RESUMEN
Space radiation is a notable hazard for long-duration human spaceflight1. Associated risks include cancer, cataracts, degenerative diseases2 and tissue reactions from large, acute exposures3. Space radiation originates from diverse sources, including galactic cosmic rays4, trapped-particle (Van Allen) belts5 and solar-particle events6. Previous radiation data are from the International Space Station and the Space Shuttle in low-Earth orbit protected by heavy shielding and Earth's magnetic field7,8 and lightly shielded interplanetary robotic probes such as Mars Science Laboratory and Lunar Reconnaissance Orbiter9,10. Limited data from the Apollo missions11-13 and ground measurements with substantial caveats are also available14. Here we report radiation measurements from the heavily shielded Orion spacecraft on the uncrewed Artemis I lunar mission. At differing shielding locations inside the vehicle, a fourfold difference in dose rates was observed during proton-belt passes that are similar to large, reference solar-particle events. Interplanetary cosmic-ray dose equivalent rates in Orion were as much as 60% lower than previous observations9. Furthermore, a change in orientation of the spacecraft during the proton-belt transit resulted in a reduction of radiation dose rates of around 50%. These measurements validate the Orion for future crewed exploration and inform future human spaceflight mission design.
RESUMEN
BACKGROUND: Anaesthesia Quality Improvement New Zealand developed a set of five quality improvement indicators pertaining to postoperative nausea and vomiting, pain, respiratory distress, hypothermia and a prolonged post-anaesthesia care unit stay. This study sought to assess the proportion of eligible institutions that were able to measure and provide data on these indicators, produce an initial national estimate of these, and a measure of variability in the quality improvement indicators across hospitals in New Zealand. METHODS: All public hospitals that provide a representative to Anaesthesia Quality Improvement New Zealand were eligible for inclusion. Participating institutions were required to provide the number and proportion of patients with each of the five quality improvement indicators over a continuous 2-week period between 1 June 2019 and 25 October 2019. The overall percentage of patients and the median percentage with each outcome were calculated. RESULTS: A total of 79.2% of eligible hospitals participated. The median incidence of the indicators ranged from 1.67% for respiratory distress to 6.31% for prolonged post-anaesthesia care unit stay. The indicator with the largest interquartile range was hypothermia and the smallest was respiratory distress (13.48 and 2.29, respectively). A large variation was seen for prolonged post-anaesthesia care unit stay, hypothermia, pain and postoperative nausea and vomiting. CONCLUSION: The majority of eligible institutions were able to measure and provide data on the quality improvement indicators. There was a low rate of respiratory distress with low variability. A large amount of variability was observed in the other indicators. Future studies are needed to explore the nature of this variability.