Work - Volume 77, issue 4

Authors: Jacobs, Karen

Article Type: Editorial

DOI: 10.3233/WOR-246005

Citation: Work, vol. 77, no. 4, pp. 1047-1048, 2024

Authors: Raei, Mehdi | Shahrbaf, Mohammad Amin | Salaree, Mohammad Mehdi | Yaghoubi, Maryam | Parandeh, Akram

Article Type: Research Article

Abstract: BACKGROUND: Occupational burnout is one of the most important consequences of the coronavirus disease pandemic, associated with psychological well-being, quality of care, and intention to leave the nursing profession. This is a major health problem with serious adverse consequences not only for nurses but also for patients and healthcare systems. OBJECTIVE: To assess burnout and its associated factors in nurses who worked in teaching hospitals during the COVID-19 pandemic in Iran. METHODS: A cross-sectional study was conducted on nurses of two COVID-19 referral hospitals in Tehran, Iran. Data were collected using the sociodemographic form and Maslach …burnout inventory-human service survey (MBI-HSS) questionnaire. Data were evaluated using SPSS software version 26. RESULTS: A total of 264 participants, 52.7% (n  = 139) were males and the mean of them age was 34.41±9.71 years. Almost 50% of nurses experienced burnout, in each dimension. Emotional exhaustion was associated significantly with job retention intention (P  = 0.01) and depersonalization was significantly associated with gender (P  = 0.02), age (P  = 0.01), educational level (P  = 0.004), work shifts (P  = 0.006), and job retention intention (P  = 0.02). In addition, personal accomplishment score was significantly associated with age (P  = 0.002), marital status (P  = 0.03), educational level (P  = 0.03), work shift (P  = 0.04) and job retention intention (P  = 0.01). CONCLUSION: The burnout rate in the COVID-19 era is high among nurses associated with improper care. Psychosocial support is needed to improve mental well-being among health care workers during unpredictable conditions like pandemics. Show more

Keywords: Burnout, psychological, professional, COVID-19, nurses, prevalence

DOI: 10.3233/WOR-220001

Citation: Work, vol. 77, no. 4, pp. 1049-1057, 2024

Authors: Ma, Lijun | Wang, Huixue | Zhang, Mi | Zu, Zhenyue | Yang, Linxi | Chen, Fenglan | Wei , Wenzhuo | Li, Xiaoming

Article Type: Research Article

Abstract: BACKGROUND: Since the outbreak of the COVID-19 pandemic, university students have been exposed to a heightened vulnerability towards developing psychological issues, such as psychological distress and shyness. Internet-based interventions offer a convenient avenue for scalability, thus prompting the development of a smartphone-based hypnotic intervention aimed at addressing shyness among university students. OBJECTIVE: We devised an innovative smartphone-based hypnotic intervention called mHypnosis to examine its impact on shyness among undergraduate students. Furthermore, we aimed to investigate whether the apprehension of negative evaluations before treatment could serve as a predictor for the effectiveness of the intervention on shyness. …METHODS: Eighty students with high shyness scores were randomly assigned to the experimental group and the control group. Another 40 participants with low shyness score were selected as the baseline group. The Shyness Scale (SS), Fear of Negative evaluation scale (FNE), Self-Acceptance Questionnaire (SAQ), and Self-Esteem Scale (SES) were used to evaluate the effect of hypnotic intervention. RESULTS: Before the intervention, the scores of the experimental and control groups on the SS, FNE, SAQ, and SES were higher than those in the baseline group (p  < 0.05). There was no significant difference in scores between the experimental and control group (p  > 0.05 ). After the intervention, the scores of the SS, FNE, SAQ, and SES were significantly lower in the experimental group than those in the control group (p  < 0.05). The pretest score of FNE could predict the shyness score after hypnotic intervention (B  = 0.35, p  < 0.05). CONCLUSION: Smartphone-based hypnotic intervention had a significant effect on ameliorating shyness during the COVID-19 pandemic; fear of negative evaluation can be a target for treating shyness. Show more

Keywords: COVID-19, hypnotherapy, randomized controlled trial, shyness mind, smartphone app, university student

DOI: 10.3233/WOR-220686

Citation: Work, vol. 77, no. 4, pp. 1059-1069, 2024

Authors: Gisour, Bita Bagheri | Ghayour Najafabadi, Mahboubeh | Zandi, Hassan Gharayagh | Shaw, Ina

Article Type: Article Commentary

Abstract: BACKGROUND: The use of teleconsultation platforms enabling health professionals to provide advice especially in the new normal post COVID-19 situation has increased in both developing and developed countries. This teleconsultation has also expanded beyond that of post COVID-19 application to other purposes such as in the treatment of musculoskeletal pain. OBJECTIVE: The purpose of this commentary is to focus on presenting a feasible guide related to physical as well as psychological aspects in relation to computer based workers that could be taught to the computer-based workers using teleconsultation platforms. METHODS: A multi-criteria search was performed among …available guidelines and approaches related to the physical and psychological aspects used for computer-based workers. RESULTS: A continuation of musculoskeletal pain creates a feedforward loop of pain and distress. Several conventional methods exist to manage musculoskeletal pain, however, the new normal situation following COVID-19 has rendered many of these moot, especially in computer based workers and with the increased reliance on teleconsultation platforms. CONCLUSIONS: During the COVID-19 pandemic, individuals were required to stay home due to varying levels of lockdown protocols and provide their usual services using online platforms both increasing sedentary behaviour in computer based workers and limiting the tools available to health professionals. Following in what is now the worldwide new normal post COVID-19 situation, individuals have adapted and accepted that they receive much of their necessary health advice using teleconsultation platforms as well. Show more

Keywords: Teleconsultation, telehealth, computer based workers, musculoskeletal disorders

DOI: 10.3233/WOR-230033

Citation: Work, vol. 77, no. 4, pp. 1071-1074, 2024

Authors: Hassan, Imad Salah | Elamin, Mohammed Elfatih Mohammed | Awad, Ahmed Hani Mubarak | Abdelgadir, Mukhtar Mohamedsalih Mukhtar | Ahmed, Mustafa Awadalla Ibrahim | Ayyad, Fatima Abdalrahman Adam Ali | Salih, Khadija Bushra Salim | Ishag, Rayan Mohammed Abdullah

Article Type: Research Article

Abstract: BACKGROUND: Employee disengagement in healthcare and business is currently at unexceptionally high levels worldwide. Disengagement negatively impacts productivity, profitability, efficiency (waste reduction), innovation, quality, customer satisfaction and experience, staff well-being, safety, mortality, staff attendance, and turnover. Despite its serious detrimental impacts, no dedicated competency-based training curriculum exists for engagement as a competency. OBJECTIVE: To develop a competency-based educational curriculum for an Engagement Competency. METHODS: A curricular roadmap comprising the following steps was observed 1. Identifying the desired outcomes needed of trainees. These must help fulfill all the Q12 Gallup survey engagement items. 2. Explicitly defining the …required Competencies, Entrustable Professional Activities, and Milestones, 3. Selecting the educational activities, and instructional methods, 4. Selecting the tools to assess progress along the milestones, and finally, 5. Designing an evaluation system to assess the outcomes of the engagement competency program. RESULTS: We developed an Engagement Competency Framework with 7 Entrustable Professional activities “rationally and practically” arranged. These are: Envision E1, Embrace E2, Empower E3, Enlighten E4, Empathize E5, Energize E6, and Evaluate E7 (the 7Es). CONCLUSION: The unfortunate global issue of disengagement in healthcare and in the business arena may be practically tackled by introducing Engagement Competency and training. It should be compulsory for all in the “leadership role". Such training may lead to remarkable performance improvement and a happier, more prosperous, and safer world. Show more

Keywords: Competency-based education, organizational change management, leadership

DOI: 10.3233/WOR-230215

Citation: Work, vol. 77, no. 4, pp. 1075-1087, 2024

Authors: Mutlu, Caner | Birinci, Tansu | Senel, Aybike | Mustafaoglu, Rustem | Bulanık Koc, Esra | Karacetin, Gul | Kaya Mutlu, Ebru

Article Type: Research Article

Abstract: BACKGROUND: Internet gaming disorder (IGD) leads to social disturbances and isolation, neglect of daily responsibilities, behavioral disorders, and physical impairments. OBJECTIVE: This study aimed to investigate the effect of IGD on spine biomechanics, range of motion in the neck and low back, and lung functions and respiratory muscle strength in children and adolescents. METHODS: Sixty-four children and adolescents with IGD (Group I) and 41 healthy controls (Group II) were included in the study. The outcomes were assessed with the Visual Analogue Scale (VAS), Internet Addiction Scale, active range of motion (AROM) in the neck and lumbar …spine, posture and spinal alignment, lung function tests, and respiratory muscle strength. RESULTS: There is a significant difference in pain intensity at rest, during activity, and daily sitting time between groups (p  < 0.05). Craniovertebral angle, shoulder asymmetry, thoracic kyphosis angle, cervical extension and rotation, and right lumbar rotation significantly decreased in Group I than in Group II (p  < 0.05). Besides, the PEF, FEF 25–75%, and respiratory muscle strength were lower in Group I than in Group II (p  < 0.05). With a multiple linear regression model, MEP, FEV1, and weekly time spent playing online games were significant predictors of internet addiction intensity (R 2  = 0.28; p  = 0.02, p  = 0.01, and p  < 0.001, respectively). CONCLUSION: Postural misalignment and increased sedentary time cause physical health deterioration and negatively affect lung functions in children and adolescents with IGD. Consequently, considering both psychological and physical health is necessary to assess the problematic nature of internet gaming. A comprehensive assessment and multidisciplinary team approach is essential to managing the IGD. Show more

Keywords: Biomechanics, posture, lung function tests, spine, internet addiction disorder, child psychiatry

DOI: 10.3233/WOR-220652

Citation: Work, vol. 77, no. 4, pp. 1089-1099, 2024

Authors: Modise, Gofaone Lady | Uys, Kitty | Masenge, Andries | du Plooy, Eileen

Article Type: Research Article

Abstract: BACKGROUND: The Motor Vehicle Accident (MVA) Fund Botswana compensates claimants who lose their incomes due to road traffic accidents. In Botswana, road traffic accidents are becoming more frequent, and the MVA Fund is experiencing escalating claims. We describe the demographic characteristics of loss of income (LOI) claimants of the MVA Fund Botswana. We assess whether demographic characteristics are related to return to work (RTW). OBJECTIVE: We retrospectively reviewed records of MVA Fund claimants and extracted demographic information. We investigated the demographic profile and the relationship between demographic information and RTW. METHODS: We reviewed …432 LOI claims received by MVA Fund from January 1, 2015 to December 31, 2020. We descriptively analysed the demographic profiles of claimants. We used a univariate analysis and multivariate logistic regression to determine the association between independent demographic variables and the dependent variable, RTW. RESULTS: MVA Fund claimants were on average 37-years-old. Claimants were mostly from low-income socio-economic backgrounds. RTW was significantly associated with injury severity, type of injury, and having a RTW plan offer. The final predictors of RTW, using logistic regression, were time away from work and severity of injury. CONCLUSION: In Botswana, claimants who had severe injuries and who stayed away from work for longer were less likely to RTW. The MVA Fund Botswana must recognise the demographic profiles of claimants which are likely to influence RTW. Show more

Keywords: Return to work, insurance claims, administrative claims, case management, traumatic injuries, absenteeism

DOI: 10.3233/WOR-220712

Citation: Work, vol. 77, no. 4, pp. 1101-1114, 2024

Authors: Alwadeai, Khalid S.

Article Type: Research Article

Abstract: BACKGROUND: Although several studies have found a link between parental or workplace smoking and asthma risk, particularly in children and adolescents, only a few studies have found this link in adults. OBJECTIVE: This study aimed to investigate the associations of sociodemographic factors, health behavior, and parental or workplace smoking with adult asthma risk in the United States (US). METHODS: A secondary data analysis on 874 participants aged 25–45 was performed using data from the 2011–2014 National Survey of Midlife Development in the United States Refresher. Participants were divided into smokers and nonsmokers. Participants were further divided …into groups A (a father or mother with a smoking history) and B (others in the house or colleagues in the workplace who had a smoking history). RESULTS: Findings from the FREQ procedure revealed that sociodemographic (female, black, school or college education, unmarried/divorced, and employed) and lifestyle (no alcohol intake, physically inactive, and obese) and clinical (diabetes and joint disease) factors were significantly associated with one- or more-fold odds of asthma among adult smokers than nonsmokers. Adult smokers in group A, particularly females, those with a high school or college education, physically inactive, and overweight or obese, had a higher risk of asthma than those in group B. CONCLUSION: Adult smokers’ risk of developing asthma is increased in the US by having smoked with their parents, being a woman, being black, having a school or college education, being single or divorced, working, not drinking alcohol, being physically inactive, being obese, having diabetes, and having a joint disease. Show more

Keywords: Asthma, parental smoking, workplace smoking, sociodemographic, health behavior, rehabilitation

DOI: 10.3233/WOR-230026

Citation: Work, vol. 77, no. 4, pp. 1115-1124, 2024

Authors: Udin, Udin

Article Type: Research Article

Abstract: BACKGROUND: Transformational leadership and organizational learning culture have become exciting topics to be explored over the last few decades. However, several previous studies have shown certain inconclusive findings regarding the link between transformational leadership and organizational learning culture. OBJECTIVE: This study fills this gap by developing a clear model and aims to examine the extent of the impact of (1) transformational leadership on organizational learning culture and intrinsic work motivation, (2) intrinsic work motivation on organizational learning culture, (3) intrinsic work motivation in mediating and moderating the relationship between transformational leadership and organizational learning culture. METHODS: …The data of this study are collected from employees working at the community health center in Indonesia. A partial least squares (PLS) based structural equation modeling (SEM) technique is used to analyze the data by utilizing the SmartPLS 3.0 software package. RESULTS: First, the results concluded that transformational leadership has a significant impact on organizational learning culture and intrinsic work motivation. Second, intrinsic work motivation has a significant impact on organizational learning culture. Third, intrinsic work motivation fully mediates the relationship between transformational leadership and organizational learning culture. Also, intrinsic work motivation moderates these variables’ relationships. CONCLUSION: The theoretical model of previous research on the relationship between transformational leadership and organizational learning culture with intrinsic work motivation as a mediator and moderator variable has yet to be fully developed both in public and private organizations, particularly in the health sector. Show more

Keywords: Transformational leadership, employee, community health center, PLS-SEM

DOI: 10.3233/WOR-230047

Citation: Work, vol. 77, no. 4, pp. 1125-1134, 2024

Authors: Hrehová, Laura | Bušková, Jitka | Seifert, Bohumil | Mezian, Kamal

Article Type: Research Article

Abstract: BACKGROUND: Sleep hygiene habits and self-reported sleep quality of those who work from home have yet to be fully understood. As working from home was widely implemented during the COVID-19 pandemic, the period might be a convenient model for studying the measures, as mentioned earlier. OBJECTIVE: This study aimed to assess sleep hygiene habits and self-reported sleep quality in people working from home in March 2020, when the COVID-19 pandemic began. METHOD: This study was designed as a cross-sectional web-based survey. An anonymous questionnaire consisted of sociodemographic variables and questions about personal habits, e.g., exercise activities …and caffeine consumption. The outcome measures to assess sleep hygiene and sleep quality were the Sleep Hygiene Index (SHI) before and after the home office (HO) and the Pittsburgh Sleep Quality Index (PSQI). RESULTS: A total of 204 responses were received. The prevalence of significant sleep disturbance (PSQI > 5) was 51 %. The mean PSQI and SHI scores were 6.15±3.385 and 17.67±7.836, respectively. PSQI and SHI showed a significant mutual positive correlation at the level of significance p  < 0.001. The total score for SHI was similar before and after working from home (p  = 0.982). However, differences were observed in its components. CONCLUSION: The total score on SHI did not change when compared before and during HO. However, working from home was associated with sleep hygiene malpractice in some individual components of SHI. On the other hand, some aspects of sleep hygiene behavior improved during HO. Show more

Keywords: Insomnia, home office, sleep hygiene index, PSQI, Pittsburgh sleep quality index

DOI: 10.3233/WOR-230074

Citation: Work, vol. 77, no. 4, pp. 1135-1142, 2024

Authors: Beltrán, Sol Patricia | Batista, Gabriel de Amorim | dos Passos, Muana Hiandra Pereira | da Silva, Hitalo Andrade | Locks, Francisco | Cappato de Araújo, Rodrigo

Article Type: Research Article

Abstract: BACKGROUND: Shoulder pain affects millions of workers worldwide and is considered one of the leading causes of absenteeism and presenteeism. Therefore, using exercises in the work environment emerges as a strategy to prevent or reduce shoulder pain. OBJECTIVE: The objective of this study was to evaluate the effects of a workplace-based exercise program on shoulder pain and function in fruit workers. METHODS: This was an 8-week parallel two-arm randomized controlled trial. Forty-four fruit workers who reported chronic shoulder pain were randomized to an Experimental Group (EG) or Control Group (CG). The EG was submitted to a …program of resistance and stretching exercises for eight weeks, twice a week. The CG received a booklet with muscle stretching and mobility exercises. The primary outcome was shoulder pain intensity; the secondary outcomes were Shoulder Pain and Disability Index (SPADI) and perceived global effect. RESULTS: Both groups showed reductions in pain intensity EG: 4.26 (95% CI 2.78–5.74) and CG: 3.74 (95% CI 1.98–5.50) points. The SPADI results showed an average reduction of 17.76 (CI 95% 3.10–32.43) for the EG and 18.39 (CI 95% 3.66–33.13) for the CG. The mean value of the perceived global effect for the CG was 3.45±2.01, and for the EG, the mean was 4.13±1.24. No differences were observed between groups in any outcome analyzed. CONCLUSION: Both groups showed significant changes in the analyzed outcomes. However, the workplace-based exercise program was not superior to the exercise booklet. Show more

Keywords: Shoulder pain, occupational health, agricultural workers’ diseases, workplace, controlled clinical trial, exercise therapy, resistance training

DOI: 10.3233/WOR-230085

Citation: Work, vol. 77, no. 4, pp. 1143-1151, 2024

Authors: Poh, Jess Xiu Yi | Chan, Kuang Hong | Tan, Samantha Si Li | Xu, Tianma

Article Type: Research Article

Abstract: BACKGROUND: Occupational therapists (OT) assess and prescribe assistive devices to older adults with limitations in performing daily living activities. Timely prescription of assistive devices to accommodate the rising demand has been affected by the COVID-19 pandemic. Tele-assessment allows for continuity of care, but its success depends on therapists’ acceptance. OBJECTIVE: This study examined OTs’ perceptions of the feasibility of conducting tele-assessment and developing a clinical practice guideline for remote prescription of assistive devices for older adults in Singapore. METHODS: Eligible OTs were recruited from purposive sampling. Semi-structured interviews were conducted via a virtual platform (Zoom). Audio …recordings were transcribed verbatim. Inductive thematic analysis using a line-by-line coding method was used to identify common trends. RESULTS: Interviews with 10 participants revealed three main themes: (1) therapists’ perceptions of the feasibility of tele-assessment, (2) criteria for safe and appropriate prescription of assistive devices via tele-assessment, and (3) practical considerations for the implementation of tele-assessment. Participants felt that tele-assessment increases efficiency with more older adults being more receptive towards technology. They also raised suggestions to address OTs’ concerns regarding the safety and accuracy prescription of assistive devices following tele-assessment. This included establishing the client’s suitability for assistive device prescription, characteristics of assistive devices, resources required, and considering the preferences of stakeholders involved. CONCLUSION: Tele-assessment for assistive device prescription by OTs appears feasible in Singapore. OTs should consider collaborating with other stakeholders to develop a tele-assessment clinical practice guideline for assistive device prescription. Further studies testing its clinical effectiveness during and/or post-pandemic are warranted. Show more

Keywords: Feasibility study, occupational therapy, telehealth, remote consultation, needs assessment, prescriptions, assistive devices, qualitative research

DOI: 10.3233/WOR-230168

Citation: Work, vol. 77, no. 4, pp. 1153-1163, 2024

Authors: Khanehshenas, Farin | Mazloumi, Adel | Nahvi, Ali | Nickabadi, Ahmad | Sadeghniiat, Khosro | Rahimiforoushani, Abbas | Aghamalizadeh, Alireza

Article Type: Research Article

Abstract: BACKGROUND: Numerous systems for detecting driver drowsiness have been developed; however, these systems have not yet been widely used in real-time. OBJECTIVE: The purpose of this study was to investigate at the feasibility of detecting alert and drowsy states in drivers using an integration of features from respiratory signals, vehicle lateral position, and reaction time and out-of-vehicle ways of data collection in order to improve the system’s performance and applicability in the real world. METHODS: Data was collected from 25 healthy volunteers in a driving simulator-based study. Their respiratory activity was recorded using a wearable belt …and their reaction time and vehicle lateral position were measured using tests developed on the driving simulator. To induce drowsiness, a monotonous driving environment was used. Different time domain features have been extracted from respiratory signals and combined with the reaction time and lateral position of the vehicle for modeling. The observer of rating drowsiness (ORD) scale was used to label the driver’s actual states. The t-tests and Man-Whitney test was used to select only statistically significant features (p  < 0.05), that can differentiate between the alert and drowsy states effectively. Significant features then combined to investigate the improvement in performance using the Multilayer Perceptron (MLP), the Support Vector Machines (SVMs), the Decision Trees (DTs), and the Long Short Term Memory (LSTM) classifiers. The models were implemented in Python library 3.6. RESULTS: The experimental results illustrate that the support vector machine classifier achieved accuracy of 88%, precision of 85%, recall of 83%, and F1 score of 84% using selected features. CONCLUSION: These results indicate the possibility of very accurate detection of driver drowsiness and a viable solution for a practical driver drowsiness system based on combined measurement using less-intrusive and out-of-vehicle recording methods. Show more

Keywords: Sleepiness, respiration, classification, machine learning, reaction time, automobile driving

DOI: 10.3233/WOR-230179

Citation: Work, vol. 77, no. 4, pp. 1165-1177, 2024

Authors: Mänttäri, Satu | Rauttola, Ari-Pekka | Halonen, Janne | Karkulehto, Jutta | Säynäjäkangas, Pihla | Oksa, Juha

Article Type: Research Article

Abstract: BACKGROUND: Long-term work with elevated arms, or overhead work, is a risk factor for musculoskeletal complaints and disorders. Upper-limb exoskeletons are a promising tool for reducing occupational workload when working with hands above shoulder level. OBJECTIVE: The purpose of this study was to assess the effects of upper-limb exoskeleton on muscular and physical strain and perceived exertion during dynamic work at four different shoulder joint angles. Further, we evaluated if there are any negative effects associated with the use of exoskeleton. METHODS: A total of 15 student participants performed dynamic work in laboratory setting with and …without an exoskeleton at four different shoulder angles: 60, 90, 120 and 150 degrees. Muscle electrical activity from 8 muscles of the upper body, perceived exertion, and heart rate were measured during the work task, and grip strength, muscle stiffness, tone, and elasticity from six muscles, m. deltoideus physiological cross-sectional area and muscle fiber pennation angle, and nerve conduction velocity were measured before and after the work task. RESULTS: Based on the results, the use of exoskeleton significantly reduced the muscle activity of the upper limb, shoulder, and back muscles. The reduction was most significant when the arm elevation was 120°, and in m. deltoideus muscle activity. RPE was also positively affected indicating reduction in workload when using exoskeleton. CONCLUSION: The results suggest that the use of upper limb exoskeleton has potential to reduce physical workload during overhead work and, consequently, reduce the risk for work-related musculoskeletal disorders. Show more

Keywords: Overhead work, passive exoskeleton, dynamic work, musculoskeletal disorders, shoulder joint, EMG

DOI: 10.3233/WOR-230217

Citation: Work, vol. 77, no. 4, pp. 1179-1188, 2024

Authors: Jatobá, Alessandro | Bellas, Hugo | Arcuri, Rodrigo | Sobral, André Luiz Avelino | Bulhões, Bárbara | Vianna, Jaqueline | de Castro Nunes, Paula | d’Avila, Adriana Lourenço | de Carvalho, Paulo Victor Rodrigues

Article Type: Research Article

Abstract: BACKGROUND: Patient referral prioritizations is an essential process in coordinating healthcare delivery, since it organizes the waiting lists according to priorities and availability of resources. OBJECTIVE: This study aims to highlight the consequences of decentralizing ambulatory patient referrals to general practitioners that work as family physicians in primary care clinics. METHODS: A qualitative case study was carried out in the municipality of Rio de Janeiro. The ten health regions of Rio de Janeiro were visited during fieldwork, totalizing 35 hours of semi-structured interviews and approximately 70 hours of analysis based on the Grounded Theory. …RESULTS: The findings of this study show that the obstacles to adequate referrals are beyond the management of vacancies, ranging from the standardization of prioritization criteria to ensuring the proper employment of referral protocols in diverse locations assisted by overloaded health workers with different backgrounds and perceptions. Efforts in decentralizing patient referral to primary care still face the growing dilemmas and challenges of expanding the coverage of health services while putting pressure on risk assessment, as well as sustaining the autonomy of physicians’ work while respecting the eligibility when ordering waiting lists. CONCLUSION: A major strength of this work is on the method to organize and aggregate qualitative data using visual representations. Limitations concerning the reach of fieldwork in vulnerable and hardly accessible areas were overcame using snowball sampling techniques, making more participants accessible. Show more

Keywords: Waiting lists, health systems resilience, health care reform, ambulatory care, risk assessment, qualitative research

DOI: 10.3233/WOR-230228

Citation: Work, vol. 77, no. 4, pp. 1189-1203, 2024

Authors: Yang, Yongzheng | Du, Zhigang | Jiang, Zehao

Article Type: Research Article

Abstract: BACKGROUND: The tunnel section is a complex traffic scenario and an accident prone area. There are differences in the performance of different driving groups in tunnel environments, which may have an impact on traffic safety. OBJECTIVE: To study the differences in the impact of tunnel environment on professional and non-professional drivers. METHODS: Based on the vehicle experimental data, the electroencephalography (EEG) power was compared for professional and non-professional drivers. The impact of illumination changes and longitudinal slope on different driving groups was analyzed. RESULTS: At tunnel entrance with severely reduced lighting, the adaptation time …of non-professional drivers to the light environment is 1.5 times that of professional drivers. When driving on the longitudinal slope, professional drivers perform better. The greater the longitudinal slope, the more obvious the advantages of professional drivers. However, in areas with relatively good traffic conditions, professional drivers are more prone to be distracted. CONCLUSION: Professional and non-professional drivers have their own advantages and disadvantages in the tunnel environment. In general, the driving adaptability of professional drivers is better than that of non-professional drivers in tunnel sections. The research conclusions provide a reference for driver safety training. Show more

Keywords: Professional drivers, human factor, driving safety, lighting environment, road alignment, EEG

DOI: 10.3233/WOR-230278

Citation: Work, vol. 77, no. 4, pp. 1205-1217, 2024

Authors: Orr, Robin M. | Milligan, Gemma S. | Blacker, Sam D. | Drain, Jace R. | Reilly, Tara | Chassé, Etienne | Siddall, Andrew | Foulis, Stephen A. | Kilding, Helen | Jamnik, Veronica

Article Type: Editorial

DOI: 10.3233/WOR-246006

Citation: Work, vol. 77, no. 4, pp. 1219-1221, 2024

Authors: Powell, Steven D. | Hogan, Joseph | Fallowfield, Joanne L. | Brown, Pieter E.H. | Tsang, Fiona | Fisken, Alison | Rowland, Daniel | Richards, Lana | Allsopp, Adrian J.

Article Type: Research Article

Abstract: BACKGROUND: The Ministry of Defence Police recognised the requirement to develop a Physical Employment Standard (PES) for the Authorised Firearms Officer –Counter Terrorism (AFO-CT) role profile. OBJECTIVE: The purpose of this study was to conduct a job task analysis to identify the most critical and physically demanding tasks performed by AFO-CT personnel. METHODS: A focus group and online survey were undertaken to identify a list of job tasks. The down-selected job tasks were objectively monitored during training events to determine the most physically demanding tasks. Tasks were ranked by physical demand and additional factors (e.g., operational …load, primary physical actions). Down-selected tasks were then included in a Subject Matter Experts (SME) task scenario generation workshop. The physiological demands of the resulting standardised scenarios were determined. RESULTS: The focus group (n  = 11) identified 13 physically demanding and critical role-related tasks. The subsequent survey (n  = 907) down-selected eight tasks with a ‘moderate’ demand or greater. Thirty AFO-CT personnel completed the eight tasks as part of routine training events. From the observed tasks, four tasks were down-selected and combined into two operationally relevant, reasonable worst-case standardised scenarios during a SME workshop. The two scenarios, ‘Conduct Armed Search in the Open for an Active Shooter’ and ‘Victim Focussed Emergency Search’ were used in subsequent phases of the research to form the basis of the AFO-CT PES. CONCLUSION: This research elucidated the most physically demanding job tasks within the AFO-CT role profile to inform the development of a MOD armed policing PES. Show more

Keywords: Physical employment standards, police, fitness, occupational demands, occupational science, physical capacity

DOI: 10.3233/WOR-230246

Citation: Work, vol. 77, no. 4, pp. 1223-1234, 2024

Authors: Canetti, Elisa F.D. | Gersbach-Seib, Ashlee | Moore, Ryan | Schram, Ben | Orr, Robin

Article Type: Research Article

Abstract: 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. Show more

Keywords: Heart rate, tactical, horse, physiological monitoring, duties

DOI: 10.3233/WOR-230283

Citation: Work, vol. 77, no. 4, pp. 1235-1244, 2024

Authors: Milligan, Gemma | O’Halloran, Joseph | Tipton, Mike

Article Type: Research Article

Abstract: BACKGROUND: Offshore wind technicians (WTs) have been identified as having an occupation with varying physical demands. Therefore, in order to assess WTs capability to undertake the job, there was a need to identify and quantify the physical requirements of the essential tasks. OBJECTIVE: To establish the essential tasks and quantify the associated minimum physical demands of being an offshore WT. METHODS: Wind Farm organisations (n  = 10) across five countries, undertook a multi-modal observational approach comprising of semi-structured interviews (n  = 45), focus groups (n  = 14), survey (n  = 167). In addition, observations, objective measurements, video footage and standard …operating procedures were reviewed. A service campaign was broken down into component tasks, and analysed in terms of technical specifications, e.g. equipment, frequency, duration, rest breaks, clothing ensembles, and the methods of best practice for undertaking each of the tasks. Task descriptions were produced and minimum performance standards recommended. RESULTS: The job tasks associated with WTs can be broken down into two categories and five areas of work (Essential infrequent = casualty evacuation and prolonged ladder climbing; Essential frequent = short ladder climbs, manual handling and working in restricted spaces). CONCLUSIONS: The results presented constitute work carried out in Phases 1 and 2 of a three phased work programme to establish a physical employment standard required by WTs working in offshore wind. These findings will underpin the development of a minimum performance standard for the global offshore wind industry. Show more

Keywords: Physical capacity assessments, physical employment standards, minimum physical performance, physical demands

DOI: 10.3233/WOR-230267

Citation: Work, vol. 77, no. 4, pp. 1245-1259, 2024

Authors: Tseli, Elena | Monnier, Andreas | LoMartire, Riccardo | Vixner, Linda | Äng, Björn | Bohman, Tony

Article Type: Research Article

Abstract: BACKGROUND: When establishing Physical Employment Standards, validity is dependent on the correct identification and characterisation of critical job tasks. OBJECTIVE: To develop and validate a standardised protocol for the identification, characterisation, and documentation of critical physical job tasks in military occupational specialities in the Swedish Armed Forces (SwAF), and propose a definition of critical physical job tasks for use in the SwAF. METHODS: A protocol was drafted with three content domains, including a preliminary definition. Protocol content validity was iteratively assessed in two consecutive stages where ten subject experts rated relevance and simplicity. A consensus panel …revised the protocol after each stage. Content validity index (CVI) was calculated as item-CVI (I-CVI) per each feature and as scale average (S-CVI/Ave) per content domain. Acceptable content validity thresholds were 0.78 and 0.90, respectively. RESULTS: The validated protocol consisted of 35 items with an I-CVI≥0.90 and≥0.80 for relevance and simplicity, respectively. The S-CVI/Ave was 0.97 for relevance and 0.98 for simplicity. The protocol was language reviewed, reorganised for easy use, and approved by the consensus panel. The final protocol includes: background and aim of the protocol, the accepted generic and critical physical job task definitions, protocol instructions, subject expert-qualifications, job task source and characteristics. CONCLUSION: A standardised protocol for identification and characterisation of critical job tasks in SwAF military occupational specialties was developed. The protocol content was rated relevant and simple by experts and will be of importance in future work establishing physical requirements in the SwAF. Show more

Keywords: Evaluation study, military personnel, physical employment standards, questionnaire, work performance

DOI: 10.3233/WOR-230263

Citation: Work, vol. 77, no. 4, pp. 1261-1272, 2024

Authors: Hogan, Joseph A. | Powell, Steven D. | Gribble, Hannah | Saunders, Samantha | Gunner, Frances | Fallowfield, Joanne L. | Brown, Piete E.H. | Allsopp, Adrian J.

Article Type: Research Article

Abstract: BACKGROUND: The current in-service Royal Naval Fitness Test has two elements to test the aerobic endurance and muscular strength of Service Personnel through generic field-based tests and a short job task simulation. However, in 2017 the Royal Navy (RN) identified a requirement to update their in-service fitness test to align with international best practice. OBJECTIVE: The purpose of this study was to conduct an Objective Job Task Analysis on critical, physically demanding tasks that could be undertaken by RN sailors during sea deployments METHODS: Twenty-one training exercises were observed across a range of contexts; Type 23 …Frigates, Type 45 Destroyers and at shore-based training facilities. A total of 203 RN personnel (age 27.8±7.1 years) were observed undertaking 36 job related tasks (e.g., ‘firefighting’, ‘damage control’, ‘abandon ship’ and ‘casualty handling’). Tasks were evaluated by cardiovascular response, primary functional movements and contextual factors to aid a Military Judgement Panel in task list down-selection. RESULTS: 14 Criterion Tasks (e.g., ‘firefighting’, ‘two-person magazine stowage’ and ‘casualty handling’) were selected to progress to the next stage of the process. Five tasks were selected based on cardiovascular responses and a further nine tasks selected based on task ergonomics and other factors. CONCLUSION: This research has identified and quantified the most physically demanding, critical roles undertaken by RN sailors on sea deployments and will inform the development of the RN Physical Employment Standard. Show more

Keywords: Physical employment standards, physical demands, physical tests, task domains, physical demands, exposure analysis

DOI: 10.3233/WOR-230264

Citation: Work, vol. 77, no. 4, pp. 1273-1283, 2024

Authors: Kloss, Emily B. | Niederberger, Brenda A. | Givens, Andrea C. | Beck, Meghan S. | Bernards, Jake R. | Bennett, Daniel W. | Kelly, Karen R.

Article Type: Research Article

Abstract: BACKGROUND: During periods of high-volume vigorous exercise, United States Marine Corps recruits often experience musculoskeletal injuries. While the program of instruction (POI) for basic training is a defined training volume, the total workload of boot camp, including movements around the base, is unknown. OBJECTIVE: The present study aimed to quantify the daily total workload, energy expenditure, and sleep during basic recruit training at Marine Corps Recruit Depot (MCRD) San Diego. METHODS: Eighty-four male recruits from MCRD San Diego wore wrist wearable physiological monitors to capture their complete workload (mileage from steps), energy expenditure, and sleep throughout …the 10-week boot camp. RESULTS: Marine recruits traveled an average of 11.5±3.4 miles per day (M±SD), expended 4105±823 kcal per day, and slept an average of 5 : 48±1 : 06 hours and minutes per night. While the POI designates a total of 46.3 miles of running and hiking, the actual daily average miles yielded approximately 657.6±107.2 miles over the 10-week boot camp. CONCLUSION: Recruit training requires high physical demand and time under tension due to the cumulative volume of movements around base in addition to the POI planned physical training. Show more

Keywords: Work, workload, military, inservice training, energy expenditure, sleep

DOI: 10.3233/WOR-230554

Citation: Work, vol. 77, no. 4, pp. 1285-1294, 2024

Authors: Tomes, Colin D. | Canetti, Elisa F.D. | Schram, Ben | Orr, Robin

Article Type: Case Report

Abstract: 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. Show more

Keywords: Biomarkers, data visualization, stress, fatigue, risk management, exercise, occupational health

DOI: 10.3233/WOR-230297

Citation: Work, vol. 77, no. 4, pp. 1295-1303, 2024

Authors: O’Halloran, Joseph | Tipton, Mike | Milligan, Gemma

Article Type: Research Article

Abstract: BACKGROUND: Offshore wind technicians (WTs) have been identified as having an occupation with high physical demands. OBJECTIVE: To characterise the physical demands of WTs, during the working day and when performing casualty rescues. METHODS: Data collection consisted of two components. Component A, 14 WTs (n  = 13 male, 1 female) were monitored over three consecutive working days. The data collected consisted of: a questionnaire; heart rate and movement data; and accelerometer data. Component B, 5 WTs (n  = 5 male) were assessed undertaking two simulated casualty evacuations. Heart rate and metabolic data were collected. RESULTS: A …working day lasted 7.5 hrs to 9 hrs, with WTs covering, on average, 4.7 km on the turbine. WTs spent 28% of their time undertaking “light activity”, 69% “moderate activity” and 3% working “vigorously”. The greatest amount of time in a day was spent working on manual handling tasks such as torque and tensioning (up to 4 hours in total). Both rescues were performed largely aerobically, with similar cardiac and metabolic demands (14.56 (4.84) mL.kg–1 .min–1 vs. 17.07 (3.54) mL.kg–1 .min–1 ). Higher RPE values were reported for the rescue from within the Hub (median (range), 13 (12–14)) compared to down the ladder (11 (7–12)), likely due to a greater requirement to manoeuvre the casualty in tight spaces. CONCLUSION: The results presented characterise the physical requirements of WTs during the working day and two casualty evacuations. These data play an important role in supporting the job task analysis for WTs working in the offshore wind industry. Show more

Keywords: Physical employment standard, minimum performance

DOI: 10.3233/WOR-230270

Citation: Work, vol. 77, no. 4, pp. 1305-1317, 2024

Authors: Carstairs, Greg L. | Michael, Scott W. | Groeller, Herbert | Drain, Jace R.

Article Type: Research Article

Abstract: BACKGROUND: Militaries have historically utilised generic physical fitness tests to assess physical readiness, but there has been a recent shift to develop physical employment standards (PES) based on actual job demands. OBJECTIVE: The purpose of this investigation was to characterise the physical demands of critical tasks performed by Royal Australian Air Force (RAAF) personnel to inform PES development. METHODS: Job task analysis were performed for 27 RAAF trades. Criterion tasks were identified through a systematic approach involving workshops and field-observations. The identified tasks were assessed for dominant physical capacity and grouped into movement-based clusters. Psychophysiological measures …were collected from personnel performing the tasks. RESULTS: Of 87 criterion tasks, 92% were characterised as manual handling dominant. Across these 87 tasks the principal physical capacities were: muscular strength (59%), muscular endurance (52%) and cardiorespiratory endurance (39%). The most common movement clusters were Lift to Platform (44%) and Lift and Carry (38%). Lift to Platform tasks required lifting to a median height of 1.32 m (1.20 –1.65 m) and a median mass of 25.0 kg (21.0 –28.9 kg) per person. Median carry mass was 25.0 kg (22.4 –36.1 kg) per person and distance was 26.0 m (17.5 –50.0 m). Median task mean ’Vdot;O2 , HR and RPE were 1.8 L.min- 1 (1.5–2.2 L.min- 1 ), 137 b.min- 1 (120–144) and 13 (12–14). CONCLUSIONS: The high proportion of manual handling criterion tasks emphasises the importance of these activities and the underlying physical capacities for RAAF personnel. Current fitness assessments are unlikely to predict job task performance. Show more

Keywords: Physical employment standards, job task analysis, physical demands analysis, muscular strength, muscular endurance, cardiorespiratory endurance, lift, lift and carry, military

DOI: 10.3233/WOR-230274

Citation: Work, vol. 77, no. 4, pp. 1319-1329, 2024

Authors: Sankari, Matias | Vaara, Jani P. | Pihlainen, Kai | Ojanen, Tommi | Kyröläinen, Heikki

Article Type: Research Article

Abstract: BACKGROUND: Military operations in urban environments requires faster movements and therefore may place greater demands on soldier strength and anaerobic ability. OBJECTIVE: The aim was to study how physical fitness and body composition are associated with occupational test for urban combat soldiers before and after a 5-day military field exercise (MFE). METHODS: Twenty-six conscripts (age = 20±1 yrs.) volunteered, of which thirteen completed the study. Occupational performance was determined by using the newly developed Urban Combat Simulation test (UCS); which included 50-m sprinting, moving a truck tire (56 kg) 2 meters with a sledgehammer, a 12-m kettlebell carry (2×20 kg) …up the stairs with a 3-m ascent, 4-time sandbag lifts (20 kg) with obstacle crossing, and a 20-m mannequin (85 kg) drag. Aerobic and muscle fitness, as well as anaerobic capacity were measured, and, body composition was assessed with multifrequency bioimpedance analysis. RESULTS: The UCS performance correlated significantly with standing long jump performance, as well as lower and upper body maximal strength before (r = –0.56 to –0.66) and after (r = –0.59 to –0.68) MFE, and, with body mass and FFM before (r = –0.81 to –0.83) and after (r = –0.86 to –0.91) MFE. In the regression analyses, fat free mass (R2 = 0.50, p  = 0.01) and counter movement jump in combat load (R2 = 0.46, p  = 0.009) most strongly explained the UCS performance. CONCLUSION: This study demonstrated that muscle mass and lower body explosive force production together with maximal strength are key fitness components related to typical urban combat soldiers‘ military tasks. Physical training developing these components are recommended. Show more

Keywords: Soldier, military, readiness, fitness, task performance, physical training

DOI: 10.3233/WOR-230239

Citation: Work, vol. 77, no. 4, pp. 1331-1340, 2024

Authors: Poirier, Martin P. | Blacklock, Rachel | Cao, Michael | Théoret, Daniel | Frei, Leslie | Gagnon, Patrick

Article Type: Research Article

Abstract: BACKGROUND: While effective apprehensions of non-compliant suspects are central to public safety, the minimal force needed to transition a suspect from standing to the ground, vital for apprehension success, has not been established. OBJECTIVE: To examine the technical-tactical behaviors of general duty police officers during simulated apprehensions and quantify the minimum force required to destabilize non-compliant suspects. METHODS: Task simulations conducted with 91 officers were analyzed to identify common grappling movements, strikes, control tactics, and changes in body posture. A separate assessment of 55 male officers aimed to determine the minimum force required for destabilization in …five body regions (wrist, forearm, shoulder, mid-chest, and mid-back). Data are presented as mean±standard deviation. RESULTS: On average, apprehensions took 7.3±3.2 seconds. While all officers used grappling movements (100%) and the majority employed control tactics (75%), strikes were seldom used (4%). Apprehensions typically began with a two-handed pull (97%; Contact Phase), 55% then attempted an arm bar takedown, followed by a two-handed cross-body pull (68%; Transition/Control Phase), and a two-handed push to the ground (19%; Ground Phase). All officers began in the upright posture, with most shifting to squat (75%), kneel (58%), or bent (45%) postures to complete the apprehension. The minimum force required to disrupt balance differed across body regions (wrist: 54±12 kg; forearm: 49±12 kg; shoulder: 42±10 kg; mid-chest: 44±11 kg; mid-back: 30±7 kg, all P  < 0.05), except between the shoulder and chest (P  = 0.19). CONCLUSION: These findings provide insights that can enhance the design and accuracy of future apprehension evaluations and inform the optimization of law enforcement physical employment standards. Show more

Keywords: Law enforcement, force, occupational health, physical fitness, physical restraint, resistance training, task performance and analysis, work performance standards

DOI: 10.3233/WOR-230307

Citation: Work, vol. 77, no. 4, pp. 1341-1357, 2024

Authors: Joseph, Dulla | Robert, Lockie | Robin, Orr | Ben, Schram | Elisa, Canetti

Article Type: Research Article

Abstract: BACKGROUND: Law enforcement (LE) applicant assessments and initial academy training vary greatly across the United States of America (USA), with 820+ academies operating across 50 different states. Rising obesity and declining physical fitness underscore the need for benchmarks of applicant physical performance. OBJECTIVE: Create a “point-in-time” descriptive profile of the performance of LE applicants and determine any differences between males, females, and age using two applicant test batteries (ATBs). METHODS: Archival data from one large USA LE academy were analysed. Applicants completed one of two ATBs; ATB1 (n  = 1674): 68.8-meter agility run (AR), 60-s push-ups, 60-s sit-ups, …60-s arm ergometer revolutions, and 2.4 km run; ATB2 (n  = 355): AR, 60-s push-ups, 60-s sit-ups, and a multistage fitness test. Data were coded for sex and age. Independent samples t -tests compared the sexes. A one-way ANOVA with Bonferroni post hoc analysis compared age groups (18– 24, 25– 29, 30– 34, 35– 39, 40 + years). RESULTS: Males outperformed females in all fitness assessments across both ATBs (p ≤0.02). The 18– 24 age group demonstrated faster run times in the AR and 2.4 km for ATB1 compared to all groups. (p ≤0.03). In ATB2, the 18– 24 age group was faster in the AR compared to all other groups except the 25– 29 age group (p ≤0.026). CONCLUSIONS: Regardless of ATB used, females and older applicants generally would benefit from specific fitness training to better prepare for academy. Older applicants may experience greater challenges in running tasks, especially those involving sprinting, which could also be impacted by qualities important for running/sprinting (i.e., maximal strength and power). Show more

Keywords: Police, academy, initial training, muscular endurance, strength, tactical

DOI: 10.3233/WOR-230333

Citation: Work, vol. 77, no. 4, pp. 1359-1368, 2024

Authors: Schram, Ben | Kukić, Filip | Janković, Rade | Dimitrijević, Rasa | Žigić, Goran | Orr, Robin | Koropanovski, Nenad

Article Type: Research Article

Abstract: BACKGROUND: Concerns are sometimes raised by police applicants undertaking physical fitness testing that they were unfamiliar with the test requirements which in turn negatively impacted their performance. OBJECTIVE: The aim of this study was to investigate the effects of a single day physical test training session on physical fitness scores of police candidates. METHODS: The sample consisted of female police candidates (n  = 133) who attended a pre-academy training session. On the first day of pre-training, candidates’ physical fitness was measured following official assessment day protocols. Measures included maximal handgrip strength, number of push-ups in 10 sec …(PU), number of sit-ups in 30 sec (SU), standing long jump (SLJ), Abalakow jump test (AJ), 12 min Cooper running test (CT), and a motor educability test (ME). After the assessment, the overseeing UCIPS staff provided a detailed test skills briefing to candidates (e.g., common mistakes made during testing, how test performance could be improved, etc.). Immediately after the briefing, candidates performed the tests once again. Differences between results were measured using a paired samples t -test with significance set at 0.05. RESULTS: Paired sample t -tests determined significant (p  < 0.001), large (Rank-Biserial Correlation = 1.00), improvements in physical fitness scores during the second assessment following familiarisation and feedback on test performance. CONCLUSION: Pre-academy training may be effective in improving candidates’ physical fitness scores, in most tests, prior to the official assessment for the enrolment to police studies. Thus, to optimise initial candidate scores and opportunities for successful enlistment, police agencies may benefit from providing pre-assessment training. Show more

Keywords: Law enforcement officer, recruit, employment standards, police academy, exercise test, fitness testing

DOI: 10.3233/WOR-230320

Citation: Work, vol. 77, no. 4, pp. 1369-1375, 2024

Authors: Lockie, Robert G. | Orr, Robin M. | Montes, Fernando | Dawes, J. Jay

Article Type: Research Article

Abstract: BACKGROUND: Fitness tests have been previously used to predict academy graduation and highlight specific capacities to be targeted in applicants/trainees to optimise their potential for academy success. OBJECTIVE: To compare the fitness of graduated and released (did not complete academy requirements) firefighter trainees and explore using decision tree analysis to predict academy graduation via fitness tests. METHODS: Retrospective analysis was conducted on 686 trainees who completed an occupational physical ability test (OPAT): Illinois agility test; push-ups; pull-ups; leg tucks; estimated maximal aerobic capacity (VO2max ); backwards overhead 4.54-kg medicine ball throw; 10-repetition maximum deadlift; and 91.44-m …farmer’s carry. Data were recorded in raw and scaled scores (tests scored from 0–100; maximum OPAT score was 800). Trainees were split into ‘graduated’ (GRAD; n  = 576) or ‘released’ (REL; n  = 110) groups. Mann-Whitney U-tests compared between-group OPAT scores. A decision tree analysis using Chi-square automatic interaction detection was conducted, with raw and scaled scores entered into the analysis. A separate analysis was conducted with only the raw scores. RESULTS: GRAD trainees outperformed REL trainees in all OPAT events (p  < 0.001). OPAT total score was the best predictor of academy graduation (p  < 0.001), followed by the deadlift score (p  = 0.003). Estimated VO2max was the only significant raw score predictor (p  < 0.001). CONCLUSIONS: GRAD trainees were fitter than the REL trainees. Fitness could predict trainees who graduated from the academy. Overall fitness (OPAT total score), muscular strength (deadlift) and aerobic capacity were important graduation predictors. Training staff could develop these fitness qualities in their trainees to potentially improve fire academy graduation rates. Show more

Keywords: Aerobic fitness, deadlift, first responder, occupational physical ability test, tactical

DOI: 10.3233/WOR-230258

Citation: Work, vol. 77, no. 4, pp. 1377-1389, 2024

Authors: Kelly, Karen | Niederberger, Brenda | Givens, Andrea | Bernards, Jake | Orr, Robin

Article Type: Research Article

Abstract: BACKGROUND: Load carriage tasks during United States Marine Corps (USMC) recruit training can cause injury. Load carriage conditioning, if optimized, can reduce injury risk. OBJECTIVE: To compare injuries sustained by USMC recruits following participation in either the Original Load Carriage (OLC) program or a Modified Load Carriage (MLC) program. METHODS: Retrospective musculoskeletal injury data were drawn from the USMC San Diego Sports Medicine injury database for recruits completing the OLC (n  = 2,363) and MLC (n  = 681) programs. Data were expressed as descriptive statistics and a population estimate of the OLC:MLC relative risk ratio (RR) was calculated. …RESULTS: The proportion of injuries sustained in the MLC cohort (n  = 268; 39% : OLC cohort, n  = 1,372 : 58%) was lower, as was the RR (0.68, 95% CI 0.61– 0.75). The leading nature of injury for both cohorts was sprains and strains (OLC n  = 396, 29%; MLC n  = 66; 25%). Stress reactions were proportionally higher in MLC (n  = 17, 6%; OLC n  = 4, 0.3%), while stress fractures were proportionately lower (MLC n  = 9, 3%; OLC n  = 114, 8%). Overuse injuries were lower in MLC (– 7%). The knee, lower leg, ankle, and foot were the top four bodily sites of injuries and the Small Unit Leadership Evaluation (SULE), Crucible, overuse-nonspecific, running, and conditioning hikes were within the top five most common events causing injury. The prevalence rates of moderate severity injury were similar (MLC = 23%; OLC = 24%), although MLC presented both a higher proportion and prevalence of severe injuries (MLC = 6%; OLC = 3%, respectively). CONCLUSION: A periodized load carriage program concurrently increased exposure to load carriage hikes while reducing injuries both during the load carriage hikes and overall. Show more

Keywords: Musculoskeletal injury, boot-camp, injury prevention, progressive overload, military training

DOI: 10.3233/WOR-230569

Citation: Work, vol. 77, no. 4, pp. 1391-1399, 2024

Authors: Lockie, Robert G. | Orr, Robin M. | Kennedy, Kelly | Dawes, J. Jay

Article Type: Research Article

Abstract: BACKGROUND: In 2020, a police department in the south-eastern USA introduced a Job-Related Task Assessment (JTA). The JTA included running, climbing, crawling, balance, direction changes, stair climbing, dragging, pushing, and simulated controlling of a struggling subject and needed to be completed by applicants in 6 : 57 min:s. It is not known whether introducing the JTA in the hiring process affected the health and fitness of hired recruits. OBJECTIVE: To compare the health and fitness of recruits hired prior to, and following, the JTA introduction. METHODS: Analysis was conducted on recruit data split into academy training year: 2016 …(n  = 91), 2017 (n  = 129), 2018 (n  = 167), 2019 (n  = 242), and 2020 (n  = 37). The 2020 group was hired after the JTA introduction and included one academy class. The following were recorded for all recruits: age, height, body mass, and body mass index; systolic and diastolic blood pressure (BP); sit-and-reach; grip strength; push-ups; sit-ups; 2.4-km run; and a physical ability test (PAT). A univariate ANOVA, with sex and age as covariates and Bonferroni post hoc, determined between-year differences. RESULTS: The recruits from 2020 were significantly lighter than 2018 recruits (p  < 0.031), had higher systolic and diastolic BP than recruits from 2016–2018 (p ≤0.006), completed the 2.4-km run faster than recruits from all years (p  < 0.001), and completed the PAT faster than the 2016 and 2019 (p  = 0.006–0.007) recruits. CONCLUSION: The JTA introduction led to the selection of recruits with lower body mass, and better aerobic (2.4-km run) and job-specific fitness (PAT). However, 2020 recruits also had higher BP which should be monitored. Show more

Keywords: Aerobic fitness, blood pressure, law enforcement, physical ability test, tactical

DOI: 10.3233/WOR-230245

Citation: Work, vol. 77, no. 4, pp. 1401-1413, 2024