Abstract An evaluation of the physiological effects on aviators of heat stress (90°F wet bulb globe temperature [WBGT]) versus a cooler condition (70°F WBGT) when wearing either a MOPPO (Mission-Oriented Protective Posture 0) uniform or a MOPP4 ensemble encumbered with a ballistic chest plate and overwater survival gear was performed at the United States Army Aeromedical Research Laboratory. The study used a repeated-measures design with 14 aviators flying 4-hour missions in a UH-60 helicopter simulator. Average crew endurance in the MOPP4-hot condition was reduced to one-third of the fully completed mission time of 309 minutes. For the hot condition, core temperature in the simulator rose 1.4°F/hour when aviators wore the encumbered MOPP4 ensemble versus 0.27°F/hour when they wore the MOPPO uniform. Sweating rate in the MOPP4-hot condition was 1,523 ml/hour, resulting in 2.5% dehydration, in contrast to 183 ml/hour and 0.9% dehydration in the MOPP4-cool condition. In this study, pilots flying realistic UH-60 simulator sorties rapidly incurred significant physiological heat strain when wearing an encumbered MOPP4 flight ensemble in hot cockpit conditions.

Researchers at the U.S. Army Research Institute of Environmental Medicine have developed and validated numerical models capable of predicting the extent of physiologic strain and adverse terrain and weather-related medical consequences of military operations in harsh environments. A descriptive historical account is provided that details how physiologic models for hot and cold weather exposure have been integrated into portable field advisory devices, computer-based meteorologic planning software, and combat-oriented simulation systems. It is important that medical officers be aware of the existence of these types of decision support tools so that they can assure that outputs are interpreted in a balanced and medically realistic manner. Additionally, these modeling applications may facilitate timely preventive medicine planning and efficient dissemination of appropriate measures to prevent weather- and altitude-related illnesses and performance decrements. Such environmental response modeling applications may therefore be utilized to support deployment preventive medicine planning by field medical officers.

There has been exponential growth in paramedicine research activity and capacity over the last decade. With a strong academic culture emerging from its tertiary-based paramedicine education pathways, Australasia sits comfortably amongst the leading regions for paramedicine research. In the absence of clear paramedicine research priorities, there is concern that inadequate support infrastructure is in place to guide researchers, academics, paramedics, and policymakers within the profession to produce meaningful research capable of triggering change and advancement. The identification of paramedicine research priorities in Australasia, along with the barriers and enablers to research in this field, will prove invaluable to support the paramedicine profession, and improve healthcare systems, and patient outcomes in Australia and New Zealand. The study used a cross-sectional survey design which aimed to identify perceived barriers and enablers to the conduct of paramedicine research in Australasia and describe the demographic profiles and characteristics of respondents across professional, academic and research themes. Of the 341 respondents, 223 (65.4%) were male, 114 (33.4%) were female, and all geographical areas were represented. Approximately 60% of participants worked for a jurisdictional ambulance service in a clinical role. The median number of years of experience in paramedicine was 13 (IQR: 6, 24), with 52.8% having less than 15 years of experience. The analysis resulted in the identification of three themes for research barriers (system, process and human) and enablers, (work conditions, worker profile, and workplace). This study identifies the disconnect between stakeholders and the provision of resources such as funding, time, training, roles and data as major barriers to conducting paramedicine research. The ability or capacity of paramedics, as health professionals, to lead and undertake their own research was not questioned. The value of evidence-based research and autonomous paramedic-led research was identified as likely to empower future capacity within the profession.

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