Music Therapy Intervention to Reduce Symptom Burden in Hospice Patients: A Descriptive Study.

Background: Music therapy (MT) offers benefits of improved symptom relief and quality of life at the end of life, but its impact on hospice patients and caregivers needs more research. Objective: To assess the impact of MT intervention on symptom burden and well-being of hospice patients and caregivers. Methods: A total of 18 hospice patients, selected based on scores ≥4 on the revised Edmonton Symptom Assessment System (ESAS-r) items on pain, depression, anxiety, or well-being, participated in MT sessions provided by a board-certified music therapist. Over a period of 2-3 weeks, 3-4 MT sessions were conducted for each. Patient Quality of life (QOL) was assessed using the Linear Analogue Self-Assessment (LASA). Depression and anxiety were measured with the Patient Health Questionnaire-4 (PHQ-4). For the 7 caregivers enrolled, stress levels were measured using the Pearlin role overload measure and LASA. Results: Patients reported a reduction in symptom severity and emotional distress and an increase in QOL. All patients endorsed satisfaction with music therapy, describing it as particularly beneficial for stress relief, relaxation, spiritual support, emotional support, and well-being. Scores on overall QOL and stress were worse for caregivers. Conclusion: This study provides evidence that MT reduces symptom burden and enhances the quality of life for hospice patients. Hospice patients and their caregivers endorsed satisfaction with MT. Given the benefits observed, integrating MT into hospice care regimens could potentially improve patient and caregiver outcomes. Larger studies should be conducted to better assess the impact of MT in this population.

Efficacy of Conservative Interventions for Musculoskeletal Conditions on Pain and Disability in Active Serving Military Personnel-A Systematic Review.

INTRODUCTION: Musculoskeletal (MSK) injuries and associated pain disorders are one of the leading causes for soldiers not being medically fit for deployment, impacting force capability and readiness. Musculoskeletal pain continues to be a leading cause of disability within military services and is associated with a substantial financial burden. A better understanding of the effectiveness of MSK pain management strategies is required. This review was designed to determine the efficacy of nonsurgical interventions, such as physiotherapy, exercise, pharmacology, and multidisciplinary programs, to manage MSK conditions in active serving military populations. MATERIALS AND METHODS: MEDLINE, Embase, CINAHL, and SPORTDiscus were searched to identify relevant randomized clinical trials. Recommended methods were used for article identification, selection, and data extraction. The Cochrane Risk of Bias tool and the Grade of Recommendation, Assessment, Development, and Evaluation were used to appraise the studies. Where possible, meta-analyses were performed. The review was conducted according to the PRISMA guidelines. RESULTS: Nineteen articles (1,408 participants) met the eligibility criteria. Low back pain (LBP) was the most frequently investigated condition, followed by knee pain, neck pain, and shoulder pain. Early physiotherapy, exercise and adjunct chiropractic manipulation (for LBP), and multidisciplinary pain programs (physiotherapy, occupational therapy, and psychology) (for chronic MSK pain) improved pain (standardized mean difference ranged from -0.39 to -1.34; low strength of evidence). Participation in multidisciplinary pain programs, adjunct chiropractic manipulation, and early physiotherapy improved disability (for LBP) (standardized mean difference ranged from -0.45 to -0.86; low to very low strength of evidence). No studies evaluated pain medication. Dietary supplements (glucosamine, chondroitin sulfate, and manganese ascorbate), electrotherapy, isolated lumbar muscle exercises, home cervical traction, or training in virtual reality showed no benefit. The studies had a high risk of bias, were typically underpowered, and demonstrated high clinical heterogeneity. CONCLUSIONS: Currently available randomized clinical trials do not provide sufficient evidence to guide military organizations or health care professionals in making appropriate treatment decisions to manage MSK pain in active serving military personnel. Future research is essential to enable evidence-based recommendations for the effective management of MSK pain conditions in this unique population.

Moderate to Vigorous-intensity Continuous Training versus Highintensity Interval Training for Improving VO2max in Women: A Systematic Review and Meta-analysis.

Traditional continuous training and high-intensity interval training (HIIT) can increase maximal oxygen uptake (V̇O2max). However, there is conflicting evidence regarding which form of training demonstrates the greatest improvements to V̇O2max, and data in women is sparse. We conducted a systematic review and meta-analyses to assess whether moderate to vigorous-intensity continuous training (MVICT) or HIIT was superior at improving V̇O2max in women. Randomised controlled and parallel studies examined the influence of MVICT and/or HIIT on V̇O2max in women. There was no statistical difference in V̇O2max improvements after training between women in the MVICT and HIIT cohorts (mean difference [MD]: -0.42, 95%CI: -1.43 to 0.60, p>0.05). Both MVICT and HIIT increased V̇O2max from baseline (MD: 3.20, 95% CI: 2.73 to 3.67 and MD: 3.16, 95% CI 2.09 to 4.24, respectively, p<0.001). Greater improvements in V̇O2max were observed in women who participated in more training sessions in both training formats. Long-HIIT was superior to short-HIIT protocols at increasing V̇O2max. Although MVICT and long-HIIT sessions elicited greater increases in V̇O2max in younger women compared to short-HIIT protocols, these differences were negligible in older women. Our findings suggest MVICT and HIIT are equally effective strategies for improving V̇O2max and indicate an effect of age on its response to training in women.

Music Therapy Intervention to Reduce Caregiver Distress at End of Life: A Feasibility Study.

BACKGROUND: Music therapy (MT) can relieve distressing end-of-life symptoms, but little is known regarding its effect on caregivers who are at risk for emotional distress as their loved ones approach death. MEASURES: Quality of life (Linear Analogue Self-Assessment), depressive and anxiety symptoms (Patient Health Questionnaire for Depression and Anxiety), and stress (Role Overload Measure) pre-MT, post-MT and at 6-month follow-up, as well as a satisfaction survey post-MT. INTERVENTION: Single MT session for 20-45 minutes OUTCOMES: 15/20 completed MT intervention, 14 also completed pre-MT and post-MT assessments, and 9 completed assessments at all 3 timepoints. Post-MT satisfaction survey (n=14) showed 100% of caregivers were very satisfied with MT and would recommend to others, and found MT very effective for emotional support (85.7%), stress relief (78.6%), spiritual support (71.4%), general feeling of wellness (71.4%), relaxation (69.2%), and pain relief (33.3%). CONCLUSIONS: Research on MT is feasible for caregivers of inpatient hospice patients. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03322228.

Female Athletes and the Menstrual Cycle in Team Sports: Current State of Play and Considerations for Future Research.

Over the past ten years there has been a dramatic rise in female sport participation and accompanying female professional national leagues across multiple sports, yet research has not followed suit. Although there are known variations between female and male physiology, training protocols in female sport are predominantly underpinned by research undertaken in male athletes. The hormonal variability experienced by women across the menstrual cycle, as well as the menstrual cycle variability between women, may contribute to the complexity of conducting rigorous physiological studies, leading to a paucity of robust sports-specific research that can be confidently applied to female athletes. Moreover, barriers exist in female sport that potentially limit the ability to conduct research, including the lack of full-time programs and limited resources. Recently, there has been increased interest in the potential effects of fluctuations in the female sex hormones, progesterone and oestrogen, on sport performance across different phases of the menstrual cycle. However, current research evaluating the menstrual cycle and physical performance (such as strength, speed, aerobic fitness, and athletes' perception of their performance) have shown inconsistent results. Additionally, methodological design across studies has shown little consistency, making it difficult to draw firm conclusions, which potentially prevents female athletes optimising their physical and sporting performance. It further impacts coaches and sports science researchers in their ability to provide appropriate training recommendations and educational opportunities. It is important to progress in female athlete research with an understanding of how the unique physiology of female athletes may influence their ability to physically perform in their respective sport, which requires representation in sports science research. This paper will provide an overview on current evidence and limitations within menstrual cycle research and provide considerations and directions for future research in this space within team sports.

Music Therapy for Anxiety and Pain After Spinal Cord Injury: A Pilot Study.

BACKGROUND: Music therapy (MT) programs have been used in various health care settings to reduce patients' pain, anxiety, and stress. However, few studies have investigated its effects on patients with spinal cord injury (SCI), a frequently serious event requiring extensive rehabilitation. OBJECTIVE: This pilot study evaluated the feasibility of offering music-assisted relaxation (MAR) during rehabilitation for patients with SCI. We also measured the effect of MAR on the patients' pain, anxiety, and stress levels. METHODS: Patients were hospitalized at Mayo Clinic (Rochester, Minnesota) from September 2015 through September 2017 for rehabilitation of an SCI. Eligible patients received 2, 20-minute, personalized MAR sessions. Interventions were facilitated by a board-certified music therapist (MT-BC) and included diaphragmatic breathing, guided imagery, and passive muscle relaxation with live guitar accompaniment and spoken, improvised, or singing voice. Two surveys (Generalized Anxiety Disorder [GAD-7] and Perceived Stress Scale [PSS-10]) were used at the time of study consent and again upon hospital dismissal. Pain, anxiety, and relaxation were assessed before and after both MT sessions with visual analog scales (VASs), scored from 0 to 10. Participants completed a 7-question satisfaction survey after the second MAR session. RESULTS: Twenty patients were enrolled (12 men, 8 women); 13 (65%) completed the MAR interventions. The mean (SD) age was 53.7 (17.7) years. VAS scores for pain significantly improved after both sessions (P ≤ .02). VAS scores for anxiety also significantly improved after both sessions (P ≤ .02), as did VAS scores for relaxation (P ≤ .02 for both). The satisfaction survey indicated that patients generally believed that they benefited from MT. Rehabilitation staff indicated that MT did not interfere with routine clinical care. CONCLUSION: MT with live MAR is a feasible treatment for patients with SCI and may be effective for reducing their pain and anxiety.

Inflammation and Oral Contraceptive Use in Female Athletes Before the Rio Olympic Games.

This study investigated the association between synthetic ovarian hormone use [i.e., the oral contraceptive (OC) pill] and basal C-reactive protein (CRP), peripheral blood immune cell subsets, and circulating pro- and anti-inflammatory cytokine concentrations in elite female athletes. Elite female athletes (n = 53) selected in Rio Summer Olympic squads participated in this study; 25 were taking an OC (AthletesOC) and 28 were naturally hormonally cycling (AthletesNC). Venous blood samples were collected at rest for the determination of sex hormones, cortisol, CRP, peripheral blood mononuclear memory and naïve CD4+ T-cells, CD8+ T-cells and natural killer cells, as well as pro- and anti-inflammatory cytokine concentrations. C-reactive protein concentrations were elevated (p < 0.001) in AthletesOC (median = 2.02, IQR = 3.15) compared to AthletesNC (median = 0.57, IQR = 1.07). No differences were reported for cortisol, cytokines, or PBMC immune cell subsets, although there was a trend (p = 0.062) for higher IL-6 concentrations in AthletesNC. Female Olympians had substantially higher CRP concentrations, a marker of inflammation and tissue damage, before the Rio Olympic Games if they used an OC. Future research should examine the potential consequences for athlete performance/recovery so that, if necessary, practitioners can implement prevention programs.

Women's Football: An Examination of Factors That Influence Movement Patterns.

Griffin, J, Larsen, B, Horan, S, Keogh, J, Dodd, K, Andretta, M, and Minahan, C. Title: Women's football: An examination of factors that influence movement patterns. J Strength Cond Res 34(8): 2384-2393, 2020-The popularity and professionalism of women's football has increased in conjunction with participation rates over the last 10 years, with projected female participation rates to double worldwide by 2026. Scientific interest has also increased, in part due to Fédération Internationale de Football Association now allowing global positioning system (GPS) units to be worn during all competitive matches, resulting in investigations into the match demands of women's football. Therefore, the purpose of the present review is to provide a summary of the literature specific to the movement patterns of women's football matches. Contemporary scientific investigation using GPS match data has led to a greater understanding of the movement patterns of football. Greater emphasis has been placed on high-speed running and sprinting during matches because of the strong link to scoring opportunities and being a distinguishing factor between international and national along with elite and subelite competition levels. Further research, however, is warranted in regard to accelerations and decelerations, given the high metabolic and mechanical loads and contribution to high-speed running and sprinting. With an influx of research into the movement patterns of match-play, investigators have begun to examine factors affecting match performance such as positional demands, age, level of competition, opponent, scoreline, and phase of the game. An understanding of the factors that influence match demands is vital to ultimately be able to understand the effects on performance and how manipulating these factors may improve football performance and reduce the risk of injury.

Practice does not make perfect: A brief view of athletes' knowledge on the menstrual cycle and oral contraceptives.

OBJECTIVES: To assess the knowledge of Australian elite female athletes surrounding the menstrual cycle and oral contraceptives. DESIGN: Cross sectional survey. METHODS: Australian female athletes (n=189) representing their state and/or country in their respective sport completed a questionnaire comprising questions (multiple choice and short answer) relating to the menstrual cycle and oral contraceptives. A knowledge 'score' was calculated by allocating one point for each correct answer; the highest knowledge score that could be achieved was 14. Linear regression analysis was used to identify variables that were independently associated with menstrual cycle and oral contraceptive knowledge. RESULTS: Almost half (47.1 %) of the athletes surveyed were currently using hormonal contraception, the majority (75.3 %) of which used an oral contraceptive pill. Nevertheless, the mean knowledge score achieved by athletes on the questionnaire was 5.03±3.06, with only 8.5 % of athletes achieving a knowledge score of 10 or above. Hormonal contraceptive use and 'identifying as an individual athlete' were two factors that were significantly associated with overall knowledge score (p≤0.004), with current hormonal contraceptive users and individual athletes scoring 1.79 and 1.66 points on average higher than non-users and team sport athletes, respectively. CONCLUSIONS: Our findings indicate that knowledge surrounding the menstrual cycle and oral contraceptives was low in most elite athletes. Further education is warranted to enable athletes to make informed decisions regarding hormonal contraception, and any educational interventions should be implemented across all athlete groups.

The effects of hydration on cognitive performance during a simulated wildfire suppression shift in temperate and hot conditions.

The effects on dehydration and cognitive performance from heat and/or physical activity are well established in the laboratory, although have not yet been studied for personnel working in occupations such as wildland firefighting regularly exposed to these types of conditions. This study aimed to investigate the effects of temperature and dehydration on seventy-three volunteer firefighters (35.7 ±â€¯13.7 years, mean ±â€¯standard deviation) during a simulation of wildfire suppression under either control or hot (18-20; or 33-35 °C) temperature conditions. Results showed cognitive performance on the psychomotor vigilance task declined when participants were dehydrated in the heat and Stroop task performance was impaired when dehydrated late in the afternoon. Firefighters may be at risk of deteriorations in simple cognitive functions in the heat whilst dehydrated, although may also experience impairments in complex cognitive functions if dehydrated late in the day, irrespective of the environmental temperature.

The Post-Exercise Inflammatory Response to Repeated-Sprint Running in Hypoxia.

This study investigated the acute inflammatory response to a repeat-sprint training session in hypoxia. Eleven amateur team-sport athletes completed a repeat-sprint training in hypoxia (RSH) protocol (4 sets of 4x4-s running sprints) in both normoxia and normobaric hypoxia (FiO2 0.145 to simulate an altitude of 3000 m) on separate days. Participants provided venous blood samples prior to (PRE), immediately after (POST), and 3 h after (3 h) completion of the protocol, and capillary blood lactate samples were taken upon arrival, at PRE, and at POST. Distance was recorded for each sprint. Venous blood samples were analysed to determine plasma concentrations of cytokines IL-1ß, IL-1ra, IL-6, IL-8, IL-10, and TNFα. There was no interaction or main effect of condition for any cytokine (p > 0.05). However, time effects indicated that IL-10 was decreased by an average of 19% across the two experimental trials at 3 h compared to POST (p = 0.04), IL-6 increased by 55% from PRE to POST (p = 0.03) then decreased by 43% from POST to 3 h (p = 0.02), and IL-8 decreased by 30% from PRE to POST (p = 0.04) and was further reduced at 3 h compared to POST (by an additional 23%; p = 0.02). A time × condition interaction (p = 0.03) indicated that lactate was higher in hypoxia. There was no interaction effect or effect of condition for sprint distance (p > 0.05). These results suggest that team-sport athletes can perform a RSH session without increasing inflammation when compared to the same training session performed in normoxia.

Immune Response in Women during Exercise in the Heat: A Spotlight on Oral Contraception.

This study compared the immune and stress response of oral contraceptive users (WomenOC; n = 9) to normally-menstruating women (WomenNM; n = 9) at rest and during exercise in temperate (TEMP; 22°C) and hot (HEAT; 35°C) conditions. Participants performed a 3-stage cycling trial in each condition at 90% (Stage 1; 30 min), 135% (Stage 2; 15 min), and 180% (Stage 3; 7.5 min) of lactate threshold 1. C-reactive protein (CRP) and immune cell counts were measured at rest, and serum cytokines (IL-1ß, IL-1RA, IL-6, IL-8, IL-10, and TNF-α) and salivary cortisol were evaluated before and after exercise in both the TEMP and HEAT conditions. There were no differences in resting immune cell counts between groups, nor any differences in cortisol or any of the pro- or anti-inflammatory cytokines measured at rest or after completion of the exercise trials (p > 0.05). However, a trend for a higher resting CRP concentration was observed in WomenOC relative to WomenNM (1.102 ± 1.182 and 0.326 ± 0.228, respectively, p = 0.07). The results obtained in the current study indicate similar immunoendocrine function in WomenOC and WomenNM both at rest and after exercise in temperate and hot environments.

Adding sleep restriction to the equation: impact on wildland firefighters' work performance and physiology in hot conditions.

PURPOSE: To examine the effects of sleep restriction on firefighters' physical task performance, physical activity, and physiological and perceived exertion during simulated hot wildfire conditions. METHODS: 31 firefighters were randomly allocated to either the hot (n = 18, HOT; 33 °C, 8-h sleep opportunity) or hot and sleep restricted (n = 13, HOT + SR; 33 °C, 4-h sleep opportunity) condition. Intermittent, self-paced work circuits of six firefighting tasks were performed for 3 days. Firefighters self-reported ratings of perceived exertion. Heart rate, core temperature, and physical activity were measured continuously. Fluids were consumed ad libitum, and all food and fluids consumed were recorded. Urine volume and urine specific gravity (USG) were analysed and sleep was assessed using polysomnography (PSG). RESULTS: There were no differences between the HOT and HOT + SR groups in firefighters' physical task performance, heart rate, core temperature, USG, or fluid intake. Ratings of perceived exertion were higher (p < 0.05) in the HOT + SR group for two of the six firefighting tasks. The HOT group spent approximately 7 min more undertaking moderate physical activity throughout the 2-h work circuits compared to the HOT + SR group. CONCLUSION: Two nights of sleep restriction did not influence firefighters' physical task performance or physiological responses during 3 days of simulated wildfire suppression. Further research is needed to explore firefighters' pacing strategies during real wildfire suppression.

Oral contraceptives augment the exercise pressor reflex during isometric handgrip exercise.

We sought to determine whether oral contraception alters the gender-related differences observed in the exercise pressor reflex during isometric handgrip exercise. Fifteen men, fifteen normally menstruating women (WomenNM), and fifteen women taking monophasic oral contraceptives (WomenOC) completed two trials of a 3-min isometric handgrip exercise protocol performed at 30% of their maximal voluntary contraction: (1) where arterial occlusion was applied to the previously exercising arm during a 3-min recovery period (Occlusion trial); (2) where no arterial occlusion was applied during recovery (Control trial). Handgrip exercise elicited greater increases in mean arterial pressure (MAP) in MEN compared to both female groups (P < 0.05), and in WomenOC compared to WomenNM in both trials (P = 0.01, P = 0.03). After 3 min of recovery, sBP was 12% (P = 0.01) and 9% (P = 0.02) higher in the Occlusion trial when compared to the Control trial for MEN and WomenOC. Conversely, arterial occlusion in recovery from handgrip did not sustain elevated sBP in the Occlusion trial, and sBP returned to recovery levels not different to the Control trial, in WomenNM (P = 0.41). These data indicate that gender-related differences in the metaboreflex during isometric handgrip exercise exist between men and normally menstruating women, but are blunted when men are compared to women taking oral contraceptives. We conclude that the suppression of 17ß-estradiol and/or progestogen in women via the administration of oral contraceptives attenuates sex-related differences in the metaboreflex during isometric handgrip exercise.

Identifying and characterising the physical demands for an Australian specialist policing unit.

Many police organisations incorporate specialist policing roles where incumbents are tasked with providing operational response capabilities above and beyond the general duties policing role. The current research utilised subjective job task analysis methods to identify and characterise the physically demanding, frequently occurring, and operationally important tasks, as well as the dominant fitness component for each task, inherent to specialist policing roles in an Australian policing organisation. This was achieved through engagement with subject matter experts and online survey responses from specialist police incumbents. In total, 11 criterion tasks were identified, which covered a range of physical capacities including muscular strength, muscular endurance, and aerobic power. The most physically demanding tasks included those with an arrest component, requiring high muscular strength and power capacities. Having identified the criterion tasks, three operational scenarios were constructed, which incorporated each of the 11 tasks in different operational contexts. The criterion tasks and composite scenarios will allow practitioners within specialised police units to develop evidence-based strategies, including physical selection procedures and physical training programs, specific to the demands of their work.

The Effects of Simulated Wildland Firefighting Tasks on Core Temperature and Cognitive Function under Very Hot Conditions.

Background: The severity of wildland fires is increasing due to continually hotter and drier summers. Firefighters are required to make life altering decisions on the fireground, which requires analytical thinking, problem solving, and situational awareness. This study aimed to determine the effects of very hot (45°C; HOT) conditions on cognitive function following periods of simulated wildfire suppression work when compared to a temperate environment (18°C; CON). Methods: Ten male volunteer firefighters intermittently performed a simulated fireground task for 3 h in both the CON and HOT environments, with cognitive function tests (paired associates learning and spatial span) assessed at baseline (cog 1) and during the final 20-min of each hour (cog 2, 3, and 4). Reaction time was also assessed at cog 1 and cog 4. Pre- and post- body mass were recorded, and core and skin temperature were measured continuously throughout the protocol. Results: There were no differences between the CON and HOT trials for any of the cognitive assessments, regardless of complexity. While core temperature reached 38.7°C in the HOT (compared to only 37.5°C in the CON; p < 0.01), core temperature declined during the cognitive assessments in both conditions (at a rate of -0.15 ± 0.20°C·hr-1 and -0.63 ± 0.12°C·hr-1 in the HOT and CON trial respectively). Firefighters also maintained their pre-exercise body mass in both conditions, indicating euhydration. Conclusions: It is likely that this maintenance of euhydration and the relative drop in core temperature experienced between physical work bouts was responsible for the preservation of firefighters' cognitive function in the present study.

Response of women using oral contraception to exercise in the heat.

PURPOSE: To compare the response of long-term oral contraceptive users (WomenOC; n = 8) to naturally menstruating women (WomenNM; n = 8) at rest and during exercise in temperate (TEMP; 22 °C) and hot (HEAT; 35 °C) conditions. METHODS: Participants performed a three-stage cycling trial in each condition at 90, 135, and 180% of lactate threshold 1 (total = 52.5 min). Heart rate (HR) and core temperature (T c) were recorded continuously, whereas blood pressure (BP), ratings of perceived exertion (RPE), blood lactate [La-], and skin blood flow (BFsk) were recorded every 7.5 min. RESULTS: Baseline T c was higher in WomenOC (37.5 ± 0.2, 37.6 ± 0.3 °C) than WomenNM (37.2 ± 0.2, 37.0 ± 0.4 °C) before the TEMP (p = 0.03) and HEAT (p < 0.01) trials, respectively. This difference remained for 22.5 min into both trials (p ≤ 0.05), after which time no between-group differences were found (p > 0.05). BFsk measured in WomenNM plateaued from 7.5 min in the HEAT, whereas BFsk measured in WomenOC increased for 15.0 min (p = 0.02) before plateauing. There were no between-group differences in HR, BP, or blood [La-] before or throughout either trial (p > 0.05). WomenOC had higher (p ≤ 0.04) RPE values than WomenNM in the HEAT, reporting 8 ± 1 and 6 ± 2 at the end of Stage 3, respectively. CONCLUSIONS: WomenOC concluded both trials with a comparable T c to WomenNM, but had a prolonged BFsk response and elevated RPE in the HEAT. Changes to BFsk and RPE observed in women using OC may have implications for exercise tolerance in hot conditions.

The Impact of Heat Exposure and Sleep Restriction on Firefighters' Work Performance and Physiology during Simulated Wildfire Suppression.

This study was designed to examine the effects of ambient heat on firefighters' physical task performance, and physiological and perceptual responses when sleep restricted during simulated wildfire conditions. Thirty firefighters were randomly allocated to the sleep restricted (n = 17, SR; 19 °C, 4-h sleep opportunity) or hot and sleep restricted (n = 13, HOT + SR; 33 °C, 4-h sleep opportunity) condition. Firefighters performed two days of simulated, intermittent, self-paced work circuits comprising six firefighting tasks. Heart rate, and core temperature were measured continuously. After each task, firefighters reported their rating of perceived exertion and thermal sensation. Effort sensation was also reported after each work circuit. Fluids were consumed ad libitum. Urine volume and urine specific gravity were analysed. Sleep was monitored using polysomnography. There were no differences between the SR and HOT + SR groups in firefighters' physiological responses, hydration status, ratings of perceived exertion, motivation, and four of the six firefighting tasks (charged hose advance, rake, hose rolling, static hose hold). Black out hose and lateral repositioning were adversely affected in the HOT + SR group. Working in hot conditions did not appear to consistently impair firefighters work performance, physiology, and perceptual responses. Future research should determine whether such findings remain true when individual tasks are performed over longer durations.

The Injury Profile of an Australian Specialist Policing Unit.

This study investigated the injuries sustained by an Australian specialist police division. Injury records spanning four-years were analyzed. The role being performed when the injury occurred, injury cause, body part injured, and injury-related costs were quantified. The percentage of personnel injured multiple times was documented. One hundred and thirty eight personnel reported injuries, 58 of these on multiple occasions. This resulted in 229 injuries and 76 claims being raised. Half of the injuries occurred during operational policing tasks, however training activities accounted for >30% of injuries. The most common injury was strain/sprain, and upper body injuries were 2.5-times more common than lower-body or torso injuries. 1107 shifts were lost, and injuries cost the organization $487,159 (Australian Dollars) over the four-year period. The injury costs (both financial and in manpower) may prompt policy makers to review the current training and post-injury rehabilitation protocols.

Simulated Firefighting Task Performance and Physiology Under Very Hot Conditions.

PURPOSE: To assess the impact of very hot (45°C) conditions on the performance of, and physiological responses to, a simulated firefighting manual-handling task compared to the same work in a temperate environment (18°C). METHODS: Ten male volunteer firefighters performed a 3-h protocol in both 18°C (CON) and 45°C (VH). Participants intermittently performed 12 × 1-min bouts of raking, 6 × 8-min bouts of low-intensity stepping, and 6 × 20-min rest periods. The area cleared during the raking task determined work performance. Core temperature, skin temperature, and heart rate were measured continuously. Participants also periodically rated their perceived exertion (RPE) and thermal sensation. Firefighters consumed water ad libitum. Urine specific gravity (USG) and changes in body mass determined hydration status. RESULTS: Firefighters raked 19% less debris during the VH condition. Core and skin temperature were 0.99 ± 0.20 and 5.45 ± 0.53°C higher, respectively, during the VH trial, and heart rate was 14-36 beats.min(-1) higher in the VH trial. Firefighters consumed 2950 ± 1034 mL of water in the VH condition, compared to 1290 ± 525 in the CON trial. Sweat losses were higher in the VH (1886 ± 474 mL) compared to the CON trial (462 ± 392 mL), though both groups were hydrated upon protocol completion (USG < 1.020). Participants' average RPE was higher in the VH (15.6 ± 0.9) compared to the CON trial (12.6 ± 0.9). Similarly, the firefighers' thermal sensation scores were significantly higher in the VH (6.4 ± 0.5) compared to the CON trial (4.4 ± 0.4). CONCLUSIONS: Despite the decreased work output and aggressive fluid replacement observed in the VH trial, firefighters' experienced increases in thermal stress, and exertion. Fire agencies should prioritize the health and safety of fire personnel in very hot temperatures, and consider the impact of reduced productivity on fire suppression efforts.