Dr Danny Maupin

Background Employment insecurity is a socioeconomic factor influencing mental health, yet the empirical evidence supporting this claim has important limitations. The fluctuations in employment insecurity throughout the COVID-19 pandemic offered a distinctive opportunity to delve deeper into this issue. By viewing employment as a dynamic process, this study explores the within-person relationship between shifts in employment status and corresponding changes in mental health. Methods 24 waves of data between April 2020 and March 2021 from the Understanding America Study (N=3824) were analysed using a within-person multilevel model. Employment security was modelled as a dynamic process involving transitions between secure employment, underemployment and unemployment with or without benefits. Mental health was measured by questionnaires on core symptoms of depression and anxiety. Results Downward transitions in employment security, from secure employment to underemployment or unemployment without benefits, were associated with worse mental health. Persisting in unemployment without benefits was also associated with poorer mental health, and regaining job security did not immediately improve it. Timely provision of unemployment benefits mitigated the adverse mental health impacts. Significant cross-level moderation effects were observed for prepandemic mental health status, Hispanic ethnicity and education level. Conclusion Downward transitions in employment security compromise mental health, and certain segments of the population experience worse consequences. Regaining job security is not associated with immediate improvement in mental health. Timely provision of unemployment benefits, providing support for both unemployment and underemployment and targeting vulnerable groups are vital for alleviating adverse mental health impacts from losing job security.

Background The underdiagnosis of cognitive impairment hinders timely intervention of dementia. Health professionals working in the community play a critical role in the early detection of cognitive impairment, yet still face several challenges such as a lack of suitable tools, necessary training, and potential stigmatization. Objective This study explored a novel application integrating psychometric methods with data science techniques to model subtle inconsistencies in questionnaire response data for early identification of cognitive impairment in community environments. Methods This study analyzed questionnaire response data from participants aged 50 years and older in the Health and Retirement Study (waves 8-9, n=12,942). Predictors included low-quality response indices generated using the graded response model from four brief questionnaires (optimism, hopelessness, purpose in life, and life satisfaction) assessing aspects of overall well-being, a focus of health professionals in communities. The primary and supplemental predicted outcomes were current cognitive impairment derived from a validated criterion and dementia or mortality in the next ten years. Seven predictive models were trained, and the performance of these models was evaluated and compared. Results The multilayer perceptron exhibited the best performance in predicting current cognitive impairment. In the selected four questionnaires, the area under curve values for identifying current cognitive impairment ranged from 0.63 to 0.66 and was improved to 0.71 to 0.74 when combining the low-quality response indices with age and gender for prediction. We set the threshold for assessing cognitive impairment risk in the tool based on the ratio of underdiagnosis costs to overdiagnosis costs, and a ratio of 4 was used as the default choice. Furthermore, the tool outperformed the efficiency of age or health-based screening strategies for identifying individuals at high risk for cognitive impairment, particularly in the 50- to 59-year and 60- to 69-year age groups. The tool is available on a portal website for the public to access freely. Conclusions We developed a novel prediction tool that integrates psychometric methods with data science to facilitate “passive or backend” cognitive impairment assessments in community settings, aiming to promote early cognitive impairment detection. This tool simplifies the cognitive impairment assessment process, making it more adaptable and reducing burdens. Our approach also presents a new perspective for using questionnaire data: leveraging, rather than dismissing, low-quality data.

Specialist police perform high-risk tasks and are required to have, and maintain, a high level of fitness. The aims of this study were to profile the strength of a specialist police unit and to investigate whether this profile remained constant over an 18-month period. Retrospective data for 47 special operations police officers (mean initial weight = 88.84 ± 8.25 kg) were provided. Officers were tested five times over 18 months for 1 repetition maximum: bench press, squat, deadlift, and pull-up. All officers continued to participate in their typical physical conditioning programs. Repeated-measures ANOVAs with Bonferroni post-hoc adjustments or Friedman tests with Wilcoxon signed-rank tests were used to compare strength values across all five time points (TPs). Alpha levels were set at 0.05. All strength values increased significantly over the 18-month period. Over the five TPs, absolute squat increased the most (+ 9%: initial mean = 125.79 ± 24.53 kg), followed by absolute bench press (+ 8%: initial mean = 109.67 ± 19.80 kg), absolute deadlift (+ 7%: initial mean = 151.64 ± 26.31 kg) and absolute pull-up (+ 4%: initial mean = 121.43 ± 14.91 kg). Relatively, the highest increase was found with the squat (+ 8%: initial mean = 1.42 ± 0.25%), followed by the bench press (+ 7%: initial mean = 1.24 ± 0.20%), deadlift (+ 6%: initial mean = 1.71 ± 0.25%) then pull-up (+ 4%: initial mean = 1.37 ± 0.15%). The period between TP3 and TP4 yielded the fewest significant increases compared with other TP differences with only absolute bench press (+ 1.7%), absolute squat (+ 1.1%) and relative bench press (+ 1.6%) changing significantly (p 

Law enforcement academies, designed to prepare recruits for their prospective career, represent periods of high physical and mental stress, potentially contributing to recruits' injuries. Managing stress via monitoring training loads may mitigate injuries while ensuring adequate preparation. However, it is vital to first understand an academy's typical training load. The aim of this study was to profile the typical training load of law enforcement recruits over the course of 22 weeks. Data were prospectively collected using global positioning system (GPS) units placed on recruits during a portion of the academy training, while a desktop analysis was retrospectively applied to six other classes. A Bland-Altman plot was conducted to assess the agreement between the two methods. A linear mixed model was conducted to analyse the difference in distances covered per week, while other variables were presented graphically. Adequate agreement between the desktop analysis and GPS units was observed. Significant differences ( -value < 0.01) in distance covered (9.64 to 11.65 km) exist between weeks during early academy stages, which coincide with increases (~6 h) in physical training. Significant decreases in distances were experienced during the last five weeks of academy training. Most acute:chronic workload ratios stayed between the proposed 0.8 to 1.3 optimal range. Results from this study indicate that large increases in training occur early in the academy, potentially influencing injuries. Utilizing a desktop analysis is a pragmatic and reliable approach for instructors to measure load.

Discussion: The aim of this research was to assess the relationship between training load variables and injury risk in a law enforcement recruit population. Recruits in this population typically engage in a ‘one size fits no-one’ training program that is centred around body weight exercises and long-distance running. [...]including more physical training around muscular strength and power could improve fitness components that are vital to law enforcement while decreasing the distance run and potentially mitigating injury risk.

Law enforcement officers routinely face unpredictable scenarios that may threaten the public, their colleagues, or themselves. In such situations, officers may be required to use firearms, with shooting accuracy becoming crucial. This literature review aimed to identify, synthesize, and report on research investigating factors that affect marksmanship in law enforcement personnel. A systematic search of seven databases was undertaken following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) approach. From an initial 5396 identified studies, 23 met the eligibility criteria. The key findings from these papers were: (1) physical exertion does not appear to decrease shooting performance, especially at close range (

The 20-m multistage fitness test (20MSFT) is commonly used by law enforcement agencies to measure aerobic fitness and to estimate maximal aerobic consumption (o(2)maxo(2)max). These measures are an important occupational variable with aerobic fitness levels linked to employment status, occupational performance, and long-term health in law enforcement officers. There are a multitude of predictive equations used to provide an estimate of o(2)maxo(2)max, with the extent of variability in the estimated o(2)maxo(2)max currently unknown in this population. This has consequences for comparisons between, and across, differing agencies, and in capabilities of deriving normative data. The aim of this investigation was to compare the variability in estimated Vo(2)max scores derived from different 20MSFT predictive equations. The 20-m multistage fitness test data from 1,094 law enforcement recruits (male n = 741, 25.2 +/- 6.3 years; female: n = 353, 25.6 +/- 5.6 years) from a single agency were retrospectively analyzed. The 20MSFT scores were transformed into estimated o(2)max scores using 6 different predictive equations. Significance was set at p < 0.05. Results demonstrated significantly different Vo(2)max scores between each predictive equation (p < 0.001; d = 0.25-1.53) and between male and female recruits (p < 0.001, r = 0.55). All estimated Vo(2)max equations showed small to very strong correlations with each other (p < 0.001; r = 0.32-0.99). The findings indicate considerable dispersion of Vo(2)max scores when using differing equations, suggesting raw 20MSFT variables (e.g., shuttles or distance completed) should be preferred to measure and apply results from aerobic fitness tests if standardized approaches are not developed within law enforcement.

The aim of this scoping review was to investigate the impact of footwear on worker physical task performance and injury risk. The review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews protocol and registered in the Open Science Framework. Key search terms were entered into five academic databases. Following a dedicated screening process and critical appraisal, data from the final articles informing this review were extracted, tabulated, and synthesised. Of 19,614 identified articles, 50 articles informed this review. Representing 16 countries, the most common populations investigated were military and firefighter populations, but a wide range of general occupations (e.g., shipping, mining, hairdressing, and healthcare workers) were represented. Footwear types included work safety boots/shoes (e.g., industrial, gumboots, steel capped, etc.), military and firefighter boots, sports shoes (trainers, tennis, basketball, etc.) and various other types (e.g., sandals, etc.). Occupational footwear was found to impact gait and angular velocities, joint ranges of motion, posture and balance, physiological measures (like aerobic capacity, heart rates, temperatures, etc.), muscle activity, and selected occupational tasks. Occupational footwear associated with injuries included boots, conventional running shoes, shoes with inserts, harder/stiffer outsoles or thin soles, and shoes with low comfort scores-although the findings were mixed. Occupational footwear was also linked to potentially causing injuries directly (e.g., musculoskeletal injuries) as well as leading to mechanisms associated with causing injuries (like tripping and slipping).

Background Injuries within law enforcement are a significant issue as they increase organisational costs and workforce strain. As one of the biggest risk factors of future injury is previous injury, minimising injuries suffered during academy has multiple beneficial and long-term effects, including a healthier and fitter police force. The purpose of this study was to profile the injuries sustained at a law enforcement academy to inform future injury mitigation strategies. Methods Injury data were provided retrospectively (from May 2012 to September 2019) from the official insurance records of a law enforcement academy and included nature, location, and activity performed at time of injury. A total of 4340 (3288 males, 938 females, 114 sex not stated) recruits participated in academy training during this period. Inclusion criteria for the data were (a) injury record related to a recruit, and (b) the recruit was injured during academy training., with injury defined as tissue damage caused by acute or repetitive trauma, inclusive of musculoskeletal, neural, and/or integumentary systems but excluding general medical conditions such as cardiac (e.g. heart attacks) or respiratory (asthma) that was subsequently reported for worker's compensation. Injury incidence rates and proportions were calculated and a Spearman's correlation analysis was conducted between injury rates over successive classes. Results An injury incidence rate of 368.63 injuries per 1000 recruits per year was calculated in this population, with a moderate correlation coefficient (r(s) = 0.60) of increasing injury rates over chronologically occurring classes. Females also had higher injury rates than male recruits, even across various fitness levels. Trauma to joints and ligaments (49.30%) was the most common injury, and the knee the most common location (23.17%) of injury. Physical training (56.10%) was the most common activity being performed at the time of injury. Conclusions This research demonstrates a large number of lower limb, musculoskeletal injuries that often occur during physical training. Further research is needed to assess suitable injury mitigation programs.

Law enforcement is an intermittently physically demanding job, interspersed with long periods of sedentary activity. To prepare for the physical demands of the job, law enforcement agencies enlist recruits into academies with a focus on physical training. Often, academies focus on aerobic-based exercise despite anaerobic fitness being strongly correlated to occupational tasks. The objective of this article is to analyze the changes in the fitness of police recruits during academy training. Initial and final fitness test results, encompassing muscular power, strength, endurance as well as aerobic and anaerobic fitness, were measured to analyze changes in fitness. Dependent t-tests showed significant increases (p < 0.05) across all fitness tests, with a trend towards larger increases in aerobic and muscle-endurance-based tests. Recruits from this academy tended to have higher fitness results compared to other academies and were either average or below average compared to age-matched standards in the general population. Physical training should persist for recruits beyond the academy to continue to develop fitness throughout their career. Academies should add a focus on muscular strength and power training as these measures relate to occupational tasks, which may better prepare recruits for demands they will be expected to face in the field.

Elite tactical units complete a variety of demanding tasks and a high level of fitness is required by this population to perform their occupational tasks optimally. The aim of this critical review was to identify and synthesize key findings of studies that have investigated the fitness profiles of elite tactical units. Included studies were critically appraised, using the Downs and Black checklist, and a level of evidence was determined. Relevant data were extracted, tabulated, and synthesized. Fourteen studies were included for review and ranged in percentage quality scores from 46% to 66% with a mean of 57.5%. Moderate interrater agreement (κ = 0.496) existed between raters. A variety of fitness measures were used across various domains of fitness. The most common measures were in the areas of anthropometric measures, strength, power, and aerobic capacity. However, there was high variety in the measures and their protocols. Though fitness appears to be a critical part of research and practice in tactical populations, currently there is no standardized measure or result for this population. Further research in fitness profiling should be completed using standardized outcome measures which cover the spectrum of the fitness demands for this population.

Purpose: Low injury rates have previously been correlated with sporting team success, highlighting the importance of injury prevention programs. Recent methods, such as acute: chronic workload ratios (ACWR) have been developed in an attempt to predict and manage injury risk; however, the relation between these methods and injury risk is unclear. The aim of this systematic review was to identify and synthesize the key findings of studies that have investigated the relationship between ACWR and injury risk. Methods: Included studies were critically appraised using the Downs and Black checklist, and a level of evidence was determined. Relevant data were extracted, tabulated, and synthesized. Results: Twenty-seven studies were included for review and ranged in percentage quality scores from 48.2% to 64.3%. Almost perfect interrater agreement (kappa = 0.885) existed between raters. This review found a high variability between studies with different variables studied (total distance versus high speed running), as well as differences between ratios analyzed (1.50-1.80 versus >= 1.50), and reference groups (a reference group of 0.80-1.20 versus

Firefighter clothing is known to restrict movement and increase the risk of musculoskeletal injury. The aim of this study was to investigate differences between clothing variations and firefighter mobility. Data were collected from eight firefighters using a randomized counterbalanced, repeated measures, design. Three different clothing variants (V1-V3) in addition to current station wear (S) were trialed. Combinations of S and V1 (SV1) and V2 (SV2) were also trialed. Outcome measures included: standing reach height; the Functional Movement Screen [FMS]; vertical jump; a visual analogue scale [VAS] for the FMS, vertical jump, step ups and crawl; and a mannequin sketch to mark areas of discomfort. V3 was preferred over S in all tasks and performed better both objectively (FMS and vertical jump) and subjectively (VAS scores). While V1 was typically associated with poorer performance, the impacts of V1 and V2 when compared to each other and S varied depending on the tasks performed. This variation was greater when V1 or V2 were worn with S (SV1 and SV2). Areas of discomfort across all variations was the knees, followed by the thighs. Clothing that has the least impact on, or improves, mobility (especially around the lower limbs) may help reduce firefighter injury and limit subjective discomfort.

Fitness is essential to specialist police forces, who have higher occupational demands than general police, and vital to performance and mission success. However, little research has been done profiling the metabolic fitness of these units and how they compare to other populations. The objective of this study was to profile the aerobic fitness of a specialist police unit. Body weight was measured to account for any impact on metabolic fitness, while VO2 max was estimated via number of shuttles completed on the 20 m Progressive Shuttle Run Test (PSRT) (n=47) on two dates one calendar year apart. There were no significant (p=.116) differences (mean difference 0.40±1.70 kg) in body weight between the initial measures (mean=88.84±8.25 kg) and the final measure (mean=89.24±8.77 kg) 13 months later. PSRT results increased significantly (p

Tactical populations often participate in demanding physical training and perform strenuous workplace tasks, increasing injury risk. Mitigating injury risk is vital for maintaining trained personnel and should be a focus for tactical populations. One such method, tracking training load, has not been studied in-depth in tactical populations, despite documented effectiveness in elite sport. Most injuries to tactical personnel are overuse in nature and therefore may be prevented by optimizing training load. Although the methods used in elite sport may not be directly transferrable to tactical environments, they may be used to inform injury mitigation strategies in tactical populations.

This paper examined the magnitude of differences in performance across domains of cognitive functioning between participants who attrited from studies and those who did not, using data from longitudinal ageing studies where multiple cognitive tests were administered. Individual participant data meta-analysis. Data are from 10 epidemiological longitudinal studies on ageing (total n=209 518) from several Western countries (UK, USA, Mexico, etc). Each study had multiple waves of data (range of 2-17 waves), with multiple cognitive tests administered at each wave (range of 4-17 tests). Only waves with cognitive tests and information on participant dropout at the immediate next wave for adults aged 50 years or older were used in the meta-analysis. For each pair of consecutive study waves, we compared the difference in cognitive scores (Cohen's d) between participants who dropped out at the next study wave and those who remained. Note that our operationalisation of dropout was inclusive of all causes (eg, mortality). The proportion of participant dropout at each wave was also computed. The average proportion of dropouts between consecutive study waves was 0.26 (0.18 to 0.34). People who attrited were found to have significantly lower levels of cognitive functioning in all domains (at the wave 2-3 years before attrition) compared with those who did not attrit, with small-to-medium effect sizes (overall d=0.37 (0.30 to 0.43)). Older adults who attrited from longitudinal ageing studies had lower cognitive functioning (assessed at the timepoint before attrition) across all domains as compared with individuals who remained. Cognitive functioning differences may contribute to selection bias in longitudinal ageing studies, impeding accurate conclusions in developmental research. In addition, examining the functional capabilities of attriters may be valuable for determining whether attriters experience functional limitations requiring healthcare attention.