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.

Gamma Radiation-Induced Degradation of Acetohydroxamic Acid (AHA) in Aqueous Nitrate and Nitric Acid Solutions Evaluated by Multiscale Modelling.

Acetohydroxamic acid (AHA) has been proposed for inclusion in advanced, single-cycle, used nuclear fuel reprocessing solvent systems for the reduction and complexation of plutonium and neptunium ions. For this application, a detailed description of the fundamental degradation of AHA in dilute aqueous nitric acid is required. To this end, we present a comprehensive, multiscale computer model for the coupled radiolytic and hydrolytic degradation of AHA in aqueous sodium nitrate and nitric acid solutions. Rate coefficients for the reactions of AHA and hydroxylamine (HA) with the oxidizing nitrate radical were measured for the first time using electron pulse radiolysis and used as inputs for the kinetic model. The computer model results are validated by comparison to experimental data from steady-state gamma ray irradiations, for which the agreement is excellent. The presented model accurately predicts the yields of the major degradation products of AHA: acetic acid, HA, nitrous oxide, and molecular hydrogen.

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.

Using the Edinburgh Visual Gait Score to Compare Ankle-Foot Orthoses, Sensorimotor Orthoses and Barefoot Gait Pattern in Children with Cerebral Palsy.

Gait analysis is one aspect of evaluation in ambulatory children with cerebral palsy (CP). Ankle-foot orthoses (AFOs) improve gait and alignment through providing support. An alternative and under-researched orthosis are sensomotoric orthoses (SMotOs). The Edinburgh Visual Gait Score (EVGS) is a valid observational gait analysis scale to measure gait quality. The aim of this study was to use the EVGS to determine what effect AFOs and SMotOs have on gait in children with CP. The inclusion criteria were: mobilizing children with a CP diagnosis, no surgery in the past six weeks, and currently using SMotOs and AFOs. Eleven participants were videoed walking 5 m (any order) barefoot, in SMotOs and AFOs. Of the participants (age range 3-13 years, mean 5.5 ± 2.9), two were female and six used assistive devices. Seven could walk barefoot. Participants had spastic diplegia (4), spastic quadriplegia (6), and spastic dystonic quadriplegia (1). Gross Motor Functional Classification System (GMFCS) levels ranged I-IV. The total score for SMotOs (7.62) and AFOs (14.18) demonstrated improved gait when wearing SMotOs (no significant differences between barefoot and AFOs). SMotOs may be a viable option to improve gait in this population. Additional study is required but SMotOs may be useful in clinical settings.

Association of sex-related differences in body composition to change of direction speed in police officers while carrying load / Asociación de diferencias relacionadas con el sexo en la composición corporal para cambiar la velocidad de dirección de oficiales de policía durante el transporte de carga

Regardless of sex or body size, police tasks may require officers to change direction speed (CODS) under occupational loads. The purpose of this study was to investigate body composition and CODS in female and male police cadets in both unloaded and occupationally loaded conditions. Body composition and CODS of 51 female (FPC) and 70 male police cadets (MPC) were assessed. Six body composition indices were used: Body mass index (BMI), percent body fat (PBF), percent of skeletal muscle mass (PSMM), protein fat index (PFI), index of hypokinesia (IH), and skeletal muscle mass index (SMMI). The CODS was assessed by Illinois Agility Test (IAT) and IAT while carrying a 10-kg load (LIAT). An independent sample t-test was used to identify the differences between the sexes. The regression determined associations between body composition and LIAT. The alpha level was set at p < 0.05 a priori. MPC had significantly higher (p < 0.001) BMI, PSMM, PFI and SMMI and lower PBF and IH than FPC. MPC were also faster in IAT and LIAT, carrying lower relative loads that imparted less of an impact on CODS performance. Body composition was strongly associated with the time to complete LIAT (R2 = 0.671, p < 0.001). Difference in relative load and body composition influenced CODS performance in both unloaded and loaded conditions. Thus, optimizing body composition through increasing skeletal muscle mass and reducing fat mass could positively influence unloaded and loaded CODS performance and improve elements of police task performance.

El trabajo policial puede requerir que los oficiales cambien la velocidad de dirección (CVD) bajo cargas ocupacionales, indistintamente del sexo o tamaño corporal. El propósito de este estudio fue investigar la composición corporal y los CVD en cadetes de policía de ambos sexos, tanto en condiciones de descarga como de trabajo. Se evaluaron la composición corporal y los CVD de 51 mujeres (CPF) y 70 cadetes de policía masculinos (CPM). Se utilizaron seis índices de composición corporal: índice de masa corporal (IMC), porcentaje de grasa corporal (PGC), porcentaje de masa muscular esquelética (PMME), índice de grasa proteica (IGP), índice de hipocinesia (IH) e índice de masa muscular esquelética (IMME). El CVD fue evaluado por Illinois Agility Test (IAT) y IAT mientras transportaba una carga de 10 kg (LIAT). Se usó una prueba t de muestra independiente para identificar las diferencias entre los sexos. La regresión determinó asociaciones entre la composición corporal y LIAT. El nivel alfa se estableció en p <0,05 a priori. CPM registraron un IMC, PMME, PGC y IMME significativamente más altos (p <0,001) y PGC e IH más bajos que las mujeres (CPF). Los CPM también fueron más rápidos en IAT y LIAT, llevando cargas más bajas, las que tuvieron un impacto menor en el rendimiento de CVD. La composición corporal estaba asociada con el tiempo para completar LIAT (R2 = 0,671, p <0,001). La diferencia en la carga relativa y la composición corporal influyeron en el rendimiento de CVD tanto en condiciones descargadas como cargadas. Por lo tanto, la optimización de la composición corporal a través del aumento de la masa del músculo esquelético, y la reducción de la masa grasa podrían influir de manera positiva en el rendimiento de CVD descargados y cargados, mejorando el rendimiento del trabajo policial.

Functional Movement Screen (FMS™) Scores and Demographics of US Army Pre-Ranger Candidates.

INTRODUCTION: The United States Army Rangers are a unique population whose training requirements are intensive, and physically and mentally demanding. The Functional Movement Screen (FMS) is a movement screening tool designed to assess movement quality and asymmetries in movement with the potential to identify injury risk. This study was a descriptive, cross-sectional investigation examining associations between FMS scores and the various measures of health and performance of active duty soldiers in light infantry units who were involved in the U.S. Army Pre-Ranger Course (PRC). MATERIALS AND METHODS: Before the PRC, 491 male soldiers (mean age = 24.0 ± 3.8 years; mean height = 176.6 ± 7.2 cm; mean body mass = 80.2 ± 9.8 kg) completed a questionnaire which included items on self-assessed physical fitness, last Army physical fitness test (APFT) score, tobacco use, and injury history. The soldiers then completed the FMS, which consisted of seven movements and three clearing tests. From the FMS results, a determination of asymmetries (i.e., differences in FMS scores between the right and left side of the body) was made. Differences between groups were analyzed via an independent sample t-test, a one-way analysis of variance, or a chi-square as appropriate. Significance was set at 0.05 a priori. RESULTS: The average composite FMS score was 16.4 (±1.9) points. Soldiers reporting ≥290 APFT points achieved a higher FMS score than those reporting lower APFT scores (16.5 ± 2.0 vs 16.1 ± 2.0 points, P = 0.03). Soldiers reporting either tobacco use or a previous musculoskeletal injury had lower FMS scores than those not reporting these (tobacco: 16.1 ± 2.1 vs 16.5 ± 1.8 points, P = 0.02; injury: 16.0 ± 2.2 vs 16.6 ± 1.8 points, P < 0.01). FMS asymmetries were not related to APFT scores, tobacco use, or self-rated fitness. As self-rated fitness increased so did APFT scores. CONCLUSIONS: Active duty soldiers of a light infantry division achieved FMS scores similar to other military populations tested, and the composite FMS score was related to higher APFT scores, absence of tobacco use, and absence of previous musculoskeletal injuries. Improving PRC candidate healthy habits through highlighting the negative associations between poorer fitness, cigarette tobacco use and movement quality, may reduce injury risk and increase PRC completion potential.

Thermal Processing of Chloride-Contaminated Plutonium Dioxide.

Over 80 heat treatment experiments have been made on samples of chloride-contaminated plutonium dioxide retrieved from two packages in storage at Sellafield. These packages dated from 1974 and 1980 and were produced in a batch process by conversion of plutonium oxalate in a furnace at around 550 °C. The storage package contained a poly(vinyl chloride) (PVC) bag between the screw top inner and outer metal cans. Degradation of the PVC has led to adsorption of hydrogen chloride together with other atmospheric gases onto the PuO2 surface. Analysis by caustic leaching and ion chromatography gave chloride contents of ∼2000 to >5000 ppm Cl (i.e., µgCl g-1 of the original sample). Although there are some subtle differences, in general, there is surprisingly good agreement in results from heat treatment experiments for all the samples from both cans. Mass loss on heating (LOH) plateaus at nearly 3 wt % above 700 °C, although samples that were long stored under an air atmosphere or preexposed to 95% relative humidity atmospheres, gave higher LOH up to ∼4 wt %. The majority of the mass loss is due to adsorbed water and other atmospheric gases rather than chloride. Heating volatilizes chloride only above ∼400 °C implying that simple physisorption of HCl is not the main cause of contamination. Interestingly, above 700 °C, >100% of the initial leachable chloride can be volatilized. Surface (leachable) chloride decreases quickly with heat treatment temperatures up to ∼600 °C but only slowly above this temperature. Storage in air atmosphere post-heat treatment apparently leads to a reequilibration as leachable chloride increases. The presence of a "nonleachable" form of chloride was thus inferred and subsequently confirmed in PuO2 samples (pre- and post-heat treatment) that were fully dissolved and analyzed for the total chloride inventory. Reheating samples in either air or argon at temperatures up to the first heat treatment temperature did not volatilize significant amounts of additional chloride. With regard to a thermal stabilization process, heat treatment in flowing air at 800 °C with cooling and packaging under dry argon appears optimal, particularly, if thinner powder beds can be maintained. From electron microscopy, heat treatment appeared to have the most effect on degrading the square platelet particles compared to those with the trapezoidal morphology.

Use of human body morphology as an indication of physical fitness: implications for police officers / Uso de la morfología del cuerpo humano como una indicación de la condición física: implicancias en oficiales de policía

Research with police officers (POs) suggests an association between body composition, physical performance and health. The aim of the study was to investigate the associations between body composition and measures of physical fitness, and their use to predict estimated physical fitness score (EPFS). The sample included 163 male POs (age = 31.61 ± 4.79 years, height = 172.97 ± 6.09 cm, body mass = 77.53 ± 11.66 kg). Eight body composition variables: body mass index (BMI), body fat mass index (BFMI), percent of body fat (PBF), percent skeletal muscle mass (PSMM), index of hypokinezia (IH), skeletal muscle mass index (SMMI), protein mass index (PMI), and fat-free mass index (FFMI); and four physical fitness measures: a 3.2 km run, a 2-minute push-up, 2-minute sit-up and estimated physical fitness score (EPFS) were correlated, followed by the regression analysis for causal relationship between body composition and EPFS. Running 3.2 km test correlated to BMI, PBF, PSMM, BFMI, and SMMI (r = 0.274, 0.250, -0.234, 0.311, p<0.01, respectively); 2-minute push-up correlated to PBF, PSMM, BFMI, SMMI, PMI, IH, and FFMI (r = -0.413, 0.436, -0.375, 0.221, 0.231, -0.411, 0.261, p<0.01, respectively); 2-minute sit-up correlated to PBF, PSMM, BFMI, and IH (r = -0.237, 0.250, -0.236, -0.218, p<0.01, respectively); and EPFS correlated to BMI, FFMI, PBF, PSMM, BFMI, and IH (r = -0.200, 0.168, p<0.05, and r = -0.369, 0.378, 0.376, -0.317, p <0.01, respectively). Two models of predictions were extracted: 1) PBF, BFMI, PMI and FFMI (R2 = 0.250, p<0.001); 2) PBF, BFMI and PMI (R2 = 0.244, p<0.001). Obtained prediction models may be a promising screening method of a POs' fitness, when conducting the physical tests is not possible or safe (obese and injured POs or bad weather conditions).

En este trabajo realizado con oficiales de policía (OP) se sugiere una asociación entre la composición corporal y el rendimiento físico y la salud. El objetivo del estudio fue investigar las asociaciones entre la composición corporal y las medidas de aptitud física, y su uso para predecir el puntaje de aptitud física estimado (PAFE). La muestra incluyó 163 OP masculinos (edad = 31,61 ± 4,79 años, altura = 172,97 ± 6,09 cm, masa corporal = 77,53 ± 11,66 kg). Se analizaron ocho variables de composición corporal: índice de masa corporal (IMC), índice de masa corporal grasa (IMCG), porcentaje de grasa corporal (PGC), porcentaje de masa muscular esquelética (PMME), índice de hipoquinezia (IH), índice de masa muscular esquelética (IMME), índice de masa proteica (IMP) e índice de masa libre de grasa (IMLG); y cuatro medidas de aptitud física: se correlacionaron una carrera de 3,2 km, una elevación de 2 minutos, una postura de 2 minutos y un puntaje de aptitud física estimada (PAFE), seguido del análisis de regresión para la relación causal entre la composición corporal y el PAFE. La prueba de ejecución de 3,2 km se correlacionó con el IMC, PGC, PMME, IMCG y IMME (r = 0,274, 0,250, -0,234, 0,311, p <0,01, respectivamente); Push-up de 2 minutos correlacionado con PGC, PMME, IMCG, IMME, PMI, IH y IMLG (r = -0,413, 0,436, -0,375, 0,221, 0,231, 0,411, 0,261, p <0,01, respectivamente); Sit-up de 2 minutos correlacionado con PGC, PMME, IMCG e IH (r = -0,237, 0,250, 0,236, -0,218, p <0,01, respectivamente); y EPFS correlacionado con IMC, IMLG, PGC , PMME, IGMC e IH (r = -0,200, 0,168, p <0,05, y r = -0,369, 0,378, 0,376, -0,317, p <0,01, respectivamente). Se extrajeron dos modelos de predicción: 1) PGC, IGMC, IMP y IMLG (R2 = 0,250, p <0,001); 2) PGC, IGMC y IMP (R2 = 0,244, p <0,00). Los modelos de predicción obtenidos pueden ser un método prometedor de detección de la condición física de los OP, cuando no es posible o seguro realizar las pruebas físicas (OP obesos y lesionados o condiciones climáticas adversas).

Molecular Hydrogen Yields from the α-Self-Radiolysis of Nitric Acid Solutions Containing Plutonium or Americium.

The yield of molecular hydrogen, as a function of nitric acid concentration, from the α-radiolysis of aerated nitric acid and its mixtures with sulfuric acid containing plutonium or americium has been investigated. Comparison of experimental measurements with predictions of a Monte Carlo radiation track chemistry model shows that, in addition to scavenging of the hydrated electron, its precursor, and the hydrogen atom, the quenching of excited state water is important in controlling the yield of molecular hydrogen. In addition, increases in solution acidity cause a significant change in the track reactions, which can be explained as resulting from scavenging of eaq- by Haq+ to form H•. Although plutonium has been shown to be an effective scavenger of precursors of molecular hydrogen below 0.1 mol dm-3 nitrate, previously reported effects of plutonium on G(H2)α between 1 and 10 mol dm-3 nitric acid were not reproduced. Modeling results suggest that plutonium is unlikely to effectively compete with nitrate ions in scavenging the precursors of molecular hydrogen at higher nitric acid concentrations, and this was confirmed by comparing molecular hydrogen yields from plutonium solutions with those from americium solutions. Finally, comparison between radionuclide, ion accelerator experiments, and model predictions leads to the conclusion that the high dose rate of accelerator studies does not significantly affect the measured molecular hydrogen yield. These reactions provide insight into the important processes for liquors common in the reprocessing of spent nuclear fuel and the storage of highly radioactive liquid waste prior to vitrification.

Load Carriage-Related Paresthesias (Part 2): Meralgia Paresthetica.

This is the second of a two-part series addressing symptoms, evaluation, and treatment of load carriage- related paresthesias. Part 1 addressed rucksack palsy and digitalgia paresthetica; here, meralgia paresthetica (MP) is discussed. MP is a mononeuropathy involving the lateral femoral cutaneous nerve (LFCN). MP has been reported in load carriage situations where the LFCN was compressed by rucksack hipbelts, pistol belts, parachute harnesses, and body armor. In the US military, the rate of MP is 6.2 cases/10,000 personyears. Military Servicewomen have higher rates than Servicemen, and rates increase with age, longer loadcarriage distance or duration, and higher body mass index. Patients typically present with pain, itching, and paresthesia on the anterolateral aspect of the thigh. There are no motor impairments or muscle weakness, because the LFCN is entirely sensory. Symptoms may be present on standing and/or walking, and may be relieved by adopting other postures. Clinical tests to evaluate MP include the pelvic compression test, the femoral nerve neurodynamic test, and nerve blocks using lidocaine or procaine. In cases where these clinical tests do not confirm the diagnosis, specialized tests might be considered, including somatosensory evoked potentials, sensory nerve conduction studies, high-resolution ultrasound, and magnetic resonance imaging. Treatment should initially be conservative. Options include identifying and removing the compression if it is external, nonsteroidal inflammatory medication, manual therapy, and/or topical treatment with capsaicin cream. Treatments for intractable cases include injection of corticosteroids or local anesthetics, pulsed radiofrequency, electroacupuncture, and surgery. Military medical care providers may see cases of MP, especially if they are involved with units that perform regular operations involving load carriage.

Plutonium and Americium Alpha Radiolysis of Nitric Acid Solutions.

The yield of HNO2, as a function of absorbed dose and HNO3 concentration, from the α-radiolysis of aerated HNO3 solutions containing plutonium or americium has been investigated. There are significant differences in the yields measured from solutions of the two different radionuclides. For 0.1 mol dm-3 HNO3 solutions, the radiolytic yield of HNO2 produced by americium α-decay is below the detection limit, whereas for plutonium α-decay the yield is considerably greater than that found previously for γ-radiolysis. The differences between the solutions of the two radionuclides are a consequence of redox reactions involving plutonium and the products of aqueous HNO3 radiolysis, in particular H2O2 and HNO2 and its precursors. This radiation chemical behavior is HNO3 concentration dependent with the differences between plutonium and americium α-radiolysis decreasing with increasing HNO3 concentration. This change may be interpreted as a combination of α-radiolysis direct effects and acidity influencing the plutonium oxidation state distribution, which in turn affects the radiation chemistry of the system.

Dietary acculturation and health-related issues of Indian immigrant families in Newfoundland.

Traditional Indian diets are high in grains, vegetables and fruits, and in this respect are substantially in accord with Canada s Food Guide to Healthy Eating. Adopting North American eating patterns carries potential health risks. In this study we explored migration-associated changes in eating patterns, lifestyle practices, and health-related issues of Indian immigrants and their families in Newfoundland. A cross-sectional survey employing a self-administered mailed questionnaire was conducted. A random sample of 132 subjects aged ten to 65+ took part. Participants were well established in Newfoundland and almost all were fluent in English. They were somewhat acculturated to foods commonly eaten in Canada. The majority reported that they were very or somewhat likely to engage in healthy lifestyle practices, and most (73%) wanted more relevant nutrition information. Consumption of grains, vegetables, and fruits was not in accordance with Canada s Food Guide to Healthy Eating. Sixty-five percent of participants reported that traditional Indian foods were not readily available, and 72% indicated a change in food-preparation methods. Studies of diverse ethnic groups are needed to guide effective nutrition education programs. University curricula and dietetic training programs should include cross-cultural courses to increase awareness of immigrants unique needs.