Fairness in Water Quality: A Descriptive Approach

Muscle strength is important for firefighters work capacity. Laboratory tests used for measurements of muscle strength, however, are complicated, expensive and time consuming. The aims of the present study were to investigate correlations between physical capacity within commonly occurring and physically demanding firefighting work tasks and both laboratory and field tests in full time (N = 8) and part-time (N = 10) male firefighters and civilian men (N = 8) and women (N = 12), and also to give recommendations as to which field tests might be useful for evaluating firefighters' physical work capacity. Laboratory tests of isokinetic maximal (IM) and endurance (IE) muscle power and dynamic balance, field tests including maximal and endurance muscle performance, and simulated firefighting work tasks were performed. Correlations with work capacity were analyzed with Spearman's rank correlation coefficient (rs). The highest significant (p<0.01) correlations with laboratory and field tests were for Cutting: IE trunk extension (rs = 0.72) and maximal hand grip strength (rs = 0.67), for Stairs: IE shoulder flexion (rs = −0.81) and barbell shoulder press (rs = −0.77), for Pulling: IE shoulder extension (rs= −0.82) and bench press (rs = −0.85), for Demolition: IE knee extension (rs = 0.75) and bench press (rs = 0.83), for Rescue: IE shoulder flexion (rs = −0.83) and bench press (rs = −0.82), and for the Terrain work task: IE trunk flexion (rs = −0.58) and upright barbell row (rs = −0.70). In conclusion, field tests may be used instead of laboratory tests. Maximal hand grip strength, bench press, chin ups, dips, upright barbell row, standing broad jump, and barbell shoulder press were strongly correlated (rs≥0.7) with work capacity and are therefore recommended for evaluating firefighters work capacity

Colorectal cancer incidences in Lynch syndrome: a comparison of results from the prospective lynch syndrome database and the international mismatch repair consortium

Objective To compare colorectal cancer (CRC) incidences in carriers of pathogenic variants of the MMR genes in the PLSD and IMRC cohorts, of which only the former included mandatory colonoscopy surveillance for all participants. Methods CRC incidences were calculated in an intervention group comprising a cohort of confirmed carriers of pathogenic or likely pathogenic variants in mismatch repair genes (path_MMR) followed prospectively by the Prospective Lynch Syndrome Database (PLSD). All had colonoscopy surveillance, with polypectomy when polyps were identified. Comparison was made with a retrospective cohort reported by the International Mismatch Repair Consortium (IMRC). This comprised confirmed and inferred path_MMR carriers who were first- or second-degree relatives of Lynch syndrome probands. Results In the PLSD, 8,153 subjects had follow-up colonoscopy surveillance for a total of 67,604 years and 578 carriers had CRC diagnosed. Average cumulative incidences of CRC in path_MLH1 carriers at 70 years of age were 52% in males and 41% in females; for path_MSH2 50% and 39%; for path_MSH6 13% and 17% and for path_PMS2 11% and 8%. In contrast, in the IMRC cohort, corresponding cumulative incidences were 40% and 27%; 34% and 23%; 16% and 8% and 7% and 6%. Comparing just the European carriers in the two series gave similar findings. Numbers in the PLSD series did not allow comparisons of carriers from other continents separately. Cumulative incidences at 25 years were < 1% in all retrospective groups. Conclusions Prospectively observed CRC incidences (PLSD) in path_MLH1 and path_MSH2 carriers undergoing colonoscopy surveillance and polypectomy were higher than in the retrospective (IMRC) series, and were not reduced in path_MSH6 carriers. These findings were the opposite to those expected. CRC point incidence before 50 years of age was reduced in path_PMS2 carriers subjected to colonoscopy, but not significantly so

Brandmäns fysiska arbetskapacitet

The overall aim of this thesis was to identify valid, simple, and inexpensive physical tests that can be used for evaluation of firefighters’ physical work capacity. Paper I included fulltime- and part-time firefighters (n = 193), aged 20-60 years. Perceived physical demands of firefighting work tasks were ranked, and comparisons between subject groups rating were done with the Mann Whitney U-test and Binominal test. Papers II and III included male firefighters and civilian men and women (n = 38), aged 24-57 years. Laboratory and field tests of aerobic fitness, muscle strength and endurance, balance, and simulated firefighting work tasks were performed. Physical capacity comparisons between subject groups were done and bivariate correlations between physical tests and work capacity in the simulated firefighting work tasks analyzed. Paper IV included the same subjects as in Paper II-III (training-set), and additional 90 subjects (prediction-set), aged 20-50 years. Laboratory and field tests of aerobic fitness, muscle strength and endurance and balance, and simulated firefighting work tasks were included. Data from the training-set was used to build models for prediction of firefighters’ physical work capacity, using multivariate statistic. The prediction-set was used to externally validate the selected models. Several work tasks were rated as physically demanding and significant differences (p &lt; 0.05) in ratings were found between full-time and part-time firefighters (Paper I). Significant differences were found between subject groups in physical capacity, and work capacity (p &lt; 0.01) (Paper II-IV). Both laboratory and field tests were significantly (p &lt; 0.01) correlated with work capacity time (Paper II-III). The prediction (R2) and predictive power (Q2) of firefighters’ work capacity (Carrying hose baskets upstairs, Hose pulling, Demolition at or after a fire, Victim rescue, and Carrying hose baskets over terrain) was R2 = 0.74 to 0.91, and Q2 = 0.65 to 0.85, and the external validation ranged between R2: 0.38 to 0.80 (Paper IV). In conclusion, rowing 500 m (s), maximal handgrip strength (kg), endurance bench press (n), running 3000 m (s and s scaled to body weight) upright barbell row (n) and standing broad jump (m) together provides valid information about firefighters’ physical work capacity.

Multivariate statistical assessment of predictors of firefighters' muscular and aerobic work capacity.

Physical capacity has previously been deemed important for firefighters physical work capacity, and aerobic fitness, muscular strength, and muscular endurance are the most frequently investigated parameters of importance. Traditionally, bivariate and multivariate linear regression statistics have been used to study relationships between physical capacities and work capacities among firefighters. An alternative way to handle datasets consisting of numerous correlated variables is to use multivariate projection analyses, such as Orthogonal Projection to Latent Structures. The first aim of the present study was to evaluate the prediction and predictive power of field and laboratory tests, respectively, on firefighters' physical work capacity on selected work tasks. Also, to study if valid predictions could be achieved without anthropometric data. The second aim was to externally validate selected models. The third aim was to validate selected models on firefighters' and on civilians'. A total of 38 (26 men and 12 women) + 90 (38 men and 52 women) subjects were included in the models and the external validation, respectively. The best prediction (R2) and predictive power (Q2) of Stairs, Pulling, Demolition, Terrain, and Rescue work capacities included field tests (R2 = 0.73 to 0.84, Q2 = 0.68 to 0.82). The best external validation was for Stairs work capacity (R2 = 0.80) and worst for Demolition work capacity (R2 = 0.40). In conclusion, field and laboratory tests could equally well predict physical work capacities for firefighting work tasks, and models excluding anthropometric data were valid. The predictive power was satisfactory for all included work tasks except Demolition

Subject group (N = 38) performances in isokinetic concentric tests of maximal and endurance upper body muscle power.

<p>Isokinetic tests of absolute (W) and relative (W·kg⁻¹) muscle power, maximal and endurance. The statistical method (SM) was parametric (P) or non-parametric (NP) (see Methods section). Parametric tests are presented as mean ± standard deviation (min-max). Non-parametric tests are presented as median ± Interquartile range (min-max). Groups marked with different symbols in rows (*, †) are significantly (p<0.01) different (* significantly different from †).</p

Anthropometric data.

<p>When significant differences between subjects groups were found with one-way ANOVA, post hoc Bonferroni analysis was carried out. The mean ± standard deviation (min–max) is presented. Subject groups marked with different symbols in rows (*, †) are significantly different (* significantly different from †) (p<0.01). Total subjects N = 38.</p

Subject group (N = 38) performances in field tests and simulated work tasks.

<p>The statistical Method (SM) was parametric (P) or non-parametric (NP) (see Methods section). Parametric tests are presented as mean ± standard deviation (min-max). Non-parametric tests are presented as median ± Interquartile range (min-max). Groups marked with different symbols in rows (*, †) are significantly (p<0.01) different (* significant different from †). Investigated work tasks were: Carrying hose baskets in a staircase (Stairs), Hose pulling (Pulling), Demolition at or after a fire (Demolition), Victim rescue (Rescue), and Carrying hose baskets over terrain (Terrain). Data is presented in kilograms (kg), Number of repetitions (N), or seconds (S). ^a One CW subject was excluded ^b Two CW subjects were excluded.</p

Correlations between work task capacity and field tests.

<p>Spearman's rank correlation coefficient (r_s) was used to analyze the simulated work tasks correlation with field tests. Investigated work tasks were: Cutting holes in the roof for fire gas ventilation (Cutting), Carrying hose baskets in a staircase (Stairs), Hose pulling (Pulling), Demolition at or after a fire (Demo), Victim rescue (Rescue), and Carrying hose baskets over terrain (Terrain). Data used in the analyses are seconds (s), kilograms (kg), Number (N), or meters (m). All field tests were significantly correlated with all simulated work tasks (p<0.01). Subjects N = 38 ^a One CW subject was excluded ^bTwo CW subjects were excluded. Numbers in bold types indicate the field test with the highest correlation to each simulated work task. ^a One CW subject was excluded ^bTwo CW subjects were excluded. Numbers in bold types indicate the laboratory test with the highest correlation with each work task.</p

Correlations between work task capacity and laboratory tests: absolute and relative muscle power in the lower body and the trunk, and dynamic balance.

<p>Spearman's rank correlation coefficient (r_s) was used to analyze the simulated work tasks correlation with maximal (M) and endurance (E) Isokinetic tests, and dynamic balance. Isokinetic tests are analyzed with the mean absolute (W) and relative (W·kg⁻¹) power and dynamic balance is analyzed with is analyzed with the overall stability index (SI). Investigated work tasks were: Cutting holes in the roof for fire gas ventilation (Cutting), Carrying hose baskets in a staircase (Stairs), Hose pulling (Pulling), Demolition at or after a fire (Demo), Victim rescue (Rescue), and Carrying hose baskets over terrain (Terrain), with time in seconds (s) used in the analyzes. ^*p<0.01. Subjects N = 38 ^a One CW subject was excluded ^bTwo CW subjects were excluded. Numbers in bold types indicate the laboratory test with the highest correlation with each work task.</p

Effects of Resistance and Endurance Training Alone or Combined on Hormonal Adaptations and Cytokines in Healthy Children and Adolescents: A Systematic Review and Meta-analysis

Background: No previous systematic review has quantitatively compared the effects of resistance training, endurance training, or concurrent training on hormonal adaptations in children and adolescents. Objective was to examine the effects of exercise training and training type on hormonal adaptations in children and adolescents. Methods: A systematic literature search was conducted in the following databases: PubMed, Web of Science, and EBSCO. Eligibility criteria were: population: healthy youth population sample (mean age &lt; 18 years); intervention: resistance training, endurance training, or concurrent training (&gt; 4 weeks duration); comparison: control group; outcome: pre- and post-levels of hormones and cytokines; and study design: randomized and non-randomized controlled trials. We used a random-effect model for the meta-analysis. The raw mean difference in hormones from baseline to post-intervention was presented alongside 95% confidence intervals (CI). Further, the certainty of evidence quality and the risk of bias were assessed. Results: A total of 3689 records were identified, of which 14 studies were eligible for inclusion. Most studies examined adolescents with fewer studies on children (age &lt; 12 years, N = 5 studies) and females (N = 2 studies). Nine exercise training programs used endurance training, five studies used resistance training, and no eligible study used concurrent training. The meta-analysis showed no significant effect of exercise training on testosterone (MD = 0.84 nmol/L), cortisol (MD = − 17.4 nmol/L), or SHBG (MD = − 5.58 nmol/L). Subgroup analysis showed that resistance training significantly increased testosterone levels after training (MD = 3.42 nmol/L) which was not observed after endurance training (MD = − 0.01 nmol/L). No other outcome differed between training types. Exercise training resulted in small and non-significant changes in GH (MD = 0.48 ng/mL, p = 0.06) and IGF-I (MD = − 22.90 ng/mL, p = 0.07). GH response to endurance training may be age-dependent and evident in adolescents (MD = 0.59 ng/mL, p = 0.04) but not when children and adolescents are pooled (MD = 0.48 ng/mL, p = 0.06). Limited evidence exists to conclude on IL-6 and TNF-α effects of exercise training. Assessments of GRADE domains (risk of bias, consistency, directness, or precision of the findings) revealed serious weaknesses with most of the included outcomes (hormones and cytokines). Conclusions: This systematic review suggests that exercise training has small effects on hormonal concentrations in children and adolescents. Changes in testosterone concentrations with training are evident after resistance training but not endurance training. GH's response to training may be affected by maturation and evident in adolescents but not children. Further high-quality, robust training studies on the effect of resistance training, endurance training, and concurrent training are warranted to compare their training-specific effects