ABSTRACT
BACKGROUND: Social media platforms are increasingly used by the general public as a source of information on health-related and legal concerns, among other topics. Reddit.com, one of the top 10 most visited websites in the United States, is a popular social media platform that allows users to anonymously discuss various topics, including workers' compensation (WC). Understanding the candid concerns of workers who are navigating WC systems will allow for the development of more effective educational resources that are tailored to the needs of this population. Methods: In January-March 2023, a cross-sectional review of anonymous public posts submitted to the r/WorkersComp section of the Reddit social media website between December 2021 and December 2022 was performed. Post content was extracted from a systematic random sample and coded into themes/sub-themes and emotional tones by two independent reviewers. A third reviewer resolved any discrepancies in coding in order to reach consensus prior to data analysis. The data were analyzed using Microsoft Excel 2019 (Microsoft Corporation, Redmond, WA, USA). RESULTS: Content from 200 original posts submitted to r/WorkersComp was reviewed and analyzed. Nearly 94.0% of posts (n =187) specified a state of residence, with posters most frequently residing within the United States in California (32.0%), New York (7.0%), Pennsylvania (5.0%), and Florida (5.0%). The most common primary theme was "medical" (27.0%, n = 54), with questions and comments related to provider complaints, medical care access, referral denials, maximum medical improvement, and independent medical examinations being the most frequent within this category. The second most common primary theme was "legal" (26.5%, n = 53), with questions and comments related to lawyer retainment and settlements being the most frequent within this category. The third most common primary theme was "general" (18.5%, n = 37), with questions and comments related to the general claims process, eligibility for WC, claim denial, and communication issues with claims adjusters being the most frequent within this category. The fourth most common primary theme was "employer" (14.0%, n = 28), with questions and comments related to employer retaliation, job security, and work restrictions being most frequent within this category. Only 37.0% of posts (n = 74) expressed a clear emotional tone, with frustration (13.5%, n = 10), fear (13.5%, n = 10), and confusion (13.5%, n = 10) being the most frequent tones observed in this sample of posts. CONCLUSIONS: Our findings indicate that there are workers who are navigating WC systems who use social media platforms such as Reddit to obtain information and advice on various aspects of WC, including medical issues, legal advice, and employer concerns. These findings may be used to address the information and education needs of workers who are navigating WC systems, which may help attenuate some of the frustrations surrounding the WC claims process.
ABSTRACT
BACKGROUND: We previously reported that female offspring of dams subjected to chronic prenatal stress (CPS) develop enhanced visceral hypersensitivity (VHS) following exposure to chronic stress in adult life that is mediated by up-regulation of spinal cord BDNF. The aims of this study were to examine the roles of estrogen receptor alpha (ERα) and an increase in spinal serotonin signaling in promoting this enhanced VHS in female rats and up-regulation of spinal cord BDNF transcription. METHODS: Pregnant dams were exposed to chronic stress from E11 until delivery. At 8 weeks, a chronic adult stress (CAS) protocol was applied for nine days. KEY RESULTS: Ovariectomy before CAS or treatment with letrozole before and during CAS significantly prevented the development of enhanced VHS in female CPS+CAS rats. Intrathecal application of ERα siRNA significantly reduced VHS, decreased lumbar-sacral spinal cord expression of both ERα and BDNF, and reversed pro-transcriptional epigenetic modifications at BDNF promoter lX. Cerebrospinal fluid serotonin levels and 5HT3A receptor expression in the LS spinal cord were both significantly increased in female CPS+CAS rats. During CAS, intrathecal infusion of alosetron significantly decreased VHS, reduced BDNF and ERα expression in the LS spinal cord, and attenuated RNA pol II and ERα binding to the BNDF core promoter IX. CONCLUSIONS & INFERENCES: Serotonin-mediated activation of 5HT3A receptors in the spinal cord drives the development of enhanced female-specific VHS in our two hit CPS+CAS through up-regulation of spinal cord ERα.
