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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]

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]

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]

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]

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]

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]

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]

This document provides summaries of various legal cases related to different topics in the field of business franchising. The cases discussed include issues such as non-compete agreements, arbitration, fraud, vicarious liability, damages, definition of franchise, choice of forum, choice of law, and contract issues. Each summary provides a brief overview of the case and its outcome, highlighting the key legal arguments and decisions made by the courts. These summaries can be useful for library patrons conducting research on specific topics in the field of business franchising. [Extracted from the article]

This commentary describes challenges in recruiting workers from marginalized industries with examples from a pilot study of janitors, custodians, and maids and their experiences of cleaning and disinfection protocols during COVID-19 and potentially associated respiratory symptoms. Recruitment strategies included contacting a local hospital, national workers' unions, and a large Arizona employer; using online Facebook groups; and contacting Arizona maid service companies and a school district. English and Spanish online and hard copy surveys about cleaning protocols and respiratory symptoms were used. Participants could also participate in online/phone interviews. Worker's compensation, liability, and confidentiality were concerns across organizations. Online surveys yielded unreliable data. Hard copy surveys were used due to workers' limited technology access. We reflect upon these challenges and discuss other strategies for recruiting from marginalized populations for occupational health research. Building trust with organizations and workers and considering technology access may ultimately increase recruitment feasibility. [ABSTRACT FROM AUTHOR]

Agriculture is a hazardous industry with undocumented injury events. Credible surveillance measures are critical for this industry, especially to guide injury prevention programs with targeted recommendations for specific commodity groups and populations. This multi-phase study explored the feasibility for two state agency databases, the Ohio Bureau of Workers' Compensation (BWC) Program and the Emergency Medical Services Incident Reporting System (EMSIRS), to augment the state's Bureau of Labor Statistics (BLS) annual reports. BWC data described injury claims in agricultural workplaces from 1999 to 2008. State EMSIRS data described the types of medical emergencies for which EMS services were requested to Ohio farms in 2013–2014. Descriptive analyses were performed on each distinctive source. Over 14,000 BWC claims were analyzed, with primary nature of injury identified as sprains and strains of bodily extremities; falls were the most common cause of injury. The EMSIRS data provided 1,376 cases, where EMS services were requested to Ohio farms at injury onset. Some cases had possibility to be excluded in CFOI or employment claims data, with 24% patients 65 years and older and 6% children 13 years and younger. The primary cause of injury was falls, and the highest reported injury type was blunt trauma. Both BWC and EMSIRS databases showed the potential to enhance Ohio's agricultural surveillance data with viable information not found in previously used systems. Each agency database had its own merits to further clarify and quantify morbidity. When used together, these sources enrich surveillance statistics to describe Ohio's agricultural injury incidents. [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]

Today's labor market has changed over time, shifting from mostly full-time, secure, and standard employment relationships to mostly entrepreneurial and precarious working arrangements. In this context, self-employment (SE), a prominent type of precarious work, has been growing rapidly due to globalization, automation, technological advances, and the rise of the 'gig' economy, among other factors. Employment precarity profoundly impacts workers' health and well-being by undermining the comprehensiveness of social security systems, including occupational health and safety systems. This study examined how self-employed (SE'd) workers sought out support from informal support systems following illness, injury, and income reduction or loss. Based on in-depth interviews with 24 solo SE'd people in Ontario, Canada, narrative analysis was conducted of participants' experiences with available informal supports following illness or injury. We identified three main ways that SE'd workers managed to sustain their businesses during periods of need: (i) by relying on savings; (ii) accessing loans and financial support through social networks, and (iii) receiving emotional and practical support. We conclude that SE'd workers managed to survive despite social security system coverage gaps by drawing on informal support systems. [ABSTRACT FROM AUTHOR]

The modern trend of telecommuting has gained popularity in recent years, with many employees working from home in lieu of reporting to brick-and-mortar offices. Yet the law has failed to keep up with this trend, particularly in the context of workers' compensation. And with the rise in telecommuting, a rise in workers' compensation claims for injuries sustained in the home is likely to follow. While the common law provides a framework for resolving telecommuter claims in Wisconsin, this framework invites inconsistent application and fails to abide by the purpose of Wisconsin's Workers' Compensation Act. In anticipation of the inevitable rise in workers' compensation claims for telecommuter injuries, the Wisconsin Legislature must address telecommuter claims in the state's workers' compensation statute. This Comment recommends that the Wisconsin Legislature amend the Workers' Compensation Act to create clear standards for the compensability of telecommuter injuries. First, this Comment summarizes the history and background of the Workers' Compensation Act while discussing how Wisconsin courts and the Labor and Industry Review Commission have resolved telecommuter claims. Next, this Comment will explore how telecommuter claims have been resolved in other jurisdictions. Finally, this Comment will analyze how Wisconsin can effectively adopt clear standards for telecommuter injuries and what those standards should require. [ABSTRACT FROM AUTHOR]

The occupation of commercial fishing is recognized as a comparatively stressful and hazardous job characterized by a myriad of risks to health, including high rates of job‐related injury, morbidity, and mortality. Nonetheless, systematic study of fisher health is limited. This paper examines a particularly understudied aspect of illness among fishers: the physical and social contexts, pathways, and potential for adverse disease interactions. The focus of the paper is on a biosocial disease process called syndemics, which increases the health burdens of this population. The paper is presented as an initial testing of the hypothesis that a "lens" of syndemics improves occupational health research and advocacy for commercial fishermen who face a substantial burden of biosocial challenges. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the associations between baseline demographics, health conditions, pain management strategies, and health-related quality-of-life (HRQoL) measures with pain management strategies at 3-month follow-up in respondents reporting current low-back pain (LBP). Study design: Cohort study of survey data collected from adults with LBP sampled from Amazon Mechanical Turk crowdsourcing panel. Methods: Demographics, health conditions, and the Patient-Reported Outcomes Measurement Information System (PROMIS)-10 were included in the baseline survey. Respondents reporting LBP completed a more comprehensive survey inquiring about pain management strategies and several HRQoL measures. Bivariate then multivariate logistic regression estimated odds ratios (ORs) with 95% confidence intervals (CIs) for the association between baseline characteristics and pain management utilization at 3-month follow-up. Model fit statistics were evaluated to assess the predictive value. Results: The final cohort included 717 respondents with completed surveys. The most prevalent pain management strategy at follow-up was other care (n = 474), followed by no care (n = 94), conservative care only (n = 76), medical care only (n = 51), and medical and conservative care combined (n = 22). The conservative care only group had higher (better) mental and physical health PROMIS-10 scores as opposed to the medical care only and combination care groups, which had lower (worse) physical health scores. In multivariate models, estimated ORs (95% CIs) for the association between baseline and follow-up pain management ranged from 4.6 (2.7–7.8) for conservative care only to 16.8 (6.9–40.7) for medical care only. Additional significant baseline predictors included age, income, education, workman's compensation claim, Oswestry Disability Index score, and Global Chronic Pain Scale grade. Conclusions: This study provides important information regarding the association between patient characteristics, HRQoL measures, and LBP-related pain management utilization. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study is to describe cost and frequency of work-related musculoskeletal disorders in Kansas. Methods: Data were provided by the Kansas Department of Labor and included all closed workers' compensation claims entailing indemnity and medical costs from 2014 to 2022. Results: Work-related musculoskeletal disorder claims entailed a median total cost of $20,097. Medical comprised 48.4% of costs, indemnity 46.4%, and legal 5.2%. The most frequently injured and costliest body part was the shoulder. Manufacturing comprised 28.4% of claims, followed by health care and office. Lifting was the most common cause, generating 32.0% of claims. Education, transportation, and mining were among industries with above average claim rates. Conclusions: Very few studies use workers' compensation data to assess work-related musculoskeletal disorder costs. This study introduces a state not yet analyzed and presents more recent years of data than available in the literature. [ABSTRACT FROM AUTHOR]

To understand the current utilisation of the clinical framework for delivery of health services to manage compensable musculoskeletal injuries from the perspectives of insurer case managers and clinical panel members. Using a qualitative descriptive approach, 15 semi-structured interviews were conducted with members of key organisations including WorkSafe Victoria and Transport Accident Commission Victoria. All interviews were recorded and transcribed verbatim and analysed using thematic analysis. Four over-arching themes were identified: (i) current use of the framework and principles is suboptimal leading to several problems including lack of evidence-based treatment by clinicians; (ii) barriers to optimal use of the framework include lack of adequate training of healthcare professionals on the framework principles and financial aspects of the compensation system; (iii) utilisation of the framework could be improved with training from peak associations, insurers, and regulating bodies; and (iv) optimal use of the framework will result in better health and work outcomes. The current use of the framework and its principles is suboptimal but can be improved by addressing the identified barriers. Rehabilitation of compensable musculoskeletal injuries is often complex. Implementing the "Clinical Framework for Delivery of Health Services" can lead to provision of time and cost effective, evidence-based rehabilitation for compensable injuries, ultimately improving patient outcomes. Clinicians can enhance the implementation of the framework principles by integrating evidence-based practice and recommendations from clinical practice guidelines in treatment of compensable musculoskeletal injuries. Implementation of the framework principles may be enhanced by reviewing the compensation funding model to allow the healthcare practitioners adequate time and remuneration to adopt the framework principles when treating persons with compensable injuries. [ABSTRACT FROM AUTHOR]

The province of Ontario, Canada, implemented mandatory day-long training for construction workers required to use fall-protection equipment. More than 400 000 training sessions were completed by 2017 when the requirement took full effect. The lost-time workers' compensation claim incidence rate attributable to falls targeted by the training was 19% lower in 2017–2019 than in 2012–2014. Rates for two comparator injuries increased or stayed the same. The decline in targeted fall claim incidence rate of the other Canadian provinces was 6%. (Am J Public Health. 2024;114(1):38–41. https://doi.org/10.2105/AJPH.2023.307440) [ABSTRACT FROM AUTHOR]

Burnout and pay satisfaction were associated with intention to leave the profession; however, overall compensation dollar amount was not correlated with intention to leave. Approaches to nurse retention should employ a multifaceted approach to effectively enhance retention rates. [ABSTRACT FROM AUTHOR]

Purpose: Close others of people with acquired neurological disability often play a key role in supporting their relative to get necessary support, and therefore have valuable insight into what facilitates quality support. Situated within a series of studies aiming to build a holistic model of quality support grounded in the lived experience of adults with acquired neurological disability, support workers and close others, this study explores the perspective of close others. Method: Following grounded theory methodology, ten close others participated. In-depth interview data was analyzed using constructivist grounded theory methods to develop themes and explore relationships between the themes. Results: A multi-level system model characterizing quality support at three levels was developed. Key factors at the dyadic level included the support worker recognizing the person as an individual and the dyad working well together. At the team level, it was important for the support team, close others, and providers to engage constructively together. At the sector level, building quality systems to develop the workforce emerged as essential. Conclusions: The findings complement the perspective of people with disability and support the key notion of quality support honouring the person's autonomy and highlight the need to raise accountability in the disability sector. [ABSTRACT FROM AUTHOR]

Background: People with intellectual disability have a poorer health status than the general population. In The Netherlands, support workers play a key role in meeting health support needs of people with intellectual disability. Research on how people with intellectual disability and their support workers experience the support worker's role in preventing, identifying, and following up health needs of people with intellectual disability is scarce. To enhance health support of people with intellectual disability it is crucial that we understand how health support is delivered in everyday practice. Therefore, this study investigated experiences of people with intellectual disability and support workers with the health support of people with intellectual disability. Method: Data collection consisted of six focus group (FG) discussions with between four and six participants (N = 27). The FGs consisted of three groups with support workers (n = 15), two groups with participants with mild to moderate intellectual disability (n = 8), and one group with family members as proxy informants who represented their relative with severe to profound intellectual disability (n = 4). The data was analysed thematically on aspects relating to health support. Results: We identified three main themes relevant to the health support of people with intellectual disability: 1) dependence on health support, 2) communication practices in health support, and 3) organizational context of health support. Dependence on health support adresses the way in which support workers meet a need that people with intellectual disability cannot meet themselves, and communication practices and organizational context are identified as systems in which health support takes place. Conclusion: This study investigated experiences with the health support of people with intellectual disability from the perspectives of people with intellectual disability and support workers. We discuss the dependence of people with intellectual disability and the complexity of health support in everyday practice. We provide practical implications that can strengthen support workers in the provision of health support for people with intellectual disability in everyday practice. The findings of this study emphasize the need for intellectual disability care-provider organizations to establish policies around consistency in support staff to make it easier to identify and follow up health needs, and an environment where support staff can develop their expertise concerning communication practices, lifestyle choices, and identifying and following up health needs. [ABSTRACT FROM AUTHOR]

Background: People with intellectual disability have a poorer health status than the general population. In The Netherlands, support workers play a key role in meeting health support needs of people with intellectual disability. Research on how people with intellectual disability and their support workers experience the support worker's role in preventing, identifying, and following up health needs of people with intellectual disability is scarce. To enhance health support of people with intellectual disability it is crucial that we understand how health support is delivered in everyday practice. Therefore, this study investigated experiences of people with intellectual disability and support workers with the health support of people with intellectual disability. Method: Data collection consisted of six focus group (FG) discussions with between four and six participants (N = 27). The FGs consisted of three groups with support workers (n = 15), two groups with participants with mild to moderate intellectual disability (n = 8), and one group with family members as proxy informants who represented their relative with severe to profound intellectual disability (n = 4). The data was analysed thematically on aspects relating to health support. Results: We identified three main themes relevant to the health support of people with intellectual disability: 1) dependence on health support, 2) communication practices in health support, and 3) organizational context of health support. Dependence on health support adresses the way in which support workers meet a need that people with intellectual disability cannot meet themselves, and communication practices and organizational context are identified as systems in which health support takes place. Conclusion: This study investigated experiences with the health support of people with intellectual disability from the perspectives of people with intellectual disability and support workers. We discuss the dependence of people with intellectual disability and the complexity of health support in everyday practice. We provide practical implications that can strengthen support workers in the provision of health support for people with intellectual disability in everyday practice. The findings of this study emphasize the need for intellectual disability care-provider organizations to establish policies around consistency in support staff to make it easier to identify and follow up health needs, and an environment where support staff can develop their expertise concerning communication practices, lifestyle choices, and identifying and following up health needs. [ABSTRACT FROM AUTHOR]

Background: Patient-reported outcome measures (PROMs) contribute to evaluating and improving the quality of patient care. Patient outcomes after rotator cuff repair (RCR) have been researched; however, the relationship between PROM response rates and individual and health care correlates has not been thoroughly investigated. Purpose: To examine differences in individual and health care factors among patients who had undergone RCR based on their PROM response rates. Study Design: Case-control study; Level of evidence, 3. Methods: Shoulder-specific and general PROMs were solicited via email and text message of all patients who underwent RCR between 2016 and 2020. Three subgroups were classified: (1) complete responders completed all 1-year postoperative PROMs, (2) partial responders answered enough questions to produce ≥1 usable score, and (3) nonresponders did not respond to a single measure. Correlates were assessed using analysis of variance and chi-square tests. Adjusted multinomial logistic regression models identified predictors of 1-year PROM response. Results: Of 2195 patients included at the 1-year follow-up, 34% were complete responders; 11%, partial responders; and 55%, nonresponders. Patients had a mean age of 61.8 years, 63% were men, and 90% were White. Pre- and postoperative PROM scores were similar across responder groups. In stepwise selection, 1-year responses (complete or partial) were associated with older age, later year of surgery, White race, and having workers' compensation insurance. The strongest predictor of PROM response was having workers' compensation insurance. Conclusion: Patients with workers' compensation insurance compared with other insurance types responded to PROMs at disproportionately higher rates. This could distort postoperative PROM scores in the population studied because there are known differences among patients with this insurance status. [ABSTRACT FROM AUTHOR]

The article discusses the application of the legal doctrine in tort law, respondeat superior, as the at-home and remote work options become popular in the U.S. Topics discussed include employers' liability for wrongful acts committed by their employees occurring within the scope of their employment, the link between respondeat superior and workers' compensation in relation to defining the scope of employment, and the view that courts should uphold strict liability in respondeat superior cases.

Climate change has created existential challenges for current models of natural hazard insurance, and it may be difficult going forward for these models to consistently, fairly and coherently manage the compensation challenges associated with climate change impacts in Europe. This paper analyses the application of a comprehensive no-fault compensation fund framework to the problem of presently uninsured and technically uninsurable losses that are currently inadequately covered by other compensation mechanisms, and for which compensation may be difficult to recover using tort law mechanisms. The proposed structure includes consideration of the purpose and form of the fund, eligibility and categories of loss covered, quantum of compensation, and funding sources. There is also a preliminary consideration of the impact of such a fund on questions of liability. The proposed model illustrates potential ways for a compensation fund to support and complement existing compensation structures such as insurance and civil liability, and provide the necessary stabilisation in European society. Further legal research in this area will require qualitative and quantitative empirical data on how existing compensation frameworks (including innovative insurance instruments like parametric insurance) have so far positively and negatively impacted the ability of victims of climate change to prepare for and recover from loss incidents, in comparison with tort law and existing insurance. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study was to establish whether the Rheumatoid Arthritis Work Instability Scale (RA‐WIS), in its current form, is applicable for use with employed people with fibromyalgia (FM) to identify the risk of work disability and need for work rehabilitation. Methods: Content validity was first investigated using cognitive debriefing interviews. Participants completed a postal questionnaire. Construct validity was assessed using Rasch analysis. Concurrent validity included testing between the RA‐WIS and work (e.g., Workplace Activity Limitations Scale) and health (FM Impact Questionnaire‐Revised (FIQ‐R) scales. Two weeks later, participants were mailed a second questionnaire to measure test‐retest reliability. Results: Interviews were conducted with 13 participants with FM. All RA‐WIS items were considered very or extremely relevant by almost all participants, with only one suggesting other items (anxiety and brain fog). Questionnaire responses were analysed from 156 employed participants: 94% women; 45.71 (SD 10.05) years of age; with time since FM diagnosis 2.99 (4.17) years (symptom duration 8.36 (SD 7.16) years). The RA‐WIS mostly satisfied Rasch model requirements and a Rasch transformation scale was created. Concurrent validity was generally good (rs = 0.55–0.66) with work scales and the FIQ‐R. Internal consistency (Person Separation Index values) was consistent with group use in FM, not individual level use. Test‐retest reliability was excellent, with intraclass coefficient (2, 1) = 0.90. Discussion: The RA‐WIS is valid and reliable for group use in employed people with FM. However, further work is needed to develop a WIS for individual use in FM. [ABSTRACT FROM AUTHOR]

There is growing recognition that people with disability have the right to be involved in making decisions that affect their lives. Decision-making support has emerged as one way to support people with cognitive disability to make decisions, however, there is a paucity of research that explores how disability support workers can be upskilled to provide decision-making support to this group. The aim of the research was to explore the impact of an evidence-based online training course on disability support workers of adults with cognitive disability. Changes in knowledge about decision-making support and confidence in providing decision-making support were explored, attitudes towards decision-making support, and facilitators and barriers. Participants completed an online training course and responded to a survey on three occasions: baseline, post-training, and at 2-month follow-up. Ninety-nine disability support workers across Australia participated in the online training and completed the baseline and post-training surveys. Thirty-six participants completed the training and all three surveys. The results revealed that there were statistically significant improvements in knowledge, confidence, and attitudes from baseline to post-training, which were maintained at 2-month follow-up. Barriers to decision-making support included service providers or other supporters, including the family of the person with cognitive disability, whilst a key enabler was knowing about the decision-making support principles. This research demonstrates that an evidence-based online training course about decision-making support can be effective in building capacity in disability support workers. There are, however, several barriers that must be addressed to facilitate the implementation of decision-making support. [ABSTRACT FROM AUTHOR]

The findings from, Determining Unmet Needs Among Workers' Compensation Stakeholders to Prevent Work Disability in the State of Vermont , suggest that there is a lack of appropriate, coordinated health care delivery available to workers' compensation applicants and beneficiaries to support their return-to-work efforts. Purpose: Vermont has high rates of young people receiving federal disability benefits leading to substantial gaps in the workforce. The purpose of this project was to determine the unmet needs of interested parties in the workers' compensation (WC) process. Methods: A type of focus group, experience groups, was used to elicit key parties' experiences in the WC system. Facilitators used open-ended prompts to encourage discussion among participants about their experience with the WC system. Data were analyzed using thematic coding procedures to identify common motifs. Results: Common themes emerged including challenges in navigating the WC system, lack of communication among stakeholders, and providing and receiving appropriate health care to facilitate RTW. Conclusions: Understanding unmet needs of interested parties in the WC process allows for the creation of targeted, high-value, early intervention strategies to reduce long-term work disability. [ABSTRACT FROM AUTHOR]

Corporate medical directors (CMDs) can provide tremendous value by leading or participating in the development of an integrated comprehensive health strategy that includes employer health benefits. Many CMDs report having benefits expertise but being underutilized while others report not having expertise. Professional organizations should support ongoing education on health-related benefits. Objective: Knowledge of health-related employer benefits is considered a core competency by the American College of Occupational and Environmental Medicine. This study seeks to understand how this translates into practice. Methods: An electronic survey was e-mailed to members of American College of Occupational and Environmental Medicine Corporate Medicine and Health and Human Performance Sections; Integrated Benefits Institute; and Employer Health Innovation Roundtable. Results: One hundred nineteen responses were received, including 54 from corporate medical directors (CMDs) and 43 from employee benefits professionals, from a variety of industries. Fifty percent of CMDs reported expertise in designing benefits, but only 25% are engaged with health benefits. The majority of CMDs thought that their involvement was important, while the majority of benefits professionals thought that it was not important. Conclusions: Many CMDs report having benefits expertise but being underutilized while others report not having expertise. [ABSTRACT FROM AUTHOR]

Multiple respiratory hazards have been identified in the cannabis cultivation and production industry, in which occupational asthma and work-related exacerbation of preexisting asthma have been reported. An employee working in a Massachusetts cannabis cultivation and processing facility experienced progressively worsening work-associated respiratory symptoms, which culminated in a fatal asthma attack in January 2022. This report represents findings of an Occupational Safety and Health Administration inspection, which included a worksite exposure assessment, coworker and next-of-kin interviews, medical record reviews, and collaboration with the Massachusetts Department of Public Health. Respiratory tract or skin symptoms were reported by four of 10 coworkers with similar job duties. Prevention is best achieved through a multifaceted approach, including controlling asthmagen exposures, such as cannabis dust, providing worker training, and conducting medical monitoring for occupational allergy. Evaluation of workers with new-onset or worsening asthma is essential, along with prompt diagnosis and medical management, which might include cessation of work and workers' compensation when relation to work exposures is identified. It is important to recognize that work in cannabis production is potentially causative. [ABSTRACT FROM AUTHOR]

Purpose: In the context of the Industry 4.0, this paper aims to investigate the state of the art of Italian manufacturing, focusing the attention on the implementation of intelligent predictive maintenance (IPdM) and 4.0 key enabling technologies (KETs), analyzing advantages and limitations encountered by companies. Design/methodology/approach: A survey has been developed by the University of Parma in cooperation with the Italian Workers' Compensation Authority (INAIL) and was submitted to a sample of Italian companies. Overall, 70 answers were collected and analyzed. Findings: Results show that the 54% of companies implemented smart technologies, increasing quality and safety, reducing the operating costs and sometimes improving the process' sustainability. However, IPdM was implemented only by the 37% of respondents: thanks to big data collection and analytics, Internet of Things, machine learning and collaborative robots, they reduced downtime and maintenance costs. These changes were implemented mainly by large companies, located in northern Italy. To spread the use of IPdM in Italian manufacturing, the high initial investment, lack of skilled labor and difficulties in the integration of new digital technologies with the existing infrastructure are the main obstacles to overcome. Originality/value: The article gives an overview on the current state of the art of 4.0 technologies implementation in Italy: it is useful not only for companies that want to discover the implementations' advantages but also for institutions or research centres that could help them to solve the encountered obstacles. [ABSTRACT FROM AUTHOR]

This study estimated the average annual number of U.S. workers' compensation (WC) claims for occupational hearing loss (OHL) and their associated cost and identified the industry/occupation classifications with the highest numbers of OHL claims. The most recent U.S. cost estimate ($242 million) was based on data from one state in 1 year (1991). WC data from the National Council on Compensation Insurance, Inc. (35 states) and two additional individual states were examined, incorporating data from 37 states and the District of Columbia. Costs and numbers of claims were estimated for the 13 missing states to develop estimates for the United States. Sensitivity analyses were also performed to develop ranges for the point estimates. The estimated U.S. average annual OHL claim cost fell within the range of $49 to $67 million during 2009–2013, with a point estimate of $60 million (2013 dollars). The estimated average annual number of OHL claims ranged from 4,114 to 5,986, with a point estimate of 4,965 claims. Based on data available from 36 states and DC, 18 of the 40 industry/occupation classifications with ≥50 OHL claims were in the manufacturing sector. WC data underestimate the true burden of OHL. Most OHL cases are not compensated. WC laws, industry composition and other factors vary widely by state, so estimates must employ data for many states. This study incorporated data from most states and utilized sensitivity and comparative analyses to obtain estimates. Workers in a wide range of industry/occupation classifications need special attention to prevent OHL. [ABSTRACT FROM AUTHOR]

Actuaries use predictive modeling techniques to assess the loss cost on a contract as a function of observable risk characteristics. State-of-the-art statistical and machine learning methods are not well equipped to handle hierarchically structured risk factors with a large number of levels. In this paper, we demonstrate the data-driven construction of an insurance pricing model when hierarchically structured risk factors, contract-specific as well as externally collected risk factors are available. We examine the pricing of a workers' compensation insurance product with a hierarchical credibility model [Jewell, W. S. (1975). The use of collateral data in credibility theory: A hierarchical model. Laxenburg: IIASA], Ohlsson's combination of a generalized linear and a hierarchical credibility model [Ohlsson, E. (2008). Combining generalized linear models and credibility models in practice. Scandinavian Actuarial Journal2008(4), 301–314] and mixed models. We compare the predictive performance of these models and evaluate the effect of the distributional assumption on the target variable by comparing linear mixed models with Tweedie generalized linear mixed models. For our case-study the Tweedie distribution is well suited to model and predict the loss cost on a contract. Moreover, incorporating contract-specific risk factors in the model improves the predictive performance and the risk differentiation in our workers' compensation insurance portfolio. [ABSTRACT FROM AUTHOR]

This article examines the issue of "take-home" COVID-19 claims, where employees who contracted the virus at work transmit it to their family members at home. It explores the impact of COVID-19 business liability shield laws on these claims and whether workers' compensation laws prevent such claims. The article also discusses whether employers have a duty of care towards employees' family members and explores exceptions to this duty. It references case law on take-home asbestos claims to provide insight into the viability of take-home COVID-19 claims. The courts have generally been hesitant to impose a duty of care on employers, considering factors such as foreseeability, the connection between the employer's actions and the harm, moral blame, and the burden on employers and society. They have also taken into account public policy concerns and the potential for an influx of litigation. Ultimately, the courts have determined that the burden on employers and the broader societal consequences outweigh the compensatory and cost-internalization aspects of negligence liability. [Extracted from the article]

This article explores the complex issue of medical marijuana reimbursement in workers' compensation claims. Despite marijuana being federally illegal, many states have legalized it for medical or adult use. The article discusses the varying approaches of different states regarding reimbursement, with some allowing it, some disallowing it, and others being undecided. The U.S. Supreme Court recently declined to review the issue, leaving it up to individual states to decide. The article provides examples of states that permit reimbursement and highlights the importance of state legislation and interpretation in determining whether reimbursement is allowed. It also notes the growing trend of states permitting reimbursement for medical marijuana in workers' compensation cases. [Extracted from the article]

Although incorporating patient reported outcomes (PROMs) into practice allows healthcare systems to evaluate the value of care provided, research and policy reflecting PROMs can only be valid if they represent all patients. Few studies have evaluated socioeconomic barriers to PROM completion, and none have done so in a spine patient population. To identify patient barriers to PROM completion one year following lumbar spine fusion. Retrospective single-institution cohort study. A total of 2,984 patients undergoing lumbar fusion between 2014 and 2020 Completion of Mental Component Score (MCS-12) and Physical Component Score (PCS-12) of Short Form-12 questionnaire 1 year postoperatively. A retrospective review was conducted of all patients undergoing 1-3-level lumbar fusion at a single urban tertiary center. PROMs were queried from our prospectively managed electronic outcomes database. Patients were considered to have complete PROMs if 1-year outcomes were available. Community-level characteristics were collected from patients' zip codes using the Economic Innovation Group Distressed Communities Index. Bivariate analyses were performed to assess factors associated with PROM incompletion along with multivariate logistic regression to control for confounders. A total of 1,968 (66.0%) had incomplete 1-year PROMs. Patients with incomplete PROMs were more likely to be Black (14.5% vs 9.3%, p<.001), Hispanic (2.9% vs 1.6%, p=.027), reside in a distressed community (14.7% vs 8.5%, p<.001), and be active smokers (22.4% vs 15.5%, p<.001). On multivariate regression, Black race (OR: 1.46, p=.014, Hispanic ethnicity (OR: 2.19, p=.027), distressed community status (OR: 1.47, p=.024), workers' compensation status (OR: 2.82, p=.001), and active smoking (OR:1.31, p=.034) all were independently associated with PROM incompletion. Surgical characteristics, including primary surgeon, revision status, approach, and levels fused were not associated with PROM incompletion. Social determinants of health impact completion of PROMs. Patients completing PROMs are overwhelmingly White, non-Hispanic, and reside in wealthier communities. Efforts should be taken to provide better education regarding PROMs and ensure closer follow-up of certain subgroups of patients to avoid furthering disparities in PROM research. [ABSTRACT FROM AUTHOR]

Purpose: Working mothers are at greater risk for postpartum depression. Maternity leave characteristics, including length, wage replacement and employment protection, could have relevant implications for mothers' mental health. We propose to explore whether there is an association between maternity leave characteristics and postpartum depression. Methods: We conducted a systematic review searching for randomized controlled trials, quasi-experimental, cohort or cross-sectional studies on five databases using search terms including maternity and parental leave and depression, as well as references in relevant articles. We identified 500 articles and included 23 of those. We used the EPHPP Quality Assessment Tool for Quantitative Studies to assess the quality of the studies. Results: Paid and longer maternity leaves tend to be associated with a reduction of postpartum depression symptoms in high-income countries. No studies explored the association between employment protection and postpartum depression. The quality of studies ranged from strong to weak, mostly influenced by study design. Conclusion: More restrictive maternity leave policies tend to be associated with higher rates of postpartum depression, although more research needs to be conducted in the Global South. [ABSTRACT FROM AUTHOR]

Delayed recovery and return-to-work readiness in post COVID-19 condition are often due to self-reported neuropsychiatric features. The neurocognitive screening evaluation (NCSE) can be used to improve outcomes, decrease work leave, and clarify symptom validity in one in-office or telehealth session for this population, postconcussional syndrome, and similar complex neuropsychiatric presentations. Objective: Efficacy of a neurocognitive screening evaluation (NCSE) in assessing symptoms and disability associated with post–COVID-19 condition (PCC) and facilitating employee recovery and return to work was evaluated. Methods: An NCSE was administered to 64 employees off work because of neurocognitive complaints attributed to post–COVID-19 condition. Neurocognitive and symptom validity data were analyzed along with recovery and return-to-work timelines. Results: A large percentage of the employees gave invalid responses and noncredible effort on psychological and cognitive tests (48%). The NCSEs with invalid profiles suggested more severe cognitive and psychiatric symptoms than valid profiles. Both valid and invalid groups had significant reductions in illness duration and lost workdays after the NCSE. Conclusions: Post–COVID-19 condition resulted in reports of mild to moderate cognitive and psychiatric symptoms with extensive mean work leave of 11 months before mental health assessment. Regardless of symptom validity, after the NCSE, the employees were released to work at an average of 3 weeks. [ABSTRACT FROM AUTHOR]