The impact of fire suppression tasks on firefighter hydration: A critical review with consideration of the utility of reported hydration measures

BACKGROUND: Firefighting is a highly stressful occupation with unique physical challenges, apparel and environments that increase the potential for dehydration. Dehydration leaves the firefighter at risk of harm to their health, safety and performance. The purpose of this review was to critically analyse the current literature investigating the impact of fighting ‘live’ fires on firefighter hydration. METHODS: A systematic search was performed of four electronic databases for relevant published studies investigating the impact of live fire suppression on firefighter hydration. Study eligibility was assessed using strict inclusion and exclusion criteria. The included studies were critically appraised using the Downs and Black protocol and graded according to the Kennelly grading system. RESULTS: Ten studies met the eligibility criteria for this review. The average score for methodological quality was 55 %, ranging from 50 % (‘fair’ quality) to 61 % (‘good’ quality) with a ‘substantial agreement’ between raters (k = .772). Wildfire suppression was considered in five studies and structural fire suppression in five studies. Results varied across the studies, reflecting variations in outcome measures, hydration protocols and interventions. Three studies reported significant indicators of dehydration resulting from structural fire suppression, while two studies found mixed results, with some measures indicating dehydration and other measures an unchanged hydration status. Three studies found non-significant changes in hydration resulting from wildfire firefighting and two studies found significant improvements in markers of hydration. Ad libitum fluid intake was a common factor across the studies finding no, or less severe, dehydration. CONCLUSIONS: The evidence confirms that structural and wildfire firefighting can cause dehydration. Ad libitum drinking may be sufficient to maintain hydration in many wildfire environments but possibly not during intense, longer duration, hot structural fire operations. Future high quality research better quantifying the effects of these influences on the degree of dehydration is required to inform policies and procedures that ensure firefighter health and safety

Maximum Likelihood Detection for Cooperative Molecular Communication

In this paper, symbol-by-symbol maximum likelihood (ML) detection is proposed for a cooperative diffusion-based molecular communication (MC) system. In this system, a fusion center (FC) chooses the transmitter's symbol that is more likely, given the likelihood of the observations from multiple receivers (RXs). We propose three different ML detection variants according to different constraints on the information available to the FC, which enables us to demonstrate trade-offs in their performance versus the information available. The system error probability for one variant is derived in closed form. Numerical and simulation results show that the ML detection variants provide lower bounds on the error performance of the simpler cooperative variants and demonstrate that majority rule detection has performance comparable to ML detection when the reporting is noisy.Comment: 7 pages, 4 figurs. This work has been accepted by the IEEE ICC 201

Technical application and the level of discomfort associated with an intramuscular electromyographic investigation into gluteus minimus and gluteus medius

Our current theoretical understanding of gluteus minimus (GMin) and gluteus medius (GMed) function is primarily based on cadaveric studies and biomechanical modelling. There is an absence of electromyographic (EMG) research that aims to verify this understanding, particularly in relation to the potentially unique functional roles of structurally distinct segments within GMin (anterior and posterior) and GMed (anterior, middle and posterior). The aim of this paper is to provide a comprehensive technical description for inserting intramuscular EMG electrodes into uniquely oriented segments of GMin and GMed; and to report the levels of discomfort associated with gluteal intramuscular electrode insertions. Fifteen healthy volunteers took part in a series of walking trials after intramuscular EMG electrodes were inserted into segments of GMin (×2) and GMed (×3) according to previously verified guidelines. Visual analogue scores following walking trials at comfortable and fast speed indicate that discomfort levels associated with these insertions were low (2.4. ±. 1.4 and 1.6. ±. 0.7 respectively). The technical descriptions and illustrations provided in this paper will allow trained intramuscular electromyographers to insert electrodes into these muscle segments with confidence

Spectrum of Microbial Diseases and Resistance Patterns at a Private Teaching Hospital in Kenya: Implications for Clinical Practice

Background: Accurate local prevalence of microbial diseases and microbial resistance data are vital for optimal treatment of patients. However, there are few reports of these data from developing countries, especially from sub-Saharan Africa. The status of Aga Khan University Hospital Nairobi as an internationally accredited hospital and a laboratory with an electronic medical record system has made it possible to analyze local prevalence and antimicrobial susceptibility data and compare it with other published data. Methods: We have analyzed the spectrum of microbial agents and resistance patterns seen at a 300 bed tertiary private teaching hospital in Kenya using microbial identity and susceptibility data captured in hospital and laboratory electronic records between 2010 and 2014. Results: For blood isolates, we used culture collection within the first three days of hospitalization as a surrogate for community onset, and within that group, Escherichia coli was the most common, followed by Staphylococcus aureus. In contrast, Candida spp. and Klebsiella pneumoniae were the most common hospital onset causes of bloodstream infection. Antimicrobial resistance rates for the most commonly isolated Gram negative organisms was higher than many recent reports from Europe and North America. In contrast, Gram positive resistance rates were quite low, with 94% of S. aureus being susceptible to oxacillin and only rare isolates of vancomycin-resistant enterococci. Conclusions: The current report demonstrates high rates of antimicrobial resistance in Gram negative organisms, even in outpatients with urinary tract infections. On the other hand, rates of resistance in Gram positive organisms, notably S. aureus, are remarkably low. A better understanding of the reasons for these trends may contribute to ongoing efforts to combat antimicrobial resistance globally

Improving Dark Energy Constraints with High Redshift Type Ia Supernovae from CANDELS and CLASH

Aims. We investigate the degree of improvement in dark energy constraints that can be achieved by extending Type Ia Supernova (SN Ia) samples to redshifts z > 1.5 with the Hubble Space Telescope (HST), particularly in the ongoing CANDELS and CLASH multi-cycle treasury programs. Methods. Using the popular CPL parametrization of the dark energy, w = w0 +wa(1-a), we generate mock SN Ia samples that can be projected out to higher redshifts. The synthetic datasets thus generated are fitted to the CPL model, and we evaluate the improvement that a high-z sample can add in terms of ameliorating the statistical and systematic uncertainties on cosmological parameters. Results. In an optimistic but still very achievable scenario, we find that extending the HST sample beyond CANDELS+CLASH to reach a total of 28 SN Ia at z > 1.0 could improve the uncertainty in the wa parameter by up to 21%. The corresponding improvement in the figure of merit (FoM) would be as high as 28%. Finally, we consider the use of high-redshift SN Ia samples to detect non-cosmological evolution in SN Ia luminosities with redshift, finding that such tests could be undertaken by future spacebased infrared surveys using the James Webb Space Telescope (JWST).Comment: 9 pages, 6 figures, accepted for publication on Astronomy & Astrophysic

HIT LIST: PRESIDENT CARTER'S REVIEW OF RECLAMATION WATER PROJECTS AND HIS IMPACT ON FEDERAL WATER POLICY

This dissertation investigates changes in funding of federal water projects and the development of new water policies during the administrations of Presidents Jimmy Carter and Ronald Reagan. I conclude that these events precipitated a shift in the Bureau of Reclamation's mission. Carter's proposed recommendations to terminate funding on several large federal water projects, dubbed the "Hit List," as well as proposed water policy changes--specifically local cost sharing, increased conservation, acreage limitation, federal reserved water rights, and rules pertaining to sections 208, 303, and 404 of the Clean Water Act--significantly shaped regional and national politics including the Sagebrush Rebellion and anti-environmentalism. While President Reagan sympathized with the Sagebrush Rebels rhetoric during his campaign, his administrations budgets and proposed local cost sharing requirements were more extensive that Carter's. The contrast and similarities between the two administrations are best seen in case studies of the two largest Bureau of Reclamation projects initially included on Carter's "Hit List," the Garrison Diversion Unit and the Central Utah Project

The Dwarf Starburst Host Galaxy of a Type Ia SN at z = 1.55 from CANDELS

We present VLT/X-shooter observations of a high redshift, type Ia supernova host galaxy, discovered with HST/WFC3 as part of the CANDELS Supernova project. The galaxy exhibits strong emission lines of Ly{\alpha}, [O II], H{\beta}, [O III], and H{\alpha} at z = 1.54992(+0.00008-0.00004). From the emission-line fluxes and SED fitting of broad-band photometry we rule out AGN activity and characterize the host galaxy as a young, low mass, metal poor, starburst galaxy with low intrinsic extinction and high Ly{\alpha} escape fraction. The host galaxy stands out in terms of the star formation, stellar mass, and metallicity compared to its lower redshift counterparts, mainly because of its high specific star-formation rate. If valid for a larger sample of high-redshift SN Ia host galaxies, such changes in the host galaxy properties with redshift are of interest because of the potential impact on the use of SN Ia as standard candles in cosmology.Comment: 25 pages, 8 figures. Accepted for publication in Ap