Evaluating the Variability Between 20-m Multistage Fitness Test Estimating Equations in Law Enforcement Recruits.

ABSTRACT: Campbell, P, Maupin, D, Lockie, RG, Dawes, JJ, Simas, V, Canetti, E, Schram, B, and Orr, R. Evaluating the variability between 20-m multistage fitness test estimating equations in law enforcement recruits. J Strength Cond Res 38(4): 742-748, 2024-The 20-m multistage fitness test (20MSFT) is commonly used by law enforcement agencies to measure aerobic fitness and to estimate maximal aerobic consumption (V̇ o2 max). These measures are an important occupational variable with aerobic fitness levels linked to employment status, occupational performance, and long-term health in law enforcement officers. There are a multitude of predictive equations used to provide an estimate of V̇ o2 max, with the extent of variability in the estimated V̇ o2 max currently unknown in this population. This has consequences for comparisons between, and across, differing agencies, and in capabilities of deriving normative data. The aim of this investigation was to compare the variability in estimated V̇ o2 max scores derived from different 20MSFT predictive equations. The 20-m multistage fitness test data from 1,094 law enforcement recruits (male n = 741, 25.2 ± 6.3 years; female: n = 353, 25.6 ± 5.6 years) from a single agency were retrospectively analyzed. The 20MSFT scores were transformed into estimated V̇ o2 max scores using 6 different predictive equations. Significance was set at p < 0.05. Results demonstrated significantly different V̇ o2 max scores between each predictive equation ( p < 0.001; d = 0.25-1.53) and between male and female recruits ( p < 0.001, r = 0.55). All estimated V̇ o2 max equations showed small to very strong correlations with each other ( p < 0.001; r = 0.32-0.99). The findings indicate considerable dispersion of V̇ o2 max scores when using differing equations, suggesting raw 20MSFT variables (e.g., shuttles or distance completed) should be preferred to measure and apply results from aerobic fitness tests if standardized approaches are not developed within law enforcement.

The Development of Normative Fitness Data and Analyzing the Relationships Between 20MSFT and 2.4-km Run Performance in Australian Police Recruits.

ABSTRACT: Campbell, P, Maupin, D, Lockie, RG, Dawes, JJ, Simas, V, Canetti, E, Schram, B, and Orr, R. The development of normative fitness data and analyzing the relationships between 20MSFT and 2.4-km run performance in Australian police recruits. J Strength Cond Res 38(11): 1951-1958, 2024-Aerobic fitness testing plays a significant role in the academy training of law enforcement recruits. There is a lack of normative data for law enforcement recruits and substantial interchangeability for choice of field-based aerobic tests. Therefore, this study aimed to develop normative percentile rankings for the 20-m multistage fitness tests (20MSFT) and 2.4-km run specific to law enforcement recruits; and to analyze the relationship between the 2 tests by linear regression. Data from 5 cohorts of law enforcement recruits completing 20MSFT ( n = 1,536) and 2.4-km run ( n = 1,499) testing during basic training at an Australian Police Academy were retrospectively analyzed. Percentile ranks were calculated (20th, 40th, 50th, 60th, 80th, and 99th) based on the number of shuttles completed and time (seconds) to complete the 2.4-km run. Results were split by sex and age (i.e., <20 years, 20-29 years, 30-39 years, and 40-49 years). Linear regression analyzed the relationship between the 20MSFT to the 2.4-km run (using both seconds and km·h -1 ), producing predictive equations to translate scores between the 2 assessments. These data presented the first detailed normative values by age and sex for Australian law enforcement recruits. Furthermore, the results demonstrated regression models could explain 65-74% of the variance observed ( r2 = 0.649-0.741) between 20MSFT performance and 2.4-km run performance. This study's findings allow for normative performance for the purpose of benchmarking fitness, setting performance goal, and rehabilitation from injury. In addition, a valid conversion through a linear regression affords cross-agency comparisons and temporal changes in test selection/recruit cohorts.

Determining the Changes in Law Enforcement Recruit Aerobic Fitness Using the 2.4-km Run and 20-m Multistage Fitness Test. Does the Type of Test Matter?

ABSTRACT: Campbell, P, Maupin, D, Lockie, RG, Dawes, JJ, Simas, V, Canetti, E, Schram, B, and Orr, R. Determining the changes in law enforcement recruit aerobic fitness using the 2.4-km run and 20-m multistage fitness test. Does the type of test matter? J Strength Cond Res 38(6): 1111-1117, 2024-Aerobic fitness is linked with academy graduation, employment, and the long-term health of law enforcement officers and is often used as a training outcome. However, different tests can be used, and aerobic improvements may differ according to the test used. The aim of this study was to determine whether recruits improved to a greater extent in 1 aerobic test compared with the other. Retrospective data from 5 law enforcement recruit cohorts (males = 741; females = 353) who underwent 18 weeks of academy training were analyzed. Initial 20-m multistage fitness test (20MSFT) and 2.4-km run assessments were completed during weeks 4 and 5 of training, with final testing completed during weeks 16 and 17, respectively. A repeated-measures analysis of variance ( p < 0.05) with a Bonferroni post hoc analysis determined changes in aerobic fitness in the 20MSFT and 2.4-km run between male and female recruits. A mean difference of 9.27 (95% confidence intervals [CI] 14.8-10.9; d = 0.63; p < 0.001) shuttle increase in 20MSFT performance and 20.1 (95% CI 16.0-24.2; d = 0.49; p < 0.001) second improvement in 2.4-km run time were demonstrated when averaged across sex, yielding a larger performance improvement for the 20MSFT compared with the 2.4-km run. Conversely, there was a smaller magnitude of change in aerobic fitness between male recruits and female recruits for the 20MSFT ( d = 0.47) compared with the 2.4-km run ( d = 0.50). The findings indicate that current academy training results in improvements to aerobic fitness and to a greater magnitude in the 20MSFT compared with the 2.4-km run. These results may affect policy considerations for law enforcement agencies regarding aerobic test selection.

Identifying the most important, frequent, and physically demanding tasks of Brazilian firefighters.

This study aimed to identify the most important, frequently performed, and physically demanding tasks performed by Brazilian firefighters and to identify tasks that could be used to assess physical fitness. A subjective task analysis was conducted. Five hundred twenty-four firefighters (84% male; 16% females) responded to an online survey and rated 37 tasks across three domains (most important, most frequent, and most physically demanding). A dichotomous decision analysis was used to inform the proposed physical fitness tests. Wildland firefighting tasks presented the highest overall mean rate. Traffic control was considered the most important and frequently performed task. Lifeguard rescue was considered the most physically demanding task. The dichotomous analysis identified 14 essential tasks (seven structural firefighting and seven automobile accidents). The tasks identified may be helpful in developing criterion physical fitness tests and training programs related to firefighters' demands.Practitioner summary: The unpredictability, variability, and dangerousness of firefighting make it challenging to observe the physical demands imposed on firefighters. A subjective task analysis was conducted to identify essential tasks performed by Brazilian firefighters. Wildland firefighting, lifeguard rescue, automobile accidents, and structural firefighting tasks were the most important, frequent, and physically demanding.

Virtual reality-based interventions for the rehabilitation of vestibular and balance impairments post-concussion: a scoping review.

BACKGROUND: Concussions and mild traumatic brain injuries are the most common causes of physical and cognitive disability worldwide. Concussion can result in post-injury vestibular and balance impairments that can present up to five years post initial concussion event, ultimately affecting many daily and functional activities. While current clinical treatment aims to reduce symptoms, the developing use of technology in everyday life has seen the emergence of virtual reality. Current literature has failed to identify substantial evidence regarding the use of virtual reality in rehabilitation. The primary aim of this scoping review is to identify, synthesise, and assess the quality of studies reporting on the effectiveness of virtual reality for the rehabilitation of vestibular and balance impairments post-concussion. Additionally, this review aims to summarise the volume of scientific literature and identify the knowledge gaps in current research pertaining to this topic. METHODS: A scoping review of six databases (PubMed, Embase, CINAHL, ProQuest, SportDiscus, Scopus) and a grey literature (Google Scholar) was conducted using three key concepts (virtual reality, vestibular symptoms, and post-concussion). Data was charted from studies and outcomes were categorised into one of three categories: (1) balance; (2) gait; or (3) functional outcome measures. Critical appraisal of each study was conducted using the Joanna Briggs Institute checklists. A critical appraisal of each outcome measure was also completed utilising a modified GRADE appraisal tool to summarise the quality of evidence. Effectiveness was assessed using calculations of change in performance and change per exposure time. RESULTS: Three randomised controlled trials, three quasi-experimental studies, three case studies, and one retrospective cohort study were ultimately included, using a thorough eligibility criteria. All studies were inclusive of different virtual reality interventions. The ten studies had a 10-year range and identified 19 different outcome measures. CONCLUSION: The findings from this review suggests that virtual reality is an effective tool for the rehabilitation of vestibular and balance impairments post-concussion. Current literature shows sufficient but low level of evidence, and more research is necessary to develop a quantitative standard and to better understand appropriate dosage of virtual reality intervention.

Injury rates in female and male military personnel: a systematic review and meta-analysis.

BACKGROUND: An effective military force is required to be agile, capable, efficient, and potent. Injuries to military personnel interrupt active-duty service and can detract from overall capability. These injuries are associated with a high individual and organizational burden, with lost work time and financial costs-all problematic for the ongoing functioning of a military force. Injury control strategies have therefore been described as force multipliers. Female personnel form an integral part of any modern defence force, but little research has examined their specific experiences of injury, to inform targeted injury control efforts. The aim of this review was to identify and synthesise findings from studies of injury rates and patterns in female military personnel, comparing them to those of male personnel. METHODS: A systematic search was conducted for studies which compared injury rates between the sexes at any stage of military service, from basic training through to deployment. Databases searched included PUBMED, CINAHL and Medline through OVID. Methodological quality of eligible articles was assessed using the Critical Appraisal Skills Program (CASP), and AXIS tools and data were extracted, synthesized, and, where possible, underwent meta-analysis. RESULTS: Of 2287 identified studies, a total of 25 studies were eligible and included. Methodological quality ranged from 60% up to a perfect score of 100%, with an average of 82% across all studies. Relative risks for injuries (reported as RR [95%CI]) to females when compared to males were 2.10 [1.89-2.33] during basic training, 1.70 [1.33-2.17] during officer training, and 1.23 [1.05-1.43] post initial training. After adjustment for differences between the sexes in average fitness levels (2-mile run time), there was no longer a significant difference in injury rates (adjusted RR: 0.95 [0.86-1.05]). Female personnel tended to make bigger improvements in their fitness during basic training than males and tended to report their injuries more frequently and sooner than males. CONCLUSION: While this review found a higher rate of reported injuries in female military personnel when compared to male personnel, differences between the sexes in average fitness levels and injury reporting behaviours may largely explain this rate difference. The difference in rates of reported injuries was greatest during basic training, and reduced thereafter, possibly due in part to a reduced difference in fitness between the sexes or increased opportunity to self-determine workloads relative to fitness levels.

Enhancing capillary blood collection: The influence of nicotinic acid and nonivamide.

BACKGROUND: Nicotinic acid and nonivamide are often applied topically during capillary blood collection to induce vasodilation. These molecules may have an influence on immune effector cell activity in nearby tissues. This study investigates whether the induction of flushing by nicotinic acid and nonivamide causes an inflammatory response that influences the composition of immune cells present in a capillary blood sample. METHODS: Females aged between 18 and 30 years old provided capillary blood samples. Experimental samples were taken from an earlobe treated with nicotinic acid and nonivamide with controls obtained from the untreated earlobe. Immunophenotypic analyses were conducted using polychromatic flow cytometry to determine whether any changes occurred in leucocyte subpopulations (CD3, CD4, CD8, CD19, CD56, and CD14) and granulocytic functional-related surface antigen markers (CD11b, CD18, CD16b, and CD66b). RESULTS: No significant differences were observed between experimental and control samples in the mean percent of parent for the lymphocyte, monocyte, or granulocyte subpopulations, or in the median fluorescence intensity of particular surface markers expressed on these leucocytes. CONCLUSION: The topical application of nicotinic acid and nonivamide is a possible method to improve capillary blood collection for immunological assessments. The use of these agents may increase the safety and compliance of patients who suffer from needle phobia or are unable to provide venous blood samples.

Comparison of capillary and venous blood in the analysis of concentration and function of leucocyte sub-populations.

PURPOSE: Compare capillary and venous blood in the analysis of concentration and function of leucocyte sub-populations. This study hypothesised that capillary samples may be used in a site-specific manner as an alternative source of blood samples for assays of leucocyte concentration and neutrophilic phagocytic function and reactive oxygen species (ROS) production, allowing acquisition of multiple samples to better monitor transient but significant post-exercise immune modulation. METHODS: Resting blood samples were simultaneously obtained from vein, finger and earlobe of healthy subjects (n = 10, age: 25.1 ± 3.1 years). Leucocyte concentrations were measured using a five-part differential haematological analyser. Leucocyte sub-populations (CD3, CD4, CD8, CD19, CD56, CD14) and granulocytic functional-related (CD11b, CD18, CD16b, CD66b) surface antigen markers, neutrophil phagocytosis (FITC-labelled Escherichia coli) and stimulated ROS production (DHR) were quantified utilizing flow cytometry. A MANOVA (α < 0.05 significance) analysed the effects of the different sampling sites in the concentrations of leucocyte populations, their surface antigen expression and granulocytic functions. RESULTS: Leucocyte concentration and neutrophilic ROS production yielded non-significant differences between sampling sites. Expression of granulocytic surface antigens was increased in both capillary sites compared to venous site (p = 0.008), particularly for adhesion markers CD11b/CD18. The percentage of neutrophils performing phagocytosis was higher in venous samples compared to finger (p = 0.025). Increased number of E. coli ingested was observed in venous sample compared to finger (p = 0.001) and to earlobe (p = 0.006). CONCLUSION: Whilst attention must be paid for varying neutrophilic surface antigen expression and further studies are needed to establish appropriate reference ranges, this study supports the use of capillary blood samples in a site-specific manner to enhance sampling capabilities field-based research.

Heart rate variability profile changes associated with specialist police selection activities: A case study.

BACKGROUND: Police Tactical Groups (PTGs) are specialist police units tasked with rigorous physical and psychosocial duties. Consequently, selection courses (SCs) for service in these units must also be rigorous. Given the intensity of SCs, holistic monitoring for potential overstress may be beneficial. Heart Rate Variability (HRV) is one holistic stress measure that can be obtained in austere environments. OBJECTIVE: The purpose of this study was to profile HRV during a PTG SC. Six (n = 6) qualified male police officers attempted a 36-hour PTG selection course held at an Australian state facility. METHODS: HRV was obtained from Equivitaltrademark EQ02 + LifeMonitor bioharnesses. The selection course consisted of physically demanding events with minimal sleep (approx. 45 mins). Only one candidate completed the full selection course; whose results are reported here. RESULTS: A visual time-series of 384 consecutive 5 min HRV analyses was generated. Contextual analysis was applied to appreciate HRV changes between SC serials. HRV decline occurred during the planning of a navigation exercise and a pack march. Increases in HRV were observed throughout the pack march exercise and rest period. CONCLUSION: This case study demonstrates the potential utility for selection personnel to obtain additional insight into candidate responses to various occupational challenges throughout an SC. Information provided by HRV monitoring may support leadership decisions when evaluating personnel holistically. For example, the ability to continue occupational task execution even while experiencing potential overstress (as measured by HRV) and after food and sleep deprivation is desirable. HRV may potentially inform stakeholders regarding overstress in PTG candidates.

The Use of Musculoskeletal Fitness Measures as Indicators of Performance in Police Occupational Tasks.

Fitness testing is employed by some law enforcement agencies to assure performance in occupational tasks. The aim of this study was to investigate associations between musculoskeletal fitness assessment scores and performance in police occupational tasks. Retrospective data from 106 law enforcement officers who completed five musculoskeletal fitness assessments (vertical jump (VJ), hand grip strength, leg back dynamometer, 1-minute push-ups and sit-ups) and three routine occupational tasks (1.22m fence jump (FJ), 8.5m victim drag (VD) with 101kg and a get-up (GU)) were collected. A standard multiple regression was performed to determine if the results in fitness assessments were predictive of performance in the occupational tasks. Models combining all fitness assessments significantly predicted performance in FJ (F(5,88)=12.228, p<0.001; adjusted R2=0.38), VD (F(5,88)=9.407, p<0.001; adjusted R2=0.31) and GU (F(5,87)=14.319, p<0.001; adjusted R2=0.42). Further analysis of individual predictors highlighted that performance in the VJ test was a significant contributor for all models, uniquely predicting 15% of FJ (p<0.001), 4% of VD (p=0.03) and 8% of GU (p=0.001) performance. Grip strength uniquely contributed 3% to performance in the VD (p=0.05) and performance in the sit-up test contributed 8% to GU performance (p=0.001). Performance in police-specific occupational tasks requires a combination of muscular strength, power, and endurance. These musculoskeletal fitness components should be ideally assessed in recruitment and return-to work practices to ensure officers can safely and optimally perform their occupational requirements.

A profile of occupational tasks performed by mounted police officers.

BACKGROUND: Within individual policing organisations, there are a wide variety of units and job roles. OBJECTIVE: To profile the occupational tasks performed by Australian mounted police officers, aiming to offer conditioning insight into this unique job role. METHODS: Thirteen fully qualified and operational mounted police officers (n = 11 females), who served in the mounted police unit for ∼3.3 (±2.3) years, participated in this observational cohort study. Participants completed a survey outlining common occupational tasks and were monitored throughout four consecutive shifts. Participants' heart rate (HR), respiratory rate (RR), and skin temperature (ST) data were collected via wearable monitoring (Equivital EQ-02, Hidalgo, UK) and body position, physical activity undertaken, task effort, and load carriage were recorded by researchers. A one-way ANOVA was used to assess mean differences in physiological measures between the three most reported tasks. RESULTS: Survey identified 130 tasks, with 38 listed as most common. The three most reported mounted police tasks were: 'horse riding' (n = 13, 34%), 'mounted patrols' (n = 10, 26%), and 'horse care' (n = 10, 26%). These were also reported as the most physically demanding. HR during 'horse care' and 'horse riding' were significantly higher than when 'mounted patrolling' (27±7bpm, p = 0.001 and 33±8bpm; p = 0.001, respectively). Mean RR was higher when 'horse riding' when compared to 'horse care' (5.3±1.6brpm) and 'mounted patrol' (8.5±1.9brpm). CONCLUSION: Mounted police officers experience unique physiological challenges throughout their routine occupational tasks. This study highlights the significance of understanding occupation-specific tasks and stressors undertaken by mounted police to develop relevant conditioning, rehabilitation, and monitoring procedures.

Law enforcement recruit fitness: Changes across the fitness spectrum.

BACKGROUND: Law enforcement is a profession of sedentary physical activity interspersed with physically demanding activity that requires high levels of fitness. It is imperative that agencies training law enforcement recruits maximise their fitness during their time at the academy. OBJECTIVE: The aim of this study was to investigate changes in physical fitness during academy training. METHODS: Retrospective data for 10 academy recruit classes, totalling 715 participants, were collected from a US law enforcement agency. The change in performance on two standardised tests were used as outcome measures. Comparisons were made between percentiles utilising one-way ANOVA and a linear mixed model (LMM). RESULTS: Overall, higher percentiles were found to have smaller improvements in physical fitness than lower percentiles. The results of the LMM support this supposition, showing that lower physical fitness scores resulted in greater improvements in a generalised fitness assessment (value = -0.45, standard error 0.02, p < 0.001) and an occupational assessment (value = -0.49, standard error = 0.02, p < 0.001). CONCLUSION: The results of this study suggest that recruits with lower physical fitness will see greater improvements during academy training. This could be due to a ceiling effect for the more fit but may also be due to recruits of higher physical fitness being under trained during academy. Utilising ability-based training and prescribing an appropriate workload to recruits of higher fitness may improve overall recruit fitness upon graduation.

An Examination of Subjective and Objective Measures of Stress in Tactical Populations: A Scoping Review.

Persons working in tactical occupations are often exposed to high-stress situations. If this stress is to be measured, an understanding of the stress outcomes used in these occupations is needed. The aim of this review was to capture and critically appraise research investigating subjective and objective outcome measures of physiological stress in tactical occupations. Several literature databases (PubMed, EMBASE, EBsco) were searched using key search words and terms. Studies meeting inclusion criteria were critically evaluated and scored by two authors using the Joanne Briggs Institute (JBI) critical appraisal tool. Of 17,171 articles, 42 studies were retained. The Cohen's Kappa agreement between authors was 0.829 with a mean JBI Score of included studies of 8.1/9 ± 0.37 points. Multiple subjective and objective measures were assessed during a variety of high-stress tasks and environments across different occupations, including police officers, emergency service personnel, firefighters, and soldiers in the military. Common objective outcomes measures were heart rate, cortisol, and body temperature, and subjective measures were ratings of perceived exertion, and the Self Trait Anxiety Inventory. Often used in combination (i.e., subjective and objective), these outcome measures can be used to monitor stressors faced by tactical personnel undergoing on-the-job training.

Heart Rate Variability Assessment of Land Navigation and Load Carriage Activities in Specialist Police Selection.

Police tactical group (PTG) personnel are exposed to physical, mental, and emotional stressors. Consequently, PTG selection courses (SCs) impart similar challenges, often resulting in candidate attrition. Holistic assessment may provide additional support to stakeholders given these risks. Heart Rate Variability (HRV) is an objective holistic stress measure that may be applicable in PTG SCs but has not been thoroughly researched. Therefore, this study aimed to report HRV data in an end-user accessible format and determine the relationship between HRV and attrition. A total of 18 qualified Australian State law enforcement officers completed a 1-day physical readiness assessment. Of those, six males progressed to an additional two-day course, on which this study is focused. This two-day selection consisted of additional physical challenges and occupational assessments. HRV was obtained from 2-lead ECGs and defined as the percentage of R-R intervals that varied by ≥50 ms (pRR50). Data were summarized in a heat map of consecutive short-term analyses. Three candidates withdrew. A logistic regression based on heat map data found high HRV was significant for predicting attrition, χ2 (6) = 8.318, p = 0.004. HRV may provide insight for PTG stakeholders monitoring attrition. While the sample size was limited and replication is needed, this study tentatively establishes value for HRV monitoring in PTG SCs.

Occupation-Induced Fatigue and Impacts on Emergency First Responders: A Systematic Review.

Fatigue in emergency first responders (EFRs) is known to affect performance abilities and safety outcomes for both patients and EFRs. The primary aim of this review was to determine the main contributors to occupation-induced fatigue in EFRs and its subsequent impacts. Following the PRIMSA checklist, academic databases (Medline, Embase, CINAHL, and SPORTDiscus) were searched using key terms with results subjected to inclusion and exclusion criteria. Populations of interest were firefighters, paramedics, or emergency call centre personnel. Of the 5633 records identified, 43 studies, which reported on 186 unique measures from a total population of 6373 participants, informed the review. Synthesis revealed fatigue was caused by lack of sleep during the shift and consistent poor sleep quality which negatively impacted cognitive function, alertness, and physical and mental health while increasing safety-compromising behaviours and injuries. Both subjective and objective assessments of fatigue are necessary for effective risk management in EFRs. EFRs that are consistently fatigued are at a greater risk of poor physical and mental health, reduced cognitive function, and increased injuries. No studies reported on fatigue in emergency call centre personnel, highlighting a literature gap. Funding was provided by the Australian Capital Territory Emergency Services Agency. Preregistration was filed in OSF: osf.io/26f3s.

Characterization of Injuries Suffered by Mounted and Non-Mounted Police Officers.

Mounted police officers are subject to unique occupational tasks which may lead to unique injuries. This study's aim was to describe policing injuries suffered by mounted police officers contextualized through comparison to non-mounted officers. Injury data from 01 July 2014 to 30 June 2020 were provided from a state policing agency's incident reporting database. The data reported the numbers and rates of injuries and classified the injuries by gender, cause, mechanism, nature, and hours worked. Of the 35,406 reported injuries, 35,255 (99.6%) injuries were reported by non-mounted police officers. An annual incidence rate of 338-364 and 626-952 injuries per 1000 personnel were reported in non-mounted and mounted police, respectively. For mounted police, the leading causes of injuries were slips, trips, and falls (23.8%), followed by repetitive tasks and movements (9.9%). Physical assault was the leading cause of injury for non-mounted police officers (21.3%), followed by slips, trips, and falls (16.0%). In mounted police, falls from heights (15.9%) and repetitive tasks and movements (10.6%) comprised the most frequently specified mechanisms of injury, as compared to physical assault (21.0%) and physical exercise (5.2%) in non-mounted police. The most common activities being performed at the time of injury for mounted police were animal handling (64.9%) as opposed to arresting an offender (31.2%) for non-mounted police. Sprains and strains and bruises and swelling were the leading natures of injuries among both mounted (44.4% and 29.1%, respectively) and non-mounted (36.6% and 21.2%, respectively) officers. The leading body sites of injury in mounted officers were the lower back (13.9%) and neck and shoulders (7.3% each), and for non-mounted police, the knee (13.9%), lower back (10.0%), and hand (8.2%) were the most common. Mounted police officers sustained injuries through different activities, causes, and mechanisms and to different body sites at 2-3 times higher incidence rates. Mounted police officers warrant specifically tailored injury mitigation and return-to-work strategies.

Exploring participant experience to optimize the design and delivery of stress exposure simulations in emergency medicine.

Objectives: Emergency department (ED) teams frequently perform under conditions of high stress. Stress exposure simulation (SES) is specifically designed to train recognition and management of stress responses under these conditions. Current approaches to design and delivery of SES in emergency medicine are based on principles derived from other contexts and from anecdotal experience. However, the optimal design and delivery of SES in emergency medicine are not known. We aimed to explore participant experience to inform our approach. Methods: We performed an exploratory study in our Australian ED with doctors and nurses participating in SES sessions. We used a three-part framework-sources of stress, the impacts of that stress, and the strategies to mitigate-to inform our SES design and delivery and to guide our exploration of participant experience. Data were collected through a narrative survey and participant interviews and analyzed thematically. Results: There were 23 total participants (doctors n = 12, nurses n = 11) across the three sessions. Sixteen survey responses and eight interview transcripts were analyzed, each with equal numbers of doctors and nurses. Five themes were identified in data analysis: (1) experience of stress, (2) managing stress, (3) design and delivery of SES, (4) learning conversations, and (5) transfer to practice. Conclusions: We suggest that design and delivery of SES should follow health care simulation best practice, with stress adequately induced by authentic clinical scenarios and to avoid trickery or adding extraneous cognitive load. Facilitators leading learning conversations in SES sessions should develop a deep understanding of stress and emotional activation and focus on team-based strategies to mitigate harmful impacts of stress on performance.

Risk factors for injuries in female soldiers: a systematic review.

BACKGROUND: Female soldiers form an integral part of any modern defence force. Previous reports have highlighted that female soldiers report injuries at higher rates than male personnel. One possible reason for this is an actual difference in underlying injury rates, purported to be due to several factors, including levels of fitness. The aim of this review was to determine risk factors for injuries in female soldiers. METHODS: A systematic search was conducted for studies which reported on risk factors for injuries in female soldiers. Databases searched included PUBMED, CINAHL and Medline through OVID. Eligible studies were rated for their methodological quality using the Critical Appraisal Skills Program (CASP) tools and data were extracted and synthesized using a critical narrative approach. RESULTS: A total of 18 articles were included in this review which reported on 18 risk factors for injury. Smoking, previous injury, no history of deployment, heavy occupational tasks, lower levels of aerobic fitness and lower number of push-up repetitions appear to be risk factors for injuries in female soldiers. Age, height, body fat, high or low BMI and body mass do not appear to be consistent risk factors for injury in female soldiers and there appears to be minimal evidence for current levels of activity, sit-up ability, and other assessments of strength, power, speed, or movement being associated with injury risk. Additionally, neither flexibility nor previous levels of activity appear to be associated with injury risk in female soldiers. CONCLUSION: Strategies to improve aerobic fitness and upper limb endurance, reduce smoking, and optimise rehabilitation from injuries and risk management for heavy occupational tasks need to be developed for female soldiers. Such strategies are also likely to reduce risks for male soldiers.

Effects of Acute Stress on Psychophysiology in Armed Tactical Occupations: A Narrative Review.

The ability to perform under extreme pressure is one of the most sought-after qualities in both sports and tactical (military, law enforcement, fire, and rescue, etc.) occupations. While tactical performance relies on both physical and mental capabilities to achieve a desired outcome, it is often hampered by the stressful environments in which these personnel work. The acute stress experienced by tactical personnel can interfere with occupational performance, impacting both physical execution of tasks and decision-making. This narrative review discusses the implications of acute stress on the psychophysiology and physical performance of personnel serving in armed tactical occupations.

Psychological, Physical, and Heat Stress Indicators Prior to and after a 15-Minute Structural Firefighting Task.

Firefighters work in strenuous conditions for prolonged periods wearing up to 20 kg of personal protective equipment. This often contributes to significant heat and cardiovascular strain. This study examined the relationships between psychological and physical measures taken prior to undertaking a 15 min firefighting task, and the occurrence of heat stress and high levels of fatigue following the task. Nine qualified firefighters completed a 15 min "live burn" scenario designed to mimic a fire started by a two-seater couch in a lounge room and completed simulated tasks throughout the duration. Logical reasoning, speed and accuracy, general motivation and fatigue, and physical and mental effort were recorded pre-scenario, and at 0- and 20-min post-scenario. General motivation and fatigue scores at 0- and 20-min post-scenario were highly correlated with each other (rs = 0.90; p = 0.001). The general motivation and fatigue scores, at 0- and 20-min post-scenario, were also strongly related to pre-task logic/reasoning test scores (Post 0 rs = -0.77, p = 0.016; Post 20 rs = -0.87, p = 0.002). Firefighters with lower logical reasoning and speed and accuracy scores were more susceptible to fatigue and impaired cognition when exposed to rises in core temperature and heat stress.