Work-related injuries in the Australian education sector: A retrospective cohort study

IntroductionEducators are exposed to several work-related hazards. Evidence suggests musculoskeletal pain, psychological distress, and student-inflicted violence-related injuries are common. However, there is little evidence on the burden of workplace injury among Australian educators.AimTo compare incidence of injury claims and duration of compensated time off work between educators and non-educators, and associated factors.MethodsRetrospective cohort study of 1,559,676 Australian workers’ compensation claims, including 84,915 educator claims, lodged between July 2009 to June 2015, from the National Dataset for Compensation-based Statistics. Cases were included if aged 18+ years and working in the education sector less than 100 h per week. Negative binomial regression models estimated the relative risk of making a compensation claim and survival analyses calculated disability duration within educators by sex, age, injury type and mechanism, socioeconomic area, remoteness, and jurisdiction.ResultsCompared to non-educators, educators had lower rates of injury claims and shorter disability durations. However, educators had a higher rate of claims for mental health conditions and assault, with the highest risk being among those in special education and education aides. Among educators, injury claim rates were highest among special educators, education aides, and secondary educators.Discussion and ConclusionThough surveys indicate Australians in the education sector have higher incidences of work-related injuries, this study found lower incidence of injury claims and shorter disability durations than others. Educators’ injury-reporting and absenteeism behaviors may be constrained by ethical, social, and administrative attitudes. Educators had higher rates of claims for mental health and assault-related injury, particularly special educators, and education aides, which suggests a need for targeted prevention efforts.     

An assessment of population-based screening guidelines versus clinical prediction rules for chlamydia and gonorrhea case finding

IntroductionMuch remains to be learned regarding the epistemology and utility of guidelines and clinical prediction rules (CPR), as well as the extent to which knowledge about risk at a population level might be pertinent to any given patient in terms of case finding accuracy. In the current paper, we offer an empirical examination that juxtaposes population-based guidelines and CPR for sexual health decision-making.Materials and methodsWe analyzed electronic medical records from asymptomatic patient visits involving tests for chlamydia or gonorrhea between 2000 and 2012 at nine publicly funded STI clinics in British Columbia to compare the case-finding accuracy for infection risk under two scenarios: (1) if the population had been screened using the Public Health Agency of Canada (PHAC) screening guidelines for chlamydia and gonorrhea; or (2) if the population has been screened using a CPR. Performance metrics evaluated included the area under the ROC curve (AUC).ResultsIn total, 35,818 individuals met the study inclusion criteria. The overall infection rate was 3.0%. Using the PHAC guidelines, the discriminatory performance of using any versus no risk factors and counts of risk factors were: AUC = 0.55, 95% CI: 0.54–0.56 and AUC = 0.64, 95% CI: 0.63–0.66, respectively. The model used to derive the CPR demonstrated good discrimination (AUC = 0.73, 95% CI: 0.71–0.74).ConclusionsThe current paper provides empirical evidence that demonstrates that population-based guidelines may not necessarily be a perfect fit for application at the individual level. Thus, we recommend risk estimation algorithms for use in sexual health services and programs.     

Trajectory of adherence to home rehabilitation among older adults with hip fractures and cognitive impairment

This study aimed to identify different trajectories of adherence to home rehabilitation for older adults with hip fracture and cognitive impairment, to examine associations between different adherence trajectories and postoperative recovery outcomes, and to explore the predictors of adherence trajectories. Group-based trajectory modeling showed two adherence trajectories: low (39.06%) and high (60.94%) adherence. The high adherence group had better activities of daily living (β=11.77, p<.001), instrumental activities of daily living (β=0.56, p<.01), femoral muscular strength (β=3.35, p<.01) on the fractured side and quality of life (β=-0.81, p=.02) than the low adherence group. Participants who established exercise habits (OR=6.49, p<.01) and consulted a physical therapist (OR=4.29, p=.03) during hospitalization were more likely to be in the high adherence group.     

锁定钢板内固定联合抗骨质疏松治疗老年肱骨近端骨折的效果

目的探讨锁定钢板内固定联合抗骨质疏松治疗老年肱骨近端骨折的效果。方法 2011年2月~2014年8月河北联合大学附属医院收治的老年肱骨近端骨折患者55例随机分为治疗组(28例)和对照组(27例)。治疗组患者给予锁定钢板内固定治疗及3个月的抗骨质疏松治疗。对照组仅采用锁定钢板内固定治疗。比较两组患者住院时间、抗骨质疏松治疗后的骨密度及肩关节功能的恢复情况。结果与对照组比较,治疗组住院时间明显缩短[(7.0±0.9)d比(10.1±0.7)d],差异有统计学意义(P<0.05)。治疗组和对照组患者术后3个月L2~4椎体骨密度分别为(0.80±0.11)、(0.64±0.04)g/cm2,差异有统计学意义(P<0.05)。治疗组肩关节功能的恢复情况:优15例、良10例、可2例、差1例;对照组:优10例、良10例、可4例、差3例,两组比较差异有统计学意义(P<0.05)。结论老年肱骨近端骨折采用锁定钢板内固定联合抗骨质疏松治疗临床效果好,住院时间短,肩关节功能恢复良好,值得临床推广应用。