Central West health and rehabilitation
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News


Student Satisfaction Survey Aug 30th, 2017



Athlete Self Reflection Form - MWAS Feb 27th, 2017



ICDC - Referral Form Details Feb 22nd, 2017



ICDC - Health Professional Report Template Feb 21st, 2017



Chronic Pain Explained - Chronic Pain Australia Jan 18th, 2017



Blood Lactate Testing Jun 13th, 2016
One of the goals of Central West Health and Rehabilitation is to provide opportunities for talented sportspeople and young athletes from the Midwest to achieve excellence in their chosen sport. One way we do this is by using various physiological testing techniques to provide enthusiastic athletes with the information they need to get the most from their training.

Blood lactate testing is a good example. Blood lactate curves have become important in the diagnosis of endurance performance, and are used for intensity prescriptions in endurance sports. 


This data is used to highlight an athlete’s blood lactate ‘deflection point’ and ‘rapid accumulation point’ during incremental exercise of any type. As well as a test of improvement, training can be built around these values to ensure an athlete is getting the most from their training time.


Blood Lactate Testing Jun 13th, 2016
One of the goals of Central West Health and Rehabilitation is to provide opportunities for talented sportspeople and young athletes from the Midwest to achieve excellence in their chosen sport. One way we do this is by using various physiological testing techniques to provide enthusiastic athletes with the information they need to get the most from their training.

Blood lactate testing is a good example. Blood lactate curves have become important in the diagnosis of endurance performance, and are used for intensity prescriptions in endurance sports. 


This data is used to highlight an athlete’s blood lactate ‘deflection point’ and ‘rapid accumulation point’ during incremental exercise of any type. As well as a test of improvement, training can be built around these values to ensure an athlete is getting the most from their training time.



Y - Balance Test May 17th, 2016



Call to boost allied health referrals to specialists May 11th, 2016




THE government should consider supporting direct referrals of chronic disease patients from allied health professionals to specialists to reduce the reliance on GPs, a parliamentary committee recommends.


The move would combat the circular process in which patients, in order to qualify for a Medicare rebate, must firstly consult a GP for a referral to an allied health professional, and then return for a subsequent initial referral to a specialist.


Under the proposal, rebates would be enabled only where a GP originally refers the patient to allied health. The GP would also have to indicate in the original referral that specialist assessment may be warranted.


The recommendation is one of 13 emerging from the House of Representatives Standing Committee on Health's inquiry into chronic disease prevention and management in primary health care.


In a 205-page report, released on Thursday, the committee also recommends increasing the number of allied health treatments that can attract a rebate each year. Allied health MBS items at present provide up to five treatment sessions per year, which may not be enough for those with ongoing conditions, the committee says.


The inquiry, which received nearly 200 submissions, also urges the government to examine reforms to the MBS to allow GPs to claim a rebate for a chronic disease management consultation and a general consultation benefit for the same person on the same day.


The committee, chaired by Liberal MP Steve Irons, showers praise on the Turnbull government's Healthier Medicare reforms, due to kick off with trials in mid-2017, saying they incorporate many of the committee's recommendations.


The committee also recommends:



  • That the government consider loosening privacy restrictions around medical practitioner access to patient records, noting the difficulties that occur when patients transition from hospital to primary care;

  • Boosting the amount and quality of data on chronic disease and service use in PHNs;

  • That the government explore ways to make better use of nurses in chronic disease care;

  • That the government examine the inclusion of an integrated health assessment check for cardiovascular disease, kidney disease and diabetes, where a patient does not already qualify for an existing assessment and the treating practitioner identifies a risk; and

  • That the government consider expanding the Practice Incentives Program to include breast, bowel and skin cancer screening.


You can read the report in full here.







Worksite Services Start for Golden Grove May 10th, 2016


Hydrotherapy can help shoulder pain Mar 5th, 2016

Hydrotherapy Exercises for Treating Anterior Shoulder Dislocation



Insight - SBS - Beating Diabetes Mar 2nd, 2016



Hydrotherapy is great for Sudden Low Back Pain Mar 2nd, 2016



The Lancet - Use of opioid painkillers increases fourfold in Australia in 10 years while most of the world lacks access to basic painrelief Feb 5th, 2016



Harnessing the power of water to train, relax, and recover Jan 7th, 2016
There are pools that contain water and then there are SwimEx Sports Therapy Pools, that capture its power. With adjustable water speeds, multiple design options and a wide, even current, SwimEx leads the aquatic industry world wide.  Our heated SwimEx therapy pool is the most versatile and powerful pool available for rehabilitation, therapy and conditioning.


Swimex Therapy pools are used by many American college and professional sports teams.  This versatile pool has adjustable depths of 48” and 60” (122cm and 152cm). It features eight distinct easy-to-identify coloured workout stations including angled plyo pads, open/closed chain kinetic exercise benches, floor inserts and an angled platform for the ultimate in aquatic running. The adjustable floor offers the option to gradually increase weight-bearing activities, creating the ideal aquatic therapy environment for progressive strength training and rehabilitation programs.

The SwimEx adjustable laminar flow adds another dimension to treatment and conditioning protocols and can be used for all levels: from the frail patient all the way up to the professional athlete.



The SwimEx Advantage:

Multiple water depths to vary weight-bearing status, enabling progression from acute rehab in non-weight-bearing environments to aggressive weight-bearing functional activities.

Deeper water to decrease swelling in an acute injury through hydrostatic pressure.

A variable speed laminar flow that targets different muscular contractions (isometric and eccentric) to achieve multiple goals.

A wide variety of workstations for stretching, seated exercises and/or closed-chain exercises.

Comfortable seating ideal for completely submerged upper extremity exercises.

The ability to treat your patient in a horizontal or vertical position to gain active, active assisted and passive shoulder and elbow range of motion exercises.



Safety matters: a safety and health training for young workers. Dec 14th, 2015
Surveys suggest that 80% of teens have worked by the time they finish high school. Although work provides many benefits for young people, it can also be dangerous.

As new workers, adolescents are likely to be inexperienced and unfamiliar with many of the tasks required of them. Yet despite teen workers’ high injury rates on the job, safety at work is usually one of the last things they worry about. Many of teens’ most positive traits—energy, enthusiasm, and a need for increased challenge and responsibility—can cause them to take on tasks they are not prepared to do safely. They may also be reluctant to ask questions or to speak up when they are feeling unsafe or threatened at work.

The National Institute for Occupational Safety and Health (NIOSH) and the American Industrial Hygiene Association (AIHA) have partnered to help make all young people aware of the critical life skills they need to stay safe and healthy on the job, now and throughout their lives. To do this they have put together the following leaflet.

 


 


NIOSH 8 Core Competencies are:



  1. Recognize that, while work has benefits, all workers can be injured, become sick, or even be killed on the job. Workers need to know how workplace risks can affect their lives and their families.

  2. Recognize that work-related injuries and illnesses are predictable and can be prevented.

  3. Identify hazards at work and predict how workers can be injured or made sick.

  4. Recognize how to prevent injury and illness. Describe the best ways to address workplace hazards and apply these concepts to specific workplace problems.

  5. Identify emergencies at work and decide on the best ways to address them.

  6. Recognize that employers are responsible for, and workers have the right to, safe and healthy work. Workers also have the responsibility for keeping themselves and co-workers safe.

  7. Find resources that help keep workers safe and healthy on the job.

  8. Demonstrate how workers can communicate with others—including people in authority roles—to ask questions or report problems or concerns when they feel unsafe or threatened.



Surfing Technique Evaluation - Lachie Jul 8th, 2015

Emerging Surf Skill Evaluation





Bottom Turn



Forehand



Backhand





Re-Entry 





Forehand



Backhand





Cutback 





Forehand



Backhand





Snap 





Forehand



Backhand





Floaters 





Forehand



Backhand





Finishes 





Forehand



Backhand





Jun 25th, 2015



After Hours Gym - Waiver Jun 24th, 2015
This is an important document and you, or your guardian, should read it carefully. By completing the Central West Health and Rehabilitation After Hours Membership Waiver, you acknowledge that you have read and understand these terms and conditions.

Joining a gym is a ‘recreational activity’ involving physical activity. Physical activity and sport in general contain inherently dangerous elements, and participation involves an assumption of risk. Accidents can and do happen which may result in personal injury, death or property damage. Prior to joining, you should ensure you are aware and comfortable with the risks involved, including those risks associated with any health condition you may have.

To the best of our knowledge, the facilities and physical activity programs offered by Central West Health and Rehabilitation have been designed and established to provide the optimum level of beneficial exercise and enjoyment without compromising the health and safety of those who utilize the facilities or participate in the activities. Because of the nature of the programs made available at Central West Health and Rehabilitation, and the equipment, which is an integral part of many of the activities, there is an inherent risk of injury which characterizes any exercise activity resulting in a practical limitation placed on Central West Health and Rehabilitation in its efforts to prevent injuries to participants, whether actively participating in exercises, utilizing the equipment or taking advantage of the various other facilities at the Centre.

Central West Health and Rehabilitation enlists your assistance in assuring that the facilities and the equipment are utilized in a proper manner so that the inherent risks which exist under the control of the Centre, as well as those outside the control of the Centre and partially within the control of each individual participant, are minimized by the participant’s thoughtful and cautious use of both the equipment and the facilities.

In consideration of the above factors, the undersigned participant acknowledges the existence of risks in connection with these activities assumes such risks and agrees to accept the responsibility for any injuries/illness sustained by him/her in the course of his/her use of the facilities and/or the equipment.

More specifically, the participant acknowledges and accepts risks in one or more of the following are as:


  1. The use of exercise equipment.

  2. Participation in related as well as unsupervised activities which are made available in the gym and other activities that may take place outside the Centre.

  3. Possible injuries or medical disorders arising out of the participant’s exercising at the facilities, such as heart attack, stroke, heat stress or other injuries which may arise such as sprains, broken bones, torn muscles, torn ligaments, etc.

  4. Accidents or injuries which occur within the facilities provided by Central West Health and Rehabilitation such as locker rooms, dressing rooms, and showers.

  5. It is recommended that participants consult with their doctors or other trained health professional before engaging in any activities which are a part of your planned exercise program.


As the gym user, it is important you acknowledge the existence of and the need for certain rules and procedures concerning the use of the equipment and facilities that are a part of the Central West Health and Rehabilitation as set out in Appendix 2. He/She agrees to abide by those rules and to make every individual effort to assure that the equipment and facilities are kept in safe and usable condition. Any breach of the rules in Appendix 2 may lead to your gym membership being cancelled, or prosecution for more serious breaches.

By signing this form, you acknowledge, agree, and understand that commencing a gym membership may involve risk. You agree and undertake any such risk voluntarily and at your own risk. You acknowledge that the assumption of risk and warning above constitutes a 'risk warning' in accordance with relevant legislation, including the Civil Liability Act 2002 (WA).

It is possible for a supplier of recreational services or recreational activities to ask you to agree that statutory guarantees under the Australian Consumer Law (which is Schedule 2 of the Competition and Consumer Act 2010 (Commonwealth) do not apply to you (or a person for whom or on whose behalf you are acquiring the services or activities).

If you sign this form, you will be agreeing that your rights (or the rights of a person for whom or on whose behalf you are acquiring the services) to sue the supplier in relation to recreational services or recreational activities that you undertake because the services or recreational activities provided were not in accordance with the guarantees are excluded, restricted or modified as set out in Appendix 1.

Print Waiver to Sign


Next - Gym Safety



Centrals - Gym Safety Procedures Jun 23rd, 2015
Joining a gym is a ‘recreational activity’ involving physical activity. Physical activity and sport in general contain inherently dangerous elements, and participation involves an assumption of risk. Accidents can and do happen which may result in personal injury, death or property damage. Prior to joining, you should ensure you are aware and comfortable with the risks involved, including those risks associated with any health condition you may have.

To the best of our knowledge, the facilities and physical activity programs offered have been designed and established to provide the optimum level of beneficial exercise and enjoyment without compromising the health and safety of those who utilize the facilities or participate in the activities. Because of the nature of the programs made available, and the equipment, which is an integral part of many of the activities, there is an inherent risk of injury which characterizes any exercise activity resulting in a practical limitation placed on Centrals in its efforts to prevent injuries to participants, whether actively participating in exercises, utilizing the equipment or taking advantage of the various other facilities at the Centre.

Centrals enlists your assistance in assuring that the facilities and the equipment are utilized in a proper manner so that the inherent risks which exist under the control of the Centre, as well as those outside the control of the Centre and partially within the control of each individual participant, are minimized by the participant’s thoughtful and cautious use of both the equipment and the facilities.

In consideration of the above factors, the undersigned participant acknowledges the existence of risks in connection with these activities assumes such risks and agrees to accept the responsibility for any injuries/illness sustained by him/her in the course of his/her use of the facilities and/or the equipment.

More specifically, the participant acknowledges and accepts risks in one or more of the following are as:


  1. The use of exercise equipment.

  2. Participation in related as well as unsupervised activities which are made available in the gym and other activities that may take place outside the Centre.

  3. Possible injuries or medical disorders arising out of the participant’s exercising at the facilities, such as heart attack, stroke, heat stress or other injuries which may arise such as sprains, broken bones, torn muscles, torn ligaments, etc.

  4. Accidents or injuries which occur within the facilities provided by Centrals such as locker rooms, dressing rooms, and showers.

  5. It is recommended that participants consult with their doctors or other trained health professional before engaging in any activities which are a part of your planned exercise program.


As the gym user, it is important you acknowledge the existence of and the need for certain rules and procedures concerning the use of the equipment and facilities that are a part of the Centrals as set out in Appendix 2. He/She agrees to abide by those rules and to make every individual effort to assure that the equipment and facilities are kept in safe and usable condition. Any breach of the rules in Appendix 2 may lead to your gym membership being cancelled, or prosecution for more serious breaches.


Next - General Gym Safety


Back - Centrals Gym Safety Procedure



Centrals - Strength Training with Free weights Jun 23rd, 2015
Resistance training (also called strength training or weight training) is the use of resistance to muscular contraction to build the strength, anaerobic endurance and size of skeletal muscles. When you do resistance training repeatedly and consistently, your muscles become stronger.

Resistance training can be dangerous if your technique is not right. It is important to pay attention to safety and good form to reduce the risk of injury. If you are interested in starting resistance training, make sure you have an assessment and program written for your specific needs. Make sure you follow any medical advice and are shown the exercises by a physiotherapist, exercise rehabilitation professional or qualified gymnasium instructor.



Safety tips for resistance training



  1. Proper technique is essential. If you’re not sure whether you’re doing a particular exercise correctly, ask a qualified personal trainer, gym instructor or exercise physiologist for help.

  2. Start slowly. If you’re starting out, you may find that you’re able to lift only a few kilograms. That’s okay. Once your muscles, tendons and ligaments get used to weight training exercises, you may be surprised at how quickly you progress. Once you can easily do 12 repetitions with a particular weight, gradually increase the weight.

  3. Only use safe and well-maintained equipment. Faulty equipment will significantly increase your risk of injury.

  4. Don’t hold your breath. Breathe normally while lifting by exhaling during the exertion or harder phase and inhaling during the easier or relaxation phase.

  5. Control the weights at all times. Don’t throw them up and down or use momentum to ‘swing’ the weights through their range of motion.

  6. Maintain a strong form while lifting, as this will prevent injury through incorrect technique. Always lift weights within your own capabilities and slow down or stop if you feel the weight is out of control or too heavy.

  7. Use the full range of motion. It is important when lifting a weight that it travels through the full range of motion of the joint. This develops strength of the muscle at all points of the motion of the joint and decreases the chance of injury through over-stretching.

  8. Wear appropriate clothing and safety equipment such as gloves. Dress comfortably and practically (for example, wear clothes that do not restrict movement and allow you to sweat easily).

  9. Maintain correct posture and body positioning (form) to reduce the risk of injury at all times.

  10. Once you have finished a set, gently place the weights on the floor – don’t drop them. Otherwise, you could injure yourself or people nearby.

  11. Don’t train if you are over-tired or feeling ill.

  12. Don’t try to train through an injury. Stop your workout immediately and seek medical advice.

  13. Muscle needs time to repair and grow after a workout. A good rule of thumb is to rest the muscle group for at least 24 hours before working the same muscle group again.


Next - Cardio Equipment


Back - Centrals Gym Safety Procedure




 



Centrals - Cardio Equipment Jun 23rd, 2015
Aerobic (cardiovascular) fitness is one of the most important components of physical fitness. Cardiovascular fitness is measured as the amount of oxygen transported in the blood and pumped by the heart to the working muscles and as the efficiency of the muscles to use that oxygen. Increasing cardiovascular fitness means increasing the capability of the heart and the rest of the cardiovascular system in their most important task, to supply oxygen and energy to your body. Cardiovascular fitness is related to age, gender, exercise habits, heredity and cardiovascular clinical status.

Having good cardiovascular fitness has many health benefits. For example, it decreases your risk of cardiovascular diseases, stroke, high blood pressure, diabetes and other diseases.

Cardiovascular fitness is best improved by activities, which employ large muscle groups working dynamically. Such activities include walking, jogging, running, swimming, skating, cycling, stair climbing and cross-country skiing.


Next - Treadmills


Back - Centrals Gym Safety Procedure


 

 



Centrals - Cardio Equipment Treadmills Jun 23rd, 2015
A treadmill is a piece of exercising equipment that consists of a conveyor belt rotated either manually or by a motor. The user will normally walk, jog or run on this device.

The most significant risk associated with the use of treadmills is friction burns, especially to young children playing on or near a treadmill. The results of these injuries can range from minor burns to serious burns requiring skin grafts and potential permanent loss of the use of hands or fingers.



Next - Safety Quiz


Back - Centrals Gym Safety Procedure



Centrals - Gym Safety Course Jun 23rd, 2015
Joining a gym is a ‘recreational activity’ involving physical activity. Physical activity and sport in general contain inherently dangerous elements, and participation involves an assumption of risk. Accidents can and do happen which may result in personal injury, death or property damage. 

The following pages provide information of exercise safety including:


  1. General Safety and Exercise Technique

  2. Strength Training with Free Weights

  3. Cardio Equipment

  4. Treadmills

  5. Brief quiz to confirm you have watched all the videos





Next - Strength Training with Free Weights


Back - Centrals Gym Safety Procedure



After Hours Gym - Exercise Safety Jun 20th, 2015
Joining a gym is a ‘recreational activity’ involving physical activity. Physical activity and sport in general contain inherently dangerous elements, and participation involves an assumption of risk. Accidents can and do happen which may result in personal injury, death or property damage. Prior to joining, you should ensure you are aware and comfortable with the risks involved, including those risks associated with any health condition you may have.

To the best of our knowledge, the facilities and physical activity programs offered by Central West Health and Rehabilitation have been designed and established to provide the optimum level of beneficial exercise and enjoyment without compromising the health and safety of those who utilize the facilities or participate in the activities. Because of the nature of the programs made available at Central West Health and Rehabilitation, and the equipment, which is an integral part of many of the activities, there is an inherent risk of injury which characterizes any exercise activity resulting in a practical limitation placed on Central West Health and Rehabilitation in its efforts to prevent injuries to participants, whether actively participating in exercises, utilizing the equipment or taking advantage of the various other facilities at the Centre.

Central West Health and Rehabilitation enlists your assistance in assuring that the facilities and the equipment are utilized in a proper manner so that the inherent risks which exist under the control of the Centre, as well as those outside the control of the Centre and partially within the control of each individual participant, are minimized by the participant’s thoughtful and cautious use of both the equipment and the facilities.

Following are a number of short videos on exercise safety. To confirm you have watched each there is a brief quiz.




Next - Strength Training with Free Weights


 



After Hours Gym - Strength Training with Free Weights Jun 20th, 2015
Resistance training (also called strength training or weight training) is the use of resistance to muscular contraction to build the strength, anaerobic endurance and size of skeletal muscles. When you do resistance training repeatedly and consistently, your muscles become stronger.

Resistance training can be dangerous if your technique is not right. It is important to pay attention to safety and good form to reduce the risk of injury. If you are interested in starting resistance training, make sure you have an assessment and program written for your specific needs. Make sure you follow any medical advice and are shown the exercises by a physiotherapist, exercise rehabilitation professional or qualified gymnasium instructor.



Safety tips for resistance training



  1. Proper technique is essential. If you’re not sure whether you’re doing a particular exercise correctly, ask a qualified personal trainer, gym instructor or exercise physiologist for help.

  2. Start slowly. If you’re starting out, you may find that you’re able to lift only a few kilograms. That’s okay. Once your muscles, tendons and ligaments get used to weight training exercises, you may be surprised at how quickly you progress. Once you can easily do 12 repetitions with a particular weight, gradually increase the weight.

  3. Only use safe and well-maintained equipment. Faulty equipment will significantly increase your risk of injury.

  4. Don’t hold your breath. Breathe normally while lifting by exhaling during the exertion or harder phase and inhaling during the easier or relaxation phase.

  5. Control the weights at all times. Don’t throw them up and down or use momentum to ‘swing’ the weights through their range of motion.

  6. Maintain a strong form while lifting, as this will prevent injury through incorrect technique. Always lift weights within your own capabilities and slow down or stop if you feel the weight is out of control or too heavy.

  7. Use the full range of motion. It is important when lifting a weight that it travels through the full range of motion of the joint. This develops strength of the muscle at all points of the motion of the joint and decreases the chance of injury through over-stretching.

  8. Wear appropriate clothing and safety equipment such as gloves. Dress comfortably and practically (for example, wear clothes that do not restrict movement and allow you to sweat easily).

  9. Maintain correct posture and body positioning (form) to reduce the risk of injury at all times.

  10. Once you have finished a set, gently place the weights on the floor – don’t drop them. Otherwise, you could injure yourself or people nearby.

  11. Don’t train if you are over-tired or feeling ill.

  12. Don’t try to train through an injury. Stop your workout immediately and seek medical advice.

  13. Muscle needs time to repair and grow after a workout. A good rule of thumb is to rest the muscle group for at least 24 hours before working the same muscle group again.


Next - Cardio Equipment




 



After Hours Gym - Cardio Equipment Jun 20th, 2015
Aerobic (cardiovascular) fitness is one of the most important components of physical fitness. Cardiovascular fitness is measured as the amount of oxygen transported in the blood and pumped by the heart to the working muscles and as the efficiency of the muscles to use that oxygen. Increasing cardiovascular fitness means increasing the capability of the heart and the rest of the cardiovascular system in their most important task, to supply oxygen and energy to your body. Cardiovascular fitness is related to age, gender, exercise habits, heredity and cardiovascular clinical status.

Having good cardiovascular fitness has many health benefits. For example, it decreases your risk of cardiovascular diseases, stroke, high blood pressure, diabetes and other diseases.

Cardiovascular fitness is best improved by activities, which employ large muscle groups working dynamically. Such activities include walking, jogging, running, swimming, skating, cycling, stair climbing and cross-country skiing.


Next - Treadmills


 

 



After Hours Gym - Treadmills Jun 20th, 2015
A treadmill is a piece of exercising equipment that consists of a conveyor belt rotated either manually or by a motor. The user will normally walk, jog or run on this device.

The most significant risk associated with the use of treadmills is friction burns, especially to young children playing on or near a treadmill. The results of these injuries can range from minor burns to serious burns requiring skin grafts and potential permanent loss of the use of hands or fingers.



Next - Safety Quiz



Jun 20th, 2015



The management of musculoskeletal disorders in the workplace Jun 16th, 2015
On balance, well-designed work carries net health benefits. Poorly designed work and unemployment are major social determinants of health inequalities. In some cases, a patient's work may have contributed to the development of their musculoskeletal disorder (MSD), or may lead to deterioration in their disorder.

Physical factors at work such as frequent or prolonged work in awkward postures or exposure to vibration may result in specific MSDs, for example, osteoarthritis of the hips in certain groups of farmers. Non-specific disorders, such as diffuse arm pain, are much less likely to be caused by physical factors at work.

Care must be taken before attributing work as the cause of an MSD; causation is usually multifactorial and work may not be the only or even the main cause. Many factors come into play, including physical and psychological aspects of the job, relationships with managers and peers and the worker's perceptions of organisational justice.

If it is believed that work has contributed to, or aggravated, a patient's disease or disorder, there is a duty to try to ensure that other workers in the same environment are not further exposed to the same risk (primary prevention). If an injuried worker is to return to the same working environment, they should endeavour to ensure that exposure to an ongoing hazard is minimised (secondary prevention).

If the patient works for an organisation that has access to injury management services, the best approach is to contact the service and explain your concerns (provided your employee consents to you doing this).


Next- Assessing Fitness for Return to Work



Assessing Fitness for Return to Work Jun 16th, 2015
'Worklessness' has profound negative effects on the injuried individual and their family. People who are unemployed suffer from poorer general health and they are more likely to participate in risk-taking behaviours such as alcohol and drug abuse, sexual promiscuity and smoking.

Unemployment also leads to wider social inequalities, and economic stress can impact on families with implications played out over decades. Importantly, regaining work may reverse these adverse health effects, and re-entry into work leads to an improvement in health.

There are several principles that health-care professionals need to take into account when assessing an individual's fitness for work.

Safety

It is important to consider not only if the person is likely to be able to perform their duties effectively, without harm to themselves, but also if the patient's return to work may lead to risk to others.

Inclusive approach

Individuals do not need to be symptom free to work. Many medical conditions, and virtually all minor health problems, have minimal implications for work and should not prevent employment.

The majority of people who are off work due to MSDs return to work within 4 weeks without vocational rehab advice or intervention. The priority at this stage is to support and encourage restoration of function and to avoid exacerbating disability, as there is evidence that occupational outcomes for most people with MSDs are improved by early return to some work.

Once an individual has been off work with an MSD for 4 weeks, an intervention to assist return to work is more likely to be required. By 26 weeks of absence, incapacity is likely to have become entrenched and rehabilitation becomes much more difficult. Therefore, the period of 4-26 weeks is often referred to as the ‘window of opportunity’ for effective return-to-work management.

Medical fitness should be assessed in relation to the particular demands of the work, such as hours; shiftwork; exposure to physical, chemical, biological and psychosocial hazards; work relationships; physical work environment; and requirement to travel.

An in-depth knowledge of the workplace and the duties of the job invaluable when assessing a employees fitness for work. Another reason this process should be done by the workplace injury management co-ordinator or injury management provider.  OH service. If such a person is not available majority descisions regards fitness to work are therefore undertaken by general practitioners (GPs) or hospital-based health professionals. These individuals often have limited knowledge of an employees workplace and roles.


Assessment of work capability is complex, and despite its importance, there is very limited scientific evidence to base RTW decisions on in part as there is no standard or valid methodology for assessing suitability for RTW used over all professions.

Outcomes from fitness for work assessments may range from ‘fit’ to ‘unfit’, with intermediate categories such as ‘fit subject to work modifications’, ‘fit with restrictions’ or ‘conditionally fit (temporarily, permanently)’. Workplace modifications to improve or adjust working conditions should always be considered.

Suitable Duties

Adjustments to work may be temporary or permanent, and they may take many forms. They may include shorter working hours, different shift patterns, avoidance of manual handling or transferring someone from a physical to a sedentary post.

For example, an employee with arthritis may benefit from starting work slightly later in the morning to allow time for the medication to take effect and early morning stiffness to reduce.

It is important to consider how individuals travel to work. Employers may be able to provide workers with a parking space to facilitate their access to work. Individuals who use public transport may temporarily or permanently benefit from travelling before or after the rush hour, so as to ensure that they get a seat.

Return to Work

Patients should be forewarned that they are likely to experience disproportionate fatigue on return to work. This symptom is likely to be more prominent in individuals with inflammatory MSDs. This can be mitigated in some cases by simple strategies such as returning to work on alternate days for the first week; returning in the middle rather than the beginning of the working week; and, if possible, working shortened hours, gradually increasing to usual working hours over a period of a few weeks.

Next - Pre-employment Physical Assessments



Physical Assessment and Return to Work Jun 16th, 2015
Work health and safety laws in Australia and other jurisdictions also require employers to provide a "safe system of work". For example, section 19 of the Work Health and Safety Act 2011 states that the "primary duty of care" is to "ensure, so far as is reasonably practicable, the health and safety of workers" by, among other things, "provision and maintenance of safe systems of work".

Pre-employment physical assessments provide vital information for such decisions, and will find more and more value as our workforce gradually ages over the coming 2-3 decades. Information gained form Physical Assessments can also be helpful in establishing pre-existing physical capacity, whch asssits in establishing return to work goals.

It is important for recruiting employers to make clear to applicants the reason why health-related questions are asked pre-employment and the purposes for which the information will be used. 

Once a job has been offered, and accepted employers may, if they wish, ask additional medical questions. If a condition is revealed that might cause the candidate problems in performing the job, then adjustments must be considered. If no adjustments are possible, or the adjustment is not considered to be reasonable by the employer, then the job offer may need to be withdrawn.

It is important that an organisation ask the advice of medical/health professionals before turning down an individual for work on health grounds.

Summary

RTW is most successful if a clear return to work plan is agreed upon; the employer is willing to make adjustments to the person's job or working environment and all health-care workers involved with the patient communicate with each other .

Main Points


  • Be inclusive in your RTW process, by considering what injuried employees can or may be able to do, rather than what they cannot do.

  • It is important an employer can entertain reasonable adjustments recommended by an employees treating GP. Alternatively an employer must be ready to provide suitable alternatives to enable employees with MSDs to return to work, stay in work or access work.

  • There is strong evidence that return to work is most successful if it involves a partnership and understanding between employers, the worker and health-care professionals.

  • There is strong evidence that temporarily modified work can facilitate early return to work.



Diabetes Support Group Jun 15th, 2015



Centrals - Physical Activity Readiness Questionnaire Jun 11th, 2015
The following is a standardised Physical Activity Readiness Questionnaire. If you answer yes to any of the following questions it is strongly recommended you discuss your answers with your Doctor or a suitable health professional. 

Once completed you will be provided a link to continue the gym use process.



Centrals - After Hours Gym Safety Questionnaire Jun 11th, 2015

To confirm you have completed our gym safety induction please answer the following questions. 




Gym Program - Beginner 1 Jun 8th, 2015

Lunge



Half Pushup



Lat Pulldown



Seated Row



Bicep Curl



Tricep Pushdown



Lateral Dumbell Raise



Sidge Bridge



Bird Dog



 



Gym Program - Beginner 2 Jun 8th, 2015

Leg Press



Bench Press



Lat Pulldown



One Arm Row



Bicep Curl



Tricep Pushdown



Lateral Dumbell Raise



Sidge Bridge



Bird Dog



 



Medical Observer - Pharmacy’s $19b deal a ‘political’ move May 29th, 2015


This article was written by Flynn Murphy

DOCTORS and consumer groups say the government has folded to the pharmacy sector with a new $19 billion agreement that puts politics above patient care.

As general practice shoulders the burden of an MBS rebate freeze, the massive funding boost for pharmacies includes a doubling of the allocation for pharmacy-delivered primary care to $1.26 billion.

Health Minister Sussan Ley introduced the legislation on Wednesday, telling parliament the Sixth Community Pharmacy Agreement would let the sector “innovate and transition from a focus on medicines supply to medicines management and pharmacy services”.

As previously revealed by Medical Observer, wound care programs, staged supply of medicine for mental health, and basic arthritis checks are likely beneficiaries of $600 million in new and expanded pharmacy services.

No specifics have yet been announced. A $50 million Pharmacy Trial Program will be established to decide which of the services meet the cut, and new and existing programs will need to be approved by the Medical Services Advisory Committee (MSAC) to be funded.

Existing services like medication adherence and medication management programs, including clinical interventions, have been allocated $613 million.

That’s despite what RACGP head Dr Frank Jones says is a lack of evidence such programs have worked.

“We wrote a strongly worded letter to the minister [in March] suggesting that there was little evidence provided – at least publicly – that what pharmacists were doing was improving patient care,” Dr Jones said.

“After that there was not really much feedback; negotiations continued between the department, the minister and the pharmacists.”

Dr Jones said the government had “given in” to the pharmacy sector.

“Our views were very plain right from the start – we really wanted to know where these dollars were going to improve patient care.”

A Pharmacy Guild of Australia spokesman said pharmacy-delivered programs were evidence-based and he did not expect any of the current programs to be knocked out by the MSAC.

He ruled vaccination programs out of the process, saying they were paid for by patients rather than the government.

Dr Brian Morton, AMA chair of general practice, said it was “amazingly short-sighted and hypocritical to give such a massive handout to the pharmacists – specifically the massive handout for expanding their scope of practice and doing primary care”.

“It’s not the way to design a healthcare system. If you’re treating a minor wound, a pharmacist would have a direct conflict of interest – are they going to sell them the cheapest dressing? Or a particularly expensive one? An ointment that could be complementary?”

Dr Morton said the money should be spent on establishing a Practice Incentives Programme payment for GPs to employ non-dispensing pharmacists in their clinics.

“That’s where there will be significant returns to quality prescribing,” he said.

Dr Jones said the agreement was a “political decision” and questioned whether it was good scientific practice to hand out the money before a two-year pharmacy review had been carried out, particularly in light of a scathing audit report about the previous agreement.

“Why didn’t we look retrospectively at what’s happening to see whether we’re spending money sensibly, as opposed to doing it prospectively when the money’s actually been given to them?”

The Sixth Community Pharmacy Agreement is one plank of the government’s five year Pharmaceutical Benefits Scheme Access and Sustainability Package, which also includes an agreement with the Generic Medicines Industry Association.

An agreement with Medicines Australia will see drug manufacturers absorb around $6.6 billion in PBS cuts.

Medicines Australia CEO Tim James said: “In response to the government’s budgetary challenges, we have agreed to meet all of the government’s savings targets… Our members have been given a number of undertakings and concessions regarding any future price-related savings throughout the life of the agreement.”

Medicines Australia and the Pharmacy Guild had both rattled their sabres in the lead-up to the federal budget, but observers say the guild came out on top while the medicines body bore the brunt of the government’s quest for budget savings.

Consumers Health Forum head Leanne Wells welcomed the measures to bring down the prices of some drugs, to announce the listing of new drugs and the introduction of an optional $1 discount on prescription medicines – which is still being fought by the guild.

But she called the pharmacy agreement a “lost opportunity to drive reforms to loosen the grip of pharmacy owners on the anti-competition rules and provision of patient services”.


Australian Doctor - Diabetes Care Project fails on cost May 25th, 2015
This article was written by 

A three-year trial of capitation and pay-for-performance funding for GP diabetes care has shown they are much more expensive than the existing MBS items.  

The $34 million Diabetes Care Project program involved 184 general practices and 7781 patients with type 1 or type 2 diabetes and was meant to test alternatives to the current MBS items for chronic disease management.

While the trial - one of the biggest in Australian general practice - showed that new funding models improved HbA1c and other clinical outcomes, there was a higher overall cost of $203 per patient than existing Medicare item-based care.

The cost was so large that researchers said the funding model used in the trial would not be value for money.

The pilot of an enrolment-based ‘healthcare home' model replaced GP Medicare payments and care plans with a flexible funding model that included lump-sum payments per patient and funding for care co-ordinators.

When adopted by practices in Victoria, Queensland and SA, patients had a statistically significant 0.2% improvement in HbA1c compared with a control group.

Improvements were also seen in outcomes such as blood pressure, lipids and waist circumference, as well as for aspects of diabetes care such as care-plan take-up, completion of recommended ‘annual cycles of care,' and allied health practitioner visits.

However, the program that offered general practices flexible payments of $200-300 per diabetes patient would not be cost-effective if implemented on a wider scale, the evaluation report concluded.

Despite reducing hospitalisation costs by $461 per patient, the Diabetes Care Project had an estimated cost per QALY of $100,000 to $250,000, well below the threshold of $50,000 deemed necessary for cost-effectiveness.

The report authors said a diabetes co-ordinated care program might be cost-effective if funding was targeted more at the highest-risk patients.

Their analysis showed that more than 60% of costs were incurred by 5% of patients with complex needs.

They therefore recommended a ‘re-calibrated' program with funding of up to $700 for high-risk diabetes patients and $100 for low-risk patients.

Dr Gary Deed (pictured), a GP with a special interest in diabetes, said the modest changes in clinical outcomes were achieved at a high cost, and one of the main lessons from the Diabetes Care Project was the need to focus on the highest-risk patients with diabetes.

"The project didn't really address the frequent flyers, the highly complex patients and their risk stratification. So really, the study may be telling us that we need more evidence before we implement broad changes to funding models in diabetes care," he told Australian Doctor.

The evaluation report also showed that when implemented without the flexible funding component, the use of IT tools for care planning and Continuous Quality Improvement processes did not improve outcomes.

Federal Health Minister Sussan Ley said the findings from the Diabetes Care Project report would be considered by the Primary Health Care Advisory Group, whose remit was to develop innovative care and funding models for people with complex and chronic illness.

It would also be used to inform the National Diabetes Strategy, with the consultation period for the advisory group extended to 31 May to allow time for feedback on the Diabetes Care Project report.


Couch to 2k Initial Questions - HBF Geraldton RunFest Program May 21st, 2015
The following is a standardised Physical Activity Readiness Questionnaire. If you answer yes to any of the following questions it is strongly recommended you discuss your answers with your Doctor or a suitable health professional. 

On clicking the 'submit' button you will be provided a link to your running program and a brief clip on running technique. We are collecting a name and email address in the event that some form of correspondence is required.

Enjoy!



Do Patients Return to Sports and Work After Total Shoulder Replacement Surgery? May 21st, 2015

Total shoulder arthroplasty (TSA) is a well-established treatment option for degenerative pathologic abnormalities of the shoulder joint and has shown satisfactory long-term functional outcomes.

As life expectancy increases and shoulder replacement surgery is routinely performed in young and active patients with degenerative conditions as well as in the elderly population, new goals of shoulder joint replacement are becoming more important, such as the ability to resume sports and return to work.


The above study demonstrated a good rate of successful return to sports in patients undergoing TSA with primary glenohumeral arthritis. Overall, 57% of patients who had ever participated in sports in their lives were doing so at final follow-up. All patients that participated in sports right before surgery were successfully able to return.

The results for return to work were far less encouraging; however, it is important to note most of the study participants were retired at the time of follow-up.

While only 14% of patients were able to return to work after shoulder replacement surgery. Using statistical assumptions, the authors suggest the majority of participants (61%) did not retire or stop their work because of TSA.

30 patients (20%) had to change their work because of shoulder replacement surgery. Six patients (3.9%) of the entire cohort were not pursuing their work at the time of recent follow-up because of problems with the affected shoulders.

It is encouraging that a large proportion of patients did progress back to normal recreational activities following TSA, which would suggest that the RTW outcomes may also be more favourable in a younger, currently working population.


Couch to 2k - HBF Geraldton RunFest Program May 20th, 2015


Next Dietitian Talk Monday 25th May 2015 at 12 noon. May 18th, 2015

Temika Lee's next Dietitian Talk is on Monday 25th May, 12 noon at Central West Health & Rehabilitation in Geraldton. This talk is free for gym members and people who are completing Central West Health & Rehab's Diabetes Management and Chronic Disease Prevention programs.


This talk covers:



  • Healthy Eating Habits

  • Glycemic Index

  • Fat Types and Cholesterol

  • Recipe Modification Label Reading



Lumbar compression forces while lifting and carrying May 12th, 2015
In the construction industry, lifting loads is a frequent occurrence. Manual material handling (MMH), in terms of lifting is associated with an increased incidence of work-related back disorders.

To prevent work-related back disorders as a result of lifting, the maximum load mass to be lifted by one worker has been set at 25 kg in the Netherlands, and the maximum load for manually lifting is set at 50 kg when lifted by two workers. Loads above 50 kg should always be lifted mechanically (Visser et al, 2015). However, mechanical transportation is not always feasible and when not available the loads should be lifted by more workers (team lifting), while not exceeding 25 kg per worker.


The above study examined the lumbar compression forces of handling loads, which occurs daily at construction sites. It was found that a 50-kg two-worker lift resulted in higher mean and maximum peak lumbar compression forces compared with a 100-kg four-worker lift.

Carrying a load while stepping over an obstacle resulted in higher mean and maximum peak lumbar compression forces compared with carrying on level ground. The variability of the peak lumbar compression forces during the carrying tasks was higher while stepping over an obstacle compared to carrying on level ground for carrying 50-kg and 100-kg loads.

Compared to lifting, carrying a 100-kg load while stepping over an obstacle or up a platform led to a higher variability. Carrying a load up a platform resulted in the highest compression forces.

To reduce peak lumbar compression forces, lifting a fixed load mass with additional workers is advised. However, the benefits of additional workers are task-dependent (e.g., carrying vs. lifting). Additionally, the question remains whether the use of an additional worker is feasible in practice.

Two overall recommendations were made:


  1. Efforts should be made to prevent manual lifting and carrying of objects to reduce exposure of high compression forces during lifting and carrying.

  2. When mechanical transportation is not possible and loads are handled manually, carrying routes should be free of any obstacles to be overcome.




Australian Doctor - Diabetes Strategy urges GP payment overhaul Apr 15th, 2015
This appeared in todays Australian Doctor written by Michael Woodhead.

Pay-for-performance incentives that would see GPs paid on the basis of how many patients they screen and treat for diabetes form a central plank of a new national diabetes strategy.

The National Diabetes Strategy consultation paper states that fee-for-service payments are not working for diabetes and should be supplemented by payments based on quality and outcomes measures.

The Federal Government's paper, released on Wednesday, lays out five key target areas for change, which include:

- increasing the number of people who are screened and diagnosed early with diabetes

- boosting the number of patients with diabetes receiving structured management programs in primary care

It notes that currently only 18% of patients with diabetes had an annual cycle of care completed by a GP, and suggested that this could be improved by linking performance benchmarks to reimbursement

"The fee-for-service model does not incentivise long-term follow-up or the proactive care of people with chronic conditions. As such, more innovative funding models are needed that combine fee-for-service reimbursement with other payment types, such as population-based payments and quality-based payments," the consultation paper said.

"The government could consider exploring (potentially through demonstration projects) an innovative combination of payment models, such as pooled funds, ‘medical homes,' capitation payments, pay for performance, and pay for quality and outcomes based on performance indicators."

The paper also suggests new funding models for allied health professionals.

Among the other proposals are a national program for detecting prediabetes and early diabetes based on the AUSDRISK tools, and programs based in Primary Health Networks to encourage annual screening for complications

The National Diabetes Strategy should also include measures to improve access to medications and devices such as insulin pumps, and encourage uptake of the PCEHR by people with diabetes, the consultation paper suggests.

The proposals have been released by the National Diabetes Strategy Advisory group, set up by former health minister Peter Dutton in 2013, which is led by endocrinologist Professor Paul Zimmet and former MP Judi Moylan.

It is accepting feedback on the proposals until 17 May and will release a final National Diabetes Strategy in late 2015.

The proposals have been backed by RACGP resident Dr Frank Jones, who said they were in line with the college's newly released new primary healthcare funding model that proposes a move away from fee-for service funding.

"[The Diabetes Strategy proposal] basically reinforces our viewpoint that you can't look after patients with chronic disease with the Medicare model that we have," he told Australian Doctor.

Dr Jones said the RACGP model would retain fee for service for acute episodic care, but would introduce patient enrolment and replace PIP and SIP incentives with practitioner and practice-directed loading payments based on "comprehensiveness" and complexity of care.

The new reimbursement would recognise the ongoing work that GPs did with patients such as those with chronic and complex diseases, according to Dr Jones.

"We really believe that GPs who provide quality care ought to be recognised," he said.


Pacing your Lifestyle and Exercise Apr 14th, 2015
“Pacing is an active self-management strategy whereby individuals develop self-efficacy through learning to balance time spent on activity and rest for the purpose of achieving increased function.”

Jamieson-Lega et al (2013)


Pacing involves learning to balance your time spent on exercise and activities, to avoid overactivity or underactivity. It is about being able to manage your chronic pain more effectively, to achieve a balance between rest and activity. This enables you to perform meaningful activities with less pain interference.

When you start an exercise program, you may struggle to adopt the right pace and technique in developing your fitness training. As a result, exercise can feel like a struggle. If you’ve experienced difficulty sticking with your exercise regime, the problem is likely to be one of pacing judgment and intensity:

a) Starting your exercise too quickly and paying the price later on

b) Completing sessions too conservatively and feeling you’ve got a lot more left in the tank

The solution is learning how to evaluate your training intensity and match it to your session so that you get maximum training benefits — and importantly, enjoy your training sessions.

“After having a serious illness a few years ago, and not being able to exercise without pain, I was unsure of how to begin an exercise plan without making my symptoms worse. I then realized that if I paced myself, I might be able to exercise successfully without the symptoms getting worse. I changed my thought processes from trying to lose weight and getting fit, to relieving the symptoms of my chronic pain. I started at a very slow pace, not pushing myself at all, a pace that I could do on my worst days, and then as it became easier, with no pain I increased the pace of my exercise program” Anonymous

Rhianne Turner Physiotherapist


 


 



Pacing your Lifestyle Apr 14th, 2015
“Pacing and balancing tasks become skills that can assist with managing chronic pain”

It is important to prioritise activities so that the most important tasks get done first. This way if you are unable to finish every task, then at least the most important tasks are done. Also, try to leave yourself plenty of time to complete each task. Pacing your lifestyle will provide you with an effective means of achieving your goal, provided you are realistic in choosing the priorities in your life.

Performing one major task in small steps each day can lead to feelings of achievement and build your coping strategies. This will take time and patience. Try not to compare yourself to what you used to be able to achieve before the onset of chronic pain, this may not be realistic initially.

Following a routine of less pleasurable activities/chores followed by enjoyable activities can also assist in the pacing process, rewarding yourself for your achievements.

WHAT TO AVOID

Chronic pain commonly leads to ‘Good days and Bad days’. It is important not to use good days for going hard at physical activity – as you will surely feel those bad days and need some time to rest and recover.

An increase in muscle pain is to be expected as you are using muscles and joints in new ways, known as Exercise Induced Muscle Soreness (EIMS).

Boom – Bust Approach is when a person does too much all at once, crashes, rests, starts to feel better and does too much once again. If activities or exercises are not spread out, a boom-bust cycle will occur. At times this may be inevitable; however when Boom-Bust approaches become habitual it can result in exhaustion, sleep disturbances, insomnia, appetite and weight changes, or mood swings. You should learn to recognise contributors such as fear avoidance, attitudes and beliefs.

Watch out for Boom-Bust signs as they can significantly increase pain levels, such as:

a) being highly motivated to achieve your goal that you significantly increase pain levels

b) being apprehensive about what may happen if things don’t get done

c) having a high number of commitments or responsibilities to meet


10 TIPS FOR SUCCESSFUL PACING

  1. Be consistent. Be persistent. Be patient with yourself.

  2. Choose something you enjoy

  3. Have a realistic timeframe, gradually making the activity harder and changing the environment (from walking on level ground to walking uphill or on the beach)

  4. Pace your activities, even on bad days (avoid good day, bad day behaviour)

  5. Have rest periods

  6. Listen to your Body: The body sends us signs and signals when it is being overworked, so it is important to balance rest and activity

  7. Stick to your designated time limit: use a timer and be disciplined in starting and stopping activities

  8. Use a diary to record your progress so you can pace accordingly and measure your achievements

  9. Avoid too large of an increase in activity to avoid a ‘Boom-Bust’ approach to exercise

  10. To improve your pacing, undertake a little more each week, gradually building up physical activity over time. It is important to set SMART goals to pace yourself so that these realistic goals can be met




Rhianne Turner Physiotherapist



Infographic- SMART Goals Apr 14th, 2015



Insurers won’t run PHNs Apr 13th, 2015
This article appeared in Medical Observer written by Julie Lambert

PRIVATE health insurers will not take roles in running new Primary Health Networks despite reports describing them as partners in successful PHN consortiums.

Health Minister Sussan Ley (pictured) on Saturday announced the successful tenderers for 28 of the 31 PHNs, which are to replace Labor’s 60 Medicare Locals as of 1 July.

Ms Ley’s media release said many of the successful PHNs were “consortiums harnessing the best skills and knowledge from a range of sources, including allied health providers, universities, private health insurers and some of the more successful former Medicare Locals”.

Adding to the impression that the insurers had managed something of a coup, a weekend news report said the Abbott government had “handed control” to a range of groups including the two major health insurers HCF and Bupa.

Giving a specific example, the News Ltd report said the North Brisbane PHN would be “run” by Metro North Brisbane Medicare Local (MNBML), together with Metro North Hospital and Health Service, Children’s Health Queensland Hospital and Health Service, Telstra Health, AMA Queensland, UnitingCare Health, and the two insurers.

However, Medical Observer has confirmed that only four of the 28 successful bids had any involvement with private health insurers, and their roles are strictly as support players.

MNBML CEO Abbe Anderson said HCF and BUPA were just two of many groups that had backed the successful application from her organisation.

“While MNBML has the support of a wide range of key participants – including those listed – I think we had over 30 organisations that provided us with letters of support and endorsement in our application,” Ms Anderson toldMedical Observer.

“But the PHN itself will be governed and managed by the same organisation that has been running the ML since its inception.

That organisation – Partners 4 Health, the registered trading name of MNBML – has been in place for four years and is very much a “grassroots” outfit, she said.  

“It has a local membership structure of over 20 organisations, all of which represent local clinicians and community groups, and that will be complemented by the formation of new clinical councils and community adviser groups,” Ms Anderson said.

She said private insurers shared the same imperatives as hospitals and primary care groups - trying to keeping people well and out of hospitals - adding they were in conversation “about the types or program we want to see".

“In our experience, private health insurers are very willing to look at chronic disease programs that benefit everyone, that aren’t just aimed at their members,” she said.

But Ms Anderson did not see any risk of a push for preferential treatment of private health fund members.

“I honestly see everyone working very collaboratively together, and I guess that’s one of the key reasons why we need the voices of GPs and other clinicians in the planning of these models, to ensure we don’t end up with systems that somebody will lose out on.”

Dr Marcus Tan, a director of WA Primary Health Alliance, which has landed contracts for three WA PHNs, said his organisation saw a similar need to take “a very collaborative approach” including input from the same two insurers.

“This is recognition of the need for an integrated healthcare system to have government, non-government and private involvement,” he said.

“The private health insurers have signalled their interest in chronic care, for example – but they are not formally part of the organisation.”

The Alliance was formed from Perth Central & East Metro ML, Goldfields-Midwest ML, Perth South Coastal ML and Fremantle ML, with endorsement from Bupa and HCF among others.

Dr Tan said he thought the Perth North, Perth South and Country WA PHNs would make the 1 July start date because much of the established resources and infrastructure of the Medicare Locals would be transitioned into the new networks.

In Victoria, the Grampians and Barwon South West PHN was also named as having a private health-fund partner aboard.  

But Jason Trethowan, CEO of Barwon Medicare Local, which will manage the new PHN covering western Victoria, said the association with locally based private health insurer GMHBA was entirely without conflict.

“Our Medicare Local is the company that will change its name and constitution to establish the PHN for western Victoria,” Mr Trethowan said, adding GMHBA and the four local hospital networks would all be critical in the rollout.

“But there’s no deals, no role in governance, no seats on boards, no interference with the running of the PHN,” he said.

“Where there are areas where [GMHBA] can support us or work with us, then we would do so.

“It was important in our submission to show we had a strong buy-on from Deakin University, four major hospital networks and also a health fund that has most of its members in our footprint.”

South Eastern NSW PHN is the fourth new entity identified by the minister’s office as having private-insurer backing.

The managing organisation is Coordinare Limited, formed by the Illawarra Shoalhaven ML, supported by the University of Wollongong and Peoplecare, a member-owned, not-for-profit health fund based in Wollongong. 


Australian Doctor - Axed preventive health program showed promise Apr 2nd, 2015
This appeared in todays Australian Doctor written by 

Australia’s national preventive health program was showing promising results before it was scrapped in last year’s budget, according to a belatedly released Department of Health report.

The National Partnership Agreement on Preventative Health (NPAPH) was introduced as a COAG initiative under Labor in 2008 with programs to reduce smoking rates, combat excess alcohol intake, boost physical activity and improve diet.

The Coalition axed the program in the 2014 federal budget and diverted the savings of $368 million over four years to the Medical Research Future Fund.

However, an independent evaluation report released under a Freedom of Information request showed that six months before the partnership agreement was abandoned, the government was told the program "appears to be a sound, evidence-based and highly appropriate investment in preventive health".

"Overall, approaches have been based on effective health promotion principles and best-available evidence, and there is a judicious mix of innovative and evidence-based strategy," the report authors said.

"Available evidence indicates that implementation is on track, and that some states and territories are achieving a good level of reach into target groups."

The programs funded by the NPAPH included the Healthy Children Initiative, the Healthy Workers initiative, the Measure Up campaign, the National Tobacco campaign, and the Healthy Communities Initiative.

The report was finalised in January 2014, when the future of the NPAPH still looked bright.

"While it is too early to reach conclusions on the likely extent that the NPAPH will achieve its longer term outcomes ... the current evidence of reasonably effective partnership processes and successful implementation of initiatives indicates that considerable progress is being made in the right direction," it concluded.

This week, 11 peak health groups raised concerns about the axing of a wide range of preventive health programs.

"We are particularly concerned about the future of the Close the Gap Indigenous Chronic Disease package, which aims to prevent chronic disease including GP services, medications and tackling smoking. The new Primary Health Networks will not be able to pick these critical programs up as they have barely been established yet," said Lisa Briggs, CEO of the National Aboriginal Community Controlled Health Organisation.

Federal Minister for Health Sussan Ley could not be reached for comment.


Realising the Health Benefits of Work for all Australians Mar 31st, 2015
Realising the health benefits of work for all Australians requires a paradigm shift in thinking and practice. It necessitates cooperation between many stakeholders, including government, employers, unions, insurance companies, legal practitioners, advocacy groups, and the medical, nursing and allied health professions.

The family doctor is best placed to advise and educate patients that, in most cases, a focus on return to work is in the best interest of the patient – for both their future and quality of life and that of their family.

Return to work is not possible for everyone, but certifying time off work – particularly when absence is long term – can have significant side effects, including increased rates of overall mortality, poorer physical health and poorer mental health and psychological wellbeing.

The following document is a consensus statement from the Australian Faculty of Occupational and Environmental Medicine. It highlights the importance of a trusted GP in assisting employee's to return to work.


Despite all of the above, research continues to show that many GPs are unlikely to recommend alternate duties for injured workers, and many GP’s who suggest a ‘special interest’ don’t always follow these best practice guidelines.

I hope that the above highlights the significant benefits to be gained from offering employees a 'trusted' GP and Injury Management Service.

 



Reassuring Employees About Low Back Pain Mar 28th, 2015
Back pain is one of the most commonly encountered conditions in Australian workplaces.

In the 2012-2013 Australian Workers Compensation Statistics 22% of serious claims were due to back pain and some 33% of serious claims were caused by muscular strain while lifting or handling objects.

Despite trends showing increasing use of advanced imaging tests, opioids, and invasive surgical and interventional procedures, with attendant increases in costs, the prevalence and burdens associated with back pain appear to be on the rise.

In fact, there is growing evidence that those who suggest a ‘special interest’ in managing back pain often provide less appropriate treatment recommendations. These providers often hold alternative beliefs regarding the association of pain and activity that influence their practice behaviour.

For example, the presence of common degenerative findings on spinal imaging poorly correlates with the presence of and severity of back pain or the likelihood of developing chronic disabling symptoms. Rather, predictors of chronicity are primarily psychosocial.

For this reason back pain is best understood as a complex biopsychosocial condition. Many other factors besides the employee's medical condition (e.g. acute back pain) affect outcomes– e.g. organizational, work-environmental, and social.

Most acute back pain improves substantially within the first 4 weeks. However, a small proportion of patients with acute back pain go on to develop chronic disabling symptoms. Such patients often are refractory to treatments and account for the majority of the costs associated with back pain. Preventing the transition from acute to chronic low back pain is therefore an important goal of current evaluation and management strategies.


The above paper provides a 2 page summary of evidence regards how best to approach the employee with acute back pain to alleviate patient worries and fears. This along with evidence based acute injury management assist in preventing the transition from acute to chronic low back pain.



Medical Observer - Better use of healthcare professionals is vital for a sustainable Medicare Mar 28th, 2015
WHILE welcoming the Abbott government’s abandonment of the GP co-payment, to ensure a sustainable Medicare system the Australian Physiotherapy Association (APA) would like to see an improvement to the use and scope of practice of existing healthcare professionals.

Removing barriers to physiotherapists referring patients directly to medical specialists with a Medicare rebate, instead of requiring a GP referral, would achieve better patient-centred care, as well as over $13 million in savings to Medicare each year. This would also reduce out-of-pocket payments for patients by more than $2 million per year.

Other sustainable measures that would improve healthcare for patients and save money include: 



  • Physiotherapists leading screening clinics to triage surgery patients. 

  • Better supporting advanced scope physiotherapists in emergency departments to deal with patients with simple but urgent musculoskeletal injuries that are currently contributing to the burden on ED doctors. This has been shown to reduce patient waits, and helps move patients out of hospital more quickly.

  • Enabling physiotherapists with additional qualifications and endorsement to prescribe medications within their scope of practice. The Medicare co-payment would have made access to primary care even more difficult for people who could least afford it.



The APA’s solution to improve the use of physiotherapists who are highly qualified and experienced primary health professionals to undertake these practices will ensure better patient-centred care and relieve pressure on the healthcare system.

The APA’s pre-budget submission for 2015–16 details APA’s recommendations on the referral to specialist issue. It is available online Click here.

The APA is the peak body representing the interests of Australian physiotherapists and their patients. It is a national organisation.

Cris Massis is CEO of the Australian Physiotherapy Association.



Many Reap Rewards in Wellness at Work! Mar 27th, 2015
Australia’s working population is becoming sedentary and workers are being asked to put off retirement and work longer hours.

TWO out of every three Australian adults have at least three or more risk factors for cardiovascular disease, diabetes and chronic kidney disease, according to a new AIHW report.

Employees with a cluster of seven heart disease risk factors have an average annual cost of ~$2640.00 more than employees with no modifiable risk factors.

Employers have a choice, proactively promote health promotion programs or expect to pay more in direct and indirect health related costs.

Workers spend a large proportion of their waking lives at the workplace and are a captive audience for any health promotion intervention.

We recognise that you, the employer, have extensive experience in ensuring the wellbeing and health of your staff. However there are times when it could be helpful to access the insight and expertise of a trusted partner to tailor services to your organisation and employee's needs.


Click to download copy

Our team of allied health professionals from a wide range of backgrounds give the perfect know-how and skills base to provide such an intervention in a proficient and energetic manner.


Medical Observer - Nine reasons why Australia needs to improve preventive health! Mar 25th, 2015
This appeared in today's Medical Observer, Written by Ruby Prosser Scully

TWO out of every three Australian adults have at least three or more risk factors for cardiovascular disease, diabetes and chronic kidney disease, according to a new AIHW report.

Multiple risk factors were also prevalent among Australians who already had one of the conditions. 

“For people with diabetes, nearly all adults (94%) had three or more risk factors, and for CVD and CKD, 84% and 77%, respectively, had three or more risk factors,” AIHW spokesperson Sushma Mathur said.

NINE FACTORS FOR ILL HEALTH

1. Just under a third of all adults have hypertension (including 22% with uncontrolled hypertension).

2. Almost two-thirds are overweight or obese, and 3% have impaired fasting glucose. 

3. Over half the population is not active at all or insufficiently active. 

4. One in six people smoke daily and one in five surpass guidelines for lifetime alcohol risk. 

5. A third of Australian adults have high LDL-cholesterol, and 63% have dyslipidaemia.

6. People with cardiovascular disease are more likely to have uncontrolled hypertension (2.1 times), be overweight or obese (1.3 times), have dyslipidaemia (1.3 times) and be inactive or insufficiently active (1.2 times) than those without CVD.

7. Almost all adults (95%) do not eat the daily recommended two serves of fruit and five serves of vegetables.

8. People with type 2 diabetes are twice as likely to have uncontrolled hypertension, be overweight or obese (1.5 times), and have uncontrolled dyslipidaemia (1.2 times) than adults without the disease.

9. People with CKD are more likely to have uncontrolled hypertension (1.9 times), or have blood glucose levels ≥6.1 mmol/L (2.8 times) than adults without CKD.

 



Australian Doctor - Legal fallout follows hike in bariatric surgery Mar 23rd, 2015
 This article, written by 

The rise in bariatric surgery has seen it become a 'medicolegal hotspot' with many patients harbouring unrealistic expectations and little understanding of the high complication rates for the procedure.

The majority of claims now being made focused on informed consent, negligent performance of the surgery and inadequate post-management and follow-up, Janine McIlwraith (pictured), principal lawyer at Slater and Gordon, told last week's Medico Legal Congress in Sydney.

Patients also needed to know the surgery was "not a panacea and just part of a solution to weight loss", she said.

"They need to be committed to lifestyle modifications after surgery, and they need to be aware of complications and their frequency."

Patients tended to be well-educated and financially well-off but expected unrealistic outcomes, so consent procedures needed to be robust, she said.

The number of procedures has increased dramatically - from just 500 in 1998/99 to over 17,000 in 2008/9. About four in 10 procedures resulted in complications, Ms McIlwraith said.

A Medical Services Advisory Committee report in 2012 said bariatric surgery should be performed as part of a multidisciplinary effort to improve long-term outcomes.

However, very few patients were receiving that kind of care, Ms McIlwraith said, with most patients visiting solo practitioners.

The spike in claim numbers for bariatric surgery could simply be the result of a rise in procedure rates, she said, "but there may be other causes worth investigating".


For successful RTW timing is everything! Mar 21st, 2015
Evidence suggests the longer the delay to rehabilitation and RTW planning following a workplace injury, the smaller the chances of a successful return to work outcome become. The following posts continue our focus on providing information to allow injury management co-ordinators to feel comfortable taking greater control of RTW processes.

DELAYS IN COMMENCING WORKPLACE BASED RETURN TO WORK

AIA Australia is a life insurance specialist trusted to protect more than 2.5 million Australian lives. AIA Australia is committed to helping people improve their health and therefore is a strong believer in workplace rehabilitation and the power it has, where health conditions permit, in getting people back to work – and therefore a full life – faster.

In August 2013 AIA produced a paper titled “A critical equation: balancing Australian worker health and company wealth” that noted in terms of physical conditions, as the number of days off work increases, the chances of successful return to work significantly decreases:


These are fairly sobering figures and are cause for alarm given a number of employers continue to take a ‘return when you are fully fit attitude’ to work related illness and injury.

WHY ARE DELAYS AN ISSUE?

Work is a determinant of health, both physical and psychological.  The longer a person is away from work for an unplanned (or unmanaged) absence the more their health can potentially suffer.

Comcare engaged a consultant to conduct research into delays in providing rehabilitation or return to work assistance for their injured employees, after they identified a trend for employees injured at work to stay off work for long periods (6-12 weeks in majoity of cases)

The results were published in the paper “BODY STRESSING INJURIES: Key messages for rehabilitation providers”.  One of the things the Consultant found in their analysis was in most cases, RTW assistance was not provided until after the normal recovery period for the injury.  Consequently by the time assistance was offered it was often no longer appropriate.

The issue here is once a body stressing injury progresses beyond 12 weeks of incapacity it becomes a ‘chronic’ injury that is much harder to manage and rehabilitate due to numerous psychosocial issues.  Equally with psychological injury claims there is often deterioration in the person’s mental status the longer they are away from work.

Amongst other findings, this report promoted that early recovery and return to work involves effective management of an injured employee by their employer and needs to commence as soon as practicable after the injury occurs and preferably before any claim for compensation is made.



Timing in RTW is everthing - What Next Mar 21st, 2015
Following on from the AIA paper, evidence from industry experts overwhelmingly supports early rehabilitation and RTW programs are a winning combination for all involved. 

Concord General Hospital, Sydney is a self insurer, who in 2003-4 found themselves with a huge number of open claims (~300), and a spate of very difficult cases who went on to have chronic pain syndromes. The organisation felt they were failing injured workers and that something needed to change.

After significant internal investigation, the consensus was that the first 4 weeks after an incident/injury was the answer, – after that you start to lose control! They instigated a rapid assessment and early intervention process, which included an assessment psychosocial risk (i.e. Yellow Flags). The idea was that high risk individuals needed to be identified in the first week/s. Nothing different needed to be done; only it needed to be done earlier. It was also important that a trusted GP was in control of the whole process through consultation and approval.

Along with aggressive acute injury/illness management, return to work planning for high risk individuals was commenced from the day of injury in the form of planning, discussion and communication between injury management co-ordinators, health professionals (GP and Physiotherapist) and employee supervisors.


Key Points of Concord Case Study:


  1. There is a significant difference between the 20% in the “high risk” category and the other 80% who manage pretty well with ‘usual care’.

  2. Psychosocial risk factors (i.e. ‘Yellow Flags’) predict the cost of a workers compensation claim within 48 hours regardless of what or where the injury occurs.

  3. The provision of an early and aggressive assessment and intervention, lead by a trusted GP can reduce costs in high risk claims.






Video - Diabetes Australia Healthy Eating Mar 20th, 2015



High Performance Jump Program Mar 10th, 2015
 

Day- Tuesday

Location – Central West Health and Rehab

Time – 4:00pm

Training focus – Jump Strength

Maximal strength determines jumping height. When trying to improve jump height athletes should focus on maximising strength development.

 

Day – Friday

Location – Central West Health and Rehab

Time – 4:00pm

Training focus – Jump Plyometrics

Plyometrics include performance of various types of body weight jumping-type exercise, like drop jumps (DJs), countermovement jumps (CMJs), alternate-leg bounding, hopping and other SSC jumping exercises. Plyometrics are a powerful tool for improving jumping performance.


Start Date: Tuesday; 21st of April 2015

Click for Registration Form


Payment required at initial physical assessment


Registration Form Mar 10th, 2015



Infographic - Calories Burned in 10 minutes! Mar 9th, 2015



Dietitian - 3 Day Food Diary Mar 9th, 2015



Test - Google Forms Mar 8th, 2015

This post is a test run of embedded Google Form data in News Post.




Medical Observer - Allied health keeps patients out of hospital Mar 7th, 2015

6th Mar 2015

Declan Bowring

STROKE, diabetes and osteoarthritis patients could avoid unnecessary hospital treatment with greater investment in allied health professionals, a new report says.

The report, produced for Services for Australian Rural and Remote Allied Health (SARRAH), found evidence that hip and knee replacements and diabetic limb amputations could be avoided and thousands of hospital beds freed up with targeted care by allied health teams.

“This report the first of its kind in Australia, has demonstrated the huge cost savings and patient benefits that Australia could achieve,” SARRAH CEO Rod Wellington said.

“It exposes the myth that allied health is an optional extra in healthcare.”

The report cited cases including:



  • A 64% drop in diabetic limb amputations and a 24% decrease in hospital stays after treatment by podiatrists under the Queensland Diabetic Foot Innovation project.

  • A 15-month reduction in the waiting list for joint replacement surgery at Melbourne’s Alfred hospital after triaging by physiotherapists.

  • Fifteen per cent of osteoarthritis patients removed from the joint-replacement waiting list at a Sydney hospital after treatment by a multidisciplinary team. 

  • A 37% prevention rate in the incidence of diabetes among 2241 high-risk participants in eight international trials after intervention by dietitians, physiotherapists and exercise physiologists.

  • Stroke care focusing on speech pathology in the NSW Illawarra region prevented 45 emergency presentations, 49 hospital admissions, 188 readmissions and saved 2808 bed days.



The report emphasised the value of physiotherapists, occupational therapists and speech pathologists in improving the function and independence of stroke patients.

Executive officer of Allied Health Professions Australia, Lin Oke, said affordability was a problem, noting Medicare Chronic Disease Management rebates for allied health services were “extremely limited”.

“The rebate of approximately $50 is based on a 20-minute service, regardless of the required length of the appointment with the allied health professional,” Ms Oke said.

“So many Australians just cannot afford the services which would keep them away from hospitals and surgical procedures.”

The report found a significant lack of access to allied health for rural patients, with only 14% of registered allied health professionals working in rural areas. 

More than 1000 deaths from diabetes in rural areas could have been prevented if the mortality rate matched that of urban areas. In very remote areas, diabetes was the second-highest cause of death.

Independent MP for Denison, Andrew Wilkie, used the report’s findings to blast the Tasmanian government for cutting allied health staff in the state.

“To sack these vital front-line workers who can get people home from hospital sooner and prevent elective surgery is complete madness,” Mr Wilkie said.

“These workers are worth their weight in gold because they save hospitals money.”

 


 

 


Infographic - Coffee Vs Tea, What is healthier? Mar 4th, 2015



Medical Observer - We’re not all the same Feb 26th, 2015


‘One size fits all’ is doomed to failure, so weight loss strategies must be tailored.

IN THE classic 1979 Monty Python movie, The Life of Brian, the lead character, Brian, tells the swarming masses, “You’re all individuals”, to which the group responds as one, “Yes, we’re all individuals”.

The fact is, we are indeed all individuals and respond differently to different pharmaceutical and lifestyle prescriptions —  weight loss being a great example.

But does this mean we need a separate program for all three million overweight or obese adult Australians? And if not, how do we individualise without over-individualising?

The first law of thermodynamics states that energy is neither gained nor lost, it just changes form.

We’re told that this is immutable. And yet change the energy balance (food in/exercise out) of 1000 people in exactly the same way and you’ll get a variation in weight loss from nothing to more than the loss predicted through any calorific formula. The question is, why?

The simple answer is that the first law is based on a physics formula, which is linear (e.g. weight = energy in — energy out).

This only works approximately in a biological system.

COUNTING CALORIES

Feedback in a living organism, such as through changes in metabolic rate, hunger levels and a range of other factors, makes generic lifestyle prescriptions such as diet and exercise, just that — generic, with huge variations around the mean.

The implications of this are profound: “A calorie is no longer a calorie.”

As the actual value of heat energy can be influenced differently by feedback in individuals, any attempt to prescribe or measure weight gain or loss by counting calories is bound to be flawed.

Using a systems theory model can complicate the issue but may be necessary.

OBESITY DRIVERS

In the UK, the Foresight Commission, a body set up to examine the future, published a complex diagram of known drivers of obesity1 which has come to be used by obesity lecturers around the world to draw a laugh. You can see it at http://www.foresight.gov.uk/Obesity/12.pdf.

Prescribing a set diet and exercise program alone to help a patient lose weight may work brilliantly for some, for whom these are the immediate divers, but it may not work at all for others.

What’s the alternative? Ultimately, a computer program including genetic analysis might reduce the variability in response. But this is some way off. So what to do in the meantime?

PERSONALITY TYPE

American obesity researcher and clinician Dr Robert Kushner has had a crack at this by looking at different personality types based on types of eaters, exercisers and stress managers.

In his book, Dr Kushner’s Personality Type Diet2 — which would normally be discarded as a ‘fad’ book on the basis of its title — Kushner developed a screening system to categorise people into six different types of eaters, exercisers and stress responders.

Kushner’s eating personality types are classified in such non-scientific categories as ‘unguided grazer’, ‘night-time nibbler’, ‘convenient consumer’, ‘fruitless feaster’, ‘mindless muncher’ and so on. Despite the appeal to a public audience, each does have some scientific basis, which is added to by Kushner’s respectability as a world-class obesity researcher.

TAILORED STRATEGIES

Breaking the weight loss responder into different groups like this, according to Kushner, can help increase the prospects of success on a weight loss program.

This is not rocket science — yet! But individual targeting in prescription, just as in marketing of consumer products, points to the way of the future.

A good clinician might do this intuitively but the increasing complexities of the modern world make it more and more difficult to do so.

Kushner’s approach is a possible way of narrowing down the individual differences in weight loss response.

But, given that there are a number of other drivers that can influence lifestyle, including sleep, the environment and relationships, don’t expect any major breakthroughs in the clinical response to weight loss. 

 



Next Dietitian Talk Friday 6th March 2015 Feb 23rd, 2015

Catherine Dumont's next Dietitian Talk is on Friday 6th March, 12 noon at Central West Health & Rehabilitation in Geraldton. This talk is free for gym members and people who are completing Central West Health & Rehab's Diabetes Management and Chronic Disease Prevention programs.


This talk covers:



  • Healthy Eating Habits

  • Glycemic Index

  • Fat Types and Cholesterol

  • Recipe Modification Label Reading



A 'Real and Substantial' Connection to Employment Feb 21st, 2015

Kathleen Kay v Woolworths Limited [2014] NSWWCC 365 (1 October 2014)


In the following case, a Woolworths Customer Services Manager, who worked predominately daytime and afternoon shifts, bought proceedings to the NSW Arbitrator. She suggested that the insurer’s decision to reject her claim was inappropriate as while her injuries did not happen at work, they were ‘substantially connected’ to her employment.

On the week of the workers accident, the shop’s floors were being stripped and resealed by cleaners. The works took place overnight, and required a manger to be present. In the afternoon of Wednesday 17 October 2012, the worker was told by her employer that she was required to work the following Thursday night to supervise the cleaners. The worker was unable to sleep before the shift due to a dentist appointment.

Upon completion of her shift at 8am on Friday, the worker had been awake for over 24 hours. On her journey home, she fell asleep at the wheel, causing her to veer onto the wrong side of the road and collide with an oncoming vehicle.

The medical evidence confirmed sleep deprivation was as a significant causal factor in the accident. The worker subsequently made a claim for workers compensation, which was declined by the insurer on the basis that there was no ‘real and substantial’ connection between her employment and the accident.


Considering a case where it was held that a ‘real and substantial’ connection does not necessarily require a worker’s employment to have caused the accident, the Arbitrator rejected the insurer’s submissions, and held that the worker satisfied the requirement set out in section 10(3A).

The Arbitrator highlighted that this section merely requires that there be a ‘real and substantial’ connection between the employment and the accident; meaning that there can be several factors involved.

The worker was required by her employer, at short notice, to complete the night shift. Her inability to properly prepare herself physically and mentally beforehand meant she was sleep deprived, which the Arbitrator accepted to be a significant factor in her accident.

Importantly, the Arbitrator held that in the circumstances, the worker’s risk of injury “was not outside the control of the employer.” The employer did not conduct any risk assessment as to whether it was safe for the worker to work the night shift, at short notice, without any substantial prior experience working the shift, and without having slept beforehand.

It was held that the employer, despite observing the worker’s tiredness at the completion of her shift, failed to determine how much sleep the worker had gotten in the preceding 24 hours. Arbitrator suggested that the employer, in order to avoid the risk, could have simply asked how the worker was feeling and offered the worker a taxi voucher.


Mal Chronique - Chronic Pain and Exercise; Evidence and Benefits Feb 19th, 2015
click to enlarge

Chronic pain involves symptoms of prolonged pain and fatigue, leading to an inactive lifestyle. However being inactive can increase your levels of pain and fatigue, leading to deconditioning of the body. Deconditioning can make you more prone to injury and put you at risk of more severe health problems.

Breaking the pain cycle can be difficult, especially if your body has been in pain for quite some time. Sometimes people feel their attempts at exercise cause more pain and lead to flare ups, avoiding exercise and turning to rest. Even if there is discomfort in the beginning, retraining your body and remaining active will be beneficial for your health and wellbeing in the long term. 

Best Evidence for Chronic Pain and Exercise

Exercise works best when delivered as part of a multi-factorial approach. This includes sound knowledge and education about your condition, physical activity and the pain experience. The body and mind love movement, where gradually becoming more active is essential for treating and managing chronic pain.  Recent evidence shows people with chronic pain reported moderate exercise decreases pain, fatigue, stress and symptoms. It also improved perceptions of health, physical function and aerobic fitness. Other studies have shown low intensity exercises such as walking and pool exercises improved joint and muscle pain, improving the ability to carry out daily activities.


Exercise-induced Hypoalgesia

Recent studies have shown exercise inhibits descending pathways. Descending pathways can inhibit or facilitate transmission of noxious (painful) information, and are therefore of major importance in pain modulation. Studies demonstrate a reduction in pain sensitivity during and following exercise, in both the healthy and chronic pain population.

Aerobic exercises (running, cycling etc) produce exercise-induced hypoalgesia, particularly when performed at moderate to high intensities for longer periods. This is also true for isometric exercises (static muscle contraction), when performed at either low or high intensities.


Benefits of Exercise


  • Joints become better lubricated and glide easier

  • Nerves and discs of the spine get their required nutrients

  • Muscles become stronger and fatigue less quickly

  • The nervous system winds down promoting relaxation

  • Increased levels of energy, improving mood and helping with anxiety and depression

  • Your body produces Endorphins - your own pain relieving medication!

  • Improves efficiency of the heart, controls blood sugar levels, and improves your ability to burn fat


 


Rhianne Turner (Physiotherapist)


Next - 7 exercise tips for people with chronic pain



5 Steps to a Better Back Feb 19th, 2015



Mal Chronique - 7 exercise tips for people with chronic pain Feb 19th, 2015

  1. Incorporate exercises in everyday life – take the stairs whenever you can, get up more often and do tasks around the home

  2. Choose exercises that you enjoy, whether its swimming, yoga, walking, or weights

  3. Add a component of aerobic exercise to your programs (swimming, walking, stationary bike)

  4. Stretching and breathing exercises are great additions to your program as they improve blood supply and nutrients to the joints, reduce your risk of injury, improve your balance, and reduce stress in muscles

  5. Avoid exercises which cause pain, though some discomfort is okay

  6. Avoid the boom-bust approach, start slowly and gradually increase your program (increasing volume before intensity)

  7. Be consistent from day to day, avoid good day and bad day behaviour



A Foundational Model for Good Work Design Jan 20th, 2015
Principles of good work design are a key element of the Safe Work Australia members collaborative project Good Work through Effective Design. This project contributes to the Australian Work Health and Safety Strategy 2012-2022 and the national action area Healthy and Safe by Design. Particular focus has been placed on achieving the strategic outcome of 'eliminating or minimizing risks and hazards by ensuring all work, work processes and systems are well designed'.

Comcare and Workplace Health and Safety Queensland have been tasked with phase one of the Good Work through Effective Design project, to produce a set of principles for good work design. Phase two of the project is to promote good work and effective design, through case studies, education and other guidance materials.


WHAT IS GOOD WORK?

‘Good work’ is healthy and safe work where the hazards and risks from the work have been eliminated or minimised, as far as reasonably practicable, through the process of design. Good work is designed to manage the structure of tasks, demands, supports, and work processes to optimise human performance, organisational productivity and job satisfaction.


ELEMENTS OF GOOD WORK DESIGN

When making decision about work tasks, activities, and responsibilities, there are typically four interrelated elements that are important. These are:



  • physical elements—aspects of the work environment or context that creates physical or physiological demands on the human body, for example physical hazards, chemical hazards and biological hazards.

  • biomechanical elements—aspects of the work that include hazardous manual tasks and the biomechanical risk factors that leads to musculoskeletal disorders, for example force, vibration and movement.

  • cognitive elements—aspects of the work that create demands on the human mental capacity, for example attention, mental workload and complexity.

  • psychosocial elements—social, psychological, and organisational aspects of work that place demands on human capacities, for example work demands, job control, supervisor/peer support, role variables, managing relationships, rewards and recognition, management of change an organisational justice.



Risk factors are interrelated and interdependent so focusing on one or two factors in isolation will likely be ineffective as a strategy. The interaction amongst elements, and their co-occurrence, means that a holistic approach should be adopted when evaluating work, and when designing solutions.

There are many models that are applied in the context of designing good work. The report reviewed the following key approaches and perspectives from the research evidence:


  • Work Design-Specific

  • Risk Management

  • Continual Improvement Process

  • Health Promotion

  • Change Management

  • Human Factors Engineering



Mal Chronique - Chronic Pain Explained Jan 13th, 2015

Chronic pain refers to pain that is experienced beyond expected healing timeframes, for example low back pain, neuropathic pain, neck pain, post operative pain, shoulder pain.

You’re not alone - 1 in 5 Australians are affected by chronic pain.

The relationship between pain and injury: Pain injury

Pain is very useful when we have an acute injury. For example, with a sprained ankle our brain sends signals of pain to cause us to limp and offload the ankle, ultimately allowing the inflammation to settle and promote healing. This is great! However in chronic pain, these signals are not so helpful.

The relationship between pain and injury becomes uncoupled in the chronic pain experience, where pain is not a reliable predictor of the severity of the injury. A multitude of other factors play a role in the chronic pain experience. The longer pain persists, the more important these ‘non-tissue related’ factors become in driving the pain experience. Pain can even occur with no identifiable cause. Take for example phantom limb pain post-amputation– pain can persist in the absence of tissue injury and even in the absence of any tissue at all.

Multiple Failed Treatments

This is not uncommon in the chronic pain population, due to the complexity of a multitude of contributing factors. The most up to date evidence for treatment is to take a multi-factorial treatment approach. Treatments that have failed to deliver adequate pain relief often do so because of failure to account the multiple factors that contribute to someone’s pain.  Treatment works best when delivered as part of a multi-factorial approach, including education and knowledge about your condition, physical activity and pain.

“It’s all in your head”

Those who have experienced chronic pain may have experienced a clinician who tells them “it’s all in your head”. This in fact has truth to it, because the brain is in the head and the brain tells us how much something hurts. Pain is a survival mechanism – when the body is injured nerve endings in the injured part send messages to the brain. When the brain suspects the body is under threat the brain acts to protect it by producing pain. Pain is created by the brain, but that does not make it any less real. The more times the brain uses a certain neural pathway, the easier it becomes to activate the pathway. Neurons that fire together, wire together – for example: if every time you lift a box there is pain in your back, the brain has created a pain experience with lifting boxes. We need to reshape this pain experience and lower the perceived threat.

 

Rhianne Turner (Physiotherapist)

 



Minimum requirements to reduce work-related musculoskeletal disorders Dec 30th, 2014
WMSDs are typically viewed as related to manual handling and as such risk management is targeted at addressing the physical aspects of jobs and tasks. However, effective risk management for MSD needs to accurately identify, assess and control the most relevant worksite risk factors for a particular job, not particular tasks. To determine what these risk factors are a participative systems approach is needed using hazard surveillance evidence collected from employees within a particular job.

Risk factors for WMSDs include psychosocial and physical hazards; therefore, to ensure effective WMSD risk management practice all relevant hazards must be identified and systematically controlled.


Research evaluating the effectiveness of various workplace interventions intended to reduce WMSD risk has identified the following key factors:


  1. A multifactorial approach–addressing psychosocial hazards concurrently with manual handling hazards;

  2. Participation by workers and their representatives, along with other stakeholders including supervisors and key managers, and management commitment which includes ensuring that workers have the time needed to participate in risk management processes and that risk controls are implemented as fully as practicable


Better understanding of MSD aetiology, based on current research evidence is required. One approach that would address these key requirements is a risk management toolkit. 

The advantage of the toolkit approach is that it can be customised by organisations to fit into their existing policies and procedures, while still offering a more holistic approach to WMSD risk management.

Next- Designing Worksite Toolkit for MSD Risk


 



Designing Worksite Toolkit for MSD Risk Dec 30th, 2014
A toolkit should provide practical tools and strategies for workplace use in identifying hazards and assessing risk. Training materials and guidance documents to support effective implementation of the risk management process should also be included. Another key requirement in using a toolkit approach is that of worker participation.

The advantage of the toolkit approach is that it can be customised by organisations to fit into their existing policies and procedures but it offers a more holistic approach to WMSD risk management—than is currently undertaken—which is needed if adequate coverage of all hazards and risks associated with WMSDs is to be undertaken.


Figure 1 above depicts three groups of workplace hazards: external (biomechanical) loads, organizational factors, and social context; those within the latter two groups are commonly known as psychosocial hazards.

Hazards within all three categories interact with each other (shown by linking arrows) and all of these hazards can affect processes internal to individual workers (internal biomechanical loading, physiological responses) and personal outcomes (discomfort, pain, impairment, disability). As shown on the right of the diagram, individual factors influence all personal processes and outcomes. ‘Stress’ is not highlighted here, although it is implicit within ‘Physiological Responses’.


Figure 2 above highlights the interacting effects on MSD risk of ‘physical’ hazards (mainly biomechanical) and psychosocial hazards. A person’s internal ‘stress response’, as shown here, occurs when situations are experienced as stressful; it is multidimensional, with physiological and behavioural, as well as cognitive and affective dimensions, with potentially profound effects on health, including MSD risk.

The model in Figure 3 below is in accord with the above 2, however but more directly applicable to workplace risk management because it provides more specific detail concerning the wide range of work-related hazards that can combine to affect risk.

MSD risk is increased if Job and Task Demands are hazardous or excessive in relation to available Coping Resources, and that risk is also affected by Other Psychosocial Hazards. The physical hazards of manual task performance are included within Job and Task Demands, along with the cognitive and emotional demands of task performance, and the broader demands of the overall job. Coping Resources are determined both by workplace factors (support systems and resources; psychosocial and physical environment influences) and by the individual’s own capabilities. Importantly, it is the combination of these diverse variables that determines risk.

Figure 3 is a great resource for planning worksite toolkit to assist to reduce worksite MSD’s. Click for downloadable template.



MSD hazards and risk factors - US National Research Council Dec 30th, 2014



Cumulative tissue damage and stress Dec 30th, 2014



Where should we target strategies to reduce work-related musculoskeletal disorders? Dec 29th, 2014
Accurate identification of all relevant hazards is the first step in effective workplace risk management of work-related musculoskeletal disorders (WMSDs). Given the huge variation in operational demands both between and within different industry sectors and their respective organisations, appropriate targeting of strategies requires careful consideration. Generic risk management strategies may not be appropriate given these large differences.

No single or multi-dimensional strategy is generally effective across occupational settings. Therefore a degree of customisation is required for maximum effectiveness.

Both physical and nonphysical work environments should be assessed so that interventions specific to individual workplaces can be developed which in turn can lead to more definitive conclusions about changes being reached.

The relative contribution of physical and psychosocial hazards to worksite MSD development may vary between different jobs, gender and age. Even in work considered as predominately physical in nature, psychosocial factors have been associated with MSD risk.

The relative importance of particular hazards will be defined by the nature of the work, as well as the physical and cognitive demands placed on individuals. Importance will also vary greatly across different organisations and sectors. In addition, the organisational and sociotechnical context in which the organisation is operating will influence a range of workplace demands including job security, deadlines and working hours, all of which have been linked to WMSD development.


Next- Where should risk management strategies be targeted?



Where should risk management strategies be targeted? Dec 29th, 2014
The conventional approach to OHS risk management has been to focus on hazard management – identifying hazards, assessing risk from each identified hazard, and taking any necessary steps to control risk from each hazard separately.

However effective risk management for MSD needs to accurately identify, assess and control the most relevant worksite risk factors for a particular job. To determine what these risk factors are a participative systems approach is needed using hazard surveillance evidence collected from employees within a particular job.

 

Target Job Levels

The following study showed risk management strategies need to be targeted at the ‘job level’ if they are to be maximally effective (i.e. target specific job task and roles, rather than specific organisations or employment sectors).

Risk mitigation should be aimed at individual jobs to ensure maximum effectiveness in reducing MSD risk. This does not suggest that organisational influences are not critically important. In a systems approach, the influences from an organisational level play a vital role in determining a range of factors directly related to job design including safety, efficiency and effectiveness.

Be Job specific, not Task Specific

Another important distinction is the need for a job rather than a task focus, which is currently employed by many ergonomists and safety personnel. Whilst tasks were not directly examined in the current study, the problem with a focus on examining specific tasks is it fails to take account of the range of activities and demands placed on an individual. By evaluating tasks it is likely that important interactions will be not be accounted for.

The potential for interactions between hazards means that risk assessment on a hazard-by-hazard basis can be unreliable, because the effect on WMSD risk of a particular observed hazard level is likely to depend on the type and severity of other hazards experienced, that is, the combination of tasks may increase the risk of developing a WMSD.

Next- What are the Minimum Requirements



Australian Workers’ Compensation Statistics, 2012–13 Dec 21st, 2014

 

The above report provides a summary of Australian workers’ compensation statistics for the 2012–13 financial year, including trends over time and an overview of time lost and compensation paid. A serious claim is a workers’ compensation claim for an incapacity that results in a total absence from work of one working week or more.

Preliminary data show there were 117 815 serious workers’ compensation claims in 2012–13, which equates to 11.1 claims per 1000 employees and 6.7 claims per million hours worked.

Injuries & musculoskeletal disorders led to 90% of serious claims in 2012–13 and the most common type was Traumatic joint/ligament & muscle/tendon injury (45%). Diseases led to 10% of serious claims and the most common type was Mental disorders (6%).

Muscular stress while lifting or handling objects caused 33% of serious claims in 2012–13p, while falls, trips & slips of a person caused 22% of serious claims. The back was the location on the body most often injured, accounting for 22% of all serious claims in 2012–13p. Other common locations were the hand, fingers & thumb (13%), shoulder (10%) and knee (9%).

Employees working as Labourers had the highest incidence rate of serious claims of all occupations in 2012–13: 27.0 serious claims per 1000 employees, more than twice the national rate. Machinery operators & drivers made 24.4 serious claims per 1000 employees. Older workers have higher median time lost from work and higher median compensation paid for their serious claims than younger workers.



Infographic - Australian Workers’ Compensation Statistics, 2012–13 Dec 21st, 2014



Obesity by Occupation - USA Dec 19th, 2014



Christmas Hours Dec 10th, 2014



Image - Psychological Injury Nov 27th, 2014



Presumption 3: methods and tools for the assessment and management of psycho social risks are not available. Nov 25th, 2014
Survey’s of various Employers, disappointingly have found that only a minority of enterprises inform their employees on psychosocial risks, let alone take appropriate actions to tackle them.

Lack of awareness, lack of resources, and lack of technical support, guidance and expertise were key needs in this area that were identified irrespective of enterprise size, sector or country.

An interesting recent development in this area is the launch of two standards.


The first was launched by the British Standards Institution in 2011 and it is the first national guidance standard on the management of psychosocial risks in the workplace.


The second was launched as a national standard on psychological health and safety in the workplace in Canada in 2013.

Is psychosocial risk prevention possible?

The ultimate question is about the risks each of us is willing to take – as an employee, manager, policy maker, individual. The answer will depend on the context each of us finds ourselves in, associated pressures, needs, and values.

A policy maker might be clear on the available evidence on the impact of psychosocial risks but might choose to focus policies on reaction and not prevention because of economic and/or political pressures.

A line manager might understand that putting more pressure on her employees will challenge their well-being, but might choose to go ahead with the plan of meeting additional targets to satisfy her superiors and contribute to the company’s survival.

An employee might realize that working 60 h per week will make them ill and limit the time spent with his family but might choose to do so to have an income in a country with high unemployment.

In all these cases, each individuals decision can be justified although, on the basis of available knowledge, each situation will not be sustainable and will perpetuate problems at different levels.



Start RTW immediately with Psycho social claims. Nov 25th, 2014
It is no secret workplace psychological injuries represent a huge burden both on the individual and their family as well and workers’ compensation schemes and society generally. Comcare reported in the 4 years to June 2010 10% of claims were attributed to ‘mental stress’ and these amounted to 35% of total claims costs.

As a result between 2007 and 2010, there were more than 17,000 ‘mental disorder’ claims at an average cost of $19,600 per claim.

Liability or Return to Work.  You Can Do Both

The huge impact and potential for exacerbation with a psychological injury leads to a focus on the liability issues at the expense of managing the employee. The patient is often left to sit at home pending the investigations and not surprisingly this does little to soothe the waters.

Most workplace psychological injuries do not happen overnight but in fact can fester for some time with employees typically showing signs like erratic behaviour, disengagement and withdrawal, more unplanned absence, increased workplace conflict and deterioration in work performance.  Consequently by the time a claim is made the worker is likely highly susceptible to what happens next.

The question of course is do they have a valid claim that needs to be addressed as per the appropriate channels but nonetheless you still have an employee with rights under the Fair Work Act (e.g. you cannot just sack them) you need to manage.

Stay At Work Should Be The Focus

There is lots of information about the Health Benefits of Work.  Safe Work Australia also supports the Stay at Work position for mental ill health as outlined in their Work Health and Safety Strategy 2012-2022; and that is what you need to discuss with the Treating Doctor.

At times you should involve a Workplace Rehabilitation Provider sooner rather than later. Rehabilitation Consultants, as a party external to the company, brings impartiality to the table and is also skilled in complex case management.

The Right Support Is Necessary

In the event of a workplace psychological injury there is no easy or one size fits all solution and an open and sensitive approach is necessary to understand the issues for the injured worker along with those of the employer.  It is important to establish communication and commence the return to work discussion. 

With the right support time off with a psychological injury need not be seen as standard or essential practice and your challenge is to make that happen.


 



Court Rules on Age Discrimination Case! Nov 24th, 2014
On the 8th of April 2014, the Federal Circuit Court in Brisbane ruled on the Fair Work Ombudsman's first litigation relating to discrimination on the grounds of age.

The 65-year-old employee began working for his employer in late 1996. His duties included taking orders, serving dishes and water, setting tables and greeting and assisting customers when asked to by the manager.

The employee took long service leave in April, 2011. When he was due to return to work, his employer told him that he would work part-time.

The employee subsequently met with his employer and raised questions about a number of issues, including his pay, later putting his concerns in writing. Shortly after, he received a letter drafted by the company's accountant informing him of the company's plans to terminate his employment on his 65th birthday. The accountant who drafted the letter had no workplace relations experience or training.

The letter stated that it was "the policy of the company that we do not employ any staff that attains the retirement age, which in your case is 65 years".

In his written response to the company, the employee stated that the termination of his employment was "irrefutably an act of blatant discrimination".

"It must be pointed out, my effectiveness as a food and beverage attendant when I turn 65 is no less than my effectiveness at the age of 64," he said.

After the company reaffirmed its position and advised the employee it did not wish to enter into further correspondence with him, the employee lodged a complaint with the Fair Work Ombudsman.

The Fair Work Ombudsman placed the matter before the Court. Following a subsequent investigation and litigation, the employer was penalised a total of $29,150 for contraventions of age discrimination and record-keeping laws.


  1. The company was fined $20,790

  2. Its joint directors and equal shareholders, were also penalised a further $4180 each.

  3. Judge Michael Burnett also instructed the employer to pay $10,000 compensation to the former employee.


Fair Work Ombudsman Natalie James says discrimination against employees on the grounds of age is unlawful and the outcome of the case serves as a warning to employers that it won't be tolerated.

"Limiting employment opportunities of workers because of their age is totally unacceptable and we take such conduct very seriously because of the impact it has on individual workers and the labour market generally," Ms James said.

Under the Fair Work Act, it is unlawful to discriminate against employees on the grounds of pregnancy, race, colour, sex, sexual preference, age, physical or mental disability, marital status, family or carer responsibilities, religion, political opinion, national extraction or social origin.

How Common

Since 2009, the Fair Work Ombudsman has received more than 80 complaints relating to age discrimination, making it among the top-five types of discrimination investigated by the Agency.

The majority of age discrimination complaints come from mature-age workers, with workers aged as young as their 40s having complained they have been discriminated against because of their mature age.

The Fair Work Ombudsman has received age discrimination complaints from mature-age workers in a range industries, with the accommodation and food, health care and social assistance, and retail industries prominent.



Reference: http://www.fairwork.gov.au/About-us/news-and-media-releases/2014-media-releases/April-2014/20140407-theravanish-penalty


When you can lawfully discriminate based on age? Nov 24th, 2014
While an employer is unable to discriminate against a person based on their age, work health and safety laws in Australia and other jurisdictions also require employers to provide a "safe system of work". For example, section 19 of the Work Health and Safety Act 2011 states that the "primary duty of care" is to "ensure, so far as is reasonably practicable, the health and safety of workers" by, among other things, "provision and maintenance of safe systems of work".

Therefore, if an employee cannot fulfil the inherent requirements of a job due to age related physical or mental change, an employer is ‘obligated’ to, for lack of a better word, discriminate based on age.

To ensure that such discrimination is lawful, you must:


  1. be sure that the person cannot perform the essential tasks of the job; and

  2. determine that any inability to perform the essential tasks of the job is due to the person’s age , i.e. not because they lack training, qualifications or experience.


Pre-employment physical assessments provide vital information for such decisions, and will find more and more value as our workforce gradually ages over the coming 2-3 decades.

Controlling the incidence of work-related injuries is economically important and important for the individual employee. Injuries occurring on the job can result in life-altering consequences to workers who depend on their physical well being for their livelihood.

Only 2% of individuals with back injuries who have been off work for more than 2 years will ever return to gainful employment. The loss of the ability to work can have a devastating consequence on not only the injured individual but also his or her entire family.

We have significant experience providing and designing pre-employment physical assessments. Contact us for more.


Presumption 2: the case for prioritization and management of psychosocial risks is not clearly defined Nov 18th, 2014
Several studies have shown the impact of psychosocial risks, work-related stress, bullying and harassment on individual health, safety and well-being, organizational performance, and societal health and prosperity. Studies document elevated odds ratios of fatal or non-fatal cardiovascular events amongst those reporting job strain, effort-reward imbalance or organizational injustice. Overall, risks are at least 50% higher amongst those suffering from stress at work compared in comparison to those who are not.

In addition, the majority of cardiovascular risk factors can be linked to adverse psychosocial work environments in terms of job strain and effort-reward imbalance. In particular metabolic syndrome, type II diabetes, hypertension, obesity, health-adverse behaviours and markers of dysregulated autonomic nervous and endocrine system activity.

Other studies have shown the direct and indirect effect of a poor psychosocial work environment on absenteeism, productivity, job satisfaction, and intention to quit. A reduction in physical and psychological health through the experience of stress can cause suboptimal performance that may lead to accidents and to other quality problems and reduced productivity, thereby augmenting operational risks. In addition, studies have suggested that between 50% and 60% of all lost working days have some link with work-related stress.

Clearly there is a data making the ‘economic’ case for psychosocial risk management. Astonishingly, there still appears to be resistance from businesses to prioritize it. This may be partly attributable to the way psychosocial risk management is understood; that is, as an approach to alleviate negative outcomes but not necessarily one to capitalize on opportunities and resources for prevention. This perception might stem from the approach employed by some key stakeholders to take a ‘reactive’ approach to dealing with psychosocial risks rather than providing some resources to proactive preventative strategies.

Businesses deal with risk and risk management routinely. Risk management is used from the development of business strategy to the execution of daily operations. However, psychosocial risk management concerns work organization, design and management. It must be embedded in business operations and not viewed as an add-on. Such a conceptualization of psychosocial risk management would also reduce resistance and stigmatization in dealing with mental health in the workplace and promote well-being and performance.



 



Results - Midwest Football Academy Nov 18th, 2014

Click image to download table of test results



 

20m Sprint

Seconds

Excellent          <2.95

Good               2.95-3.04

Average          3.05-3.20

Below Average >3.20

 

 

3000m

min:secs

Excellent          <11:00

Good               11:00-11:30

Average          11:30-12:30

Below Average >12:30

 

Vertical Jump

cm

Excellent           >70

Very Good         61-70  

Above Ave        51-60     

Average            41-50

Below Average <40

 

 


Is psychosocial risk prevention possible? Nov 18th, 2014
Although the prevalence and impact of psychosocial risks is now widely acknowledged as a priority in health and safety, there remains resistance by key stakeholders in prioritizing psychosocial risk management both in business and policy making. Psychosocial risks are still considered by some stakeholders difficult to address in a preventative fashion.

The following paper explores why this is still the case by discussing three presumptions in relation to the current state of evidence in this area.

 

Presumption 1: there is no clear definition and understanding of psychosocial risks by key stakeholders and businesses.

Psychosocial hazards are aspects of work organization, design and management that have the potential to cause harm on individual health and safety as well as other adverse organizational outcomes such as sickness absence, reduced productivity or human error. They include several issues such as work demands, the availability of organizational support, rewards, and interpersonal relationships, including issues such as harassment and bullying in the workplace.  The types of issues employers are asked to consider include workload, work schedules, role clarity, communication, rewards, teamwork, problem-solving, and relationships at work.

Can any business flourish without effectively managing these issues? And if there is clear evidence that not managing these issues effectively can lead to poor employee health, presenteeism, absenteeism, human error and reduced productivity why is there resistance when it comes to health and safety legislation in this area?

Perhaps difficulties in understanding arise from the ‘traditional’ perspective in health and safety, based on risk management. Businesses deal with ‘risk’ and ‘risk management’ routinely in areas such as finance, strategy, and operations (among others). As such, the principles of risk management, which are based on being proactive, are not at all foreign to them. However, the same cannot be claimed for other key stakeholders involved in psychosocial risk management, such as occupational health services.

Experts working in occupational health services traditionally have a ‘reactive’ perspective to psychosocial illness, supporting individuals and organizations deal with problems they experience, and not designing a work environment that will prevent them from occurring. The approach employed to deal with psychosocial risks is very much focused on ‘mending harm’ and not sufficiently on prevention through managing risks.

Psychosocial risk management should not be approached solely through a health and safety perspective (and not solely from a human resource management perspective either since this often lacks prioritization) but from a strategic perspective both at organizational and at policy level.




10 tips for managing shift work Nov 11th, 2014
Shift work can have negative effects on a person’s health. For instance, working at night and sleeping during the day can disrupt the body’s natural circadian rhythms. Circadian rhythms are the body’s natural cycles that control a person’s appetite, sleep, mood and energy level.

Interfering with a person’s circadian rhythms can result in:

- stress;

- fatigue;

- depression;

- headaches;

- high blood pressure; and

- an increased risk of developing stomach ulcers and heart disease.

 

Shift work also has organisational risks. Workers are at their least competent and watchful at the end of a shift. Fatigued workers are more likely to make mistakes and to have poor concentration and response times. Workers at the end of a long shift who are responsible for part of a worksite might:

- leave the workplace in an untidy and dangerous way;

- fail to conduct proper handover for the next worker about to begin their shift;

- neglect to properly carry out a safety process; and

- fail to identify safety risks for themselves and other workers.

 


10 tips for managing shift work

Follow these 10 tips to effectively manage shift workers:


  1. Ensure that a worker’s work cycle includes no more than six consecutive 8-hour shifts or four consecutive 12-hour shifts.

  2. Keep night work to a minimum. Workers should be given as few night shifts in a row as possible.

  3. Make shifts shorter when the work is particularly hazardous or exhausting.

  4. Ensure that workers who work 12-hour shifts or night shifts do not regularly work overtime.

  5. Ensure that workers rarely work more than 7 days in a row.

  6. If possible, keep workers’ shift cycles consistent.

  7. Give adequate notice of roster changes.

  8. Ensure that workers have sufficient breaks during their shifts, particularly for those working long shifts and undertaking high-risk work.

  9. Give workers adequate time between the end of one shift and the start of another to rest and recuperate.

  10. Have a handover policy in place to ensure effective handover for the next worker.



Workers who exercise lower health risks, cost less Oct 28th, 2014

This study looked at the impact of exercise on 4,345 employees in a financial services company. Roughly 30 percent of employees were high risk and suffering from metabolic syndrome, a dangerous cluster of risk factors associated with diabetes and heart disease.

The study found that when the high-risk employees accumulated the government-recommended 150 minutes of moderate-intensity exercise a week, their health care costs and productivity equalled that of healthy employees who didn't exercise enough.

We can't control our family history and some health indicators such as cholesterol can be difficult to manage, but if individuals get enough exercise, the negative impacts of metabolic syndrome could be mitigated.

Employees with metabolic syndrome who exercised enough cost $2,770 in total health care annually, compared to $3,855 for workers with metabolic syndrome who didn't exercise enough.

With a bit of imagination, employers can develop and implement low cost interventions and programs that make it easy for workers to exercise on the job. Some examples include walking groups, signs reminding employees to take the stairs rather than the elevator, or developing and distributing maps of walking routes that fit into a lunch hour.

Central West Health and Rehabilitation has programs to assist this process, including services for remote workforces. Contact Us for more

 

 


Productivity measures in employees with and without Metabolic Syndrome and with and without sufficient physical activity Oct 28th, 2014



Health care cost measures in measures in employees with and without Metabolic Sydrome and with and without sufficient physical activity Oct 28th, 2014



Infographic- Burn more calories walking Oct 17th, 2014



Predicting time on prolonged benefits for injured workers with acute back pain Oct 16th, 2014
Work disability due to back pain (BP) is a multidimensional problem associated with high compensation and treatment costs. Costs associated with productivity losses due to BP (indirect costs) are estimated to be 85 % of total costs in the general population and even higher in work related BP.

Workers who are at low risk for chronic disability will most likely return to work (RTW) with limited assistance. Those at high risk for chronic disability may benefit from tailored interventions. If so, the burden of BP could be reduced through the early identification of those at high risk of chronic disability and delayed RTW.

Most of the existing literature relies on information gathered from injured workers, which is often limited to clinical factors. However, work-related BP is a multidimensional problem; therefore, predictive factors should be collected from several key actors [workplace partners, health-care providers (HCPs), injured workers, insurers] to capture the complex interactions that influence outcomes.

 

The following factors were predictive of a longer time on benefits:


  1. older age,

  2. greater physical demands in the workplace,

  3. employer doubt regarding the work-relatedness of the back injury,

  4. receiving a prescription for opioids during the first 4 weeks of the claim.


The following factors were predictive of a shorter time on disability benefits:


  1. union membership,

  2. availability of an early RTW program,

  3. positive recovery expectations on the part of health-care providers,

  4. being entered in a work rehabilitation program, and

  5. communication of functional ability to RTW



Implications

High risk individuals can be selected within the first 4 weeks following acute low back pain.

Early RTW planning and strong communication between the employer, and a trusted health care team improves outcomes.



What should you do if a worker claims their work is unsafe to perform? Oct 15th, 2014
A worker who refuses to perform work because of genuine safety concerns cannot be liable for industrial action.

If a worker complains of a safety risk in the work they perform, undertake the following steps:


  1. Ask the worker to identify the hazard and the risk it poses;

  2. Control the risk by eliminating the hazard or implementing risk controls; and

  3. Ensure workers are fully trained in the new work procedures.


If the hazard can’t be controlled, stop the process if possible and consider what alternative safe work you can offer workers.

If a union threatens industrial action in relation to a health and safety concern, notify the union of the steps you have taken and engage them in any dispute resolution processes you take.

If the worker has a health and safety representative or if your workplace has a health and safety committee, they must also be included in the dispute resolution process.


 

Next- What if the issue is difficult to fix?



Work debate spaces: Improve safety practices with employee input. Oct 15th, 2014
In daily work, there will always be situations that are either not covered by the rules or in which the rules are locally inapplicable. To foster participatory approaches in safety it is necessary to develop means to consider the actual organization and interactions among workers.

Safety relies on the ability of workers to assess the applicability of procedures and adaptations to carry them out. In order to progress, it is necessary to consider the safety approach as adaptive, dynamic, and developmental. Although the concepts around the development of a safety and safety culture are well developed, tools and methods that enable practitioners to ensure that the system in which they work are resilient and able to bounce back quickly to errors or other unexpected events are required.

Participatory approaches may play a key role. But how to develop participatory approaches that articulate the formal and the living organization? A possible way is the discussion and confrontation of points of view between different stakeholders of the organization around elements of the real work.

Work debate spaces (WDS)

To foster participatory approaches in safety it is necessary to develop means to consider the actual organization and interactions among workers. These are concepts developed by the approaches ‘Strategizing’ and ‘Work of Organization’.

Strategizing: This approach integrates the routines of meetings, discussions, or data processing in the definition and implementation of a ‘strategy’. It is important that the strategic issues of the organization are not decided and imposed by the leaders, but rather are the result of a daily construction with all stakeholders of the organization.

Work of Organization: This approach describes a living organization: occupational rules are developed by the employees in order to mitigate the defects of the formal organization, and to develop safety.

Both approaches consider an organization defined simultaneously by the leaders and by local and temporary regulations constructed by employees in the field. The questions they raise are needed to feed the managerial and strategic levels of the organization.


Articulating safety challenges is only possible with a working group to identify the situations that are particularly difficult to manage, to discuss them within the organizations and to propose changes.

WDS's are a time for discussion. The group advocates the discussion of work on a regular and protected basis, coordinated by a manager who does not belong to the direct hierarchy (e.g. Health and Safety Representatives). This method acts as a medium that deals with all the arrangements, compromises and adaptations that are required for safety system changes.

WDS permit not only the improvement of safety, but also help develop the competences of the employees, management and HR department with the bigger picture realities of health and safety. It allows safety to move beyond the traditional perimeter of the retrospective analysis of dysfunctions, and enter in learning dynamic starting with field situations. It allows the development of safety by different levels in the company, and progresses the organization beginning with experiences within the organization itself. This permits the development of an enabling environment for safety

It is necessary that the executive committee be engaged in the process by supplying the technical, organizational, and human means so that the WDS can be instigated. A preliminary phase is necessary, based on observations and interviews with workers, to engage the elements for the development of the WDS. Within these spaces, some conditions are defined so that people can experience the improvement proposals: a discussion based on real work activity, a joint elaboration and evaluation of solutions based on a dynamics of confrontation. 


 



Sick leave patterns in common musculoskeletal disorders Oct 14th, 2014
Musculoskeletal disorders (MSDs) are the most common causes of severe long-term pain and physical disability and have a major impact on society.

Sick leave is an important public health problem with both social, economic and health related consequences for the individual as well as social and economic consequences for society, and MSD’s are one of the most common reasons for work disability and sick leave.


20 251 sick leave periods were issued for 16, 673 with a mean (SD) age of 43. The main purpose was to give a descriptive overview of sick leave patterns in different diseases within the group of MSDs, including all doctors prescribed sick leave. The aim was to get comparable estimates of duration, age and sex distribution and patterns of recurrent sick leave for the different subgroups.

Adjusted for age, the mean number of days per sick leave period was 26 days for low back pain and 27 days for myalgia (i.e. other soft tissue disorders not classified elsewhere). Disc disorders and rheumatoid arthritis had the longest periods with a mean of 150 and 147 days respectively. For hip and knee osteoarthritis the mean was 81 and 116 days respectively


The distribution of number of sick leave periods, over age categories, and between men and women, was different for the different disease groups. For back disorders, the total number of sick leave periods was highest in the age groups 40–44 and 45–49, with a similar pattern for women and men. The number of sick leave periods for knee and hip osteoarthritis peaked in the older age groups with a predominance of men in the hip osteoarthritis group.  Myalgia had a more even distribution over the age categories with similar patterns for men and women.


25% had more than one sick leave period during the two years. Out of the six studied disease groups, individuals with rheumatoid arthritis had the greatest share of recurrent sick leave periods (34%) despite also having a greater share of long sick leave periods. The other conditions with typically long sick leave periods, e.g., disc disorders and hip osteoarthritis, had less recurrent sick leave (15 and 18% respectively), while typical conditions with short sick leave periods, e.g., back pain and myalgia, had more episodes of recurrent sick leave.

 


Exercise and start talking: tips to help improve FIFO workers’ mental health Oct 13th, 2014
FIFO workers are being urged to implement six simple strategies in order to stay mentally healthy.

Avoiding the wages trap, keeping the lines of communication open and staying physically fit are among the steps workers can take to improve their mental health, according to industry support group Mining Family Matters.

Numerous studies into the wellbeing of FIFO workers has found stress, anxiety, divorce, drug and alcohol use and a sense of helplessness are prevalent among the workforce.

A study last year by Lifeline WA and Edith Cowan University psychologists, found a number of issues affecting FIFO workers’ mental health. In August the West Australian parliament unanimously backed an inquiry into the link between FIFO mining rosters and suicide.


 

Mining Family Matters has suggested the following strategies:


  1. Be honest about how you're feeling and tackle problems as a team. Many problems that arise are symptoms of the FIFO lifestyle, rather than relationship problems.

  2. Set shared goals.

  3. Don't assume that your life is tougher than your partner's. (Life is not a competition - you're both exhausted.)

  4. Get financial advice to ensure good wages are saved and invested wisely, instead of being trapped by large debt.

  5. Exercise regularly - it will improve the health of both body and mind.

  6. Try to keep the lines of communication open when you're apart (and if you don't feel like talking, explain why in a loving way).



 



Video - Wheelchair Basketball Fitness Circuit Oct 11th, 2014



Video - Diabetes ABCs Oct 9th, 2014



So what can we include in a worksite health promotion program? Oct 9th, 2014
Worksite health promotion programs should be developed to suit the nature of your business and the needs of your workers. Therefore, a health promotion program that fits one company will not necessarily fit the next.


So what can you include in your health promotion program?

Some options are easy to implement, others take more time and resources. Here are a few examples of what you could do in your workplace:


  • develop health and safety policies and procedures that have a commitment to the wellbeing of your workers at their core;

  • create a supportive working environment where a work/life balance is promoted;

  • encourage positive social interaction and personal skill building in your workers through social events and participation;

  • always provide non-alcoholic options at work-related functions and educate your workers on alcohol and drug misuse;

  • inspire your workers and encourage learning with workshops and guest speakers during lunch breaks;

  • provide health services to workers such as physical health checks, eye tests, flu vaccination,  

  • provide access to a range of health resources, including specialist information from external agencies;

  • create awareness by holding seminars on issues such as stress management, healthy eating or quitting smoking;

  • provide showers, changing rooms and bicycle racks to aid and encourage a physical activity for your workers' commute;

  • organise a corporate rate for your workers to join the local gym;

  • provide filtered water and facilities for preparing healthy lunches;

  • provide access to counselling for smokers who want to quit; and

  • encourage participation in a organised community events such as fun runs.


Remember, the level of resource commitment your business makes to these kinds of programs is up to you – there is no right or wrong answer but the most important thing to remember is that when your workers are feeling good they will be performing well and that has many benefits for your business.

 


The most effective worksite health promotion program Oct 9th, 2014
These are tips that will assist you in making the most effective worksite health promotion program you can. Use them alongside the 8 steps to an effective health promotion program, and you will be halfway there!


An effective health promotion program will do the following:



  • Be coordinated by a person with the necessary skills and resources to commit to the project.

  • Have the long-term commitment of the company (workers, management, directors) to achieve long-term results.

  • Be integrated with the operations of the company.

  • Have the capacity to adapt when the needs of the business or its workforce change.

  • Be available to everyone in the company.

  • Involve consultation between managers and workers to guide the direction of the program.

  • Use resources within the workplace, as well as those available outside the workplace (such as community resources), to reduce the cost of the program.

  • Be a mix of low-cost strategies with higher-cost and commitment strategies.  

  • Reinforce and support the company health and safety plan.

  • Use external experts and agencies for addressing specific problem areas within your business, e.g. quitting smoking.

  • Involve senior management participation in the activities, exercises and strategies that make up the program.

  • Be promoted to workers to:

  • encourage participation voluntarily;

  • increase understanding of the program and its advantages; and

  • increase awareness and involvement in improving the program.

  • Demonstrate the benefits of working with the company to potential workers.

  • Not look down upon workers for not participating.

  • Be reviewed regularly and reported back to senior management.



Remember, there are many factors that can affect a person’s health and well-being, both physically and psychologically. Some of these factors will exist within the workplace, e.g. relationships with colleagues, working environment, level of job satisfaction, and some of these factors will exist outside the workplace, e.g. personal relationships, living conditions, lifestyle choices.

 

Central West Health and Rehabilitation can provide cost effective assistance. Contacts


 


Work disability among workers with knee arthritis Sep 22nd, 2014
The prevalence of knee osteoarthritis (OA) among individuals active in the workforce will increase considerably in the next generation and a significant percentage of these individuals are expected to experience work disability because of this disease.

Knee OA is responsible for prolonged sick leaves and early retirement in a small percentage of workers; however, many workers will have the disease for a long time and remain active in the workforce, not achieving their optimal productivity. Knee OA seems to affect partial work disability or ‘presenteeism’, defined as the loss of work productivity in terms of quantity or quality because of an illness or an injury in individuals who are present at their job, rather than absenteeism.

graphic

The above review was to summarize the existing knowledge on:

(a) work disability risk factors;

(b) efficient interventions to reduce work disability in individuals with knee OA.

 

Risk factors

The only study (Bieleman et al., 2013) that answered the research question on work disability risk factors provided data from a large-scale prospective cohort of good quality. On the basis of this study, age and previous work absence episodes can be viewed as predictors of work disability for OA patients. Bieleman et al. mainly focused on physical personal factors; however, it is now well established that psychological factors such as perceived job strain, social support from co-workers and supervisors, job satisfaction, and self-efficacy influence work participation among individuals with RA and other MSK disorders. Work environment (physical work demands, work adaptation) could also play a major role.

 

Interventions

Only two studies on work disability intervention were found, the results of these studies converged to conclude that compared with standard care interventions, education-based interventions seemed to be more effective in reducing work disability.

 



Excessive occupational sitting is not a “safe system of work” - Is it time to implement risk control strategies Aug 29th, 2014
graphicBeing able to work usually has a positive impact on health. However, changes in the physical demands of work and increased use of computers have led to many workers now being employed in sedentary jobs. While these have traditionally been thought of as safe work environments, recent evidence suggests this mode of work — often involving long uninterrupted periods of sitting — may be hazardous, contributing substantially to the growing chronic disease burden associated with obesity, diabetes, cardiovascular disease and cancer.

Importantly, being sedentary (ie, too much sitting) is not the same as being physically inactive. Insufficient client physical activity is defined in the public health context as not meeting the guidelines to accumulate at least 2.5 to 5 hours of moderate-intensity physical activity per week. Both physical inactivity and sedentary time have an impact on health: physical inactivity is estimated to account for 5.5% of all-cause premature mortality, and excessive sitting time, after adjusting for physical activity, accounts for 5.9%.

Even if workers meet physical activity guidelines (i.e. are physically active), they can still have high exposure to sedentary time!

Work health and safety laws in Australia and other jurisdictions require employers to provide a "safe system of work". For example, section 19 of the Work Health and Safety Act 2011 states that the "primary duty of care" is to "ensure, so far as is reasonably practicable, the health and safety of workers" by, among other things, "provision and maintenance of safe systems of work".

This has lead a number of experts voice the following (Straker et al, 2014):

a) the systems of work commonly observed in contemporary offices demonstrate a high likelihood of excessive sitting hazard;

b) the degree of harm associated with this hazard is likely to be substantial;

c) the evidence for this is now widely known;

d) there are available ways to minimise the risk; and

e) the cost of these strategies is proportionate to the risk.

For these reasons many advanced organisations are implementing risk control strategies. Some risk reduction strategies, such as introducing standing meetings, are costless, while other strategies have a cost. Changes to work systems can reduce sedentary time. Alterations to the individual physical environment (eg, sit–stand workstations or active workstations) and combined approaches (including individual, environmental and organisational changes) have achieved substantial reductions in total occupational sitting time and prolonged unbroken sitting time.

In an aging population, those organisations that don’t may find themselves having to catch up as legislation and Health Professionals start to recognise available evidence suggesting contemporary offices are failing to provide a “safe system of work” for their patients.

For example, Doctors should be prescribing behaviour to reduce occupational sedentary exposure where this may exacerbate, or be exacerbated by, an existing medical condition. A doctor who is aware that a patient has a prolapsed disc in the spine would require the patient to refrain from lifting heavy objects at work. In the same way, a doctor who is aware that a patient’s cardiovascular condition necessitates remaining active and avoiding excessive sedentary exposure should inform the patient and employer of the need for the patient to regularly move to maintain wellbeing!



Strategies to help you stand up, sit less and move more Aug 29th, 2014
Many advanced organisations are implementing strategies to reduce prolonged sitting. Some risk reduction strategies, such as introducing standing meetings, are costless, while other strategies have a cost. Changes to work systems can reduce sedentary time. Alterations to the individual physical environment (eg, sit–stand workstations or active workstations) and combined approaches (including individual, environmental and organisational changes) have achieved substantial reductions in total occupational sitting time and prolonged unbroken sitting time.

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Here are 12 strategies to help you stand up, sit less and move more


  1. Walk over and talk to colleagues instead of emailing them.

  2. Remove bins and/or printers from your office and use central ones.

  3. Dispose of waste and/or collect printing more frequently.

  4. Drink more water so you have to go to the water cooler (and bathroom) more often.

  5. Use a bathroom that is further away.

  6. Step outside for fresh air.

  7. Use the stairs instead of the lift.

  8. Use an active way of commuting to work (walk or ride a bike, stand up in the train, or stand up to wait for your train/bus).

  9. Park your car further away from your workplace and have a short walk, or park in short-term parking so you have to walk back to move your car.

  10. Have lunch away from your desk.

  11. Walk laps of the floor at regular intervals to break up the day.

  12. Walk around the neighbourhood at lunch. You can mark out two or three timed walking routes to fit into your working day and promote variety.




 


Scientists Discover Area of Brain Responsible for Exercise Motivation Aug 27th, 2014


Scientists at Seattle Children’s Research Institute have discovered an area of the brain that could control a person’s motivation to exercise and participate in other rewarding activities – potentially leading to improved treatments for depression.

Researchers have discovered that a tiny region of the brain – the dorsal medial habenula – controls the desire to exercise in mice. The structure of the habenula is similar in humans and rodents and these basic functions in mood regulation and motivation are likely to be the same across species.

Exercise is one of the most effective non-pharmacological therapies for depression. Determining that such a specific area of the brain may be responsible for motivation to exercise could help researchers develop more targeted, effective treatments for depression.

Changes in physical activity and the inability to enjoy rewarding or pleasurable experiences are two hallmarks of major depression. But the brain pathways responsible for exercise motivation have not been well understood. 

The study used mouse models that were genetically engineered to block signals from the dorsal medial habenula. Compared to typical mice, who love to run in their exercise wheels, the genetically engineered mice were lethargic and ran far less.

In a second part of the studye, the mice could “choose” to activate this area of the brain by turning one of two response wheels with their paws. The mice strongly preferred turning the wheel that stimulated the dorsal medial habenula, demonstrating that this area of the brain is tied to rewarding behaviour.



Factors influencing return to work after hip and knee replacement Aug 27th, 2014
Hip and knee arthritis causes significant problems in the working-age population and can lead to a reduced quality of life, change in employment or unemployment. The 10th National Joint Registry reported that 18–20% of patients undergoing hip and knee replacement in England and Wales were under the age of 60 years (NJR. National Joint Registry for England and Wales 10th Annual Report, 2013. www.njrcentre.org.uk)

Heavy lifting and bending have been reported as important factors in the development and progression of arthritis. The effect of arthritis on employment depends on the type of work usually performed, with manual or lifting jobs associated with increased levels of unemployment due to arthritis. In addition to a loss of employment, arthritis has also been associated with a prolonged sickness absence or a change in the type of work performed.

Studies have quantitatively assessed the role of surgery in returning the patient to work after joint replacement. Joint replacement may enable patients to continue working, which may be more cost-effective in the long term as patients remain economically productive members of the society. However literature is sparse regarding factors affecting return to work after knee or hip replacement.


The above review of qualitative and quantitative literature aimed to address the following questions (See table 2):

1) What are the employed patient’s expectations from a joint replacement before and after surgery?

2) Who is most at risk of not returning to work after joint replacement surgery?

3) What external factors are important to help patients return to work?

4) Does age of the patient determine their ability/motivation to return to work?

5) Are patients able to return to work at the same level? 




Infographic - Sitting and Injury Aug 24th, 2014



Infographic - Coffee, Alcohol, Water Aug 22nd, 2014



Infographic - Injury First Aid Aug 18th, 2014



Hypoglycemia Aug 5th, 2014
handoutgraphicHypoglycemia is a condition that occurs when the blood glucose level has dropped too low, usually below 4mmol/L, although some people may have symptoms at a slightly higher level. Hypoglycaemia is commonly referred to as a ‘hypo’, low blood glucose or insulin reaction. It is important to treat hypoglycaemia quickly to stop the blood glucose level from falling even lower.

Hypoglycaemia is most common in people who inject insulin or are taking tablets to manage their diabetes. It is not a problem for those who do not take medication to manage their diabetes. Talk to your doctor or trusted health professional (diabetes educator, exercise physiologist, pharmacist etc) to find out your risk.

 



Video - Blood Presure Aug 4th, 2014



One in five serious workplace injuries involve a tradie Aug 2nd, 2014
graphicAustralia's hundreds of thousands of tradies may enjoy the outdoors, but it does come at a price with one in five of all serious workplace injuries involving a tradie.

Startling figures from the Australian Physiotherapy Association's latest health report, released today, show tradies have among the highest number of injuries, musculoskeletal conditions and other health and safety risks of any profession. Many from smaller businesses who are harder for national health and safety initiatives to reach.  

Released as part of Tradies National Health Month, the Stop Trading Your Health Away report shows nearly one in five serious workplace-related injuries involve a tradie, making them one of the most affected professions in Australia.

Musculoskeletal health costs $20.9 billion annually in direct health and lost productivity costs in Australia.

Within the industry, construction workers are currently claiming 34 per cent of workers’ compensation claims. More than half of these claims were related to muscular stress while handling a range of materials, tools or other equipment.

Tradies are also among one of the largest proportions of occupations with the highest incidence of early retirement. Statistics show that tradies are 35 per cent to 50 per cent more likely to retire before the age of 60 compared to professional workers.

 

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Is Manual Handling Training Worth it?



Video - Nerve Pain Aug 1st, 2014



Video - Phases of Pain Jul 31st, 2014



Case Study - Concord General Hospital, Sydney Jul 27th, 2014
grphicEmployers, insurers and workers’ groups have expressed a growing interest in return-to-work (RTW) interventions after injury or illness. As disability management is increasingly being integrated into employers’ and insurers’ mandates, there has been a focus on workplace-based RTW interventions.

Some injuries take longer to heal due to the nature of the injury and management. We have generally found three types of disability groups have come to light over the years.

The first is the short duration claim where the patient has a well-defined acute episode (i.e. flu, strain or sprain). These cases will return to work often with minimal intervention.

The second (and often most difficult) group represents the patients with sub-acute or progressive diseases or injuries. This population often needs help with ensuring the medical interventions are enough to progress back to health. They may need help in finding their way through the health care maze and psychosocial issues can be a major barrier to RTW.

The third group are those with terminal or debilitating diseases, such as Chronic Pain, Cancer or Multiple Sclerosis, that may eventually prevent return to work.


Concord General Hospital in Sydney is a self insurer, who in 2003-4 found themselves with a huge number of open claims (~300), and a spate of very difficult cases who went on to have chronic pain syndromes. The organisation felt they were failing injured workers and that something needed to change.

The initial step was to change their existing rehabilitation policy. They developed a database to track workers from notification to finalisation. They developed resources such as suitable duties lists for a majority of departments, and increased the role of managers in the rehabilitation process. They also took steps to increase the level of communication by having regular meetings between supervisors and managers of major departments to review claims and provide comparative data.

The consensus was that the first 4 weeks after an incident/injury was the answer, – after that you start to lose control! They instigated a rapid assessment and early intervention process, which included an assessment psychosocial risk (i.e. Yellow Flags). The idea was that high risk individuals needed to be identified in the first week/s. Nothing different needed to be done; only it needed to be done earlier. It was also important that the GP was in control of the whole process through consultation and approval.

The first question to answer was; “can these high risk individuals be found early, and if so, do they actually costs more?” Injured workers filled out a psychosocial risk questionnaire and were followed through until they returned to work with a final certificate. Each injured worker was categorised and claim costs were reviewed and compared across the high, medium and low risk groups.

The answer to Question 1 appeared to be a resounding YES! (see image)


The next question was then “what can be done about it?” Concord’s approach was to; (a) activate an independent Vocational Rehab Provider within first 2 weeks; (b) complete an independent psychological assessment, and subsequent treatment within 2 weeks; (c) complete an independent Medical Consultation within 4 weeks; (d) have the file reviewed if not returned to work within 4-6 weeks.

The emphasise of the above approach did not appear to do anything different to what usually happens, it simply did it much earlier in the management process.

The results were quite impressive; primarily there was a 25% reduction in the costs of each ‘high risk’ claim. This equated to a $4331.00 saving per high risk claim. (see image)



Implications:

There is a significant difference between the 20% in the “high risk” category and the other 80% who manage pretty well with ‘usual care’.

Psychosocial risk factors (i.e. ‘Yellow Flags’) predict the cost of a workers compensation claim within 48 hours regardless of what or where the injury occurs.

The provision of an early and aggressive assessment and intervention, lead by a trusted GP can reduce costs in high risk claims.



Vocational Rehabilitation - What do they do? Jul 26th, 2014
Approved Vocational Rehabilitation Providers (Voc Rehab) can assist an injured worker if there are problems with the return to work process. Voc Rehab providers are commonly health professionals such as occupational therapists, physiotherapists, exercise physiologists or psychologists who ‘generally’ have expertise in addressing the physical, psychological and/or workplace barriers that may prevent an injured worker returning to work.

Workplace rehabilitation providers are approved by WorkCover WA and have the qualifications, experience and expertise appropriate to provide timely intervention with services based on the assessed need of the worker and the workplace.

GraphicWhat does a workplace rehabilitation provider do?

A voc rehab provider is essentially an injury management co-ordinator. Voc Rehab will attempt to deliver an appropriate professional return to work program when the situation requires an external provider (see below).

If an initial assessment indicates that rehabilitation services are recommended, the rehabilitation provider must discuss the findings of the assessment with the employer, the injured worker and the treating medical practitioner.

The rehabilitation provider should give a copy of their plan to the injured worker, employer and treating medical practitioner. The insurer should also receive a copy of the service plan; in most instances, the insurer will provide approval for payment of rehabilitation expenses as part of the claim.

In all circumstances, employers should remain the workplace decision maker regarding return to work activities.

What rehabilitation services may be recommended?

Rehabilitation providers can provide any of the following services in helping workers return to work:

- support counselling

- vocational counselling

- purchase of aids and appliances

- case management

- retraining criteria assistance

- specialised retraining program assistance

- training and education

- workplace activities

- placement activities

- assessments (functional capacity, vocational, ergonomic, job demands, workplace and aids and appliances)

- general reports

When should a workplace rehabilitation provider be engaged?

The worker is unable to carry out pre-injury duties and there is a need to identify alternative or modified duties with either the same employer, or with a new employer.

There is a need to complete a practical assessment of a worker’s capacity to return to work (for example, when there are conflicting opinions of the worker’s physical or psychological capacity to return to work; or there are reports of ongoing symptoms when the worker is at work).

The worker is experiencing problems associated with returning to work (for example, personality clashes with worksite injury management staff.).

Modifidations are required to the workplace are being considered to assist the workers return to work (for example, special lifting equipment or special seating arrangements).

There is a need to assess the suitability of a return to work program with a new employer if this is identified by the injured worker, employer and treating medical practitioner as the new rehabilitation goal.

There is a need to determine whether retraining is likely required. (back)


Who pays for a workplace rehabilitation provider?

Vocational rehabilitation providers are approved by WorkCover WA and their costs are covered by the Prescribed Amount in every workers’ compensation claim. Costs may vary according to the services they provide, but the maximum amount they can charge is determined by WorkCover WA and reviewed annually. These costs will add to your yearly claim costs, used to determine your insurance premiums.

How to activate a referral to a workplace rehabilitation provider?

GraphicAn injured worker, employer or treating medical practitioner can initiate a referral to a workplace rehabilitation provider - see the list of Approved Vocational Rehabilitation Providers. However, to comply with their conditions of approval, the provider must ensure all parties agree to the referral for rehabilitation services.

A referral may be completed on the Workplace Rehabilitation Referral Form or may be made on the worker’s First or Progress Certificate of Capacity.

Note: Injured workers have the right to choose their vocational rehabilitation provider, even when the referral is made by a medical practitioner or employer.


August is Tradies National Health Month Jul 25th, 2014
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Throughout the month of August the APA and Steel Blue will run Tradies National Health Month – a health awareness campaign to educate tradies on the importance of full body health and safety. The Australian Physiotherapy Association and Blue Steel have teamed up to create a month that focuses on full-body health and safety for tradies to improve awareness and support in this area.

Click the Link below to Play the Game - Pain Breaker

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These organisations have also developed a wide array of great handouts and resources, which we have provided to help Tradies look after their minds and bodies. A few are provided below, many more are avaliable at the website.

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Return to work following Shoulder Surgery Jul 24th, 2014
shoulder imageRotator cuff tears are a common shoulder problem affecting more than half the population older than sixty years of age. Surgery may be used to treat a rotator cuff disorder if the injury is very severe or if nonsurgical treatment has failed to improve shoulder strength and movement sufficiently.

Surgery to repair a torn rotator cuff tendon usually involves; (a) removing loose fragments of tendon, bursa, and other debris from the space in the shoulder where the rotator cuff moves (debridement); (b) making more room for the rotator cuff tendon so it is not pinched or irritated. If needed, this includes shaving bone or removing bone spurs from the point of the shoulder blade (subacromial smoothing); (c) sewing the torn edges of the supraspinatus tendon together and to the top of the upper arm bone (humerus).

Acevedo etal, 2014 attempt to determine common clinical practices among 372 shoulder and elbow surgeons with regard to rotator cuff repair and management, including return to work practices. 89% of the surgeons surveyed suggested dedicating over half of their practice to the treatment of shoulder pathology.

Regards Healing Rates

Half of surgeons suggested 80% to 90% healing rate for small tears(<2cm).

70% to 43.1% of surgeons suggest 80% healing rate for large tears (2 to 4 cm).

49% of surgeons suggested 50% to 60% healing rate for massive tears (>5 cm).

70% of survey participants told their patients that their shoulder would be 'as good as it gets' one year after surgery.

A large number of surgeons (55.3%) do not allow their patients to drive a car until the arm is out of the sling full time.

91.3% of respondents reported that they would perform surgery on a current smoker despite the body of evidence showing the relationship of smoking and rotator cuff disease, and smokers having a higher retear rate. Surgeons often have a difficult time getting patients to quit smoking and smokers are still able to attain successful outcomes in most cases, albeit with higher risk of failure and longer recovery times.

Regards Lifting Restrictions

37.3% of surgeons recommended a lifting limit of 0.5kg at one month, and 29.4% allowed 4.5kg at three months. By six months and one year after surgery, a majority of respondents advised their patients to let pain be their guide as a limit to lifting (62.7% and 72.8%, respectively).

Regards Return to Work

Surgeons were asked when they allowed their patients to return to work at a sedentary job and to a manual labor job after repair of small, large, and massive rotator cuff tears.

The most common response in regard to return to a sedentary job was one to two weeks for small tears (41.2%), large tears (38.2%), and massive tears (34.3%).

For a manual labor jobs, two responses were most common; 34.7% allow patients to return to work at three months, and 35.6% allow return to work at four months after repair of small tears. Additionally, 17.8% of respondents allowed return at six months for small tears. After repair of a large tear or a massive tear, respondents most commonly allow their patients to return to manual labor at four months (29.4%) or six months (34%), respectively.

In regard to patients with Workers’ Compensations claims, a large percentage of surgeons do not allow a return to manual labor until six months postoperatively for small tears (56.6%). There was a consensus with surgeons who allow return to work after six months for large tears (68%). After repair of a massive tear, 40.2% allow return to work after at least six months, but 38.2% responded 'maybe never.'

 




Return to work following routine Knee Arthroscopy Jul 19th, 2014
Knee injuries are a common workplace problem and Knee arthoscopy is the most common procedure performed by orthopaedic surgeons (Salata et al, 2010). However there is scanty literature documenting expected recovery duration (often suggested as anywhere from nine days to four weeks for routine uncomplicated arthroscopy).

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The above study of a military population noted that while patients were able to walk around without any support at two weeks post surgery, 88% still had restriction to activities of daily living (and therefore work) because of knee related problems. Function improved gradually over the following 12 weeks. At 6 weeks 91% resumed their preinjury status which reached 94% in eight weeks.

Predictors of poor  outcomes include total removal of the meniscus or removal of the peripheral meniscal rim, lateral meniscectomy, degenerative meniscal tears (more common in older age groups), presence of chondral damage (more common in older age groups), presence of hand osteoarthritis suggestive of genetic predisposition, and increased body mass index.

Psychosocial factors (anger, depression, social support [i.e. workplace support]) play a significant role in recovery and are predictive of surgical outcomes (Rosenberger et al, 2006). Patients undergoing surgery must cope with the psychological and physical stress that often accompanies injuries and surgical procedures. In addition, patients must cope with the demands of the recovery process, which likely include managing postoperative pain and limitations in physical functioning (Rosenberger et al, 2004).


Implications

Following routine knee arthrscope the majority of workers should have capacity for 'suitable' modified duties by 2 week. However remember some patient will still be having considerable difficulty with tasks of daily life such as dressing, climbing stairs and getting up from sitting.

The majority of workers should be able to complete normal duties by 6-8 weeks following surgical date. However, some 6-10% still may need some duty modification beyond this.

Those at risk of a longer recovery can be predicted pre-surgically or early post surgically by the following:

  1. Age

  2. Type of procedure (full meniscus removal, peripheral meniscus lession, cartlidge damage and or microfissuring)

  3. Poor Lifestyle factors (High BMI, current smoker)

  4. Psychosocial factors (anger, depression, poor social/workplace support)





Video - Mentally Healthy Small Business Jul 18th, 2014



Infographic - Costs of Unhappy Employees Jul 18th, 2014

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9 tips to reduce the risks for an ageing workforce Jul 17th, 2014
Australia’s population will both grow strongly and become older in the medium term. This population growth and ageing will affect labour supply, economic output, infrastructure requirements and governments’ budgets, and has lead to the gradual increase in the retirement age from 65-70 for those people born after 1965.

As for safety on the job, workers who are older actually tend to experience fewer workplace injuries than their younger colleagues. This may be because of experience gathered from years in the workplace, or because of factors such as increased caution and awareness of relative physical limitations.

This caution is well-founded. When accidents involving older workers do occur, the workers often require more time to heal, underscoring the need for a well-planned return to work program.

Also evidence suggests incidents affecting older workers are more likely to be fatal. A recent Safe Work Australia document suggested people over 65 have a higher fatality rate (7.73 fatalities per 100,000 workers) than their young work collegues (0.98 fatalities per 100 000 workers). This underscores the need for employers to be mindful of how best to gradually adapt the conditions of work to protect workers as well as explore opportunities for preventative programs that can maintain or build the health of employees through their working life.


Here are 9 tips you can use to eliminate or reduce the risks posed to older workers in your workplace:


  1. Ensure that a person (regardless of age) is suited to the task and can carry it out safely; Pre-employment Physical Assessments are vital.

  2. Adapt tasks to suit older workers, e.g. an older worker with reduced physical strength may spend more time operating machinery than labouring;

  3. Rotate physically demanding or repetitive tasks;

  4. Provide ergonomically-designed work area and workstations for all workers;

  5. Regularly assess stress levels of workers and implement stress management training if required;

  6. Train all workers in injury prevention strategies (it is important to keep in mind that as you age, the pace and way that you learn changes, meaning that training requirements may be different for older workers and training may require repetition);

  7. Ensure workplace lighting is adequate for the job at hand;

  8. If possible, offer older workers flexible work arrangements, (e.g. reduced hours, fixed term contracts, working from home); and

  9. Consult workers about where they are having trouble and keep them informed about what you are doing to reduce the risks.




Cost savings from early ergonomics involvement in projects Jul 17th, 2014
graphicRegardless of the other benefits that may be realized from ergonomic improvements, managers usually are not able to justify providing funds for the intervention unless there is a clear economic benefit to be derived. Accordingly, in developing an ergonomics proposal for management, it is extremely important to clearly identify the costs and economic benefits that can be expected and outline how they will be measured.

Fortunately, properly planned and implemented ergonomics projects usually do result in significant economic benefits, and the literature consistently has shown that the earlier there is professional ergonomics participation in workplace design, the less costly is the effort.

For example, a number of studies have suggested the ergonomics portion of the engineering budget increases from about 1% of the budget when ergonomists are brought in at the beginning of a development project, to more than 12% when brought in after the system is put into operation.

This increase is believed to happen when ergonomists are brought in late in the project because serious human–system interface problems have surfaced that require major retrofits in order to correct them. A second major cost saving of early, or pre-emptive, ergonomics involvement can be in reducing the total cost of the design budget.



Personnel-related benefits from pre-emptive ergonomic involvement include:

Increased output per worker- Increased output per worker can be done for improvements in workplace design, hardware product design, software design and work system (macroergonomic) design.

Reduced error rate- Because correcting errors takes time, reduced errors frequently translate into increased productivity. Reducing errors also translates into fewer, accidents, and resultant reductions in equipment damage, personnel injuries, and related costs.

Reduced accidents, injuries, and illness- One of the most frequently encountered benefits. For example in one reported case study an ergonomically designed pistol grip type of knife was introduced to replace a conventional straight handle knife for deboning chickens and turkeys in a poultry packaging plant. This enabled the employees to de-bone the foul without having to significantly deviate their wrists, as was the case with the conventional knife. The resulting reduction in cases of carpal tunnel syndrome, tendonitis, and tenosynovitis translated into a saving in workmen’s compensation of $100,000 per year.

Reduced absenteeism- Reductions in lost time from persons failing to show up to work for reasons other than accidents, injuries, or illness, already noted, also is a common outcome of effective ergonomic interventions. Reduced absenteeism also can result in a productivity increase.

Reduced turnover- When ergonomic interventions improve the quality of work life, it is not uncommon to see a reduction in turnover rate, which can represent a significant financial benefit.

Reduced training time- Reductions in training requirements may come about because work system changes result in easier to perform functions and processes that require less time to learn. Alternatively, training requirements may be reduced because of:

(a) less turnover,

(b) reductions in lost time from accidents and injuries,

(c) less absenteeism, or

(d) because fewer people are required to perform a given function

Reduced skill requirements- Improved job designs and related work system processes may also result in reducing the skill requirements required to perform some jobs

Reduced maintenance time- Ergonomic improvements to jobs, worksites, equipment, or work systems can result in reducing the system’s maintenance requirements, thus requiring fewer maintenance personnel.



Doctors With a Special Interest in Back Pain Have Poorer Knowledge About How to Treat Back Pain Jul 16th, 2014
Doctor surveys continue to demonstrate that general practitioners only partially manage low back pain (LBP) in an evidence-based way. This is despite increasing evidence that positive advice to stay active and continue or resume ordinary activities is more effective than rest and early investigation and specialist referral are unwarranted in the majority of cases. In part, this may reflect physician knowledge and beliefs, although physician behaviour may be influenced by many factors including patient expectation and other psychosocial factors.

Providers treating LBP may hold alternative beliefs regarding the association of pain and activity that may influence their practice behaviour. The preparedness of the clinicians to change may be another important barrier that has not been well studied to date.

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The aim of the above study was to determine whether general practitioners’ beliefs about LBP differ according to whether they have a special interest in back pain, musculoskeletal medicine or occupational medicine; and whether these beliefs are modified by having had continuing medical education (CME) about back pain in the previous 2 years.

The results found that GP’s that suggested a ‘special interest’ in back pain were more likely to provide back pain management contrary to the best available evidence. GP’s with a special interest in occupational medicine and physicians with recent Continued CME about back pain had significantly better back pain management beliefs.


Implications

Many other factors besides the employee's medical conditions affect outcomes– e.g. organizational, work-environmental, and social. Providing employees a preferred medical provider and building a relationship with them by presenting them with appropriate and helpful information can improve not only return to work, but also patient management.




Video - Low Back Pain Jul 16th, 2014



Safe Work Australia - Worker fatalities Australia 2013 Jul 15th, 2014
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Data has been released by Safe Work Australia. The aim of this report was to highlight the number of people who died in 2013 from injuries that arose through work-related activity.

In 2013, 191 workers were fatally injured at work. This is 16% lower than the 228 deaths recorded in 2012 and 39% lower than the highest number of worker deaths recorded in the series in 2007. Most of the decrease from 2012 to 2013 was due to a decrease in the number of workers killed in vehicle crashes on public roads (68 down to 43).

The 191 fatalities in 2013 equates to a fatality rate of 1.64 fatalities per 100 000 workers. This is the lowest fatality rate since the series began 11 years ago. The highest fatality rate was recorded in 2004 (2.94).


Notable characteristics of worker fatalities in 2013 include:

- 176 of the 190 fatalities (92%) involved male workers. The fatality rate for male workers was 10 times the rate for female workers.

- Self-employed workers have much higher fatality rates than employees. In 2013, self-employed workers had a fatality rate of 4.39 fatalities per 100 000 self-employed workers, which was over three times the rate for employees of 1.32. The fatality rate for employees has fallen consistently over the past six years but there has been no improvement in the rate for self-employed workers. Perhaps highlighting the difficulties reaching small enterprises. Small enterprises often have limited resources to prioritise these risks and to improve the working environment, and they often have difficulties in complying with legislation.

- Fatality rates increased with age from 0.98 fatalities per 100 000 workers aged less than 25 years to 7.73 for workers aged 65 years and over. However if self-employed workers are removed then the fatality rate for older workers is substantially lower (4.56).

- Truck drivers accounted for 20% of worker fatalities over the past 11 years with 51 truck drivers killed on average each year. In 2013, 39 truck drivers were killed.

- Farm workers accounted for 18% of worker fatalities in 2013. This includes 24 farm managers and 11 farm labourers killed while working.


These are just some of the findings in the new Safe Work Australia report: Work-related traumatic injury fatalities, Australia 2013.


Infographic - Worksite Health Promotion Jul 14th, 2014

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Workplace Walking Group - Worth the Effort?? Jul 13th, 2014
The combination of stress alongside sedentary behaviour is widespread in many workplaces. Therefore, workplace interventions specifically targeting sedentary behaviour and stress may help alleviate some of the risks for heart disease. Individuals who do not engage in regular physical activity (PA) have a 20–30% greater risk for heart disease, thus sedentary behaviour has been identified as a key health issue.

The workplace is a suitable location for incorporating PA, such as walking, at a community level. Increasing activity during suitable periods of the day, such as lunchtime, provide opportunities for performing moderate activity and may, thus, break up long periods of sedentary time.

Current guidelines suggest that employers should encourage more active transport to and from work, more moving within the working day and promote walking during work breaks. Walking is eminently suited to population exercise prescription as it is easy to do, requires no special skills or facilities, and is achievable by virtually all age groups with little risk of injury.

The lunch break is often a time when employees continue to remain at their workstations due to work demands or peer-pressure from colleagues. Thus a detrimental cycle of increased stress and sedentary behaviour can prevail. The lunch period offers an opportunity to engage in moderate PA, interrupting long periods of sedentary time (i.e. prolonged sitting) and providing an opportunity to decrease stress levels and restore physical and mental fatigue.

The American College of Sports Medicine has adopted the recommendation that "every adult should accumulate 30 minutes of moderate intensity activity on most, preferably all, days of the week". However, compliance with these guidelines requires considerable commitment in terms of time spent exercising per week (≥ 150 minutes) and this may deter individuals from starting an exercise programme. There is some evidence that a training frequency of as low as two days per week may elicit improvements in cardio respiratory fitness in the lower fitness categories.


Murphy et al, 2006 evaluated the benefit of a progressive eight week workplace walking program. Participants walked twice per week for 45 minutes at a speed of their own choosing.

The results suggested self-paced walking 45 min, 2 days per week for eight weeks, reduces systolic BP and prevented an increase in body fat, in previously sedentary employees, and was associated with high adherence.

As there was little evidence this exercise intervention improved other markers of heart disease (Aerobic fitness, diastolic BP, body mass, cholesterol and other cardiac enzymes). This walking prescription may be useful as a stepping-stone to further increase levels of exercise in a previously sedentary workforce.

 



The Daily Routines of Famous Creative People Jul 11th, 2014


 



 




Media Release - Disadvantaged Australians Most at Risk of Obesity Jul 9th, 2014

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Image - The Priority Competency Model for Employee Supervisors Jul 9th, 2014

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Proof Exercise Changes Everything Jul 8th, 2014
The average adult needs at least two hours and 30 minutes of activity each week, if it's at a moderate intensity level, like brisk walking. Up the intensity to jogging or running, and you can aim for at least 75 minutes a week. Add in a couple of strengthening sessions a week, and you can expect to build muscle, protect your heart, avoid obesity and even live longer.

That's not to say that shorter bouts of exercise aren't worth it. Even just in 10-minute increments, exercise can make a marked difference in health and well-being. But those of us who make exercise part of their regular routine -- without overdoing it -- are certainly reaping the biggest benefits.



How much time do you spend sitting? Jul 7th, 2014



Preventing Shoulder and Neck pain in the Workplace Jul 5th, 2014
Neck and shoulder pain is a frequent health problem in employees. Globally, the annual prevalence has been estimated to range from 27.1 to 47.8 %. In general, acute neck pain resolves within days or weeks. However, neck pain may recur in 50–60 % of cases within 1 year, and for one in ten, neck pain may become a chronic condition. Thus, the identification of risk factors for neck/shoulder pain at the work place may be important in the prevention of recurrent and possibly chronic pain.

The prevalence of neck/shoulder pain varies considerably across occupations. In addition to mechanical exposure, several psychosocial factors have been acknowledged as potential risk factors. The best documented mechanical risk factors is repetitive movement of the shoulder and neck flexion repetitive associated with repetitive work or precision work. Other mechanical factors like working with the hands above the shoulders, awkward postures, heavy lifting and manual handling have been discussed as possible risk factors, but the evidence is limited or inconclusive.

Several systematic reviews have designated high job demands and low social/work support as the most consistent psychosocial risk factors, whereas different aspects of job control (e.g. influence on the work situation) have been identified as potentially important but less consistent predictors of neck/shoulder pain

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The aim of the above study was to determine work related psychosocial and mechanical factors that contribute to the risk of moderate to severe neck/shoulder pain. A significant relationship existed between both mechanical and psychosocial factors and the development of neck/shoulder pain in the general working population. Highly demanding jobs, neck flexion and awkward lifting appear as the most consistent and important predictors of neck/shoulder pain. Other significant work-related factors were low levels of supportive leadership, hand/arm repetition and working with the hands above shoulder.

Interventions aimed at reducing the development or return of neck/shoulder pain in the general working population may benefit from focusing on a range of both work-related mechanical and psychosocial factors.

Contact us for more.


 



Is Manual Handling Training Worth it? Jul 5th, 2014
graphicManual handling has been defined as any activity requiring the use of force exerted by a person to lift, lower, push, pull, carry, move, hold or restrain a person, animal or object. If these tasks are not carried out safely, there is a risk of injury and research shows a significant linkage between musculoskeletal injuries and manual handling, with the primary area of physiological and biomechanical concern being the lower back (Bernard et al, 1997).

Only some 2% of individuals with back injuries who have been off work for more than 2 years will ever return to gainful employment. The loss of the ability to work can have a devastating consequence on not only the injured individual but also his or her entire family.

Measures to reduce risk of injury start with the requirement to avoid hazardous manual handling wherever practicable. Where this is not possible, attention should be given to the provision of lifting aids and task/workplace design. If a job cannot be ergonomically modified to be less physically demanding Pre-employment Physical Assessment is vital. It is important not to place individuals in a job for which they do not have the physical capabilities to perform.

graphicEmployers are also required to provide their employees with health and safety information and training, and where relevant this should be supplemented with more specific training on manual handling injury risks and prevention (Work Safe Australia, 2011).

The type of training offered and its effectiveness often depends on a multitude of factors such as method of teaching, organization setting and type of training technique that is used. However, concerns have been raised over the efficacy of current manual handling training methods (Dawson et al, 2007).




The Most Effective Manual Handling Training Jul 5th, 2014
Employers are required to provide manual handling information and training, and where relevant this should be supplemented with more specific training on manual handling injury risks and prevention (Work Safe Australia, 2011). Manual handling training and its effectiveness often depends on a multitude of factors such as method of teaching, organization setting and type of training technique that is used. However, concerns have been raised over the efficacy of current manual handling training methods (Dawson et al, 2007).

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The above study systematically reviews the literature to determine the effectiveness of manual handling training interventions. Current manual handling training practices appear largely ineffective in reducing injury. Furthermore, there is considerable evidence supporting the idea that the principles learnt during training are not applied in the working environment.

The lack of effectiveness of technique- or educational based training is widely acknowledged; (i) people tend to revert to previous habits if training is not reinforced; (ii) emergency situations, the unusual case, a sudden quick movement, increased body weight or reduced physical well-being may overly strain the body and (iii) if job requirements are stressful, behaviour modification will not eliminate risk.

What has shown promise is strength and flexibility training based on industry specific ergonomic principles and task analysis (i.e. a regular exercise program including activities that replicate worksite tasks) (Dawson et al, 2007; Clemes et al, 2010). Manual handling training is generally given over a very short time; as a result, the “training” is really more of an information session. When training is specific to the task and dispensed over a longer timeframe, a decrease in back loading and back injuries is possible (Schibye et al., 2003).

As there is strong evidence of an association of occupational injury occurrence and certain personal and non-occupational risk factors. In industry, effective injury reduction programs should go beyond traditional methods of job-related ergonomic risk factors and include personal factors such as smoking, weight control, and alcohol abuse (Craig et al, 2006). More general whole body physical fitness and strength also has greater benefits in terms of reducing manual handling when combined with specific training alone

At Central West Health and Rehabilitation our Small Business Injury Management Service includes gym membership and ‘task specific’ conditioning sessions to assist you and your employees to improve manual handling and reduce injury risk.




The mechanical risks of prolonged sitting in the workplace should not be overlooked Jul 5th, 2014
Low back pain (LBP) is an important public health problem in all industrialized countries. It remains the leading cause of disability in persons younger than 45 years and comprises approximately 40% of all compensation claims in the United States. More than one-quarter of the working population is affected by LBP each year, with a lifetime prevalence of 60–80%.

With the rapid development of modern technology, sitting has now become the most common posture in today’s workplace. Some three-quarters of all workers in industrialized countries have sedentary jobs that require sitting for long periods. Because of the reported link with LBP and the fact that in industrialized countries more of the population acquires a sedentary lifestyle, research examining sitting postures is becoming increasingly relevant (Dankaerts etal, 2006).


Among high risk occupational activities believed to increase low back pain, sitting is commonly cited as a risk factor along with heavy physical work, heavy or frequent lifting, non-neutral postures (i.e., trunk rotation, forward bending), pushing and pulling, and exposure to whole body vibration (WBV) (i.e., Truck driving, plant operation). It has been shown that intradiscal pressure is increased during sitting postures and prolonged static sitting postures are believed to have a negative effect on the nutrition of the intervertebral disc (Lis et al, 2006). Individuals who sit for extended periods can be at increased risk of injury if full flexion movements are attempted after sitting. This risk was evident after 1 hour of sitting, which could be of particular concern for those who design work–rest schedules and job-rotation schemes (Beach et al, 2005).

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The above systematic review found the prevalence rate of reported LBP in those occupations that require the worker to sit for the majority of a working day is significantly higher than the prevalence rate of the general population. While the rate of LBP among occupations requiring extended periods of sitting was not quite as high as the rate of LBP among more strenuous occupations, it has been noted that the sitting group had the highest hospitalization rate for LBP (Lee et al, 2001). This suggests when low back injuries occur in people with sedentary occupations, these injuries tend to be more severe.

The risk of prolonged sitting in the workplace should not be overlooked and this risk appears to increase when coupled with whole body vibration (e.g truck driving or operating plant) and sustained awkward seating postures (e.g. lordosed or kyphosed, overly arched, or slouched).

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Bovenzi and Betta compared a group of agricultural tractor drivers with a group of office workers. Both groups were exposed to static load due to prolonged sitting. However, only the tractor drivers group was exposed to the combined factors of WBV and awkward posture. They found that tractor drivers were 2.39 times more likely to report LBP than office workers.

Those people with chronic LBP (CLBP) often demonstrate difficulty in adopting a neutral midrange position of the lumbar spine. Furthermore, studies have described that during sitting CLBP patients often adopt such awkward seating postures potentially leading to abnormal tissue strain, pain  and increased injury risk (Dankaerts etal, 2006).

At Central West Health and Rehabilitation our Small Business Injury Management Service includes gym memberships and conditioning sessions for workers who sit the majority of a working day.

Contact us for more



Pre-Employment Physical - Cost Effective and Useful Jul 3rd, 2014
Pre-employment testing such as radiographic evaluations, physician administered physical exams, and lumbar range of motion, have generally been shown to be ineffective for injury prevention or injury prediction (Jackson, 1994). Strength testing when correlated to job specific tasks has shown a correlation to work-related injuries. Individuals lacking the physical capabilities to work at the level that their job physically required had a significantly increased incidence of low back injuries.

Controlling the incidence of work-related injuries is economically important for industry, but is of far more importance for the individual employee. Injuries occurring on the job can result in life-altering consequences to workers who depend on their physical well being for their livelihood. Only 2% of individuals with back injuries who have been off work for more than 2 years will ever return to gainful employment. The loss of the ability to work can have a devastating consequence on not only the injured individual but also his or her entire family.

The most efficient methods of controlling workmen’s compensation expenses are geared toward lowering the rate of injury. Several authors have demonstrated that jobs requiring heavier lifting result in a higher incidence of low back pain. One method of controlling work injury rates is to ergonomically re-engineer jobs to be less physically demanding. This approach creates a safer, less physically stressful work environment that benefits the employee. If a job cannot be ergonomically modified to be less physically demanding, it becomes a safety issue to place individuals in a job for which they do not have the physical capabilities to perform.

Aiming to identify and monitor any functioning or health abnormality in prospective employees, pre-employment medical examinations traditionally rely on the classic assessment of specific medical conditions or substance abuse. However, this is not particularly relevant for fitness-for-work decisions. The assessment of fitness for work related to physical and mental job demands seem a better predictor than searching for a medical diagnosis.

There is strong evidence of an association of occupational injury occurrence and certain personal and non-occupational risk factors. In industry, effective injury reduction programs should go beyond traditional methods of job-related ergonomic risk factors and include personal factors such as smoking, weight control, and alcohol abuse (Craig et al, 2006).


As well as highlighting candidate suitability, pre-employment physical assessments (PEPA's) with a trusted service provider provide a number of other important benefits:


  • PEPA's provide a mechanism that can be tightened or loosened according to the employment environment.

  • PEPA's provide a great place for manual handling education and training for injury prevention advice.

  • PEPA's provide a great place to highlight and commence worksite health promotion for high risk employees.

  • PEPA's can be used to negotiate a reduction in your insurance premiums when discussing your yearly insurance premiums with insurers.


Central West Health and Rehabilitation has significant experience in designing and providing Cost Effective Pre-employment Physical Assessments. Contact us for more




Video - Central West Health and Rehabilitation Jul 3rd, 2014



Alcohol: Impact on Sports Performance and Recovery Jul 1st, 2014
Above the safe levels recommended by the WHO, alcohol consumption becomes hazardous (4–6 or 2–4 standard drinks per day for males and females, respectively). Even larger amounts are classified as harmful and may significantly increase the risk.

In addition to hazardous, chronic alcohol consumption, heavy acute episodic or binge drinking, classified as the consumption of 60g of alcohol in a single drinking episode, is associated with significant physical, psychological and social harm. Approximately 16.5 % of the world’s population are thought to participate in heavy episodic drinking on a weekly basis of negative mental and physical health issues, such as a range of cancers, hypertension, stroke and injuries related to violence.


While acute and chronic misuse of alcohol is common place in the general population, the athletic/sporting population is not exempt from such behaviour. Athletes often do not consider alcohol as harmful in the same way they consider other recreational drugs. Therefore it is important athletes have a full understanding of the implications alcohol consumption may have on sporting performance, recovery and, perhaps more importantly, general health.

The most relevant point is how the consumption of alcohol after exercise alters recovery and adaptation. Dehydration has been shown to impair performance and so adequate rehydration and restoration of electrolytes after exercise is important to ensure recovery before the next training session or event. It has been suggested that the best opportunity for optimising glycogen stores occurs when carbohydrate is consumed in the initial hours after exercise; after that time, glycogen storage rates decrease significantly.

However, in many sports this period after competition may be spent consuming alcohol instead of following correct nutritional strategies. Small volumes of alcohol, at a dose less than 0.49 g/kg Body Weight, after exercise without negatively impacting rehydration, however, if fluid replacement is not a priority, for example if optimal performance is not required the next day, then the consumption of alcohol post-exercise in larger volumes may be acceptable, at least from a hydration stand point.

Particularly important for males, in both athletic and general populations, is the reduced production of testosterone and subsequent effects on body composition, protein synthesis and muscular adaptation/regeneration; these effects are likely to inhibit recovery and adaptation to exercise. Low doses of alcohol, post-exercise are unlikely to be detrimental to repletion of glycogen, rehydration and muscle injury; however, the effects of alcohol are dependent on the timing of consumption, nutritional status and the priority given to optimal rates of recovery. Higher doses should be avoided if injury to skeletal muscle has occurred. While very high, hazardous doses of alcohol consumed after strenuous exercise may not directly impact performance in the days after exercise, such bingeing behaviour is associated with long-term physical, psychological and social harm and should therefore be avoided.

It should be remembered that alcohol is a poison and as such should be treated as one!

While less likely to occur than drinking large volumes of alcohol after sports, the consumption of even low doses of alcohol prior to athletic endeavour should be discouraged due to negative effects of alcohol on endurance performance.



Health Related interventions for Shift Workers Jul 1st, 2014
Shift work is prevalent in healthcare, emergency services, manufacturing, retail, and hospitality. Some jobs require regular work on the same night shift (ie, permanent night shift), while others are employed on rotating shift schedules involving days and nights.

Shift work, particularly work at night, has been found to disrupt endogenous circadian rhythms involved in melatonin expression, sleep patterns, food digestion, and other physiological processes. Work at night is associated with a range of known and potential adverse health effects.

Aside from potential cancer risks, shift workers also experience increased incidence of chronic illnesses including cardiovascular disease, diabetes, and metabolic syndrome (a combination of obesity, dyslipidemia, high cholesterol, and insulin resistance), as well as gastrointestinal disorders, workplace injuries, and disruption of family and social life.

The short- and long-term effects of shift work on sleep have also been studied. Night work has been shown to reduce sleep quantity and quality on workdays and days off. While shift workers tend to fall asleep rapidly in the morning immediately following a night shift, sleep tends to be shorter due to the natural awakening effects of circadian rhythms during the daytime, as well as social cues and daytime commitments. Sleep questionnaires completed by shift workers show reduced sleep length and higher frequencies of sleep difficulties, intermittent sleep, and early waking. Poor sleep quality and quantity have been shown to be related to various chronic diseases including diabetes, cardiovascular disease, and obesity. Thus, sleep quantity and quality are important outcomes of interventions aimed at improving long-term health among shift workers.

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There is a need for interventions that can be implemented in workplaces – or by workers outside of work hours – to mitigate the harmful effects of shift work. The main objective of this review was to synthesize intervention studies designed to mitigate the adverse health effects of shift work.

Controlled light exposure

The aim of interventions that control light exposure is to shift circadian rhythms and subsequently promote adaptation to work at night, thereby minimizing health effects. A combination of timed bright light and light-blocking goggles appeared to promote adaptation to shift work as primarily measured by changes in sleep and melatonin. Timed exposure to high intensity light during night shifts and wearing goggles during the commute home can increase circadian adaptation. Multi-pronged interventions to control light exposure may be more effective than using bright light or light-blocking goggles alone. Adverse events for bright light exposure were headaches or feelings of heat/cold in response.

Shift schedule change

Fast-forward rotating shifts tended to report more favourable results for sleep. However, findings were inconsistent for changes in shift length or start time. Shift workers may be less likely to engage in regular physical activity, smoking cessation, and healthy diet, which may contribute to increased risks of adverse health outcomes. Objective outcomes that may be the result of improved lifestyle habits, such as low-density lipoprotein cholesterol; triglycerides, fasting glucose, and blood pressure; cardiorespiratory fitness; and blood pressure, did show improvement in association with a change in shift schedule.

Interventions directed at physical activity and weight loss improved cardiorespiratory fitness and strength, body composition, blood pressure, and physical activity. This suggests that lifestyle habits may not improve spontaneously among shift workers as a result of shift schedule changes, and interventions specifically targeted at improving lifestyle behaviours may be necessary. Adverse effects were difficulty scheduling social or family activities as a result of a shift schedule change.

Behavioural interventions

Physical activity improved sleep length with variable results on subjective sleep quality, and education about sleep hygiene strategies resulted in significantly improved REM sleep time. A 1-hour rest period during the night resulted in no significant change in sleep duration following the night shift. Other outcomes were also evaluated. Exercise significantly increased maximal aerobic capacity and strength, although circadian phase did not differ between groups, as measured by body temperature. A group based lifestyle intervention for weight loss was associated with significantly decreased body mass index and blood pressure and significantly improved physical activity and fruit intake. 

Pharmacological interventions

Studies of melatonin, hypnotics, and stimulants showed mixed results, potentially due to different doses administered to workers, compliance, shift schedule variation, and other factors. Administration of Modafinil did not significantly change endogenous melatonin levels or sleep quantity before or after night shifts. Armodafinil resulted in a small but statistically significant improvement in nighttime sleep latency but had no effect on daytime sleep. Some adverse effects were reported, including insomnia and headache from Modafinil, and nausea, anxiety, low-back pain, and other effects from Armodafinil.

Conclusions

Comprehensive, evidence-based approaches that include best practices in shift scheduling, a range of options to control exposure to light and dark, support for physical activity and healthy eating, as well as pharmacological agents, may be the best ways to improve health. There is also a need to develop and test novel approaches, like social support, possibly using new technologies such as smart phones to help with sleep or other adverse effects. There is no “one size fits all” solution, and individual shift workers may have different responses to interventions as the result of chronobiology, personal preferences that affect compliance, or other factors that remain to be assessed.


Fruit juice: just another sugary drink Jun 30th, 2014
The evidence for a role of sugar-sweetened beverages (SSBs) in the development of obesity and associated comorbidities, is becoming increasingly convincing.

Liquids have a smaller satiating effect than do solid foods, and consequently excess calories consumed in liquid form are not fully compensated for by reduction of intake of other foods. Evidence exists that non-alcoholic beverages contribute a substantial proportion of daily sugar intake (about a quarter of sugar intake in the UK), are consumed separately from other dietary components, are of little nutritional benefit, and that alternatives in the form of low-sugar drinks and water are readily available.

By contrast with the growing consensus to limit SSB intake, consumption of fruit is regarded as virtuous, with WHO guidelines recommending consumption of fruit and vegetables—eg, in the UK, the guidelines recommend five servings per day, and one of these portions can be in the form of fruit juice.

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However, fruit juice has a similar energy density and sugar content to SSBs: 250 ml of apple juice typically contains 110 kcal and 26 g of sugar; 250ml of cola typically contains 105 kcal and 26·5 g of sugar. Additionally, by contrast with the evidence for solid fruit intake, for which high consumption is generally associated with reduced or neutral risk of diabetes, high fruit juice intake is associated with increased risk of diabetes.

In the modern context, where society is faced with an energy surfeit, health-care providers and policy makers must take every opportunity to help individuals to cut unnecessary calories from their diet. Some go as far as suggesting that fruit juices are sugary drinks and should be taxed and/or recommend elimination of all fruit juice consumption from children’s diets.

While extreme, this does highlight that the debate about the SSB reduction should include fruit juice.

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Lifting Strategies of Expert and Novice Workers Jun 28th, 2014
Manual material handling (MMH) involves considerable physical work demands and is considered a high-risk task for low back pain (LBP). The risk increases with the magnitude of the physical exposure in terms of the load moment, trunk motion dynamics and trunk posture. There exists a large variability in low back loading and lifting posture that could be explained by individual differences (between subjects) and by trial-to-trial variations. Thus, for the same task, spine loading and posture can change markedly between trials and individuals.

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liftgraphicThe above study showed that 'expert' workers differed from novices mostly in the posture-related variables (lumbar flexion angle, trunk inclination, knee flexion) and much less in the back loading ones (peak resultant moment or asymmetrical moment at L5/S1). Experts posture was quite different from the novices at the instant of the peak resultant moment as they bent their trunk and lumbar region less (even when age was accounted for with the lumbar flexibility index). Moreover, their knees were more flexed when the box was lifted from the floor of the pallet. Experts were also closer to the box during both the lifting and the deposit phases (See Image).

These posture-related variables could have a major impact on the distribution of internal forces on the spine, but expertise had a very small effect on the external back loading variables (peak resultant moment and peak asymmetrical moment at L5/S1), which are important indicators of risk in terms of work-related back injuries.

Various intervention strategies, such as training employees in safe lifting techniques, are used with the aim of protecting workers from back injuries. Recent reviews have seriously questioned the effectiveness of training programs as a mean of reducing back injuries. However, these reviews are based on a small number of studies, and the quality of the training intervention is generally not questioned. Important aspects such as the content of the training course, its duration and its specificity to the work context are worth consideration. 

A simple question that still needs to be answered is  “What should be taught?”.

Manual handling training is generally given over a very short time; as a result, the “training” is really more of an information session. When training is specific to the task and dispensed over a longer timeframe, a decrease in back loading and back injuries is possible (Schibye et al., 2003). The following study suggests ergonomic intervention with the aim of reducing external back loading should primarily focus on major factors such as the load height and horizontal distance between the lumbar spine and the load lifted in order to reduce the external back moment, and not just on workers’ technique.



Image - Expert and novice Lifting Jun 28th, 2014

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Video - Incorrect Vs Correct Lifting Jun 28th, 2014



External Assistance for Injury Management Systems Jun 27th, 2014
Western Australia is fortunate to have an insurance premium-related incentive scheme where a company’s insurance premium is graded according to claim experience. However, smaller enterprises often have difficulty making use of the benefits.


graphicNational Occupational Health and Safety (OHS) intervention programmes are often difficult to implement in smaller enterprises. Despite it being generally accepted that small enterprises with less than 50 employees have higher exposure to occupational hazards than larger organisations, smaller enterprises often have limited resources to prioritise risks and to improve the working environment, and they often have difficulties in complying with legislation.

The Western Australian workers’ compensation system requires every employer to:

1) Have workers’ compensation cover for all workers (penalties apply for avoidance).

2) Have a documented Injury Management System outlining the steps taken when a worker is injured and contact details of person responsible for the Injury Management System.

3) Establish and implement a Return to Work Program as soon as practicable after:

- the treating doctor indicates in writing the need for a Return to Work Program; or

- the worker’s treating doctor signs a medical certificate to the effect that the worker has partial capacity for work or has total capacity for work but is unable to return to their pre-injury position for some reason.

Small enterprises constitute a major challenge for efforts to improve occupational injury management as they, on one hand, have extensive needs, and on the other hand, are difficult to reach. At particular stages in a businesses development there is legitimate grounds, both personal and financial, for sourcing an external service provider to assist with the injury management and injury management system development.


Costs of Going it Alone:

1) Time to Research a System $$/hour

2) Time to design a system $$/hour

3) Time for Template Design $$/hour

4) Costs of employing Injury Management Co-ordinator $$/hour


Central West Health and Rehabilitation offer a ‘low cost’ Injury Management Service specifically designed for Small Businesses not yet ready to employ specific Injury Management Staff.



The role of client motivation in Return to Work Jun 26th, 2014
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To reach the desired return to work outcome, the Rehabilitation Counsellor is required to identify social, economic, and environmental factors that may adversely affect a client’s motivation toward rehabilitation. Motivation has been recognised as an essential component in managing medical issues, adjusting to physical disability, cognitive impairment, returning to work, and improving psychosocial functioning.

It is too simplistic to say people are motivated or not; rather people are motivated by different things and this can be influenced. Motivation refers to the underlying internal and external influences on behaviour that determine whether a person will achieve the desired rehabilitation goals. 

The current article focuses on understanding the concept of motivation, reasons for its presence or absence, and why motivation is important to the workplace rehabilitation process. The authors also explore significant influencing factors that may be utilised to increase motivation and promote more successful return to work outcomes.

Immediately after the onset of work disability/injury, the return to work aspect of rehabilitation may not be a priority; however as the rehabilitation and return to work process develops, priorities change and motivations to reach personal goals are highlighted. Motivation does not become a focus at any one point in the rehabilitation process, but rather should be maintained throughout the return to work process. Positive and lasting results most likely occur when a client becomes motivated, actively engaged, and invested in change in all aspects of their life.



Factors that Influence Motivation



  1. Internal motivation- the willingness, readiness, and desire to change to achieve the desired outcome

  2. Key stakeholders- It is important that all stakeholders have the potential to gain from the worker successfully returning to work to ensure each stakeholder has an interest in motivating the client to strive for the return to work outcome

  3. Social supports- strong network of good relationships.

  4. External regulation- Pressure from third party payers in many settings dictates a short-term and limited funding approach to change, which makes motivation more critical. It also makes motivation more difficult to establish as clients have less control.

  5. Perceived costs and benefits- the client might be more willing to participate in the rehabilitation process if they are able to see the benefits and payoffs in the future. Possible costs within a workplace rehabilitation plan include the required effort to participate fully, as well as the associated tiredness or pain.

  6. Hope and individual beliefs surrounding working identity- People have increased motivation to return to work if their job is meaningful and they have a sense of belonging and being appreciated.



GP and patient predictions of sick-days duration Jun 25th, 2014

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In general practice, sick-listing (give days off work) is a frequent and cost-generating measure often experienced as problematic for the doctor. One reason is that sick-listing involves assessment of how the symptoms reduce the patient’s ability to work, requiring physicians to rely on the patient’s own description of the job and his/her capacity to do it. From the patient’s point of view, the sick note is important if his/her self-perceived ability to work is low. Without the note the patient must keep on working, and patients often worry that working may affect their health negatively. Thus, consultations involving sick-listing assessment involve several difficult considerations on the part of both the physician andthe patient.

In this study the correspondence between the patients’ and the GPs’ perception of the duration of sick-listing was not high. Furthermore, the correspondence between the patients’ and GPs’ respective predictions of sick-listing duration, made at the first consultation, and the respective actual duration was rather low. 


Implications

Many other factors besides the employee's medical conditions– e.g. organizational, work-environmental, and social. These factors might be hard to take into consideration at the first consultation, and might not become evident until after several visits. Early in the process, medical factors might be more important for both the physician and the patient, and only a brief consultation may be made regarding workplace factors. This seems to be a relevant approach; however, being sick-listed might in itself influence the patient ’ s motivation and confidence in returning to work. It is important to address issues related to occupation and the workplace early in the consultation to support the process of returning to work efficiently. This can be assisted by the Injury Management Co-ordinator attending initital medical appointments, or providing your employees a preferred medical provider

In the present study, the overall correspondence between the GPs ’ prediction of the interval until return to work and the actual duration of sick-listing was not high on the whole. It is possible that the patients ’ expectations might have affected the interval until their return to work. Patient expectations and a focus on return to work is important to promote from the first medical appointment.


 



Poor nutrition leads to development of chronic diseases Jun 24th, 2014
GraphicInternational research involving the University of Adelaide has shown for the first time that poor nutrition – including a lack of fruit, vegetables and whole grains – is associated with the development of multiple chronic diseases over time.

The results of the study, which looked at health, diet and lifestyle data of more than 1000 Chinese people over a five-year period, are published in this month's issue of the journal Clinical Nutrition.

Study co-author Dr Zumin Shi, from the University of Adelaide's School of Medicine suggested "Those participants who ate more fresh fruit and vegetables, and more grains other than wheat and rice, had better health outcomes overall. Grains other than rice and wheat – such as oats, corn, sorghum, rye, barley, millet and quinoa – are less likely to be refined and are therefore likely to contain more dietary fibre. The benefits of whole grains are well known and include a reduction in cardiovascular disease, diabetes and colorectal cancer."


Video - Dietitian Summary Jun 23rd, 2014



Video - Fat Vs Sugar Jun 23rd, 2014


Video - What is Diabetes Jun 22nd, 2014



Video - Energy Balance and Weight Loss Jun 22nd, 2014



Video - Exercise and Chronic Disease Jun 22nd, 2014



Video - Behaviour Change and New Years Resolutions Jun 22nd, 2014



Rationale for using an intermediary to assist small businesses with Injury Management Systems Jun 22nd, 2014
It is generally accepted that small enterprises with less than 50 employees have higher exposure to occupational hazards than larger organisations. Small enterprises often have limited resources to prioritise these risks and to improve the working environment, and they often have difficulties in complying with legislation. Small enterprises constitute a major challenge for the society’s effort to improve occupational injury management as they, on one hand, have extensive needs, and on the other hand, are difficult to reach. Just one worksite injury could produce serious economic consequences to a unprepared small business.

Central West Health and Rehabilitation work specifically with small enterprises as a trusted intermediary to assist with injury management processes.

Hasle and Limborg have developed a model for reaching out to small enterprises with intervention programmes. The model emphasises the need for inclusion of not only the concrete changes of the working environment but also the process in which small enterprises are approached and motivated to start a change process.

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The model can be used to construct a stepwise procedure for the design of working environment programmes. The idea is to start from the right side of the model and subsequently work backwards through the chain in order to end up with a full designed programme. The design procedure therefore has five steps:


  1. Defining the OHS challenges of the target group (health outcome).

  2. Selecting methods and solutions that can improve the working environment by reducing the exposure and thereby producing the intended health outcome (improvement of the working environment).

  3. Developing theories about mechanisms which can motivate the target group to initiate change. On the general level, there are three main mechanisms: regulation, incentives, and information (change process).

  4. Analysing how the specific context of the target group may influence motivation and implementation of the intervention (context).

  5. Designing the programme which builds on the results of the four preceding steps (programme).


This method has been used in the development of a practical intervention programme aimed at small construction enterprises. The transparency opens the possibility for critical discussions and thereby improvements of both design criteria and design conclusions.

Contact Us for an Injury Management System Assessment



Fatal accidents in the Western Australian mining industry 2000-2012 Jun 21st, 2014
graphicThis report examines the 52 fatal mining accidents that occurred in Western Australia over the 13-year period from 2000 to 2012, inclusive. The information was analysed to identify common hazards, causation factors and critical activities.

Twenty-four causation factors were identified and used to provide a framework for analysis. A person might conduct 50 to 100 tasks during a shift, of which just one or two could lead to a situation with the potential for serious injury or death. So knowledge of the critical tasks is important when addressing risks. 

Factors for which trends or clusters were identified were:


  1. Occupation of deceased

  2. Duration in the role

  3. Duration at the mine site

  4. Supervisors Duration in the role

  5. Compliance with procedures

  6. Trigger events

  7. Time of day

  8. Surface or underground

  9. Commodity group

  10. Original equipment manufacturers’ procedures

  11. Age of deceased

  12. Roster cycles


These factors are discussed in more detail in the relevant document along with significance of trigger events to individual fatalities and critical activities.


Strategies to Help Employees Return to Work Jun 21st, 2014
Engaged and productive employees are the lifeblood of almost every business. No employer wants valuable human resources at home when they could be working. Time off work is unhealthy. The longer an employee is off work the less chance there is of returning to work (RTW).


The World Health Organization for example, stated in an international study that safe and productive work is a major source of physical and psychological well-being.


Does your workplace currently have an Injury Management System as required by Workcover WA? Are you seeing the results that you expected to see? Maybe your workplace is fully insured or you are trying to manage your benefit programs in-house, or as part of duties of the HR Department. Have you become overburdened with administration and less than satisfactory results?

The key components of an Injury Management System should include:

Senior support


One of the foundations of a solid injury management is to get senior support on side. The challenge of managing disability in both human and financial terms is enormous, yet the factors involved in finding the right strategy are still poorly understood at an organizational level. There are many reasons to get an organisation interested in injury management.

Early Identification


Injury Management Systems begin with early identification of injuried workers.  Also crucial is the identification of potential conditions that can result in worker disability.

The sooner there are the correctly identified symptoms the sooner return to work planning can put in place strategies to resolve them. Early intervention is proactive and affords the opportunity to identify which claims may need special handling to resolve them early.

Evaluation of medical, psychosocial and return to work needs.


We have found three types of disability groups have come to light over the years.

GROUP 1

The first is short duration claim where the patient has a well-defined acute episode (i.e. flu, strain or sprain). These cases will return to work often with minimal intervention.

GROUP 2

The second group represents patients with sub-acute or progressive diseases or injuries. This population often needs help with ensuring the primary interventions are enough to progress back to health. They may need help in finding their way through the health care maze to a provider that can assist in resolving their medical or psychosocial issues. It is important to keep this group focused on the return to work goal and that may need assistance via a graduate RTW.

GROUP 3

The third group are those with terminal or debilitating diseases, such as Chronic Pain, Cancer or Multiple Sclerosis, that may eventually prevent return to work. The primary needs are ensuring these people are familiar with the range of services available in their community and providing help with ongoing discussions on their level of ability.


Ability Management


In all three groups, there are essential best practices to bear in mind.

Focus on what the person can do, not the cure. If disability limits what a person can do due to illness, injury or a condition then effective management, rather than eliminating symptoms, discusses what the employee is able to do.

Symptoms such as pain are not disability, they are symptoms. Often staying at home and dwelling on the pain can lead to a Chronic Pain Syndrome. Work provides many people with friends, support networks, focus, meaning and distraction from ruminating on a condition. 

Focus on ability is the goal, while being compassionate but firm. It is important to work together and empathize with the conflicting feelings of pain versus disability; however, through gradual transition back to work the symptoms will decrease as the tolerance for activity or interaction increases.

Return to Work


Return to work should always be the goal.

From the first interaction with the employee, their physician, their manager, and/or the union representative (where applicable) make it clear that any treatment, medication, protocol or intervention is for returning the employee to work as soon as possible. Encourage health care providers to set up tentative return to work dates.

Discuss the appropriate treatment duration. For example, with a back injury, emphasize that a few days bed rest, active physiotherapy, rapid reactivation, and return to normal activity levels, is the general strategy for most people.

In this situation, it is also necessary to emphasize that returning to work is not about waiting for the absence of pain. What the employee is able to do, not pain, is the benchmark for returning to work.

Reasonable job accommodations or transitional jobs (i.e. suitable duties) are a necessary part of effective return to work. An effective return to work program often includes a phase in which the employee returns for specified periods and specific tasks. The intent should always be a return to a regular position. This could be either the pre-disability position – or another suited to the employee’s skills, capabilities and knowledge. Alternative duties should be re assessed regularly.


Measurement of the results


An effective injury management program needs to have a way to measure its outcomes.

Comparison of data from one period to the next is critical to measure the effectiveness of a particular intervention. When the goals set for the system are measurable it helps to determine their effectiveness. In the end you are able to say, “what was it before and how are we doing now.”

As well as gathering the data, there is the need to communicate the results and use them to drive prevention programs. When you get all parties involved to embrace the broader view of disability management it can be a very effective part of taking care of your business.

Contact Us for an Injury Management System Assessment



Video - Understanding Chronic Pain Jun 21st, 2014



Returning to work – a long-term process reaching beyond the time frames of multimodal non-specific back pain rehabilitation Jun 21st, 2014
imageLow Back pain (LBP) is a common health problem. Furthermore, long-term back pain often exerts a negative impact on participation in everyday activities. Health professionals strongly emphasise the importance of focusing rehabilitation on aspects that improve the patient’s well-being and quality of life. Return To Work (RTW) might then be a possible, but not a necessary, feature of LBP rehabilitation. This is one explanation for the modest effect rehabilitation has exerted on reduced sickness absence.

Previous research has found that focusing on the patient’s everyday life is important in efforts aimed at reducing sickness absenteeism and in increasing RTW as well-functioning everyday life can promote RTW. Still, other research has shown that patients may also experience uncertainty about how to proceed with the process of RTWafter rehabilitation is completed, particularly when there has not been a clear connection between features in the rehabilitation and the patients’ work situations. Furthermore, interventions that included structured meetings of employee, employer and health professional, that took up planning and agreements regarding suitable work modifications, appeared to be more effective in the promotion of RTW in people with back pain on long-term sick leave than the interventions that do not include these features. This is despite significant research highlighting the health benefits of work.

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In the above study, Fifteen participants were interviewed, all were working with multimodal rehabilitation for people with non-specific back pain in eight different rehabilitation units. The participants experienced RTW as a long-term process reaching beyond the time frames of the medical rehabilitation. Their attitudes and, their patients’ condition, impacted on their work which focused on psychological and physical well-being as well as participation in everyday life. Health professionals often created an action plan for the RTW process, however the responsibility for its realisation was often transferred to others (i.e. the patient). The participants described limited interventions in connection with patients’ workplaces.


Implications

Rehabilitation programs targeting return to work (RTW) for people with non-specific back pain needs to include features concretely focusing on vocational issues.

Health and RTW is often seen as a linear process in which health comes before RTW. Rehabilitation programs could be tailored to better address the reciprocal relationship between health and work, in which they are interconnected and affect each other.

The RTW process is reaching beyond the time frames of the multimodal rehabilitation but further support from the patients are asked for. The rehabilitation programs needs to be designed to provide long-term follow-up in relation to the patients’ work.



Time to Move on Physical Activity as Usual Care for Mental Illness Jun 18th, 2014

Physical inactivity is estimated to cause 9% of premature mortality worldwide, but recognition of the benefits of being physically active is increasing. In addition to the cardiometabolic benefits of regular bodily movement, physical activity has repeatedly been shown to have antidepressant and anxiolytic qualities, both as monotherapy and as adjunctive therapy. At what point do we decide that sufficient evidence exists for a cultural change within psychiatric care, whereby exercise physiologists or physical therapists (and indeed dietitians) are considered as standard members of the multidisciplinary mental health team?


Simon Rosenbaum, BSc from the The George Institute for Global Health, Sydney, Australia gives us some good reasons why in this blog post:


Time to Move on Physical Activity as Usual Care for Mental Illness


 




The Role of the Australian Workplace Return to Work Coordinator: Essential Qualities and Attributes Jun 18th, 2014

 


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In the Australian context, a return to work (RTW) Coordinator (or Injury Management Co-ordinator) assists an injured worker with workplace-based support and regulatory guidance for the duration of their injury. Coordinating the RTW process has been considered an effective approach for managing workplace injuries. This study aimed to provide insight as to the skills and attributes needed for the role of the workplace RTW Coordinator from their experience and perception.


Conclusion: Effective management by the RTW Coordinator of the complex RTW process is essential to facilitate a smooth transition for the injured worker, alongside maintaining a professional relationship with the employer and external stakeholders. The results of this study can be utilised to further improve the selection of future RTW Coordinators.


Three key themes clearly emerged:graphic



  1. Communication skills

  2. RTW Coordinator characteristics

  3. Managing the RTW process



Sedentary behavior increases the risk of certain cancers Jun 17th, 2014
 

Physical inactivity has been linked with diabetes, obesity, and cardiovascular disease, but it can also increase the risk of certain cancers, according to a study published June 16 in the JNCI: Journal of the National Cancer Institute. To assess the relationship between TV viewing time, recreational sitting time, occupational sitting time, and total sitting time with the risk of various cancers,  Schmid and Leitzmann of the  Department of Epidemiology and Preventive Medicine, University of Regensburg, Germany, conducted a meta-analysis of 43 observational studies, including over 4 million individuals and 68,936 cancer cases.

When the highest levels of sedentary behavior were compared to the lowest, the researchers found a statistically significantly higher risk for three types of cancer—colon, endometrial, and lung. Moreover, the risk increased with each 2-hour increase in sitting time, 8% for colon cancer, 10% for endometrial cancer, and 6% for lung cancer, although the last was borderline statistically significant. The effect also seemed to be independent of physical activity, suggesting that large amounts of time spent sitting can still be detrimental to those who are otherwise physically active. TV viewing time showed the strongest relationship with colon and endometrial cancer, possibly, the authors write, because TV watching is often associated with drinking sweetened beverages, and eating junk foods.

The researchers write “That sedentariness has a detrimental impact on cancer even among physically active persons implies that limiting the time spent sedentary may play an important role in preventing cancer….”

In the studies analysed, the least amount of time people spent sitting down was about two or three hours. Each two hours per day increase in sitting time above this level was said to increase the risk of bowel, endometrial and lung cancer.

 



Postures assumed when using laptop computers and desktop computers Jun 17th, 2014
 

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This study evaluated the postural implications of using a laptop computer. Laptop computer screens and keyboards are joined, and are therefore unable to be adjusted separately in terms of screen height and distance, and keyboard height and distance. The posture required for their use is likely to be constrained, as little adjustment can be made for the anthropometric differences of users. In addition to the postural constraints, the study looked at discomfort levels and performance when using laptops as compared with desktops.

 

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The results showed significantly greater neck flexion and head tilt with laptop use. The other body angles measured (trunk, shoulder, elbow, wrist, and scapula and neck protraction/retraction) showed no statistical differences. The average discomfort experienced after using the laptop for 20min, although appearing greater than the discomfort experienced after using the desktop, was not significantly greater. When using the laptop, subjects tended to perform better than when using the desktop, though not significantly so. Possible reasons for the results are discussed and implications of the fundings outlined.

 


 

 


Mental Toughness Jun 12th, 2014
graphic'Mental toughness' is a term that is often thrown around as central to high sports performance.

Defined as a personal capacity to produce consistently high levels of subjective (e.g., personal goal achievement) or objective (e.g., race times) performance despite everyday challenges and stressors as well as significant adversities.

Mental toughness is often discussed as a collection of personal characteristics including attributes such as self-confidence, optimistic thinking, buoyancy, self-determination and self-efficacy. Self Efficacy theory suggests the degree to which individuals perceive their actions as efficacious will determine how much effort they expend and for how long they persist on tasks.

 


 

Mental Toughness has been shown to be related to performance, and related to a social environment that nurtures autonomy, competence, and relatedness (termed autonomy-supportive). Autonomy-supportive environments are characterized by the offering of choice (within boundaries), the acknowledgment of feelings or perspectives, the use of noncontrolling actions and feedback, the provision of meaningful rationales, and the nurturing of individuals’ inner motivational resources (e.g., curiosity, enjoyment, belonging). In comparison, controlling environments are characterized by the manipulative use of rewards, negative conditional regard, intimidation, and excessive personal control.

It is suggesed that the provision of autonomy-supportive environments lead to the facilitation of mental toughness, whereas controlling environments may lead to the forestallment of mental toughness. Mental toughness development is contingent on an athlete being afforded opportunities to explore and engage in tasks volitionally (e.g., self-directed learning), perceiving themselves as competent and feeling challenged during learning (e.g., being able to demonstrate skill mastery, engage in competitive challenges), and feeling respected, cared for, and needed by those around them (e.g., positive social support, a sense of belonging).

 

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Understanding Training Load Jun 12th, 2014
I get asked about training load quite a lot. Coaches will generally ask about how to periodise an athletes training load, athletes will ask about how can they adjust their training so that they can get better recovery or optimise this training load so they can peak for competition and parents want to know how they can ensure that their kids are going to be overtrained.

The first point to make is that training load is a very important variable to have under close control. It is possible to manipulate training variables within a week to maximise an athletes readiness to train. This has a double effect in that it decreases the risk of overtraining, leading to injury and illness, as well as increasing the likelihood that an athlete will gain a high level performance outcome.

I was at a conference in 2008 and heard a presentation from a prominent Performance Coach who was working with a Super Rugby team at the time. He used an analogy to describe training load that I quite like. He spoke about each athlete having a cup and every time we train or compete we are filling that cup with a volume of fluid congruent with the intensity of that that session or game. Every time that athlete performed an action to help their recovery, such as having a day off, getting a massage or doing a pool session, they empty their cup of a volume of fluid congruent with the benefit gained from the recovery modality. The end goal was to have the cup as full as possible without overflowing and when the cup did overflow, the athlete was at greater risk of illness and injury. I’m sure that there are people out there who could poke holes in this analogy but I like the imagery that it provokes.

This analogy points out the importance of managing training load and that it is about balance and in order to do that we need to have a tool for measuring an athlete’s training load. Training load is commonly assessed using a subjective assessment tool such as the RPE scale. The RPE scale is comes in various forms and correlates a number to a descriptor of an athlete’s level of exertion. In order to assess an athlete’s training load, we need to ask them to rate the difficulty of the training session within the first 30 minutes of them finishing the training session. We ask them to rate how difficult the session was physically and mentally and ask them to take into consideration how they felt prior to starting the session. This will alter the score based on their residual levels of fatigue. We then multiply this score by the duration of the session, which give us an arbitrary unit, which is our training load. We then total the score and record these values over a period of weeks.

There has been a lot of research about training load and while there are individual variations it has been found that when using the Borg 1-10 RPE scale, when athletes have a week of training where they are above 3500 points, they are at increased risk of having an adverse outcome such as injury or illness. Consecutive weeks of training load values greater than 3500 points can further increase the risk of injury and illness related to over training.

In my career I have found monitoring training load to be a very useful tool from a number of aspects, namely:



  • Maximising performance outcomes through ensuring effective difficulty of training contrasted with adequate recovery

  • Decreasing the risk of injury and illness through flagging consecutively high weekly training loads

  • Monitoring the training load of players as they return from injury to ensure adequate return to full fitness, while minimising the risk of re-injury



I have also found that there is no single structure that can be applied to any athlete. It is definitely more of an art rather than a science with regard to determining what an individuals training load tolerances are during various sections of the season. I have had some athletes who have been able to tolerate weekly training loads greater than 4000 points during pre-season, while other athletes can only manage less than 2000 points per week before they start to breakdown.

It is important to plan your season according to the requirements of the athletes from a training load point of view. During pre-season phase we need to have periods of increasing intensity contrasted with periods of rest and recovery in order to training hard to gain a physiological effect and then allow the body to recover. During the in-season phase we need to allow athletes a chance to peak for their games and competitions which are generally more taxing on their bodies than training sessions.

I want to present 3 case studies of athletes at various levels throughout their season. I hope that these give a good example of how different each athletes training load can be and how there isn’t necessarily a correct answer, other than doing what is right for the athlete.

The first case is of a junior elite athlete who plays cricket and is currently in her off-season phase. The emphasis of her training is essentially based in the gym and working on improving her bilateral strength as she has development significant asymmetry in both her upper and lower body throughout the last cricket season. As you can see from graph of the athletes weekly training load scores, she is barely reaching the limits of what she would be allowed normally during the pre-season phase.

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We would normally give an athlete like this up an allowance of up to 3500 points per week and she has barely reached an average of 1000 across the 10 week off-season phase. In week 18 of the above graph she will switch into a pre-season phase where she will have a much more structured training load graph which will be more phasic to allow for adaptation and progressive overload as she becomes strong and fitter.

The second case is a basketballer who lives in regional Western Australia. She is involved in an elite development squad which trains fortnightly in Perth. There are 2 other girls who also live rurally and fortnightly they all travel between 5-6 hours to attend weekend camps for the squad. The weekend camps are very hard and they generally consist of two days with a cumulative training and game time of approximately 10 hours. The graph below demonstrates this fortnightly variation and ‘spike’of intensity followed by a lower volume week.

graphic

The above graph demonstrates an interesting pattern which shows a combination of two very key criteria. Firstly, the athlete was able to tolerate the heavy weeks better as her conditioning improved. Secondly, this graph shows the benefit of regular education to improve physical performance. As the athlete improves their ability to tolerate training load of high intensity also improves therefore, what would have been a very similar weekend camp results in a lower total training load. The second part of this equation is athlete education and improving training scheduling. I spent a lot of time educating the athlete on the importance of reducing her training load during the ‘off-weeks’. There are a number of ways that this can be done:



  • Reduce training time - instead of training for 90 minutes train for 60 minutes

  • Reduce training intensity - instead of doing a shooting session with repeat sprints in the session, do a shooting session with a slow jog between shots

  • Swap training sessions to recovery sessions - don’t get on the court, instead go to the pool and do a recovery session, get on a bike and do an off-loaded conditioning session or get a massage



The final training load graph that I would like to address is a field hockey athlete who is in the in-season phase. This athlete is currently doing 3-4 skills/conditioning sessions per week in addition to 2-3 weights sessions on top of games as weekends. This athlete can be best described as a very intense athlete who trains very hard during every session, irrespective of how their body and mind is feeling. The issue with athletes such as these is keeping their training load under control as they often struggle with holding back and run the risk of over training.

graphic

During week 13 the athlete developed a viral cold from which it took 3 weeks to fully recover. Note that prior to this period of time she had one week at 6000 points followed by one week at 3000 points, then three consecutive weeks over 3000 points. Ideally the athlete would have been given an easy week in week 12 (less than 1000 points), a moderate week in week 13 (2000 points) and then allowed to go back to normal in week 14. I would speculate that her illness would have been easier to manage had this process been undertaken. The difficulty with monitoring this athlete is that she is an amateur athlete who manages a lot of her own training sessions away from the gym. This is the first time that she is in our academy program as well and we are only just starting our education process with our athletes. In a professional team setting for example, we would have grabbed a hold of her at the start of week 12 and 100% controlled every aspect of her training from a duration and intensity point of view to allow her to still compete but at the same time ensure that she didn’t over train during consecutive weeks. A good lesson for us all!

So that is my little blog on training load, hopefully you have been able to gain some insight from the examples that I have given. My parting thoughts are my three mantras that you should always consider when attempting to manage training load:


  1. Manage each athlete as an individual

  2. Think about the athlete as a person - think physical and mental wellbeing

  3. Get the data on to paper in whichever format you deem necessary - if you don’t have data you have nothing!!


I hope you enjoyed this little read - all the best with your monitoring and I’ll chat with you next time.

 

Adrian Cois

Performance Coach

BAppSci (Exercise Science)

adrianlcois@gmail.com


Media Release - Five Years of Health Reform COAG Jun 12th, 2014

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Infographic - Exercise Jun 11th, 2014

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Heads Up - Preventing psychological injury Jun 4th, 2014
Creating a mentally healthy workplace is everyone's responsibility! The Heads Up campaign was launched last month to business leaders to take action on mental health. As part of Heads Up, an Action Plan will be unveiled later this month.

Safe Work Australia and work health and safety regulators have resources which can assist organisations manage mental health in their workplace. For example, Safe Work Australia recently published a number of fact sheets:

Preventing Psychological Injury Under Work Health and Safety Laws, to assist persons conducting a business or undertaking and workers address psychological health risks to ensure the health, safety and welfare of all persons at work

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Workers' Compensation Legislation and Psychological Injury, which provides a general overview of the employer’s role under workers’ compensation legislation in relation to psychological injuries.

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Healthy Aging at Work Jun 4th, 2014
graphicAustralia’s population will both grow strongly and become older in the medium term. This population growth and ageing will affect labour supply, economic output, infrastructure requirements and governments’ budgets, and has lead to the suggested increase in the retirement age from 65-70 for those people born after 1965. Such changes are likely to have down stream impacts on employers due to a gradual increase in the average age of your workforce.

Safety and Health Outcomes Associated with Aging and Work

Aging affects a variety of health conditions and outcomes, including both chronic health conditions and likelihood of on-the-job injury. However, the exact nature of these relationships has only recently been better understood, and it is quickly becoming clear that appropriate programs and support in the workplace, community, or at home can help workers live longer, more productive lives.

Chronic Disease and Aging

Arthritis and hypertension are the two most common health conditions affecting older workers, impacting 47% and 44%, respectively, of workers over the age of 55. An even greater proportion of workers (more than 75%) are estimated to have at least one chronic health condition that requires management. Diabetes is perhaps the most costly of these; one study found that 1/3 of all Medicare spending goes towards management of diabetes.

The frequency of these conditions and others in older adults has important implications for workers can physically perform their duties, but also when. Higher morbidity means more absenteeism when an employee feels sick and more presenteeism when an employee is ill but shows up to work regardless. However, individual health risk factors are a stronger influence on future healthcare associated costs than advancing age alone. In comparing young workers with “high risk” of chronic disease (5 or more risk factors) to older workers with few or no risk factors, the younger workers had significantly higher medical costs associated despite the disparity in the age groups: 19-34 year olds, versus older workers aged 65-74.

Safety and Aging

As for safety on the job, workers who are older actually tend to experience fewer workplace injuries than their younger colleagues. This may be because of experience gathered from years in the workplace, or because of factors such as increased caution and awareness of relative physical limitations. The caution is well-founded. When accidents involving older workers do occur, the workers often require more time to heal, underscoring the need for a well-planned return to work program. Some evidence suggests incidents affecting older workers are more likely to be fatal, underscoring the need for employers to be mindful of how best to adapt the conditions of work to protect workers as well as explore opportunities for preventative programs that can maintain or build the health of employees through their working life.

Benefits of an Age-Friendly Workforce

Employers increasingly see the value that older workers bring to the job. Older workers have greater institutional knowledge and usually more experience. They often possess more productive work habits than their younger counterparts. They report lower levels of stress on the job, and in general, they get along better with their coworkers. Finally, they tend to be more cautious on the job and more likely to follow safety rules and regulations.

Workplaces, often out of necessity, have adapted to older workers.  Discrimination based on age or disability is inappropriate, and current government policy is rewarding and supporting the retention and employment of qualified workers despite limitations that may come from age or disability. However, some employers are more proactive than others, realizing that a well-designed, employee-centered approach to the physical nature and organization of work benefits all workers regardless of their age.

Workplace design, the flexibility of the work schedule and certain ergonomic interventions increasingly focus on the needs of older employees. Many workplace accommodations are easy to make and are inexpensive. Modern orthotics, appropriate flooring and seating, optimal lighting, and new information technology hardware and software can smooth the way to continued work for older individuals. New emphasis on job sharing, flexible work schedules, and work from home can support added years in the job market for many. Although work may not be beneficial for all older persons, for many it is an important avenue to economic security, enhanced social interaction, and improved quality of life.


 

 


Simple Strategies for an Age-Friendly Workplace Jun 4th, 2014
Many effective workplace solutions are simple, don’t have to cost very much, and can have large benefits if implemented properly with worker input and support throughout all levels of management.

Below are some strategies for preparing your workplace for a healthier, safer and more age-friendly workforce. Consider putting these strategies in place today:



  • Prioritize workplace flexibility. Workers prefer jobs that offer more flexibility over those that offer more vacation days. To the extent possible, give workers a say in their schedule, work conditions, work organization, work location and work tasks.

  • Match tasks to abilities. Use self-paced work, self-directed rest breaks and less repetitive tasks

  • Avoid prolonged, sedentary work. Prolonged sedentary work is bad for workers at every age. Consider sit/stand workstations and walking workstations for workers who traditionally sit all day. Provide onsite physical activity opportunities or connections to low-cost community options.

  • Manage hazards. Including noise, slip/trip hazards, and physical hazards - conditions that can challenge an aging workforce more.

  • Provide and design ergo-friendly work environments. Workstations, tools, floor surfaces, adjustable seating, better illumination where needed, and screens and surfaces with less glare.

  • Utilize teams and teamwork strategies for aging-associated problem solving. Workers closest to the problem are often best equipped to find the fix.

  • Provide health promotion and lifestyle interventions including physical activity, healthy meal options, tobacco cessation assistance, risk factor reduction and screenings, coaching, and onsite medical care. Accommodate medical self-care in the workplace and time away for health visits.

  • Invest in training and building worker skills and competencies at all age levels. Help older employees adapt to new technologies, often a concern for employers and older workers.

  • Proactively manage reasonable accommodations and the return-to-work process after illness or injury absences.

  • Require aging workforce management skills training for supervisors. Include a focus on the most effective ways to manage a multi-generational workplace.



 


Media Release - Mentally Healthy workplaces attract better staff Jun 3rd, 2014

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Interactions Between Injured Workers and Insurers in Workers’ Compensation Systems Jun 3rd, 2014


Most research on the effects of compensation has concentrated on examining outcomes rather than considering the compensation process itself. There has been little attention paid to the interactions between stakeholders and only recently has the client’s view been considered as worthy of investigation. This systematic review aimed to identify and synthesize findings from peer reviewed qualitative studies that investigated injured workers interactions with insurers in workers’ compensation systems.


Conclusion: Interactions between insurers and injured workers were interwoven in cyclical and pathogenic relationships, which influence the development of secondary injury in the form of psychosocial consequences instead of fostering recovery of injured workers. This review suggests that further research is required to investigate positive interactions and identify mechanisms to better support and prevent secondary psychosocial harm to injured workers. 


 



Get Active for 60 Days Jun 2nd, 2014

Every week it seems that we are being bombarded by all kinds of new ways to exercise that promise to strip fat and make us have strong arms, ripped abs and steel-like legs. But how do we decide what is actually going to get us the results and what is not? It seems that there has to be a right answer, something that is right there in front of us waiting to jump out at us. Is it Crossfit with its new fusion of strongman training and olympic lifting, is it hot yoga where you lose 4kgs in one session, is it boot camp where we pretend we are US Marines and get yelled at by someone with too many tattoos and a haircut that is too short. How do we know what is the answer?



The answer is simple - none of them are! The key to success is to be active in anyway possible. The benefit of programs listed above is that they motivate us, they keep us interested and they teach us a new skill, things which we humans thrive on. It is important to remember that key to achieving your exercise goals is to simply move. What does that mean exactly? Physical activity takes many forms - walking the dog, going on a nature walk, surfing, housework and yardwork. If you are one of those people who is flipping through the pages of popular culture magazines constantly looking for the newest fad, keep doing that, but also try incorporating exercise into your daily life. Take the stairs over the elevator, park the car a couple of blocks away from work and walk more in your day, ride your bike twice per week instead of driving your car and instead of watching TV with the kids for 30 minutes, go for a family walk.



We all need to stop seeing exercise as another thing that we need to add to our day and expect that some new fad is going to suddenly change us from having a low activity lifestyle to being a gym junkie - it won't happen! So here is my mantra - try it for 60 days, change something about your daily routine that means you need to walk and extra 30 minutes and get your family involved in it as well. Give it a go and hashtag your progress to #getactivefor60days.


Enjoy your new active lifestyle.


Adrian Cois.



Next Dietitian Talk Thursday 12th June 2014 at 12.30pm. May 28th, 2014

Temika Lee's next Dietitian Talk is on Thursday 12th June, 12.30pm at Central West Health & Rehabilitation in Geraldton. This talk is free for gym members and people who are completing Central West Health & Rehab's Diabetes Management and Chronic Disease Prevention programs.


This talk covers:



  • Healthy Eating Habits

  • Glycemic Index

  • Fat Types and Cholesterol

  • Recipe Modification Label Reading



Infographic- Dietary Salt May 23rd, 2014

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Science of Laziness May 23rd, 2014


Shoulder muscle loading during over head tasks May 22nd, 2014
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The task of wall painting produces considerable risk to the workers, both male and female, primarily in the development of upper extremity musculoskeletal disorders. The aim of this study was to investigate the influence of gender, work height, and paint tool design on shoulder muscle activity and exerted forces during wall painting. 

Results: For both genders, the high working height imposed greater muscular demands compared to middle and low heights.

Conclusion: These findings suggest that, if possible, avoiding work at extreme heights will reduce fatigue onset and subsequently assist to prevent and mitigate potential musculoskeletal shoulder/neck injuries

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Infographic- Common Hazards for the Home Handyman May 22nd, 2014

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Infographic - Why Lift Weights May 20th, 2014

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Exercise is Medicine - InfoGraphic May 16th, 2014

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Poster - Sitting Take a Stand! May 9th, 2014

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Poster - Stand up for Your Health May 9th, 2014

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ABS - Soft Drinks, Burgers and Chips May 9th, 2014

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Walking Anatomy, Physiology and Benefits May 8th, 2014

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Health risks we'll face if we work till 70 May 8th, 2014
 

With the pension set to rise to 70, it's not just those doing hard physical labour who need to consider whether they can finish their working life with their health intact.

Yes, we're living longer, as Federal Treasurer Joe Hockey loves to remind us. A child born in Australia today can expect to live to around 82, up from about 55 in 1900.

Unfortunately, these extra years are not always healthy ones.

"Not all of the benefits of increased life expectancy are equating to [improved] quality of life," says Professor Mark Harris, executive director of the Centre for Primary Health Care and Equity at the University of NSW.

And as the number of older workers grows – as predicted with a shift to a pension age of 70 – so too will the proportion of people in the workforce affected by conditions such as heart disease, cancer, diabetes, arthritis, osteoporosis, cognitive problems as well as vision and hearing loss, Harris says.

 

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How healthy will older workers be?


The proportion of Australians who rate their health as only fair or poor generally doubles between each life stage from 7 per cent of 15-24 year-olds to 13 per cent of 25-64 year-olds to 31 per cent of people aged 65 and over.

Some diseases that are more prevalent in older people and the implications of this for older workers (or those newly retired) are:

 

Cancer – For many types of cancer, the risk increases with age. By 75, 1 in 3 men and 1 in 4 women will be affected. Survival rates are improving, but even for those diagnosed in mid-life, treatments may need to continue for years and can leave ongoing disabilities.

Cardiovascular disease – The proportion of people affected almost doubles from 45-54 and 55-64. This grows by a further third or so (to almost half the population) by 65-79.

Osteoarthritis – a degenerative joint condition which often affects hands, hips, knees and ankles. After age 45, the prevalence rises sharply. "It hardly ever kills you but it can really affect your quality of life," Harris says. Arthritis and other problems affecting muscles and bones are among the leading cause of employment restrictions.

Type 2 diabetes – Around 15 per cent of 45-54 year-olds have type 2 diabetes and this increases to around 28 per cent of 65-74-year-olds. Says Harrris: "Someone with diabetes who has lots of complications, they may not die but they may spend a period of time quite disabled. They may even have to have amputations."

Vision disorders: Almost double between ages 35-44 and 45-54.

Hearing disorders: Around a third of people are affected by age 55-64 and this continues to grow.

Falls – start to increase age 70-74.

Cognitive issues: "Not necessarily dementia, but people simply having vascular problems in their brains. This starts to happen in the 70s particularly; people start not to be able to function as they have been."

 




Reference:


http://www.abc.net.au/health/thepulse/stories/2014/05/08/4000407.htm



Heart Week 2014 Sunday 4 May - Saturday 10 May 2014 May 5th, 2014

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8 Ways to Prevent Sprains & Strains in the Workplace May 4th, 2014
50% of worksite injuries are sprains and strains are the greatest cause of workplace injury.

In the workplace most of these types of injuries are caused by manual tasks such as lifting or carrying loads, working in fixed positions, repetitive tasks or using heavily vibrating toolsThe second greatest cause of sprains and strains is slips, trips and falls at ground level and from heights such as jumping from vehicles, which can cause lower limb and back strains.

While some workplace hazards are easy to spot like a missing guard on a saw or a bucket in the middle of a busy shop floor sprains and strains are not always that obvious.  This is because they can be caused by the way work is designed and carried out like awkward body posture, high body force and high task repetition that is more insidious.

1.  Recognise the Signs – Aches, Become Pains, Become Injuries

Often musculoskeletal injury comes with warning signs and symptoms before an injury occurs, and long before any work is missed. Review the incident reports, listen to your workforce and keep an eye out for things like:



  • Comments about discomfort or pain

  • Stretching or rubbing muscles while working

  • Repetitive similar injuries with specific tasks

  • High turnover or absenteeism in a particular section



2.  Consult about Musculoskeletal Hazards

Talk to workers about the most difficult parts of the job like holding awkward body postures and doing highly repetitive work for extended periods and find a better way together.  Workers who are doing the job are generally best placed to find solutions.

3.  Fix the Hazards

Consider what improvements could be made to the way work is done to improve working posture such as the position of the work or change the workstation layout to eliminate excessive reaching or leaning forward.  Next time you go through a checkout look at the workstation layout and I am sure you will see the risks.

Position frequently used tools and equipment within easy reach and consider adjustable tables to accommodate everyone.  Likewise reduce manual handling by using mechanical lifts to support and to move heavy loads and try to eliminate the lift by changing how objects are stored.  Reducing the physical force and task repetition needed to do the job should be another focus.

Poor health contributes to the risk of strains and sprains. Workplace health promotion has a role in improving emplyee resilience

4.  Consider Individual Factors.

It’s important to take care of the entire body with exercise, proper posture, a sensible diet and adequate rest.  Injury is less likely in a worker who is physically fit than someone whose muscles or ligaments have weakened over time from lack of exercise or age.  Smoking and fatigue are also issues that impact the wear and tear on a body.

Promote individual physical fitness and healthy living through a company wellness program.  Think about introducing stretching before and during work to warm-up muscles and help relieve strain.  Provide training and coach workers frequently on how to move material safety using lifting equipment and safe postures.

5.  Focus on Ergonomic Design

Ergonomics is the match between design, the environment and the individual. It is not a one size fits all.  It allows quality work to be completed safely and easily by fitting the job to the worker and providing appropriate equipment. For example someone who is taller needs a different chair to someone below average height.

6.  Look at Organisational Hazards

If there is poor communication and organizational cooperation and limited worker involvement in decisions that affect working tasks then this will be reflected in a poor corporate culture, low worker morale and higher time lost and costs associated with sprains and strains such as workers’ compensation premium.

7.  Find Workplace Champions

Active OHS can help you address the risks in your workplace. It’s hard to effect change on your own.  It’s a Pantene thing it won’t happen overnight but it will happen if you have the right tools and support. Having workplace wellness champions can assist with raising overall awareness of the health, safety and welfare of the workforce by providing general information to colleagues as well as providing specific details on workplace risks and the support and assistance that is available to effect change.

8. Are you winning?

Set some Benchmarks. How does your workers’ compensation premium compare to other businesses in your industry?  Where do you sit when it comes to sprains and strains?

 

If you aren't winning our IMS Assessment is inexpensive and can help highlight areas of need. Contact us for more 


Reducing just six risk factors could prevent 37 million deaths from chronic diseases over 15 years May 3rd, 2014
Reducing or curbing just six modifiable risk factors -- tobacco use, harmful alcohol use, salt intake, high blood pressure and blood sugar, and obesity -- to globally-agreed target levels could prevent more than 37 million premature deaths over 15 years, from the four main non-communicable diseases (NCDs; cardiovascular diseases, chronic respiratory disease, cancers, and diabetes) according to new research published in The Lancet.

 

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Worryingly, the findings indicate that not reaching these targets would result in 38.8 million deaths in 2025 from the four main NCDs, 10.5 million deaths more than the 28.3 million who died in 2010. This is the first study to analyse the impact that reducing globally targeted risk factors will have on the UN's 25x25 target to reduce premature deaths from NCDs by 25% relative to 2010 levels by 2025.

Using country-level data on deaths and risk factors and epidemiological models, Professor Majid Ezzati from Imperial College London, UK, and colleagues estimate the number of deaths that could be prevented between 2010 and 2025 by reducing the burden of each of the six risk factors to globally-agreed target levels -- tobacco use (30% reduction and a more ambitious 50% reduction), alcohol use (10% reduction), salt intake (30% reduction), high blood pressure (25% reduction), and halting the rise in the prevalence of obesity and diabetes.

Overall, the findings suggest that meeting the targets for all six risk factors would reduce the risk of dying prematurely from the four main NCDs by 22% in men and 19% for women in 2025 compared to what they were in 2010. Worldwide, this improvement is equivalent to delaying or preventing at least 16 million deaths in people aged 30-70 years and 21 million in those aged 70 years or older over 15 years.

Writing in a linked Comment, Professor Rifat Atun from Harvard School of Public Health, Harvard University, Boston, MA, USA says, "With political will and leadership, the 25×25 targets are well within reach. But despite robust evidence, well-proven cost-effective interventions, and a compelling case for action made by [this study] to address risk factors for NCDs to save millions of lives, political apathy prevails. Even with much discourse, meaningful and durable action against NCDs is scarce, with little accountability to achieve the promises made and the targets set at the General Assembly in 2011.

 

Complete our Free LifeRISK score to find out how many risk factors you have.

 

 


Obesity Surgery - Pre-Surgical Nutrition May 2nd, 2014
Many people waiting obesity surgery do not realise that the aim of the band is to sharply reduce food consumption. Preoperative education should include eating, psychological implications and risks and disadvantages of obesity surgery. Our registered dietitian can help patients make informed decisions.

People considering bariatric surgery must begin with preoperative weight loss using very low calorie diet (VLCD) meal replacements and low energy foods for 2—6 weeks. Some weight loss before the surgery reduces liver size and visceral and subcutaneous adiposity, making stomach access during surgery that much easier, minimising operative risks and length of surgery.

Our dietitian encourages the Optifast approach as the most evidence based VLCD.

 

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Introducing restrictive eating practices early also means patients understand what is required post-surgery. The length of this preoperative diet may depend on the patient’s initial weight and the maximum weight hospital and surgery beds can safely manage. 

A preoperative assessment of nutrient markers is recommended with sufficient time to correct nutritional deficiencies. Despite their well-nourished appearance, these patients are often found to be deficient in nutrients such as folate, iron, selenium vitamin B12 and vitamin D. Vitamin D may be low due to reduced sunlight cutaneous synthesis and modest dress. 

Preoperative nutrient defeciencies can be caused by poor diet choices, chronic dieting and medication side-effects. This pre-screening is also useful to distinguish post-surgery complications and biochemical changes.

Reference:


http://www.medicalobserver.com.au/news/banding-to-help-the-obese



Obesity Surgery - Post-Surgical Nutrition May 2nd, 2014
For the first two months the goals of postoperative nutrition care are to maintain adequate hydration; to correct and maintain nutrient status, including vitamins, minerals and protein, which are needed for healing; and to return gradually to normal food consistency.

Consistency begins with a liquid diet for the first 1—2 weeks, followed by puréed and soft foods for 2—4 weeks, and then smaller serves of normal foods. Progression through each texture will depend on the patient’s tolerance, and formulated products may be required. Nutritional deficiencies can still occur though from poorly tolerated foods and food consistencies, and unusual diets.

It is important for you to be psychological ready for this change in diet habits, as some patients continue dysfunctional eating of energy-dense, nutrient-poor foods — just in smaller portions.

Lifelong changes in eating behaviour are required, depending on the procedure, such as eating regular, but much smaller meals, eating more slowly, cutting food into small pieces and chewing well, and avoiding filling up on liquids. Frequent testing of nutrient markers is required every six months in the first 1—2 years.

An exercise program is also a necessary part of the postoperative routine. Along with diet compliance, exercise helps prevent weight regain and maintain weight loss.

 


 

Reference:



Safety First - Reduce UV Apr 30th, 2014

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Infographic - Multiple Sclerosis Apr 30th, 2014

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Infographic - Arthritis Apr 29th, 2014

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Workers Comp Cost Containment Starts With Post-Injury Investigation Apr 27th, 2014
Employers often think they have completed their investigation of the new workers’ compensation claim when they have finished filling out the WorkCover WA Claim Lodgement Form (CLF) and First Medical Certificate; The information on the CLF is a good start on investigating a new injury claim, but it is not the only information that needs to be developed when investigating an injury claim.

Much of the information on the CLF – employee name, address, date of birth, social security number, and home phone number – can be taken right off the employee’s personnel file; Other information to complete the CLF– date and time of the accident, location of the accident, what happen, etc., can be obtained from the injured employee’s supervisor or department manager. Often the CLF is completed without the injury management co-ordinator for the employer ever talking to the injured employee. This is a major mistake.


Post-Injury Interview Should Be Thorough


The injury managment co-ordinator should interview the injured employee, in person if possible or by phone if an in person interview is not possible, to discuss the accident. The interview should include several important questions or topics:


  1. Exactly where in the workplace did the accident occur?

  2. Was the employee doing his/her regular job?

  3. How did the accident occur?

  4. Was a third party responsible for the injury? (Think Cost Recovery).

  5. Repeat the details of the accident to the employee to verify your understanding of the accident is correct.

  6. Confirm the accident occurred within the course and scope of employment.

  7. Ask the employee what the employer can do to prevent the accident from happening again.

  8. Obtain the names of all coworkers who witnessed the accident.

  9. Ask the employee to provide a detailed description of all injuries, including symptoms and level of pain.

  10. Ask the employee what is the medical provider’s diagnosis, prognosis, treatment plan and work restrictions. (Think Return to Work)

  11. Confirm the employee treated at the designated medical facility.

  12. If the employee has treated at an unauthorized medical provider, instruct the employee on the correct medical provider for any additional medical treatment.

  13. If the employee has the right to select his/her own medical provider, obtain the name of the medical provider along with the address and phone number.

  14. Ask the employee if they have ever had a prior injury. (This includes both work-related injuries and non-work related injuries). Later, after your discussion with the employee, compare their answers to their job application to see if their “new work injury” is a pre-existing medical problem.

  15. If the employee does disclose a prior work-related injury(s), obtain the name of the employer(s) and the date(s) of the prior injury(s).

  16. Discuss with the injured employee what work the employee is still capable of doing within the work restrictions set by the medical provider. (Think Suiitable Duties)

  17. Review with the employee what the medical management program will do to assist in their recovery.

  18. Reinforce the need for the employee to contact you following each doctor’s visit for the purpose of providing you with an update on the medical recovery and the work restrictions.



Good Information Creates Improved Work Comp Claim Outcomes


While this might seem like a lot of information to collect if the employee should be off work only for a few days or a few weeks, it is essential you do so. When the employer does not have a complete investigation and complete understanding of the medical care and progress, there is a much higher probability the injured employee will exploit the injury and being off work a few months or years rather than days or weeks.

Also, your investigation into the claim can often be essential in the prevention, or at least limitation, of medical treatment and lost work days due to pre-existing medical conditions. Plus, when employees know that the employer thoroughly investigates every injury claim, the incidents of fraudulent claims is greatly diminished.


Work Cover WA - Worker Compensation Claim Form Apr 27th, 2014

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Work Cover WA - First Medical Certificate Apr 27th, 2014

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Physical Activity Levels in Children Apr 26th, 2014
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Physical Activity during childhood produces immediate and, long-term health benefits in adulthood. WHO international guidelines recommend that children participate in at least 60 minutes of moderate-to-vigorous physical activity (MVPA) daily. Worldwide, research has indicated that children are not achieving these guidelines, with estimates of activity levels varying both between and within countries. For example, 42% of children aged six to 11 years in the United States [16] participate in 60 minutes of MVPA daily. Similarly, in the United Kingdom (UK), objectively measured PA measurements indicate that just 51% of four to 10 year olds (33% of four to 15 year olds) meet the recommended guidelines. Achieving the recommended levels of PA per day is essential for the prevention and treatment of many health problems such as obesity. In particular, with evidence of tracking PA from childhood through adolescence and into adulthood, developing an active lifestyle from a young age may also produce long term benefits.

Being a member of a sports or fitness club, and, having an active favourite hobby were both positively associated with higher levels of PA. Exceeding two hours of total screen time and being overweight or obese were negatively correlated with higher PA levels. Children who were members of a sports or fitness group were almost twice as likely to be in the high PA group compared to children who were not. Exceeding 2 hours of totoal screen time reduced the likelihood of high PA by 44%.



Managing Stress Apr 23rd, 2014

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10 proactive hazard identification methods Apr 23rd, 2014
Here are 10 methods you could adopt to identify health and safety hazards before an incident occurs:


  1. conducting pre-start discussions on the work to be carried out;

  2. encouraging workers to recognise and highlight hazards while performing work;

  3. carrying out safety inspections and audits of the workplace and work procedures;

  4. conducting job safety analyses (or similar task evaluation processes);

  5. monitoring, measuring and testing the working environment such as noise monitoring, electrical testing and atmospheric testing;

  6. analysing proposed new or modified plant, material, process or structure;

  7. conducting hazard (or risk) surveys;

  8. reviewing product information, e.g. safety data sheets, operating manuals; and

  9. researching publicly available data on hazards, e.g. newspaper articles, industry or safety regulator alerts; and

  10. looking at past incident and near-miss reports. 


Reference:



7 Things We Can Learn About Aging Gracefully Apr 23rd, 2014
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The world's largest population of older healthy adults is on the Japanese island of Okinawa. And the last two people who held the title of world's oldest person (116 in both cases) were from Japan.

So what does Japan know that the Western world doesn't about longevity and aging? We'd broaden that to what does the East know that the West doesn't? Here are seven things we can learn from the East about aging:


  1. Healthy arteries don't just happen; you need to work at them.

  2. Yes, genes matter.

  3. It isn't just that they live longer; they live better.

  4. They not only exercise, but they do it as a community.

  5. The need to get things in balance is understood.

  6. A diet is what you eat for life; dieting is what occurs when you don't have a diet

  7. Naps are your friend.



How to manage an ageing workforce Apr 17th, 2014
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In his Autumn statement last year, the chancellor of the exchequer set in motion plans to raise the state pension age to 70 for today's young people, on course to be the highest in the world. The question of whether people will need to work longer in the future is pretty much settled but there is still a lack of clarity about what work will be like for older workers of the future and how managers will oversee increasingly ageing workforces.

Answering the question of how to extend working life made a significant advance when the NHS Working Longer Review group reported the preliminary findings of its investigation into the impact of higher pension ages on the delivery of health services. This is the largest review of working practices in relation to age undertaken in the UK.

The outcome of their work is likely to prove seminal to the construction of a 21st century workplace bespoke to an ageing workforce for four reasons.


  1. Listen to the concerns of the staff

  2. Career progression

  3. A precious resource

  4. The need for dialogue with unions


 




Fight back against insurance premium increases Apr 15th, 2014
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These recommendations together will give your control in the battle to minimize the cost of workers’ compensation.

Safety Program:

The lowest cost workers’ compensation claim is the one that never occurs. When an insurer is calculating your annual premium they review the frequency of accidents and the severity of the accidents that do occur, as well as the costs. A strong safety program will incorporate safety training for all employees, manual handling training, a job hazard analysis to identify and eliminate causes of accidents, work-site evaluations and inspections to prevent accidents, and a safety specialist or safety committee to keep safe practices at the fore-front of your work process.

Return to Work Program:

It is mandatory for your company to have an injury managment system and a company-wide return to work policy should be implemented. The return to work policy should be a part of every new employee’s orientation. It should be posted on the employee’s bulletin board and be discussed in staff meetings. All employees should know a job will be available to them as soon as they medically approved for light duties.

The company’s Injury Management Co-ordinator (IMC) should place a call to the medical provider the day of the initial medical treatment to learn the work restrictions provided by the doctor. The IMC should advise the doctor of the employer’s willingness to modify the employee’s job duties to comply with the work restrictions and be able to provide details of avaliable suitable duties.

Wellness Program:

An integrated health and wellness program will reduce the cost of workers’ compensation by reducing the impact of comorbidities on the injured employee’s recovery. The combination of unhealthy employee's and an aging population, with moves to increase the retirement age mean you will be increasingly hiring people with with one or a number of chronic conditions. By reducing obesity, diabetes, hypertension and physical deconditioning, an injured employee recovers faster from an injury, reducing both the amount paid for medical care and the time lost from work.

Get started with our free online LifeRISK Program.

Medical Cost Control Program:

In Western Australia, medical expenses make up ~16.0% of the total cost of worker comp. By directing the injured employee to a doctor with vocational medicine experience who understands the need to get the employee back to work as soon as feasible, you will eliminate unnecessary medical treatment and unnecessary delay in the employee returning to work. 

From the moment of injury and Post-Injury Investigation, until the injured employee has reached maximum medical improvement,  the course of the medical care should be managed. Initially, an IMC or occupational nurse can arrange the immediate first aid and any subsequent medical appointments. If the injury is severe, and the employee is going to be off work, the IMC or a preferred voc rehab provider can monitor and assist with coordination of medical care.


Line Supervisors - An Important role in RTW Apr 15th, 2014
Although there are many stakeholders in the RTW process, and employees supervisor has a pivotal role. A review of workers’ compensation systems in Australia revealed that injured workers nominated someone from the workplace as providing the most help with their RTW (16 %), third after their general practitioner (20 %) and their physiotherapist (19 %). Of that 16 %, nearly one-third (30 %) of injured workers nominated their immediate supervisor as the most helpful person at the workplace compared with occupational health and safety (OHS) officers (8 %), human resource (HR) staff (3 %) or RTW coordinators (3 %). However, 16 % of injured workers said their supervisor made RTW harder and these workers were less likely to sustain RTW

Employee supervisors provide:

  • modified work,

  • interpret policies,

  • assist with access to resources,

  • monitor workers’ health and functioning,

  • facilitate communication among stakeholders, and

  • communicate positive messages of concern and support, while having intimate knowledge of the jobs available.

  • The interface among upper management, rehabilitation and health care providers, coworkers, and the injured worker. 



However supervisors frequently experience role conflict between their production responsibilities and the demands of the modified work program. Some do not have a good understanding of musculoskeletal disorders (MSDs) or the ergonomic principles underlying the selection of appropriate duties or how to modify duties to meet the medical restrictions. These problems may result in the supervisor either not adhering to restrictions set by the medical certificate or preferring the worker to be fully recovered before RTW, neither of which is desirable. 

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Johnston et al, 2014 put forward a model of the 10 competencies that should receive priority in any training delivered to supervisors. Supervisors need and seek support from experts in managing staff returning to work. This support can assist with complex cases, provide clarity to the supervisor’s role, and connect the returning worker to the services available within the organization. In large organizations this support may be available from in-house rehabilitation and RTW specialists but small to medium sized organizations may be disadvantaged by its absence.


  1. Managing and respecting privacy issues and medical and other confidential information received

  2. Knowing the tasks and workload of the worker’s job 

  3. Knowing what and how much the injured worker can and can’t do and how the injury impacts on the demands of the job 

  4. (MHC) Managing privacy issues in terms of disclosure, e.g. with co-workers

  5. Being honest

  6. Being able to manage conflict 

  7. Being able to deliver sensitive information, including information the injured worker doesn’t want to hear

  8. Being fair and just 

  9. Communicating in a respectful and appropriate way

  10. Knowing their legal obligations as supervisors





Sports Performance Testing Apr 14th, 2014
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Independent Medical Examinations and Specialist Assessment Apr 13th, 2014
Independent medical and Specialist examinations (IME's) can be an effective way to determine an injured worker’s medical status. But too often, they turn out to be a waste of money.

Here are a few tips for understanding getting the most from an IME:


  1. Before scheduling an IME, the claims manager and treating GP must know its purpose. Be specific about the details. Whether the issue is misdiagnosis, causation or degree of disability, provide medical reports, witness and injured worker statements, and other supporting materials.

  2. Find out the state’s laws and applicable treatment guidelines. Make a checklist of what needs to be done, how and when. Some states dictate timing and conditions of the IME. More often than not, IMEs occur too late in the process. Therefore, start considering an IME when the medical pieces of a claim are not fitting together and/or “red/yellow  flags” are showing up.

  3. To ensure credibility, hire well qualified and highly respected doctors. Those with a relevant specialty tend to get more weight than generalists. Doctors with successful private practices, are affiliated with teaching hospitals or are involved in research are generally given more credence.

  4. IMEs related to returning an injured worker to the job should include specific job requirements (i.e duties registry/suitable duties registry) according to the employer, physician input and the employer’s efforts to assure return to work.

  5. Communicate clearly to appropriate parties throughout the claims process. No matter how much you follow the other steps, miscommunication can cause something to go wrong.




Return to Work Tips Apr 13th, 2014
 


Returning injured workers to work is simply the right thing to do. Return to work is as humane as providing immediate appropriate medical care because workers who do not return to the job face lower salary potential in the future. There are several reasons for this. Working is good for us both physically and mentally, and the longer workers are away from the job and feel disconnected from their employer, the harder returning to work becomes. At a basic level, successful employers maintain contact with injured employees and believe that finding work for them during recovery is important. They prepare for return to work before an injury occurs, set clear expectations, consistently monitor employees on modified duty and more.

Here’s more ideas from the experts:

Consider taking the long view. Since workers who spend years loading and unloading heavy objects are more likely to sustain an injury, consider developing career paths for blue-collar workers. Potential career progression jobs include fork life operator or inspector.

Create a Suitable Duties Registry before an injury occurs. Approach each department of your organization to find out what work can be done by someone on limited duty. Constantly update the job list. Each job should include the position’s physical demands to appropriately match the injured employee to the job.

Have a formal written early return-to-work policy. A 'written' injury management sytem is legislatively required in WA. Consider including language limiting the time frames for the light duty as well as cautioning how transitional duty must meet relevant medical restrictions.

Clearly communicate to employees about workers’ compensation. This is most clearly and transperantly done by a formal Injury Managment Policy.

After injury, contact the injured worker as soon as possible. When the immediate supervisor and Injury Management Co-ordinator learn of the incident or the claim, he or she should contact the injured worker within 24 hours. Assistthe employee with filing a workers’ compensation claim forms and tell workers they are missed and that accommodations will be made for a transitional job as soon as possible.

Involve the injured worker’s doctor when developing a modified duty job with multiple restrictions. Rather than merely telling the worker about the modified job, put together a team that includes human resources, the supervisor, engineer and employee to work together to anticipate potential glitches. 

Informally gather the crew, supervisor, and the employee before putting him or her on transitional duty. This will make it easier to follow the doctor’s orders when everyone is aware of the worker’s restrictions as the employee works up to their MMI.

Ensure supervisors are accommodating rehabilitation plans by granting injured workers permission to elevate their feet, stretch and walk as recommended by the doctor.

To discourage re-injury, require managers to record workers’ activities when they return to the job. Include not only workers’ accomplishments but also tasks that they refuse. A detailed record of abilities and accomplishments could deter non-compliance and discrimination claims.

Encourage workers on modified duty jobs to spend their free time practicing safety exercises instead of sending workers home when they finish their work early. Injured workers can also get more safety training by watching videos or taking safety quizzes.  Perhaps they can share what they learned at a safety meeting.


Arthritic knee solutions Apr 11th, 2014
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CONSIDER the alternative to total knee replacement in young, active patients with arthritis.

Medial compartment arthritis of the knee causes pain and interferes with the activities of many physiologically young and active patients.

Treatment options for these patients are limited if they wish to stay physically active. Total knee replacement (TKR) is reliable at providing pain relief for these patients but it restricts their work and sporting capabilities considerably.

The main goal of a high tibial osteotomy (HTO) is to realign the leg to decrease the pain associated with arthritis.

In younger patients who wish to remain active, this improves function and slows arthritis progression. Older or less active patients may be satisfied with a TKR.

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Art of War - Lessons for Sport Apr 11th, 2014
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The Physical Genius Apr 10th, 2014

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Cochrane Review - Childhood Obesity Apr 10th, 2014

Prevention of childhood obesity is an international public health priority given the significant impact of obesity on acute and chronic diseases, general health, development and well-being. The international evidence base for strategies that governments, communities and families can implement to prevent obesity, and promote health, has been accumulating but remains unclear. This review primarily aims to update the previous Cochrane review of childhood obesity prevention research and determine the effectiveness of evaluated interventions intended to prevent obesity in children, assessed by change in Body Mass Index (BMI). Secondary aims were to examine the characteristics of the programs and strategies to answer the questions "What works for whom, why and for what cost?"

 

AUTHORS' CONCLUSIONS

We found strong evidence to support beneficial effects of child obesity prevention programmes on BMI, particularly for programmes targeted to children aged six to 12 years. However, given the unexplained heterogeneity and the likelihood of small study bias, these findings must be interpreted cautiously. A broad range of programme components were used in these studies and whilst it is not possible to distinguish which of these components contributed most to the beneficial effects observed, our synthesis indicates the following to be promising policies and strategies:


  • school curriculum that includes healthy eating, physical activity and body image;

  • increased sessions for physical activity and the development of fundamental movement skills throughout the school week;

  • improvements in nutritional quality of the food supply in schools;

  • environments and cultural practices that support children eating healthier foods and being active throughout each day;

  • support for teachers and other staff to implement health promotion strategies and activities (e.g. professional development, capacity building activities);

  • parent support and home activities that encourage children to be more active, eat more nutritious foods and spend less time in screen based activities.



Habits Predict Physical Activity on Days When Intentions Are Weak Apr 8th, 2014
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Physical activity is regulated by controlled processes, such as intentions, and automatic processes, such as habits. Intentions relate to physical activity more strongly for people with weak habits than for people with strong habits, but people’s intentions vary day by day. Physical activity may be regulated by habits unless daily physical activity intentions are strong. This study suggested that on days when people had intentions that were weaker than typical for them, habit strength was positively related to physical activity, but on days when people had typical or stronger intentions than was typical for them, habit strength was unrelated to daily physical activity. Efforts to promote physical activity may need to account for habits and the dynamics of intentions.



Mothers improve their daughters’ vegetable intake Apr 5th, 2014
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An intervention was designed for mothers to provide more vegetables to their daughters’ diet. The self-regulation intervention in mothers led to an increase in vegetable intake among their daughters. Engaging mothers in self-regulatory health promotion programmes may be a feasiblestrategy to facilitate more vegetable intake among their daughters.

 



A management accounting perspective on safety Apr 5th, 2014
 

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Management accounting supports decision making in organisations by providing managers with relevant information and analysis on the performance, costs, and benefits of a certain operation. For safety-related issues, cost-based calculations dominate practice, and typical measures include cost per injury or the total cost of accidents. Monetary information is needed to guide safety-related decision-making. Besides focusing on financial information, management accounting should also focus on non-financial information, such as safety improvement, strategic safety objectives and employee relations. 

In safety-related investments, the monetary costs of an investment are usually well known, but the monetary value of the benefits is hard to calculate. Thus, there is a need for cost–benefit evaluation methods, including the non-financial benefits and value created though preventing accidents. In addition to calculating the safety investment costs, the efficiency of the improvements, such as productivity improvements, quality and the value of safety goodwill, should be evaluated as well.

The objective of this paper is to chart current management accounting practices related to safety issues on the basis of findings from relevant literature. Moreover, we discuss the applicability of certain management accounting methods for safety-related decision-making and how these can be used to improve current practices further. The relevant methods include the Balanced Scorecard approach, the payback period, the simple rate of return, and the benefit-to-cost ratio. They all offer means of calculating the cost and benefits of safety if the basic problems of uncertainty, valuation, perimeter of analysis, and quantification of costs and benefits are perceived. Valuing human life in cost–benefit analyses is also discussed.

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Exercise is medicine - For the body and the brain Mar 27th, 2014

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Cognitive decline is one of the most pressing healthcare issues of the 21st century. Worldwide, one new case of major cognitive decline (ie, dementia) is detected every 4 seconds. Given that no effective pharmacological treatment to alter the progress of cognitive decline exists, there is much interest in lifestyle approaches for preventing or treating dementia. One attractive solution that aligns with the above criteria is exercise. However,despite a large and consistent pool of evidence generated over the past five decades linking exercise to improved cognitive functions in older adults, there is a reluctance among academics, healthcare practitioners and the public alike to embrace exercise as a prevention and treatment strategy for cognitive decline. 

Since 2010, we have additional evidence from Random Controled Trials (RCT) that exercise, both moderate-to-vigorous intensity aerobic and resistance training, promotes cognitive and brain plasticity and have gained further insight into underlying mechanisms. In 2011, Erickson et al demonstrated that aerobic exercise resulted in increased hippocampal volume in healthy communitydwelling older adults. Furthermore,changes in hippocampal volume in the aerobic exercise group were significantly associated with increased spatial memory performance. Voss et al8 demonstrated that aerobic exercise improved the functional connectivity or temporal coherence of brain regions that are functionally related in a network known to deteriorate with ageing.For resistance training, Liu-Ambrose et al demonstrated increased functional plasticity after 12 months of training with corresponding improvement in selective attention and conflict resolution in healthy older women. Among older women with Mild Cognitive Impairment, Nagamatsu et al demonstrated that 6 months of resistance training led to improved executive functions, spatial memory and associative memory with concurring functional plasticity. In the same study, the authors also found that aerobic training improved verbal memory and learning.

Conclusion: Exercise should be promoted as an essential component of healthy ageing given that reducing physical inactivity by 25% could prevent as many as one million cases of dementia worldwide.

 

References:


  1. Erickson KI, Voss MW, Prakash RS, et al. Exercise training increases size of hippocampus and improves memory. Proc Natl Acad Sci USA 2011;108:3017–22.

  2. Voss MW, Prakash RS, Erickson KI, et al. Plasticity of brain networks in a randomized intervention trial of exercise training in older adults. Front Aging Neurosci 2010;2,pii:32.

  3. Liu-Ambrose T, Nagamatsu LS, Graf P, et al. Resistance training and executive functions: a 12-month randomized controlled trial. Arch Intern Med 2010;170:170–8.

  4. Nagamatsu LS, Handy TC, Hsu CL, et al. Resistance training promotes cognitive and functional brain plasticity in seniors with probable mild cognitive impairment. Arch Intern Med 2012;172:666–8.

  5. Nagamatsu LS, Chan A, Davis JC, et al. Physical activity improves verbal and spatial memory in older adults with probable mild cognitive impairment: a 6-month randomized controlled trial. J Aging Res 2013,2013:861893.


 


Older Workers - How are the Japanese looking after their aging workforce Mar 26th, 2014
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Unique efforts of the Japanese industries in meeting the needs of the super-aged society are introduced through their association with International Association for Universal Design (IAUD). Considerations are made on how successes were brought about, what can be learned as well as what issues should be addressed in the future.


What’s the best diet for weight loss? Mar 25th, 2014
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Click for Full Article

 

When it comes to weight loss, there are no magic tricks that guarantee success. What works for you is likely to be different to what works for your partner, neighbour or workmate. The best advice is to find a healthy eating regime – let’s call it a diet – that you can stick to. You may choose a specific diet book or commercial program to kick start your weight loss, but in the longer term, switch to an eating pattern you can live with for good.

The diet that works best will depend on many factors: your current weight, dieting history, how much weight you need to lose, reasons for wanting to lose weight, your knowledge and skills around food preparation and nutrition, personal supports and the time you have to focus on weight loss.

But first, a warning about fad diets.

Fad diets can work in the short-term because they lead to a reduction in total kilojoules but are usually nutritionally inadequate. They often ban specific foods or food groups, such as carbohydrates, and promise miraculous results. Or they may promote unproven fat burning or other supplements. Fad diets generally contradict advice from credible health professionals. Research shows the more radical the diet approach, the more likely you are to give up because of boredom or unpleasant side-effects including bad breath, constipation, and even gall bladder disease.

 

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Seasonal Fruit Chart - Click for Printout Mar 25th, 2014

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Seasonal Vegetable Chart - Click for Printout Mar 25th, 2014

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Breaking up prolonged sitting with walking improves blood sugar levels Mar 24th, 2014

This study suggests that interrupting sitting time with frequent brief bouts of light-intensity activity, but not standing, imparts beneficial postprandial responses that may enhance cardiometabolic health. These findings may have importance in the design of effective interventions to reduce cardiometabolic disease risk.

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Steps to progress difficult Workers Compensation Claims Mar 23rd, 2014
Circumstances like the injured worker regularly getting no work capacity certificates without reporting any difficulties to their supervisor; maintaining they cannot do certain tasks despite apparently being within their certified work capacity; making requests of the Doctor to certify them to not work in certain areas/ locations; wanting to come in early and leave early on their reduced hours; requesting to work Monday to Wednesday for the 3 days they are certified for despite the Tuesday and Thursday being proposed as ‘rest days’ given their injury.

What to do?


1.  Engage with the Nominated Treating Doctor (NTD)

If you haven’t already you need to do whatever it takes to get the NTD to see you are not the ‘enemy’. Letting the NTD know you are committed to the early, safe and sustained return to work of their patient by sending the NTD details of the injured worker’s Return to Work Plan or arranging a Case Conference.

2.  Get a Second Opinion

It is important to have objective information on the injured worker’s current work capacity e.g. is there an issue that has not been addressed, does treatment need to change, is there fear of re-injury.  You could use your Preferred Medical Advisor or ask your insurer to arrange an Vocational Rehabilitation Referral.  It is important you do this ASAP as the longer a RTW Plan is not closely managed the harder it is to get it back on track and the more impact on the workplace culture.

3.  Know the Nominated Treating Doctor does not Run Your Business.

It is the domain of the NTD to diagnose and advise on work capacity, treatment and prognosis.  The NTD does not have the mandate to dictate which section someone works in or where they are located except maybe if there is a psych issue or genuine travel restriction but even then those can probably be managed in collaboration with the NTD like a co-worker collects the person.

4.  Develop a Detailed Return to Work Plan

The RTW Plan should detail all the information that is relevant to the injured worker such as their work capacity, suitable duties, hours and days of work and what they should do if they can’t adhere to it.  Points such as when the person starts and finishes, how they get to work (if travel is an issue), who they report to, what they do on the designated breaks (are they supposed to be resting, can they smoke?), when they attend physio and what time they leave and return for the appointment.  You get the drift I am sure.

5.  Monitor the RTW Plan Closely

As the RTW Co-ordinator it is your job to ensure the RTW Plan is relevant, progressing and adhered to.  Contact the injured worker every time they advise they have no work capacity to ensure the RTW Plan is still suitable, collaborate with the treatment providers and Insurer as well as engage with the NTD to keep the RTW Plan progressing.

6. Remember the Injuried Employee also has Responsibilities!


 



Optimal handle position for boxes Mar 22nd, 2014
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Previous studies indicate that Manual Material Handling (MMH) is not only the most frequent but also the most costly category of compensable loss in the workplace. Handles on objects are very important for enhancing the safety and efficiency of manual handling for people who use them. In this study, four different prototype boxes with auxiliary handles were designed to determine the optimal handle position of a box based on the evaluated user preferences and body part discomfort. The results show that the subjects preferred the upper part of the handle on a small box regardless of handling position; while the mid to upper parts of the handle on a big box were preferred for handling above the waist height. BPD also indicated that an upper handle was less stressful for a relatively smaller box than a big one; and mid to upper handles were less comfortable for a big box.Box

Conclusions: this study found that upper handles on boxes were the most appropriate in many MMH cases, but for bulky boxes or stacking heights above the waist level, there was a need to design a box with both upper and middle handles. It also should be considered that a different handling position may require a middle or lower handle.

 



10 Reasons Why Injured Workers become Chronic Claims Mar 20th, 2014
Some injuries take longer to heal due to the nature of the injury and management. However following are 10 psychosocial factors that lead to poor workers compensation outcomes. 

1. They Choose the Wrong Doctor

Just because the Family Doctor got them through the coughs and colds it does not mean their Dr is equipped to best treat their work-related back injury. Best practice in the management of workers with soft tissue injuries includes early return to work and advice to stay active and yet many Nominated Treating Doctors persist in certifying these patients with no work capacity. This results in deconditioning, detachment from the workplace and distress for both the worker and employer. It is important to realise the Health Benefits of Work.

A Doctor skilled in Occupational Health is Vital

2.Their Employer Does Not Take Control of Injury Management and RTW

In the absence of a well trained and supported RTW Co-ordinator and effective injury management and return to work procedures an injured worker chooses their Family Doctor as the Nominated Treating Doctor that is the first mistake.  The second one is to for the Employer to totally rely on the Agent to drive the process.

3. Referral to Rehabilitation is Delayed

It’s a fact the earlier an injured worker gets assistance to return to work the better the outcome.  Clearly this makes good business sense as someone sitting at home with an injury is not thinking good thoughts not to mention the impact on the NSW employer’s premium.  However the it does appear to improve outcomes for patients also.

4. The System Makes Them Sicker

Liability is obviously a big issue in the workers compensation system meaning injured workers might have to attend a raft of assessments that can overmedicalise their condition.  So what might have started out as a simple injury starts to feel like something very serious.  In any case if you are not back at work then you need to prove that you actually cannot work that entrenches the sick role.  Sadly too there is often no-one on the team telling them otherwise.

5. They Lack the Health Literacy to Make Themselves Better

Injured workers can tend to not ask questions of their Doctors as they are used to doing as they are told and after all it is a common assumption Doctors do leap tall buildings and catch speeding bullets in their teeth.  Some Doctors might even speak with God.  Low health literacy reduces the success of treatment and increases the risk of medical error.

6. Pain must mean there is Something Seriously Wrong with Me

The evidence that tissue pathology does not explain chronic pain is overwhelming and yet injured workers who have been badly managed and managed themselves badly end up in this hopeless cycle of inactivity and inaction for fear they will make themselves worse.  Some even have needless surgery because that’s what their Doctors suggested – refer to the assumption of speaking with God.

7. They Want to be 100% Better

We all age and our bodies endure wear and tear so when an injury happens there might be underlying features that made the worker prone to such an injury and in fact it easily could have happened at home where there would be no liabiity.  The issue is aches and pains go with wearing out and 100% better is not achievable.

8. They Think the Employer Should Pay

Anger can be a big factor in Chronic Pain.  My employer did this to me and I am going to make them pay.  It’s a pity the injured worker can trash their own life in the process.

9. They Persist with Unhelpful Treatment because the Employer is Paying.

It’s like the company car that goes from reverse to first at 50 kph if someone else is paying the bill then you won’t be judicious about what are the benefits and the value of what you are getting.  Poor health literacy also does not help.  Persisting with passive physiotherapy for example even makes you worse as you decondition and it entrenches the sick role.

10. Some People Don’t want to Go Back to Work

Sadly a workers’ compensation lifestyle can very quickly and easily prevail.  You don’t have to perform and you get to pick up the kids from school so the by the time your pay drops it is not such an issue and anyway you have sort of painted yourself into a corner.


Health Benefits of Work Mar 20th, 2014

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The Australasian Faculty of Occupational and Environmental Medicine (AFOEM), a Faculty of the Royal Australasian College of Physicians (RACP), is pleased to introduce the Australian and New Zealand Consensus Statement on the Health Benefits of Work. Realising the Health Benefits of Work presents compelling international and Australasian evidence that work is generally good for health and wellbeing, and that long term work absence, work disability and unemployment generally have a negative impact on health and wellbeing. Realising the health benefits of work for all Australians requires a paradigm shift in thinking and practice. It necessitates cooperation between many stakeholders, including government, employers, unions, insurance companies, legal practitioners, advocacy groups, and the medical, nursing and allied health professions.


The following are the fundamental principles of the above document in regards to the relationship between health and work:



  1. Work is generally good for health and wellbeing;

  2. Long term work absence, work disability and unemployment have a negative impact on health and wellbeing;

  3. Work is an effective means of reducing poverty and social exclusion;

  4. Work must be safe so far as is reasonably practicable.

  5. Work practices, workplace culture and work-life balance are key determinates of individual health, wellbeing and productivity;

  6. Individuals seeking to enter the workforce for the first time, seeking reemployment or attempting to return to work after a period of injury or illness, face a complex situation with many variables.Good outcomes are more likely when individuals understand the health benefits of work, and are empowered to take responsibility for their own situation; and

  7. Health professionals exert a significant influence on work absence and work disability, particularly in relation to medical sickness certification practices



Lap Banding and Obesity Mar 20th, 2014
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DIETITIANS and EXERCISE PHYSIOLOGIST  play a vital role in optimising outcomes for people undergoing bariatric procedures. Bariatric surgery provides substantial and sustained weight loss and ameliorates obesity-related chronic disease risk factors in morbidly obese patients However this comes at the risk of complications such as nutritional deficiencies, food intolerance and further operations. What nutritional factors need to be considered pre- and post-bariatric surgery and what recommendations should health professionals make?

Bariatric procedures change the gastrointestinal system and its normal functions, affecting ingestion, digestion and absorption of food and nutrients. As a result, less food and energy are consumed, malabsorption of nutrients occurs and the body uses existing fat stores leading to weight loss. The NHMRC recognises that bariatric surgery is more effective in achieving weight loss in adults with obesity than nonsurgical weight loss interventions.  Weight loss is substantial: approximately 20—30% of body weight in people with a BMI > 35. 

As a result, obesity comorbidities — such as cardiovascular disease, dyslipidaemia, hypertension, type 2 diabetes, glucose intolerance, insulin resistance, metabolic syndrome, chronic renal disease, gastro-oesophageal reflux, polycystic ovarian syndrome, non-alcohol fatty liver disease, obstructive sleep apnoea and overall mortality risks — are reduced. It is difficult to establish however whether improvements are due to the weight loss itself, or changes in hormone balance, metabolism, pressure dynamics and mechanics caused by the bariatric surgery. 

Bariatric ops

Bariatric surgery can be considered for those morbidly obese adults who have tried all other methods of weight loss and repeatedly failed, and their mortality risk from chronic diseases is greatly increased. 

The four main surgical procedures performed in Australia are: 

Laparoscopic adjustable gastric banding (LAGB),

Roux-en-Y gastric bypass (RYGB)

Sleeve gastrectomy 

Biliopancreatic diversion. 

Dietitian’s role with bariatric patients

Accredited Practising Dietitians (APDs) are well qualified to undertake:

preoperative dietary assessments, including screening for nutritional deficiencies and treatment with supplements

commencing preoperative weight loss plans using VLCDs

post-surgery dietary assessments

counselling on progression of diet consistency

continual long-term review of nutrient markers

prescribing and reinforcing supplements

encouraging mindful eating.

Exercise Physiologist's role with bariatric patients

An exercise program is also a necessary part of the postoperative routine. Along with diet compliance, exercise helps prevent weight regain and maintain weight loss.

 


 

References



Obesity caused one in eight hospital admissions for women Mar 20th, 2014
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Obesity caused by poor lifestyle choices such as diet are the cause of one in eight hospital admissions for women over 50-years-old, according to a new study.

Researchers from the University of Oxford found that hospital admissions for women over 50 are commonly caused by issues to do with obesity or being overweight, and that these issues accounted for around 2 million days in hospital a year. 

The research was part of the Million Women Study, one of the biggest health research projects currently taking place in the UK.

 


 


101 Reasons To Exercise - Are your reasons on here? Mar 19th, 2014

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Dietitian Talk this Friday 21st March at 11.30am Mar 19th, 2014

Temika Lee's next Dietitian Talk is on Friday 21st March 2014, 11.30am at Central West Health & Rehabilitation in Geraldton. This talk is free for gym members and people who are completing Central West Health & Rehab's Diabetes Management and Chronic Disease Prevention programs.


This talk covers:



  • Healthy Eating Habits

  • Glycemic Index

  • Fat Types and Cholesterol

  • Recipe Modification Label Reading



Unhealthy fat consumption advice too ‘simplistic’ Mar 18th, 2014
logoGuidelines urging people to eat less "unhealthy" fat may be too simplistic, new research suggests. In a meta-analysis of data from 72 studies involving more than 600,000 participants from 18 countries, researchers found no overall association between saturated fat consumption and heart disease, contrary to current advice.

In addition, levels of "healthy" polyunsaturated fats such as omega 3 and omega 6 had no general effect on heart disease risk. But different specific strains of fat did have some impact. Two kinds of saturated fat found in palm oil and animal products were weakly associated with heart disease, while a dairy fat called margaric acid was significantly protective. Similarly, two types of omega-3 fatty acid found in oily fish – EPA and DHA – and the omega-6 fat arachidonic acid were linked to a lower risk of heart disease.

Popular omega-3 and omega-6 supplements appeared to have no benefit.

 



What is more important walking speed or duration? Mar 18th, 2014
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With aging of the population chronic heart failure (HF) hasbecome a major health issue throughout the world. This study aimed to assess the association between walking and other leisure time PA and Heart Failure in a large population study with repeated examination and more than 30 years follow-up with emphasis on the independent effects of speed and duration of walking. 

Conclusions: the results suggest that intensity rather than duration may be important for risk reduction with the lowest risks seen in those reporting high speeds of walking.


Do you have a Injury Management Policy? Mar 16th, 2014
reference graphicAmong other things, the Western Australian workers’ compensation system requires every employer to:

Have workers’ compensation cover for all workers (penalties apply for avoidance).

Have a documented Injury Management Policy and Injury Management System outlining the steps the employer will take if a worker is injured and the contact details of the person who will have day-to-day responsibility for the Injury Management System.

What is an injury management policy?

An injury management policy reflects an employer’s commitment to the principles of injury management and return-to-work and forms the basis for your injury management program. Your injury management policy should focus on and address injury management and returntowork issues.

What should an employer include in an injury management policy?

Ideally, your Injury Management Policy should:

reflect your commitment to the principles of effective injury management and return to work for injured/ill workers; promoting the principles of early reporting, early intervention, injury management and the return to work hierarchy as specified in the Workcover WA Return to Work and Injury Management Model.

state your commitment to the development and implementation of an Injury Management Program, which is supplemented by written procedures, readily available in the workplace, identifying the roles, rights and responsibilities of all parties.

include the right of an injured/ill worker to choose their own ‘Accredited’ Primary Treating Medical Practitioner and participate in the selection of their Accredited Workplace Rehabilitation Provider.

require return to work plans and injury management plans be developed in consultation with all parties in accordance with the Injury Management Program.

be appropriate to the nature and scale of your organisation, be written so that it is easily understood by employees and capable of being implemented in your workplace. The policy should be developed in consultation with, and endorsed by, all workplace parties with provision for input by unions if requested by workers.

be consistent with the Workers’ Compensation and Injury Management Act 1981 and the Workers’ Compensation Code of Practice (Injury Management) 2005, other supporting legislation and guidelines and your insurers Injury Management Policy; the policy should also be consistent with your health and safety policy and other management systems.

promote continuous improvement and be reviewed regularly (annually) to demonstrate your commitment to the policy and to ensure it remains consistent with the Injury Management Program Guidelines.

be explained to all new workers joining your organisation and be displayed prominently in appropriate locations so your workers can easily read it.

While inititally daunting Central West Health and Rehabilitation IMS Assessment process can assist you to meet your Workcover WA Obligations.


 


 



Workplace Based Return-to-Work Programs Mar 15th, 2014
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Employers, insurers and workers’ groups have expressed a growing interest in return-to-work (RTW) interventions after injury or illness. As disability management is increasingly being integrated into employers’ and insurers’ mandates, there has been a focus on workplace-based RTW interventions. This paper is a systematic review conducted to review the effectiveness of workplacebased RTW interventions. There was strong evidence that work disability duration is significantly reduced by work accommodation offers and contact between healthcare provider and workplace;and moderate evidence that it is reduced by interventions which include early contact with worker by workplace, ergonomic work site visits, and presence of a RTW coordinator.

Conclusions: This systematic review provides the evidence base supporting that workplace-based RTW interventions can reduce work disability duration and associated costs. 

For more on our IMS Assessment please contact us.

 



Walking to work and adult physical activity levels Mar 15th, 2014
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One approach to increasing physical activity levels is to promote active travel i.e. walking and cycling. There is increasing evidence of the link between adult obesity levels and travel behaviour, one indicator of which is that countries with highest levels of active travel generally have the lowest obesity rates. The objective of this study was to examine the contribution to adult physical activity levels of walking to work. Total weekday physical activity was 45% higher in participants who walked to work compared to those travelling by car. 

Conclusions: Walking to work was associated with overall higher levels of physical activity in young and middle-aged adults.

 


 



Return To Work - Optimizing the Role of Stakeholders Mar 15th, 2014

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Work disability is now conceptualized as a function of organizational, jurisdictional and social influences, rather than as primarily medically determined. Return-to-work (RTW) interventions are no longer restricted to clinic-based medical interventions: insurers have become involved through case managers; employers have realized that organizational policies impact RTW outcomes; and providers have become interested in expanding their involvement to achieve better outcomes. There is growing consensus that while attending to the physical/medical aspects of the work disabled employee is important, much of the variability in RTW outcomes is accounted for by what takes place at the workplace. There is increasing evidence of greater effectiveness ofworkplace-based interventions as opposed to interventions provided outside the workplace. Organizational factors are also known to have significant impact on work disability costs. To reduce insurance or disability costs and ensure compliance with a growing number of government regulations concerning workplace safety and disability, employers have been increasingly interested in improving their disability management practices.


This study analyzes the RTW stakeholder interests and suggests that friction is inevitable; however, it is possible to encourage stakeholders to tolerate paradigm dissonance while engaging in collaborative problem solving to meet common goals. We review how specific aspects of RTW interventions can be instrumental in resolving conflicts arising from differing paradigms: calibration of stakeholders’ involvement, the role of supervisors and of insurance case managers, and procedural aspects of RTW interventions.


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Why diets often fail? Mar 11th, 2014
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Almost everyone who has tried to lose weight has tasted the bitter pill of failure. That feeling you get when, despite all your desires to be healthier, to fit into sassier clothes or to shimmy through life (and into aeroplane seats) with greater ease and comfort, you just can’t stick with your diet and exercise plans for long enough to get there.

People failing to lose weight frequently blame themselves, as does almost everyone around them. In fact, even a sizeable proportion of health professionals consider obesity to be an individual failing. But this attitude displays complete ignorance of human physiology and how it impacts weight loss. 

 



Must Dos before you dismiss an ill or injured worker Mar 11th, 2014
If you have an ill or injured worker, you might think that it is in your best interest to get them back into the workplace and working as quickly as possible - but this is not always the case. Early return to work is not always the right approach; it can agitate and extend an issue that could have been resolved in a shorter time with more rest.

The decision to return a worker to work should be based on what the worker is capable of safely doing when they return to work.

The decision about when a worker should return to work should be made with consultation between management, the worker, and after seeking professional medical advice.

What if the worker is not fit for their pre-injury duties?

If you determine (with the advice of a medical professional) that the worker will not become fit for their pre-injury duties for the foreseeable future, you will need to decide whether:



  • you can offer the worker ongoing employment in a modified role to accommodate their condition; or

  • you are going to terminate their employment.



If both parties agree to the modified duties, then a new contract of employment can be drawn up. If this is the case, you can set goals that you and the injured worker have agreed on to ensure there is a clearly communicated expectation that the injured worker will return to their pre-injury duties.

Remember, if a worker continues on modified duties for a prolonged period with no current plan to return to their pre-injury duties, it is arguable that the worker has been permanently appointed to a new role. When this occurs, the worker's old contract of employment is effectively terminated and replaced with a new one.

If this were the case, you would be unable to dismiss the worker on the basis that they are permanently unable to return to their original position, as they have been appointed to a new role.


7 things you MUST do before dismissing an ill or injured worker

Employers are generally prohibited from dismissing an employee because of incapacity due to illness or injury. However, there are certain circumstances in which you can dismiss an employee who is ill or injured.

Before you terminate an injured worker, you must ensure that you do the following things:


  1. Obtain sound medical evidence regarding the worker's incapacity.

  2. Determine, and be able to prove, that the worker is unable to perform the job they were employed to perform.

  3. Determine, and be able to prove, that there is no reasonable measure you can take to accommodate the worker's injury or illness.

  4. Do not create an expectation in the worker that you will provide them with modified duties on an ongoing basis.

  5. Give the worker an opportunity to respond to the allegation that they are unfit for their duties and to the intention to terminate their employment.

  6. Consider the worker's length of service, employment history and the impact of dismissal on them.

  7. Check that you have no obligation to provide suitable employment under the workers' compensation legislation in your jurisdiction.


 


Reference:


http://www.healthandsafetyhandbook.com.au/



Safety culture, hardiness, and musculoskeletal complaints Mar 9th, 2014
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This study explores the mechanisms linking the psychosocial characteristics of the workplace with employees’ work-related musculoskeletal complaints. Poor safety climate perceptions represent a stressor that may elicit frustration, and subsequently, increase employees’ reports of musculoskeletal discomforts. Results from an employee sample supported that when employees’ perceived safety was considered a priority, they experienced less frustration and reported fewer work-related upper body musculoskeletal symptoms. Psychological hardiness, a personality trait that is indicative of individuals’ resilience and success in managing stressful circumstances, moderated these relationships. Interestingly, employees with high hardiness were more affected by poor safety climate.

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Figure: Interaction between psychological safety climate and psychological hardiness for predicting frustration.



Diet,sleep and exercise - Lifestyle factors related to Depression Mar 9th, 2014
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Research on major depression has confirmed that it is caused by an array of biopsychosocial and lifestyle factors. Diet, exercise and sleep are three such influences that play a significant mediating role in the development, progression and treatment of this condition. This review summarises animal and human based studies on these factors and their influence on dysregulated pathways associated with depression:



  • neuro-transmitter processes,

  • immuno-inflammatory pathways,

  • hypothalamic–pituitary–adrenal(HPA)axis disturbances,

  • oxidative stress and antioxidant defence systems,

  • neuroprogression, and

  • mitochondrial disturbances



Mental health interventions, taking into account the bidirectional relationship between these lifestyle factors and major depression are likely to enhance the benefits of treatment.



Pilates Training for People With Fibromyalgia Syndrome Mar 9th, 2014
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Pilates exercises had positive effects on pain and function, especially immediately after the exercise program. Comparison of these 2 treatment groups showed superiority of Pilates over relaxation/stretching exercises in the short term for pain and function, but no statistical difference existed between groups 3 months after the end of the treatment program. This finding points to the necessity of an uninterrupted Pilates program in order to sustain the significant improvement obtained immediately after the treatment period.

pain          pain

 


Never to late to increase your activity level Mar 8th, 2014
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Previous studies have examined the effects of mid-life physical activity on healthy ageing, but not the effects of taking up activity later in life. We examined the association between physical activity and healthy ageing over 8 years of follow-up. In comparison with inactive participants, moderate, or vigorous activity at least once a week was associated with healthy ageing, after adjustment for age, sex, smoking, alcohol, marital status and wealth. Becoming active or remaining active was associated with healthy ageing in comparison with remaining inactive over follow-up. Sustained physical activity in older age is associated with improved overall health. Significant health benefits were even seen among participants who became physically active relatively late in life.

 



Why so many Australians are obese and how to fix it Mar 7th, 2014
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In 1980 just 10% of Australian adults were obese; by 2012 this figure had risen to 25%, among the highest in the world.

The food industry lobby and their friends in government would have us believe this comes down to reduced personal responsibility for what we eat and how much we move. We might, then, expect to find evidence that people are becoming less responsible. But statistics show the opposite: we are much more likely to drive more safely, drive sober, and not smoke, for example. Yet when it comes to food, something is different. Our changing food environment has undermined our capacity to be responsible in the first place.

 

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Strength Training Vs Endurance Training Mar 6th, 2014

Dr Spence's thesis summarises the results of the first prospective randomised longitudinal study which has utilised optimal contemporary imaging methods such as MRI and Doppler ultrasound to specifically address the hypothesis that distinct training modalities have different effects on cardiac and vascular structure and function. This integrative human physiology experiment provides a comprehensive morphological and functional assessment of cardiovascular changes, challenging accepted textbook dogma by providing novel information regarding changes in both the heart and arteries of humans in response to exercise. This study directly addressed the question of differential impacts of exercise modality on vascular adaptations of arteries in humans in response to a relatively prolonged training intervention period. We conclude that both endurance and resistance modalities have impacts on arterial size, function and wall thickness in vivo, which would be expected to translate to decreased cardiovascular risk.


Prevention Program - Cost-Saving to the Employer Mar 4th, 2014
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To prolong sustainable healthy working lives of construction workers, a prevention program was developed which aimed to improve the health and work ability of construction workers. The objective of this study was to analyze the cost-effectiveness and financial return from the employers’ perspective of this program.

293 workers in 15 departments were randomized to the intervention or control group (n¼7). After 12 months, the absenteeism costs were significantly lower in the intervention group than in the control group. At 12-month follow-up, no significant differences were found with respect to the primary outcomes (work ability, mental and physical health status) and secondary outcomes (musculoskeletal symptoms), meaning that the intervention was not cost-effective in comparison with the control group. The net benefit was 641 guilders ($448.00 Aust) per worker, and the intervention generated a positive financial return to the employer.

The intervention in the present study was cost-saving to the employer due to reduced sickness absenteeism costs in the intervention group compared with the control group.

 



Real Life Case Study - Metabolic Syndrome Mar 3rd, 2014

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The following Case study is taken from Exercise is Medicine e-Newsletter.

 

James is a 52 year old academic, diagnosed with Metabolic Syndrome in 2013.  He has never smoked and consumes an average of six standard drinks a week.

As a participant of a University of Queensland study, The Effect of Exercise Intensity on Metabolic Syndrome, James was prescribed supervised high intensity interval training (HIIT) for 16 weeks (3 sessions per week) on a cycle ergometer.  Each training session consisted of 4 x 4 minutes of cycling exercise at 85-95% peak heart rate (HRpeak), alternated with 3 minutes of active recovery at 50-60% HRpeak.  A 10-minute warm-up at 60-70%HRpeak and a 3-min cool-down was also conducted within each session. Throughout all training sessions, speed was maintained at 60-70 revs per minute whilst the load was adjusted to ensure that the prescribed target heart rates were met.

James has now finished the HIIT program and is continuing the program at home three times per week.  He attends a monthly HIIT session as part of the study until the 12-month testing follow-up. 

Results

After the 16-week HIIT intervention, James no longer meets the criteria for metabolic syndrome as shown on the table below.  He is no longer on cholesterol treatment.

James’ measurements against the risk factors* for Metabolic Syndrome: 

*Risk factors according to the International Diabetes Federation (IDF) criteria

The evidence behind the intervention:

High intensity interval training (HIIT) has been shown by a recent meta-analysis (including 10 randomized studies) to be superior in enhancing cardiorespiratory fitness in patients with lifestyle-induced cardiometabolic diseases (HIIT Vs. MICT; 19.4% Vs. 10.3%) (Weston et al. 2013).  Given the ability of increased cardiorespiratory fitness in attenuating traditional risk factors of cardiovascular disease (CVD) (Blair et al. 1996; Warburton et al. 2007), this finding proves to be clinically significant.  More specifically, in 2008, a pilot study by Tjonna and colleagues showed a greater improvement in cardiorespiratory fitness (HIIT Vs. MICT; 35% Vs. 16%) and a reduction in the composite number of CVD risk factors following HIIT (4x4min at 90%HRmax, 3x/week, 16 weeks) compared to an isocaloric MICT (70%HRmax, 47 mins) in 32 patients with metabolic syndrome.  Interestingly, nearly half (45%) of the patients in the HIIT group were no longer diagnosed with the metabolic syndrome after the 16-week program compared to only 38% in the MICT group, with this change only significant in the HIIT group. Furthermore, this study also revealed HIIT to have a greater impact in other physiological measures such as insulin sensitivity, mitochondrial function, and endothelial function compared to the isocaloric MICT


Physical Activity and Happiness Mar 2nd, 2014
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To investigate the associations among changes in leisure-time physical activity (LTPA) and changes in happiness over a  12 year period. 17 276 Canadians were followed from 1994 to 2009. People who were inactive at baseline were more likely to be unhappy after 2 years and 4 years of follow-up than those who were active. Leisure-time physical activity was associated with maintaining happiness and avoiding unhappiness. Changes from activity to inactivity status from one 2-years cycle to the next were associated with changes from happiness to unhappiness.

Although the same principles of physiologic adaptation to exercise apply to nonathletes, the “motivation” factor is very different. Human-centered design holds great promise for the development of prevention programs because it incorporates patient preferences and desires as the programs are being developed.

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Job Strain as a Risk Factor for Physical Inactivity Mar 2nd, 2014
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Low job control and too high or too low job demands, have been suggested to increase the likelihood of physical inactivity during leisure time. The authors examine the association between unfavorable work characteristics and leisure-time physical inactivity in a total of 170,162 employees (50% women; mean age, 43.5 years). The odds for physical inactivity were 26% higher for employees with high-strain jobs (low control/high demands) and 21% higher for those with passive jobs (low control/low demands) compared with employees in low-strain jobs (high control/low demands). This data suggest that unfavorable work characteristics may have a spillover effect on leisure-time physical activity.


Predictors of Work Absence Following a Work Injury Feb 27th, 2014
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This study examined if the factors associated with days of absence following a work-related injury are similar for mental health versus musculoskeletal (MSK) conditions. Mental health conditions were associated with a greater number of days of absence over the 2 years following first incapacity compared to MSK conditions. Differences were observed in employment, injury and industry variables on absence from work for mental claims compared to MSK claims. Predictors of days away from work in the 2 years following an injury differ for mental health versus MSK claims.

 

 

 


World Health Organisation - Physical Activity Feb 27th, 2014

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  • Physical inactivity is the fourth leading risk factor for death worldwide.

  • Approximately 3.2 million people die each year due to physical inactivity.

  • Physical inactivity is a key risk factor for noncommunicable diseases (NCDs) such as cardiovascular diseases, cancer and diabetes.

  • Physical activity has significant health benefits and contributes to prevent NCDs.

  • Globally, one in three adults is not active enough.

  • Policies to address physical inactivity are operational in 56% of WHO Member States.

  • WHO Member States have agreed to reduce physical inactivity by 10% by 2025.



Employee Physical and Psychosocial risk factors Feb 26th, 2014
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While in recent years there has been a growing awareness among mining companies of the need to address physical injuries and environmental issues, there remains a lack of knowledge about how psychosocial risks independently and in conjunction with physical risks affect the health, general well-being and quality of life of mine workers. Responses from 307 participants showed mining equipment, ambient conditions, and work demands and control as being significant predictors of quality of life and general well-being after controlling for demographics. Age as a demographic variable also had important implications, with older workers experiencing better well-being and quality of life. Implications of findings for the mining sector in Ghana and other developing countries are discussed as a starting point towards developing further initiatives in this area.

 

Glen dealing with Stress of pool championships (see all 5 parts on youtube)



 

 



How high heels harm and how to make it better Feb 25th, 2014
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High-heeled shoes are thought to characterise femininity and beauty, making the wearer feel self-assured and elegant. But they also alter alignment of the feet, legs, and back, and can have long-term effects on posture and health.

Feet suffer considerably inside high-heeled shoes. The higher the heel, the more the foot slides inside the shoe and the greater the pressure and friction under the heel, the ball of the foot, and the big toe.

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Mitigating harm


Women who love high-heeled shoes are unlikely to stop wearing them, even if they become aware of the problems they may cause. So here are some suggestions to reduce the harmful effects of high heels:

choose a shoe with moderate heel height, no higher than five centimetres, and a fastening over the instep;

wear high heels for short periods of time, and take a pair of flat shoes or runners to change into if you have to walk a long distance during the day;

choose a shoe with a wide heel base, or a wedge heel, to reduce the load under the front of your foot;

avoid running in high-heeled shoes as pressure under the foot increases considerably when running, even at low speed;

use a shoe insert to reduce pressure on the forefoot and heel; and

do calf muscle stretching exercises every day to maintain ankle flexibility.

Reference:


http://theconversation.com/health-check-how-high-heels-harm-and-how-to-make-it-better



Raise the conversation on rising weight Feb 25th, 2014
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SINCE the mid-1980s the weight status of Australian children has changed significantly, with the prevalence of overweight doubling and obesity trebling at the start of the 21st century. The latest data estimate that approximately one in four Australian children is currently overweight or obese. Translating the current prevalence into real numbers, there are approximately 736,000 Australian children aged 5—18 years who are classified as overweight/obese (of which 222,000 are obese).  Tertiary paediatric obesity services in Australia are inadequate to meet treatment requirements of these children.

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The foremost question is whether society would accept a prevalence rate of 25% in other preventable paediatric disorders (e.g. pertussis, poliomyelitis, diphtheria)? Given the clear evidence that obesity during childhood increases obesity risk across the life course and lays down the foundations for developing myriad metabolic chronic diseases, it is difficult to understand criticism of proponents calling for better child obesity prevention investments. The prevalence of overweight/obesity is approximately 6% points higher among children from lower compared with higher socioeconomic backgrounds (~26% vs 20%). Similarly the prevalence is higher among primary school aged children from Middle-Eastern (~36%) and Asian (~28%) backgrounds compared with English-speaking counterparts (~22%), and among Indigenous children (~28%). There is a double burden for children from non-English speaking backgrounds living in areas of social disadvantage.

 


Reference:


http://www.medicalobserver.com.au/news/raise-the-conversation-on-rising-weight



Where does exercise time come from? Feb 22nd, 2014
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When people undertake a new exercise program, the time spent in other domains, such as sleep or screen time, must be reduced to accommodate the new activity. If someone starts jogging at lunchtime, for example, they will need to find time not only for the jogging, but also for changing into exercise clothes, showering and changing back into work clothes after the run. Where does this time come from? Which “time reservoirs” are drawn upon? This study aimed to investigate how previously inactive adults modify their time budgets when they undertake a new physical activity program.

Participants who did significantly increase their Physical Activity levels appeared to increase Active Transport and spend less time watching television/videogames by the end of the intervention period. 


Next - Time out for exercise


 



Preventing work disability due to work injuries Feb 22nd, 2014
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The process of returning disabled workers to work presents numerous challenges. In spite of the growing evidence regarding work disability prevention, little uptake of this evidence has been observed. This literature review and collection of experts’ opinion presents the evidence for work disability prevention, and barriers to evidence implementation. Some clinical interventions (advice to return to modified work and graded activity programs) and some non-clinical interventions (at a service and policy/community level but not at a practice level) are effective in reducing work absenteeism. Implementation of evidence in work disability is a major challenge because intervention recommendations are often imprecise and not yet practical for immediate use, many barriers exist, and many stakeholders are involved. 

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Suitable Duties - Some Care needed Feb 21st, 2014

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In the section on Modified Duties, or suitable duties, as they are called in the workers’ compensation arena the point is made that employers need to ensure the documents and other discussions surrounding the initial and ongoing offer of modified duties should reflect they are temporary and time-limited pending a return to the agreed position ie in most cases the pre-injury role.  The authors also note the length of time the modified duties are offered needs to be carefully considered and regularly reviewed to avoid suggestions that since the worker has been doing them for so long, it is not a burden for the employer to continue offering the modified duties and it is unfair to withdraw them. Keeping the following 5 steps in mind should assist in controlling the above risk:



  1. Assessing The Suitable Duties

  2. Establishing The Prognosis

  3. Documenting The Path

  4. Monitoring The Plan

  5. Reviewing The Plan


Central West Health and Rehabilitation's Employer Services division offers an Injury Managements System online assessment to help you check you are meeting your obligations. Contact us to know more.



400 annual diabetes diagnoses in young Australians Feb 19th, 2014
 

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AROUND 400 new cases of type 2 diabetes are diagnosed each year in Australian children and young people. And although the rates of new cases have largely remained stable over the last decade (2002–03 to 2011–12), the emerging burden of type 2 diabetes is a cause for concern, according to a new report by the Australian Institute of Health and Welfare (AIHW). The report is the first to document incidence and prevalence estimates for type 2 diabetes in children and young people.

The increase in type 2 diabetes in children and young people was attributed in part to high rates of overweight and obesity in these age groups. The incidence was found to increase with age – from three new cases per 100,000 population in 10–14 year-olds to eight per 100,000 in 15–19-year-olds and 16 per 100,000 for those aged 20–24 years.

Between 2006–11, the age-specific rate of type 2 diabetes for Indigenous Australians was eight times higher than non-Indigenous among 10–14-year-olds. As of June 2012 there were around 2200 children and young people aged 10–24 years diagnosed with type 2 diabetes. But the AIHW believes these figures to be an under-estimate, due to limitations of data collection such as undiagnosed diabetes, misdiagnosis between type 1, type 2 and monogenic diabetes in this age group, and misreporting. However, the study found no evidence of a rise in the rate of new cases of type 2 diabetes in young people over 2002–03 to 2011–12 and rates fell in the 20–29 year group.

“Given that type 2 diabetes is largely preventable, there is considerable potential for health, social and economic gains through effective actions based on the best available evidence,” the report stated.

 

Reference:



Promoting Exercise in the Workplace Feb 18th, 2014
The "EIM Physical Activity in the Workplace: A Guide" supports organisations in the promotion of physical activity in the workplace and to reduce sedentary behaviour. It is a collation of current evidence and best practice, including a toolkit of resources and audit tools.

Topics covered include:

Recommended levels of physical activitySedentary behaviourBarriers to increasing physical activityPromoting active transportEmpowering employees, andMaking physical activity a cultural fit.

The target audience includes senior management, human resource units, health promotion units and workplace health committees. It’s content and recommendations are applicable to small, medium and large organisations.

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The Process of Change Feb 16th, 2014
When it comes to health recommendations, we mostly know the drill:

TTM ModelExercise most days of the week;

eat a varied and nutritious diet;

keep your body mass index less than 25;

get enough sleep;

keep up with medical screenings for blood pressure, cholesterol, and blood sugar;

don’t smoke;

and limit alcohol to seven drinks a week.

Reducing stress;

improving relationships;

Developing new interests or hobbies.

When trying to change non-constructive behaviour it is important to remember that behaviour change is rarely a discrete, single event. During the past decade, behaviour change has come to be understood as a process of identifiable stages through which people pass.

People who are trying to change an unwanted habit or behaviour are more successful if they approach this process in an appropriate way depending on which of the five stages of the stage of change model their actions most closely resemble.



What is an Employee Assistance Program? Feb 16th, 2014
An Employee Assistance Program (EAP) is a work-based intervention program designed to enhance the emotional, mental and general psychological wellbeing of all employees and includes services for immediate family members. The aim is to provide preventive and proactive interventions for the early detection, identification and/or resolution of both work and personal problems that may adversely affect performance and wellbeing. These problems and issues may include, but are not limited to, relationships, health, trauma, substance abuse, gambling and other addictions, financial problems, depression, anxiety disorders, psychiatric disorders, communication problems, legal and coping with change.

The Employee Assistance Professional Association of Australasia (Inc)


Is the Peak Australasian Body representing provider and user members that supply Employee Assistant Programs in the workplace. In co-operation with employees and management, EAPAA members' primary objective is to provide the most effective employee assistance services to individuals and their families suffering from personal or work related problems, which negatively affect their work and wellbeing.



Are you considering Ergonomics in your Workplace Feb 16th, 2014
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All this talk of sedentary workers and reducing the risks posed to them has reminded me of the other risks for workers who may sit in the same position for most of their working day: poor posture and repetitive movements. Work duties that involve poor posture and repetitive movements, such as typing, can cause muscle fatigue and injuries to other soft tissue. For example, people working at desks for extended periods often adopt postures that lead to discomfort and injury over time, such as carpal tunnel syndrome.


Ergonomics is the process of designing workplaces, equipment and systems so that they are suited to the user. This approach can be applied to numerous aspects of a workplace such as chairs, tables, keyboards, computer screens and telephones.Incorporate the principles of ergonomic design into your workplace. This may include, for example, purchasing office chairs that provide a headrest, adjustable height and adequate lumbar support.It is really important to take a 'proactive' rather than a 'reactive' approach to these types of hazards. This means that rather than responding to an incident when it occurs, you should look for and address areas in your workplace that are in need of improvement.You can also do small things in the workplace to reduce poor ergonomics such as:

Position desks and chairs so that the elbow is level with or slightly higher than the keyboard.

Place computer screens at an appropriate distance from the worker (between 350mm to 750mm) and at an appropriate height (the top of the screen should be just below eye level).

Remember, there are also lots of exercises your workers can do at their workstations to help reduce posture and movement hazards. Train your workers in methods like this and don't forget to train workers who work from home in these practices as well. Consult them about their needs, and ensure that any equipment you provide is appropriate and they are aware of potential hazards related to sedentary work, poor posture and repetitive movements, how to identify the hazards, and how to avoid them. 


Select your Injury Management Coordinator Feb 15th, 2014

Injury Management GuideAll employers must nominate an employee to have day-to-day responsibility for the Injury Management System – usually referred to as the Injury Management Coordinator.

In small business the owner often fills this role. A medium-sized business may designate the role on a part or full-time basis. Large businesses may need to appoint a number of Injury Management Coordinators across many sites.

Choose an Injury Management Coordinator carefully. An ability to communicate and develop rapport with a range of different people are important skills to consider when selecting the person for this role.

The Injury Management Coordinator will need your support to perform their role effectively. You should ensure they have access to relevant training, resouces and any other assistance required to carry out their roles.


Contribution of Age and Workplace to Exercise and BMI Feb 15th, 2014
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The workplace is an important domain for adults, and many effective interventions targeting physical activity and weight reduction have been implemented in the workplace. This paper reports on the distribution of physical activity and BMI by age in a population of hospital-based healthcare workers and investigates the relationships among workplace characteristics, physical activity, and BMI. Workers reporting greater decision latitude and job flexibility reported greater physical activity. Overweight and obesity increased with age, even after adjusting for workplace  characteristics. Sleep deficiency and workplace harassment were also associated with obesity. These findings underscore the persistent impact of the work environment for workers of all ages. Based on these results, programs or policies aimed at improving the work environment, especially decision latitude, job flexibility, and workplace harassment should be included in the design of worksite-based health promotion interventions targeting physical activity or obesity.

 



Love boosts health Feb 14th, 2014

Medical Observer


AUSTRALIANS shot by Cupid's arrow are the happiest and healthiest in the land — until they get engaged. After that things tend to get a bit stressful, particularly for the bride-to-be. But the honeymoon glow lasts longer than most people think.

Couples with up to two children and people in same-sex relationships are among the happiest and healthiest, according to the Alere Wellness Index made up of scores for exercise, psychological wellbeing, nutritional health, alcohol, smoking, medical conditions and body mass.Couples with three or more children aged under 16 have increased stress, according to the index, which is based on 50,000 surveys a year conducted by Roy Morgan Research.Men in a same-sex relationship are prone to drinking too much and putting on weight.Separated and divorced people are the least healthy, with poor psychological scores and high rates of smoking.

Single people, particularly women aged 35 –49, do worst on a psychological level, according to the index. But things improve for single people aged 65 and older.In general, people who describe themselves as planning to get married do more exercise than others and are less likely to smoke or drink to excess. 

The people in the best psychological shape are those aged older than 65 who are planning to marry. Younger engaged men and women are slimmer than other groups, but husbands-to-be perform less exercise and have a less healthy diet than average. Younger women also have better than average overall health but score badly on psychological wellbeing, with more than four in 10 engaged women saying they feel stressed.

Young Couple


List of Approved Workers Compensation Insurers Feb 13th, 2014

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Insurers are integral to the workers’ compensation system in Western Australia. They have a role in assessing claims made by workers, and indemnifying employers of compensation for accepted claims.

Approved Insurers


Effective Injury Management System Feb 13th, 2014
Injury Management Guide

All employers must have an Injury Management System. An Injury Management System is a written description of the steps you will take when there is an injury in your workplace. An employer is also required to develop a formal (written) return to work program for a worker when the medical practitioner:

advises the employer in writing that a return to work program should be established for the worker

signs a medical certificate indicating that the worker has partial capacity to return to work

signs a medical certificate indicating that the worker has total capacity to return to work, but for some reason is not able to return to the position held immediately prior to injury.

Employers are encouraged to read WorkCover WA’s Injury Management: A Guide for Employers publication which provides information to assist employers to understand their legal obligations and contains a three step approach to effective injury management.



Five men’s issues to watch - Medical Observer Feb 12th, 2014


WHAT'S ahead for men’s health? Here are five issues to watch as the year unfolds.

A focus on men’s health in Australia has been reinvigorated in recent years with the launch of the 2010 National Men’s Health Policy. But new issues continue to emerge, so it is important to remain vigilant in addressing areas of need. In particular, health issues facing younger males — including drugs in sport and pressures around body image — have gained growing media attention.


Sport

Until recently most us of may have thought the major male health issue around sport was participation levels. But 2013 was the year that performance-enhancing drugs and ‘supplements’ came to the attention of the mainstream media.

The health consequences of drugs in sport can get lost within the media hoopla and the drama of high-profile sports people implicated in these activities, plus the associated legal and sporting regulatory issues. And let’s keep in mind that what takes place in the elite levels of sport often propagates throughout the amateur ranks as well. The use and abuse of ‘recreational’ drugs and alcohol also has a long but not particularly glorious history in Australian sport. It will be interesting to observe how the major sporting codes will approach the use of social and performance-enhancing drugs in 2014 and beyond.

Body image

Recent evidence suggests that body image concerns are more prevalent in boys than previously thought, and that boys may manifest these concerns in a different manner to girls.

The finding that boys tend to be concerned about muscularity (rather than concerns about thinness observed in females) has significant implications for diagnosis and treatment of eating disorders in men and boys.

Dads get the blues too

Becoming a parent for the first time marks a major life milestone, and is also a time of significant lifestyle upheaval. Health professionals are beginning to recognise that the mother and the father both share the emotional and psychological impacts of new parenthood. Postnatal depression in men is now on the health agenda with support services being developed, albeit in the early stages.

Prostate cancer

Several promising new approaches to the diagnosis of prostate cancer are under investigation. While the venerable PSA is not likely to fall into disuse any time soon, we can look forward to a future where more specific markers for prostate cancer may play a role in diagnosis and management.

In the meantime, the use of the PSA test will continue to be a contentious issue, as will recommended treatment and management practices. Careful analysis of quality evidence must remain the cornerstone of this debate.

Erectile dysfunction

Erectile dysfunction (ED) is more than just old blokes worrying about their sexual performance. Men who experience ED face a higher risk of developing cardiovascular disease compared to men who do not. The degree of risk for a cardiovascular event after developing ED is said to be similar to that of current smoking or a family history of ischaemic heart disease.

While specific treatments to promote erectile function, usually starting with options such as PDE5 inhibitors, are effective, management of any identified cardiovascular disease or risk factors should follow a diagnosis of ED. It is hoped that awareness of the role of a man’s penis as a barometer for his overall health will become more widespread in 2014.

 


Safety management for heavy vehicle transport Feb 12th, 2014

Big TruckThis paper reviews the literature concerning safety management interventions, that have been effective in reducing injury outcomes in occupational health and safety (OHS) and road safety, and assesses their applicability to reducing crash and injury outcomes in heavy vehicle transport. The operational and management characteristics that were associated with reduced crash and injury risk included: safety training, management commitment, scheduling or journey planning, size of organisation or freight type, worker participation, incentives and safety or return to work policies. Other characteristics that might be associated with lower incident and injury rates were risk analysis/corrective actions, prior safety violations, crashes or incidents, vehicle conditions or physical work environment, vehicle technologies, recruitment and retention, pay and remuneration systems, communications/ support, safety or quality management accreditation, financial performance, and worker characteristics and attitudes. The review also highlighted gaps in the literature requiring further research.


Pilates training results in improved flexibility Feb 12th, 2014

Pilates training may result in improved flexibility. However, its effects on body composition, health status, and posture are more limited and may be difficult to establish. Further study might involve larger sample sizes, comparison with an appropriate control group, and assessment of motor unit recruitment as well as strength of truncal stabilizers.

 

 


Workers Compensation Insurance Policies & Premiums Feb 12th, 2014
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Workers’ compensation insurance protects employers from financial costs when a worker sustains a work-related injury or disease. It also protects injured workers by providing weekly payments to cover loss of earning capacity, payment of reasonable medical and rehabilitation expenses, and other entitlements.

Take out insurance

You can obtain insurance cover from any of the insurers approved by the Minister to underwrite workers' compensation insurance. It is important to shop around to get the best policy for your business.

Standard workers' compensation policy

All insurers are required to issue workers' compensation policies in an approved form. WorkCover WA has issued a Standard Employer Indemnity Policy (PDF - 70kb) which is the basis of all workers' compensation policies.

How your insurance premium is calculated

WorkCover WA determines and applies recommended premium rates to each industry classification, and updates the rates annually. However, insurers can discount these rates or load (increase) them by up to 75%.

In determining the premium rate for your business, your insurer will:
Request a wages declaration as the recommended premium rate applies to the aggregate amount of wages, salaries or other remuneration paid to an employer's workers

Assign an industry classification to your business - all premiums for a particular industry are calculated on the same rate

Examine the risk factors (claims history, safety and injury management policies etc) associated with your business

Discount the recommended industry rate by any amount, or surcharge it by up to 75%, depending upon an employer's individual risk factor

Insurers may surcharge more than 75% with approval from WorkCover WA, dependent upon the claims experience and risk associated with the operation of an employer’s business

Apply your premium rate. Only one rate applies for each ‘establishment’ - defined as a unit covering all the operations of a company conducted at or from a single location. If an employer conducts more than one industry at the same single location, the classification of the employer's predominant industry (based on gross remuneration) applies.

Adjust your premium following the submission of your actual gross wages, depending on whether the actual wages were more or less than the estimate you first provided. If you wish to renew your policy with the same insurer, you need to submit (on the same declaration) an estimate of gross wages to be paid the following year.



Display and device size effects on the usability Feb 10th, 2014

Notebook setup



A balance between portability and usability made the 10.100 diagonal screens popular in the Mobile PC market (e.g., 10.100 mini-notebooks/netbooks, convertible/hybrid ultraportables); yet no academic research rationalizes this phenomenon. This study investigated the size effects of display and input devices of 4 mini-notebooks (netbooks) ranged in size on their performances in 2 simple and 3 complex applied tasks. It seemed that the closer the display and/or input devices (touchpad/touchscreen/ keyboard) sizes to those sizes of a generic notebook, the shorter the operation times (there was no certain phenomenon for the error rates). With non- significant differences, the 10.100 and 8.900 mininotebooks (netbooks) were as fast as the 11.600 one in almost all the tasks, except for the 8.900 one in the typing tasks. The 11.600 mini-notebook (netbook) was most preferred; while the difference in the satisfactions was not significant between the 10.100 and 11.600 ones but between the 700 and 11.600 ones.


Sit less, move more: New physical activity guidelines Feb 10th, 2014

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Australians should aim for around 60 minutes of physical activity per day, double the previous recommendation, according the new national physical activity guidelines, published today.

And for the first time, the guidelines urge the 12 million Australians who are sedentary or have low levels of physical activity to limit the time they spend sitting.

The recommendations aim to prevent unhealthy weight gain and reduce the risk of some cancers. Physical inactivity is the second-greatest contributor to the nation’s cancer burden, behind smoking.

The guidelines emphasise that doing any physical activity is better than doing none, but ideally adults will get 150 minutes of moderate physical activity each week. This includes brisk walking, recreational swimming, dancing and household tasks such as raking leaves.

This could be swapped for 75 minutes of high-intensity exercise that makes you “huff and puff”, such as jogging, aerobics, fast cycling and many organised sports. Ten minutes of vigorous exercise equals moderate-intensity activity.

 

 

 


Health cost of spoonfuls of sugar Feb 10th, 2014

 


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RESEARCH showing high consumption of added sugar more than doubles the risk of cardiovascular mortality has prompted Australian experts to renew calls for labelling reform to help curb sugar consumption.

Leading nutritionist Dr Rosemary Stanton said labelling reform was needed to compel food manufacturers to disclose the percentage of added-sugar in their products, rather than just list total sugars.

“The body of research basically shows that it’s only added sugar that’s the problem ... but the food industry has resisted putting added sugar on the label”, Dr Stanton said. “We need something to alert people to how much they are actually consuming, because I don’t think they really know.”


Sit to stand office workstations Feb 9th, 2014

This review examines the effectiveness of sitestand workstations at reducing worker discomfort without causing a decrease in productivity. Four databases were searched for studies on sit-stand workstations, and five selection criteria were used to identify appropriate articles. This review concluded that sit-stand workstations are likely effective in reducing perceived discomfort. Eight of the identified studies reported a productivity outcome. Three of these studies reported an increase in productivity during sit-stand work, four reported no affect on productivity, and one reported mixed productivity results. Therefore, this review concluded that sit-stand workstations do not cause a decrease in productivity.



No equipment needed home exercise programs Feb 9th, 2014

WebsiteGraphic


 



How do leaders motivate safety? Feb 8th, 2014

This study examined the impact of specific leader behaviours on employee’s safety performance. Based on self-regulation framework, we examined three safety-specific leader behaviours: safety inspiring, safety monitoring, and safety learning on two distinct employee safety behaviours: safety participation and safety compliance. While safety inspiring is positively and specifically related to safety participation, safety monitoring is positively and specifically related to safety compliance. Further, we also showed that the relationship between safety monitoring and safety participation can be moderated by the degree to which leaders encourage safety related learning. Implications for theory and practice are discussed.


 



The Psychology of Hunger Feb 8th, 2014
Physiological Hunger is a feeling of discomfort or weakness caused by lack of food. However hunger also refers to the desire to eat.

A DESIRE TO EAT IS NOT ALWAYS BECAUSE OUR TUMMY IS EMPTY!

Of course the stomach does participate in the regulation of hunger. The stomach empties at a relatively constant rate in all mammals. As the stomach contracts, we feel more and more hungry. Usually, we start feeling hungry when the stomach is approximately 60% empty and we feel very hungry when the stomach is 90% empty.

However very early studies in rats and humans from the 1940's showed that even when the nerves connecting the stomach to the brain are cut or severed, we still feel hunger. Even more persuasive was the finding that when people's stomachs are surgically removed for medical reasons, these individuals continue to experience hunger. Clearly there is more to hunger than just the empty feeling in the stomach!

The following handout gives a number of strategies that many people hve found helpful to promote negative energy balance and weightloss.

Handout Image

Click to open

 



Healthy Snack Feb 7th, 2014

Are your snacks letting you down?  Try this healthy dip recipe and serve with chopped vegetables, corn thins or rice crackers!


Ingredients:
1 x 450g can baby beetroot, drained, coarsely choppedDipGraphic

250g low fat Greek-style yoghurt

2 tbsp fresh lemon juice

1 tsp ground cumin

1 tsp ground coriander

Freshly ground pepper

 


Method:
Mix all ingredients in a bowl and serve

 




The Pilates method: history and philosophy Feb 6th, 2014
Pilates Studio


Until the mid-1980s the Pilates Method of exercise was little known outside the world of dance but has grown in popularity rapidly in the last decade: coming out of obscurity. This article traces its history in context and examines the initial principles of the method, with the beginnings of modern developments.


Added Sugar Triples Heart Disease Risk Feb 5th, 2014

Sugar Treats

CONSUMING too many sugary sweets, desserts and drinks can triple your chances of dying from heart disease. Scientists in the US have found a relevant association between the proportion of daily calories supplied by sugar-laden foods and heart disease death rates.The researchers specifically focused on added sugar in the diet – that is, sugar added in the processing or preparing of food, rather than natural sources.


One sugar-sweetened beverage a day is enough to increase the risk of dying from cardiovascular disease (CVD). For people obtaining a quarter of their calories from added sugar, the risk tripled compared with those whose sugar contribution was less than 10%. Sugar consumption in the top fifth of the range studied doubled the likelihood of death from heart disease. Dietary guidelines from the World Health Organization recommend that added sugar should make up less than 10% of total calorie intake. A single can of fizzy drink can contain 35g of sugar, providing 140 calories.


The authors concluded: "Our findings indicate that most US adults consume more added sugar than is recommended for a healthy diet." A higher percentage of calories from added sugar is associated with significantly increased risk of heart disease related death."


Professor Naveed Satta, from the British Heart Foundation Glasgow Cardiovascular Research Centre at the University of Glasgow, said: "We have known for years about the dangers of excess saturated fat intake, an observation which led the food industry to replace unhealthy fats with presumed 'healthier' sugars in many food products."However, the present study, perhaps more strongly than previous ones, suggests that those whose diet is high in added sugars may also have an increased risk of heart attack. Of course, sugar per se is not harmful – we need it for the body's energy needs - but when consumed in excess it will contribute to weight gain and, in turn, may accelerate heart disease."Helping individuals cut not only their excessive fat intake, but also refined sugar intake, could have major health benefits including lessening obesity and heart attacks. The first target, now taken up by an increasing number of countries, is to tax sugar-rich drinks."



Sizing up Australia - the next step Feb 5th, 2014
Safe Work Australia is a national policy setting body whose key role is to improve work health and safety and workers’ compensation arrangements across Australia. Key action areas under the Australian Work Health and Safety Strategy 2012 – 2022 are to promote the role of safe design in eliminating and minimising risks to work health and safety, and research and evaluation.

In January 2009 Safe Work Australia published an independent report entitled Sizing Up Australia: How contemporary is the anthropometric data Australian designers use? (Sizing Up Australia) (Veitch, Caple et al. 2009). Sizing Up Australia identified a need to conduct an Australian Body Sizing Survey to make available anthropometric data that could be used to design safer workplace equipment and workplaces. It proposed making this a public infrastructure project to maximise the use of the data, as even given base data, design and testing are still expensive for designers and manufacturers.

This survey will measure the body size of Australian workers. These measurements will be free to anyone interested in designing for Australian workplaces or choosing workplace equipment from ladders to hospital beds from forklifts to seats in aircraft and cars. Similar surveys undertaken in other countries have helped improve work health and safety, increase productivity and reduce inefficiency. The 2009 Australian Safety and Compensation Council report “Sizing Up Australia: How contemporary is the anthropometric data Australian designers use?’ found Australia needs a body sizing survey if it is to achieve similar outcomes.

Picture


Veitch, Fitzgerald et al. (2013). Sizing Up Australia – The Next Step. Canberra: Safe Work Australia



Obesity; the leading preventable risk factor for cancer Feb 4th, 2014

Emily Dunn 4-2-2014. Medical Observer


OBESITY has become the biggest preventable risk factor for cancer in Australia after smoking, a study from the World Health Organization has shown. The 2014 World Cancer Report, last released six years ago, also showed that cancer has overtaken heart disease as the leading cause of death in Australia and almost every other country, killing an estimated eight million people globally each year, including more than 43,000 Australians. This number is expected to rise to 20 million globally by 2025. The report estimated the global cost of cancer to be $1.33 trillion a year in 2010, equating to 2% of the world's GDP, a figure that could be reduced by up to $200 billion a year if more was done to prevent cancer.


“For non-smokers, the single biggest preventable cause of cancer is obesity in terms of the number of cancer sites affected,” Mr Slevin told MO





Reference:


http://www.medicalobserver.com.au/news





 


 




Pilates Exercise for Healthy People Feb 4th, 2014

This study evaluated evidence for the effectiveness of the Pilates exercise (PME) in healthy people. It concluded there was strong evidence to support the use of Pilates to improve flexibility and dynamic balance, and moderate evidence to enhance muscular endurance.

Pilates Graphic



Most GPs not recommending Return To Work Feb 2nd, 2014
There are significant benefits to be gained from offering employees a 'trusted' Injury Management Service.

graphic


A recent study shows that Victorian GPs are unlikely to recommend alternate duties for injured workers. This is despite a growing body of evidence showing that safe work is good for health and that return to work (RTW) after injury or illness can promote recovery. The study’s examination of over 120,000 medical certificates provided to injured workers in Victoria from 2003 to 2010 found that more than 70% of initial medical certificates issued by GPs advised injured and ill workers to not work. Less than a quarter of medical certificates recommended workers return to work on modified duties. 

The Australasian Faculty of Occupational and Environmental Medicine’s (AFOEM) 2011 Consensus Statement on the Health Benefits of Work suggested the following:



  • Work is generally good for health and wellbeing;

  • Long term work absence, work disability and unemployment have a negative impact on health and wellbeing;

  • Work is an effective means of reducing poverty and social exclusion;

  • Work practices, workplace culture and work-life balance are key determinates of individual health, wellbeing and productivity;

  • Good outcomes are more likely when individuals understand the health benefits of work, and are empowered to take responsibility for their own situation; and

  • Health professionals exert a significant influence on work absence and work disability, particularly in relation to medical sickness certification practices.



Dr Collie says that the working days lost to over-protective medical certificates are highly relevant amidst the current debate on increasing national productivity, as well as scrutiny of the viability of our national compensation systems. “We know that GPs play a front line role in returning injured workers to work as they as the first point of contact with the health care system for many injured workers and the main gatekeepers to workers compensation and disability benefits,” said Dr Collie.

The researchers concluded that the high proportion of medical certificates recommending complete absence from work presents “major challenges” to return to work, labour force productivity, the viability of the compensation system, and long-term social and economic development.


Ten tips for communicating with doctors Feb 2nd, 2014

You can get an injured worker back to work sooner if you build a great relationship with their treating practitioner. According to Occupational Physician Dr Robyn Horsley, that’s all about getting your communication style right.


Making a plan to communicate


“Employers need to sort out who they’re talking to, when they’re going to talk to them and what they’re going to talk about,” says Robyn. “It can’t be about diagnosis, it can’t be about discussing any of the psychological side of things. It has to be about capacity, certificate clarification and when the worker can return to work.”


Many employers might think they can’t get too involved because of confidentiality issues, but Robyn says an employer’s role is as much about being information-giving as anything else.


Top ten tips for discussing a case with the doctor


1.       Ring at the right time.


“Having an awareness of how doctors work can get rid of some of the frustration [of dealing with them],” advises Robyn. Doctors are paid for face to face contact, treating patients - not for things such as phone calls.If doctors are in the middle of a very busy day, they won’t be keen to have discussions with non-patients.


Contact the doctor’s receptionist and ask when the best time would be to call; this is usually not on a Monday or Friday.


2.       Call the right practice location.


If the treating practitioner works from multiple sites, make sure you’re ringing the actual practice where your injured worker sees the doctor. This ensures that the patient file is available, which is crucial.


“For those in the hospital system, you may have to ring them, sort out who you need to speak to, let them know who you are and make an appropriate time to ring them back in a day or so, to give them time to retrieve and read the file notes,” says Robyn.


3.       Ensure the doctor has the correct file.


“If you ring and you talk about a worker, but the doctor doesn’t have the file in front of them, they’re at a disadvantage.” says Robyn. Make sure you’ve notified the receptionist about whom you’ll be referring to, in your conversation with the doctor, so he /she can have the file up in front of them when speaking with you.


4.       Be succinct and clear.


Introduce yourself, where you are from, your role and the reason for your call very briefly. You can also fax or email through details of what you want to talk about prior to the call, such as a list of alternate duties for the doctor’s consideration.


5.       Be precise about what you want to know.


E.g., what the injured worker can or can’t do, or when RTW can begin. You can also ask about increasing work hours, or clarification of medical certificate details. Don’t be intrusive - pushing for medical information - or you’ll risk getting the doctor off-side. 


6.       One major question per phone call.


“When you’re ringing a doctor, you don’t want to ring with a shopping list of things,” says Robin. “You’re much better sorting out one or two things that you want to achieve in that particular conversation.  If there are multiple things then you probably need to make another time.”


7.       Check your phone style.


Make sure you’re also being “information giving”.  Avoid opinions about whether the worker’s condition is legitimate – remember that it’s ultimately up to the insurance agent to decide.


8.       Be aware of the doctor’s mood.


"If a doctor is curt,” says Robyn, “they may have had a shocking morning - they’re human like the rest of us. There may have been multiple things that have gone wrong and the last thing they need is another phone call. Or, they may have a room full of people and they’re already behind.”


If you get through to the doctor and they sound tense or on edge, it’s best to keep the conversation brief and suggest you ring at a better time.


9.       Dealing with psychiatrists.


“Psychiatrists are very sensitive about giving any information at all,” warns Robyn. “If the employer wants to give information to a psychiatrist, they probably need to do it in writing. If they want formal communication with a psychiatrist, my advice would be to communicate through a rehab provider or a doctor - with the patient’s consent’.


10.   Record all conversations.


Make a note of what’s been said so that you can relay it to the injured employee. Ideally, the employee should be present while the conversation takes place, via speakerphone or conference call. This might be logistically difficult for a Case Manager, but is a great way to maximise information to the employee and minimise confusion and misunderstandings.


Reference:


http://www.rtwmatters.org/article/article.php?id=1333


 



150 minutes of exercise predicts survival Feb 2nd, 2014

Almeida OP, Khan KM, Hankey GJ, et al. (2014) 150 minutes of vigorous physical activity per week predicts survival and successful ageing: a population-based 11-year longitudinal study of 12 201 older Australian men. British Journal of Sports Medicine. 48:220–225


Physical activity has been associated with improved survival, but it is unclear whether this increase in longevity is accompanied by preserved mental and physical functioning, also known as healthy ageing. This study was designed to determine whether physical activity in 12 201 older Australian men was associated with healthy ageing in later life. The results of this study showed that a lifestyle that incorporates physical activity increases by almost 2 fold the chance men aged 65–83 years remain alive and free of functional or mental impairments after 10–13 years.




Consensus in Workers Compensation? Feb 1st, 2014

WC image


Conventional wisdom is that workers' compensation is a contentious industry. Doctors don't agree with lawyers. Regulators don't agree with service providers.  Injured workers don't agree with insurance agents. We already 'know' that the parties are at odds with one another, so one or another side attempts to impose its 'solution' to create order out of disagreement.


The idea that the stakeholders and service providers in one state could agree on 'what needs to be done' in workers' compensation goes against the grain of conventional thought in the industry.  People from different states can only agree that 'their' system is the best, and the one that everyone else ought to follow, right? Over the course of two years Deakin University invested in the process of asking the people who participate in the system, from regulators and insurance agents, medical and allied health personnel, lawyers, employers and injured workers what they thought would make workers' compensation more successful, and it turned out that they agreed on many important suggestions for systemic improvement.


The Stakeholders Speak: Reflections on a National Stakeholder Engagement Series has recently been published by DeakinPrime. The national report discusses a methodology participants described as "unique in the history of the industry" and the surprising range of consensus opinions that were reached on issues ranging from psychological harm to return to work and from medical certificates to accident reporting statistics. The document also contains the individual reports for each of the state and territory stakeholder engagement events across Australia, so that comparisons are possible. The Stakeholders Speak is required reading for anyone who wants to understand the best ways to improve of the outcomes for injuried workers.


 


Reference: 


http://deakinprime.com/news-and-publications/news/consensus-in-workers-compensation/


 



The Couch to 5k in 9 weeks running program Feb 1st, 2014

C25K Graphic


Couch to 5km (C25K), is a phone application designed to help you progress to running 5 kilometres or 30 minutes over 9 weeks. It's a gentle introduction to getting the body moving, starting off alternating between walking and running small distances, and slowly building up until after 8 weeks, you're ready to run 5 kilometre or 30 minutes non stop.


Important to answer no to the following questions before attempting to progress to running:



  1. Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?

  2. In the past month, have you had chest pain when you were not doing physical activity?

  3. Do you feel pain in your chest when you do physical activity?

  4. Do you lose your balance because of dizziness or do you ever lose consciousness?

  5. Do you have a bone or joint problem (e.g. back, knee or hip) that could be made worse by a change in your physical activity?

  6. Is your doctor currently prescribing medication for your blood pressure or a heart condition?

  7. Do you have Type 2 Diabetes?

  8. Do you have an injury?

  9. Do you know of any other reason why you should not do physical activity?


If you answered yes to any of the following you need to discuss this program with an Exercise Physiologist, Physiotherapist or your Doctor before commencing.


 



What is Medicare and how does it work? Feb 1st, 2014

Sample Medicare Card


Medicare is Australia’s universal health scheme. It is a Commonwealth government program that guarantees all citizens (and some overseas visitors) access to a wide range of health services at little or no cost.


Medicare is funded through a mix of general revenue and the Medicare levy. The Medicare levy is currently set at 1.5% of taxable income with an additional surcharge of 1% for high-income earners without private health insurance cover.


Medicare funds access to health care in two main ways. The first, the Medical Benefits Scheme, provides benefits to people for:



  • out-of-hospital medical services, including general practitioner (GP) and specialist services

  • selected diagnostic imaging and pathology services

  • dental care for children in limited circumstances

  • eye checks by optometrists

  • allied health services in limited circumstances, and

  • medical services for private patients in public and private hospitals (excluding accommodation, theatre fees and medicines).


The benefits paid to patients under Medicare are generally 85% of the fee listed for the service in the Medicare Benefits Schedule (75% of the schedule fee for private patients in hospital). When providers are willing to accept the Medicare benefit as full payment for a service, they bill the government directly (bulk-billing) and the patient is not charged.


The Commonwealth’s Medicare scheme also guarantees public patients in public hospitals free treatment. Public hospitals, however, are funded jointly by the Commonwealth and state and territory governments (who own and operate public hospitals).


Medicare sits alongside the Pharmaceutical Benefits Scheme, which subsidised the cost of a wide range of pharmaceuticals.


For more and a discussion of future difficulties see the full article at The Conversation.


 



Exercise and Academic Attainment in Adolescents Jan 31st, 2014

Kid Studying


Booth JN, Leary SD, Joinson C, et al (2014) Associations between objectively measured physical activity and academic attainment in adolescents from a UK cohort.  British Journal of Sports Medicine 48:265–270


To test the associations between objectively measured free-living physical activity (PA) and academic attainment in adolescents. 4755 participants (45% male) had total Physical Activity measured at age 11. Data was related to school assessment results in English, Maths and Science at ages 11, 13 and 16. Findings suggest a long-term positive impact of Moderate to Vigorous Physical Activity on academic attainment in adolescence. 



Lower Diabetes Risk with Strength training Jan 28th, 2014

Grøntved A, Pan A, Mekary RA, Stampfer M, Willett WC, et al. (2014) Muscle-Strengthening and Conditioning Activities and Risk of Type 2 Diabetes: A Prospective Study in Two Cohorts of US Women. PLoS Med 11(1): e1001587. 


The findings come from a study that tracked the health of nearly 100,000 US nurses over a period of eight years. Lifting weights, doing press-ups or similar resistance exercises to give the muscles a workout was linked with a lower risk of diabetes. The benefit seen in the study was on top of any gained from doing aerobic workouts that exercise the heart and lungs – something which adults are meant to do for at least 150 minutes a week.



Home exercise program to ge tyou started. Click here for handout


 



Optimising Return to Work Programs Jan 28th, 2014


Franche et al (2005) Workplace-Based Return-to-Work Interventions: Optimizing the Role of Stakeholders in Implementation and Research. Journal of Occupational Rehabilitation 15(4): 525-542


The challenges of engaging and involving stakeholders in return-to-work (RTW) intervention and research have not been well documented. This article contrasts the diverse paradigms of workers, employers, insurers, labor representatives, and healthcare providers when implementing and studying workplace-based RTW interventions. Analysis of RTW stakeholder interests suggests that friction is inevitable; however, it is possible to encourage stakeholders to tolerate paradigm dissonance while engaging in collaborative problem solving to meet common goals. We review how specific aspects of RTW interventions can be instrumental in resolving conflicts arising from differing paradigms: calibration of stakeholders’ involvement, the role of supervisors and of insurance case managers, and procedural aspects of RTW interventions. Engaging stakeholders, and ethical aspects associated with that process are discussed. Developing methods for engaging stakeholders, determining the optimal level and timing of stakeholder involvement, expanding RTW research to more diverse work settings, and developing RTW interventions reflecting all stakeholders’ interests.



Exercise to Retire Healthy Jan 27th, 2014

Out of shape individuals have more difficulty transferring from bed to a chair, using the toilet, dressing, bathing, preparing meals and walking normal distances. Muscle strength declines by approximately 15% per decade between the ages of 60 and 80 years. However this decline is not mandatory, those who participate in regular strength training activities can increase muscle mass and strength during the same period. These increases lead to improvements in gait efficiency and mobility tasks such as shopping, bend over, and climbing stairs.moderate level continuous aerobic fitness activity can significantly increase ones mobility status.


Those over 65 years of age, who participate in regular exercise consisting of appropriate strength training, moderate intensity fitness training and flexibility training show higher levels of mobility and less functional disability than there inactive counter parts. Your exercise goals should focus on maintaining a functional level, preventing soft tissue and joint injury and maintaining or reducing your risk of cardiovascular problems.


To get you going I have put together six of my favourite home exercise activities.



  1. Walking. Weight-bearing exercise is one of the best all around activities for those over 65. It is evident that between 3 to 4 hours of walking a week (30+ minutes per day) is associated with a reduction in your risk of coronary event.

  2. Squats. Good exercise to maintain strength in the leg muscles, stand erect behind a chair or table and place your hands on the object for balance.  Bend your knees then rise to the upright starting position.

  3. Step-ups. Good exercise to promote leg strength and endurance, as well as challenging your balance. Find a single step or a number of steps and step up and down repeatedly.

  4. Calf raises. Good exercise to strengthen the muscles in your lower leg. These muscles are important in controlling normal postural sway. With your heels of the edge of a step slowly raise up onto your toes while not allowing your knees to bend, hold for a brief period and return to the starting position.

  5. Shoulder blade squeezes. Some believe strength of the muscles in the upper back promotes good postural alignment. Allow your hands to hang down by your side, while standing or perched on the edge of a chair. Relax the muscles in your neck and turn your arms out at the shoulders so that your thumbs turn away from your belly button. Gently squeeze your shoulder blades together, and hold for between three-10 relaxed breathes. You should feel a small area of muscles between your shoulder blades working, but not the muscles up into your neck.

  6. Wall push-ups. Chest and upper limb strength is important for moving from sitting to standing, moving from the ground to standing or lifting objects. Stand leaning against a wall in a normal push-up position. Allow your elbows to bend so your nose moves towards the wall. Use your chest and arm muscles to push your self away from the wall and back to the starting position


 The following clip adds a few extras. Click for handout


 



Safety activities in small businesses Jan 27th, 2014

Sinclair and Cunningham (2014) Safety activities in small businesses. Safety Science 64:32–38


This study uses data from a national random survey of firms (n = 722) with less than 250 employees conducted in 2002. It was found that, regardless of firm size or industry, safety activities were more common in 2002 than they were in a similar 1983 study. Having had an OSHA inspection in the last five years and firm size were stronger predictors of safety activities than industry hazardousness and manager’s perceptions of hazardousness. All four variables were significant predictors. Further progress in the prevention of injuries in small firms will require attention to factors likely subsumed within the firm size variable, especially the relative lack of slack resources that might be devoted to safety activities.



Funny little Clip



Neck and shoulder muscle activity during work tasks Jan 26th, 2014

sit desk graphic


Ng et al (2014) Neck and shoulder muscle activity during standardized work-related postural tasks. Applied Ergonomics 45:556-563


The aim of the present study was to assess the activity levels of the neck muscles during static postures under controlled and standardized conditions, and to determine whether the muscle activity differed between sexes. Muscle activity was recorded unilaterally from the sternocleidomastoid and upper trapezius muscle in 17 participants whilst they were performing various postural tasks. The intensity of muscle activity was ranked as light (<3%MVC), moderate (3%MVC  EMG  8%MVC), and substantial (>8%MVC). During most tasks the two muscles contracted light to moderately. Head leaning and shoulder shrugging postures yielded substantial muscle activity in both muscles. Muscle activity did not differ significantly between male and female participants. Our findings provided normative values, which will enhance future studies of muscle activity during work in a natural, unrestrained environment.



Modest Weight Loss Improves Heart Disease Risk Jan 26th, 2014

Wing et al (2011) Benefits of Modest Weight Loss in Improving Cardiovascular Risk Factors in Overweight and Obese Individuals With Type 2 Diabetes. Diabetes Care 34:1481–1486


Modest weight losses of 5 to 10% of initital weight were associated with significant improvements in heart disease risk at 1 year, but larger weight losses had greater benefits. 




Preventing Low Back Pain in the Workplace Jan 26th, 2014

Maher (2000) A systematic review of workplace interventions to prevent low back pain. Australian Journal of Physiotherapy 46: 259-269


A systematic review of randomised controlled trials was undertaken to evaluate the effectiveness of workplace interventions to prevent low back pain. Potential trials were located by a computerised search supplemented with citation tracking. The methodological quality of the trials was assessed on 11 criteria and the level of evidence for each intervention was determined, based upon the amount, consistency and quality of evidence from the trials. The review located 13 trials that were generally of moderate quality. The trials suggest that workplace exercise is effective, braces and education are ineffective, and workplace modification plus education is of unknown value in preventing low back pain.


Flyer Graphic


Click for More


 



Workers’ Compensation Premiums: How do they work? Jan 24th, 2014

The cost of workers’ compensation premiums are driven by three primary factors:



  1. The industry you work in (and therefore the gazette rate for your industry);

  2. Your wage roll; and

  3. Your claims costs.


The first two factors are largely set in stone. WorkCover WA estimates the total cost of the scheme for the next year and determines the overall amount of premium that must be collected to cover these costs. The gazette rate for each industry is calculated based on the total amount of premium required and the historical performance of individual industries within the scheme.


Therefore, your understanding of claims costs and how to control them is your only opportunity to impact on the cost of your workers’ compensation premium. Claims costs are the actual dollars spent by the insurer when an injury occurs, plus the insurer’s estimate of what the total cost will be by the time the injury has resolved and the claim is closed.


As the employer, you can make decisions about and have legislative control over the following areas:



  1. Medical treatment – refer injured workers to consultant doctors with excellent communication skills;

  2. Wages – you may choose not to recoup wages;

  3. Rehabilitation – in many cases, you are capable of overseeing this with internal resources.


Your understanding of these factors, your approach to injury management and your relationship with your insurer to communicate this will impact on outstanding reserves and can ultimately reduce the cost of the claim. However, the establishment of preventative strategies and a consistent, proactive support system for your injured workers is critical to achieving the above outcome.


Claim Cost Image


Click for more



Don't just sit there! Jan 23rd, 2014

We know sitting too much is bad, and most of us intuitively feel a little guilty after a long TV binge. But what exactly goes wrong in our bodies when we park ourselves for nearly eight hours per day, the average for a U.S. adult apparently. This handout was published in the Washington Post and has been forwarded around by the Australian Physiotherpay Association.


Sitting Graphic


Click to download


 



Effects of restrictive clothing during manual handling Jan 22nd, 2014

Eungpinichpong W et al, (2013) Effects of restrictive clothing on lumbar range of motion and trunk muscle activity in young adult worker manual material handling. Applied Ergonomics. 44:1024-1032


Epidemiologic studies have reported that tasks involving lifting with repetitive trunk bending and heavy loads pose risk factors for low back pain (LBP). Recent research has found LBP in adolescents to be more frequent than previously suspected. Trunk bending requires multi-joint coordination for lumbopelvic and hip movements as well as trunk muscle activation. However, if there is restriction of one of the multiple joints in the lumbo-pelvic and hip regions, this can result in altered movement and biomechanics of the remaining unrestricted joints. Tight pants, specifically sizes smaller than fit to a wearer’s anthropometry, may restrict hip movement and alter trunk muscle activity during work tasks and leisure. Such clothing has become a popular clothing choice for adolescents. Previous research observed reduced hip mobility in association with increased spinal flexion and extension. This mobility limitation and spinal motion may be factors contributing to development of LBP. In this study twenty-eight young adultsperformed box lifting, liquid container handling while squatting, and forward reaching while sitting on a task chair when wearing tight pants (sizes too small for the wearer) vs. fit pants (correct size according to anthropometry). Each task was repeated three times and video recordings were used as a basis for measuring lumbar range of motion (LRoM). 



Results revealed significant effects of both pants and task types on the normalized LRoM, trunk muscle activity and subjective ratings of LBD. The LRoM was higher and trunk muscle (ES) activity was lower for participants when wearing tight pants, as compared to fit pants. Discomfort ratings were significantly higher for tight pants than fit. These results provide guidance for recommendations on work clothing fit in specific types of manual material handlingactivities in order to reduce the potential of low-back pain among younger workers in industrial companies.


 


 



Daily step count, Insulin sensitivity and adiposity Jan 22nd, 2014

Dwyer et al (2010) Association of change in daily step count over five years with insulin sensitivity and adiposity: population based cohort study. BMJ 2010;341:c7249


Recent increases in type 2 diabetes and obesity in many countries, including the United States and Australia, have been partly attributed to declines in physical activity. The aim of this study was to examine the relation between change in physical activity (measured objectively by pedometer) over a five year period and each of body mass index, waist to hip ratio, and insulin sensitivity. The study concluded that an increase in physical activity over time, measured objectively by pedometer, is associated with better insulin sensitivity probably due to lower body fat.


Making life a little more physically demanding can reduce your risk of chronic disease




Management of Rotator Cuff Syndrome in the Workplace Jan 21st, 2014

The University of New South Wales Rural Clinical School, Port Macquarie has developed guidelines for the clinical management of rotator cuff syndrome in the workplace. Shoulder pain is a common musculoskeletal presentation in primary care practice – both degenerative and acute. As such, it provides a challenge to all involved in prevention and treatment, from patients to clinicians to employers.


Document Cover


 Click to read



Flatulence - Good or Bad? Jan 21st, 2014

Funny little clip on a funny little topic.




Strategies for Preventing Back Problems Jan 20th, 2014

Arial M, Benoît D and Wild P (2014) Exploring implicit preventive strategies in prehospital emergency workers: A novel approach for preventing back problems. Applied Ergonomics. inpress: 1-7


Back problems are a major occupational health issue for most labour intensive Jobs. THe following study of Paramedics used a questionnaire survey of 334 paramedics and emergency medical technicians and an ergonomic work practice analysis involving shadowing ambulance crews in 12 medical emergency services (over 400 hours). A majority of ambulance professionals had experienced back pain in the twelve-month period before the survey. Work practice analysis revealed strategies and 'tricks of the trade' used by ambulance professionals to reduce the chances of back strain while working. Multiple regression analyses showed that self-reported use of such strategies was associated with fewer back symptoms. Preventive strategies should be integrated into specialised training programs the work settings.


Table 3 shows strategies used by the Paramedic staff, many of which can be utilised in other labour intensive roles


Preventative Strategies


 


 


 



Understanding Habits Jan 20th, 2014

To understand your own habits, you need to identify the components of your loops. Once you have diagnosed the habit loop of a particular behaviour, you can look for ways to supplant old vices with new routines. This little clip explains it nicely.



 



Sedentary Screen Time and Heart Function Jan 19th, 2014

GIBBS BB, REIS JP, SCHELBERT EB, CRAFT LL, SIDNEY S, LIMA J, and LEWIS CE (2014) Sedentary Screen Time and Left Ventricular Structure and Function: The CARDIA Study. Medicine and Science in Sports and Exercise, Vol. 46, No. 2, pp. 276–283


Sedentary screen time (watching TV or using a computer) predicts heart disease outcomes independently from moderate and vigorous physical activity. Screen time and left ventricule structure and function was measured in 2854 participants, age 43–55 yr. Sedentary screen time is associated with greater LVM in white adults, and this relationship was largely explained by higher overall adiposity. It is suggested that sedentary screen time potentially contributes to adverse cardiac remodeling through its association with comorbidities (hypertension and diabetes) and, to a greater extent, overall adiposity. The most plausible interpretation was that sedentary screen time contributes to obesity and obesity-related comorbidities, which in turnmay lead to increased LVM, LVM indexed to height and volume, and relative wall thickness. 


Sitting Killing You Graphic



8 tips to reduce the risks of sedentary work Jan 19th, 2014

Sitting Hams Graphic


Use these tips to help your sedentary workers avoid long-term health issues caused by insufficient movement throughout their working day:



  • Encourage workers to alternate between computer work and a variety of other tasks where possible.

  • Take regular breaks from typing and other repetitive activities, e.g. a pause break every half hour to stand up and stretch.

  • Commit to making life a little more difficult! Take advantage of situations throughout the day when standing and moving is possible, e.g. take the stairs rather than the lift, stand up when you are commuting on public transport. 

  • Incorporate methods to reduce sedentary work practices into your company policies and procedures, e.g. your working from home policy should promote regular standing breaks throughout the day.

  • If possible, change the working environment and task design to promote workers to stand and move around more often.

  • Train your managers and supervisors in the risks of sitting for prolonged periods of time and the importance of physical activity throughout the working day.

  • Encourage a working environment where there is open discussion about the best ways to promote less sitting and more movement.

  • Teach your workers to remind each other to stand and move throughout the day.


Exercising outside the workplace as a risk control for sedentary work?


While we all know that to maintain a healthy lifestyle, at least 3 sessions of exercise each week is recommended — long periods of sedentary work during the day can still have adverse effects on your health even if you exercise 5 days a week outside of work! So encourage your workers to exercise and participate in activities that involve movement on their days off (this could be done through a health promotion program), but do not assume that this means you don't need to implement control measures for your sedentary workers.


 



Sitting time and Death in Australia Jan 17th, 2014

van der Ploeg HP, Chey T, Korda RJ, Banks E, and Bauman A (2012) Sitting Time and All-Cause Mortality Risk in 222 497 Australian Adults. Archives and  Internal Mrdicine 172(6):494-500


Prolonged sitting is considered detrimental to health. This study aimed to determine the independent relationship of sitting time with all-cause mortality. Sitting less than 8 h/d and meeting the physical activity recommendation (2.5 hours per week) protected against death. The adverse effects of prolonged sitting are thought to be mainly owing to reduced metabolic and vascular health. Prolonged sitting has been shown to disrupt metabolic function, resulting in increased plasma triglyceride levels, decreased levels of high-density lipoprotein cholesterol, and decreased insulin sensitivity, which appear to be at least partially mediated by changes in lipoprotein lipase activity. It has also been suggested that sedentary behaviour affects carbohydrate metabolism through changes in muscle glucose transporter protein content. 


GraphSittingMortality



Shoulder and Lower Back loads during cart Pushing Jan 17th, 2014

Manual material handling (MMH) tasks typically consist of activities such as lifting/lowering, pushing/pulling, and holding/carrying loads. The primary jobs of the workers at these distribution centers involve order picking and delivery, which typically are performed using manual handling aids such as carts, trolleys, and hand-pallet trucks on level and ramped surfaces. The use of such assist devices eliminates manual carrying and in some cases lifting and lowering, changing the nature of MMH tasks predominantly to pushing and pulling. It has been estimated that nearly half of MMHtasks common at workplaces consist of pushing and pulling exertions performed on level surfaces and variable inclined ramps.


Nimbarte AD, Sun Y, Jaridi M and Hsiao H (2013) Biomechanical loading of the shoulder complex and lumbosacral joints during dynamic cart pushing task. Applied Ergonomics 44:841-849


The primary objective of this study was to quantify the effect of dynamic cart pushing exertions on the biomechanical loading of shoulder and low back. Ten participants performed cart pushing tasks on flat (0), 5, and 10 ramped walkways at 20 kg, 30 kg, and 40 kg weight conditions. At the lumbosacral joint, negligible loading in the mediolateral direction was observed compared to the anterioposterior and compression directions. Among the shoulder complex joints, the peak reaction forces at the acromioclavicular and glenohumeral joints were comparable and much higher than the sternoclavicular joint. Increased shear loading of the lumbosacral joint, distraction loading of glenohumeral joint and inferosuperior loading of the acromioclavicular joint may contribute to the risk of work-related low back and shoulder musculoskeletal disorder with prolonged and repetitive use of carts.


 


 


 



Returning to work after an injury Jan 16th, 2014

Understanding the role of your prefered GP, and the difficulties they face in dealing with return to work following injury can help improve workers compensation outcomes.  


Fenner P (2013) Returning to work after an injury. Australian Family Physician 42(4):182-185


Workplace injuries are common, cause significant morbidity for workers and have considerable economic impact. General practitioners can play an important role in facilitating early return to work, improving outcomes for all parties. This article provides guiding principles for the initial assessment and early treatment phase of injury with a primary focus on the rehabilitation and return to work process. A case management approach to assist injured workers return to work that involves collaboration between the injured worker, medical and rehabilitation providers, the employer and work insurers, achieves better outcomes. Efficient rehabilitation involves good initial assessment, effective early treatment, early mobilisation and good communication between all parties. General practitioners have an important role to play in facilitating this process.



Weight training cuts type 2 diabetes risk in women Jan 16th, 2014

WOMEN who regularly lift weights or do other resistance exercise may reduce their risk of developing type 2 diabetes, a study has found. Researchers from Harvard Medical School followed up 99,316 women aged 36–81 years who were participants in the Nurses’ Health Study and found that those who reported weekly sessions of just 30 minutes of total muscle-strengthening activity had an 18% lower relative risk of type 2 diabetes, compared to their non-weight lifting counterparts.


Grøntved et al, (2014) Muscle-Strengthening and Conditioning Activities and Risk of Type 2 Diabetes: A Prospective Study in Two Cohorts of US Women. PLOS Medicine 11(1):e1001587


 Girl Lifting Weights


 




 


 


 




Next Dietitian Talk Friday 31st January 2014 at 11.30am. Jan 15th, 2014

Temika Lee's next Dietitian Talk is on Friday 31st January 2014, 11.30am at Central West Health & Rehabilitation in Geraldton. This talk is free for gym members and people who are completing Central West Health & Rehab's Diabetes Management and Chronic Disease Prevention programs.


This talk covers:



  • Healthy Eating Habits

  • Glycemic Index

  • Fat Types and Cholesterol

  • Recipe Modification Label Reading



Wrist posture affects hand and forearm stress Jan 15th, 2014

Qin J, Chen H and Dennerlein JT (2013)Wrist posture affects hand and forearm muscle stress during tapping. Applied Ergonomics 44:969-976


Non-neutral wrist posture is a risk factor of the musculoskeletal disorders among computer users. This study aimed to assess internal loads on hand and forearm musculature while tapping in different wrist postures. The sustained high motor unit recruitment of extensors suggests a greater risk than other muscles especially in flexed wrist posture. This study demonstrated from the perspective of internal tissue loading the importance of maintaining neutral wrist posture during keying activities.


 



8 steps to an effective health promotion program Jan 14th, 2014

Step 1: Gain management approval – it is important to have the backing of the company leaders and stakeholders to ensure there will be a company commitment to the program. Put a proposal forward to develop a health promotion program to get the ‘go-ahead’.   



Step 2: Determine the expectations and goals of the health promotion program – this step involves identifying the needs of the business and its workers in developing the program. How will the health promotion program benefit the business? What issues will it address? Consult workers and get them involved from the beginning to ensure the program you develop attends to their concerns and interests.


Step 3: Decide who will coordinate the program – there needs to be a person or a team at the helm of the program to ensure it is planned and carried out effectively to achieve its goals.


Step 4: Plan how the program will address the set goals and objectives – this step involves determining the methods you will use in your health promotion program to address the identified concerns and needs of your workplace and workers.


Step 5: Identify the resources and skills needed – what do you need to make the plan a reality? Determine the level of resources (cost, people, expertise, etc) needed to implement the health promotion program and seek out these resources. 


Step 6: Implementation – put all the plans into place. 


Step 7: Promote your program – you need to make sure that your workers know what’s going on. Encourage them to be involved – promote the program and make it inviting, point out the benefits and get your workers excited about it.


Step 8: Monitor and review the program – once it’s all in place, don’t forget to go back and review the program. Workplaces change, the people inside them change, and you need to ensure the health promotion program remains relevant. Make any relevant adjustments.


Healthier Workplace WA is currently offering grants to reduce out of pocket costs of Worksite Health Promotion.



The financial burden of physical inactivity Jan 14th, 2014

More and more people with sedentary employment appear to be having difficulty reaching adequate physical activity levels. New technology means less physical effort is required for daily living and life is becoming increasingly busy as we strive for cars, televisions, computers, and convenience. The apparent technological revolution is making us all a little 'soft around the edges', compared to our physically hard working ancestors.


Some suggest we expend up to 800Kcal less per day than our parents and grand parents did in the 1970's. This is the equivalent of 8-10km of walking per day.


More alarming was the data collected by the Australian Diabetes, Obesity and Lifestyle Study. This was a large, continuing survey of the health habits of almost 12,000 Australian adults. Along with questions about general health, disease status, exercise regimens, smoking, diet and so on, the survey asked respondents how many hours per day in the previous week they had spent sitting in front of the television. Television viewing time is a useful, if somewhat imprecise, marker of how much someone is engaging in 'sedentary' behaviour.


This group concluded that an adult who spends an average of six hours a day watching TV over the course of a lifetime can expect to live 5 years less.


The financial burden of physical inactivity



 



Cost-effectiveness of Ergonomics and Manual Handling Jan 14th, 2014

There has been a perennial call for ergonomics to demonstrate that it is good value for money. Quite apart from the legal, ethical and moral aspects of ergonomics, Stanton and Barber, 2004  argue not whether an organisation can afford ergonomics, but rather whether the organisation can afford not to consider ergonomics. 



Health promotion programs - 10 benefits for business Jan 13th, 2014

Health promotion (or wellbeing) programs can be a very effective way for you to cultivate a healthy mindset and lifestyle in your workers, both within and outside the workplace.


The reason this is important is that the choices your workers make outside the workplace can affect their health and safety inside the workplace, the place where you have an obligation for that person’s wellbeing.


Examples of topics that your health promotion program may cover include:



  • physical activity/inactivity;

  • healthy eating/diet;

  • tobacco smoking;

  • alcohol and other drug misuse;

  • emotional wellbeing;

  • dental health;

  • mental wellbeing;

  • safe social environments/behaviours;

  • UV protection; and

  • sexual health and wellbeing.


The needs and nature of your business will affect what your health promotion program will cover, and how much time and resources your business puts into them.


What are the advantages of health promotion programs?


Health promotion programs involve educating your workers about ways they can go about adopting healthier lifestyles for themselves. There are many ways that your business can benefit from having an effective health promotion program in place, including:



  • increase in worker productivity

  • demonstration of company commitment to workers’ health and safety

  • decrease in workers’ compensation claims

  • reduction in absenteeism

  • reduced long-term health problems in workers

  • reduced turnover

  • reduction in health and safety risk of injury and illness

  • increase in worker motivation and job satisfaction

  • improved alertness and concentration on the job; and

  • attractive to candidates for employment.



Commit to making life a little harder Sep 15th, 2013
More and more people with sedentary employment appear to be having difficulty reaching adequate physical activity levels. New technology means less physical effort is required for daily living and life is becoming increasingly busy as we strive for cars, televisions, computers, and convenience. The apparent technological revolution is making us all a little 'soft around the edges', compared to our physically hard working ancestors.

 

Some suggest we expend up to 800Kcal less per day than our parents and grand parents did in the 1970's. This is the equivalent of 8-10km of walking per day.

Graphic

 

More alarming was the data collected by the Australian Diabetes, Obesity and Lifestyle Study. This was a large, continuing survey of the health habits of almost 12,000 Australian adults. Along with questions about general health, disease status, exercise regimens, smoking, diet and so on, the survey asked respondents how many hours per day in the previous week they had spent sitting in front of the television. Television viewing time is a useful, if somewhat imprecise, marker of how much someone is engaging in 'sedentary' behaviour.

 

This group concluded that an adult who spends an average of six hours a day watching TV over the course of a lifetime can expect to live 5 years less.



Next Dietitian Talk Friday 16th August 2013 at 12 noon. Jul 30th, 2013

Temika Lee's next Dietitian Talk is on Friday 16th August 2013, 12 noon at Central West Health & Rehabilitation in Geraldton. This talk is free for gym members and people who are completing Central West Health & Rehab's Diabetes Management and Chronic Disease Prevention programs.


This talk covers:



  • Healthy Eating Habits

  • Glycemic Index

  • Fat Types and Cholesterol

  • Recipe Modification Label Reading


 


 



LifeRISK Program - Online preventative health program. Jul 30th, 2013

A broad range of lifestyle risk factors have been identified that act independently and in combination. These Lifestyle factors have Economic and Financial consequences. These costs have been estimated for various populations.



Lifestyle risk factors increase your personal medical costs compared to those individuals with no lifestyle risk factors.


The following program will help you to identify your individual risk factors. The Initial Assessment is private and confidential, and covers areas such as diet, activity levels, alcohol consumption, smoking, family history and mental health.


This assessment leads to a LifeRISK Score.


Your LifeRisk Score is a 'dollar value' and can be thought of as an estimate of extra medical costs from now until the end of your life, due to your lifestyle choices.


You can access the LifeRISK program here or by clicking on it in the Quick Links.



Next Dietitian Talk Friday 7th June 2013 at 12 noon. May 22nd, 2013

Temika Lee's next Dietitian Talk is on Friday 7th June 2013, 12 noon at Central West Health & Rehabilitation in Geraldton. This talk is free for gym members and people who are completing Central West Health & Rehab's Diabetes Management and Chronic Disease Prevention programs.


This talk covers:



  • Healthy Eating Habits

  • Glycemic Index

  • Fat Types and Cholesterol

  • Recipe Modification Label Reading


 



Next Dietitian Talk Friday 7th June 2013 at 12 noon. May 22nd, 2013

Temika Lee's next Dietitian Talk is on Friday 7th June 2013, 12 noon at Central West Health & Rehabilitation in Geraldton. This talk is free for gym members and people who are completing Central West Health & Rehab's Diabetes Management and Chronic Disease Prevention programs.


This talk covers:



  • Healthy Eating Habits

  • Glycemic Index

  • Fat Types and Cholesterol

  • Recipe Modification Label Reading



Next Dietitian Talk Thursday 18th April 2013 at 12 noon. Mar 27th, 2013

Catherine Dumont's next Dietitian Talk is on Thursday 18th April 2013, 12 noon at Central West Health & Rehabilitation in Geraldton. This talk is free for gym members and people who are completing Central West Health & Rehab's Diabetes Management and Chronic Disease Prevention programs.


This talk covers:



  • Healthy Eating Habits

  • Glycemic Index

  • Fat Types and Cholesterol

  • Recipe Modification Label Reading


There are also Supermarket Tours led by Catherine, please register your interest at the dietitian talk.



Next Dietitian Talk Thursday 28th February 2013 at 12 noon. Feb 21st, 2013

Catherine Dumont's next Dietitian Talk is on the 28th February 2013, 12 noon at Central West Health & Rehabilitation in Geraldton. This talk is free for gym members and people who are completing Central West Health & Rehab's Diabetes Management and Chronic Disease Prevention programs.


This talk covers:



  • Healthy Eating Habits

  • Glycemic Index

  • Fat Types and Cholesterol

  • Recipe Modification Label Reading


There are also Supermarket Tours led by Catherine, please register your interest at the dietitian talk.



Next Dietitian Talk Thursday 24th January 2013 at 12 noon. Jan 21st, 2013

Catherine Dumont's next Dietitian Talk is on the 24th January 2013, 12 noon at Central West Health & Rehabilitation in Geraldton. This talk is free for gym members and people who are completing Central West Health & Rehab's Diabetes management program.


This talk covers:



  • Healthy Eating Habits

  • Glycemic Index

  • Fat Types and Cholesterol

  • Recipe Modification Label Reading


There are also future Supermarket Tours led by Catherine, please register your interest at the dietitian talk.



Next Dietitian Talk Thursday 29th November at 12 noon. Oct 31st, 2012

Catherine Dumont's next Dietitian Talk is on the 29th November, 12 noon at Central West Health & Rehabilitation in Geraldton. This talk is free for gym members and people who are completing Central West Health & Rehab's Diabetes management program.


This talk covers:



  • Healthy Eating Habits

  • Glycemic Index

  • Fat Types and Cholesterol

  • Recipe Modification Label Reading


Plus there will be some tips for Christmas!



Next Dietitian Talk Thursday the 23rd of August at 12 noon Aug 13th, 2012

Catherine Dumonts next Dietitian Talk is on the 23rd of August; 12 noon at Central West Health and Rehabilitation in Geraldton. This talk is free for gym members and people who are completing relevant Central West Health and Rehabilitation Programs.



This talk covers:



  • Healthy Eating Habits

  • Glycemic Index

  • Fat Types and Cholesterol

  • Recipe Modification Label Reading




Next Dietitian Talk 26th of July at 12noon Jul 11th, 2012

Catherine Dumonts next Dietitian Talk is on the 26th of July; 12 noon at Central West Health and Rehabilitation in Geraldton. This talk is free for gym members and people who are completing Central West Diabetes management program.


This talk covers:



  • Healthy Eating Habits

  • Glycemic Index

  • Fat Types and Cholesterol

  • Recipe Modification Label Reading



Healthy Worker Package Jul 7th, 2012

Central West Health and Rehabilitation is proud to introduce our Healthy Worker Package. This service is designed to assist your workforce to move towards postive behaviour change. This leads to:



  • Improved Productivity

  • Reduced Absenteeism

  • Lower medical costs for the individual and the employer. More


Click for Flyer



Next Dietitian Talk 21st of June May 25th, 2012

Catherine Dumonts next Dietitian Talk is on the 21st of June; 12 noon at Central West Health and Rehabilitation in Geraldton. This talk is free for gym members and people who are completing Central West Diabetes management program.


This talk covers:



  • Healthy Eating Habits

  • Glycemic Index

  • Fat Types and Cholesterol

  • Recipe Modification Label Reading



Free Cancer Council Exercise Group May 4th, 2012


Are you or someone you care for living with cancer? The cancer council of WA is offering a free 12 week life now exercise group. Remaining and becoming a little more active has been shown to reduce side effects of cancer treatment and improve survival rates. The program includes 2 exercise groups per week for 12 weeks. An initial assessment is important to make sure you are doing suitable exercise. The cost of the initial assessment can be covered by one of your Medicare Exercise Physiology sessions (see chronic disease management section in services tab).


Group starts 22nd of May 2012. To register call Ben Clune on 0899650697 or phone the Cancer Council on 131120.


More Information


 


 



Workforce Management Package Apr 4th, 2012

Central West Health and Rehabilitation is proud to introduce our Workforce Management Package. This service is designed to assist an employer to manage each stage of an employee’s lifecycle with a focus on:



  • Prevention

  • Injury Management

  • Return to Work


Click for More on Employer Services


More Information


 


 



Midwest Football Academy ends its first Year Mar 18th, 2012

The inaugrual year of the East Fremantle Midwest Football Academy ended in early march. The players all made significant physical improvement to their football. East Fremantle have been very impressed with the preparedness of the boy's who came to Perth to tryout for Colts. Central West Health and Rehabilitation had a significant role providing












  • Strength & Conditioning

  • Injury Management

  • Musculoskeletal Screening

  • Nutrition Education

  • Game Preparation


For more on our Sports Performance Program Click Here


 


 



Next Dietitian Talk 22nd March Mar 2nd, 2012

Catherine Dumonts next Dietitian Talk is on the 22st of March at 12 noon at Central West Health and Rehabilitation in Geraldton. This talk is free for gym members and people who are completing Central West Diabetes management program.


 This talk covers: 



  • Healthy Eating Habits

  • Glycemic Index

  • Fat Types and Cholesterol

  • Recipe Modification Label Reading



Total Joint Replacement Program Feb 25th, 2012

Central West Health and Rehabilitation now brings you a complete evidence based joint replacement rehabilitation program to ensure you gain the most benefit from your surgical procedure. Our team provides you support and guidance through all phase of the process:



  • Pre-surgical Preparation

  • Physiotherapy Care in SJOG Hospital

  • Physiotherapy & Rehabilitation following Discharge


Click for More



Next Dietitian Talk 21st Feb Feb 2nd, 2012

Catherine Dumonts next Dietitian Talk is on the 21st of February at 12 noon. This talk is free for gym members and people who are completing Central West Diabetes management program. This talk covers:



  • Healthy Eating Habits

  • Glycemic Index

  • Fat Types and Cholesterol

  • Recipe Modification Label Reading


 


 



Physiotherapy at SJOG hospital Geraldton Jan 29th, 2012

Todd Teakle is now accredited to provide physiotherapy services at St John of Gods Hospital in Geraldton. See our Rehabilitation page under the services tab above for more details of our Total Joint replacement program.



Free Cancer Council Exercise Group Jan 20th, 2012

Are you or someone you care for living with cancer? The cancer council of WA is offering a free 12 week life now exercise group. Remaining and becoming a little more active has been shown to reduce side effects of cancer treatment and improve survival rates. The program includes 2 exercise groups per week for 12 weeks. An initial assessment is important to make sure you are doing suitable exercise. The cost of the initial assessment can be covered by one of your Medicare Exercise Physiology sessions (see chronic disease management section in services tab). To register call Ben Clune on 0899650697 or phone the Cancer Counsel on 131120.




Next Dietitian Talk Jan 20th, 2012

The next group Dietitian Talk is on the 14th of February at 12 noon.



Next Diabetes Talk 15-12-2011 Nov 8th, 2011

We will be discussing: Why you don't want diabetes. Good ways to avoid getting diabetes. Recent advances in diabetes treatments.



Physiotherapist Geraldton Oct 11th, 2011

Physiotherapist near geraldton Physiotherapy in Geraldton Physiotherapist Geraldton Geraldton Physiotherapy


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