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The vast majority of claimants with rotator cuff tears underwent a repair with older aged patients increasingly undergoing TSA as either a primary or secondary procedure. Background: Rotator cuff repair (RCR) is increasingly being performed for both acute traumatic and degenerative tears of the rotator cuff, whereas total shoulder arthroplasty (TSA) is reserved for osteonecrosis of the humeral head, arthritis of the glenohumeral joint, and failed RCR. Objective: This study aimed to assess the incidence and patient characteristics of rotator cuff tears (RCTs), RCRs, and TSAs among workers' compensation claimants. Methods: A total of 8347 RCTs indemnity claims filed to Accident Fund Group from 2007 to 2022 were studied. Results: Over the study period, the percentages of RCTs increased from 41% to 65% among shoulder injury indemnity claimants, RCRs increased from 88% to 92% of RCTs, and TSAs increased from 1% to 5%. Conclusions: RCT, RCR, and TSA have increased dramatically among workers' compensation claimants, with age of the injured worker being the primary determinant of the increase. [ABSTRACT FROM AUTHOR]

Workforce issues are central to the changes necessary to create safer and higher-quality services for people with intellectual disabilities. This article examines the Disability Royal Commission's (the Commission) workforce recommendations relating to the disability services sector, which has been beset by chronic workforce problems since the introduction of the National Disability Insurance Scheme (NDIS). We describe the rich evidence in the Commission's Final Report and its analysis of key issues such as work value, disability worker qualifications, training, and worker registration. Many of these issues are especially relevant to people with intellectual disabilities, who need sophisticated, highly skilled support provided by experienced workers, characteristics that can be scarce in a high-turnover industry with persistent labour shortages and almost no barriers to entry. However, the Commission ultimately backs away from making recommendations on the most controversial issues, including the price-setting matrix for disability support services, known as the Disability Support Worker Cost Model. Unchanged, this will continue to constrain the sector's ability to create high-quality working environments conducive to continuous learning that will support people with intellectual disabilities in the way they want to be supported. [ABSTRACT FROM AUTHOR]

AbstractPurposeMethodsResultsConclusion\nIMPLICATIONS FOR REHABILITATIONRecovering from compensable injuries can be influenced by a variety of factors including the claimant’s experience of distress during the claims process. In order to develop cross-scheme, nation-wide strategies to improve claimants’ interactions with the compensation system, reduce claimant distress, and improve claimant outcomes, it is important to understand sources of claims-related distress from the perspective of both claimants and clinicians.An exploratory qualitative design was undertaken using semi-structured interviews with 13 claimants and 26 clinicians from four injury compensation schemes in five Australian states. A collaborative and reflexive thematic analysis was undertaken with an inductive approach to coding, and themes were constructed for claimants and clinicians across compensation schemes.Claimants and clinicians interviews revealed four main sources of distress, including (1) complexity and delays in administrative processes, (2) interruptions to recovery caused by treatment delays, (3) non-individualised approaches to care, and (4) a lack of support for navigating the claims process.Sources of claims-related distress identified by claimants and clinicians in the present study point to the urgent need for nationwide systems level changes to reduce claimant distress in the pursuit of better claimant outcomes.People who have a compensable insurance claim experience often experience interactions with the insurer and claims process as stressful.Providing information about the claims process to people with a compensable injury may help to reduce claim-related distress during recovery.Finding opportunities to provide social support and reassurance to people with a compensable injury may help them feel supported and reduce distress.Reducing distress for people who are recovering from a compensable injury may lead to better recovery outcomes.People who have a compensable insurance claim experience often experience interactions with the insurer and claims process as stressful.Providing information about the claims process to people with a compensable injury may help to reduce claim-related distress during recovery.Finding opportunities to provide social support and reassurance to people with a compensable injury may help them feel supported and reduce distress.Reducing distress for people who are recovering from a compensable injury may lead to better recovery outcomes. [ABSTRACT FROM AUTHOR]

There has been limited research on the health impacts of extreme bushfire exposure among emergency responders (ER) involved in suppressing extreme bushfires. This study aimed to evaluate the associations between extreme bushfires and ER's compensated injury and illness in Victoria, Australia. State-wide ER compensation claims from January 2005 to April 2023 were analysed. Logistic regression modelling was used to identify factors associated with compensation claims during the extreme bushfire periods in 2009 and 2019/20, compared to all other claims, adjusting for seasonality (summer). Of the 44,164 included claims, 1105 (2.5%) had recorded injury/disease onset dates within extreme bushfire periods, and 11,642 (26.4%) occurred in summer months. Over half of claims were made by police (52.4%), followed by ambulance officers/paramedics (27.2%) and firefighters (20.5%). Extreme bushfire period claims were associated with older workers (odds ratio/OR = 1.58,95%CI = 1.30–1.92, ages ≥ 55 vs. 35–44 years). Mental disorders (OR = 1.61,95%CI = 1.25–2.07), intracranial injuries (OR = 3.04,95%CI = 1.69–5.48) and infections/parasites (OR = 3.11,95%CI = 1.61–5.98) vs. wounds were associated with extreme bushfire period claims. Given the expected increase in extreme bushfire events and the ageing workforce, study findings underscore the importance of primary and secondary prevention in ER. This can include periodic health surveillance for older workers, access to early treatment, and ongoing support for mental health conditions. [ABSTRACT FROM AUTHOR]

There has been limited research on the health impacts of extreme bushfire exposure among emergency responders (ER) involved in suppressing extreme bushfires. This study aimed to evaluate the associations between extreme bushfires and ER’s compensated injury and illness in Victoria, Australia. State-wide ER compensation claims from January 2005 to April 2023 were analysed. Logistic regression modelling was used to identify factors associated with compensation claims during the extreme bushfire periods in 2009 and 2019/20, compared to all other claims, adjusting for seasonality (summer). Of the 44,164 included claims, 1105 (2.5%) had recorded injury/disease onset dates within extreme bushfire periods, and 11,642 (26.4%) occurred in summer months. Over half of claims were made by police (52.4%), followed by ambulance officers/paramedics (27.2%) and firefighters (20.5%). Extreme bushfire period claims were associated with older workers (odds ratio/OR = 1.58,95%CI = 1.30–1.92, ages ≥ 55 vs. 35–44 years). Mental disorders (OR = 1.61,95%CI = 1.25–2.07), intracranial injuries (OR = 3.04,95%CI = 1.69–5.48) and infections/parasites (OR = 3.11,95%CI = 1.61–5.98) vs. wounds were associated with extreme bushfire period claims. Given the expected increase in extreme bushfire events and the ageing workforce, study findings underscore the importance of primary and secondary prevention in ER. This can include periodic health surveillance for older workers, access to early treatment, and ongoing support for mental health conditions. [ABSTRACT FROM AUTHOR]

Objectives: The aim of the study is to characterize the incidence of SARSCoV-2 exposure and COVID-19 infection among California workers' compensation claims in 2020 and examine risk factors for exposure. Methods: Using a case-control approach, we combined machine learning techniques and job exposure matrices to assess associations between exposures and illness claims and clusters of claims within specific worksites over a 3-week period. Results: Of the 117,125 COVID-19 claims, most were primarily among younger groups, of shorter tenure, and from health care occupations. Illness claims were among older groups with longer tenure. Jobs with very close physical proximity and high physical activity, along with transportation and warehousing industries, were associated with being part of a cluster of claims. Conclusions: The findings merit further study but indicate respiratory viral transmission and support efforts to systematically incorporate work-related variables into other California data sources. [ABSTRACT FROM AUTHOR]

Workers with low back pain (LBP) frequently seek care from physiotherapists. We sought to identify patterns of physiotherapy attendance and factors associated with these patterns in Australian workers with accepted compensation claims for LBP. We included workers with accepted workers' compensation claims for LBP from 4 Australian states between 2011 and 2015. We used trajectory modelling to identify distinct groups of workers based on the number (ie, volume) of monthly physiotherapy attendances over a 2-year period from claim acceptance. Descriptive statistics and logistic regression models were used to compare the characteristics of the groups. A small but significant proportion attend numerous times over a long period. 79.0% of the sample (N5 22,767) attended physiotherapy at least once in the 2 years after claim acceptance. Among these, trajectory modelling identified 4 distinct patterns of attendance. Most (N = 11,808, 51.9%) recorded a short-term low-volume pattern, 26.8% (n = 6089) recorded a short-term high-volume pattern, 14.3% (n = 3255) recorded a long-term low-volume pattern, and 7.1% (n = 1615) recorded a long-term high-volume pattern. Workers from Victoria (OR 0.34, 99% CI 0.31, 0.37), South Australia (OR 0.69, 99% CI 0.60, 0.80), and Western Australia (OR 0.79, 99% CI 0.69, 0.88) were significantly less likely to attend physiotherapy than workers from Queensland. Victorian workers were significantly more likely to be in one of the 2 long-term trajectory groups (OR 8.17, 99% CI 6.86, 9.73; OR 18.68, 99% CI 13.57, 25.70). In conclusion, most compensated Australian workers with LBP attend physiotherapy. Significant interjurisdictional differences between attendance patterns suggests that policy may play an important role in healthcare delivery. [ABSTRACT FROM AUTHOR]

Introduction Methods Results Conclusion The COVID‐19 pandemic challenged primary care to rapidly innovate. In response, the Western Victorian Primary Health Network (WVPHN) developed a COVID‐19 online Community of Practice comprising general practitioners (GPs), practice nurses, pharmacists, aged care and disability workers, health administrators, public health experts, medical specialists, and consumers. This Experience Report describes our progress toward a durable organizational learning health system (LHS) model through the COVID‐19 pandemic crisis and beyond.In March 2020, we commenced weekly Community of Practice sessions, adopting the Project ECHO (Extension of Community Health Outcomes) model for a virtual information‐sharing network that aims to bring clinicians together to develop collective knowledge. Our work was underpinned by the LHS framework proposed by Menear et al. and aligned with Kotter's eight‐step change model.There were four key phases in the development of our LHS: build a Community of Practice; facilitate iterative change; develop supportive organizational infrastructure; and establish a sustainable, ongoing LHS. In total, the Community of Practice supported 83 unique COVID‐19 ECHO sessions involving 3192 h of clinician participation and over 10 000 h of organizational commitment. Six larger sessions were run between March 2020 and September 2022 with 3192 attendances. New models of care and care pathways were codeveloped in sessions and network leaders contributed to the development of guidelines and policy advice. These innovations enabled WVPHN to lead the Australian state of Victoria on rates of COVID vaccine uptake and GP antiviral prescribing.The COVID‐19 pandemic created a sense of urgency that helped stimulate a regional primary care‐based Community of Practice and LHS. A robust theoretical framework and established change management theory supported the purposeful implementation of our LHS. Reflection on challenges and successes may provide insights to support the implementation of LHS models in other primary care settings. [ABSTRACT FROM AUTHOR]

AbstractPurposeBackgroundPositionConclusion\nIMPLICATIONS FOR REHABILITATIONThis position paper aims to: (1) summarise the current state of the Australian disability support sector and its need to advance training practices that enhance empathetic behaviours; (2) Highlight how virtual reality technology is currently being deployed in training in the sector; and (3) highlight challenges that may arise from a lack of user acceptance testing and user experience design considerations, and why future studies are needed to explore these factors.The disability support industry has responded to new market demands for DSWs to provide quality supports that take a client-centred approach. To achieve this, some disability service providers have turned to virtual reality.Due to factors such as limited user acceptance testing, lack of user experience design practices, such undertakings may prove to be an expensive and ineffective exercise. Future studies should focus on ways to increase the sector’s acceptance of virtual reality interventions. Design considerations need to ensure the product is intuitive, easy to learn, and able to be used as intended.Future design considerations include, (1) their level of technical literacy, (2) their attitude and perception of technology, and (3) how to communicate the onboarding message and incorporate a co-design approach.Rethink research and co-design considerations aimed at disability support worker virtual reality training interventionsConsider the disability support sector’s technical literacy level during design stagesAssess the disability support sector’s attitude and perception of technologyExplore how to best communicate the onboarding message to win over disability support workers to use new technology through a co-design approachRethink research and co-design considerations aimed at disability support worker virtual reality training interventionsConsider the disability support sector’s technical literacy level during design stagesAssess the disability support sector’s attitude and perception of technologyExplore how to best communicate the onboarding message to win over disability support workers to use new technology through a co-design approach [ABSTRACT FROM AUTHOR]

Background: A prospective cohort study was conducted to assess the predictors of failure of nonoperative treatment, defined as the patient undergoing surgery for symptomatic, atraumatic full-thickness rotator cuff tears. We present the 10- year follow-up data of this population to determine if predictors for surgery change over time, and secondarily we report the outcomes of the cohort. Methods: At the time of enrollment, demographic, symptom, rotator cuff anatomy, and patient-reported outcome data were collected in patients with symptomatic, atraumatic full-thickness rotator cuff tears. Patients underwent a standard physical therapy protocol for 6 to 12 weeks. Patient data were then collected at 1, 2, 5, 7, and 10 years. Failure of nonoperative treatment was defined as the patient electing to undergo surgery. Results: Of the 452 patients in the original cohort, 20 patients (5%) withdrew from the study, 37 (9%) died before 10 years, and 40 (9%) were otherwise lost to follow-up. A total of 115 patients (27.0%) underwent a surgical procedure at some point during the 10-year follow-up period. Of these patients, 56.5% underwent surgery within 6 months of enrollment and 43.5%, between 6 months and 10 years. Low patient expectations regarding the efficacy of physical therapy were found to be a predictor of early surgery. Workers' Compensation status and activity level were more important predictors of later surgery. Patient-reported outcome measures all improved following physical therapy. For patients who did not undergo a surgical procedure, patient-reported outcome measures did not decline over the 10-year follow-up period. Conclusions: Low patient expectations regarding the efficacy of physical therapy were found to be a predictor of early surgery, whereas Workers' Compensation status and activity level were predictors of later surgery. Physical therapy was successful in >70% of patients with symptomatic, atraumatic full-thickness rotator cuff tears at 10 years. Outcome measures improved with physical therapy and did not decline over the 10-year follow-up period. [ABSTRACT FROM AUTHOR]

AbstractPurposeMaterials and methodsResultsConclusions\nIMPLICATIONS FOR REHABILITATION:Immigrant workers are more likely to suffer work-related injuries compared to native-born Canadians. Their physical rehabilitation usually involves physiotherapy. This study sought to better understand the experiences of injured immigrant workers receiving compensation and physiotherapy treatments.We conducted a qualitative study using an interpretive descriptive methodology. Semi-structured interviews were completed with 10 compensated immigrant workers about the physiotherapy services they received. Transcripts were analyzed thematically and with an intersectional lens.Two major themes were identified: 1) complex pathways to physiotherapy, and 2) key pillars of physiotherapy experiences. The first theme demonstrates that a lack of familiarity with the health and compensation systems, delayed access to physiotherapy, and cumulative burdens complicate the care of immigrant workers. The second theme shows that moral/emotional support, pain relief, and the recognition of sociocultural beliefs and fears are key aspects to improving the experiences of care for these workers.This study offers new insights into physiotherapy in the context of a work injury, which may help physiotherapists adapt care to the complex needs of immigrant workers. The intersectional lens used in the analysis offers interesting ways of accounting for the multiple social identities of these workers.Injured immigrant workers are at a heightened risk of experiencing impacts on both their physical and mental well-being.Rehabilitation professionals should be supported with resources and training to facilitate timely access to care for immigrant workers, including education on the health and compensation systems.Healthcare institutions should ensure that rehabilitation professionals have the tools and support to develop culturally sensitive approaches that address systemic and sociocultural barriers faced by immigrant workers.Injured immigrant workers are at a heightened risk of experiencing impacts on both their physical and mental well-being.Rehabilitation professionals should be supported with resources and training to facilitate timely access to care for immigrant workers, including education on the health and compensation systems.Healthcare institutions should ensure that rehabilitation professionals have the tools and support to develop culturally sensitive approaches that address systemic and sociocultural barriers faced by immigrant workers. [ABSTRACT FROM AUTHOR]

Policy PointsWorkers' compensation agencies have instituted opioid review policies to reduce unsafe prescribing. Providers reported more limited and cautious prescribing than in the past; both patients and providers reported collaborative pain‐management relationships and satisfactory pain control for patients.Despite the fears articulated by pharmaceutical companies and patient advocates, opioid review programs have not generally resulted in unmanaged pain or reduced function in patients, anger or resistance from patients or providers, or damage to patient–provider relationships or clinical autonomy.Other insurance providers with broad physician networks may want to consider similar quality‐improvement efforts to support safe opioid prescribing. Context: Unsafe prescribing practices have been among the central causes of improper reception of opioids, unsafe use, and overdose in the United States. Workers' compensation agencies in Washington and Ohio have implemented opioid review programs (ORPs)—a form of quality improvement based on utilization review—to curb unsafe prescribing. Evidence suggests that such regulations indeed reduce unsafe prescribing, but pharmaceutical companies and patient advocates have raised concerns about negative impacts that could also result. This study explores whether three core sets of problems have actually come to pass: (1) unmanaged pain or reduced function among patients, (2) anger or resistance to ORPs from patients or providers, and (3) damage to patient–provider relationships or clinical autonomy. Methods: In‐depth semistructured interviews were conducted with 48 patients (21 from Washington, 27 from Ohio) and 32 providers (18 from Washington, 14 from Ohio) who were purposively sampled to represent a range of injury and practice types. Thematic coding was conducted with codebooks developed using both inductive and deductive approaches. Findings: The consequences of opioid regulations have been generally positive: providers report more limited prescribing and a focus on multimodal pain control; patients report satisfactory pain control and recovery alongside collaborative relationships with providers. Participants attribute these patterns to a broad environment of opioid caution; they do not generally perceive workers' compensation policies as distinctly impactful. Both patients and providers comment frequently on the difficult aspects of interacting with workers' compensation agencies; effects of these range from simple inconvenience to delays in care, unmanaged pain, and reduced potential for physical recovery. Conclusions: In general, the three types of feared negative impacts have not come to pass for either patients or providers. Although interacting with workers' compensation agencies involves difficulties typical of interacting with other insurers, opioid controls seem to have generally positive effects and are generally perceived of favorably. [ABSTRACT FROM AUTHOR]

Introduction: Work-related Musculoskeletal Disorders (WMSDs) are a typical health problem and a significant cause of disability among workers from various fields across the industrialized world. Although aircraft mechanics and maintenance technicians experience high rates of workplace injuries, there is scarce evaluation of injury risk exposures from the various jobs/tasks in this industry. This study was conducted to investigate the prevalence of work-related musculoskeletal Discomfort/pain among maintenance personnel at RMAF in Malaysia and association between risk factors and MSD. Materials and methods: A total of 40 aviation maintenance personnel (Engineering department) from the Royal Malaysian Air Force (RMAF) were randomly selected via the simple random sampling. Relevant data were collected using ergonomics assessment tools comprising Cornell Musculoskeletal Discomfort Questionnaire (CMDQ). Data analysis was performed using Statistical Package for the Social Sciences (SPSS) version 25.0. Results: Based on the 12-month prevalence of WMSDs, the lower back region recorded the highest percentage of body discomfort and pain (77.5%) (CI 95%: 64.0-91.0), followed by the neck region (70%) (CI 95%: 55.0-85.0). Chi square analysis for the one-week prevalence shows that there is association between age (p=0.012) and duration of services in Royal Malaysian Air Forces (p=0.008) with prevalence of musculoskeletal symptoms. Age and duration of services in Royal Malaysian Air Forces is directly associated. Workers in the aviation maintenance industry, particularly those working in the engine bay, were exposed to a high risk of back, shoulder, and wrist region injury, which affected their well-being and productivity. Hence, aviation maintenance workers were recommended to perform routine physical exercises as an alternative ergonomic intervention. Conclusion: In conclusion, WMSD massively impacts workers' well-being in the aviation maintenance industry. Thus, an appropriate and effective ergonomic intervention, such as routine physical exercises, should be designed to protect workers from the severe impact of WMSDs. [ABSTRACT FROM AUTHOR]

Objective: We estimated associations of a rest break ordinance, implemented for construction workers in Dallas, Texas in 2016, with workplace injuries and illnesses. Methods: We used workers' compensation claims data to compare changes in rates of injuries and illnesses among Dallas County, Texas construction (ie, "treated") workers with changes in untreated workers, before (2013-2015) and after (2016-2018) a rest break ordinance was implemented. Results: Immediately after the ordinance was implemented, rates of injuries/illnesses among treated workers were modestly lower than in comparison workers (rate ratio comparing postmandate vs premandate rates, treated vs comparison workers: 0.89, 95%confidence interval: 0.72-1.11). Postordinance versus preordinance slope trends were similar in the treated versus the comparison group. Conclusions: Ten-minute rest breaks were associated with modestly lower rates of workplace injury/illnesses. More comprehensive standards may be needed for protection. [ABSTRACT FROM AUTHOR]

Background: Diseases and conditions related to the respiratory system contribute to work-related morbidity, mortality, and disability. Details on the causes and nature of work-related respiratory disease and the specific industries in which they occur are limited. This study identifies respiratory-related claims in the Ohio Bureau of Workers' Compensation (OHBWC) system and describes claim and worker characteristics to inform public health surveillance. Methods: We developed a list of respiratory-related International Classification of Diseases Clinical Modification (ICD-CM) diagnosis codes and searched over 2 million claims filed between 2001 and 2018 in the OHBWC system for at least one of these codes. The claim characteristics, rates of claims by employer industry classification, and causes of claims from narrative text were determined for these respiratory-related claims. Results: Among the 23,015 respiratory-related claims (5.8 per 10,000 full-time equivalents [FTE]), 54.6% had at least one ICD-CM code for Allergic Reactions and 30.6% had at least one code for Toxic Effects of Substances Chiefly Non-medicinal as to Source. Claim causes from narrative text included Chemical Exposure (30.3%), Activity Suggesting Exposure (24.4%), and Vapors, Gases, Dusts, or Fumes (VGDF) Exposure (19.3%). The highest overall rates of respiratory-related claims among private employers were for the agriculture, forestry & fishing (11.4 per 10,000), public safety (ambulance services) (11.3), and manufacturing (10.7) industry sectors. Conclusions: Respiratory-related claims in the OHBWC system were often acute in nature and included allergic reactions. Narratives from these claims provide insight into the work-related exposures and events causing claims or the disease and symptom factors surrounding claims. [ABSTRACT FROM AUTHOR]

• Aviation manufacturing is a key industry in Kansas with potential safety concerns. • Workers' compensation claims that accrued indemnity from 2014 to 2022 were examined. • The median total cost of such claims was $26,941 in 2022 dollars. • The hand and shoulder together comprised over half of claims. • Overexertion and repetitive motion were the most common causes. Workers' compensation injuries entail burdensome financial and social costs. This study's objective was to describe cost and frequency of workplace injuries in aviation manufacturing in the state of Kansas using workers' compensation data. Manufacturing incurs more workers' compensation claims in Kansas than any other industry, and aviation contributes more of those claims than any other sub sector. Workers' compensation insurance and reporting are required in the state of Kansas. Data were provided by the Kansas Department of Labor (KDOL) and included all closed workers' compensation claims entailing indemnity and medical costs filed in the state from 2014 to 2022. Cost of claim data were normalized to 2022 U.S. dollars and data were analyzed as a function of percentage and claim cost by body part, type of injury, cause of injury, specific musculoskeletal disorder type, and as a function of age and gender injury rates. Aviation claims entailed a median total cost of $26,941 and represented 8% of all closed claims filed in the state from 2014 to 2022. The grand total direct cost over the nine-year period was $75,404,147. Medical costs comprised 48.6% of all costs, indemnity 45.0%, and legal 6.4%. The most frequently injured body part was the hand/wrist (35.9%) followed by the shoulder (20.6%), and the most expensive body parts were related to the back. Overexertion (38.6%) was the most common cause followed by repetitive motion (22.8%). Work-related musculoskeletal disorders were the most common type accounting for 67.4% of all claims. Men and workers aged 55–64 incurred slightly higher claim rates than average. A sharp decrease in number of claims closed in 2021 coincided with production shutdowns the previous year related to the Covid-19 pandemic and design issues. Aviation manufacturing is a key industry in Kansas and this study is the first known to describe costs and frequencies of workplace injuries in the sector using workers' compensation data. This guide to the most problematic and costly injuries in aviation manufacturing helps practitioners prioritize prevention strategies to most effectively reduce workplace injury and helps safety and health practitioners in prioritizing prevention efforts to reduce the most severe and costly aviation manufacturing injuries and illnesses. It also brings attention to some special considerations when working with safety data from 2020 to 2022 related to the Covid-19 pandemic. [ABSTRACT FROM AUTHOR]

Time off work after traumatic hand injury not only affects individuals but also has socioeconomic repercussions, becoming a serious problem from the viewpoint of labor shortages. In depopulated rural areas, the impact of labor shortages due to time off work is more serious than in urban areas; however, few studies have examined return to original work in rural areas. The purpose of this study was to investigate the patient demographics at the time of hand injury that affect return to original work in a rural area of Japan. We retrospectively examined 246 patients with traumatic hand and/or forearm injuries who were working at the time of injury, and who underwent surgical operations and postoperative rehabilitation in a level II hospital in a rural agricultural area. We examined patients' initial demographic data, including gender, age, occupation (white or blue collar), employment status (self-employed, full-time, or part-time workers), complications other than hand injury, workers' compensation, dominant hand injury, and injury severity as determined using the modified Hand Injury Severity Score. Multivariate logistic regression analysis examined the association between initial patient demographics and return to original work within 150 days after injury. In total, 186 patients (76 %) were able to return to original work within 150 days. A multivariate logistic regression analysis showed that three explanatory variables (i.e., severity of injury, complications other than hand injury, and female gender) significantly compromised return to original work. In the treatment of traumatic hand injury, intensive support should be provided for return to original work for patients who are expected to have difficulty returning to work quickly. In addition, labor shortages can be mitigated by sharing information with the workplace about patients' prospects of return to original work. [ABSTRACT FROM AUTHOR]

We conducted a comprehensive review of state workers' compensation laws in the United States to evaluate the extent to which they support first responders with mental injury. Most state workers' compensation systems divide mental injuries into categories based on their presumed etiology: physical-mental, mental-physical, and mental-mental. Major differences exist among states as to which workers are eligible. Proving workplace causation can be difficult where no traumatic physical injuries exist. Latency periods, time limits, preexisting health conditions, restrictions as to types of condition covered, and complex chains of causation may make this burden, which falls on the claimant, even more challenging. Only nine (9) states enacted presumption of causation laws for mental health conditions to ease claimants' burden of proof. This contrasts starkly with presumption laws for chronic and infectious diseases. State decision-makers should create presumptions that mental health conditions in first responders are caused or significantly exacerbated by their stressful workplaces. Key message: Workers' compensation benefits for first responder mental health fall short compared to benefits for physical injury, and chronic and infectious disease. State policies need to change to follow the growth in our knowledge of how common mental injury is among first responders. Compassionate and expedient reimbursement of workers' compensation claims for mental injury constitutes the fulfillment of our moral obligation to those who provide a critical public health safety net. [ABSTRACT FROM AUTHOR]

Whether compensation serves as a motivational resource for employees is still a debated subject. It has been suggested that the effect of pay on motivation could be contingent on the satisfaction of the basic psychological needs as outlined by self‐determination theory. The current research explored the role of amount of base pay as well as pay fairness discrepancy in relation to basic psychological need satisfaction, autonomous work motivation and, in turn, psychological well‐being (i.e., vigor and emotional exhaustion), turnover intentions, and work performance. Managerial need support was also included in the model, so its mechanisms and its effects on the outcomes could be measured against those of pay. Using a combination of archival data and employees' self‐reports from 593 Norwegian workers, results revealed that amount of base pay did not predict satisfaction of any of the basic needs, pay fairness discrepancy negatively predicted satisfaction of the needs for autonomy and relatedness and positively predicted satisfaction of the need for competence, whereas managerial need support significantly predicted satisfaction of all three needs. While there was no significant direct relation from amount of base pay to any of the outcomes, results showed a significant direct relation from managerial need support to psychological well‐being (positive to vigor and negative to emotional exhaustion) and turnover intentions (negative). There was also a significant direct positive relation from pay fairness discrepancy to turnover intentions. [ABSTRACT FROM AUTHOR]

To address the gap in preventative support, the aim of the Family Disability Worker (FDW) role is to offer support for parents and cares of children with disabilities and additional needs, who do not meet the criteria to access services through the children with disabilities social work team. This Welsh evaluation included a survey for professionals (n = 23) and parents/carers (n = 5) to explore their attitudes on the new FDW role. Following this, a series of semi-structured interviews were completed to gather the experiences of professionals (n = 23) and parents/carers (n = 3) of working with the FDW. The findings suggest the development of preventive social work practice to reduce isolation and support these families to feel connected to their community. The participants shared attitudes and experiences supporting the development of the FDW role, to enhance and develop creative and strength-based approaches to social work practice to be operationalised through a new FDW practice toolkit. [ABSTRACT FROM AUTHOR]

Widening income inequality is a serious social concern in many countries. We examine the causal effect of a negative demand shock on executive compensation and worker wages using a quasi-natural experiment, considering Japanese firms that experienced a sudden and substantial export decline following the global financial crisis in the late 2000s. Worker wages tended to decline significantly more relative to executive compensation after the crisis in firms depending more on exports, causing a wider pay differential. We establish the robustness of our difference-in-difference results by considering selection into exporters, excluding sporadic exporters, and controlling for foreign ownership or liquidity. [ABSTRACT FROM AUTHOR]

Background: There are 1.3 billion people with disabilities globally, and they frequently face barriers to accessing healthcare, contributing to their worse health and higher mortality. However, little research has explored patient-reported approaches to improve healthcare for persons with disabilities. Consequently, this study aimed to explore possible solutions and recommendations to address the existing barriers to access to healthcare for persons with disabilities in rural Uganda. Methods: We conducted 27 semi-structured interviews with individuals with various disabilities in rural Luuka district, Eastern Uganda, between September and November 2022. The participants included individuals with visual impairment (n = 5), physical impairment (n = 5), hearing impairment (n = 6), multiple impairments (n = 5), intellectual/cognitive impairment (n = 5), and albinism (n = 1). Interviews were recorded, transcribed verbatim, and thematically analysed. We categorized the solutions using the Missing Billion disability-inclusive health systems framework. Results: Our findings, framed within the health systems framework, revealed several critical themes. On the demand side, suggested solutions emphasized advocacy and sensitization for persons with disabilities, their communities, and caregivers about healthcare needs. Socio-economic empowerment and community-based health services were also highlighted as essential. On the supply side, participants stressed the importance of training healthcare workers on disability, facilitating dialogue and experience-sharing sessions, and employing health workers with disabilities. Additional recommendations included improving accessibility and reasonable accommodation, organizing inclusive services like special clinic days and outreaches, ensuring representation in health facility management, and establishing comprehensive rehabilitation services with affordable assistive devices. Conclusion: The multifaceted solutions proposed by persons with disabilities highlight the complex challenges they face in accessing healthcare services and highlight the necessity for comprehensive, sustainable interventions. The call to action for policymakers and healthcare providers is to prioritise the incorporation of disability-inclusive practices and explore multi-dimensional approaches that foster a more inclusive healthcare environment that adequately meets the needs of persons with disabilities. [ABSTRACT FROM AUTHOR]

Traumatic injuries to the peripheral nervous system (PNI) can lead to severe consequences such as paralysis. Unfortunately, current treatments rarely allow for satisfactory functional recovery. The high healthcare costs associated with PNS injuries, worker disability, and low patient satisfaction press for alternative solutions that surpass current standards. For the treatment of injuries with a deficit of less than 30 mm to bridge, the use of synthetic nerve conduits (NGC) is favored. However, to develop such promising therapeutic strategies, in vitro models that more faithfully mimic nerve physiology are needed. The absence of a clinically scaled model with essential elements such as a three-dimension environment and dynamic coculture has hindered progress in this field. The presented research focuses on the development of an in vitro coculture model of the peripheral nervous system (PNS) involving the use of functional biomaterial which microstructure replicates nerve topography. Initially, the behavior of neuron-derived cell lines (N) and Schwann cells (SC) in contact with a short section of biomaterial (5 mm) was studied. Subsequent investigations, using fluorescent markers and survival assays, demonstrated the synergistic effects of coculture. These optimized parameters were then applied to longer biomaterials (30 mm), equivalent to clinically used NGC. The results obtained demonstrated the possibility of maintaining an extended coculture of SC and N over a 7-day period on a clinically scaled biomaterial, observing some functionality. In the long term, the knowledge gained from this work will contribute to a better understanding of the PNS regeneration process and promote the development of future therapeutic approaches while reducing reliance on animal experimentation. This model can be used for drug screening and adapted for personalized medicine trials. Ultimately, this work fills a critical gap in current research, providing a transformative approach to study and advance treatments for PNS injuries. [ABSTRACT FROM AUTHOR]

AbstractPurposeMethodsResultsConclusion\nIMPLICATIONS FOR REHABILITATIONMany disabled people require support workers to complete personal care, daily tasks and participate in life roles. Due to the intimate nature of community disability support in domestic environments, understanding what facilitates positive relationships is paramount. We examined the intricate interplay of context and mechanisms that drive positive relationship outcomes for disabled people, their family members and support workers.A realist-informed, participatory methodology involving three participant groups: disabled people, family members, and disability support workers.Sixteen participants participated in two workshops per group (5 disabled people, 5 family members, and 6 disability support workers). All three participant groups prioritised three key generative mechanism processes involved in positive relationship outcomes: (1) having clear communication, (2) building trust, and (3) developing a sense of flow. We describe how each mechanism manifested in a unique way for each group, and also how the activation of each mechanism was influenced by a dynamic resources/tensions balance specific to each group.We describe the interaction between three mechanism processes involved in triadic relationships between disabled people, family members, and support workers. Attention is now required to explore strategies to negotiate the resource/tension balance particular to each group.Clear communication, building trust, and developing flow are crucial mechanisms necessary for positive and sustainable relationships between disabled people, family members, and support workers.However, we need to consider the intricate interplay of these mechanisms within triadic relationships between disabled people, family members, and support workers when enacting strategies to support sustainable relationships.By understanding the specific ways these mechanisms are activated differently for disabled people, family, and support workers, rehabilitation professionals can better tailor community care processes.This will promote greater efficacy of disability support systems and inform more effective, strategic distribution of resources.Clear communication, building trust, and developing flow are crucial mechanisms necessary for positive and sustainable relationships between disabled people, family members, and support workers.However, we need to consider the intricate interplay of these mechanisms within triadic relationships between disabled people, family members, and support workers when enacting strategies to support sustainable relationships.By understanding the specific ways these mechanisms are activated differently for disabled people, family, and support workers, rehabilitation professionals can better tailor community care processes.This will promote greater efficacy of disability support systems and inform more effective, strategic distribution of resources. [ABSTRACT FROM AUTHOR]

Objective: This study analyzed Ohio workers' compensation data to identify potential prevention strategies for common oil and gas extraction industry claims. Methods: Claim rates for 2001-2018 were calculated per full-time equivalent employee. Descriptive analyses on free-text descriptions of lost-time (LT) claims (>7 days away from work) identified common characteristics among claims and injured workers. Results: Among 3134 claims, 860 (27%) were LT. The industry group, drilling contractors, experienced the highest LT claims rate, whereas the cost from servicing contractors was the highest. Contact with objects and equipment caused the highest LT claims rate. The most frequent LT occupation was roustabout, and the most frequent LT work activity was material handling. Transportation incidents caused most fatalities and hospitalizations. Over half of LT claims were from short-tenured workers. Conclusions: Both proven and innovative approaches are needed to reduce severe workers' compensation claims in this industry. [ABSTRACT FROM AUTHOR]

We estimate the impact of temperatures on work-related accident rates in Italy by using daily data on weather conditions matched to administrative daily data on work-related accidents. The identification strategy of the causal effect relies on the plausible exogeneity of short-term daily temperature variations in a given spatial unit. We find that both high and cold temperatures impair occupational health by increasing workplace injury rates. The positive effect of warmer weather conditions on work-related accident rates is larger for men and for workplace injuries. Older workers and jobs in the service sector are instead affected less. Colder temperatures lead to a substantial increase in commuting accidents, especially on rainy days. [ABSTRACT FROM AUTHOR]

Prison farms are common programs within correctional services; however, knowledge is limited regarding the agricultural prison industry. As a starting point for further study and policy development, we conducted a scoping review to map knowledge on the industry. The results show many publications focused on the agricultural prison industry were outdated, United States-based, and/or non-original research. Findings reveal agricultural positions tend to be filled by prisoners with pre-existing work skills and relatively low support needs and agricultural positions are not necessarily driven by market demands. Findings also show prisoners experience a lack of workplace protections, such as workers’ compensation, the ability to unionize, and adequate workplace safety and hazardous materials training. Yet, a purported benefit of agricultural programs was improved food security for prisoners. Other finds show there is a predominant focus on self-sufficiency and cost-savings for prisons in the face of inadequate or worsening budgets but limited available data quantifies relationship, prison farms shift from being rehabilitative-focused to profit-driven over a certain amount of acres. We conclude by identifying gaps in the literature on the agricultural prison industry and listing areas of future inquiry. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the patient reported outcomes (PROs) of patients undergoing hip arthroscopy (HA) for femeroacetabular impingement syndrome (FAIS), a condition where irregular bone growth in the hip joint leads to friction and pain during movement, who have worker's compensation (WC) or no-fault insurance (NF) versus commercial insurance (CI) at both 2 year and 5 year follow-up. Methods: This was a single center, single surgeon, retrospective analysis performed between August 2007 and May 2023 of consecutive patients that underwent HA, a minimally invasive surgical procedure used to diagnose and treat problems inside the hip joint through small incisions, for FAIS. Patients were divided into two cohorts—those with WC/NF and those with commercial insurance (CI). Patient reported outcomes (PROs), which included modified Harris Hip Score (mHHS) and Non-Arthritic Hip Score (NAHS), were collected preoperatively, as well as at least 2-year postoperatively. Additionally, other clinically relevant outcomes variables including prevalence of revision surgery and conversion to total hip arthroplasty were recorded. Results: Three hundred and forty three patients met inclusion criteria. There were 32 patients in the WC/NF cohort and 311 patients in the commercial cohort. When controlling for age, sex, and Body Mass Index (BMI), WC/NF status was associated with lower mHHS at both 2 year (β = − 8.190, p < 0.01, R2 = 0.092) and 5 year follow-up (β = − 16.60, p < 0.01, R2 = 0.179) and NAHS at 5 year follow up (β = − 13.462, p = 0.03, R2 = 0.148). The WC/NF cohort had a lower rate of achieving Substantial Clinical Benefit (SCB) for mHHS at 2-years follow-up (66.7% vs. 84.1%, p = 0.02).The rate of revision hip arthroscopy was significantly higher in the worker's compensation/no fault cohort than the commercial insurance cohort (15.6% vs. 3.5%, p < 0.01). The rate of conversion to total hip arthroplasty (THA) in the WC/NF cohort was not significantly different than the rate of conversion to THA in the commercial insurance cohort (0.0% vs. 3.2%, p = 0.30). Conclusion: Patients with WC/NF insurance may expect a significant improvement from baseline mHHS and NAHS following HA for FAIS at short-term follow-up. However, this improvement may not be as durable as those experienced by patients with CI. Additionally, WC/NF patients should be counseled that they have a higher risk of undergoing revision hip arthroscopy than similar CI patients. Level of evidence: III, Retrospective Comparative Prognostic Investigation. [ABSTRACT FROM AUTHOR]

Background: There is a paucity of literature evaluating long-term outcomes and survivorship of patients undergoing primary hip arthroscopy with capsular repair for femoroacetabular impingement syndrome (FAIS). Purpose: To report 10-year survivorship and patient-reported outcomes (PROs) after primary hip arthroscopy with capsular repair for FAIS and evaluate the effect of capsular repair in patients at the highest risk for conversion to arthroplasty. Study Design: Cohort study; Level of evidence, 3. Methods: Data were prospectively collected and retrospectively reviewed on all patients undergoing primary hip arthroscopy with capsular repair between October 2008 and February 2011. Patients with a minimum 10-year follow-up on the modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), and visual analog scale for pain (VAS) scores were selected. The preoperative and minimum 10-year follow-up Hip Outcome Score—Sports Specific Subscale (HOS-SSS) scores were also reported, if available. Patients with ipsilateral hip surgery, worker's compensation, Tönnis osteoarthritis grade >1, and hip dysplasia (lateral center-edge angle <25°) were excluded. Survivorship, PROS, and clinical benefit—minimal clinically important difference (MCID) and Patient Acceptable Symptom State (PASS)—were reported. An additional propensity-matched subanalysis was performed on patients at the highest risk for conversion to arthroplasty, comparing patients undergoing capsular repair to patients with unrepaired capsules. Results: A total of 145 (n = 130 patients) out of 180 eligible hips (n = 165 patients) had a minimum 10-year follow-up (80.6%). Also, 126 hips (86.9%) belonged to women, and 19 hips (13.1%) belonged to men. The mean patient age was 30.3 ± 12.9 years. The survivorship rate was 91% at the 10-year follow-up. The cohort experienced significant improvements (P <.001) in the mHHS, NAHS, HOS-SSS, and VAS for pain scores. Moreover, the cohort achieved high rates of the PASS for the mHHS (89.8%), high rates of the MCID for the mHHS (82.4%), and high rates of the MCID for VAS for pain (80.6%) scores. In the propensity-matched subanalysis performed on patients with the highest risk for arthroplasty, 29 hips with capsular repair were matched to 81 hips with unrepaired capsules. While both groups experienced significant improvements in all PROs (P <.05), the group without capsule repair trended toward a higher conversion to arthroplasty rate when compared with the repair group. In addition, an odds ratio was calculated for the likelihood of converting to arthroplasty after having an unrepaired capsule compared with capsular repair (2.54 [95% CI, 0.873-7.37]; P =.087). Conclusion: Patients undergoing primary hip arthroscopy with capsular repair experienced a high survivorship rate of 91% at a minimum 10-year follow-up. Patients who did not convert to arthroplasty saw favorable improvements in PROs and achieved high clinical benefit rates. In addition, among those patients at the highest risk for conversion to arthroplasty, a trend toward greater survivorship was observed with capsular repair. [ABSTRACT FROM AUTHOR]

While medical and health science librarians' median salaries have increased over the last forty years; however, inflation-adjusted salaries are lower than in 2008. Utilizing data from the Medical Library Association's salary surveys from 1983 to 2023, this column explores median salary changes over time by discussing the median salary's performance against inflation and how the 2008 recession and the 2020 COVID-19 pandemic impacted salaries. From 2017 to 2023, the median salary increased by 18%, but after adjusting for inflation, the median salary decreased by almost 6%. The findings have serious implications for recruitment and retention in medical and health sciences librarianship. [ABSTRACT FROM AUTHOR]

Context Methods Findings Conclusions Policy Points Workers’ compensation agencies have instituted opioid review policies to reduce unsafe prescribing. Providers reported more limited and cautious prescribing than in the past; both patients and providers reported collaborative pain‐management relationships and satisfactory pain control for patients. Despite the fears articulated by pharmaceutical companies and patient advocates, opioid review programs have not generally resulted in unmanaged pain or reduced function in patients, anger or resistance from patients or providers, or damage to patient–provider relationships or clinical autonomy. Other insurance providers with broad physician networks may want to consider similar quality‐improvement efforts to support safe opioid prescribing. Workers’ compensation agencies have instituted opioid review policies to reduce unsafe prescribing. Providers reported more limited and cautious prescribing than in the past; both patients and providers reported collaborative pain‐management relationships and satisfactory pain control for patients. Despite the fears articulated by pharmaceutical companies and patient advocates, opioid review programs have not generally resulted in unmanaged pain or reduced function in patients, anger or resistance from patients or providers, or damage to patient–provider relationships or clinical autonomy. Other insurance providers with broad physician networks may want to consider similar quality‐improvement efforts to support safe opioid prescribing. Unsafe prescribing practices have been among the central causes of improper reception of opioids, unsafe use, and overdose in the United States. Workers’ compensation agencies in Washington and Ohio have implemented opioid review programs (ORPs)—a form of quality improvement based on utilization review—to curb unsafe prescribing. Evidence suggests that such regulations indeed reduce unsafe prescribing, but pharmaceutical companies and patient advocates have raised concerns about negative impacts that could also result. This study explores whether three core sets of problems have actually come to pass: (1) unmanaged pain or reduced function among patients, (2) anger or resistance to ORPs from patients or providers, and (3) damage to patient–provider relationships or clinical autonomy.In‐depth semistructured interviews were conducted with 48 patients (21 from Washington, 27 from Ohio) and 32 providers (18 from Washington, 14 from Ohio) who were purposively sampled to represent a range of injury and practice types. Thematic coding was conducted with codebooks developed using both inductive and deductive approaches.The consequences of opioid regulations have been generally positive: providers report more limited prescribing and a focus on multimodal pain control; patients report satisfactory pain control and recovery alongside collaborative relationships with providers. Participants attribute these patterns to a broad environment of opioid caution; they do not generally perceive workers’ compensation policies as distinctly impactful. Both patients and providers comment frequently on the difficult aspects of interacting with workers’ compensation agencies; effects of these range from simple inconvenience to delays in care, unmanaged pain, and reduced potential for physical recovery.In general, the three types of feared negative impacts have not come to pass for either patients or providers. Although interacting with workers’ compensation agencies involves difficulties typical of interacting with other insurers, opioid controls seem to have generally positive effects and are generally perceived of favorably. [ABSTRACT FROM AUTHOR]

Productivity loss because of chronic pain in the working age population is a widespread concern internationally. Interventions for chronic pain in working age adults might be expected to achieve enhanced productivity in terms of reduced costs of workers' compensation insurance, reduced disability support, and improved rates of return to work for injured workers. This would require the use of measures of productivity in the evaluation of chronic pain management interventions. The aim of this review was to identify and interpret the productivity outcomes of randomised controlled trials reported by studies that conducted economic evaluations (eg, cost-effectiveness and cost-utility) of chronic pain management interventions in the working age population published from database inception to March 2023. Econlit, Embase, and Pubmed electronic databases were searched, yielding 12 studies that met the selection criteria. All 12 studies used absenteeism to measure productivity, translating return to work measures into indirect costs. Only one study included return to work as a primary outcome. Ten studies found no statistically significant improvements in productivity-related costs. Despite evidence for reduced pain-related disability after pain management interventions, this review suggests that the use of measures for assessing productivity gains is lacking. Including such measures would greatly assist administrators and payers when considering the broader societal benefits of such interventions. [ABSTRACT FROM AUTHOR]

Purpose: The objectives of this study were to: report minimum 5-year outcomes in patients undergoing TSA and determine characteristics predictive of patients achieving an excellent functional outcome. Methods: Pre-operative demographic variables and Simple Shoulder Test (SST) scores were obtained pre-operatively and at a minimum of five years after surgery. A final SST ≥ 10 and percentage of maximal possible improvement (% MPI) of ≥ 66.7% were determined to be the thresholds for excellent outcomes. Univariate and multivariate analysis were performed to identify factors associated with excellent five year clinical outcomes. Results: Of 233 eligible patients, 188 (81%) had adequate follow-up for inclusion in this study. Mean SST scores improved from 3.4 ± 2.4 to 9.7 ± 2.2 (p < 0.001). Male sex was an independent predictor of both SST ≥ 10 (OR 3.46, 95% CI 1.70–7.31; p < 0.001) and %MPI ≥ 66.7 (OR 2.27, 95% CI 1.11–4.81, p = 0.027). Workers' Compensation insurance was predictive of not obtaining SST ≥ 10 (OR 0.12, 95% 0.02–0.60; p = 0.016) or %MPI ≥ 66.7 (OR 0.16, 95% CI 0.03–0.77, p = 0.025). MCID was passed by the vast majority (95%) of patients undergoing TSA and did not necessarily indicate an excellent, satisfactory outcome. Conclusion: Male sex and commercial insurance coverage were significantly associated with these excellent outcomes, while Workers' Compensation insurance was associated with failure to achieve this result. Thresholds for excellent outcomes, such as final SST ≥ 10 and %MPI ≥ 66.7, may be useful in identifying the characteristics of patients who benefit most from TSA. [ABSTRACT FROM AUTHOR]

Introduction: The goal of this research is to identify the factors that negatively impact the achievement of the minimum clinically significant change (MCID) for the American Shoulder and Elbow Surgeons (ASES) score within the realm of various orthopedic shoulder procedures. Methods: We conducted a comprehensive review of studies published from 2002 to 2023, utilizing OvidMedline and PubMed databases. Our search criteria included terms such as "minimal clinically important difference" or "MCID" along with associated MeSH terms, in addition to "American shoulder and elbow surgeon" or "ASES." We selectively included primary investigations that assessed factors linked to the failure to achieve MCID for the ASES score subsequent to orthopedic shoulder procedures, while excluding papers addressing anatomical, surgical, or injury-related aspects. Results: Our analysis identified 149 full-text articles, leading to the inclusion of 12 studies for detailed analysis. The selected studies investigated outcomes following various orthopedic shoulder procedures, encompassing biceps tenodesis, total shoulder arthroplasty, and rotator cuff repair. Notably, factors, such as gender, body mass index, diabetes, smoking habits, opioid usage, depression, anxiety, workers' compensation, occupational satisfaction, and the preoperative ASES score, were all associated with the inability to attain MCID. Conclusion: In summary, numerous factors exert a negative influence on the attainment of MCID following shoulder procedures, and these factors appear to be irrespective of the specific surgical technique employed. Patients presenting with these factors may perceive their surgical outcomes as less successful when compared to those without these factors. Identifying these factors can enable healthcare providers to provide more effective counseling to patients regarding their expected outcomes and rehabilitation course. Furthermore, these findings can aid in the development of a screening tool to better identify these risk factors and optimize them before surgery. [ABSTRACT FROM AUTHOR]

In the recent years, food delivery platforms in Southeast Asia have accepted people with disabilities as delivery workers, framing it as economic empowerment. This article examines this ambivalent bargain of economic rehabilitation in Singapore where Grab is headquartered. Drawing from historical records, it first traces the relations of "platform" to "access," demonstrating how the framework of curative intermediaries had historically shaped expectations around work. Access in the 1980s was envisioned as intermediating infrastructural connections that could provide disabled people with resources, transforming them from liabilities to productive personhoods. The second portion draws from interviews with disabled delivery workers to highlight the problems that constitute this investment in intermediaries and cure. Although accommodative platforms provide some degree of economic inclusion, these accommodations are often partial, resulting in precarity, attrition, and injury. "Curative platforms," therefore, signals the investment and twinning of cure and violence that subject the disabled to a compromised existence. [ABSTRACT FROM AUTHOR]

Exposure of an individual to occupational and environmental risk factors for a certain disease affects them and their family. Children are highly vulnerable in this setting because they are family-dependent. This review discusses diseases that occur in children according to the occupational and behavioral characteristics of their parents. Toxic agents in the home environment can affect children’s health. Maternal exposure to substances during pregnancy may directly affect fetal outcomes. The Industrial Accident Compensation Insurance Act in Korea was amended in 2023 to compensate for children’s adverse health effects due to their parents’ occupational risks. The long working hours and smoking behaviors of parents and toxic materials in the home environment are highlighted. To control for the diverse factors affecting children’s health in medical research, this review introduces directed acyclic graphs. Pediatric, occupational, and environmental medicine must collaborate to prevent childhood diseases related to environmentalfactors. [ABSTRACT FROM AUTHOR]

A limited number of studies have examined factors associated with opioid use and a comparison of cooccurring disorders and healthcare costs between opioid users and nonusers in North Carolina. The authors sought to determine comorbid conditions and other selected clinical outcomes associated with an increased likelihood of opioid use disorder (OUD). They also aimed to compare rates of various outcomes between OUD and non-OUD cases. Objectives: Opioid use disorder (OUD) is characterized as a chronic condition that was first outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition , and now the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision. It encompasses frequent opioid usage, cravings, the development of tolerance, withdrawal symptoms upon discontinuation, unsuccessful attempts to quit or reduce use, and recurrent use even when faced with negative consequences. Both national- and state-level data show that overdose deaths associated with prescription opioids are increasing at an alarming rate. The increasing overdose deaths from illicitly manufactured fentanyl and other synthetic opioids compound this epidemic's burden. The present study sought to determine the prevalence and potential factors associated with OUD in North Carolina. Methods: Using the State Inpatient Database, a retrospective cross-sectional study was conducted to identify OUD-related discharges between 2000 and 2020. Descriptive statistics and rates of OUD per 1000 discharges were calculated. Simple and multivariable logistic regression models were used to identify factors associated with increased odds of having an opioid use disorder diagnosis at discharge. The deviance-Pearson goodness of fit statistic was also used. Variables were identified using International Classification of Diseases, Ninth Revision, Clinical Modification , and International Classification of Diseases, Tenth Revision, Clinical Modification , codes in the discharge records. Results: Of 19,370,483 hospitalizations that occurred between 2000 and 2020 in North Carolina, 483,250 were associated with OUD, a prevalence rate of 24.9 cases per 1000 discharges. The highest OUD rates were seen among adults who self-paid for their hospitalization, those with Medicaid, and those with other types of payors such as Workers' Compensation and the Indian Health Service; individuals between 25 and 54 years old; tobacco and alcohol users; Native American patients; patients located in urban areas; patients with lower household income; White patients; and female patients. OUD also was associated with increased odds of having one or more comorbid psychiatric disorders when controlling for other factors. Conclusions: Although preventive measures are crucial, including policies that discourage prescribing opioids for noncancer pain and those that target the manufacturing and distribution of synthetic opioids, providing integrated care for patients with OUD and co-occurring psychiatric and/or physical disorders is equally important. These findings suggest the need for a system-wide public health response focused on the expansion of primary prevention and treatment efforts, including crisis services, harm reduction services, and recovery programs. [ABSTRACT FROM AUTHOR]

BACKGROUND: Posttraumatic stress injury (PTSI) is a term used to describe a range of psychiatric difficulties which arise following exposure to a psychologically traumatic event. The impact of being diagnosed with multiple psychiatric conditions on the return-to-work (RTW) outcomes of individuals with PTSI has not been adequately researched. OBJECTIVE: The current study examined whether the presence of two or more psychiatric conditions occurring simultaneously is predictive of RTW outcomes in workers with PTSI. METHOD: A population-based cohort design was conducted using archival data from injured workers admitted to a PTSI rehabilitation program. Differences in RTW outcomes and demographic, administrative, and clinical variables were compared between individuals with single and multiple psychiatric diagnoses. A range of variables were entered into a multivariable logistic regression model predicting RTW. RESULTS: The final logistic regression model indicated workers had higher odds of RTW if they had a single psychiatric diagnosis (Adjusted Odds Ratio (AOR) 2.20), non-elevated scores on a measure of traumatic stress (AOR 1.85), and reported higher self-perceived readiness to RTW (AOR 1.24). CONCLUSION: Being diagnosed with multiple psychiatric conditions appears to be associated with more negative RTW outcomes following PTSI rehabilitation. [ABSTRACT FROM AUTHOR]

AbstractPurposeMethodResultsConclusions\nIMPLICATIONS FOR REHABILITATIONRates of return to work (RTW) are declining in the Australian workers compensation system alongside significant economic and social costs, disputes, and secondary psychological injury. Non-medical assessment of workplace injuries now considers psychosocial and workplace factors, and worker participation in the assessment process is limited. This scoping review examines studies regarding non-medical assessment during the acute phase of rehabilitation in terms of costs, disputes, secondary psychological injury, and worker participation.An electronic and manual search of relevant articles across four databases was conducted using PRISMA guidelines, followed by quality assessment.Of the 1,630 studies retrieved, 12 met the inclusion criteria with most focused on assessment for risk of obstructed or delayed RTW.Non-medical assessment in the acute stage of rehabilitation identifies risk for delayed or complicated RTW, overlooking potential for the process of assessment to contribute to disputes and development of secondary psychological injury. Doubt around the capacity of workers to participate objectively in assessment persists. These are aspects of assessment worthy of further exploration for their impact on RTW outcomes.Early assessment of injured workers is a key aspect of the rehabilitation process and there have been calls for greater injured worker involvement in their rehabilitation.Rehabilitation professionals should consider an injured worker’s phase of disability when conducting assessment for support needs.Consideration of psychological vulnerabilities of injured workers should be incorporated into assessment of support needs.Rehabilitation professionals should seek out ways to increase participation of injured workers in assessment of their support needs.Early assessment of injured workers is a key aspect of the rehabilitation process and there have been calls for greater injured worker involvement in their rehabilitation.Rehabilitation professionals should consider an injured worker’s phase of disability when conducting assessment for support needs.Consideration of psychological vulnerabilities of injured workers should be incorporated into assessment of support needs.Rehabilitation professionals should seek out ways to increase participation of injured workers in assessment of their support needs. [ABSTRACT FROM AUTHOR]

Persistent symptoms are common after acute COVID-19, often referred to as long COVID. LongCOVIDmay affect the ability to performactivities of daily living, including work. Long COVID occurs more frequently in those with severe acute COVID-19. This guidance statement reviews the pathophysiology of severe acute COVID-19 and long COVID and provides pragmatic approaches to long COVID symptoms, syndromes, and conditions in the occupational setting. Disability laws and workers' compensation are also addressed. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study is to compare work disability duration of intraprovincially and interprovincially mobile workers with nonmobile workers in British Columbia, Canada. Methods: Workers' compensation claims were extracted for workers injured between 2010 and 2019. Employer and residential postal codes were converted to economic regions to define nonmobile, intraprovincially, and interprovincially mobile workers. Quantile regression models using matched cohorts were used to estimate differences in work disability days at different percentiles of the distribution. Results: Compared with nonmobile workers, both mobile worker groups had longer work disability durations, particularly interprovincially mobile workers. Differences persisted in injury-stratified models and were partially or fully attenuated in some industry-stratified models. Conclusions:Workers' compensation systems, employers, and healthcare providers may need to tailor specific interventions for mobile workers who are from out-of-province as well as traveling between regions in the province. [ABSTRACT FROM AUTHOR]

Objective: To describe the outcomes effect of removing the medical surveillance component from a heat illness prevention program (HIPP) for outdoor workers from a Central Texas municipality. Methods: Heat-related illness (HRI) frequency and workers' compensation (WC) cost were assessed retrospectively in a cohort of 329 workers from 2011-2019. During 2011-2017, the HIPP included training, acclimatization, and medical surveillance. In 2018-2019, a modified (mHIPP) was implemented that included training and acclimatization, but without medical surveillance. Results: The HRI rate during HIPP averaged 19.5 per 1000 workers during the first 4 years, dropped to 1.01 per 1,000 workers over the next 3 years, (2015-2017), and increased during mHIPP, to 7.6 per 1,000 workers. Discussion: Although the case increase during the mHIPP was small, medical surveillancemay be an important component in lowering workforce HRI. [ABSTRACT FROM AUTHOR]

Background: Total knee arthroplasty (TKA) is a commonly performed knee surgery and prior arthroscopic meniscectomy (AM) has been linked to an increased risk of TKA in the general population. Objective: To study the relationship between AM and TKA among injured workers whose medical care is paid for under workers' compensation (WC). Method: A total of 17,247 lost-time claims depicting all arthroscopic knee surgical procedures performed from 2007 to 2017 were followed to the end of 2022 and analyzed. Results: The odds ratio of undergoing a TKA for those with a preceding AM is 2.20, controlling for age, sex, and attorney involvement. Conclusions: Undergoing an AM is associated with an increased risk of TKA in WC claimants. [ABSTRACT FROM AUTHOR]

Background: Approximately 90% of patients who undergo arthroscopic rotator cuff repair (RCR) are satisfied with their pain levels and function after surgery. However, a subset of patients experience continued symptoms that warrant revision surgery. Preoperative risk factors for RCR failure requiring revision surgery have not been clearly defined. Purpose: To (1) determine the rate of RCR failure requiring revision surgery and (2) identify risk factors for revision surgery, which will help surgeons to determine patients who are at the greatest risk for RCR failure. Study Design: Systematic review and meta-analysis; Level of evidence, 4. Methods: A systematic review and meta-analysis in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were performed. The initial search resulted in 3158 titles, and 533 full-text articles were assessed for eligibility. A total of 10 studies met the following inclusion criteria: (1) human clinical studies, (2) arthroscopic RCR, (3) original clinical research, and (4) evaluation of preoperative risk factors for revision. Results: After a full-text review, a total of 16 risk factors were recorded and analyzed across 10 studies. Corticosteroid injection was the most consistent risk factor for revision surgery, reaching statistical significance in 4 of 4 studies, followed by workers' compensation status (2/3 studies). Patients with corticosteroid injections had a pooled increased risk of revision surgery by 47% (odds ratio, 1.44 [95% CI, 1.36-1.52]). Patients with workers' compensation had a pooled increased risk of revision surgery by 133% (odds ratio, 2.33 [95% CI, 2.09-2.60]). Age, smoking status, diabetes, and obesity were found to be risk factors in half of the analyzed studies. Conclusion: Corticosteroid injections, regardless of the frequency of injections, and workers' compensation status were found to be significant risk factors across the literature based on qualitative analysis and pooled analysis. Surgeons should determine ideal candidates for arthroscopic RCR by accounting for corticosteroid injection history, regardless of the frequency, and insurance status of the patient. [ABSTRACT FROM AUTHOR]

Background: Sculpting is a common occupation in India. However, there have been no studies from India on sculpting-related silicosis. Aims: The aims of this study were to evaluate- 1. awareness of disease related to sculpting. 2. Clinical, radiological, and physiological parameters in "sculpting workers" suffering from silicosis. Settings and Design: This was a retrospective evaluation of data collected during compensation visits for silicosis in workers of the sculpting industries. Methods and Material: The data were collected between January 2021 to April 2023. A total of 114 patients were evaluated. All patients underwent clinical evaluation including awareness about the disease, chest radiography, high-resolution computed tomography (HRCT) scan of the chest, and spirometry. Results: The majority of patients (109) (95%) did not use any personal protective equipment while at work and did not have any awareness regarding preventive measures. On chest radiography, small opacities (rounded or irregular) and large opacities were seen in 84 (73.7%) and 26 (22.8%) patients, respectively. The size of large opacities was significantly proportionate with duration of job (P = 0.019). HRCT chest was more sensitive compared to chest radiographs. 94 (82.4%) patients were having abnormal spirometric findings. Conclusions: The benefits of prevention of silica dust exposure and patient education considerably outweigh the benefits of early detection and treatment of silicosis, as there was an increase in the size of lesions with increasing duration of exposure. There should be a national health program on silicosis to protect worker's health. [ABSTRACT FROM AUTHOR]