EDITORIAL article Front. Nutr., 12 October 2023Sec. Nutrition and Metabolism Volume 10 - 2023 | https://doi.org/10.3389/fnut.2023.1306052

Objectives: This study aimed to examine the impact of extreme heat exposure frequency on inflammation and well-being in UK Fire Service personnel.Methods: 136 Fire personnel and 14 controls (CON) were recruited [92 Firefighters (FF), 44 Breathing Apparatus Instructors (BAI)]. BAI were split into low (LBAI; <= 15 exposures per month) and high (HBAI; >= 20 exposures per month) categories. Measures of inflammation, mood and fatigue were collected at 0, 3 and 6 month times points. These variables were analysed for differences between groups and association with frequency of exposure.Results: HBAI exhibited raised IL-1 beta, IL-6, IL-10, IgE and lower IgM (p < 0.05). In addition, IL-1 beta, IL-6, IL-10 and IgM were associated with monthly exposure number, with exposures accounting for 15.4% of the variance in IL6, 11.8% of IL-1 beta and 25.2% of IL-10. No differences in mood or fatigue were reported (p > 0.05).Conclusion: High exposure firefighting consistently causes systemic inflammation without perceptual recognition of potential health risks.

BACKGROUND:We evaluated the safety, efficacy, and acceptability of a new device designed to facilitate uterine compression in women with postpartum haemorrhage (PPH).METHODS:A prospective, phase two clinical device trial with concurrent qualitative study, conducted in a UK consultant obstetric unit. The device was used in addition to standard care in women unresponsive to initial oxytocin therapy. The primary effectiveness outcome was additional blood loss of over 1000mls, whilst safety was assessed through adverse events. Interviews assessed device feasibility and acceptability, and were analysed using framework analysis.RESULTS:We recruited 57 women with clinical PPH after vaginal birth; 67% were primiparous and 47% had undergone operative birth. All but two (96%) had atony as a cause of the haemorrhage; in addition, 30% also had bleeding from lacerations and 11% had retained tissue. After device use, only one woman had additional blood loss over 1000mls, although 3 women (7%) needed a Bakri balloon and 14% received a blood transfusion. All but one clinician felt that the device was easy to use. Clinicians stated that the device assisted management in 85% of cases. All 56 women who responded stated that if they bled in a future birth they would want the device to be used again. There were no serious adverse events related to the device. However, 3 events were judged as 'possibly' being caused by the device - 2 minor vaginal grazes and one postnatal episiotomy infection and breakdown. Lax vaginal tissue complicated the use of the device in three women. In 47 interviews, participants, birth partners, clinician users and attending midwives viewed the device positively. Clinicians found it useful as a way of stopping blood loss and as an aid to diagnose the source of bleeding.CONCLUSIONS:The PPH Butterfly may provide a rapid, acceptable and effective treatment for postpartum haemorrhage. Clinical Trial Registration prospective with ISRCTN15452399 11/09/2017 (www.isrctn.com/ISRCTN15452399).

This paper interrogates the phenomenon of boredom at work by considering Ernst Jünger’s potential contribution. We contend that Jünger offers an important yet overlooked alternative to the dominant perspectives of boredom in Management and Organization Studies (MOS), which are largely composed of ‘simple’ psychological diagnoses and managerial prescriptions. Such studies largely understand boredom as a localised experience at work which can be overcome by targeted managerial prescriptions, techniques and interventions. In contrast we show how Jünger understands boredom from a ‘profound’ perspective as a central feature of modernity. This is premised on Jünger’s broader critique of the bourgeois values that define 20th and 21st century managerial work and organization. Jünger’s cultural-historical perspective is therefore aligned to the discrete field of Boredom Studies. By addressing how Jünger understands ‘work’ as the defining feature of the modern age, his critique situates the phenomenon of boredom at work within the broader social, institutional and cultural order of the 21st Century. While Jünger does not set out to provide a theory of boredom as such, we reconstruct such a theory through an exegesis of his writing on ‘work’ and ‘danger’. This reveals boredom and danger as phenomenologically intertwined concepts, which is an understanding of boredom that has not been considered in MOS or Boredom Studies. It is through this, we argue, that Jünger’s conception of work holds the potential for a powerful critique and understanding of boredom at work under the contemporary regime of neoliberal managerialism.

Background: Several interventions have been used to relieve chronic low back pain (CLBP). This study aimed to compare the effects of pain neuroscience education (PNE) followed by motor control exercises (MCEs) with core stability training (CST) on pain, disability, and balance in women with CLBP. Methods: Thirty-seven women with CLBP were randomly divided into two groups of PNE/MCE (n = 18, 55.2 ± 2.6 years) or CST (n = 19, 54.6 ± 2.4 years). Eight weeks of PNE/MCE or CST were prescribed for each group, independently. Pain intensity (VAS scale), disability (Roland Morris Disability Questionnaire), unipodal static balance, and dynamic balance (time up and go test) were measured at the beginning and 8 weeks after the intervention. Two-way mixed ANOVA was used to analyze the results with alpha of 5%. Results: After 8 weeks, there was a significant difference in VAS scale between groups (p = 0.024), with both PNE/MCE and CST showing 58% and 42% reductions, respectively. There were no differences for all other variables between groups. Regarding pre- to post-comparisons, both groups showed improvements in all dependent variables (p < 0.001). Conclusion: The treatment with PNE/MCE was more effective in improving pain disability and unipodal static and dynamic balance than treatment with CST. Even so, both treatments were shown to be valid and safe in improving all dependent variables analyzed in women with CLBP.

Objectives: To investigate the efficacy of heat acclimation (HA) in the young (Y-EX) and elderly (E-EX) following exercise-HA, and the elderly utilising post-exercise hot water immersion HA (E-HWI). Design: Cross-sectional study. Method: Twenty-six participants (Y-EX: n = 11 aged 22 +/- 2 years, E-EX: n = 8 aged 68 +/- 3 years, E-HWI: n = 7 aged 73 +/- 3 years) completed two pre-/post-tests, separated by five intervention days. Y-EX and E-EX exercised in hot conditions to raise rectal temperature (T-rec) >= 38.5 degrees C within 60 min, with this increase maintained for a further 60 min. E-HWI completed 30 min of cycling in temperate conditions, then 30 min of HWI (40 degrees C), followed by 30 min seated blanket wrap. Pre-and post-testing comprised 30 min rest, followed by 30 min of cycling exercise (3.5 W.kg(-1) H-prod), and a six-minute walk test (6MWT), all in 35 degrees C, 50% RH. Results: The HA protocols did not elicit different mean heart rate (HR), T-rec, and duration T-rec >= 38.5 degrees C (p > 0.05) between Y-EX, E-EX, and E-HWI groups. Resting T-rec, peak skin temperature, systolic and mean arterial pressure, perceived exertion and thermal sensation decreased, and 6MWT distance increased pre-to post-HA (p < 0.05), with no difference between groups. Y-EX also demonstrated a reduction in resting HR (p < 0.05). No change was observed in peak T-rec or HR, vascular conductance, sweat rate, or thermal comfort in any group (p > 0.05). Conclusions: Irrespective of age or intervention, HA induced thermoregulatory, perceptual and exercise performance improvements. Both exercise-HA (E-EX), and post-exercise HWI (E-HWI) are considered viable interventions to prepare the elderly for heat stress. (C) 2021 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Since it was first articulated by Antonio Gramsci in his Prison Notebooks (1929–1935), Fordism has been understood at two interconnected levels. At one level, it is understood in secular materialist terms as an archetypal system of mass production. At another, as a techno-economic paradigm of capitalist expansion. However, little attention has been given to the philosophical influences and ideas that underpinned Henry Ford’s (1863–1947) worldview and how this came to influence the formation of the factory systems at his Highland Park and River Rouge complexes. In most textbooks, it is assumed that Ford based his industrial design on a technological intensification of F.W. Taylor’s Principles of Scientific Management. This article seeks to examine the origins and rationale behind Ford’s factory system by exploring the relationship between his personal worldview and the ‘ism’ which came to bear his name. Through a cultural-historical analysis, this article critically explores Henry Ford’s personal Fordism, and argues that what has come to be understood as one of the most ‘secular’ and ‘materialist’ processes of organising ‘men and machine’ began with an attempt by Henry Ford to realise a ‘metaphysical’ ideal that was informed by the popular philosophical and theological thought of the previous century. By returning to the ideas and the context of this period, Ford’s engagement with the work of the American Transcendentalist, Ralph Waldo Emerson (1803–1882) is considered to both contextualise Henry Ford’s Fordism and explore the philosophical tensions at the heart of his organisational theory and practice.

The progression from pre-diabetes to overt type 2 diabetes is largely attributed to β-cell dysfunction and reduced insulin responsiveness. Exercise improves β-cell function in type 2 diabetics, however in pre-diabetic populations there is no data to support a similar response to acute high intensity exercise. Nine individuals diagnosed with prediabetes [HbA1c; 6.1 (0.2)%)] underwent a resting control, a continuous exercise and a high-intensity exercise trial.

The initial bedside care of premature babies with an intact cord has been shown to reduce mortality; there is evidence that resuscitation of term babies with an intact cord may also improve outcomes. This process has been facilitated by the development of bedside resuscitation surfaces. These new devices are unaffordable, however, in most of sub-Saharan Africa, where 42% of the world's 2.4 million annual newborn deaths occur. This paper describes the rationale and design of BabySaver, an innovative low-cost mobile resuscitation unit, which was developed iteratively over five years in a collaboration between the Sanyu Africa Research Institute (SAfRI) in Uganda and the University of Liverpool in the UK. The final BabySaver design comprises two compartments; a tray to provide a firm resuscitation surface, and a base to store resuscitation equipment. The design was formed while considering contextual factors, using the views of individual women from the community served by the local hospitals, medical staff, and skilled birth attendants in both Uganda and the UK.

Hyperthermia and exertional heat illness increase gastrointestinal (GI) permeability, although whether the latter is only via hyperthermia is unclear. The aim of this pilot study was to determine whether different changes in GI permeability, characterized by an increased plasma lactulose:rhamnose concentration ratio ([L:R]), occurred in exercise hyperthermia in comparison to equivalent passive hyperthermia. Six healthy adult male participants (age 25 +/- 5 years, mass 77.0 +/- 6.7 kg, height 181 +/- 6 cm, peak oxygen uptake [(V) over dotO(2peak)] 48 +/- 8 ml.kg(-1).min(-1)) underwent exercise under hot conditions (Ex-Heat) and passive heating during hot water immersion (HWI). Heart rate (HR), rectal temperature (T-CORE), rating of perceived exertion (RPE), and whole-body sweat loss (WBSL) were recorded throughout the trials. The L:R ratio, peak HR, change in HR, and change in RPE were higher in Ex-Heat than HWI, despite no differences in trial duration, peak core temperature or WBSL. L:R was strongly correlated (p < 0.05) with HR peak (r = 0.626) and change in HR (r = 0.615) but no other variable. The greater L:R in Ex-Heat, despite equal T-CORE responses to HWI, indicates that increased cardiovascular strain occurred during exercise, and exacerbates hyperthermia-induced GI permeability at the same absolute temperature.

Objective: To assess the acceptability, safety and efficacy of the PPH Butterfly, a new uterine compression device, in women with postpartum haemorrhage (PPH). Design: A phase two clinical device trial using matched historical controls, with accompanying grounded theory study. Setting: UK university consultant obstetric unit. Population: women with PPH after vaginal birth unresponsive to initial oxytocin therapy. Outcomes were compared to historical controls matched on blood loss, parity and type of birth. Methods: after oral consent, trained staff used the device in additional to normal care. Main Outcome Measures: The primary outcome was additional blood loss >1000mls. Qualitative interviews assessed device feasibility and acceptability. Results: Of the 57 recruits, two-thirds were primiparous and almost half had undergone operative birth. Two percent of recruited women had additional blood loss of over 1000mls compared to 8% of 113 controls (adjusted odds ratio 0.13, 95% CI (0.02 to 1.09)). Women treated with the device received significantly more additional treatments and had higher rates of exclusive breast-feeding at discharge. There were no serious adverse events related to the device. In 47 interviews, participants, birth partners, clinicians and attending midwives viewed the device positively. Clinicians found it useful to stop blood loss and diagnose the source of bleeding. Conclusions: the PPH Butterfly is acceptable and may have clinical benefits: it is a promising device for PPH management. Funding: National Institute for Health Research invention for innovation (i4i) program (II-LA-0715-200008) Keywords: postpartum haemorrhage, childbirth, oxytocin, third stage of labour, uterine compression. Registration: prospective ISRCTN (15452399); www.isrctn.com/ISRCTN15452399

Purpose This paper aims to reconsider the significance of Henry Ford’s claim that “History is more or less bunk”. It argues that this seemingly philistine remark can be understood as a specific historiographical position which informed Ford’s wider worldview, management approach and philosophy of industry. Design/methodology/approach The paper draws on primary philosophical works, secondary criticism and archival evidence. These sources detail the context in which the claim was made, the ideas underpinning its articulation and the conceptual basis on which Ford’s wider perspectives and contributions to historical experience can be interpreted. Findings This paper interprets Ford’s claim as a gesture of allegiance to a deeper cultural sensibility that was informed by Ralph Waldo Emerson’s transcendental view of history. Practical implications In addition to offering a rereading of Ford’s historiographical position, Emerson’s thought is discussed in relation to Ford’s subsequent “living history” project (Greenfield Village), which is considered the materialisation of his historical and industrial worldview. Originality/value This interpretation reveals how a specific historiographical position held by one of the twentieth century’s leading industrialists offers new insights into his wider worldview and philosophy of industry. It contributes to recent studies that challenge taken-for-granted narratives in management history and recent work that has highlighted the influence of transcendental principles on Ford’s philosophy of industry.

This article seeks to examine, in a cultural–historical perspective, how the ‘graduate’ has developed as a character central to a significant segment of the contemporary labour market. The argument begins by showing how the rise of the ‘new’ or ‘knowledge economy’ (throughout the 1990s and 2000s) became a new source of pressure on generations entering the world of work. Higher education has been, and continues to be, presented by political, corporate and educational institutions as a core platform upon which future possibilities of personal achievement and accomplishment depend. Gradually, the vocabulary and character of the ‘graduate’ has become more visible through complex and refined modes of cultural dissemination. The themes through which this character is articulated today have, we argue, cultural roots that are not entirely new. With reference to David Riesman’s early understanding of the formation of this kind of cultural ‘character’, we examine Charles Webb’s 1963 novel The Graduate. As a cultural–historical resource, it can be revisited half a century later in order to investigate the historical movement of certain themes and questions that now outline what a ‘graduate’ could and should be. The imperatives that underlie the labour market for graduate schemes open up questions that pertain not only to immediate matters of employment. Rather, the discourses of ‘graduate work’ and ‘employability’ now appropriate deeper concerns regarding the meaning of individual freedom, choice and self-determination. Who is the ‘graduate’ and what are some of its cultural roots?

Background Gout has been associated with weaker foot/leg muscles and altered gait patterns. There is also evidence of on-going foot pain and an increased risk of tendinopathy, with the Achilles and patellar tendons most frequently affected in gout. Additionally, the inflammation associated with gout may change tissue elasticity. Ultrasound imaging utilising shear wave elastography (SWE) offers a non-invasive method of quantifying changes in tendon stiffness. SWE findings have not previously been reported in individuals with gout. We sought to determine differences in Achilles tendon stiffness in people with gout compared to controls (non-gout). Methods: A cross sectional study comparing 24 people with gout and 26 age/sex-matched controls. Clinical and demographic data were collated, and US imaging used to determine tendon thickness, presence of gouty tophi and/or aggregates and levels of angiogenesis. Ten shear wave elastography (SWE) measures were taken along the centre of a longitudinal section of the mid-portion of each Achilles tendon. Prior to data collection, intra-observer error was good (0.75). Data were summarised using descriptive statistics and a repeated measures ANCOVA was used to compare SWE measures between the two groups for the left and right foot separately after accounting for Body Mass Index (BMI). Results: A small proportion of those with gout presented with intra-tendon aggregates and/or intra-tendon tophi in one or both tendons. There was no statistically significant difference in tendon thickness between groups. Neo-vascularity was present in a third of gout participants. SWE findings demonstrated significantly reduced tendon stiffness in those with gout compared to controls: right Achilles mdiff =1.04m/s (95% CI (0.38 to 1.7) p=0.003 and left Achilles mdiff = 0.7m/s (95% CI 0.09 to 1.32) p=0.025. No relationship between the presence of tophi and SWE values were detected. Conclusion: Subjects with chronic gout show significantly reduced Achilles tendon stiffness compared to non-gout controls. From a clinical standpoint, our findings were similar to SWE measurements in subjects with Achilles tendinopathy and who did not have gout.

Key points Patients with renal failure undergoing maintenance haemodialysis are associated with insulin resistance and protein metabolism dysfunction. Novel research suggests that disruption to the transmembrane protein linkage between the cytoskeleton and the extracellular matrix in skeletal muscle may contribute to reduced amino acid metabolism and insulin resistance in haemodialysis. ILK, PINCH1 and pFAKTyr397 were significantly decreased in haemodialysis compared to controls, whereas Rac1 and Akt2 showed no different between groups. Rac1 deletion in the Rac1 knockout model did not alter the expression of integrin‐associated proteins. Phenylalanine kinetics were reduced in the haemodialysis group at 30 and 60 min post meal ingestion compared to controls; both groups showed similar levels of insulin sensitivity and β‐cell function. Key proteins in the integrin–cytoskeleton linkage are reduced in haemodialysis patients, suggesting for the first time that integrin‐associated proteins dysfunction may contribute to reduced phenylalanine flux without affecting insulin resistance in haemodialysis patients. AbstractMuscle atrophy, insulin resistance and reduced muscle phosphoinositide 3‐kinase‐Akt signalling are common characteristics of patients undergoing maintenance haemodialysis (MHD). Disruption to the transmembrane protein linkage between the cytoskeleton and the extracellular matrix in skeletal muscle may contribute to reduced amino acid metabolism and insulin resistance in MHD patients. Eight MHD patients (age: 56 ± 5 years: body mass index: 32 ± 2 kg m–2) and non‐diseased controls (age: 50 ± 2 years: body mass index: 31 ± 1 kg m–2) received primed continuous l‐[ring‐2H5]phenylalanine before consuming a mixed meal. Phenylalanine metabolism was determined using two‐compartment modelling. Muscle biopsies were collected prior to the meal and at 300 min postprandially. In a separate experiment, skeletal muscle tissue from muscle‐specific Rac1 knockout (Rac1 mKO) was harvested to investigate whether Rac1 depletion disrupted the cytoskeleton‐integrin linkage, allowing for cross‐model examination of proteins of interest. ILK, PINCH1 and pFAKTyr397 were significantly lower in MHD (P < 0.01). Rac1 and Akt showed no difference between groups for the human trial. Rac1 deletion in the Rac1 mKO model did not alter the expression of integrin‐associated proteins. Phenylalanine rates of appearance and disappearance, as well as metabolic clearance rates, were lower in the MHD group at 30 and 60 min post meal ingestion compared to controls (P < 0.05). Both groups showed similar levels of insulin sensitivity and β‐cell function. Key proteins in the integrin–cytoskeleton linkage are reduced in MHD patients, suggesting for the first time that integrin‐associated proteins dysfunction may contribute to reduced phenylalanine flux without affecting insulin resistance in haemodialysis patients.

Fire Service Instructors (FSI) experience ~10 times more fire exposures than firefighters (FF), the increased physiological stress from this potentially puts them at risk of ill health and future cardiac events. This study aimed to establish whether FSI exhibit elevated biomarkers associated with cardiac event risk, identify if FSI experience systemic inflammation linked to fire exposure frequencies and evaluate a proposed exposure limit of 9 per month. Blood samples were collected from 110 Fire Service personnel (age: 44 {plus minus} 7 yrs; height: 178.1 {plus minus} 7.1 cm; body mass: 84.3 {plus minus} 12.0 kg, FSI n = 53, FF n = 57) for biomarker analysis. Work history details were collected from all participants. Participants with biomarker concentrations above healthy reference ranges were classified as "at risk". Neutrophil/lymphocyte ratio, platelet count, cardiac troponin T, interleukin-6 (IL-6), interleukin-1β (IL-1β), Disclaimer: This is a confidential document. immunoglobulin G (IgG) and C reactive protein (CRP) were greater in FSI than FF (p<0.05). Multiple regression analysis revealed 18.8% of IL-6, 24.9% of IL-1β, 29.2% of CRP, and 10.9% of IgG variance could be explained by number of heat exposures per month. Odds ratios revealed that those above the 9 per month exposure limit were 6-12 times more likely to be classified as "at risk" and were 16 times more likely to experience symptoms of ill health. Increased cytokine levels suggest FSI experience systemic inflammation, which is related to symptoms of ill health. We propose that an exposure limit could reduce the prevalence of these biomarker risk factors and ill health. New Findings: Fire service instructors are frequently exposed to live fire scenarios, representing the most extreme chronic occupational heat exposure. These individuals report a series of unique health issues. This study seeks to identify if the number of exposures completed are associated with inflammatory and immunological markers and symptoms of ill health. Fire service instructors exhibit greater levels of inflammatory markers in comparison to firefighters. Fire exposure numbers are positively related with the prevalence of ill health and inflammation. Implementation of a proposed 9 exposure limit per month may be appropriate to minimise health issues. Dual Publication: No Funding: University of Brighton: Emily Rachel Watkins, Mark Hayes, Peter Watt, Alan James Richardson, N/A; The Fire Service College: Emily Rachel Watkins, Mark Hayes, Peter Watt, Alan James Richardson, N/A; East Sussex Fire and Rescue Service: Emily Rachel Watkins, Mark Hayes, Peter Watt, Alan James Richardson, N/A Grant reference numbers are not available due to the nature of the funding received (internal funding and consultancy funding) Disclaimer: This is a confidential document.

This reflective case-history presents the findings of a 12-week pilot study of a collaborative organizational change project which oversaw the implementation of predictive policing technology (PPT) into a territorial police force in the North of England. Based on the first year of a two-year initiative, the reflections consider the impact on the future of the project and their potential future application and cultural embeddedness, beyond the organizational and time-bound specifics of this case.

New Findings What is the central question of this study? Fire service instructors are frequently exposed to live fire scenarios, representing the most extreme chronic occupational heat exposure. These individuals report a series of unique health issues. We sought to identify whether the number of exposures completed was associated with inflammatory and immunological markers and symptoms of ill health. What is the main finding and its importance? Fire service instructors exhibit greater levels of inflammatory markers in comparison to firefighters. The number of exposures to fire is positively related to the prevalence of ill health and inflammation. Implementation of a proposed limit of nine exposures per month might be appropriate to minimize health issues. AbstractFire Service Instructors (FSIs) experience ∼10 times more fire exposures than firefighters (FFs), and the increased physiological stress from this potentially puts them at risk of ill health and future cardiac events. The aim of the study was to establish whether FSIs exhibit elevated biomarkers associated with cardiac event risk, identify whether FSIs experience systemic inflammation linked to the frequency of fire exposure and evaluate a proposed exposure limit of nine exposures per month. Blood samples were collected from 110 Fire Service personnel (mean ± SD, age,44 ± 7 years; height, 178.1 ± 7.1 cm; and body mass, 84.3 ± 12.0 kg; FSIs n = 53 and FFs n = 57) for biomarker analysis. Work history details were collected from all participants. Participants with biomarker concentrations above healthy reference ranges were classified as being ‘at risk’. The neutrophil‐to‐lymphocyte ratio, platelet count, cardiac troponin T, interleukin (IL)‐6, IL‐1β, C‐reactive protein and immunoglobulin G were greater in FSIs than in FFs (P < 0.05). Multiple regression analysis revealed that 18.8% of IL‐6, 24.9% of IL‐1β, 29.2% of C‐reactive protein and 10.9% of immunoglobulin G variance could be explained by the number of exposures to heat per month. Odds ratios revealed that those FSIs above the nine per month exposure limit were six to 12 times more likely to be classified as ‘at risk’ and were 16 times more likely to experience symptoms of ill health. Increased cytokine levels suggest that FSIs experience systemic inflammation, which is related to symptoms of ill health. We propose that an exposure limit could reduce the prevalence of these biomarker risk factors and ill health.