Assessing the validity of tympanic temperature to predict core temperature of firefighters in different environmental conditions

The present study examined the validity of tympanic temperature measurements as a predictor of core temperature on the fireground in different environmental conditions. Fiftyone volunteer firefighters participated in the study across four different conditions, the conditions consisted of; 1) passive (i.e., no intervention) cooling in cold ambient temperatures (0-6°C); 2) cooling (through water immersion) in cool ambient temperatures (10-12ºC); 3) cooling (through water immersion) in warm ambient temperatures (21.5°C); and, 4) passive cooling in warm ambient temperatures (22°C). Firefighters wore full structural personal protective clothing while performing common firefighting duties including search and rescue tasks for 20-40 minutes. There was no difference between core and tympanic temperature immediately post-exercise across any condition. However, for all conditions, tympanic temperature dropped significantly faster than core temperature from 0 minutes, and remained significantly lower (p < 0.05) than core temperature from nine to 20 minutes post-training. The results show that there is no consistent difference between core and tympanic temperature during recovery from a simulated firefighting task across a range of different ambient conditions. Agencies should, accordingly, prioritize investigating other practical markers of core temperature as part of a broader heat stress management plan for firefighters.

Diabetes prevention research: a systematic review of external validity in lifestyle interventions

Context

Type 2 diabetes is a major contributor to disease burden globally. A number of systematic reviews support the efficacy of lifestyle interventions in preventing Type 2 diabetes in adults; however, relatively little attention has been paid to the generalizability of study findings. This study systematically reviews the reporting of external validity components and generalizability of diabetes prevention studies.

Evidence acquisition

Lifestyle intervention studies for the prevention of Type 2 diabetes in adults with at least 6 months' follow-up, published between 1990 and 2011, were identified through searches of major electronic databases. External validity reporting was rated using an assessment tool, and all analysis was undertaken in 2011.

Evidence synthesis

A total of 31 primary studies (n=95 papers) met the selection criteria. All studies lacked full reporting on external validity elements. Description of the study sample, intervention, delivery agents, and participant attrition rates were reported by most studies. However, few studies reported on the representativeness of individuals and settings, methods for recruiting settings and delivery agents, costs, and how interventions could be institutionalized into routine service delivery. It is uncertain to what extent the findings of diabetes prevention studies apply to men, socioeconomically disadvantaged individuals, those living in rural and remote communities, and to low- and middle-income countries.

Conclusions

Reporting of external validity components in diabetes prevention studies needs to be enhanced to improve the evidence base for the translation and dissemination of these programs into policy and practice.