Perspectives on remote learning of orthotic fabrication by certified hand therapists.

BACKGROUND: The COVID-19 pandemic caused disruption to continuing educational opportunities for hand therapists. In response, some courses were offered via online platforms, including virtual orthotic fabrication courses. It is important to determine the effectiveness and benefits of these courses for educating certified hand therapists and examine if remote learning of orthotic fabrication skills has continued merit and relevance. PURPOSE: To investigate the value and effectiveness of orthotic fabrication courses taught in a virtual format. STUDY DESIGN: Cross-sectional, mixed methods survey study. METHODS: A 31-item survey consisting of Likert-type, direct response, and open-ended questions about experiences and opinions of virtual orthotics courses was electronically delivered to certified hand therapists. Data analysis included descriptive and correlational statistics to highlight frequencies, ranges, and relationships between the participant demographics and opinions/experiences. Thematic analysis guided the coding of the qualitative data. RESULTS: A total of 459 responded, with a response rate of 9.7%. Most respondents had not participated in online courses on orthotic fabrication. Those that did reported high satisfaction but noted that clinical experience and knowledge from previous courses influenced this experience. Most participants felt that novice clinicians and students would not gain enough skills and confidence from online courses. However, participants with all levels of experience found the courses to be of value. CONCLUSIONS: Results suggest that while online learning of this skill set is valuable and effective, it is most beneficial for experienced clinicians. Disadvantages included the lack of instructor feedback necessary for hands-on skill development and the lack of peer interaction. Advantages included convenience of time, cost, accessibility, and the ability to revisit the topic as needed. Online learning of orthotic fabrication skills is a sustainable option for clinicians seeking to advance their skills. Nevertheless, it is not a substitute for initial training for novice hand therapists due to the lack of feedback and skill development.

A framework for using data and collaboration to drive prevention through engineering design: Reducing injury and severity in greenhouse and nursery workers.

INTRODUCTION: A framework of collaboration between safety professionals and design engineers was proposed that provided direction for utilizing analysis of quantitative and qualitative data to prevent worker injury. This interdisciplinary, context-steeped approach can be utilized across a variety of industries to promote risk reduction by designing equipment and processes to prevent common workplace injuries in the first place. Safety professional expertise in regional worker's compensation claims analysis (including statistical analysis on a quantitative basis and qualitative analysis of trends in written injury descriptions of circumstance) provided the starting point for identifying industries of interest for this approach. METHOD: Followed by education of design engineers on safety approaches (including hazard identification, the ANSI/ASSP Z590.3 consensus-based standard), tools such as risk assessment matrices and methods for effective on-site work observation and interviews with workers affords transfer of knowledge. Design engineers then utilize safety influenced design problem identification and goal criteria to create and select concepts for eventual detail design and prototype testing on-site. This approach was implemented in a case-study at a Midwest greenhouse industry facility site in summer of 2019. Two problem areas were identified and addressed with two unique engineering designs that were prototyped and utilized at the facility with success. PRACTICAL APPLICATION: This approach can apply to other industries and collaborative teams in the future to prevent worker injury by design.

Utilization of 3D printed orthoses for musculoskeletal conditions of the upper extremity: A systematic review.

STUDY DESIGN: Systematic Review INTRODUCTION: 3D printed orthoses are emerging as a possible option in the field of hand therapy to fabricate conventional casts and orthoses. It is unknown how this technology is currently being used to treat upper extremity musculoskeletal conditions, and if 3D orthoses are comparable to custom- made low temperature thermoplastic orthoses fabricated by hand therapists. PURPOSE OF THE STUDY: The primary aim of this review was to investigate the utilization, effectiveness and feasibility of 3D printed technology to manufacture custom orthoses for musculoskeletal conditions of the upper extremity. METHODS: Studies describing 3D printed orthoses or casts used in treatment with patients were included following a comprehensive literature search using CINAHL, PubMed, Medline, ProQuest, and EBSCO databases. The selected studies had to address musculoskeletal conditions of the elbow, wrist, hand and/or digits that would typically be immobilized with a cast or brace or orthotic or orthosis. RESULTS: Ten studies met the inclusion criteria. Study designs included case studies, case series, and 1 randomized clinical trial. 3D printed orthoses/casts appear to be comfortable, provide adequate immobilization, and have pleasing aesthetics. However, expensive equipment, lack of appropriate software and scanning tools and lack of highly skilled clinicians are all factors preventing the implementation of 3D printed orthoses into current clinical practice. DISCUSSION: 3D printed orthoses appear to be effective at immobilization of a limb, aesthetically pleasing, and utilize lightweight and well -ventilated materials. However, the feasibility of implementing 3D printing technology in hand therapy settings remains challenging in part due to the resources required. CONCLUSIONS: While 3D printing shows promise, the high cost of equipment, lack of training and skill of clinicians and the long time required for production are all factors that need to be improved to make 3D printing a viable option in the hand therapy setting.

High Prevalence of Iron Deficiency Exhibited in Internationally Competitive, Non-Professional Female Endurance Athletes-A Case Study.

BACKGROUND: While iron deficiency is commonly discussed in populations of professional female athletes, less is known about highly trained, sub-elite female athletes (e.g., those winning international age-group competitions) who generally have less access to medical and allied health support. METHODS: Thirteen non-professional highly trained female endurance athletes provided training diaries and completed a blood test, where iron markers of haemoglobin (Hb), haematocrit (Hct), C-reactive protein (Crp), serum iron, serum ferritin, and transferrin were assessed. Resting metabolic rate (RMR) and body composition using dual-energy X-ray absorptiometry (DXA) were also obtained. Participants were classified as iron deficient (ID) if serum ferritin was <30 ug/L serum ferritin. RESULTS: Six of the 13 females were classified as ID. Serum iron, ferritin, Hb, Hct, and ferrin were greater in the ID group (p < 0.05). Crp resulted in large to very large correlations with serum iron (r = -0.72), serum ferritin (r = -0.66), and transferrin (r = 0.70). CONCLUSIONS: In this population of highly trained female athletes, 46% were diagnosed with sub-optimal iron levels, which could have lasting health effects and impair athletic performance. The need for more education and support in non-professional athletes regarding iron deficiency is strongly advised.

Risk factors for occupational injuries in schools among educators and support staff.

INTRODUCTION: School districts employ a large number of employees who work in educational (e.g., teachers) or other support roles, including educational assistants, custodians, food service, bus drivers, and community and recreation workers. District employees perform a wide array of job tasks and experience a wide spectrum of work-related risks and injuries. METHODS: Workers' compensation data were coupled with Minnesota Department of Education district employee denominator data to evaluate risk factors for injury and severity. Variables included district location and type, employee job classification, age, and gender. Rates of injury and rate ratios were calculated to measure comparative injury risk using negative binomial regression and 95% confidence internals. Incidence and frequency of injury cause, nature, and body part we calculated. RESULTS: Saint Paul and Minneapolis metropolitan area (versus non-metro) districts had higher risk (RR = 1.35, 95%CI = 1.18-1.54) of employee injuries. All job classifications in support roles had increased risk of injury claims versus educators, however food service (RR = 5.14, 95%CI = 4.61-5.74), custodial (RR = 3.85, 95%CI = 3.41-4.34), and transportation (RR = 4.15, 95%CI = 3.38-5.10) exhibited the highest comparative risk to educators; significant risk of lost-time injury was also present in these workers. Males and females had similar risk of injury for all claims, however males had elevated risk of lost-time injury (RR = 1.46, 95%CI = 1.26-1.69) versus females. All age groups >41-years-old exhibited increased risk of injury as compared to 31-40-year-olds. The magnitude of lost-time injury risk also increased with age. Falls and slips (29.1%), strains/sprains/ruptures (45.2%), and upper extremities (31.3%) most frequent cause, nature, and body part injured, respectively. CONCLUSIONS: Characteristics of districts, schools, workers, and their jobs tasks and hazards vary. Many categories of support staff in schools have elevated risk of injury, including lost-time injury, as compared to educators. Practical Applications: Injury prevention in schools should be approached by targeting job classifications; high risk jobs can be prioritized for prevention.

Case Study: Energy Availability and Endocrine Markers in Elite Male Track Cyclists.

AIM: To highlight energy availability status, resting metabolic rate measures, dietary protein intake, and testosterone concentration in 4 elite male track cycling athletes (mean [SD]: age: 20.8 [1.5] y, body mass: 76.3 [3.6] kg, height: 181.8 [2.9] cm). METHOD: A cross-sectional observation included measures of energy availability (energy intake minus exercise energy expenditure, divided by fat-free mass), resting metabolic rate from indirect calorimetry, dietary protein intake from food records, blood analysis to assess sex hormone status, and performance markers. RESULTS: Midrange testosterone (16.9-19.8 nmol/L), lowered resting metabolic rate ratio (0.76-0.98), varied luteinizing hormone (4-10 U/L), and suboptimal energy availability (26-41 kcal/kg fat-free mass/d, range) were observed in the male track cyclists. Protein intakes ranged from 2.0 g to 2.8 g protein/kg/d. CONCLUSION: The current cohort may have within-day energy deficiency, putting them in a catabolic state.

Differential effectiveness of the Minnesota Safe Patient Handling Act by health care setting: An exploratory study.

BACKGROUND: The Minnesota Safe Patient Handling (MN SPH) Act requires health care facilities to implement comprehensive programs to protect their workers from musculoskeletal injuries caused by lifting and transferring patients. Nursing homes, hospitals, and outpatient facilities each face unique challenges implementing and maintaining SPH programs. The objective of the study was to compare patient handling injuries in these three health care settings and determine whether change in injury rate over time differed by setting following enactment of the law. METHODS: Workers' compensation data from a Minnesota-based insurer were used to describe worker and claim characteristics in nursing homes, hospitals, and outpatient facilities. Negative binomial models were used to compare claims and estimate mean annual patient handling claim rates by health care setting and time period following enactment of the law. RESULTS: Consistent with national data, the patient handling claim rate was highest in Minnesota nursing homes (168 claims/$100 million payroll [95% confidence interval: 163-174]) followed by hospitals (35/$100 million payroll [34-37]) and outpatient facilities (2/$100 million payroll [1.8-2.2]). Patient handling claims declined by 38% over 10 years following enactment of the law (vs. 27% for all other claims). The change in claims over time did not differ by health care setting. CONCLUSIONS: In this single-insurer sample, declines in workers' compensation claims for patient handling injuries were consistent across health care settings following enactment of a state SPH law. Though nursing homes experienced elevated claim rates overall, results suggest they are not lagging hospitals and outpatient facilities in reducing patient handling injuries.

Emotions in Indian music history: anxiety in late Mughal Hindustan.

Music's ability to stimulate the emotions has long been fundamental to the aesthetics and reception of India's elite raga-based traditions. These emotions are generally studied aesthetically through the lens of 'rasa': the Sanskrit theory that proposes the musician's role is to stimulate one of nine distilled emotional essences (rasas) that is 'tasted' by the audience. But here I ask the inverse question: what emotions arose when historical listeners were threatened with the loss of that crucial source of emotional stimulus; and how were those negative emotions expressed through historical texts? In this paper, I consider the Hayy al-Arwah, a music treatise and tazkira (biographical collection) written by an ex-Mughal official from Delhi living in exile in Patna c. 1785-88, Miyan Zia-ud-din 'Zia'. Zia-ud-din's work reveals much about the emotions felt by musicians and music lovers affected by the violent political upheaval centred on late Mughal Delhi c1740-80 - but not in obvious ways. For such an emotional subject, his writing is curiously dispassionate. Nevertheless, I argue that his writing was impelled by one very powerful emotion in particular: anxiety. In order to approach the question I examine some alternative ways we might get at the emotional resonances of texts like the Hayy al-Arwah: through genre, in this case the tazkira; the etic observations of modern neuroscience; and a turn outwards to writings of more emotionally loquacious contemporaries, here the Urdu poet Mir Taqi 'Mir'. I argue it is precisely Zia-ud-din's detatched attention to detail, as he traced hundreds of lost and scattered musicians and listeners, that reveals the emotional driving force behind the writing of the Hayy al-Arwah to be a deep and abiding anxiety engendered by the very real existential threat of war and exile to the music of late Mughal Delhi. In writing the Hayy al-Arwah, Zia-ud-din acted as witness and record keeper for his community to insure against the potential loss of the music of his beloved homeland. At the same time, the work of gathering and reporting information acted to alleviate his anxiety over the threatened disappearance of what was to him a most important source of personal solace.

Biological and Socio-Cultural Factors Have the Potential to Influence the Health and Performance of Elite Female Athletes: A Cross Sectional Survey of 219 Elite Female Athletes in Aotearoa New Zealand.

Health is a pre-requisite for optimal performance yet the parameters which govern health and performance of elite female athletes are little understood. The aim of this study was to quantify the health status of elite female athletes, and understand sociocultural factors influencing that status. The survey addressed demographic, health and athletic performance history, training load, contraceptive use, sport-specific appearance and performance pressures, and communication barriers. Three hundred and fifty-seven elite New Zealand female athletes were recruited to complete an on-line survey. Two hundred and nineteen athletes completed the survey. Oligomenorrhea/amenorrhea had been diagnosed in only 12% of athletes compared with 50% of athletes not on hormonal contraception who reported symptoms consistent with this diagnosis. Stress fractures and iron deficiency were common and associated with oligomenorrhoea/amenorrhea (P = 0.002), disordered eating (P = 0.009) or menorrhagia (P = 0.026). Athletes involved in individual sports (P = 0.047) and with higher training volumes (P < 0.001) were more likely to report a medical illness. Seventy-three percent of athletes felt pressured by their sport to alter their physical appearance to conform to gender ideals with 15% engaging in disordered eating practices. Barriers to communicating female health issues included male coaches and support staff, and lack of quality information pertaining to health. Elite female athletes may fail to reach peak performance due to specific health issues and undiagnosed pathology. Sociocultural factors influence the effectiveness of support of female's health and performance. Organizational and cultural change is required if elite female athletes are to combine optimal health with best performance.

Evaluation of the Minnesota Safe Patient Handling Act: trends in workers' compensation indemnity claims in nursing home workers before and after enactment of the law.

OBJECTIVES: The 2007 Minnesota Safe Patient Handling Act aims to protect healthcare workers from injuries caused by lifting and transferring patients. The effectiveness of the law in nursing homes is unknown. This policy evaluation measured changes in patient handling injuries before and after the law was enacted. Additionally, it assessed whether effects of the law were modified by facility levels of staffing and retention. METHODS: Workers' compensation indemnity claims for years 2005-2016 were matched to annual direct care productive hours and facility characteristics (eg, profit status, hospital affiliation and region) for all Medicaid-certified nursing homes in Minnesota. Trends in patient handling claims were analysed using negative binomial regression with generalised estimating equations. The primary predictors were time period, staff hours per resident day and staff retention. RESULTS: The patient handling indemnity claim rate declined by 25% in years 4-6 and 38% in years 7-9 following enactment of the law. Claims for all other injuries and illnesses declined by 20% in years 7-9 only. Associations between time period and patient handling claims did not vary by levels of staffing or retention. However, independent of time, facilities with annual retention ≥75% (vs <65%) had a 17% lower patient handling claim rate. CONCLUSIONS: Results suggest the law reduced patient handling claims in nursing homes. However, claim rates were elevated in facilities with low worker retention and those that were non-profit, not hospital-affiliated or in a non-metro area. Facilities with these characteristics may benefit from targeted state grants and consultation efforts.

Where are all the men? Low energy availability in male cyclists: A review.

Most of the low energy availability (LEA) research has been conducted in female populations. The occurrence of LEA in male athletes is not well known, even with an understanding of the components involved in and contributing to LEA. Cycling is a major risk factor for LEA due to inherent sports characteristics: low impact, high energy demands, and a common perception that leanness is a performance advantage. The purpose of this review is to discuss the cycling-specific studies that have documented components of RED-S. The review demonstrates male cyclists (1) experience energy deficits daily, weekly and throughout a season; (2) exhibit lower bone mineral density at the spine compared to the hip, and low bone mineral density correlating with LEA and; (3) demonstrate downregulation of the endocrine system with elevated cortisol, reduced testosterone and insulin-like growth factor 1. The complexity of LEA is further explored by the socio-psychological contribution that may impact eating behaviours, and therefore increase the risk of developing LEA. Future research directions include applying multifaceted research methods to gain a greater understanding of this syndrome and the effect of LEA on male cyclists.

Occupational differences in workers' compensation indemnity claims among direct care workers in Minnesota nursing homes, 2005-2016.

BACKGROUND: Nursing assistants have one of the highest injury rates in the U.S., but few population-based studies assess differential injury risk by occupation in nursing homes. This statewide study assessed differences in musculoskeletal disorders (MSDs) and patient handling injuries among direct care workers in Minnesota nursing homes. METHODS: Indemnity claims from the Minnesota workers' compensation database were matched to time at risk from the Minnesota Nursing Home Report Card to estimate 2005 to 2016 injury and illness claim rates for certified nursing assistants (CNAs), licensed practical nurses (LPNs), and registered nurses (RNs). Associations between occupation and claim characteristics were assessed using multivariable regression modeling. RESULTS: Indemnity claim rates were 3.68, 1.38, and 0.69 per 100 full-time equivalent workers for CNAs, LPNs, and RNs, respectively. Patient handling injuries comprised 62% of claims. Compared to RNs, CNAs had higher odds of an indemnity claim resulting from an MSD (odds ratio [OR] = 1.67; 95% confidence interval [CI], 1.31-2.14) or patient handling injury (OR = 1.89; 95% CI, 1.47-2.45) as opposed to another type of injury or illness. CNAs had lower odds of receiving temporary and permanent partial disability benefits and higher odds of receiving a stipulation settlement. CONCLUSIONS: CNAs in Minnesota nursing homes are at heightened risk for lost time MSDs and patient handling injuries. Claims filed by CNAs are more frequently settled outside the regular workers' compensation benefit structure, an indication that the workers' compensation system is not providing adequate and timely benefits to these workers.

Teaching orthotic design and fabrication content in occupational therapy curricula: Faculty perspectives.

STUDY DESIGN: Cross-sectional survey study. INTRODUCTION: Occupational therapy (OT) programs must provide students with the skills necessary to fabricate orthoses. Input from OT educators can provide valuable insight into how these skills are taught and the resources used. PURPOSE OF THE STUDY: Explore how instruction in orthotic fabrication is addressed in OT education programs. METHODS: Surveys were distributed to all accredited OT programs in the United States. Quantitative data were analyzed using descriptive statistics, and content analysis was done on qualitative data to identify themes. RESULTS: Overall response rate was 25%. Most programs teach orthotic fabrication with demonstration and hands-on laboratory time. Almost half add digital videos in their orthotic course content. The average number of orthoses made ranged from 2 to 5, and the resting hand, wrist, and short opponens immobilization orthoses are the most commonly taught. DISCUSSION: This study examined the orthotic fabrication curricula in OT programs in the United States, including the time devoted to this topic, types of orthoses covered, course structure and pedagogical strategies used, and whether faculty anticipated changes in their orthotic content. The majority of programs offer this content within other existing courses within the curriculum, including coursework in physical dysfunction, OT interventions, orthopedics, and biomechanics. Only 15% of participants in the current study reported teaching orthotic content as a separate course in their curricula. Interestingly, some participants reported that they plan to offer a full separate orthotics course in their future curricula, whereas others reported combining orthotics content with other coursework or reducing the time spent making custom orthoses in the classroom. It would appear that there is still considerable variability in course structure and content in current OT programs. CONCLUSION: Participants feel that orthotic fabrication is an essential and integral component of their curricula and that the importance of hands-on learning experiences contributes to students' preparedness and ability to use this knowledge. Student feedback indicated that more time and instruction is desired. Sharing teaching experiences can enhance emerging OT curricula and can impact future practice. Educators must strive to improve and refine curricular content to ensure that graduates have the skills necessary to meet the orthotic needs of their clients.

Comparing disability and return to work outcomes between alternative and traditional workers' compensation programs.

BACKGROUND: The Union Construction Workers' Compensation Program (UCWCP) was developed in 1996 as an alternative workers' compensation arrangement. The program includes use of a preapproved medical and rehabilitation network and alternative dispute resolution (ADR), and prioritizes a quick and safe return-to-work. The aim of this study is to determine if differences in recovery-related outcomes exist between UCWCP and the statutory workers' compensation system (SWCS). METHODS: Claims data from 2003 to 2016 were classified as processed through UCWCP or SWCS. Outcomes included: temporary total disability (TTD), vocational rehabilitation (VR), claim duration and costs, and permanent partial disability (PPD). The relative risk of incurring TTD, VR, and PPD in UCWCP vs SWCS was calculated using log-binomial regression. Linear regression examined the relationship between programs and continuous outcomes including costs and duration. Estimates were adjusted for age, sex, wage, and severity. RESULTS: The UCWCP processed 15.8% of claims; higher percentages of UCWCP claimants were older and earned higher wages. Results point to positive findings of decreased TTD incidence and cost, lower risk of TTD extending over time, higher likelihood of VR participation, and less attorney involvement and stipulation agreements associated with UCWCP membership. Differences were more apparent in workers who suffered permanent physical impairment. CONCLUSION: Findings suggest that the defining programmatic elements of the UCWCP, including its medical provider and rehabilitation network and access to ADR, have been successful in their aims. Claims with increased severity exhibited more pronounced differences vs SWCS, potentially due, in part, to greater use of programmatic elements.

Student-inflicted injuries to staff in schools: comparing risk between educators and non-educators.

OBJECTIVE: Student-inflicted injury to staff in the educational services sector is a growing concern. Studies on violence have focused on teachers as victims, but less is known about injuries to other employee groups, particularly educational assistants. Inequities may be present, as educational assistants and non-educators may not have the same wage, benefits, training and employment protections available to them as professional educators. We identified risk factors for student-related injury and their characteristics among employees in school districts. METHODS: Workers' compensation data were used to identify incidence and severity of student-related injury. Rates were calculated using negative binomial regression; risk factors were identified using multivariate models to calculate rate ratios (RR) and 95% CIs. RESULTS: Over 26% of all injuries were student-related; 8% resulted in lost work time. Special and general education assistants experienced significantly increased risk of injury (RR=6.0, CI 5.05 to 7.15; RR=2.07, CI 1.40 to 3.07) as compared with educators. Risk differed by age, gender and school district type. Text analyses categorised student-related injury. It revealed injury from students acting out occurred most frequently (45.4%), whereas injuries involving play with students resulted in the highest percentage of lost-time injuries (17.7%) compared with all interaction categories. CONCLUSION: Student-inflicted injury to staff occurs frequently and can be severe. Special education and general assistants bear the largest burden of injury compared with educators. A variety of prevention techniques to reduce injury risk and severity, including policy or environmental modifications, may be appropriate. Equal access to risk reduction methods for all staff should be prioritised.

Anatomy education in occupational therapy curricula: Perspectives of practitioners in the United States.

The study of human anatomy is an integral component in the education of future occupational therapists, yet there is a paucity of research that explores the anatomy needs of students and new practitioners. As a follow up from a pilot study that surveyed a small cohort of practicing therapists, this article aimed to determine occupational therapy (OT) practitioners' views on anatomy course structure and content deemed important to include in OT curricula, entry level practitioners' anatomy knowledge, and application of anatomy in current practice. A Likert scale and free text questionnaire was distributed to practicing occupational therapists across the United States. Fifty-four percent of the participants in this cohort favored a standalone course, as compared to 94% in the pilot study group. Anatomy course content areas were comparable across groups. Systems identified as essential to cover in an OT anatomy course included skeletal, muscular, and nervous. Regions included the upper limb, thorax/trunk, head and neck, and lower limb. Seventy percent of participants in both groups felt that entry-level practitioners had adequate anatomy knowledge; 30% did not. Practice areas requiring anatomy knowledge included assessment of joint movement, muscle strength, pain, and functional mobility. Qualitative analysis of free text response data revealed the importance of anatomy knowledge in OT assessment and intervention strategies, determining the impact of injury or disease on occupational performance, client safety, and communication with other health care professionals and families. Anat Sci Educ 11: 243-253. © 2017 American Association of Anatomists.

Workers' compensation loss prevention representative contact and risk of lost-time injury in construction policyholders.

INTRODUCTION: Insurance loss prevention (LP) representatives have access and contact with businesses and employees to provide targeted safety and health resources. Construction firms, especially those smaller in size, are a high-risk population. This research evaluated the association between LP rep contact and risk for lost-time injuries in construction policyholders. METHODS: Workers' compensation data were utilized to track LP rep contact with policyholders and incidence of lost-time injury over time. Survival analysis with repeated events modeling calculated hazard ratios (HR) and 95% confidence intervals (CI). RESULTS: Compared no LP contact, one contact was associated with a 27% reduction of risk (HR=0.73, CI=0.65-0.82), two with a 41% (HR=0.59, CI=0.51-0.68), and three or more contacts with a 28% reduction of risk (HR=0.72, CI=0.65-0.81). CONCLUSIONS: LP reps appear to be a valuable partner in efforts to reduce injury burden. Their presence or contact with policyholders is consistent with reduction in overall incidence of lost-time injuries. PRACTICAL APPLICATIONS: Reduction in lost-time injuries, resulting in reduced workers' compensation costs for policyholders and insurance companies, builds a business-case for safety and injury prevention. LP reps are often a low or no-cost benefit for insurance policyholders and may be an important injury prevention resource for small firms and/or those with lack of safety resources and staff.

Anatomy in occupational therapy program curriculum: practitioners' perspectives.

Anatomy education is undergoing significant transformation. It is unknown whether changes are in accordance with occupational therapy (OT) practice needs. The purpose of this pilot study was to survey OT clinicians to determine their perspectives on the value of anatomy in OT curricula, and anatomical knowledge required for practice. In addition to demographics, the survey asked questions on the value of a standalone anatomy course, integration of anatomical content in other coursework, practice areas requiring anatomy knowledge, course content, teaching media recommendations, and their opinions regarding whether graduates have adequate anatomy knowledge for competent practice. Surveys were distributed to OT practitioners in the state of Arizona (n = 107). Response rate was 51% on electronic surveys, 29% on mailed surveys. All respondents recommended an anatomy course in OT curricula; 97% as a standalone course with integration of course content throughout the curriculum. The most recommended teaching method was cadaver dissection. Content areas identified as important to cover included skeletal, muscular, and nervous systems. Regions recommended were the upper limb, thorax/trunk, head and neck, and lower limb. Practice areas requiring anatomy knowledge included joint range of motion and strengthening treatment interventions, goniometry, muscle strength testing, assessing muscle tone, wheelchair assessment/prescription, orthotics, physical agent modalities, and activity adaptation. Eighty-one percent felt that entry-level practitioners had adequate knowledge for competent practice. This study supports inclusion of a separate anatomy course in OT curricula, continued use of cadavers, and the importance of including input from practicing clinicians when determining anatomy course content.

Injury rates, severity, and drug testing programs in small construction companies.

PROBLEM: Construction work is hazardous and workers consistently rank in the top of all occupations and industries for illicit drug and heavy alcohol use. METHODS: Drug-testing programs were classified into three categories: no program, pre-employment/post-accident, and pre-employment/post-accident/random/suspicion. We analyzed workers' compensation claims from 1,360 construction companies over a six-year period to assess the possible association of testing program with injury rate. RESULTS: Compared to no program, results respectively were RR=0.85 (CI=0.72-1.0) and RR=0.97 (CI=0.86-1.10) for all injuries, and RR=0.78 (CI=0.60-1.03) and RR=1.01 (CI=0.86-1.19) for lost-time injuries. Variability of results was exhibited across trade and union status, among other categories. SUMMARY: Drug-testing programs may be associated with lower, non-significant, injury rates in this population. IMPACT ON INDUSTRY: Drug-testing programs may be associated with lower injury rates, but care should be exercised to ensure accurate injury reporting, characterize underlying safety practices of a company, and to determine quality and consistency of testing.