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Background: Small and medium-sized enterprises (SMEs) represent 95 % of businesses and are economically essential. When occupational injuries occur, scientific literature suggests that the return-to-work (RTW) success rate is proportional to the size of enterprises and the way RTW is managed may put workers in SMEs at risk. As most studies on RTW organizational practices have been conducted with large enterprises, little is known about how RTW is managed in SMEs., Objective: The aim of this study was to explore SME's organizational practices in the RTW process of workers having suffered an occupational injury., Methods: Semi-structured phone interviews were conducted with 15 participants from 3 different stakeholder categories (i.e., SME representatives, workers, and healthcare professionals) in order to explore their experiences regarding RTW in SMEs. Data were analyzed using a phenomenological analysis strategy., Results: SMEs' organisational practices evoked by participants gather in three themes: 1) Reducing the risks of occupational injuries (i.e., ensuring injury prevention), 2) Managing occupational injuries (i.e., dealing with the initial occupational injury, handling administrative aspects of work disability, and being actively involved in the RTW process), and 3) Preventing consequences of occupational injuries (i.e., adapting operations following injuries)., Conclusion: Organizational practices for RTW are used diversely in SMEs. Proposed lines of action adapted to the realities and needs of SMEs may be beneficial to hundreds of thousands of workers, enterprises and professionals involved in the RTW process.

Background: The novel coronavirus (COVID-19) that emerged in late 2019, and later become a global pandemic, has unleashed an almost unprecedented global public health and economic crisis., Objective: In this perspective, we examine the effects of COVID-19 and identify a likely 'new normal' in terms of challenges and opportunities within the fields of disability, telework, and rehabilitation., Methods: We use a systems thinking lens informed by recent empirical evidence and peer-reviewed qualitative accounts regarding the pandemic to identify emerging challenges, and pinpoint opportunities related to health and changing employment infrastructure of people with disabilities and rehabilitation professionals., Results: From our interpretation, the key leverage points or opportunities include: (1) developing disability-inclusive public health responses and emergency preparedness; (2) enabling employment and telework opportunities for people with disabilities; (3) addressing the new requirements in rehabilitation service provision, including participating as essential team members in the care of people with infectious diseases such as COVID-19; (4) embracing the added emphasis on, and capacity for, telehealth; and (5) developing greater resilience, distance learning, and employability among the rehabilitation workforce., Conclusions: The COVID-19 pandemic has become increasingly challenging to the lives of people with disabilities and rehabilitation professionals; however, key challenges can be minimized and opportunities can be capitalized upon in order to 'build back better' after COVID-19.

Background: Research is needed on how to optimize the return-to-work process for persons with mental health problems., Objective: To develop a model that explains how employer and rehabilitation professional mental health literacy may influence strategies used in the return-to-work of persons with mental health problems., Methods: A grounded theory study design was used to collect and analyse interview data from 23 employers and 22 rehabilitation professionals., Results: The analysis resulted in four categories, illustrated in a conceptual process model: 1) seeing mental health problems through past experiences; 2) separating understandable and incomprehensible mental health problems; 3) balancing safeguarding one's personal interest with providing adequate support; and 4) facing conflicts and uncertainty in employee/service user return-to-work. A positional map of employer/rehabilitation types was created based on level of negative attitudes and uncertainty in supporting employees/service users and the employer in relation to the level of comprehensive understanding of mental health problems., Conclusions: Professional mental health literacy needs to be increased. Interventions need to be developed that provide employers with targeted support and knowledge in mental health literacy. Education on how to prevent and detect common mental health problems in the workplace is needed.

Background: Many people living with mental illness want paid work, but finding and maintaining mainstream employment remains challenging. In recent decades, social enterprises have emerged as one alternative site for paid employment. Existing research has examined the experiences of people with mental illness working in social enterprises, but less is known about the organizational character of these workplaces., Objective: The objective of this paper is to develop a better understanding of social enterprises as organizational contexts for workers with mental illness., Methods: The research employed a qualitative methodology, conducting semi-structured interviews with executive directors and managers at 42 organizations operating 67 social enterprises across CanadaRESULTS:While there are strong similarities in organizational mandate to create meaningful employment there are also important variations between social enterprises. These include variations in size, economic activity and organizational structure, as well as differences in hours of work, rates of pay and the nature and extent of workplace accommodation. These variations reflect both immediate organizational contexts as well as broader economic constraints that enterprises confront., Conclusions: Understanding the varied nature of social enterprises is important for thinking about future enterprise development, and the capacity of such organizations to create meaningful employment for people living with mental illness.

Background: What a stroke means for working-age persons has not been sufficiently studied from a sociological perspective., Objective: This article uses the empirical material of a larger study to describe and analyze how institutional practices and discourses influence attempts to return to work after a stroke., Methods: Semi-structured interviews were conducted with ten persons who have had a stroke and ten civil servants and professionals from the Swedish Public Employment Service, the Social Insurance Agency, and different health care institutions. The qualitative analysis was inspired by institutional ethnography., Results: The analysis shows how persons who have had a stroke and civil servants and professionals in welfare organizations share the same goal: a return to working life for the former. The persons in this study related to, translated, and put into practice discourses of normality and employability in this process. However, there were, at times, conflicting institutional practices between the different organizations., Conclusions: Conflicting institutional practices connected to the discourses of normality and employability contribute to the difficulties that persons who have had a stroke face when trying to return to work after recovery.

Background: Telework has been promoted as a viable workplace accommodation for people with disabilities since the 1990s, when information and communication technologies (ICT) had developed sufficiently to facilitate its widespread adoption. This initial research and accompanying policy recommendations were prescriptive in nature and frequently aimed at employers., Objective: This article adds to existing policy models for facilitating successful telework outcomes for people with disabilities. Drawing upon two studies by the Rehabilitation Engineering Research Center on Workplace Accommodations, we expound on employee-side considerations in the implementation of telework., Methods: Our policy model utilizes established typologies for policy evaluation to develop a process model that considers rationales and implementation factors for telework among people with physical disabilities., Results: Telework may be used as an accommodation for disability, but employee rationales for telework are more complex, involving work-life balance, strategies for pain and fatigue not formally recognized as disability, and expediency in travel and transportation. Implementation of telework as a component of workplace operations is similarly multifaceted, involving non-technology accommodations to realize job restructuring left incomplete by telework., Conclusions: Our model grounds new empirical research in this area. We also renew our call for additional research on effective telework practices for people with disabilities.

Background: Telework, the use of distance communication technologies to participate in the workforce, has been suggested as a promising employment strategy for individuals with disabilities., Objective: The goal of this study was to obtain a better understanding of the benefits and negative impacts of telework, as well as the supports and challenges to telework activities, for persons who use augmentative and alternative communication (AAC)., Methods: This study used a series of focus group discussions, conducted on the internet, to examine the employment experiences of nine individuals with disabilities who used AAC and who held jobs that involved the use of telework., Results: Four major themes emerged from the discussion: (a) benefits of telework, (b) negative impacts of telework, (c) strategies for addressing negative impacts of telework, and (d) recommendations for improving employment outcomes for individuals who use AAC., Conclusions: In summary, while participants identified the elimination of travel time and flexible work schedules as key strengths of telework, concerns were expressed regarding feelings of isolation and the difficulty in separating home and work environments. The participants also emphasized the important role of educational programs in supporting the acquisition of literacy and self-advocacy skills, and the need for post-secondary programs to support the school-to-workplace transition.

Background: Employees frequently do not engage in help-seeking due to the associated social costs. Despite the importance of help-seeking, little research has been done to explore factors affecting whether individuals will or will not engage in help-seeking at work, and existing research has thus far not addressed help seeking in the telework context., Objective: This paper expands the current literature on help-seeking by exploring this behavior in the context of teleworkers and develops propositions regarding how aspects of virtual work environments will help determine teleworkers' willingness to engage in help-seeking behavior., Methods: This article presents a review with critical analysis and integration of selected telework and help-seeking literatures., Results: Grounded in the literature on inequity/indebtedness and the literature on threats to self-esteem, theoretically-derived research propositions are developed that help shed insights into help seeking behaviors in the telework context. These research propositions encompass media presence and the teleworker's perceived opportunity for reciprocation, and their associated impacts on the perceived cost of seeking help., Conclusion: The proposed research propositions provide practitioners and researchers a means to be better able to assess telework applications and prevent unintended effects. Through such systematic understanding of how telework alters the perceived cost of seeking help and the teleworker's willingness to seek help, telework may be further improved to contribute to more effective and productive individuals and organizations.

Background: Proponents of telework arrangements assert that those who telework have more control over their work and family domains than their counterparts who are not permitted to work from home., Objective: Using Karasek's theory we hypothesized that the relationship between demands (hours in work per week; hours in childcare per week) and strain (work role overload; family role overload) would be moderated by the number of hours the employee spent per week teleworking (control)., Methods: To determine how the number of telework hours relates to work role overload and family role overload, we follow the test for moderation and mediation using hierarchical multiple regression analysis as outlined by Frazier et al. [50] We used survey data collected from 1,806 male and female professional employees who spent at least one hour per week working from home during regular hours (i.e. teleworking)., Results: As hypothesized, the number of hours in telework per week negatively moderated the relation between work demands (total hours in paid employment per week) and work strain (work role overload). Contrary to our hypothesis, the number of hours in telework per week only partially mediated the relation between family demands (hours a week in childcare) and family role overload (strain)., Conclusions: The findings from this study support the idea that the control offered by telework is domain specific (helps employees meet demands at work but not at home).

This paper uses a case study to examine attitudinal barriers to employment and underemployment. We follow the career path of PR, a woman with multiple physical impairments, as she seeks financial independence through several employment strategies. In these, she faced attitudinal barriers and employment situations without opportunity for advancement. Eventually, PR opens her own business, turning to an alternative loan program to acquire the funds necessary to purchase a ready-made vehicle that matches her needs for accessible transportation. Use of this vehicle to provide delivery services for her business has more than doubled her income.

With the rising number of teleworkers who are working in non-traditional work locations, health and safety issues are even more critical. While telework offers attractive alternatives to traditional work locations, it is not without challenges for employers and workers. A macroergonomics approach or work system design for telework programs is proposed to address these new challenges. This approach explains the impact of organizational, psychosocial and workplace risk factors on teleworker's health and safety. A process for managing the health and safety of teleworkers is presented along with preventive strategies to provide an injury-free working environment.

Objective: This study provides a test of a conceptual framework of the stress-related health consequences of "precarious" employment experiences defined as those associated with instability, lack of protection, insecurity across various dimensions of work, and social and economic vulnerability., Methods: Data were drawn from the Canadian Survey of Labor and Income Dynamics (SLID), a nationally representative longitudinal labor-market survey (1999-2004). Logistic regression analysis estimated the impact of several dimensions of precarious employment on two health outcomes: low health status and low functional health., Participants: For each calendar year we selected a subsample of individuals with close ties to the labor-market--i.e., aged 25 to 54, not full-time students, and employed at least 9 months of the year. We excluded individuals who were self-employed, those in management-level positions, and individuals who reported less than good health at the beginning of the year., Results: Certain work characteristics (low earnings, the lack of an annual wage increase, substantial unpaid overtime hours, the absence of pension benefits, manual work) predict an increased risk of adverse general and/or functional health outcomes., Conclusions: Proactive regulatory initiatives and all-encompassing benefits programs are urgently required to address emerging work forms and arrangements that present risks to health.

Objective: This research seeks to identify job characteristics and workplace policies conducive to the job success of individuals with bipolar disorder, and to examine the interactions between employers and bipolar employees regarding requested workplace accommodations., Participants: The study population consists of 39 adults who were in outpatient care and diagnosed with bipolar I or II disorder., Methods: Each participant completed a mail-in questionnaire regarding workplace characteristics that would enhance job performance., Results: Primary beneficial work characteristics reported are schedule flexibility, autonomy, and supervisor willingness to provide accommodations. Specific helpful characteristics noted by participants include allowances for working at home, leaves of absence, frequent breaks, barriers between work spaces, control over goal-setting, creativity, and avoidance of jobs with pace set by machinery. Twelve of the 26 workers requested workplace changes, and of the 12 requests, 10 were implemented. Incidents of employer bias were reported., Conclusion: The experiences of the survey participants regarding beneficial workplace accommodations may help to improve the productivity and well-being of other individuals with bipolar disorder.

Aims: The objective of this pilot study was to explore whether organisational change and work-related stress, as measured by the Job Content Questionnaire, were associated with first-ever stroke among working people aged 30-65., Methods: In a case-control study a total of 65 consecutive cases, aged 30-65 years of age, with first-ever stroke were recruited from four hospitals in Sweden during 2000-2002. During the same period, 103 random population controls in the same age interval were recruited. Data on job-related stress and traditional medical risk factors were collected by a questionnaire., Results: In the multivariate analyses, organisational change (OR 3.38) increased the likelihood of stroke, while experiencing an active job (OR 0.37) decreased the likelihood of stroke. Regarding risk factors outside work, age (OR 1.11), low physical activity (OR 5.21), low education (OR 2.48) and family history of stroke (OR 2.59) were associated with increased likelihood of stroke., Conclusion: This study suggests an association between organisational change, work-related stress and stroke. The likelihood of stroke was lower for people in active job situations.

Work organization consists of three contexts: (a) the external context/factors, (b) the organizational context/practices, and, (c) the work context/process. The investigation of work organization may lead to more effective prevention and intervention for work-related injury and illness. Studies have suggested that workers with limited English proficiency may be more prone to work-related injury and illness. The purposes of this qualitative phenomenological study were to gain a better understanding of the meaning of work organization to Chinese workers with English as a second language (ESL) and to explore their lived experiences on how work organization affects their health. Ten in-depth face to face interviews were conducted with Chinese ESL workers (5 males and 5 females; ages ranged from 22 to 41 years) who were employed in English-speaking workplaces in the Greater Toronto Area, Ontario, Canada. Interviews were translated and transcribed before importing them into NUD*IST, a qualitative data management software program. The transcripts were then coded, and categories were developed based on the codes. Subsequently, eight themes were identified from the categories. Work organization was perceived by Chinese ESL workers to be at an impersonal and distant level. Workers also identified work organization related issues (i.e., employers' priority, communication, work culture, job autonomy, recognition, and individual characteristics) as factors affecting their health at workplaces. However, these workers commonly expressed resignation towards their own health. Workplaces, especially those with Chinese ESL workers, need to place greater emphasis on implementing effective health and safety approaches to maximize the health of these workers.

Telecommuting, whether full time, part time, or over short periods when the need arises, can be an important accommodation for employees with disabilities. Indeed, telecommuting may be the only form of accommodation that offers employees whose disabilities fluctuate a means to stay consistently and gainfully employed. This article describes one employer's experience in considering a request for telecommuting as a reasonable accommodation for a particular employee. Drawing on real-life examples, both positive and negative, this article provides a win/win framework for decision-making that can help employers evaluate the use of telecommuting as a possible accommodation and facilitates open and ongoing communication between employer and employee.

Teleworking, a restructuring of the manner in which work occurs, based on information communication technologies (ICTs), is a promising way of further integrating people with disabilities into the workplace. In contrast to telecommuting, in which the work is primarily shifted in locale, telework is a restructuring of the tasks to be accomplished within the larger work setting which could result in "work" being done remotely, or collaboratively with coworkers (remotely or not) using ICTs. Drawing upon a review of the literature, this paper explores the relationship between telework and people with disabilities. While the advent of telecommuting and subsequently "teleworking" might open increased opportunities for the hiring of people with disabilities, it may also place severe constraints on the type of work, workplace environment and interactions, and accumulation of social capital for people with disabilities. Whereas much of the prevailing literature on telework and disability is often proscriptive in nature and is written with an audience of employers in mind, it is just as important to consider policy options from the standpoint of the employee as well. This paper proposes a number of policy approaches for the creation of an inclusive work environment for teleworkers with disabilities that can minimize, as much as possible, the social isolation faced by teleworkers with disabilities while maximizing their participation within the workplace community. Policy objectives for enhancing telework for people with disabilities fall into three general categories: 1) research, 2) outreach, and 3) interventions.