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Healthcare
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Health and Readiness of Tactical Populations
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Health and Readiness of Tactical Populations

A special issue of Healthcare (ISSN 2227-9032).

Deadline for manuscript submissions: 30 June 2025 | Viewed by 9755

Special Issue Editor

Dr. Mark Abel

E-Mail Website
Guest Editor
First Responder Research Laboratory, University of Kentucky, Lexington, KY 40506-0219, USA
Interests: firefighter; first responder; health; injury; law enforcement; military; operator; safety; tactical
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Tactical populations include first responders (firefighters, law enforcement officers, EMS personnel, etc.) and military personnel that have committed to protect life and property. Many of these occupations require the performance of arduous physical tasks in austere environments. As such, musculoskeletal injuries, psychological (e.g., PTSD) and physical morbidities (e.g., cancer, cardiovascular disease, obesity), and decreased physical fitness occur across the career span. We are pleased to invite you to provide researchers, administrators, and practitioners with empirical research to elucidate these occupational threats, identify risk factors and mechanisms associated with their occurrence, and provide evidence-based practices to address them in tactical populations.

In this Special Issue, original research articles and reviews are welcome. Research aims and study designs on tactical populations may include (but not limited to) the following:

  • Elucidate and evaluate critical mental and physical health, injury, and performance issues confronting tactical populations;
  • Quantitative and qualitative investigations to identify risk factors and mechanisms of injuries;
  • Longitudinal assessments of interventions to enhance health, injury, fitness and occupational performance outcomes to develop evidence-based practices;
  • Cross-sectional designs to evaluate the role of physical fitness and occupational readiness in health and injury outcomes;
  • Validation research to develop relevant assessments of occupational physical ability and technologies to support operator readiness in recruit and incumbent populations and to guide return to duty post-injury;
  • Evaluate the impact of allostatic load (physical and psychological stressors) on occupational readiness, health, and injury outcomes.

We look forward to receiving your contributions.

Dr. Mark Abel
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • firefighter
  • first responder
  • health
  • injury
  • law enforcement
  • military
  • operator
  • safety
  • tactical

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (4 papers)

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Research

14 pages, 1613 KiB  
Article
A Quantitative Analysis of Internal and External Loads in Aviation Firefighting Using a Simulated Scenario
by Bronia Glen, Jodie Wills, Rhiannon Campbell, Stuart Cormack, Paul Tofari, Brendan Parsey, Rohan Edmonds and Tim Doyle
Healthcare 2025, 13(2), 97; https://doi.org/10.3390/healthcare13020097 - 7 Jan 2025
Viewed by 903
Abstract
Background/Objectives: Aviation firefighting is a strenuous occupation that requires individuals to engage in intense physical activity amidst elevated stress levels and extreme environmental conditions. Despite this, there has been limited investigation regarding the internal and external loads associated with aviation firefighting tasks, which [...] Read more.
Background/Objectives: Aviation firefighting is a strenuous occupation that requires individuals to engage in intense physical activity amidst elevated stress levels and extreme environmental conditions. Despite this, there has been limited investigation regarding the internal and external loads associated with aviation firefighting tasks, which include hose dragging, stair climbing, casualty evacuation, and fire extinguishing in airports and aircrafts. The aim of this study was to examine the internal and external loads placed on aviation firefighters. By identifying these demands, this study seeks to inform the development of targeted training strategies, improve job safety, and lower the risk of musculoskeletal injuries. Methods: Sixteen Australian aviation firefighters (35.13 ± 8.2 years) were recruited and assigned specific roles to complete an aircraft firefighting scenario. Measures of heart rate (HR), oxygen consumption (V˙O2), and rating of perceived exertion (RPE) were used to quantify internal load, while measures of completion time and distance travelled were used to quantify external load. Results: The median scenario completion time was 21 min (IQR = 5), with each role travelling a median distance of 245–541 m. During the scenario, median average HR values ranged between 61.1 and 72.0% HRmax and median maximal HR values ranged between 77.8 and 84.4% HRmax. As the only group to record V˙O2, driver firefighters operated at a median average V˙O2 of 49% of their V˙O2max and achieved a median maximal V˙O2 of 78% of their V˙O2max. Conclusions: This study effectively identified the task-specific internal and external loads associated with aviation firefighting, offering valuable insights for developing specific training protocols for firefighters to ensure appropriate physical capacity to perform their job roles safely. Full article
(This article belongs to the Special Issue Health and Readiness of Tactical Populations)
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11 pages, 226 KiB  
Article
The Medico-Legal and Social Aspects of the Eligibility Examination for Enrolment in the Seafarers Registry: A Single-Center Retrospective Study
by Antonietta Porzio, Alessandro Feola, Edoardo Mazzini, Angelo Lauro, Maria Rosaria Forte, Marco Trabucco Aurilio and Carlo Pietro Campobasso
Healthcare 2024, 12(23), 2410; https://doi.org/10.3390/healthcare12232410 - 30 Nov 2024
Viewed by 782
Abstract
Background: Working on board presents unique healthcare challenges for maritime personnel. Italian Law mandates a medical fitness assessment for seafarers registry enrolment. The Port Health Officer assesses seaworthiness and, against this judgment, the applicants can appeal to the First-degree Medical Commission. Studies on [...] Read more.
Background: Working on board presents unique healthcare challenges for maritime personnel. Italian Law mandates a medical fitness assessment for seafarers registry enrolment. The Port Health Officer assesses seaworthiness and, against this judgment, the applicants can appeal to the First-degree Medical Commission. Studies on maritime personnel’s medical fitness are limited and primarily focus on the health conditions of individuals already employed in the maritime sector. Methods: A retrospective study reviewed 459 medical reports of 361 seafarers from Naples’ Port Authority First-degree Medical Commission (2013–2022). Characteristics such as sex, age, diseases, and suitability judgments were analyzed. Results: Out of the 361 candidates, most were male with an average age of 28.67 years. A total of 160 (44.32%) were deemed suitable for matriculation in both the first and second categories, 79 (21.88%) were approved for one category, 53 (14.68%) were found not suitable, and 69 (19.11%) are still under assessment. Eye diseases were most common (50.83%), followed by cardiovascular and orthopedic conditions. Applicants with poorly controlled diabetes mellitus, epilepsy, psychiatric disorders, and advanced tumors were declared unsuitable. Conclusion: Our study provides opportunities to improve applicants’ awareness of the physical requirements for pursuing a career in navigation and to update the list of illnesses and physical impairments used for this medico-legal evaluation. Full article
(This article belongs to the Special Issue Health and Readiness of Tactical Populations)
13 pages, 1210 KiB  
Article
Differences in Workloads of Maximal Tasks in Active-Duty Firefighters
by Rudi A. Marciniak, Carly A. Wahl and Kyle T. Ebersole
Healthcare 2024, 12(15), 1495; https://doi.org/10.3390/healthcare12151495 - 27 Jul 2024
Viewed by 1188
Abstract
The purpose of this study was to compare the workload of a maximal treadmill test (TREAD) and a fire suppression task (BURN) in firefighters and to examine their relationships to fitness as measured by body mass index (BMI), percent body fat (BF%), and [...] Read more.
The purpose of this study was to compare the workload of a maximal treadmill test (TREAD) and a fire suppression task (BURN) in firefighters and to examine their relationships to fitness as measured by body mass index (BMI), percent body fat (BF%), and peak aerobic capacity (VO2PEAK). The amount of time spent in the heart rate (HR) intensity ranges of 50–59% HRMAX (ZONE1), 60–69% HRMAX (ZONE2), 70–79% HRMAX (ZONE3), 80–89% HRMAX (ZONE4), and ≥90% HRMAX (ZONE5) quantified the workload as the Edward’s Training Impulse for TREAD (ETRIMPTREAD) and BURN (ETRIMPBURN). The ETRIMPTREAD was significantly less than ETRIMPBURN. For TREAD, ZONE5 > ZONE2 and ZONE3. For BURN, ZONE4 > ZONE1, ZONE2, and ZONE5 > ZONE1, ZONE2, and ZONE3. A lower BF% and greater VO2PEAK were related to a greater ETRIMPTREAD and unrelated to ETRIMPBURN. For BURN only, a lower BF% and greater VO2PEAK were related to less time in ZONE5. BMI was unrelated to all workload measures. Laboratory-based maximal exercise testing does not adequately reflect the workload of simulated fire suppression and therefore may not be indicative of firefighter readiness to meet job demands. Less-fit firefighters rely on higher cardiovascular intensities to complete the same workload, and practitioners should consider this when selecting strategies to reduce job-associated cardiovascular risk. Full article
(This article belongs to the Special Issue Health and Readiness of Tactical Populations)
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22 pages, 1957 KiB  
Article
Optimising Combat Readiness: Practical Strategies for Integrating Physiological and Psychological Resilience in Soldier Training
by José Francisco Tornero-Aguilera, Maria Stergiou, Alejandro Rubio-Zarapuz, Alexandra Martín-Rodríguez, Luís Miguel Massuça and Vicente Javier Clemente-Suárez
Healthcare 2024, 12(12), 1160; https://doi.org/10.3390/healthcare12121160 - 7 Jun 2024
Cited by 4 | Viewed by 5907
Abstract
This narrative review examines the intricate psychophysiological interplay between cognitive functions and physical responses within military personnel engaged in combat. It elucidates the spectrum of responses elicited by symmetric and asymmetric warfare alongside specialised combat scenarios, including close-quarters and subterranean warfare. Central to [...] Read more.
This narrative review examines the intricate psychophysiological interplay between cognitive functions and physical responses within military personnel engaged in combat. It elucidates the spectrum of responses elicited by symmetric and asymmetric warfare alongside specialised combat scenarios, including close-quarters and subterranean warfare. Central to this discourse is the emphasis on integrating training programs beyond physical conditioning to encompass psychological resilience and decision-making efficacy under duress. The exploration further ventures into applying advanced technologies such as virtual reality and wearable devices, highlighting their pivotal role in augmenting training outcomes and supporting soldier health. Through a detailed analysis of psychophysiological variations across different military branches of service, the narrative review advocates for bespoke training regimens and support frameworks tailored to address the unique exigencies of each service branch. Concluding observations stress the importance of evolving military training paradigms, advocating for adopting realistic, immersive training simulations that mirror the complexities of the contemporary battlefield. This synthesis aims to contribute to the ongoing discourse on optimising military training protocols and enhancing the operational readiness and well-being of armed forces personnel. This narrative review is essential for military psychologists, trainers, and policymakers, aiming to bridge the gap between theoretical knowledge and practical implementation in military training programs. Full article
(This article belongs to the Special Issue Health and Readiness of Tactical Populations)
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