bluuebunny/crossref_metadata_2025 huggingface dataset:
Late Holocene human remains from northwest Queensland, Australia: archaeology and palaeopathology
Authors: Domett K.M. , Wallis L.A. , Kynuna D. , Kynuna A. , Smith H.
Published: November 2014

A human burial of late Holocene age was recently excavated from inland northwest Queensland and studied prior to reburial by the Indigenous community. Bones from the lower thoracic region to the feet were recovered. The person had been interred in a crouched position, resting on their lower legs (shins) and wrapped in paperbark. Similar burial techniques have been described in the region's ethnographic literature, and this site represents the first known archaeological example.

Ascertaining a firm date for the burial is problematic owing to the nature of the radiocarbon calibration curve in recent centuries. A detailed analysis of the bones indicated the individual to be an adult female, most likely of middle age. There are some significant pathological lesions present that are indicative of treponematosis. The geographic and cultural context of the burial leads us to suggest the most likely diagnosis is treponarid.
Mask Cave: Red‐slipped pottery and the Australian‐Papuan settlement of Zenadh Kes (Torres Strait)
Authors: McNiven Ian J. , Dickinson William R. , David Bruno , Weisler Marshall , von Gnielinski Friedrich , Carter Melissa , Zoppi Ugo
Published: November 2014

Excavations at Mask Cave on the sacred islet of Pulu off Mabuyag in the central west of Zenadh Kes (Torres Strait) reveal four occupational phases: Phase 1 (2900–3800 years ago), Phase 2 (2100–2600 years ago), Phase 3 (1500–1700 years ago) and Phase 4 (last 1500 years). Faunal remains indicate marine specialization (turtle and fish) during all phases. Petrographic analysis of sherds of finely made red‐slipped pottery dating back 2400–2600 years reveals a unique fabric in terms of current understandings of Oceanic ceramic technologies. Mineral inclusions are consistent with local geology suggesting local manufacture and the existence of Indigenous Australia's first pottery tradition. Pre‐ceramic Phase 1 is associated with demographic expansions across the western islands of Zenadh Kes by local populations of marine‐based hunter‐gatherers who were primarily Aboriginal language speakers. Phase 2 is associated with the immigration of Papuan maritime, horticultural and pottery‐making peoples to the eastern and western islands of Zenadh Kes commencing 2600 years ago. Australian then Papuan settlement expansions across the western islands of Zenadh Kes explain why the local Western‐Central Language has an Aboriginal base with a Papuan overlay. First colonization of the eastern islands by Papuans explains why the local Meriam Mìr language is Papuan. Early red‐slipped pottery in Zenadh Kes is linked to southern coastal Papuan pottery traditions that are reassessed to have a comparable 2600 year antiquity. Papuan settlement of the southern Papuan coast and Zenadh Kes was an extension of the post‐Lapita settlement of the Pacific, an event memorialized in part by Torres Strait Islander oral tradition.
Review
Authors: Allen Harry
Published: November 2014

Many Exchanges: archaeology, history, community and the work of Isabel McBryde Edited by Ingereth Macfarlane with Mary‐Jane Mountain and Robert Paton. Aboriginal History Monograph 11, Canberra, 2005. ISBN 09585637 7 2. Pp. xxxv+402. $A33.
Review
Authors: Kirch Patrick V.
Published: November 2014

Archaeology of Oceania: Australia and the Pacific Islands Edited by Ian Lilley. Blackwell Publishing, Oxford 2006. Pp. xx + 396. ISBN 0‐6312‐3082‐3 (GBP60 Hbk); 0‐6312‐3083‐1 (GBP22.99 Pbk)
Treatment of complex gaseous emissions emitted by a rendering facility using a semi‐industrial biofilter
Authors: Malhautier Luc , Cariou Stéphane , Legrand Paul , Touraud Evelyne , Geiger Philippe , Fanlo Jean‐Louis
Published: November 2014

BACKGROUND

To improve process design, and scale‐up of gas biofilters, a thorough understanding of compounds degradation mechanisms within model engineering biofilters is needed. The aim of this study is then to investigate the spatial distribution of pollutants removal within an experimental semi‐industrial biofilter fed with industrial emissions from a rendering plant.

RESULTS

A stratification pattern of pollutants removal has been highlighted: nitrogenous compounds, esters, volatile fatty acids (VFA), alcohols, ketones and aldehydes are completely or mostly removed especially in the biofilter layers near the gas inlet. In return, the removal of sulphur compounds seems to begin when nitrogenous and oxygenated compounds are almost fully degraded. A sequential degradation of sulphur compounds is also observed: hydrogen sulphide is eliminated in the biofilter section near the gas inlet while methylmercaptan (removal efficiency 87%) and dimethyl disulphide (DMDS) (removal efficiency 73%) are mainly eliminated in the second half of the column.

CONCLUSION

An on‐site semi‐industrial biofilter used for waste gas abatement in an animal‐rendering plant exhibited spatial distribution of the compounds removal efficiency. The removal of organic sulphur compounds is not complete. Hence, this work emphasizes the importance of improving gas biofilters to achieve complete elimination of pollutants causing unpleasant odours. © 2014 Society of Chemical Industry
A fully validated method for the determination of lacosamide in human plasma using gas chromatography with mass spectrometry: Application for therapeutic drug monitoring
Authors: Nikolaou Panagiota , Papoutsis Ioannis , Spiliopoulou Chara , Voudris Constantinos , Athanaselis Sotiris
Published: November 2014

A simple gas chromatographic method with mass spectrometry detection was developed and validated for the determination of lacosamide in human plasma. Lacosamide and the internal standard, levetiracetam‐d6, were extracted from 200 μL plasma, by a solid‐phase extraction through HF Bond Elut C18 columns, and derivatized using N‐methyl‐N‐tert‐butyldimethylsilyltrifluoroacetamide with 1% tert‐butyldimethylsilylchloride in acetonitrile. The limit of quantification was found to be 0.20 μg/mL and the assay was linear up to 20.0 μg/mL with correlation coefficient ≥0.994. The intra‐ and interday precision values were <4.1% in terms of relative standard deviation (%) and the values of intra‐ and interday accuracy were found to be within –7.2 and 5.3% in terms of relative error (%). Absolute recovery of the method for lacosamide was determined at three concentration levels and ranged from 92.5 to 97.6%. The developed method uses small volumes of plasma and proved to be simple, rapid, and sensitive for the determination of lacosamide in plasma. This method can be used in routine every day analysis of plasma samples obtained from patients who follow respective antiepileptic treatment and for the investigation of clinical and forensic cases where lacosamide is involved.
Phosphonate‐Containing Polymeric Networks: Swelling in Water Controlled by Metal Ions
Authors: Kemnitz Melanie , Tabatabai Monir , Utterodt Andreas , Ritter Helmut
Published: November 2014

A crosslinking agent of thioether containing a phosphonic acid, (3‐((11‐((1,3‐bis(meth­acryloyl­oxy)propan‐2‐yl)oxy)‐11‐oxoundecyl)thio)‐propyl)phosphonic acid (6), is synthesized. The crosslinking agent is characterized by electrospray ionization (ESI), NMR, and Fourier transform infrared (FTIR) spectroscopy. After the copolymerization with N,N'‐dimethyl­acrylamide, the influence of the metal ions Ca2+, Fe3+, and La3+ on the swelling behavior of these disc‐shaped samples is examined. The rheological behavior of unswollen and swollen crosslinked copolymers is also investigated with respect to the added metal ions.

image
Vertical gradients in regional alveolar oxygen tension in supine human lung imaged by hyperpolarized 3He MRI
Authors: Hamedani Hooman , Shaghaghi Hoora , Kadlecek Stephen J. , Xin Yi , Han Biao , Siddiqui Sarmad , Rajaei Jennia , Ishii Masaru , Rossman Milton , Rizi Rahim R.
Published: November 2014

The purpose of this study was to evaluate whether regional alveolar oxygen tension (PAO2) vertical gradients imaged with hyperpolarized 3He can identify smoking‐induced pulmonary alterations. These gradients are compared with common clinical measurements including pulmonary function tests (PFTs), the six minute walk test, and the St. George's Respiratory Questionnaire.

8 healthy non‐smokers, 12 asymptomatic smokers, and 7 symptomatic subjects with chronic obstructive pulmonary disease (COPD) underwent two sets of back‐to‐back PAO2 imaging acquisitions in the supine position in two opposite directions (top to bottom and bottom to top), followed by clinically standard pulmonary tests. The whole‐lung mean, standard deviation (DPAO2) and vertical gradients of PAO2 along the slices were extracted, and the results were compared with clinically derived metrics. Statistical tests were performed to analyze the differences between cohorts.

The anterior–posterior vertical gradients and DPAO2 effectively differentiated all three cohorts (p <0.05). The average vertical gradient PAO2 in healthy subjects was −1.03 ± 0.51 Torr/cm toward lower values in the posterior/dependent regions. The directional gradient was absent in smokers (0.36 ± 1.22 Torr/cm) and was in the opposite direction in COPD subjects (2.18 ± 1.54 Torr/cm). The vertical gradients correlated with smoking history (p =0.004); body mass index (p =0.037), PFT metrics (forced expiratory volume in 1 s, p =0.025; residual volume/total lung capacity percent predicted, p =0.033) and with distance walked in 6 min (p =0.009).

Regional PAO2 data indicate that cigarette smoke induces physiological alterations that are not being detected by the most widely used physiological tests. Copyright © 2014 John Wiley & Sons, Ltd.
Electronic, magnetic, and spin‐polarized transport properties of hybrid graphene/boron‐nitride nanoribbons having 5‐8‐5 line defects at the heterojunction
Authors: Lan Tran Nguyen , Ho Le Bin , Hai Tran Hoang
Published: November 2014

Using the spin‐polarized density functional theory, we have investigated electronic, magnetic, and spin‐polarized transport properties of hybrid boron‐nitrde/graphene (BNC) nanoribbons having the BB and NN line defect at the heterojunction. Our results show that the defective systems behave as robust spin‐selective half‐semiconductor in the whole range of the graphene nanoribbon width considered in this work. Application of an electric field gives rise to antiferromagnetic half‐metallic behavior in both systems. The range of electric field maintaining the half‐metallicity is much larger for the BB line defect system than for the NN line defect system. Beyond a threshold of field intensity, the NN line defect system becomes nonmagnetic semiconductor, while the BB line defect system behaves as ferromagnetic metal with spin density located at the heterojunction. Finally, the spin‐polarized transport calculation reveals that both systems can be efficient spin filters.
Improved analysis‐error covariance matrix for high‐dimensional variational inversions: application to source estimation using a 3D atmospheric transport model
Authors: Bousserez N. , Henze D. K. , Perkins A. , Bowman K. W. , Lee M. , Liu J. , Deng F. , Jones D. B. A.
Published: November 2014

Variational methods are widely used to solve geophysical inverse problems. Although gradient‐based minimization algorithms are available for high‐dimensional problems (dimension >106), they do not provide an estimate of the errors in the optimal solution. In this study, we assess the performance of several numerical methods to approximate the analysis‐error covariance matrix, assuming reasonably linear models. The evaluation is performed for a CO2 flux estimation problem using synthetic remote‐sensing observations of CO2 columns. A low‐dimensional experiment is considered in order to compare the analysis error approximations to a full‐rank finite‐difference inverse Hessian estimate, followed by a realistic high‐dimensional application. Two stochastic approaches, a Monte‐Carlo simulation and a method based on random gradients of the cost function, produced analysis error variances with a relative error <10%. The long‐distance error correlations due to sampling noise are significantly less pronounced for the gradient‐based randomization, which is also particularly attractive when implemented in parallel. Deterministic evaluations of the inverse Hessian using the Broyden–Fletcher–Goldfarb–Shanno (BFGS) algorithm are also tested. While existing BFGS preconditioning techniques yield poor approximations of the error variances (relative error >120%), a new preconditioner that efficiently accumulates information on the diagonal of the inverse Hessian dramatically improves the results (relative error <50%). Furthermore, performing several cycles of the BFGS algorithm using the same gradient and vector pairs enhances its performance (relative error <30%) and is necessary to obtain convergence. Leveraging those findings, we proposed a BFGS hybrid approach which combines the new preconditioner with several BFGS cycles using information from a few (3–5) Monte‐Carlo simulations. Its performance is comparable to the stochastic approximations for the low‐dimensional case, while good scalability is obtained for the high‐dimensional experiment. Potential applications of these new BFGS methods range from characterizing the information content of high‐dimensional inverse problems to improving the convergence rate of current minimization algorithms.
Probing DNA Helicase Kinetics with Temperature‐Controlled Magnetic Tweezers
Authors: Gollnick Benjamin , Carrasco Carolina , Zuttion Francesca , Gilhooly Neville S. , Dillingham Mark S. , Moreno‐Herrero Fernando
Published: November 2014

Motor protein functions like adenosine triphosphate (ATP) hydrolysis or translocation along molecular substrates take place at nanometric scales and consequently depend on the amount of available thermal energy. The associated rates can hence be investigated by actively varying the temperature conditions. In this article, a thermally controlled magnetic tweezers (MT) system for single‐molecule experiments at up to 40 °C is presented. Its compact thermostat module yields a precision of 0.1 °C and can in principle be tailored to any other surface‐coupled microscopy technique, such as tethered particle motion (TPM), nanopore‐based sensing of biomolecules, or super‐resolution fluorescence imaging. The instrument is used to examine the temperature dependence of translocation along double‐stranded (ds)DNA by individual copies of the protein complex AddAB, a helicase‐nuclease motor involved in dsDNA break repair. Despite moderately lower mean velocities measured at sub‐saturating ATP concentrations, almost identical estimates of the enzymatic reaction barrier (around 21–24 kBT) are obtained by comparing results from MT and stopped‐flow bulk assays. Single‐molecule rates approach ensemble values at optimized chemical energy conditions near the motor, which can withstand opposing loads of up to 14 piconewtons (pN). Having proven its reliability, the temperature‐controlled MT described herein will eventually represent a routinely applied method within the toolbox for nano‐biotechnology.
Hearing loss in adult patients with Fabry disease treated with enzyme replacement therapy
Authors: Suntjens Eefje B. , Smid Bouwien E. , Biegstraaten Marieke , Dreschler Wouter A. , Hollak Carla E. M. , Linthorst Gabor E.
Published: November 2014

Introduction

Data on prevalence, natural history, and effect of enzyme replacement therapy (ERT) on hearing loss (HL) in Fabry disease (FD) are scarce.

Methods

This is a retrospective study with cross‐sectional and longitudinal analyses. Low and high‐frequency HL in the Dutch FD cohort was studied in four groups: classical and non‐classical FD patients with or without ERT. To study effects of ERT, longitudinal data, corrected for age and gender according to ISO‐1999 guidelines, were analyzed with mixed models.

Results

In the cross‐sectional analysis, 107 FD patients (41 males), median age 47.6 years (18.8–80.6) were analyzed. At baseline, i.e., before start of ERT, HL was present in 18 patients (16.8 %), of whom four had bilateral sensorineural HL. HL was more often present in patients with the classical phenotype than non‐classical patients (p < 0.01). Likewise, males had more often HL than females. Compared to the general population, FD patients show a median HL of 8.2 dB at low frequencies (p < 0.01) and 29.5 dB at ultra‐high frequencies (p < 0.01). Longitudinal analyses (n = 91) revealed that ERT treated patients show a similar rate of decline, not significantly different from healthy controls.

Conclusion

Adult FD patients, especially classical affected males, show impaired hearing. Longitudinal analyses during ERT in these patients demonstrates a decline of HL similar to healthy controls, but HL present before initiation of therapy cannot be reversed. Whether early therapy can prevent hearing loss is unknown.
Health‐Related Quality of Life in Patients with MPS II
Authors: Needham Mary , Packman Wendy , Quinn Natasha , Rappoport Maxwell , Aoki Christa , Bostrom Alan , Cordova Matthew , Macias Sandra , Morgan Cynthia , Packman Seymour
Published: November 2014

Mucopolysaccharidosis type II (MPS II), also known as Hunter syndrome, is a chronic and progressive X‐linked lysosomal disease that mainly affects males. The National MPS Society (2013) reports that MPS II affects 1 in 100,000 to 1 in 150,000 males worldwide. Two distinct forms of the disease are based on age of onset and clinical course: attenuated and severe. MPS II affects many organ systems including the nervous, cardiovascular, gastrointestinal and respiratory systems. Clinical manifestations can include progressive hearing loss, mental impairment, and enlarged liver and spleen. This study focuses on the health‐related quality of life of individuals (HRQOL) with MPS II as measured by the parent and self‐report versions of the Pediatric Quality of Life Inventory (PedsQL™). Both parents of patients with MPS II as well as patients themselves reported lower scores on all domains of the PedsQL™ (physical, emotional, social and school functioning) indicating that children with MPS II have an overall lower HRQOL when compared to a healthy sample. When compared with patients with other chronic illnesses (cancer, MSUD, galactosemia,), the MPS II sample had significantly lower scores on a number of PedsQL™ scales, suggesting an overall lower HRQOL. No significant relationships were found using scores from parent or self report PedsQL™ measures and length of time on ERT.
Antifungal activity of a termite queen pheromone against egg‐mimicking termite ball fungi
Authors: Matsuura Kenji , Matsunaga Takeshi
Published: November 2014

The sophisticated colony organization of eusocial insects is attributed to their elaborate chemical communication systems. Pheromones mediate most behaviors involved in colony organization including foraging, defense, brood care, and caste regulation. The number of candidate compounds available to regulate multiple systems may be biosynthetically finite and the production of several compounds instead of a single one may be more costly. Therefore, strong selection pressures encourage the use of single natural products for many purposes. Such versatility of signal substances is especially characteristic of queen pheromones in eusocial Hymenoptera. However, little is known about the multifunctionality of the recently identified termite queen pheromone. Here, we demonstrate that volatile compounds in the queen pheromone of a termite,Reticulitermes speratus(Kolbe), have fungistatic properties. Application of the pheromone compoundsn‐butyl‐n‐butyrate and 2‐methyl‐1‐butanol significantly reduced the germination rates of the egg‐mimicking parasitic termite ball fungus. These pheromone compounds also suppressed mycelial growth of the termite ball fungus and some entomopathogenic fungi. However, the inhibitory activity of each substance differed among fungal strains. Termites likely employ these antimicrobial volatiles to protect eggs and queens, and secondarily as communication agents informing queen fertility. This study supports the notion of evolutionary parsimony, wherein pheromones are originally used as defensive compounds and their communicative function develops secondarily, which is well‐documented in social Hymenoptera.
Gartland type III supracondylar humerus fractures: Outcome and complications as related to operative timing and pin configuration
Authors: Abbott Matthew D. , Buchler Lucas , Loder Randall T. , Caltoum Christine B.
Published: November 2014

Purpose

Supracondylar fractures of the humerus are the most common fracture of the elbow in children. The purpose of this study was to evaluate, in terms of outcomes and complications, Gartland type III pediatric supracondylar humerus fractures treated at a pediatric level-one trauma center over a 7-year period, specifically addressing the impact of time to surgery on the incidence of complications and conversion to open reduction.

Methods

We retrospectively reviewed 297 pediatric patients that sustained a closed Gartland type III supracondylar humerus fracture treated between December 2004 and December 2011. The time to the operating room was calculated from the medical records for each patient. The outcome measures evaluated were operative time, conversion to open procedure, and perioperative and postoperative complications.

Results

In our study, there were 30 complications in 25 children (8.4%). Conversion to open reduction occurred in 28 children (9.4%). The time from the emergency department to the operating room was not significantly correlated with increased complications, increased operative time, or conversion to open reduction ( p > 0.05). Crossed pinning resulted in an increased risk of overall complications [odds ratio (OR) = 2.6] and iatrogenic nerve injuries (OR = 9.3). Complications also occurred more commonly in boys (OR = 3.3) and in older patients ( p = 0.0069)

Conclusions

We found no significant correlation between the time to surgery and complications, operative time, or need for open reduction. These findings support the trend of treating Gartland type III supracondylar humerus fractures in a less urgent manner. In addition, our study supports the concept that cross pinning leads to more complications than lateral pinning, including an 8-fold increase in iatrogenic nerve injury.
Simultaneous Bilateral Video-Assisted Thoracoscopic Surgery for the Treatment of Primary Spontaneous Pneumothorax
Authors: Wang Xin , Wang Lei , Wang Huayong , Zhang Hao
Published: November 2014

We determined the feasibility and clinical efficacy of simultaneous bilateral video-assisted thoracoscopic surgery (VATS) for treating primary spontaneous pneumothorax (PSP). We performed a retrospective analysis of the efficacy of simultaneous bilateral resection of pulmonary bullae using VATS in 21 PSP patients that were treated at our hospital from February 2010 to August 2013. We found bilateral bullae in all patients through the intraoperative exploration. Surgical procedures were successfully completed in all patients without conversion to thoracotomy. The mean time of surgery was 128.76 ± 13.82 min (range 100–150 min). Total amount of intraoperative bleeding was 80–200 ml. Total drainage of bilateral thoracic ducts was 200–500 ml at the 1st postoperative day with a mean drainage of 321.42 ± 82.66 ml. Bilateral thoracic ducts were removed 4–8 days postoperatively with a mean time of 4.7 days. The duration of postoperative hospitalization was 5–9 days with a mean duration of 7 days. No patient had serious complication(s) and all patients were discharged after full recovery. The patients were followed up for 6–18 months after the surgery and no relapse occurred. In conclusion, treating the unilateral PSP by simultaneous bilateral VATS is safe and effective. It reduces patients’ risk of second surgery and also minimizes patients’ suffering and costs incurred.
“You teach us to listen,… but you don’t teach us about suffering”: self-care and resilience strategies in medical school curricula
Authors: Outram Sue , Kelly Brian
Published: November 2014

This article examines the pre-vocational preparation of doctors to cope with the demands of clinical practice, drawing on literature from across a number of domains: mental health, psychological stress among medical students and medical practitioners; and self-care strategies in medicine curricula. High rates of psychological distress in medical students and medical practitioners were consistently reported. A number of questions remain pertinent to medical education: how does the experience of medical education impact on this level of distress, and possibly exacerbate pre-existing student vulnerabilities? What will help future doctors respond to, and cope with, suffering in their patients? Can the formal curriculum build resilience? Medical schools and educators have a responsibility to address these questions and to provide effective self-care curricula. In this review promising interventions such as mindfulness training are reported, frameworks to guide self-awareness in medical students are suggested, and recommendations for a self-care curriculum are made.
Retrospective on the Construction and Practice of a State-Level Emergency Medical Rescue Team
Authors: Lei Zhang , Haitao Guo , Xin Wang , Yundou Wang
Published: November 2014

For the past few years, disasters like earthquakes, landslides, mudslides, tsunamis, and traffic accidents have occurred with an ever-growing frequency, coverage, and intensity greatly beyond the expectation of the public. In order to respond effectively to disasters and to reduce casualties and property damage, countries around the world have invested more efforts in the theoretical study of emergency medicine and the construction of emergency medical rescue forces. Consequently, emergency medical rescue teams of all scales and types have come into being and have played significant roles in disaster response work. As the only state-level emergency medical rescue force from the Chinese People’s Armed Police Forces, the force described here has developed, through continuous learning and practice, a characteristic mode in terms of grouping methods, equipment system construction, and training.(Diaster Med Public Health Preparedness. 2014;8:422-425)
Navigating work disability paradigms and reform in Canada
Authors: Tompa Emile
Published: November 2014

Objective: We investigate labour-market earnings of workers’ compensation claimants from three distinctly different workers’ compensation insurance support programs for claimants with permanent impairments. These three programs, which existed in Ontario, Canada in different periods over the last 25 years, are the Permanent Disability (PD) program, the Future Economic Loss (FEL) program, and the Loss of Earnings (LOE) program. The nature of benefit determination and the return to work supports provided by three programs are very different. The focus of the study is on evidence of programmatic impact on labour-market earnings recovery trajectories over nine years post injury.

Methods: The study included claimants sampled from each of the three programs who sustained a permanent impairment from a work injury. Claimants were identified in a Revenue Canada tax file database known as the Longitudinal Administrative Databank (LAD), which is a longitudinal 20% simple random sample of all Canadian tax filers. Each claimant was matched with similar uninjured controls that were also in the LAD, based on sex, age, labour-market earnings amounts and trajectories in the four years prior to injury, and a propensity score. Statistical modeling analysis was undertaken to compare the labour-market earnings trajectories of claimants relative to their matched controls using data on earnings over the nine years post injury. Analyses focused on sub-strata defined by program, sex, age, permanent impairment level, and pre-injury earnings. A key issue of interest was to determine which program of supports resulted in the best labour-market earnings recovery.

Results: Five distinct earnings recovery trajectories were identified. Claimants in various demographic and pre-injury earnings sub-strata from the LOE program cohort had a statistically significant lower probability of the lowest earnings recovery trajectory, and higher probability of the second highest trajectory compared to the PD cohort. Results for the LOE program were similar to the FEL program.

Conclusions: Injured workers from the LOE program appear to fare better than claimants from the PD program and similarly to those from the FEL program in terms of labour-market earnings recovery over the nine years post injury. Across all programs, older claimants fare more poorly, and women fare worse than men in terms of labour-market earnings recovery.
Evidence-based treatment guidelines: at work in a microcosm
Authors: Whelan Patricia
Published: November 2014

Background: Medical treatment under workers’ compensation represents just a miniscule portion (about 1 percent) of total medical costs in the U.S. Furthermore, legislation and rules are determined autonomously by each state.

Objective: To study Workers’ Comp systems in each state and determine what, if any, impact states adopting the use of evidence-based treatment guidelines has had to outcomes within the respective states. Hypothesis: Worker’ comp medical care, and the outcomes of that care in each state, can theoretically represent a microcosm of what could be achieved in an entire country.

Methods: A trend began in 2003, starting with California, for states to consider adopting Evidence-Based Treatment Guidelines EBTGs) as a mechanism to insure timely and quality care for injured workers by following the least invasive, most-effective treatments today's science has to offer. Bi-products to the effective implementation of EBTGs, include earlier return to work, better outcomes resulting in reduced indemnity costs, less friction in the system (providers know what treatments are authorized and will be paid for), fewer episodes of over-utilization of services, and decreased medical costs, benefiting employers, insurers, providers and business. Findings: Outcomes where true EBTG have been implemented: Ohio adopted EBTGs in 2003. A Pilot conducted in 2005 showed a decrease in medical costs by 64%, lost days by 69% and treatment delays by 77%. Texas adopted EBTG in 2006; Total costs have declined by 50%, patients are recovering more quickly, more providers are willing to treat these patients, opioid abuses have declined and many states are looking to adopt this model.

Discussion: Other state outcomes and essential elements needed in an EBTG will be discussed, time permitting.

Conclusion: Outcomes realized through the adoption/implementation of evidence-based treatment guidelines by selected states, need not be isolated to the US or to the “microcosm” of workplace injuries and illnesses. Countries adopting evidence-based treatments guidelines within their healthcare systems can benefit from the same results: more timely and quality care, better outcomes, reduced costs, less disputes, reduced utilization of unnecessary procedures and services.
Examining the adequacy / efficiency of the legal regime regarding the right of employment for people with disabilities in Malaysia
Authors: Wahab Harlida Abdul
Published: November 2014

Objective: The study aims to explore factors of workplace injury and chronic illnesses patients in a return to work program which are associated with return to work outcomes.

Design: A retrospective cohort study. Setting: Return to Work Department, Social Security Organisation, Malaysia. Method: All participants of the Return to Work Rehabilitation Program who were absent from work due to workplace injury and chronic illnesses between January 2008 and December 2013 with no other history of injury were included. The main outcome of the study was the number in days from day one of injury prior to return of gainful employment. Hierarchical multiple regression methods were used to determine the identified factors that influence the return to work outcome.

Results: An initial study with data from January 2008 and December 2011 of cases with occupational injury showed 66% (n = 1,552) of the participants had returned to work. The average number of days to return to work was 201 days. Hierarchical multiple regression analysis identified duration of referral to the Return to Work rehabilitation program, monthly salary, Whole Person Impairment ratings, DASS 21 anxiety and DASS 21 stress scale as factors that influenced return to work, explaining 32% of the variance. However a continuous for the remaining cases such as cases with chronic illnesses will be included in the final results of this study.

Conclusion: Currently, a total of 66% participants had returned to employment after occupational injury. It is essential to understand the complex pathway from the point of injury and illnesses until returning to work in order to develop more effective return to work practices.
Nigeria is a highly multicultural and multilingual society and is divided along class lines and in between these lines are less privileged disabled people who often suffer the most
Authors: Edwards Uzoma , Ike Osita , Aiminhiefe Mark Hobere
Published: November 2014

Nigeria is made up of not less than 250 divergent ethnic nationalities and since independence in 1960 has had no success in reducing social inequality, social injustice and achieving even development, especially as it affects the disabled in our society. Furthermore, the neglect of the disabled is deliberately nurtured and sustained by the activities of the government, the ruling class and certain dominant social groups.

This presentation will contend that if the existing widening gap between the rich and poor remains unchecked, the long term implication will be widespread instability that will lead to further disadvantage of the less privileged (including the disabled) in Nigeria. Although the future does not look bright, there are certain measures that can be put in place that can form the bedrock for instituting a society where every individual is recognised, nurtured, their full potential is developed and are given equal opportunity.
Neighbours’ attitudes toward people with disabilities in Melbourne
Authors: Team Tecle
Published: November 2014

Deinstitutionalisation of Kew Residential Services (KRS) residents proceeded group by group and took place from October 2002 to April 2008. Residents relocated into either newly built or pre-purchased houses located across Melbourne. In Australia and other developed countries, limited studies suggest that people with intellectual and physical disabilities relocated into group homes have poor social integration into a community.

This presentation is based upon findings from a quantitative research project aimed to investigate neighbours’ attitudes towards people with intellectual and physical disabilities living in the Inner Southern Region of Melbourne, who relocated to group homes after closure of KRS. The administered check list questionnaire contained three main parts, including (1) participants’ socio-demographic details, (2) information and strategies neighbours being introduced with the group home people, and (3) the Interaction with Disabled Persons (IDP) Scale. A total number of 290 participants whose properties located in the Inner Southern Region of Melbourne were randomly identified for participation in this study. The collected responses were analysed, applying descriptive statistics, bivariate analyses, trivariate analysis, and multivariate analyses.

The results of bivariate analyses revealed a statistically significant association between frequency of face-to-face contacts with the group home residents and neighbours’ attitudes towards them, indicating that neighbours who had contacts with the group home residents on a daily/weekly basis had more positive attitudes towards them than the neighbours who had contacts on a less frequent basis. Other variables that were identified as important in bivariate analysis were age, marital status and employment status, and were used in multivariate analysis.
A physiotherapy network provided with training, monitoring and support achieves improved return to work and health outcomes
Authors: Coburn Paul
Published: November 2014

Background: In 2007, the Health and Disability Strategy Group (HDSG) of the TAC and Victorian WorkCover Authority recognised an opportunity to improve scheme outcomes by working more closely with health disciplines. To investigate whether this was feasible, a pilot program was proposed with a select group of physiotherapists. Objectives: To determine whether a network of physiotherapists who were provided with training, monitoring and support could achieve improved outcome in return to work and health outcomes.

Method: In 2008, 92 physiotherapists undertook a select tender process and then completed training in return to work, the HDSG's Clinical Framework and familiarisation of the compensation system for work related and motor accident injuries. The outcomes of this network physiotherapist program were evaluated internally and by three independent research organisations to determine 1) impact on return to work, 2) impact on health outcomes, 3) patient satisfaction and 4) satisfaction of the physiotherapist providing the service. Results: When compared to non-network physiotherapist, the network physiotherapists demonstrated improved return to work for clients, better health outcomes, and greater patient satisfaction. Therapist satisfaction was also higher within the network physiotherapists.

Discussion: This body of work conducted on a pilot group of physiotherapists demonstrates improved outcomes in a number of important domains for the management of worker's and motor accident injuries. It indicates that there is a benefit for schemes in supporting clinical programs. Current evidence suggests that compensable patients have worse health outcomes than their non-compensable counterparts. There is a need to promote programs that are beneficial to patients, compensable schemes and providers. Further investigation is required to demonstrate this benefit on a larger scale.

Conclusions: This study indicates that there may be opportunities to improve health outcomes by investment from compensable bodies in training, support and monitoring of specific health disciplines.
Creating a compelling business case for employers; psychosocial benefit for mature workers
Authors: Gatt Kristine
Published: November 2014

Twenty years ago, those of us in the allied health field were trained to believe that mature people didn't lodge workers’ compensation claims and mature workers didn't have injuries because they ‘knew their work environment so well’. Only 7 years ago, insurers believed that their book of claims in Workers’ Compensation had no age related correlation to claims costs. We now know that all of these assumptions do not stand up in relation to the current workforce in Australia and we are building a wealth of knowledge about the mature cohort in today's workforce.

This presentation will guide the audience through the process of developing a compelling business case to assist employers understand the cost benefit of proactively engaging with their mature employees and the benefits for both the workers over fifty five years of age and businesses in Australia.

In developing a business case, the first stage of a strategy is being formulated for the care and well-being of mature workers, this leads to preparedness for effective return to work measures in the event of injury and health maintenance strategies for mature workers. The side benefits to a business are vast; from reduced turnover and associated costs, the retention of knowledge to reduced insurance costs and productivity benefits.

Five years of analytical data will be presented to demonstrate the trending, the influences and precautionary tales for those committed to the psychological well-being of the mature workforce in Australia.
Barriers for the injured indigenous person to return to work
Authors: Flavell Howard
Published: November 2014

Aboriginal and Torres Strait Islander people carry a high disease burden with a consequent reduced life expectancy. There are reduced opportunities for conventional employment with further difficulties if the person has a disability. Nevertheless meaningful participation in community activities can occur. This paper will explore these issues giving examples of how this can be facilitated.
Realising the health benefits of safe work - a continuing professional education for primary care practitioners
Authors: Sleigh Kevin
Published: November 2014

Background: General Practitioners complete around 91% of compensable certificates, and play a significant role in promoting the awareness of the health benefits of work. The Australasian Consensus Statement on the Health Benefits of Work developed by the Australasian Faculty of Occupational and Environmental Medicine (AFOEM) has been endorsed by 100 organisations including the Royal Australian College of General Practitioners (RACGP). The Victorian WorkCover Authority and TAC has undertaken a program of work focussing on the delivery of a general practice education and awareness raising program.

Objectives: The objectives of the program were to; engage Medicare Locals to undertake a general practice education and awareness raising program, develop training materials for Medicare Local staff to undertake practice liaison visits, recruit and train General Practice peer educators to deliver in-practice education and develop and deliver content for continuing professional development events in selected Medicare Locals.

Methods: A suite of educational resources were developed and tailored to suit delivery in a General Practice setting. The Medicare Locals were targeted if they had high certification rates, the educational events were delivered in-practice settings and Principal findings The practice target was reached in all Medicare Locals, a total of 457 general practices across the five Medicare Locals were visited. The program was successful in raising awareness of the health benefits of work amongst GPs and practice staff.

Discussion: The education has given general practitioners the impetus to talk to patients early about the health benefits of work and has the potential for GPs to be more confident in their clinical management of compensable patients.

Conclusion: That the educational program continue with the Victorian WorkCover Authority and TAC working with key peak bodies and medical colleges to ensure education about the Health Benefits of Safe Work become a mandatory component of all GP postgraduate training.
Developing a concise set of principles for use by clinicians and regulators to determine the need for treatment within a compensable setting
Authors: Coburn Paul
Published: November 2014

Background: Delivering quality health services in a cost effective manner is becoming an increasingly critical issue for insurance companies and government agencies. The Clinical Framework used as part of peer review has been proposed as an alternative for institutions to control costs and maintain optimal clinical care.

Objectives: To develop a concise set of principles for use by clinicians and regulators to determine the need for treatment within in a compensable setting.

Method: The Clinical Framework was first implemented in 2003 at the Victorian WorkCover Authority as part of peer review of physiotherapy management of injured workers. It consists of five principles that clinicians and institutions use to determine the ongoing need for intervention. The Framework allows clinicians to exercise judgment in selecting treatment with due consideration to the evidence and patient's individual needs. Results: Following its introduction in 2003, it broadened to apply to chiropractic, osteopathy, psychology, and occupational therapy. In 2012 it was endorsed across Australia for motor accident and worker's compensation bodies by the representative bodies of the above disciplines. In 2013 Federal Minister Shorten released a review of the SRC Act which recommended amendments including “medical treatment must meet objective standards such as those in the Clinical Framework.”

Discussion: This paper will discuss some of the issues that have been addressed in implementing the Clinical Framework on over 20,000 files over the past ten years.

Conclusions: The Clinical Framework is a document that has won broad acceptance across the Australian compensable system in allied health as part of sustaining quality care while reducing unnecessary costs.
Quality evaluation of workers’ compensation hospital in Korea
Authors: Won Jong-Uk
Published: November 2014

Background: The length of hospital stay among occupationally injured workers was too long comparing to national health insurance patients in Korea. Also return-to-work rate was low comparing to other countries. The Korea Workers’ Compensation & Welfare (COMWEL) has tried to upgrade the quality of care workers’ compensation contract hospitals since several years. One of the tries was to evaluate the workers’ compensation contract hospitals. However, many hospitals argued the appropriateness of the hospital evaluation.

Objectives: This study was performed to evaluate the appropriateness of the workers’ compensation contract hospital evaluation.

Methods: The total number of 500 hospitals was selected to evaluate among about 5,500 contracts hospitals according to their size or the number of occupationally injured patients. The main evaluation items were hospital facilities and equipment, health personnel, including doctors, record keeping, appropriateness of hospital care, outcomes, including return-to-work, length of hospital stay, satisfaction, etc. Multiple logistic regression was performed to evaluate the appropriateness of the results of this hospital evaluation. The dependent variables were return-to-work rate and length of hospital stay and independent variables were severity of injured workers, disability rate, company size, etc.

Results: The hospitals were classified three categories according to the evaluation score; high, middle, and low quality. The return-to-work rate of high-quality hospitals was significantly higher (odds ratio 1.81; CI 1.27 – 2.58) than others. However, the length of hospital stay was not different among them.

Conclusion: Return-to-work rate is one of the useful indicators for evaluating the occupational health care. Even though these are preliminary results, this evaluation method for the occupational health care hospitals would be appropriate for the purpose. The more specific analysis should be needed.
Taking a practical look at the Americans with Disabilities Act (ADA) in the United States
Authors: Bibens Carrie
Published: November 2014

This presentation will provide a practical look at the Americans with Disabilities Act (ADA) in the United States. This disability non-discrimination act has undergone recent amendments changing the landscape for employers and changing their responsibilities to stay compliant. We will review how the changes in the ADA differ today for employers in the United States and we will also provide a comparison with other discriminatory acts in the world. The changes to be discussed include issues of “qualification” and “reasonableness” of accommodation and what these changes mean to real employer examples. The example will demonstrate one disability insurance carrier's approach to addressing this change by providing in support of their policyholders’ responsibilities to stay compliant.