Virtual ergonomics (VE) tools have had an impressive impact on the automotive, aviation, and defence industries. Despite the progress made in the last four decades, the tool complexity and application potential in other industries continues to invite improvement opportunities. Firefighting is an occupation with a high musculoskeletal injury burden that can benefit from innovative VE tools. This dissertation aims to: 1) improve VE tools for traditional and novel applications, and 2) identify injury risk to firefighters during fire suppression tasks. This dissertation begins by proposing a set of joint-specific and whole-body posturing guidelines for the manual manipulation of digital human models (DHMs) in the context of automotive manufacturing. Simulation accuracy improved with the implementation of posturing guidelines. These findings are useful instructions for virtual simulation ergonomists, software developers of posture prediction algorithms, and those charged with determining manufacturing ergonomics protocols. Descriptive ergonomic analyses of 48 firefighters in full bunker gear performing three common fire suppression tasks were then performed to identify the required ergonomic action needed for these tasks. Next, two VE tools (Jack and 3DSSPP) and Microsoft Kinect® 3D motion capture data were used to conduct an in-depth analysis of the most difficult task, the high-rise pack lift. The analysis included developing a methodology for modeling the external loads due to personal protective equipment. In addition to describing the firefighter injury risk exposure during common fire suppression tasks, the results highlight the strengths, limitations, and areas for further improvement of VE technology. Overall, VE tool improvements include suggesting guidelines for manual DHM posturing, understanding the strengths and limitations of using 3D motion capture gaming technology for posturing DHMs, and developing strategies to account for external loads due to personal protective equipment. Following these improvements, VE technology shows promise as an ergonomic assessment tool for firefighters. / Thesis / Doctor of Philosophy (PhD) / Virtual ergonomics (VE), which uses digital human models in virtual workstations, allows for efficient and detailed ergonomic assessments of tasks that are otherwise difficult or impossible to perform. However, more research is needed to identify tool improvements for both traditional and new applications. This work proposes, evaluates, and ultimately recommends a set of postural guidelines for the posturing of digital human models to ensure accurate simulation and subsequent assessment of real assembly-line worker movement patterns. Next, firefighter ergonomics, a relatively new application for VE tools, is introduced by first describing the injury risks associated with common fire suppression tasks. The strengths, limitations, and potential of applying VE tools to firefighting ergonomics are then highlighted through an example of simulating the high-rise pack lift task using two VE tools. Overall, the results contribute to the evolving field of VE by challenging current methodologies and highlighting new opportunities for VE tools.

Sports medicine professionals are continuously attempting to keep the incidence of injuries down. One way to accomplish this is to employ preventive methods that identify athletes who are at a greater risk of becoming injured prior to the start of the athletic season. The Functional Movement Screen™ (FMS) is a screening method that attempts to identify those individuals at risk of sustaining injuries by determining deficits in athletes' mobility and stability. This is an area of great conflict because athletic injuries result from many factors, not only in mobility and stability weaknesses. Therefore, it must first be determined whether deficient scores on the FMS are the result of the proposed weakness, or rather other potential risk factors. Functional Movement Screen™ scores were collected from 136 collegiate Division 1-A football players from three athletic programs. The scores were separated into one of three groups based upon the position played by each subject: (1) skill group, (2) combo group, and (3) line-of-scrimmage group. Data were also collected on each subject's height, weight, and relative body weight (BMI). The results of the ANOVA and Tukey HSD showed that there was a significant difference p < 0.05 between the line-of-scrimmage group and the skill group, as well as between the line-of-scrimmage group and the combo group. No significant difference was demonstrated between the combo group and the skill group. The results of the Pearson Correlation demonstrated a significant negative relationship p < 0.05 between the height of an athlete and the score received on the FMS. Significant negative relationships p < 0.01 were shown between the weight of an athlete and the score received on the FMS, as well as the relative body weight (BMI) and the athletes' score on the FMS. The results suggest that the score an athlete receives on the FMS may not reflect mobility and stability deficiencies because other factors affect the outcome of the scores. Therefore, at the present time, the FMS may not be a reliable tool by itself for identifying athletes who are at a greater risk of sustaining non-contact types of injuries. / Ph. D.

Females suffer anterior cruciate ligament (ACL) injuries at a 2 to 10-fold greater rate compared to male athletes participating in similar sports. Altered movement patterns and inadequate knee stiffness are two interrelated factors that may increase ACL injury risk. Onset of these neuromuscular risk factors may coincide with the rapid adolescent growth that results in the divergence of a multitude of neuromuscular parameters between sexes. The overall purpose of this dissertation was to determine if neuromuscular ACL injury risk factors in female athletes increase following rapid growth and development compared to males. Male and female athletes were tested with three-dimensional motion analysis techniques during a drop vertical jump over two consecutive years to determine if ACL injury risk factors increased. Pubertal females showed a significant longitudinal increase in knee abduction angle compared to post-pubertal females and both male groups. The increase in knee abduction angle appeared to remain consistent, as the post pubertal female cohort had greater overall knee abduction compared to post-pubertal males. Similar results were found with a greater magnitude of knee abduction moment in post-pubertal females compared to males. Males and females increased ankle, knee and hip active stiffness from the first to second year of testing. Ankle and hip stiffness were increased significantly more in the pubertal group compared to post-pubertal. Sex and maturational group differences were found in hip and ankle joint stiffness. Post-pubertal males had significantly greater hip stiffness than the other groups (even when normalized to body mass). This indicates that post-pubertal males utilized a different neuromuscular strategy during landing. Males had a significantly greater increase from year to year in vertical jump height compared to females. Vertical jump height is often related to a measure of whole body power and indicates that males had a significant neuromuscular spurt compared to females. Early puberty appears to be a critical phase related to the divergence of increased ACL injury risk factors. Injury prevention programs that focus on neuromuscular training may be beneficial to help address the development of ACL injury risk factors that occur in female athletes during maturation.

All-terrain vehicles (ATVs) were first developed and marketed in the U.S. in the 1970s. They have soared in popularity for occupational and recreational uses since that time. In 2008, there were approximately 10.2 million all-terrain vehicles (ATVs) in use in the United States. In 2001, it was estimated that 23 million Americans rode ATVs; 69% were adults and 31% children (CPSC, 2003). Deaths and injuries from ATVs have increased over time. According to the U.S. Consumer Product Safety Commission, Kentucky led the nation for ATV deaths from 2002-2006, with increasing numbers of fatalities annually. ATV use on farms is increasing across the country because the vehicles provide an efficient and reliable replacement for horses and tractors for farm work, such as checking livestock, feeding, or fence repair. Aging farmers and farmers with physical disabilities can often increase their productivity by using ATVs for their transportation needs on the farm. ATVs also serve as an inexpensive and popular recreational vehicle used by families especially in rural areas. In 2001, there were an estimated 481 ATVs per 1,000 (CI95% ± 27) farms in the southern region of the U.S. A literature review and a descriptive cross-sectional study were conducted. The specific aims of this dissertation were to: 1. Critically analyze the state of the science on ATV-related injury risk factors and explore recreational and occupational use of ATVs on farms. 2. Describe individual characteristics and demographic factors that are associated with ATV ownership and ridership among adult farmers. 3. Describe individual characteristics and environmental factors that are associated with ATV injury on farms. 4. Test models for predicting ATV ownership, ATV ridership, and ATV injury risk factors among adult farmers.

Despite wide application of community-based programmes to prevent injuries and promote health over the last 25 years, there is a paucity of evaluations from which to obtain evidence regarding the effectiveness and critical factors contributing to achieving effectiveness of these programmes. Research on community-based injury prevention programmes thus far has been driven by the question “does it work?” However, merely establishing whether a programme works or not provides insufficient information to generate new knowledge about these programmes. Many programme evaluations have been characterised as “black box” evaluations, with inadequate information about the intervening and contextual factors that mediate the relationship between the programme and its effects. Opening the black box is essential to developing the best evidence in relation to community-based programmes. Keeping the question “does it work?” in mind as a departure point, the seven studies of this thesis address different aspects of the questions “why does it work?” and “how does it work?” The aim is to aid in the understanding of factors that influence the operation and effectiveness of community-based injury prevention programmes. The findings from the studies support a number of conclusions with regard to the three research questions posed. There is limited evidence for the effectiveness of communitybased injury prevention programmes. Some of the problems of providing convincing evidence are due to the methodological difficulties of evaluating these programs. Contextual conditions and the amount of financial resources available to a programme are key factors associated with the effectiveness of community-based injury prevention programmes. There is inconclusive evidence regarding the importance of some of the socalled success factors described in the scientific literature for achieving effectiveness. While many programmes have access to locally collected injury data, they devote limited time to the analysis of this ssembled data. When selecting interventions, many programmes rely upon tuitive and subjective methods, e.g. discussions in networks, feedback from the general public, and experiences gained in their own work. This style of decision making is “experience-based” rather than evidence-based. The theoretical underpinning of the community-based approach has certain shortcomings, which could explain some of the difficulties in demonstrating effectiveness seen with many of these programmes. Programmes overwhelmingly define geographical units as communities. However, these entities can be highly heterogeneous and characterised by a weak sense of community, which can yield insufficient community member participation and intersectoral collaboration, as well as inadequate reach for many programmes. At the same time, none of the most plausible assumptions of the community-based approach appears to be fully or widely applied in programme practice. The implication is that many community-based programmes do not function at an optimum level.

This thesis looked at traffic crashes in the emirate of Dubai in the United Arab Emirates (UAE) to establish the current situation in road safety and ways of improving it. A global overview of road safety literature revealed that standards of road safety vary widely by region. Key indicators like fatality rate and risk (Jacobs et al, 2000) were found to be higher in most neighbouring Gulf Cooperative Council (GCC) countries (10-25 fatalities/100,000 pop., 3-5 fatalities/10,000 motor vehicles) than in the best-performing Western countries (6 fatalities/100,000 pop., 1 fatality/10,000 motor vehicles). Interventions and countermeasures to tackle specific road safety issues were reviewed from international studies. Countermeasures were chosen with consideration for the local situation in Dubai within the categories of Human, Environmental and Vehicle factors. Examples of selected measures include offending driver punishment (Human), Electronic Stability Control (Vehicle) and central barriers (Environment). These measures were mostly studied in different environments to those in Dubai so the aspect of knowledge transfer between areas of different cultural and environmental conditions was discussed. Data from real world injury crashes (as collected by Dubai Police and the Roads & Transport Authority) over twelve years (1995 2006) were subject to macroanalysis in SPSS to identify the main issues over the past decade. 18,142 crashes involving 30,942 casualties and 48,960 vehicles were analysed at the outset. The following issues were among the main concerns: - High proportion of fatal crashes out of all injury crashes (13.5% compared to 1.4% in the UK); - Most fatal crashes involved a single vehicle hitting a pedestrian; - Most injury crashes involved a single vehicle; - Inconsiderate driving was the most common crash cause cited by the police. Countermeasures found in the literature to counteract these problems were then suggested for application and the estimated savings from applying them were calculated. Savings were quantified as either reductions in casualties or injury crashes. Furthermore, cost savings for the calculated reductions were estimated using existing UK crash costs due to the scarcity of UAE crash cost estimates. Calculation of the estimated improvement in safety if these countermeasures were applied retrospectively meant a reduction of 4,634 injury crashes and 1,555 casualties over the 12-year period with an estimated cost saving of approximately £368 million or 2.7 billion Dirhams. To refine this method more detailed data on crashes were required and collected from the dedicated crash investigation team files in Dubai Police for 2006 and part of 2007. This new dataset (300 crashes) was put into a purpose-built database with over 140 fields and subject to microanalysis to more accurately match the problems and interventions. Six interventions were matched to individual cases in the database where they would have positively altered the outcome. This process was verified by independent crash experts and investigators. The benefits from these six countermeasures were then weighted to calculate the benefits for the whole crash population over a year. Examples of specific interventions included guardrails along the roadside; grade-separated crossing facilities for pedestrians; Electronic Stability Control and speed cameras. The estimated total reduction in crashes was 2,412 annually with calculated savings of £40 million or 280 million Dirhams. This was the first time this geographical area was studied in such depth and detail to allow the calculation of benefits from interventions matched to known road safety issues. Various limitations were encountered such as the unavailability of GIS basemaps and the continuously changing infrastructure and population of Dubai. Numerous areas of further work were identified. Such work areas include hospital studies for collecting injury data to compare with police data; changing vehicle standards so that they are better suited to local crash types; the calculation of crash and injury costs based on local figures; vehicle fleet analysis for comparing different vehicle segments and exposure; and improved data collection and storage methods.

Název: Nejčastější úrazy v judu, jejich prevence a následná rehabilitace. Cíle: Hlavním cílem této práce je zhodnotit nejčastější úrazy judistů České republiky, zjistit mechanismy jejich vzniku a navrhnout systém opatření, který zminimalizuje výskyt zranění. Metody: V této práci byly použita metoda písemného dotazování a metoda korelačně- deduktivní. Metoda písemného dotazování byla použita ke zjištění nejčastějších úrazů, preventivních opatření a následné rehabilitace judistů. Metoda korelačně- deduktivní byla aplikována ke studiu případných korelací mezi charakteristikou úrazů, věkem, pohlavím a technickým stupněm judistů. Výsledky: Nejčastější výskyt úrazů judistů České republiky je v oblasti kolenního, ramenního a hlezenního kloubu. Ve většině přápadů se jedná o poranění měkkých tkání, které vznikají při hodu a boji o úchop převážně během tréninku. S přibývajícím věkem judistů se zvyšuje četnost jejich zranění, přičemž frekvence úrazů u mužů je větší než u žen. S vyšším technickým stupněm judisty roste i celkový výskyt úrazů. Vliv preventivních opatření nebyl na výskytu zranění prokázán. Respondenti, absolvující poúrazovou rehabilitaci, nebo alespoň používající ortopedické pomůcky, včetně tapingu, zaznamenali nižší výskyt úrazů než jedinci, kteří neabsolvovali žádnou z rehabilitačních...

Back injury in nursing is a significant concern for the health of the worker, the costs to the healthcare system, and the safety of the patients. Current injury prevention measures include ergonomic adjustments to the work environment, the use of mechanical lifting equipment, policies to limit manual handling of patients, and the teaching of lifting techniques. These measures have been met with limited success in reducing injury rates. Little is known about whether changing the lifting biomechanics used in the healthcare setting can lower high injury rates across the profession. The purposes of this dissertation were to: 1) identify the biomechanical risk factors routinely encountered by healthcare workers during the performance of their daily job tasks and 2) determine whether nurses with formal training in weightlifting have better biomechanical performance during routine nursing tasks than nurses with no training. This dissertation included the development of a conceptual model to guide the research. The framework identified the impact of muscle fatigue on the biomechanics used in lifting and moving of heavy equipment and patients. The worker characteristics that affect muscle fatigue include age, gender, height, BMI and the type of recreational activities outside of the workplace. These characteristics were controlled for in two studies aimed at providing a greater understanding of biomechanics used by nurses during routine patient care related activities. The first study addressed a gap in knowledge related to the biomechanics of lifting techniques used by nurses in the work environment, specifically of the anterior rotation of the trunk and pelvis, angles of the hips, knees, and lumbar spine, and muscle activation of core and leg muscles used during patient care activities. We analyzed the biomechanics used by 11 senior level nursing students lifting a simulated patient attached to a rigid spine board from the floor to a standing height. Previous studies have identified that a lumbar spine angle in excess of 22.5 degrees flexion when performing a lift places a worker at a greater risk for back injury. Biomechanical risk factors effecting this lumbar spine angle identified in this study included the anterior rotation of the trunk and pelvis in the starting position of the lift, the angle of the hips and knees during the lifting cycle, the dominate muscle activation of the rectus femoris during the lifting cycle influencing the anterior pelvic rotation, and minimal activation of the core muscles required to add stability to the spine during the lift. This dissertation identifies common biomechanical risk factors routinely encountered by healthcare workers, and gives indication of differences between nurses with formal weightlifting training and those that have not received formal weightlifting training. The differences in body positioning and core stabilization can help reduce the biomechanical risks of back injury in nursing.

Local public health units in the province of Ontario, Canada, are often the primary source of health promotion and health education resources, but many do not provide programming specific to the Indigenous population. As of January 2018, modernization of the Ontario Public Health Standards requires public health units to work with the Indigenous population in providing culturally appropriate programs and services. The practice question guiding the capstone project was to determine what chronic disease and injury prevention programs exist that are culturally appropriate for the Indigenous population. The purpose of this project was to do an environmental scan and compile an inventory of existing health promotion programming that is culturally appropriate to the Indigenous population. In total, 72 Indigenous-specific programs were identified from the 26 organizations that were included in the environmental scan. Of the 26 organizations, 3 were public health units, 7 were Aboriginal health access centers, 7 were Indigenous friendship centers, 5 were Indigenous health organizations, and 4 were non-Indigenous organizations with an Indigenous component. Results from the capstone project will inform public health units of available, culturally appropriate programs that can be adapted to their local context, thereby addressing a significant gap in the current public health system. This doctoral project aligns with the design of a new model of care in the Ontario public health system and has the potential to address a gap in practice at both the local and provincial level by providing culturally appropriate guidance in the effective delivery of CDIP programming specific to the Indigenous population. This positive social change would impact the health status of this underserved population.

<p>Background: Three epidemiological studies conducted in Rwanda have highlighted that many people at different levels in the community of soccer do not implement accepted control measures for reducing the risk of injuries. However, little is known about what soccer community members themselves know about injury prevention. Purpose: The aim of this study was to identify perceptions of factors influencing the implementation of soccer injury prevention strategies in Rwanda.</p>