeletal muscles, particularly affecting the lower limbs. We hypothesized that it is possible to improve blood circulation to the lower extremities in simulated microgravity by forcing the blood to deliver heat to the feet through heating parts of the upper body and thighs. METHODS: In Study 1, seven men and four women were assessed in an environmental chamber with head-down tilt (HDT) at 14 degrees, wearing a newly developed shortened multi-compartment liquid cooling/warming garment (SLCWG) with local tubing networks covering parts of the head, torso, thigh, arms, and hands, with fingers, lower leg, and feet exposed. Study 2 was the same as Study 1 with a new cohort of four men and two women, and the assessment of toe blood perfusion on all subjects. Heat was applied as follows: Stage 1--SLCWG inlet water temperature 33 degrees C to stabilize comfort; Stage 2--inlet water temperature 8-10 degrees C (in combination with HDT) to reach a criterion of 25 degrees C finger temperature (Tfing); and Stage 3--inlet water temperature 45 degrees C to restore Tfing to 33 degrees C. RESULTS: Improvement of foot circulation by delivering more heat to the upper body and thighs was noted; increases in toe temperature (Ttoe) suggest enhanced perfusion. From Stage 2 to 3, there were significant increases in Ttoe (p < 0.05), a significant decrease in diastolic BP (DBP) (p < 0.05), and a significant change across stages in subjective perception of foot comfort (p < 0.001) and foot heat (p < 0.06). Further, toe blood perfusion increased significantly from Stage 2 to 3 (p < 0.05). CONCLUSIONS: Moderate partial heating of the upper body/thighs improved blood circulation in the feet in simulated microgravity by delivering heat to the lower extremities through restriction of heat exchange with the environment in the heated body parts. This technique could serve as a supplemental countermeasure for increasing blood circulation to the lower extremities.

A 1-year, three-couple expedition as a crew analog for a Mars mission.

This study assessed the intrapersonal and interpersonal functioning of a three-couple expedition group that included a 2 1/2-year-old child which was ice-locked on a boat in the High Arctic during a major portion of the expedition. Personality assessment indicated that team members were generally well adjusted, scoring relatively higher on well-being and achievement and relatively lower on stress reactivity. Weekly mood ratings showed that the group exhibited significantly higher positive than negative affect. Reported negative events were relatively most frequent at the beginning of the Arctic stay and toward the end of the darkness period and were lowest during the initial darkness interval. The period of darkness had both a salutary and negative impact. A highly important means of coping with stress was seeking emotional support from one's partner. Selection of couples with strong bonds with their partner appears to be one viable approach for crew selection for long-duration missions.

Women and couples in isolated extreme environments: applications for long-duration missions.

Expedition teams provide a number of analogs relevant to crew selection for long-duration space missions. Three groups were studied that varied in team composition. Group 1 was a two woman international dyad that traversed the Antarctic continent in 97 days. Similarities in problem solving approach, respect for each other's opinions, and a collaborative process of decision making were evident. Group 2 was composed of four women, all from different countries, engaged in a six week trek across Greenland. The most important factors in overcoming interpersonal difficulties and contributing to the successful completion of the expedition were mutual respect and motivation to maintain positive and supportive relationships. Group 3 consisted of three married couples from different countries icelocked on a boat in the High Arctic for a 9 month period. The emotional support of and ability to confide in their partner were extremely important in alleviating interpersonal tensions, and contributed to the generally effective functioning of the group. Women add an element of emotional support and help to other team members that is not as evident in all-male groups. Selection of couples with strong bonds to each other is another paradigm for crew selection for extended missions.

Comparison of different cooling regimes within a shortened liquid cooling/warming garment on physiological and psychological comfort during exercise.

The aim of this study was to compare the effectiveness of different cooling regime intensities to maintain physiological and subjective comfort during physical exertion levels comparable to that engaged in during extravehicular activities (EVA) in space. We studied eight subjects (six males, two females) donned in our newly developed physiologically based shortened liquid cooling/warming garment (SLCWG). Rigorous (condition 1) and mild (condition 2) water temperature cooling regimes were compared at physical exertion levels comparable to that performed during EVA to ascertain the effectiveness of a lesser intensity of cooling in maintaining thermal comfort, thus reducing energy consumption in the portable life support system. Exercise intensity was varied across stages of the session. Finger temperature, rectal temperature, and subjective perception of overall body and hand comfort were assessed. Finger temperature was significantly higher in the rigorous cooling condition and showed a consistent increase across exercise stages, likely due to the restriction of heat extraction because of the intensive cold. In the mild cooling condition, finger temperature exhibited an overall decline with cooling, indicating greater heat extraction from the body. Rectal temperature was not significantly different between conditions, and showed a steady increase over exercise stages in both rigorous and mild cooling conditions. Ratings of overall comfort were 30% higher (more positive) and more stable in mild cooling (p<0.001). The mild cooling regime was more effective than rigorous cooling in allowing the process of heat exchange to occur, thus maintaining thermal homeostasis and subjective comfort during physical exertion.