Search

Objective: The objective of this study was to compare the incidence of work-related injury and illness presenting to Ontario emergency departments to the incidence of worker's compensation claims reported to the Ontario Workplace Safety & Insurance Board over the period 2004-2008.Methods: Records of work-related injury were obtained from two administrative data sources in Ontario for the period 2004-2008: workers' compensation lost-time claims (N=435,336) and records of non-scheduled emergency department visits where the main problem was attributed to a work-related exposure (N=707,963). Denominator information required to compute the risk of work injury per 2,000,000 work hours, stratified by age and gender was estimated from labour force surveys conducted by Statistics Canada.Results: The frequency of emergency department visits for all work-related conditions was approximately 60% greater than the incidence of accepted lost-time compensation claims. When restricted to injuries resulting in fracture or concussion, gender-specific age differences in injury incidence were similar in the two data sources. Between 2004 and 2008, there was a 14.5% reduction in emergency department visits attributed to work-related causes and a 17.8% reduction in lost-time compensation claims. There was evidence that younger workers were more likely than older workers to seek treatment in an emergency department for work-related injury.Conclusions: In this setting, emergency department records available for the complete population of Ontario residents are a valid source of surveillance information on the incidence of work-related disorders. Occupational health and safety authorities should give priority to incorporating emergency department records in the routine surveillance of the health of workers. [ABSTRACT FROM AUTHOR]

Objectives Given the tendency for young people to show elevated work injury rates, this study sought to examine trends in young worker and adult compensation claim rates in a Canadian province. Methods Workers' compensation records and labour force survey data from 1991 to 2007 were used to compute claim rates by age group. To examine the contribution of work-related factors to claim rates by age group, multivariate analyses included industry and job tenure. Results Descriptive analysis showed that age groups had different rates of declines over the time period. Multivariate analyses showed that claim rate declines for older adults were greatest prior to 1999. Young workers showed the largest declines after 1999. There was no indication that changes in industry or job tenure accounted for the trends in claim rates among older or younger workers. Conclusions This study is one of the first to show a convergence in youth and adult workers' compensation claims in a North American jurisdiction. Ruling out work-related factors increases the possibility that systemic interventions may have contributed to the convergence. This provides policy makers in occupational health and safety with empirical data to guide targeting of resources. [ABSTRACT FROM AUTHOR]

Introduction: We report on physicians' beliefs, confidence and clinical practice relative to the provision of smoking cessation interventions in northwestern (NW) Ontario, where tobacco use and tobacco-related disease prevalence are high and smoking cessation services are scarce. Methods: Physicians working at the 12 rural hospitals in NW Ontario were eligible for inclusion in the study. Survey items included clinical practices based on the '5 A's' protocol for tobacco intervention, and beliefs about, confidence in, and barriers and facilitators to intervention. Results: Physicians from 8 of the 12 hospitals responded. Almost all (> 91%) reported positive beliefs about providing smoking cessation interventions and were confident intervening. Relative to the 5 A's protocol for tobacco intervention, 100% of respondents ask, advise, assess and assist patients to quit smoking, and 89% arrange follow-up. The most frequent methods of assistance included pharmacotherapy, suggestions of specific actions to make it easier to quit and recommendations for alternatives to tobacco use. The most frequent barrier to intervenion was lack of time. Discussion: Based on respondents' positive beliefs, confidence and current clinical practice relative to tobacco interventions, physicians in NW Ontario seem well positioned to play a key role in helping to reduce the high rates of tobacco use and tobacco-related diseases by providing smoking cessation interventions to patients who have been admitted to hospital. [ABSTRACT FROM AUTHOR]

The principal aim of this study was to examine how different ramp rates influenced the attainment of peak physiological responses during incremental arm crank ergometry (ACE). Additionally, the study examined whether there was any evidence for the development of an 'excess' VO (2) during ACE due to upward curvi-linearity in the VO (2)-work rate relationship, and whether this was influenced by the ramp rate. Sixteen physically active, though non-specifically trained, men (mean +/- S age 30 +/- 8 years; height 1.79 +/- 0.07 m; body mass 84.7 +/- 13.2 kg) volunteered to participate. Having completed a familiarisation test, all subjects returned to the laboratory to complete two ramp tests on an electrically-braked ergometer in a counter-balanced order. Both ramp tests started at 60 W with work rate subsequently incremented by either 6 or 12 W . min (-1). Pulmonary gas exchange was measured breath-by-breath throughout the tests. Subjects achieved a greater final work rate during the 12 W . min (-1) test compared to the 6 W . min (-1) test (168 +/- 28 vs. 149 +/- 26 W; p < 0.001). The VO (2peak) (3.06 +/- 0.65 vs. 2.96 +/- 0.48 L . min (-1); p = 0.27), HR (peak) (179 +/- 15 vs. 177 +/- 16 b . min (-1); p = 0.17) and V.E (peak) (112 +/- 22 vs. 105 +/- 16 L . min (-1); p = 0.09) were not different between the tests, but VCO (2peak) (3.54 +/- 0.64 vs. 3.27 +/- 0.46 L . min (-1); p = 0.01) RER (peak) (1.17 +/- 0.07 vs. 1.11 +/- 0.06; p < 0.001), and end-exercise blood (lactate) (11.9 +/- 2.1 vs. 10.8 +/- 2.6 mmol . L (-1); p = 0.005) were all higher in the 12 W . min (-1) test. An 'excess' VO (2) was observed in 13 out of 16 tests at 12 W . min (-1) and in 15 out of 16 tests at 6 W . min (-1). Neither the magnitude of the 'excess' VO (2) (0.42 +/- 0.41 vs. 0.37 +/- 0.18 L . min (-1); p = 0.66) nor the VO (2) at which the V.O (2)-work rate relationship departed from linearity (2.17 +/- 0.34 vs. 2.18 +/- 0.32 L . min (-1); p = 0.94) were significantly different between the two ramp tests. These data indicate that differences in ramp rate within the range of 6 - 12 W . min (-1) influence the peak values of work rate, VCO (2) and RER, but do not influence peak values of VO (2) or HR during ACE. The development of an 'excess' VO (2) appears to be a common feature of ramp exercise in ACE, although the mechanistic basis for this effect is presently unclear. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Sjögren's syndrome (SS) is an autoimmune condition affecting salivary glands, for which a clearly defined pathogenic autoantibody has yet to be identified. Autoantibodies that bind to the muscarinic M3 receptors (M3R), which regulate fluid secretion in salivary glands, have been proposed in this context. However, there are no previous data that directly show antisecretory activity. This study was undertaken to investigate and characterize the antisecretory activity of anti-M3R. METHODS: Microfluorimetric Ca2+ imaging and patch clamp electrophysiologic techniques were used to measure the secretagogue-evoked increase in [Ca2+]i and consequent activation of Ca2+-dependent ion channels in individual mouse and human submandibular acinar cells. Together, these techniques form a sensitive bioassay that was used to determine whether IgG isolated from patients with primary SS and from control subjects has antisecretory activity. RESULTS: IgG (2 mg/ml) from patients with primary SS reduced the carbachol-evoked increase in [Ca2+]i in both mouse and human acinar cells by approximately 50%. IgG from control subjects had no effect on the Ca2+ signal. Furthermore, the inhibitory action of primary SS patient IgG on the Ca2+ signal was acutely reversible. We repeated our observations using rabbit serum containing antibodies raised against the second extracellular loop of M3R and found an identical pattern of acutely reversible inhibition. Anti-M3R-positive serum had no effect on Ca2+-dependent ion channel activation evoked by the direct intracellular infusion of inositol 1,4,5-triphosphate. CONCLUSION: These observations show for the first time that IgG from patients with primary SS contains autoantibodies capable of damaging saliva production and contributing to xerostomia. The unusual but not unprecedented acute reversibility of the effects of anti-M3 autoantibodies is the subject of further research. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To determine the prevalence of satisfaction with community participation and to examine associations between change in functional status and satisfaction with community participation for persons with orthopedic impairments. DESIGN: Retrospective study of 3832 patients discharged from medical rehabilitation facilities in 2001 using information from the IT Health Track database. RESULTS: Primary measures were the FIM instrument and satisfaction with community participation. The majority of patients (86.9%) were satisfied (very or somewhat) with their level of community participation. Positive-change scores in FIM total from admission to the 80- to 180-day follow-up were associated with an 8% increased odds of being in a higher satisfaction with community participation level (odds ratio, 1.08; 95% confidence interval: 1.07, 1.09) after controlling for age, gender, marital status, race/ethnicity, insurance source, length of stay and functional status. Similarly, positive-change score in motor (odds ratio, 1.09; 95% confidence interval: 1.08, 1.10) and cognition (odds ratio, 1.26; 95% confidence interval: 1.19, 1.32) FIM measures from admission to follow-up were associated with greater satisfaction with community participation. CONCLUSION: Gains in functional status were significantly associated with greater satisfaction with community participation. Satisfaction with community participation provides information useful to evaluate patient recovery after discharge from inpatient medical rehabilitation. [ABSTRACT FROM AUTHOR]

The aim of this study was to determine the effects of Rotor, a new cycle crank configuration that effectively allows the pedals to move independently throughout the duty cycle, on indices of endurance cycling performance in trained cyclists. Ten cyclists (5 Rotor users and 5 non-users; age (mean +/- SD): 22 +/- 5 y; VO(2)max: 69.5 +/- 5.1 mL x kg(-1) x min(-1)) volunteered to participate in the study. On four separate days, the subjects performed four cycle-ergometer tests, i.e. two incremental tests and two 20-min tests. An imposed crank rate of 75 rev x min(-1) was used during all tests. The incremental protocol started at 112.5 W, and the power output was increased by 37.5 W every 3 min until volitional exhaustion. The 20-min tests were performed at a fixed power output equivalent to 80% of the highest power output that the cyclists maintained for a complete 3-min period during incremental tests. Both types of tests were performed with the conventional crank system and the Rotor following a counter-balanced, cross-over design. Gas exchange parameters were measured in all the tests and blood lactate was determined at the end of each 3-min period (incremental tests) and at the end of the 20-min tests. A three factor (pedalling system used during the tests x habitual pedalling system x power output [incremental tests] or time [20-min tests]) ANOVA with repeated measures on power output (incremental tests) or time (20-min tests) was used to analyse several indices of performance, e.g. peak power output, VO(2)max, lactate threshold, onset of blood lactate accumulation, economy, delta, and gross efficiency. No differences (p > 0.05) were found between the Rotor and conventional systems for any of the aforementioned variables. It seems that the theoretical advantage brought about by the Rotor system, i.e. improved contra-lateral cooperation of both legs, would be minimized in trained cyclists. Although field studies are needed to assess the possible implications, in terms of actual racing, of the new system, commonly used indicators of endurance cycling performance do not seem to be improved with the Rotor in trained cyclists. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To examine the options for use, efficiency, and effectiveness for structuring a population-based telephone smoking-cessation service. METHODS: Callers (n=632) to a 1-800 number were randomized in a 2 (50-minute counseling with 2/6 calls) x 2 (pamphlet/booklet) design with print only control. RESULTS: Six-month use of the service was 0.6% of adult smokers. Service promotion cost 31.02 dollars/person. Telephone counseling resulted in higher continued abstinence (5%) than did print only (1%), P<.05. Amount of print and calls did not increase cessation. Six calls resulted in lower completion rates than 2 (22% vs 56%, P<.05). CONCLUSIONS: For planning, consider 1% use, low-cost promotion, pamphlet, 50-minute initial counseling plus 2 follow-ups, and minimize call-attempts. [ABSTRACT FROM AUTHOR]

Objective: Examine disparity in health services and outcomes for adults with a hip fracture or lower extremity joint replacement.Materials and Methods: This study examined 28,522 patient records including 12,328 (mean age 76.6 years) with hip fracture and 16,194 (mean age 71.8 years) with joint replacement.Results: Non-Hispanic white and black patients were significantly (P < 0.05) more likely to be discharged home alone and responsible for their own care than were Asian or Hispanic patients. Sixty-four percent of Hispanic patients received inpatient rehabilitation after hip fracture and 36% after hip or knee arthroplasty. In contrast, 58% of non-Hispanic white persons, 67% of black persons, and 56% of Asian persons received inpatient medical rehabilitation after hip or knee joint replacement.Conclusion: Disparity in outcomes appeared to be related to family structure and social support. [ABSTRACT FROM AUTHOR]

OBJECTIVES: Length of stay (LOS) and hospital readmission for persons receiving medical rehabilitation were examined. METHODS: A total of 96,473 patient records (1994-1998) were analyzed. Mean age of patients was 68.97 years; 61% were female and 83% were non-Hispanic White. RESULTS: A decrease in LOS of 6.07 days (SD = 3.23) and increase in hospital readmission were found across all impairment groups (P < .001). Readmission increases ranged from 6.7% for amputations to 1.4% for orthopedic conditions. LOS was longer (2.1 days) for readmitted patients (P < .01). Age was not a significant predictor of rehospitalization. CONCLUSIONS: Understanding variables associated with rehospitalization is important as prospective payment systems are introduced for postacute care. [ABSTRACT FROM AUTHOR]

Nurse executives have joined hospital administrative teams, but are they accepted as fully integrated team executives? Learn how nurse executives and their influential colleagues view integration and its influences. [ABSTRACT FROM AUTHOR]

As the new millennium approaches, speculation is growing about the direction to be taken by the fields of environmental health and food protection. Hazard analysis critical control point (HACCP) training has been introduced to the food industry to assist food service representatives in identifying and monitoring the critical control points for safe food handling. This study investigates the effects of HACCP training on the food industry. A survey of food service workers was conducted to assess the degree to which food safety training has affected the promotion of a safer food service environment. The purpose was to identify areas of the training programs that could be improved and to promote a more meaningful educational experience both for regulatory officials and for the food industry. [ABSTRACT FROM AUTHOR]

Discusses the significance of the agreement on trade-related aspects of Intellectual Property Rights prepared for the World Trade Organization's (WTO) Symposium on Competition Policy and the Multilateral Trading System on international competition. Obligations of WTO on procedural fairness mechanisms; Role of public authorities in competition law enforcement; Different categories of anti-competitive behavior.