Background Climate change has effects on multiple aspects of human life, such as access to food and water, expansion of endemic diseases as well as an increase of natural disasters and related diseases. The objective of this review is to summarize the current knowledge on climate change effects on military occupational health, military healthcare in a deployed setting, and defense medical logistics. Methods Online databases and registers were searched on August 22nd, 2022 and 348 papers retrieved, published between 2000 and 2022, from which we selected 8 publications that described climate effects on military health. Papers were clustered according to a modified theoretical framework for climate change effects on health, and relevant items from each paper were summarized. Results During the last decades a growing body of climate change related publications was identified, which report that climate change has a significant impact on human physiology, mental health, water- and vector borne infectious diseases, as well as air pollution. However, regarding the specific climate effects on military health the level of evidence is low. The effects on defense medical logistics include vulnerabilities in the cold supply chain, in medical devices functioning, in need for air conditioning, and in fresh water supply. Conclusions Climate change may transform both the theoretical framework and practical implementations in military medicine and military healthcare systems. There are significant knowledge gaps on climate change effects on the health of military personnel in operations of both combat and non-combat nature, alerting the need for prevention and mitigation of climate-related health issues. Further research within the fields of disaster and military medicine is needed to explore this novel field. As climate effects on humans and the medical supply chain may degrade military capability, significant investments in military medical research and development are needed.

https://www.frontiersin.org/articles/10.3389/fpubh.2023.1099031/pdf

Does climate change transform military medicine and defense medical support?

Abstract The background of big data has developed deeply, the application of the field has been broadened, and the value of data has been vigorously manifested. In order to study the interaction between physical culture education and exercise in universities in this era, this paper uses Clementine 12.0 data mining software to build a data mining model of association rules of university physical culture education courses and mine the course feature vectors. Based on the mining results, we designed the second classroom physical culture education courses with different physical culture characteristics. Constructing a scoring method and rating scale for the effectiveness of physical exercise among college students, and the physical exercise index scores are obtained through fuzzy operations. Finally, the interaction between physical culture education and exercise in universities in this context is analyzed according to the relationship between physical culture education courses and physical exercise performance. After the physical culture education course began, the physical exercise intensity score of the experimental group of first-year college girls increased by 8%, the physical exercise time score increased by 10%, the physical exercise frequency score increased by 15.2%, and the total physical exercise score increased by 7% after the physical culture education course. This shows that university physical culture education is positively correlated with college students’ physical activity, and campus physical culture has a significant predictive effect on students’ subjective performance of physical activity behavior. Optimizing university physical culture education not only improves students’ physical quality and promotes the development of their physical and mental health but also provides a reference for strengthening students’ physical education.

https://sciendo.com/pdf/10.2478/amns.2023.1.00115

Research on the interaction between university physical culture education and college students’ physical exercise in the context of big data

ASHP Executive Forums on Cold Chain Management of Pharmaceuticals in Health Systems.

Abstract Temperature excursions during product storage, transportation, and handling can deteriorate product quality. Following a temperature excursion event, the impact of the event on the product quality should be evaluated to determine if the product can be used or if it needs to be discarded. Pharmaceutical companies are required to have defined procedures for managing temperature excursions and performing impact assessment after an excursion occurs. In an increasingly complex supply chain, it is vital to develop processes that can expedite the review of these events. A tier-based approach is presented for analyzing the impact of temperature excursion on commercial small molecule drug products intended to be stored at room temperature. Utilization of each of the three tiers is based on whether the excursion temperature and/or excursion duration are within a predetermined, product-specific, allowable range. The stress study temperature defines the allowable temperature range, while the allowable duration is determined using a mathematical approach outlined in this article. Tier 1, specific to the product, allows products to be dispositioned for use without further assessment when temperature excursion events fall within both the product-specific allowable excursion temperature and duration ranges. Tier 2 applies when the excursion temperature is within the allowable range, but the duration exceeds it. Lot-specific release data is used for impact assessment in this tier. Finally, Tier 3 utilizes Arrhenius extrapolation to predict the final degradation and perform the impact assessment when the excursion temperature surpasses the allowable temperature range. Graphical Abstract 

Temperature Excursion Management: A Tier-Based Approach for Commercial Oral Solid Dosage Forms

Background: Medications requiring refrigeration for stability are commonly used across hospitals. Temperature-sensitive medications may not have their temperature requirements maintained due to breaches in the cold chain, especially refrigerator failure. This is usually caused by malfunction of the refrigerator unit or by power outage. After multiple power outages at our institution involving refrigerators with temperature probes located in different areas of the refrigerator, we hypothesised that the fixed temperature probe may not accurately reflect the temperature of the medications themselves. Methods: We conducted simulations of power outages in a commonly used medication refrigerator, using additional temperature data loggers, placed on the refrigerator shelf and inside a cardboard box to replicate the temperature inside medication containers to determine if there was a difference in the time to breach cold chain conditions (>8°C) and to return to appropriate refrigerated temperatures (<8°C) when power was restored. Results: All data loggers took a longer time to breach cold chain conditions than the refrigerator probe (12.5 minutes vs 23-26 minutes) but took longer to return to acceptable temperature after power was restored (17.5 minutes vs 70.5-89 minutes). Conclusion: This exploratory research suggests that temperatures vary within a refrigerator depending on the type and location of probe and that medications within may take longer to breach cold chain conditions but also take longer to return to cold chain conditions compared with fixed refrigerator temperature probes. Further research is required to determine whether these variations occur across different sizes/brands of refrigerators and the effect on stability on refrigerated medications.

Temperature Excursions in Cold Chain Management—Assessing the Accuracy of Refrigerator Temperature Probes

DISCLAIMER
In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.


PURPOSE
The aim of this review was to build upon previous literature describing the maximum duration for which refrigerated medications can tolerate room temperature excursions while maintaining stability and potency.


METHODS
During a 12-month period ending in June 2021, the prescribing information and published monographs from multiple pharmacy compendia were reviewed for all medications and biologic products approved by the US Food and Drug Administration (FDA) for human use since January 2000. Products that were subsequently withdrawn from the US market were excluded. When temperature excursion data was unavailable in published form, product manufacturers were surveyed via telephone and/or email. Acceptable storage information for all products for which storage is recommended at temperatures below room temperature (20-25 °C [68-77 °F]) was compiled and arranged in tabular format.


RESULTS
Of the 705 products or formulations approved by FDA during the predefined time period, 246 were identified as requiring storage at temperatures below room temperature. After review of available prescribing information and manufacturer communications, if applicable, acceptable periods of excursion to temperatures at room temperature or higher were identified for 214 products (87%).


CONCLUSION
Information related to acceptable periods of room temperature excursion was compiled for a total of 214 products approved for US distribution since 2000. The included tables may increase patient safety and decrease medication loss or related expenditures.

https://academic.oup.com/ajhp/article-pdf/79/15/1296/45024036/zxac118.pdf

Allowable room temperature excursions for refrigerated medications: A 20-year review.

Optimizing optimization: A six-year quality improvement project focused on students' APPE preferences.

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Allowable room temperature excursions for refrigerated medications: A 20-year review.

Optimizing optimization: A six-year quality improvement project focused on students' APPE preferences.