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In this paper, we investigate the relationship between local wages and the internal structure of the regional knowledge base. The purpose is to assess if the workers' compensations are related to the peculiarities of the knowledge base of the regions in which they supply their labor services. The test of this hypothesis is based on the assessment of the impact of related vis-à-vis unrelated knowledge variety on cross-regional wage differentials. The empirical analysis is carried out by exploiting patent data and a unique employer–employee administrative dataset. First, using OECD-PATREG data on patent filing, we build information entropy indexes proxying the variety of NUTS 3 regions' knowledge bases, and the decomposition in the related and unrelated component. Second, we assess the impact of these indexes on wages based on administrative data from the Italian National Institute of Social Security. Our results suggest that workers employed in regions with a heterogenous knowledge structure earn positive wage premia, while related variety has a negative effect on compensation levels. [ABSTRACT FROM AUTHOR]

Negotiations between workers and firm management are a defining feature of labor markets around the world. By many measures, labor relations have deteriorated substantially in recent years, often leading to [...]

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

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

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

Purpose: A comprehensive review of the literature on the time between the onset of symptoms and the first episode of care and its effects on important worker outcomes in compensated musculoskeletal conditions is currently lacking. This scoping review aimed to summarize the factors associated with time to service and describe outcomes in workers with workers' compensation accepted claims for musculoskeletal conditions. Methods: We used the JBI guidelines for scoping reviews and reported following the PRISMA-ScR protocol. We included peer-reviewed articles published in English that measured the timing of health service initiation. We conducted searches in six databases, including Medline (Ovid), Embase (Ovid), PsycINFO, Cinahl Plus (EBSCOhost), Scopus, and the Web of Science. Peer-reviewed articles published up to November 01, 2022 were included. The evidence was summarized using a narrative synthesis. Results: Out of the 3502 studies identified, 31 were included. Eight studies reported the factors associated with time to service. Male workers, availability of return to work programmes, physically demanding occupations, and greater injury severity were associated with a shorter time to service, whereas female workers, a high number of employees in the workplace, and having legal representation were associated with a longer time to service. The relationship between time service and worker outcomes was observed in 25 studies, with early access to physical therapy and biopsychosocial interventions indicating favourable outcomes. Conversely, early opioids, and MRI in the absence of severe underlying conditions were associated with a longer duration of disability, higher claim costs, and increased healthcare utilization. Conclusion: Existing evidence suggests that the time to service for individuals with compensated musculoskeletal conditions was found to be associated with several characteristics. The relationship between time to service and worker outcomes was consistently indicated in the majority of the studies. This review highlights the need to consider patient-centred treatments and develop strategies to decrease early services with negative effects and increase access to early services with better outcomes. [ABSTRACT FROM AUTHOR]

Purpose: The primary objective of this study was to explore individuals' perspectives on the factors, situations or events that contributed to their perceptions of injustice following occupational injury. Materials and Methods: The study sample consisted of 30 participants (18 women, 12 men) who had submitted a time-loss claim for a work-related musculoskeletal injury. Participants with elevated scores on a measure of perceived injustice were interviewed about the factors that contributed to their sense of injustice. A thematic analysis was conducted to identify the broad classes of situations or events that participants experienced as unjust in the weeks following occupational injury. Results: Three dominant themes emerged from the interviews: (1) Invalidation, (2) Undeserved suffering and (3) Blame. Inductively derived subthemes reflected specific dimensions of post-injury experiences that contributed to participants' sense of injustice. Conclusions: Given that suffering and invalidating communication are potentially modifiable factors, there are grounds for optimism that intervention approaches can be developed to prevent or reduce perceptions of injustice in the aftermath of debilitating injury. The development of intervention approaches that are effective in preventing or reducing perceptions of injustice holds promise of contributing to more positive recovery outcomes in individuals who have sustained debilitating work injuries. [ABSTRACT FROM AUTHOR]

Background: Understanding the self-rated health of industrially disabled individuals is an important variable that significantly affects their quality of life, satisfaction, and return to work after an industrial accident. Since the health of people with industrial disabilities is affected by various environments and variables, interventions and policies that are suitable for their characteristics are needed. Objectives: This study aimed to identify changes in self-rated health among industrially disabled individuals, distinguish between different latent classes, and verify predictive factors for each latent class. Methods: Four time-point datasets from the 2018–2021 panel study of Korean workers' compensation insurance were used. Using the latent growth curve model, an overall trajectory of self-rated health of industrially disabled individuals was confirmed, and the number and characteristics of different trajectories were identified using the latent class growth model. Multinomial logistic regression analysis was used to identify the predictive factors for each class. Results: Four classes of self-rated health trajectories were identified: low-decreasing (21.7%), moderate-increasing (15.7%), high-decreasing (56.1%), and low-stable (6.5%) classes. A multinomial logistic regression analysis revealed that significant determinants (age, capacity, type of industrial accident, grade of disability, mental activity, outdoor activity, and social relationships) were different for each latent class. Capacity level affected all potential class classifications. Conclusions: To improve the self-rated health of industrially disabled individuals, it is necessary to develop an appropriate strategy that considers the characteristics of the latent class. [ABSTRACT FROM AUTHOR]

When accidents occur, employees rely on the workers' compensation system to provide continuing wages and medical benefits. This study addresses a fundamental workers' compensation gap—the lack of an Employee Workers' Compensation Experience (EWCE) scale. While current metrics monitor direct costs, they often overlook the psycho-social impacts on employees. The study introduces a structured EWCE scale that encompasses dimensions of claim communication, psychological and emotional impacts, and uncertainty regarding the claim outcome. The EWCE scales relevance is emphasized by its ability to predict turnover intentions, burnout, and obligations to come to work sick outcomes. Discriminate, convergent, and predictive validity tests corroborate the scales' effectiveness. These findings allow employers, policymakers, and researchers to create a safer, more inclusive work environment by measuring and monitoring workers' compensation claim outcomes. This scale bridges the critical knowledge gap and offers an analytical tool to enhance workers' compensation policies and outcomes. [ABSTRACT FROM AUTHOR]

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In sheltered employment centres, staff planning and scheduling activities are critical for operations managers. A generic framework is not easy to set up not only because legal issues are diverse and differ among these service organization types, but one worker may not fit in anywhere at any time. This complexity is greater when workers with specific needs perform work activities in many labour enclaves and different sectors. In this paper, a mixed-integer linear model to solve workers' shift assignments to other workplaces and various activities to form teams is proposed. The novelty of the proposed model lies in considering specific features, such as the skills matrix and the affinity matrix, between the different actors in a labour enclave. The model is validated using real instances from a case study, and several objectives are tested and discussed. The decision support system that sustains the model is introduced and managerial issues are discussed. [ABSTRACT FROM AUTHOR]

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

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

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

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

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

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

Despite an equal willingness to participate in clinical trials, there is evidence that several minority populations are systematically under-represented in studies. One potential cause and frequently used exclusionary criterion in orthopedic trials is patients with active workman's compensation (WC) insurance claims. The purpose of this study is to determine demographic differences in patients undergoing arthroscopic rotator cuff repair with commercial and government insurance vs workers compensation claims. This was a retrospective review of patients who underwent primary arthroscopic rotator cuff repair at a single institution in the northeastern United States from 2018 to 2019. Patients undergoing revision cases were excluded. Chart review was used to extract demographic data such as age, gender, insurance, and reported race. A total of 4553 patient records were reviewed and included. There were 742 WC patients and 3811 non-WC patients. Two hundred and forty-four patients did not report their race. Overall, WC patients differed from non-WC with respect to race (P < 0.001). One hundred and eleven (15.0%) of WC and 293 (7.7%) non-WC patients reported being 'Black' or 'African American' (P = 0.002). This compares to 368 (49.6%) WC and 2788 (73.2%) non-WC patients who reported 'White' (P < 0.001). About 16.8% of WC patients were identified as 'Hispanic or Latino,' compared to 5.2% of non-WC (P < 0.001). African American and Hispanic/Latino patients are over-represented in workman's compensation patient populations relative to non-workman's compensation. Conversely, white patients are over-represented in non-WC patient populations, which serve as the basis for the majority of clinical study populations. Excluding workman's compensation patients from clinical trials may lead to an underrepresentation of African American and Hispanic/Latino patient populations in orthopedic clinical trials. In doing so, the generalizability of the results of rotator cuff repair clinical outcomes research to all races and ethnicities may be compromised. [ABSTRACT FROM AUTHOR]

Background: Rising obesity rates in the workforce are accompanied by a hidden cost burden to employers due to work productivity loss. Understanding the impact of obesity on work productivity is essential for employers to provide tailored weight loss interventions in the workplace. Objectives: To measure work loss and associated productivity costs among employees with overweight/obesity compared with employees with normal weight. Methods: This retrospective cohort study used the MerativeTM MarketScan® Health and Productivity Management Database to identify adult employees with ≥1 diagnosis code reporting a body mass index (BMI) between 1/1/2015‐12/31/2019. Based on the earliest BMI, employees were assigned to normal weight (BMI 19–24.9), overweight (BMI 25–29.9), obesity class 1 (BMI 30–34.9), obesity class 2 (BMI 35–39.9), and obesity class 3 (BMI ≥40) cohorts. Among employees with data for each work loss category (absenteeism, short‐term disability [STD], long‐term disability [LTD], worker's compensation [WC]) during the 12‐month follow‐up, the percentage of employees with work loss, number of hours/days lost, and associated productivity costs were reported. Results: 719,482 employees (normal weight: 106,631, overweight: 230,637, obesity class 1: 185,850, obesity class 2: 101,909, obesity class 3: 94,455) were included. Outcomes increased with each higher BMI category for the mean number of absence hours ([in order of BMI category]: 262, 273, 285, 290, 304) and percentage of employees with a claim (STD: 6.8%, 7.6%, 9.7%, 11.7%, 17.0%; LTD: 0.4%, 0.4%, 0.5%, 0.6%, 0.8%; WC: 2.7%, 2.8%, 3.4%, 3.6%, 3.5%). Estimated costs to the employer associated with absenteeism, STD, LTD, and WC were $1,036, $611, $38, and $95 higher per year (respectively) in the obesity class 3 cohort relative to the normal weight cohort. Conclusions: This real‐world analysis demonstrated that employees with overweight/obesity had higher loss of work productivity compared with employees with normal weight. Further studies are warranted to determine the long‐term impacts on work productivity loss if overweight and obesity are left untreated. [ABSTRACT FROM AUTHOR]

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

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

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

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

Purpose: Given the serious question raised by the subprime of the 2008 global financial crisis over the rising practices of excessive rewarding of executives in the USA and European firms, the executive pay-performance nexus has emerged as a popular topic of debate in the contemporary corporate finance research. Conducted mostly on the Anglo-Saxon contexts, research outcomes have been inconclusive and dichotomous. Considering this backdrop, this study aims to investigate the endogenous relationship between executive compensation and risk taking in the context of the USA. Design/methodology/approach: Using a large sample of non-financial firms from 2010 to 2020 based on panel data and two-stage least square regression. In this study, the riskier corporate decision is measured as book leverage and ratio of R&D expense to total assets. Chief executive officers' (CEO) experience and age are used as instrumental variables, and these are expected to influence compensation incentives and, hence, affect firm riskiness indirectly. Firm size, return on assets and CEO turnover are reported to affect compensation and corporate decisions, therefore, included as control variables. Given that higher executive compensation is related to riskier corporate decision in firms, this study incorporates total wealth (i.e. accumulated equity related compensation) as an additional proxy of compensation, and this selection is justifiable by the perfect contracting notion of the agency theory. Findings: The results of this study show a significant positive and increasing nexus among compensation and riskier corporate decisions. Besides, the compensation level proxied through the percentage of each form of compensation in total compensation is very important as greater equity and greater salary diminishes risk taking. Practical implications: The outcomes of this study have useful implications for firm stakeholders and policymakers. Originality/value: The level of pay measured by the percentage of each type of compensation in total compensation is of utmost importance as it can increase or decrease risk taking in corporate decisions. [ABSTRACT FROM AUTHOR]

Objectives: Traumatic injury surveillance can be enhanced by describing injury severity trends. This study reports trends in work‐related injury severity for males and females over the period 2004–2017 in Ontario, Canada. Methods: A weighted measure of workers' compensation benefit expenditures was used to define injury severity, obtained from the linkage of workers' compensation claims to emergency department (ED) records where the main injury or illness was attributed to work. Denominator counts were obtained from Statistics Canada's Labor Force Survey. Trends in the annual incidence of injury, classified as low, moderate, or high severity, were examined using regression modeling, stratified by age and sex. Results: Over a 14‐year observation period, there were 1,636,866 ED records included in the analyses. Overall, 57.6% of occupational injury records were classified as low severity, 29.5% as moderate severity, and 12.8% as high severity conditions. There was an increase in the incidence of high severity injuries among females (annual percent change (APC): 1.52%; 95% CI: 0.77, 2.28), while the incidence of low and moderate severity injuries generally declined for males and females. Among females, injuries attributed to animate mechanical forces and assault increased as causes of low, moderate, and high severity injuries. The incidence of concussion increased for both males (APC: 10.51%; 95% CI: 8.18, 12.88) and females (APC: 16.37%; 95% CI: 13.37, 19.45). Conclusion: The incidence of severe work‐related injuries increased among females in Ontario between 2004 and 2017. The methods applied in this surveillance study of traumatic injury severity are plausibly generalizable to applications in other jurisdictions. [ABSTRACT FROM AUTHOR]

Background: There is little information about predictors of physical therapy (PT) use among injured workers with back pain. The primary objective of this study is to investigate the associations between PT use and baseline factors not routinely captured in workers' compensation (WC) data. Methods: We conducted a secondary analysis using the Washington State Workers' Compensation Disability Risk Identification Study Cohort, which combines self‐reported surveys with claims data from the Washington State Department of Labor and Industries State Fund. Workers with an accepted or provisional WC claim for back injury between June 2002 and April 2004 were eligible. Baseline factors for PT use were selected from six domains (socio‐demographic, pain and function, psychosocial, clinical, health behaviors, and employment‐related). The outcome was a binary measure for PT use within 1 year of injury. Bivariate and multivariable logistic regression models were conducted to evaluate the associations between PT use and baseline factors. Results: Among the 1370 eligible study participants, we identified 673 (49%) who received at least one PT service. Baseline factors from five of the six domains (all but health behaviors) were associated with PT use, including gender, income, pain and function measures, injury severity rating, catastrophizing, recovery expectations, fear avoidance, mental health score, body mass index, first provider seen for injury, previous injury, and several work‐related factors. Conclusion: We identify baseline factors that are associated with PT use, which may be useful in addressing disparities in access to care for injured workers with back pain in a WC system. [ABSTRACT FROM AUTHOR]

Research Findings: Despite the importance of early care and education (ECE) for children's early learning and parents' labor force participation, workers average low pay with few benefits. The precarity of work and low compensation contribute to staff turnover and other problems, with potential implications for staff well-being, children's development, and parents' employment. The COVID-19 pandemic exacerbated problems relating to the supply of and staff recruitment and retention in ECE. This paper provides a brief background and then reviews the empirical research linking early ECE worker compensation with program quality, children's outcomes, and staff turnover. We identified a range of studies that examined pay or workplace benefits in ECE, the majority of which used nonexperimental methods. In general, most studies found small associations among low compensation, poor worker mental health or well-being, or turnover or intentions to leave their jobs or the early childhood field. Fewer studies examined associations between compensation and measures of quality or children's outcomes, finding small or nonsignificant associations. One study using experimental methods found evidence that financial bonuses reduced staff turnover. Practice or Policy: Together, evidence suggests that low worker compensation is linked with poorer worker outcomes and staff turnover in ECE. [ABSTRACT FROM AUTHOR]

Assembly lines are production lines used to manufacture products, ranging from mass-production products to mass-customisation with low unit products. Assembly lines consume the largest parts of investment funds and involve the largest proportion of companies' labour force. However, workers in assembly lines are exposed to work-related musculoskeletal disorders (MSDs) and ergonomics problems. Poor distribution of workloads reduces the performance of assembly lines and causes workers MSDs and injuries, largely affecting the economics of production systems and resulting in high workers' compensation and absenteeism costs. Furthermore, ergonomics problems and MSDs impact product quality and decrease productivity. We propose a methodology for taking physical ergonomics into account as early as in the design phase of assembly lines. This methodology is based on Integer Linear Programming for the assembly line balancing problem with consideration of ergonomics with a quantitative fatigue and recovery criterion. As solving approach, we develop a dedicated exact algorithm, denoted Iterative Dichotomic Search, to solve low and medium-size instances of the problem. We validate our approach by proposing numerical experiments and analysis on instances from the literature. [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 environmental factors.

Objectives: To determine the national burden of working time lost to occupational injury and disease in Australia compensable by workers' compensation schemes; to characterise the distribution of time lost by age, sex, and injury and disease type. Study design: Retrospective population‐based study; analysis of National Dataset for Compensation‐based Statistics (NDS) data. Setting, participants: Granted workers' compensation claims by people aged 15–100 years including payment of wage replacement benefits for time off work lodged in Australia, 1 July 2012 – 30 June 2017. Main outcome measures: Working years lost (WYL) per annum (total number of years of wage replacement benefits paid to injured and ill workers), overall and by sex, age, and injury and disease type; WYL per 10 000 fulltime equivalent (FTE) years worked. Results: A total of 755 330 eligible claims with complete data for analysis variables by people aged 15–100 years were identified, for compensable injuries and disease that led to 41 194 (95% confidence interval [CI], 41 020–41 368) WYL/year. The annual WYL number and rate were each higher for men (25 367 [95% CI, 25 230–25 503] WYL/year; 42.6 [95% CI, 42.1–43.1] WYL/10 000 FTE years) than for women (15 827 [95% CI, 15 720–15 935] WYL/year; 38.8 [95% CI, 38.2–39.4] WYL/10 000 FTE years). Workers aged 45–100 years made 66 742 claims per year (44.1% of all claims) but incurred 21 763 WYL/year (52.8% of all WYL). Traumatic joint and muscle injuries led to 16 494 WYL/year (40.0% of all WYL), musculoskeletal disorders to 8547 WYL/year (20.7%), mental health conditions to 5361 WYL/year (13.0%), fractures to 4276 WYL/year (10.4%), and wounds and lacerations to 3449 WYL/year (8.4%). Conclusions: Occupational injury and disease covered by workers' compensation result in lost working time in Australia equivalent to more than 41 000 fulltime jobs. Distribution of the burden reflects the greater labour force participation of men, slower recovery of older workers, and the impact of common occupational injuries and diseases. Population‐based monitoring of lost working time could support effective occupational health surveillance and allocation of resources for protecting the health of Australian workers. [ABSTRACT FROM AUTHOR]

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

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

Purpose: Medicines are often prescribed to workers with musculoskeletal disorders (MSDs) and injuries to relieve pain and facilitate their recovery and return to work. However, there is a growing concern that prescription medicines may have adverse effects on work function. This scoping review aimed to summarize the existing empirical evidence on prescription medicine use by workers with MSD or injury and its relationship with work-related outcomes. Methods: We identified studies through structured searching of MEDLINE, EMBASE, PsycINFO, CINAHL Plus, Scopus, Web of Science and Cochrane library databases, and via searching of dissertations, theses, and grey literature databases. Studies that examined the association between prescription medicine and work-related outcomes in working age people with injury or MSDs, and were published in English after the year 2000 were eligible. Results: From the 4884 records identified, 65 studies were included for review. Back disorders and opioids were the most commonly studied musculoskeletal conditions and prescription medicines, respectively. Most studies showed a negative relationship between prescription medicines and work outcomes. Opioids, psychotropics and their combination were the most common medicines associated with adverse work outcomes. Opioid prescriptions with early initiation, long-term use, strong and/or high dose and extended pre- and post-operative use in workers' compensation setting were consistently associated with adverse work function. We found emerging but inconsistent evidence that skeletal muscle relaxants and non-steroidal anti-inflammatory drugs were associated with unfavorable work outcomes. Conclusion: Opioids and other prescription medicines might be associated with adverse work outcomes. However, the evidence is conflicting and there were relatively fewer studies on non-opioid medicines. Further studies with more robust design are required to enable more definitive exploration of causal relationships and settle inconsistent evidence. [ABSTRACT FROM AUTHOR]

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

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

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

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

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