Firefighters\u27 physical activity across multiple shifts of planned burn work

Little is currently known about the physical activity patterns of workers in physically demanding populations. The aims of this study were to (a) quantify firefighters\u27 physical activity and sedentary time within (2-h periods) and across planned burn shifts; and (b) examine whether firefighters\u27 activity levels during one shift or 2-h period was associated with their activity levels in the following shift or 2-h period. Thirty-four salaried firefighters (26 men, 8 women) wore an Actical accelerometer for 28 consecutive days. Time spent sedentary (SED) and in light- (LPA), moderate- (MPA) and vigorous-intensity physical activity (VPA) were derived using validated cut-points. Multilevel analyses (shift, participant) were conducted using generalised linear latent and mixed models. Firefighters spent the majority of a planned burn shift (average length 10.4 h) or 2-h period engaged in LPA (69% and 70%, respectively). No significant associations were observed between SED and physical activity levels between consecutive planned burned shifts or 2-h periods. The physical activity that a firefighter engaged in during one shift (or 2-h period) did not subsequently affect their physical activity levels in the subsequent shift (or 2-h period). Further research is needed to establish how workers in physically demanding populations are able to sustain their activity levels over long periods of time

Exercising Caution Upon Waking–Can Exercise Reduce Sleep Inertia?

Sleep inertia, the transitional state of reduced alertness and impaired cognitive performance upon waking, is a safety risk for on-call personnel who can be required to perform critical tasks soon after waking. Sleep inertia countermeasures have previously been investigated; however, none have successfully dissipated sleep inertia within the first 15 min following waking. During this time, on-call personnel could already be driving, providing advice, or performing other safety-critical tasks. Exercise has not yet been investigated as a sleep inertia countermeasure but has the potential to stimulate the key physiological mechanisms that occur upon waking, including changes in cerebral blood flow, the cortisol awakening response, and increases in core body temperature. Here, we examine these physiological processes and hypothesize how exercise can stimulate them, positioning exercise as an effective sleep inertia countermeasure. We then propose key considerations for research investigating the efficacy of exercise as a sleep inertia countermeasure, including the need to determine the intensity and duration of exercise required to reduce sleep inertia, as well as testing the effectiveness of exercise across a range of conditions in which the severity of sleep inertia may vary. Finally, practical considerations are identified, including the recommendation that qualitative field-based research be conducted with on-call personnel to determine the potential constraints in utilizing exercise as a sleep inertia countermeasure in real-world scenarios

Exercising Caution Upon Waking–Can Exercise Reduce Sleep Inertia?

Sleep inertia, the transitional state of reduced alertness and impaired cognitive performance upon waking, is a safety risk for on-call personnel who can be required to perform critical tasks soon after waking. Sleep inertia countermeasures have previously been investigated; however, none have successfully dissipated sleep inertia within the first 15 min following waking. During this time, on-call personnel could already be driving, providing advice, or performing other safety-critical tasks. Exercise has not yet been investigated as a sleep inertia countermeasure but has the potential to stimulate the key physiological mechanisms that occur upon waking, including changes in cerebral blood flow, the cortisol awakening response, and increases in core body temperature. Here, we examine these physiological processes and hypothesize how exercise can stimulate them, positioning exercise as an effective sleep inertia countermeasure. We then propose key considerations for research investigating the efficacy of exercise as a sleep inertia countermeasure, including the need to determine the intensity and duration of exercise required to reduce sleep inertia, as well as testing the effectiveness of exercise across a range of conditions in which the severity of sleep inertia may vary. Finally, practical considerations are identified, including the recommendation that qualitative field-based research be conducted with on-call personnel to determine the potential constraints in utilizing exercise as a sleep inertia countermeasure in real-world scenarios

The impact of sleep restriction and simulated physical firefighting work on acute inflammatory stress responses

OBJECTIVES: This study investigated the effect restricted sleep has on wildland firefighters\u27 acute cytokine levels during 3 days and 2 nights of simulated physical wildfire suppression work. METHODS: Firefighters completed multiple days of physical firefighting work separated by either an 8-h (Control condition; n = 18) or 4-h (Sleep restriction condition; n = 17) sleep opportunity each night. Blood samples were collected 4 times a day (i.e., 06:15, 11:30, 18:15, 21:30) from which plasma cytokine levels (IL-6, IL-8, IL-1β, TNF-α, IL-4, IL-10) were measured. RESULTS: The primary findings for cytokine levels revealed a fixed effect for condition that showed higher IL-8 levels among firefighters who received an 8-h sleep each night. An interaction effect demonstrated differing increases in IL-6 over successive days of work for the SR and CON conditions. Fixed effects for time indicated that IL-6 and IL-4 levels increased, while IL-1β, TNF-α and IL-8 levels decreased. There were no significant effects for IL-10 observed. CONCLUSION: Findings demonstrate increased IL-8 levels among firefighters who received an 8-h sleep when compared to those who had a restricted 4-h sleep. Firefighters\u27 IL-6 levels increased in both conditions which may indicate that a 4-h sleep restriction duration and/or period (i.e., 2 nights) was not a significant enough stressor to affect this cytokine. Considering the immunomodulatory properties of IL-6 and IL-4 that inhibit pro-inflammatory cytokines, the rise in IL-6 and IL-4, independent of increases in IL-1β and TNF-α, could indicate a non-damaging response to the stress of simulated physical firefighting work. However, given the link between chronically elevated cytokine levels and several diseases, further research is needed to determine if firefighters\u27 IL-8 and IL-6 levels are elevated following repeated firefighting deployments across a fire season and over multiple fire seasons

Sleep in wildland firefighters: what do we know and why does it matter?

Wildland firefighters perform physical work while being subjected to multiple stressors and adverse, volatile working environments for extended periods. Recent research has highlighted sleep as a significant and potentially modifiable factor impacting operational performance. The aim of this review was to (1) examine the existing literature on firefighters’ sleep quantity and quality during wildland firefighting operations; (2) synthesise the operational and environmental factors that impact on sleep during wildland firefighting; and (3) assess how sleep impacts aspects of firefighters’ health and safety, including mental and physical health, physical task performance, physical activity and cognitive performance. Firefighters’ sleep is restricted during wildfire deployments, particularly when shifts have early start times, are of long duration and when sleeping in temporary accommodation. Shortened sleep impairs cognitive but not physical performance under simulated wildfire conditions. The longer-term impacts of sleep restriction on physiological and mental health require further research. Work shifts should be structured, wherever possible, to provide regular and sufficient recovery opportunities (rest during and sleep between shifts), especially in dangerous working environments where fatigue-related errors have severe consequences. Fire agencies should implement strategies to improve and manage firefighters’ sleep and reduce any adverse impacts on firefighters’ work

Improving cardiometabolic health with diet, physical activity, and breaking up sitting: what about sleep?

Cardiometabolic disease poses a serious health and economic burden worldwide and its prevalence is predicted to increase. Prolonged sitting, lack of physical activity, poor diet, and short sleep duration are ubiquitous behaviors in modern society, and all are independent risk factors in the development of cardiometabolic disease. Existing evidence demonstrates that breaking up prolonged periods of sitting is beneficial for cardiometabolic health, however, studies have not controlled for prior sleep duration. This article examines how prolonged sitting and short sleep duration independently contribute to cardiometabolic risk, and how breaking up sitting and obtaining adequate sleep may reduce this risk. We suggest that as prolonged sitting and short sleep duration influence the same cardiometabolic parameters, there is potential for short sleep to attenuate the positive impact of breaking up prolonged sitting with physical activity. Likewise, breaking up prolonged sitting and obtaining adequate sleep together could improve predictors of cardiometabolic disease, i.e., the combined effect may be stronger than either alone. To explore these perspectives, we propose a research agenda to investigate the relationship between breaking up prolonged sitting with physical activity and short sleep duration. This will provide an evidence-base for informing the design of interventions to reduce the burden of cardiometabolic disease on communities worldwide

How the chance of missing the alarm during an on-call shift affects pre-bed anxiety, sleep and next day cognitive performance

© 2018 Elsevier. This manuscript version is made available under the CC-BY-NC-ND 4.0 license: http://creativecommons.org/licenses/by-nc-nd/4.0/ This author accepted manuscript is made available following 12 month embargo from date of publication (September 2018) in accordance with the publisher’s archiving policy.This study investigated how the likelihood of missing an alarm affects pre-bed anxiety, sleep and next day cognitive performance during on-call shifts. Participants (n=24) completed one adaptation night, one control night and two on-call nights in a time-isolated sleep laboratory. On one of the on-call nights, participants were informed that they would be woken by a loud alarm that they would definitely not be able to sleep through (low likelihood of missing the alarm). On the other on-call night, participants were informed that they would be woken by a quiet alarm that they may sleep through (high likelihood of missing the alarm). The two on-call nights were counterbalanced. Pre-bed anxiety was measured using the State Trait Anxiety Inventory x-1, while sleep macro- and micro-architecture was examined via routine polysomnography and power spectral analyses respectively. Following each sleep, cognitive performance was assessed four times (0930, 1200, 1430, 1700) using the 10-min psychomotor vigilance task (PVT). Results indicated that while pre-bed anxiety was similarly increased during both high and low likelihood of missing the on-call alarm conditions compared with control, only in the high likelihood condition was total sleep time shorter and sleep efficiency lower compared with the control condition. However, more wake after sleep onset was found in the low likelihood condition compared with control. PVT data indicate that response times (mean reciprocal and mean fastest 10% of reaction time) were fastest in the low likelihood condition, indicating better performance when compared with both other conditions. However, there were significantly more lapses in the low likelihood condition compared with control. No significant EEG power spectral differences were observed. As such, it appears that there are detrimental effects of both on-call conditions on anxiety, sleep and performance, with sleep poorest when the likelihood of missing the alarm is high. The adverse impacts on sleep and performance outcomes while on-call may be mitigated by the implementation of workplace systems to reduce the likelihood of missing alarms (e.g., having two available options for contacting on-call workers).This study was funded by an Australian Research Council Discovery grant (DP 150104497). Funding for Madeline Sprajcer’s PhD scholarship was provided by this grant. Dr Grace Vincent is supported by an Early Career Fellowship at Central Queensland University

Winter and spring controls on the summer food web of the coastal West Antarctic Peninsula

Understanding the mechanisms by which climate variability affects multiple trophic levels in food webs is essential for determining ecosystem responses to climate change. Here we use over two decades of data collected by the Palmer Long Term Ecological Research program (PAL-LTER) to determine how large-scale climate and local physical forcing affect phytoplankton, zooplankton and an apex predator along the West Antarctic Peninsula (WAP). We show that positive anomalies in chlorophyll-a (chl-a) at Palmer Station, occurring every 4-6 years, are constrained by physical processes in the preceding winter/spring and a negative phase of the Southern Annular Mode (SAM). Favorable conditions for phytoplankton included increased winter ice extent and duration, reduced spring/summer winds, and increased water column stability via enhanced salinity-driven density gradients. Years of positive chl-a anomalies are associated with the initiation of a robust krill cohort the following summer, which is evident in Adelie penguin diets, thus demonstrating tight trophic coupling. Projected climate change in this region may have a significant, negative impact on phytoplankton biomass, krill recruitment and upper trophic level predators in this coastal Antarctic ecosystem

Visión general de las percepciones regionales sobre el rol de la educación superior para el desarrollo humano y social

Nuestro informe ha estudiado en su Parte I temas globales seleccionados acerca del rol de la educación superior para el desarrollo humano y social. Este trabajo es una síntesis de las perspectivas regionales -África Subsahariana, Estados Árabes, Asia y el Pacífico, Europa, América del Norte y América Latina y el Caribe- acerca del rol de la educación superior para el desarrollo humano y social basado en la contribución de los autores en cinco áreas claves: una de ellas es el estado de la educacion superior en cada región desde la celebración de la Conferencia Mundial sobre Educación Superior (CMES, 1998); y otra de las cuatro áreas clave se refiere a los posibles roles futuros, estrategias y acciones de la educación superior para promover el desarrollo humano y social.Peer Reviewe

Derivation, validation, and clinical relevance of a pediatric sepsis phenotype with persistent hypoxemia, encephalopathy, and shock

OBJECTIVES: Untangling the heterogeneity of sepsis in children and identifying clinically relevant phenotypes could lead to the development of targeted therapies. Our aim was to analyze the organ dysfunction trajectories of children with sepsis-associated multiple organ dysfunction syndrome (MODS) to identify reproducible and clinically relevant sepsis phenotypes and determine if they are associated with heterogeneity of treatment effect (HTE) to common therapies. DESIGN: Multicenter observational cohort study. SETTING: Thirteen PICUs in the United States. PATIENTS: Patients admitted with suspected infections to the PICU between 2012 and 2018. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We used subgraph-augmented nonnegative matrix factorization to identify candidate trajectory-based phenotypes based on the type, severity, and progression of organ dysfunction in the first 72 hours. We analyzed the candidate phenotypes to determine reproducibility as well as prognostic, therapeutic, and biological relevance. Overall, 38,732 children had suspected infection, of which 15,246 (39.4%) had sepsis-associated MODS with an in-hospital mortality of 10.1%. We identified an organ dysfunction trajectory-based phenotype (which we termed persistent hypoxemia, encephalopathy, and shock) that was highly reproducible, had features of systemic inflammation and coagulopathy, and was independently associated with higher mortality. In a propensity score-matched analysis, patients with persistent hypoxemia, encephalopathy, and shock phenotype appeared to have HTE and benefit from adjuvant therapy with hydrocortisone and albumin. When compared with other high-risk clinical syndromes, the persistent hypoxemia, encephalopathy, and shock phenotype only overlapped with 50%-60% of patients with septic shock, moderate-to-severe pediatric acute respiratory distress syndrome, or those in the top tier of organ dysfunction burden, suggesting that it represents a nonsynonymous clinical phenotype of sepsis-associated MODS. CONCLUSIONS: We derived and validated the persistent hypoxemia, encephalopathy, and shock phenotype, which is highly reproducible, clinically relevant, and associated with HTE to common adjuvant therapies in children with sepsis