E-scooter riders have an increased crash risk compared to cyclists [1 ]. Hospital data finds increasing numbers of injured e-scooter riders, with head injuries as one of the most common injury types [2]. To decrease this high prevalence of head injuries, the use of e-scooter helmets could present a potential countermeasure [3]. Despite this, studies show a generally low rate of helmet use rates in countries without mandatory helmet use laws [4][5][6]. In countries with mandatory helmet use laws for e-scooter riders, helmet use rates are higher, but generally remain lower than bicycle use rates [7]. As the helmet use rate is a central factor for the safety of e-scooter riders in case of a crash and a key performance indicator in the European Commission's Road Safety Policy Framework 2021-2030 [8], efficient e-Scooter helmet use data collection methods are needed. However, currently, human observers are used to register e-scooter helmet use either in direct roadside observations or in indirect video-based observation, which is time-consuming and costly. In this study, a deep learning-based method for the automated detection of e-scooter helmet use in video data was developed and tested, with the aim to provide an efficient data collection tool for road safety researchers and practitioners.

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It is imperative for strength and conditioning coaches to conduct a detailed analysis of the demands of a sport, identifying normative data where possible to permit an evidence-based evaluation of an athlete's current performance status and to inform the development of specific goals for the athletes' development. Part one of this article reviews the demands of female soccer and provides normative data from published research identifying specific areas that require development in female soccer players. Part two recommends evidence-based approaches integrated to athlete development and injury prevention strategies, as a result of the needs analysis.

Title of diploma's thesis: The effectiveness of program in lower limbs injuries in handball Abstract: The theoretical part of diploma's thesis contains detailed description of anatomy and kinesiology of knee and ankle joints. It also link injuries which affect this parts of body. This part contains accident occurrence in sports, causes and mechanism of injury. We could not forget the theoretical treatment for the prevention of injury. The practical part is the creation and application of a simple prevention motion program that will have a preventive effect in terms of lower limb injuries of female handball players. Research thesis therefore dealt efficiency of our original motion program. We checked the statistically processed data on the number and type of injuries in female players of handball in the first league of women. The effectiveness of our motion program was confirmed by reducing the number of injuries of the lower limbs in the intervention group. Key words: lower limb injury, injury prevention, accident occurrence, special prevention motion program

Pressure injuries (PIs) affect an estimated 2.5 million people in America and cost the nation approximately $11.6 billion each year. The goal of this DNP project was to minimize the rate of PIs at a home health care agency through effective teamwork. Prevention of PIs is very important because PIs damage patients' skin integrity, cause significant amount of pain, are costly to treat, and cause life-threatening infections. The purpose of this DNP project was to evaluate nursing compliance with PI prevention measures and the level of nursing teamwork at the project agency. The Braden-Bergstrom conceptual framework was used to explain the etiology and progression of PI while Lewin's Change Theory was used to promote behavioral change in the nursing team. The practice-focused questions for closing the gap between nursing knowledge and practice were what percentage of nurses complied with standard PI prevention guidelines and what was the level of nursing staff teamwork in the agency per the Nursing Teamwork Survey [NTS]. This PI prevention initiative used a cross-sectional design. Data collection involved review of nursing documentation and electronic surveying of all nursing staff using the MISSCARE survey, the NTS, and the AHRQ assessment checklists, which were completed via SurveyMonkey, an online survey software. The impact of the PI prevention initiative was assessed by comparing the results of the documentation review and surveys pretest to the posttest results. There was significant improvement in nursing compliance with PI prevention and treatment. Pressure injury incidence rate fell from 13.6% to 5.1%. The positive social impact includes improving patient care and safety, minimizing PI incidence and producing an efficient team.

<p>Low back pain (LBP) is a significant problem among the nursing population worldwide. Manual lifting and shifting of heavy objects and patients are primary contributing factors. Nurses are supposed to be knowledgeable about the risk factors and preventive measures and effectively apply it into practice to prevent them from sustaining back injuries. Strategies to reducing the incidences of LBP in nurses have been previously implemented but with little outcomes. The purpose of this study was to explore the relationship between occupational risk factors and the prevalence of LBP in nurses at MOI, Tanzania. Therefore, the study examined / the prevalence of LBP amongst nurses, work-related risk factors contributing to LBP, knowledge and effectiveness of back care techniques, and barriers to effective back care techniques in clinical nurses.</p>

BACKGROUND and OBJECTIVES: Low-back overexertion injuries represent a large proportion of fireground “strains, sprains and muscular pains” and are a leading cause of disability and early retirement in firefighters. Given the inherently hazardous and unpredictable nature of many fireground activities, it is often infeasible to implement “task-focused” ergonomic controls and there are limited options to accommodate injured firefighters. Accordingly, effective and practical “worker-focused” injury prevention approaches are needed. Toward this end, four studies were conducted to address the following global thesis objectives: 1) Examine the possible role that firefighters’ personal movement strategies could have on their occupational low-back loading demands and injury potential; and 2) Compare the effects of two different exercise approaches on firefighters’ occupational low-back loading demands and injury potential. STUDY 1: Low-Back Loading Demands during Simulated Firefighting Tasks – Inter-Subject Variation and the Impact of Fatigue and Gender. Background: Non-modifiable fireground duties are considered hazardous for low-back health, but personal movement strategies could modulate low-back loading demands and injury potential. Study objectives were to quantify low-back loading demands during simulated firefighting tasks and to examine the impact of fatigue and gender on the peak loading response. Methods: Ten men and 10 women performed a battery of laboratory-simulated firefighting tasks before and following repeated bouts of a fatiguing stair-climbing protocol. An EMG-assisted three-dimensional dynamic biomechanical model was used to compute peak L4/L5 joint forces during task performance. Results: Peak low-back loading demands varied considerably between subjects and tasks, but 70% of all loading variables examined were of greater magnitudes in male subjects and 40% of all loading variables were of lower magnitudes in both males and females after stair-climbing. Some inter-subject variation in low-back loading was attributed to body size differences, but between- and within-subject differences in movement strategies also contributed to low-back loading variability between subjects and over time. Conclusions: Results of this study suggest that characteristics of individuals, tasks performed, and physical fatigue may influence peak low-back loading demands and injury potential in firefighters. Despite considerable inter-subject variation in the internal low-back loading response to fixed external task and environmental constraints, opportunities to attenuate low-back loading demands through movement behaviour adaptations alone may be limited to only a subset of fireground activities. STUDY 2: Ankle Immobilization alters Lifting Kinematics and Kinetics – Occupational Low-Back Loading Demands and Potential for Injury. Background: Firefighters with lingering lower extremity functional impairments could be forced to move in ways that increase their potential for sustaining occupational low-back lifting injuries. The study objective was to examine the impact of unilateral ankle immobilization on lifting kinematics and kinetics. Methods: With and without their right ankle immobilized, 10 male volunteers performed laboratory-simulated occupational lifting tasks. Together with force platform data, three-dimensional kinematics of the lumbar spine, pelvis, and lower extremities were collected, and a three-dimensional dynamic biomechanical model was used to calculate peak low-back compression and shear loading demands. Results: In comparison to the unaffected conditions, ankle immobilization resulted in less knee (p-values between 0.0004 and 0.0697) and greater lumbar spine (p-values between 0.0006 and 0.3491) sagittal motion when lifting. Associated with this compensatory movement strategy were greater L4/L5 anterior/posterior reaction shear forces (p-values between 0.0009 and 0.2450). However, in a few cases where individual compensatory movement strategies differed from the “group” response (i.e., subjects increased their sagittal knee and hip motion on the affected side), peak L4/L5 joint compressive loads increased while the peak L4/L5 anterior-posterior shear did not change. Conclusions: Distal lower extremity joint dysfunction can alter the way in which individuals move and load their low-backs when lifting. The specific ways in which individuals compensate for personal movement constraints could alter the potential site and mechanism of occupational low-back injury. STUDY 3: FMS™ Scores and Occupational Low-Back Loading Demands – Whole-Body Movement Screening as an Ergonomic Tool? Background: Results of Study 1 suggested that a whole-body movement screen could be used to identify personal characteristics that constrain movement behaviour in ways that impact occupational low-back loading demands and injury potential. The purpose of this study was to examine if Functional Movement Screen™ (FMS) scores could be used to project the low-back loading response to lifting. Methods: Sagittally symmetric and asymmetric laboratory-based lifting tasks were performed by 15 firefighters who scored greater than 14 on the FMS (high-scorers) and 15 size-matched low-scorers (FMS < 14). A three-dimensional dynamic biomechanical model was used to calculate low-back loading demands, and lumbar spine posture was recorded when peak low-back compression was imposed. Results: Regardless of the task performed, there were no differences in peak L4/L5 joint compression (p ≥ 0.4157), anterior/posterior reaction shear (p ≥ 0.5645), or medial/lateral reaction shear (p ≥ 0.2581) loading demands between high- and low-scorers. At the instant when peak compression force was detected, lumbar spine deviation was not different between high- and low-scorers about the lateral bend (p ≥ 0.4215), axial twist (p ≥ 0.2734), or flexion/extension (p ≥ 0.1354) axes. Conclusions: Using the previously established musculoskeletal injury prediction threshold value of 14, the composite FMS score did not project the low-back loading response to lifting. Future attempts to modify or reinterpret FMS scoring are warranted given that several previous studies have revealed links between composite FMS scores and musculoskeletal complaints. STUDY 4: Movement- vs. Fitness-Centric Exercise – Firefighter Fitness, Whole-Body Movement Qualities, and Occupational Low-Back Loading Outcomes. Background: The impact of exercise on firefighter job performance and cardiorespiratory fitness has been studied extensively, but its effect on musculoskeletal loading remains less understood. The aim of this study was to compare various physical fitness, general movement quality, and low-back loading outcomes between groups of firefighters who completed fitness- or movement-centric exercise. Methods: Fifty-four firefighters participated and were assigned to a control (CON), fitness-centric exercise (FIT), or movement-centric exercise (MOV) group. Before and after 12 weeks of exercise, subjects performed a physical fitness test battery, the Functional Movement Screen™ (FMS), and laboratory-simulated firefighting tasks during which low-back loading demands were quantified. Results: FIT and MOV subjects exhibited statistically significant improvements in nearly all measures of physical fitness (i.e., body composition, cardiorespiratory capacity, muscular strength, power, endurance, and flexibility), but FMS scores and occupational low-back loading demands were not impacted in a consistent way across individuals. Conclusions: Improving physical fitness can enhance job performance and prevent cardiac events in firefighters, but it was not clear that 12 weeks of exercise would alter their occupational low-back loading demands. Given variability in individual responses, the short study duration, and limited number and nature of tasks examined, more research incorporating alternative biomechanical and statistical analyses is needed to better understand how individuals adapt to chronic exercise and what impact these adaptations have on occupational movement behaviours, low-back loading demands, and low-back loading capacity. SUMMARY and CONCLUSIONS: Results confirmed that fireground activities are potentially hazardous for low-back health, as simulated occupational low-back loading demands routinely exceeded recommended exposure limits in the studies performed. However, results also indicated that personal movement strategies – possibly influenced by body size, preference, gender, physical fatigue, or distal lower extremity joint dysfunction – could alter occupational low-back loading demands and injury potential. It could not be concluded that occupational low-back loading demands and injury potential would be consistently affected by short-term improvements in physical fitness, nor could the low-back loading response to lifting be projected by scoring above or below 14 on the Functional Movement Screen™. Future research is warranted to examine the low-back loading demands associated with performing non-fireground duties, as opportunities may exist to implement ergonomic strategies to control cumulative low-back loading exposures. Particular attention should be paid to the exercise and training practices of firefighters, as musculoskeletal injuries sustained during these activities are potentially avoidable and could reduce the capacity of the musculoskeletal system to withstand demands imposed during non-modifiable fireground operations.

<p>Low back pain (LBP) is a significant problem among the nursing population worldwide. Manual lifting and shifting of heavy objects and patients are primary contributing factors. Nurses are supposed to be knowledgeable about the risk factors and preventive measures and effectively apply it into practice to prevent them from sustaining back injuries. Strategies to reducing the incidences of LBP in nurses have been previously implemented but with little outcomes. The purpose of this study was to explore the relationship between occupational risk factors and the prevalence of LBP in nurses at MOI, Tanzania. Therefore, the study examined / the prevalence of LBP amongst nurses, work-related risk factors contributing to LBP, knowledge and effectiveness of back care techniques, and barriers to effective back care techniques in clinical nurses.</p>

BACKGROUND and OBJECTIVES: Low-back overexertion injuries represent a large proportion of fireground “strains, sprains and muscular pains” and are a leading cause of disability and early retirement in firefighters. Given the inherently hazardous and unpredictable nature of many fireground activities, it is often infeasible to implement “task-focused” ergonomic controls and there are limited options to accommodate injured firefighters. Accordingly, effective and practical “worker-focused” injury prevention approaches are needed. Toward this end, four studies were conducted to address the following global thesis objectives: 1) Examine the possible role that firefighters’ personal movement strategies could have on their occupational low-back loading demands and injury potential; and 2) Compare the effects of two different exercise approaches on firefighters’ occupational low-back loading demands and injury potential. STUDY 1: Low-Back Loading Demands during Simulated Firefighting Tasks – Inter-Subject Variation and the Impact of Fatigue and Gender. Background: Non-modifiable fireground duties are considered hazardous for low-back health, but personal movement strategies could modulate low-back loading demands and injury potential. Study objectives were to quantify low-back loading demands during simulated firefighting tasks and to examine the impact of fatigue and gender on the peak loading response. Methods: Ten men and 10 women performed a battery of laboratory-simulated firefighting tasks before and following repeated bouts of a fatiguing stair-climbing protocol. An EMG-assisted three-dimensional dynamic biomechanical model was used to compute peak L4/L5 joint forces during task performance. Results: Peak low-back loading demands varied considerably between subjects and tasks, but 70% of all loading variables examined were of greater magnitudes in male subjects and 40% of all loading variables were of lower magnitudes in both males and females after stair-climbing. Some inter-subject variation in low-back loading was attributed to body size differences, but between- and within-subject differences in movement strategies also contributed to low-back loading variability between subjects and over time. Conclusions: Results of this study suggest that characteristics of individuals, tasks performed, and physical fatigue may influence peak low-back loading demands and injury potential in firefighters. Despite considerable inter-subject variation in the internal low-back loading response to fixed external task and environmental constraints, opportunities to attenuate low-back loading demands through movement behaviour adaptations alone may be limited to only a subset of fireground activities. STUDY 2: Ankle Immobilization alters Lifting Kinematics and Kinetics – Occupational Low-Back Loading Demands and Potential for Injury. Background: Firefighters with lingering lower extremity functional impairments could be forced to move in ways that increase their potential for sustaining occupational low-back lifting injuries. The study objective was to examine the impact of unilateral ankle immobilization on lifting kinematics and kinetics. Methods: With and without their right ankle immobilized, 10 male volunteers performed laboratory-simulated occupational lifting tasks. Together with force platform data, three-dimensional kinematics of the lumbar spine, pelvis, and lower extremities were collected, and a three-dimensional dynamic biomechanical model was used to calculate peak low-back compression and shear loading demands. Results: In comparison to the unaffected conditions, ankle immobilization resulted in less knee (p-values between 0.0004 and 0.0697) and greater lumbar spine (p-values between 0.0006 and 0.3491) sagittal motion when lifting. Associated with this compensatory movement strategy were greater L4/L5 anterior/posterior reaction shear forces (p-values between 0.0009 and 0.2450). However, in a few cases where individual compensatory movement strategies differed from the “group” response (i.e., subjects increased their sagittal knee and hip motion on the affected side), peak L4/L5 joint compressive loads increased while the peak L4/L5 anterior-posterior shear did not change. Conclusions: Distal lower extremity joint dysfunction can alter the way in which individuals move and load their low-backs when lifting. The specific ways in which individuals compensate for personal movement constraints could alter the potential site and mechanism of occupational low-back injury. STUDY 3: FMS™ Scores and Occupational Low-Back Loading Demands – Whole-Body Movement Screening as an Ergonomic Tool? Background: Results of Study 1 suggested that a whole-body movement screen could be used to identify personal characteristics that constrain movement behaviour in ways that impact occupational low-back loading demands and injury potential. The purpose of this study was to examine if Functional Movement Screen™ (FMS) scores could be used to project the low-back loading response to lifting. Methods: Sagittally symmetric and asymmetric laboratory-based lifting tasks were performed by 15 firefighters who scored greater than 14 on the FMS (high-scorers) and 15 size-matched low-scorers (FMS < 14). A three-dimensional dynamic biomechanical model was used to calculate low-back loading demands, and lumbar spine posture was recorded when peak low-back compression was imposed. Results: Regardless of the task performed, there were no differences in peak L4/L5 joint compression (p ≥ 0.4157), anterior/posterior reaction shear (p ≥ 0.5645), or medial/lateral reaction shear (p ≥ 0.2581) loading demands between high- and low-scorers. At the instant when peak compression force was detected, lumbar spine deviation was not different between high- and low-scorers about the lateral bend (p ≥ 0.4215), axial twist (p ≥ 0.2734), or flexion/extension (p ≥ 0.1354) axes. Conclusions: Using the previously established musculoskeletal injury prediction threshold value of 14, the composite FMS score did not project the low-back loading response to lifting. Future attempts to modify or reinterpret FMS scoring are warranted given that several previous studies have revealed links between composite FMS scores and musculoskeletal complaints. STUDY 4: Movement- vs. Fitness-Centric Exercise – Firefighter Fitness, Whole-Body Movement Qualities, and Occupational Low-Back Loading Outcomes. Background: The impact of exercise on firefighter job performance and cardiorespiratory fitness has been studied extensively, but its effect on musculoskeletal loading remains less understood. The aim of this study was to compare various physical fitness, general movement quality, and low-back loading outcomes between groups of firefighters who completed fitness- or movement-centric exercise. Methods: Fifty-four firefighters participated and were assigned to a control (CON), fitness-centric exercise (FIT), or movement-centric exercise (MOV) group. Before and after 12 weeks of exercise, subjects performed a physical fitness test battery, the Functional Movement Screen™ (FMS), and laboratory-simulated firefighting tasks during which low-back loading demands were quantified. Results: FIT and MOV subjects exhibited statistically significant improvements in nearly all measures of physical fitness (i.e., body composition, cardiorespiratory capacity, muscular strength, power, endurance, and flexibility), but FMS scores and occupational low-back loading demands were not impacted in a consistent way across individuals. Conclusions: Improving physical fitness can enhance job performance and prevent cardiac events in firefighters, but it was not clear that 12 weeks of exercise would alter their occupational low-back loading demands. Given variability in individual responses, the short study duration, and limited number and nature of tasks examined, more research incorporating alternative biomechanical and statistical analyses is needed to better understand how individuals adapt to chronic exercise and what impact these adaptations have on occupational movement behaviours, low-back loading demands, and low-back loading capacity. SUMMARY and CONCLUSIONS: Results confirmed that fireground activities are potentially hazardous for low-back health, as simulated occupational low-back loading demands routinely exceeded recommended exposure limits in the studies performed. However, results also indicated that personal movement strategies – possibly influenced by body size, preference, gender, physical fatigue, or distal lower extremity joint dysfunction – could alter occupational low-back loading demands and injury potential. It could not be concluded that occupational low-back loading demands and injury potential would be consistently affected by short-term improvements in physical fitness, nor could the low-back loading response to lifting be projected by scoring above or below 14 on the Functional Movement Screen™. Future research is warranted to examine the low-back loading demands associated with performing non-fireground duties, as opportunities may exist to implement ergonomic strategies to control cumulative low-back loading exposures. Particular attention should be paid to the exercise and training practices of firefighters, as musculoskeletal injuries sustained during these activities are potentially avoidable and could reduce the capacity of the musculoskeletal system to withstand demands imposed during non-modifiable fireground operations.