Union, employer and compensation system gaps and failures: Workers with injuries perceptions.

BACKGROUND: Workers who suffered a workplace injury and submitted a claim with the compensation board in Ontario often faced economic and non-economic costs that provoked depressive feelings, family strain, financial strain, and feelings of diminished self-worth. OBJECTIVE: This qualitative descriptive study aimed to understand the perceived gaps and failures associated with the support systems (e.g., union, compensation and employer) that were in place to assist some male underground workers in Sudbury, Ontario, Canada, who had suffered a workplace injury and had a compensation claim. METHODS: Twelve in-depth, in-person, individual, semi-structured interviews were conducted and data were transcribed verbatim and anonymized at the time of transcription. Data analysis followed Braun and Clarke's guidelines for thematic analysis. RESULTS: Themes that emerged include: unfair and inadequate recognition of an injury; limited communication with stakeholders involved with their claim, including claim adjudicators, challenges when returning to work, and compensation claim system barriers. CONCLUSIONS: Cooperation, collaboration, knowledge transfer, and decreased power imbalances could help to reduce the economic and non-economic strain felt by a worker with an injury. Additionally, a government-funded third-party advocate who knows the medical system, union contracts, the workers' compensation system, and employer policies and practices could act on behalf of an injured worker.

Who cares? The impact on caregivers of suspected mining-related lung cancer.

Background: In the present study, we investigated the emotional, physical, financial, occupational, practical, and quality-of-life impacts on caregivers of patients with mining-related lung cancer. Methods: This concurrent, embedded, mixed-methods study used individual in-depth qualitative interviews and the 36-item Short Form Health Survey (version 2: RAND Corporation, Santa Monica, CA, U.S.A.) quality-of-life measure with 8 caregivers of patients with suspected mining-related lung cancer who had worked in Sudbury or Elliot Lake (or both), and sometimes elsewhere. Individuals who assist workers in filing compensation claims were also interviewed in Sudbury and Elliot Lake. Interviews (n = 11) were transcribed and analyzed thematically. Results: Caregiver themes focused on the long time to, and the shock of, diagnosis and dealing with lung cancer; not much of a life for caregivers; strong views about potential cancer causes; concerns about financial impacts; compensation experiences and long time to compensation; and suggestions for additional support. Quality-of-life scores were below the norm for most measures. Individuals who assist workers in preparing claims were passionate about challenges in the compensation journey; the requirement for more and better family support; the need to focus on compensation compared with cost control; the need for better exposure monitoring, controls, resources, and research; and job challenges, barriers, and satisfaction. Conclusions: Caregivers expressed a need for more education about the compensation process and for greater support. Worker representatives required persistence, additional workplace monitoring and controls, additional research, and a focus on compensation compared with cost control. They also emphasized the need for more family support.

Ondansetron, a 5-HT3 antagonist, improves cerebellar tremor.

It has been previously shown that ondansetron, a 5-HT3 antagonist, can ameliorate vertigo in patients with acute brainstem disorders. A coincidental benefit was the improvement of cerebellar tremor in some patients with both vertigo and tremor. To further evaluate this effect, a placebo controlled, double blind, crossover study was conducted of a single dose of intravenous ondansetron in 20 patients with cerebellar tremor caused by multiple sclerosis, cerebellar degeneration, or drug toxicity. The principal outcome measures were the change in blind assessment of a writing task (spiral copying) and the timed completion of a nine hole peg test. Thirteen of 19 patients were deemed to have improved spiral copying after treatment with ondansetron when compared with baseline performance. One patient had a better response to the placebo compared with baseline performance (P = 0.00024). Patients completed the nine hole peg test in less time after ondansetron than after placebo (P = 0.08). Twelve patients thought that their tremor was functionally improved with the ondansetron treatment. None thought that the placebo gave improvement (P = 0.00098). The efficacy of orally administered ondansetron in tremor control is currently under study.