title: Aircraft loading and freezer enhancements: lessons for medical research in remote communities.
abstract: BACKGROUND
  Type 2 diabetes (T2D) and impaired glucose tolerance (IGT), historically extremely rare in children, is becoming prevalent among First Nations children. In Canada, many of these children live in remote villages accessible only by float plane. Because T2D has many long-term health implications, prevention and early identification are critical.
  
  
  METHODS
  We developed a process for sending a fully equipped endocrinology team to a remote community to screen the children for T2D and IGT. Float plane (sea plane) travel has several unexpected limitations for a medical research team. These include having to travel in good visibility (visual flight rules), limited payload capacity, and restriction against transporting dry ice. The benefits include avoiding the usual security restrictions.
  
  
  RESULTS
  We developed and tested a custom-built insulation jacket and system of backup battery packs for the countertop -25 degrees C freezer (in lieu of dry ice) to transport frozen blood samples from the village to our hospital's laboratory. We also ensured that the five-member research team, its equipment, and the consumable supplies stayed within the maximum takeoff weight of the airplane and met center-of-gravity criteria to ensure a safe flight.
  
  
  CONCLUSIONS
  Using the insulated freezer, sample integrity was maintained throughout the flight, and a safe weight-and-balance trip was achieved for the team and supplies. The team obtained complete T2D screening data on 88% of children in the remote community.
authors.affiliation: Endocrinology & Diabetes Unit, BC Children's Hospital, University of British Columbia, Vancouver, BC, Canada.
authors.forename: Roy
authors.initials: R
authors.lastname: Gagnon
authors.forename: Faith
authors.initials: F
authors.lastname: Gagnon
authors.forename: Constadina
authors.initials: C
authors.lastname: Panagiotopoulos
mesh_terms: D000401:Aircraft; D002170:Canada; D002648:Child; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis; D004704:Endocrinology; D005615:Freezing; D018149:Glucose Intolerance / Q000175:diagnosis; D006302:Health Services Research; D006801:Humans; D008685:Meteorological Concepts; D019035:Rural Health Services; D013048:Specimen Handling / Q000295:instrumentation*; D014195:Travel