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BackgroundHypothermia is an independent predictor of increased morbidity and mortality in patients with trauma. Several strategies and products have been developed to minimise patients’ heat loss in the prehospital arena, but there is little evidence to inform the clinician concerning their effectiveness.MethodsWe used a human torso model consisting of two 5.5-litre fluid bags to simultaneously compare four passive (space blanket, bubble wrap, Blizzard blanket, ambulance blanket) and one active (Ready-Heat II blanket) temperature preservation products. A torso model without any temperature preservation device provided a control. For each test, the torso models were warmed to 37°C and left outdoors. Core temperatures were recorded every 10 min for 1 h in total; tests were repeated 10 times.ResultsA significant difference in temperature was detected among groups at 30 and 60 min (F (1.29, 10.30)=103.58, p<0.001 and F (1.64, 14.78)=163.28, p<0.001, respectively). Mean temperature reductions (95% CI) after 1 h of environmental exposure were the following: 11.6 (10.3 to 12.9) °C in control group, 4.5 (3.9 to 5.1) °C in space blanket group, 3.6 (3 to 4.3) °C in bubble-wrap group, 2.1 (1.7 to 2.5) °C in Blizzard blanket group, 6.1 (5.8 to 6.5) °C in ambulance blanket group and 1.1 (0.7 to 1.6) °C in Ready-Heat II blanket group.ConclusionsIn this study, using a torso model based on two 5 L dialysate bags we found the Ready-Heat II heating blanket and Blizzard blanket were associated with lower rates of heat loss after 60 min environmental exposure than the other devices tested.

BackgroundThe use of helicopter emergency medical services (HEMS) has increased significantly in the UK since 1987. To date there has been no research that addresses HEMS pilots and medical crews' own ideas on the risks that they view as inherent in their line of work and how to mitigate these risks. The aim of this survey is to describe and compare the attitudes and perceptions towards risk in HEMS operations of these staff.MethodsA questionnaire was administered electronically to a representative selection of HEMS doctors, paramedics and pilots in the UK. A number of questions were grouped into common themes, and presented as Likert scales and ranking where appropriate. Descriptive and comparative results were presented and statistically analysed.ResultsThe target sample of 100 consecutive respondents was achieved. All questionnaires were entirely completed. Respondents attributed the most risk to night HEMS operations without the use of night vision goggles, commercial pressure and mechanical aircraft failure. There was no statistical difference in overall perception of safety and years of experience (p=0.58) or between professions (p=0.08). Those who had experienced a crash were more likely to believe that HEMS operations are not inherently safe (p=0.05).ConclusionsWe have surveyed a cross-section of the HEMS operational community in the UK in order to describe their perceptions of safety and risk within their professional life. Two-thirds of respondents believed that HEMS operations were inherently safe. Those who did not seemed to be influenced by personal experience of a crash or serious incident. We support increased operational training for clinical crewmembers, an increased emphasis on incident reporting and a culture of safety, and careful attention to minimum training and equipment requirements for all HEMS missions.

The recent renaissance within animal geography has tended to focus on the spatial orderings of animals by humans, rather than on the lived geographies and experiences of animals themselves. We suggest that one reason for this imbalance is methodological – a persistent commitment to human-centred methods somewhat at odds with the more-than-human aspirations of the sub-discipline. In this paper we review and critically assess methodological developments in three areas that we consider to be especially significant for developing animals’ geographies: (i) techniques for tracking the spatialities of animal culture; (ii) scientific and artistic engagements in inter-species communication; and (iii) geographic tools afforded by genetic analyses. In conclusion, we reflect on the promise and some of the challenges to developing these methods within (what is still largely known as) human geography.

Background There is a rich body of literature addressing the topic of illegal hunting of wild terrestrial mammals. Studies on this topic have risen over the last decade as species are under increasing risk from anthropogenic threats. Sub-Saharan Africa contains the highest number of terrestrial mammals listed as vulnerable, endangered or critically endangered. However, the spatial distribution of illegal hunting incidences is not well documented. To address this knowledge gap, the systematic map presented here aims to answer three research questions: (1) What data are available on the spatial distribution of illegal hunting of terrestrial mammals in Sub-Saharan Africa in relation to environmental and anthropogenic correlates i.e. proximity to roads, water bodies, human settlement areas, different land tenure arrangements and anti-poaching ranger patrol bases? (2) Which research methodologies have primarily been used to collect quantitative data and how comparable are these data? (3) Is there a bias in the research body toward particular taxa and geographical areas? Methods Systematic searches were carried out across eight bibliographic databases; articles were screened against pre-defined criteria. Only wild terrestrial mammals listed as vulnerable, endangered or critically endangered by the International Union for Conservation of Nature (IUCN) whose geographical range falls in Sub-Saharan Africa and whose threat assessment includes hunting and trapping were included. To meet our criteria, studies were required to include quantitative, spatially explicit data. In total 14,325 articles were screened at the level of title and abstract and 206 articles were screened at full text. Forty-seven of these articles met the pre-defined inclusion criteria. Results Spatially explicit data on illegal hunting are available for 29 species in 19 of the 46 countries that constitute Sub-Saharan Africa. Data collection methods include GPS and radio tracking, bushmeat household and market surveys, data from anti-poaching patrols, hunting follows and first-hand monitoring of poaching signs via line transects, audio and aerial surveys. Most studies have been conducted in a single protected area exploring spatial patterns in illegal hunting with respect to the surrounding land. Several spatial biases were detected. Conclusions There is a considerable lack of systematically collected quantitative data showing the distribution of illegal hunting incidences and few comparative studies between different tenure areas. The majority of studies have been conducted in a single protected area looking at hunting on a gradient to surrounding village land. From the studies included in the map it is evident there are spatial patterns regarding environmental and anthropogenic correlates. For example, hunting increases in proximity to transport networks (roads and railway lines), to water sources, to the border of protected areas and to village land. The influence of these spatial features could be further investigated through meta-analysis. There is a diverse range of methods in use to collect data on illicit hunting mainly drawing on pre-existing law enforcement data or researcher led surveys detecting signs of poaching. There are few longitudinal studies with most studies representing just one season of data collection and there is a geographical research bias toward Tanzania and a lack of studies in Central Africa.

Medicine has historically advanced during conflict, but military medical services have consistently regressed during peace. As over a decade of campaigning in Iraq and Afghanistan draws to a close, securing the legacy of hard won clinical lessons and retaining flexibility to adapt to new patterns of illness and injury during contingency is critical. Central to sustaining exceptional outcomes for future operations and to maintaining the current position of the Defence Medical Services as providers of clinical excellence is retaining the capability to innovate. This capability must extend across the spectrum of clinical innovation-concepts, guidelines, equipment (invention and adoption), curricula (design, assessment and refinement), research and Defence diplomacy. To achieve this requires a strategy, a 'roadmap', with a clear vision, end state and centres of gravity (core strengths that must be protected). The direction for innovation will be guided by emergent analysis of the future character of military medicine. Success will be determined by ensuring the conditions are met to protect and enhance the existing 'winning culture'.

Connectivity is a central concept in contemporary geographies of nature, but the concept is often understood and utilised in plural ways. This is problematic because of the separation, rather than the confusion, of these different approaches. While the various understandings of connectivity are rarely considered as working together, the connections between them have significant implications. This paper thus proposes re‐thinking connectivity as a “multiple”. It develops a taxonomy of existing connectivity concepts from the fields of biogeography and landscape ecology, conservation biology, socio‐economic systems theory, political ecology and more‐than‐human geography. It then considers how these various understandings might be re‐thought not as separate concerns, but (following Annemarie Mol) as “more than one, but less than many”. The implications of using the connectivity multiple as an analytic for understanding conservation practices are demonstrated through considering the creation of wildlife corridors in conservation practice. The multiple does not just serve to highlight the practical and theoretical linkages between ecological theories, social inequities and affectual relationships in more‐than‐human worlds. It is also suggestive of a normative approach to environmental management that does not give temporal priority to biological theories, but considers these as always already situated in these social, often unequal, always more‐than‐human ecologies.

By contrast, France still has on average one death every two years. 2 Mefloquine is not the automatic first choice for chemoprophylaxis according to UK Armed Forces current policy. 3 Service policy follows national best practice and is based on regularly updated guidance issued by the UK Advisory Committee on Malaria Prevention. 4 The drug is one of the available options, and the choice will follow a detailed assessment of the malaria risk related to travel balanced against individual factors.

Background Over the last two decades there has been an increase in the demand for land in Sub Saharan Africa, particularly from foreign agribusiness investment to provide food for an increasing human population. The majority of land outside of protected areas in sub-Saharan Africa is under customary tenure. Due to poor land administration in the region, communities living in undocumented land areas tend to be at greater risk of eviction from increasing liberalisation of land markets. To prevent local displacement and disturbance to investment caused by land disputes tenure clarification is growing in importance on national and international agendas. Land conversion can fragment wildlife habitat while reducing the suitable range areas of terrestrial mammal populations on the continent. Simultaneously illegal hunting is on the rise for a wide variety of taxa driven by a demand for food and income from the sale of animal products. To enable a better understanding of how land tenure arrangements impact upon spatial variations in illegal hunting, this protocol sets out the parameters for an evidence map which will collate and analyse the spatially explicit quantitative evidence that exists showing the effect of land tenure on illegal hunting of endangered terrestrial mammals in sub-Saharan Africa. Sub-Saharan Africa is the region of focus as it contains the highest number of terrestrial mammals listed as vulnerable, endangered or critically endangered by the International Union for Conservation of Nature. Taking stock of what methods have been used to gather data and where evidence exists can guide future research in this area while informing conservation interventions. Methods This evidence map will compare: (1) data availability on the spatial distribution of illicit hunting of endangered terrestrial mammals across different land tenure regimes in sub-Saharan Africa; (2) research methodologies that have primarily been used to collect quantitative data on illegal hunting and comparability of existing data; (3) preferences in the research body toward particular taxa and geographical areas, (4) the evidence map will provide an analysis on the influence other environmental and anthropogenic determinants that influence the spatial distribution of illicit hunting incidences, e.g., proximity to roads, water bodies, range patrol bases etc. Eight academic databases and numerous organisation repositories will be searched for relevant studies by three authors. Double screening will be carried out on all articles to locate studies that meet the specified inclusion criteria, for inclusion studies must contain spatially explicit quantitative data on illegal hunting of endangered terrestrial mammals as defined by the International Union for the Conservation of Nature. Relevant information from studies will be extracted to a custom-made extraction form. The resulting map will consist of a narrative synthesis, descriptive statistics and a heat map in the form of a matrix. By providing an overview of the evidence base the resulting map can inform future meta-analyses by showing where there is sufficient comparable data while guiding conservation interventions by indicating geographical areas where species are most at risk.