•Burnout, as a stress-related process, does negatively impact safety performance.•Work pressure and work-family conflict were positively associated with firefighter burnout.•Burnout now has to be ...considered a legitimate safety concern within the fire service.
Burnout, in the context of emotional exhaustion, cynicism and depersonalization, has resulted in detrimental effects to workers. The relationship with safety outcomes, however, has not been fully explored, particularly in the American fire service. The main focus of this study is to delineate the relationships between work stress, work-family conflict, burnout and firefighter safety behavior outcomes.
Data were collected from career firefighters in the southeastern United States (n = 208). Path analysis, which allows for the simultaneous modeling of regression relationships, was completed to assess the relationships between work stress, work-family conflict and burnout and the relationships between burnout and multiple firefighter safety behavior outcomes including compliance with personal protective equipment procedures, safe work practices and safety reporting and communication behavior.
Analyses indicated that both work stress and work-family conflict predicted burnout and burnout negatively influenced personal protective equipment compliance, adherence to safety work practices, and safety reporting and communication.
Firefighter burnout significantly impacts firefighter safety performance. Firefighters are less likely to exhibit compliance oriented and self-protective behaviors, which may have implications on overall firefighter safety, health and wellbeing.
Little research has explored burnout and its causes in the American fire service. Data were collected from career firefighters in the southeastern United States (n = 208) to explore these ...relationships. A hierarchical regression model was tested to examine predictors of burnout including sociodemographic characteristics (model 1), work pressure (model 2), work stress and work-family conflict (model 3) and interaction terms (model 4). The main findings suggest that perceived work stress and work-family conflict emerged as the significant predictors of burnout (both p < .001). Interventions and programs aimed at these predictors could potentially curtail burnout among firefighters.
•Safety-specific transformational leadership was positively associated with safety motivation.•Safety motivation was positively associated with personal protective equipment use.•Safety-specific ...transformational leadership had a direct relationship with personal protective equipment use.
Personal protective equipment (PPE) use, although normally the last line of preferred hazard control, is vital to protecting firefighters. It is vital that research identify factors that positively influence firefighter behaviors associated with PPE use. Data were collected from 742 career firefighters working for metropolitan fire departments in both the eastern and western United States. Structural equation modeling was used to assess the hypothesized model and relationships between safety-specific transformational leadership, safety motivation and effective use of personal protective equipment. Safety-specific transformational leadership was positively associated with firefighter safety motivation and safety motivation was positively associated with personal protective equipment use. There was also a significant direct relationship between safety-specific transformational leadership and personal protective equipment use. Transformational leadership has not been an emphasis in the fire service because of its hierarchical structure and paramilitary-like traditions. Current fire service stakeholders have called for changes in leadership strategies and the overall culture within the fire service. This research provides additional evidence that safety-specific transformational leadership can bolster safety motivation among firefighters and can result in enhanced safety performance, including the proper and effective use of personal protective equipment.
Grassroots innovations for sustainability are attracting increasing policy attention. Drawing upon a wide range of empirical research into community energy in the UK, and taking recent support from ...national government as a case study, we apply three distinct analytical perspectives: strategic niche management, niche policy advocacy, and critical niches. Whilst the first and second perspectives appear to explain policy influence in grassroots innovation adequately, each also shuts out more transformational possibilities. We therefore argue that, if grassroots innovation is to realise its full potential, then we need to also pursue a third, critical niches perspective, and open up debate about more socially transformative pathways to sustainability.
Acne vulgaris is a highly heritable skin disorder that primarily impacts facial skin. Severely inflamed lesions may leave permanent scars that have been associated with long-term psychosocial ...consequences. Here, we perform a GWAS meta-analysis comprising 20,165 individuals with acne from nine independent European ancestry cohorts. We identify 29 novel genome-wide significant loci and replicate 14 of the 17 previously identified risk loci, bringing the total number of reported acne risk loci to 46. Using fine-mapping and eQTL colocalisation approaches, we identify putative causal genes at several acne susceptibility loci that have previously been implicated in Mendelian hair and skin disorders, including pustular psoriasis. We identify shared genetic aetiology between acne, hormone levels, hormone-sensitive cancers and psychiatric traits. Finally, we show that a polygenic risk score calculated from our results explains up to 5.6% of the variance in acne liability in an independent cohort.
Type 1 diabetes (T1D)-an autoimmune disease that destroys the pancreatic islets, resulting in insulin deficiency-often begins early in life when islet autoantibody appearance signals high risk
. ...However, clinical diabetes can follow in weeks or only after decades, and is very difficult to predict. Ketoacidosis at onset remains common
and is most severe in the very young
, in whom it can be life threatening and difficult to treat
. Autoantibody surveillance programs effectively prevent most ketoacidosis
but require frequent evaluations whose expense limits public health adoption
. Prevention therapies applied before onset, when greater islet mass remains, have rarely been feasible
because individuals at greatest risk of impending T1D are difficult to identify. To remedy this, we sought accurate, cost-effective estimation of future T1D risk by developing a combined risk score incorporating both fixed and variable factors (genetic, clinical and immunological) in 7,798 high-risk children followed closely from birth for 9.3 years. Compared with autoantibodies alone, the combined model dramatically improves T1D prediction at ≥2 years of age over horizons up to 8 years of age (area under the receiver operating characteristic curve ≥ 0.9), doubles the estimated efficiency of population-based newborn screening to prevent ketoacidosis, and enables individualized risk estimates for better prevention trial selection.
Firefighting is a hazardous occupation and there have been numerous calls for fundamental changes in how fire service organizations approach safety and balance safety with other operational ...priorities. These calls, however, have yielded little systematic research.
As part of a larger project to develop and test a model of safety climate for the fire service, focus groups were used to identify potentially important dimensions of safety climate pertinent to firefighting.
Analyses revealed nine overarching themes. Competency/professionalism, physical/psychological readiness, and that positive traits sometimes produce negative consequences were themes at the individual level; cohesion and supervisor leadership/support at the workgroup level; and politics/bureaucracy, resources, leadership, and hiring/promotion at the organizational level. A multi-level perspective seems appropriate for examining safety climate in firefighting.
Safety climate in firefighting appears to be multi-dimensional and some dimensions prominent in the general safety climate literature also seem relevant to firefighting. These results also suggest that the fire service may be undergoing transitions encompassing mission, personnel, and its fundamental approach to safety and risk.
These results help point the way to the development of safety climate measures specific to firefighting and to interventions for improving safety performance.
•Safety climate in firefighting appears to be multi-level.•There is value in developing occupation specific measures for firefighting.•The focus group results provide initial framework for developing measures.•The American fire service may be in transition with respect to safety.
Activation of CD4+ T cells results in rapid proliferation and differentiation into effector and regulatory subsets. CD4+ effector T cell (Teff) (Th1 and Th17) and Treg subsets are metabolically ...distinct, yet the specific metabolic differences that modify T cell populations are uncertain. Here, we evaluated CD4+ T cell populations in murine models and determined that inflammatory Teffs maintain high expression of glycolytic genes and rely on high glycolytic rates, while Tregs are oxidative and require mitochondrial electron transport to proliferate, differentiate, and survive. Metabolic profiling revealed that pyruvate dehydrogenase (PDH) is a key bifurcation point between T cell glycolytic and oxidative metabolism. PDH function is inhibited by PDH kinases (PDHKs). PDHK1 was expressed in Th17 cells, but not Th1 cells, and at low levels in Tregs, and inhibition or knockdown of PDHK1 selectively suppressed Th17 cells and increased Tregs. This alteration in the CD4+ T cell populations was mediated in part through ROS, as N-acetyl cysteine (NAC) treatment restored Th17 cell generation. Moreover, inhibition of PDHK1 modulated immunity and protected animals against experimental autoimmune encephalomyelitis, decreasing Th17 cells and increasing Tregs. Together, these data show that CD4+ subsets utilize and require distinct metabolic programs that can be targeted to control specific T cell populations in autoimmune and inflammatory diseases.
During the arrival of the COVID-19 pandemic, various professional ethical guidance was issued to (and for) health and social care professionals in England and Wales. Guidance can help to inform and ...support such professionals and their patients, clients and service users, but a plethora of guidance risked information overload, confusion, and inconsistency.
During the early months of the pandemic, we undertook a rapid review, asking: what are the principles adopted by professional ethical guidance in England and Wales for dealing with COVID-19? We undertook thematic content analysis of the 29 documents that met our inclusion criteria.
The 29 documents captured 13 overlapping principles: respect, fairness, minimising harm, reciprocity, proportionality, flexibility, working together, inclusiveness, communication, transparency, reasonableness, responsibility, and accountability.
We intend this attempt to collate and outline the prominent principles to be helpful, particularly, for healthcare practice during the COVID-19 pandemic and, hopefully, for future pandemic planning. We also offer some reflections on the guidance and the principles therein. After describing the principles, we reflect on some of the similarities and differences in the guidance, and the challenges associated not only with the specific guidance reviewed, but also with the nature and import of "professional ethical guidance".
•Strategic Niche Management (SNM) analysis is applied and tested with a civil society-led grassroots innovation (GI).•Community energy projects exhibit diverse activities, institutional forms, goals ...and values; not always mainly about energy.•Projects are under-resourced; little formal learning takes place; social skills are critical to embedding projects in new areas.•Twin track development, with no apparent causal link between projects’ activities and niche formation, contradicts SNM.•GI projects contribute to, and benefit from, multiple niches, reducing effectiveness of SNM recommendations.
System-changing innovations for sustainability transitions are proposed to emerge in radical innovative niches. ‘Strategic Niche Management’ theory predicts that niche-level actors and networks will aggregate learning from local projects, disseminating best practice, and encouraging innovation diffusion. Grassroots innovations emerging from civil society are under-researched, and so we investigate the UK community energy sector to empirically test this model. Our analysis draws on qualitative case study research with local projects, and a study of how intermediary organisations support local projects. We examine the extent and nature of interactions and resource flows between projects and intermediary actors in order to evaluate the utility of niche theories in the civil society context. While networking and intermediary organisations can effectively spread some types of learning necessary for diffusion, this is not sufficient: tacit knowledge, trust and confidence are essential to these projects’ success, but are more difficult to abstract and translate to new settings. We discuss the implications of our findings for niche theory, for community energy and other grassroots practitioners aiming to build robust influential niches, and for policymakers.
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