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 chopped

250g low fat Greek-style yoghurt

2 tbsp fresh lemon juice

1 tsp ground cumin

1 tsp ground coriander

Freshly ground pepper

 

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."

Veitch, Fitzgerald et al. (2013). Sizing Up Australia – The Next Step. Canberra: Safe Work Australia

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. 

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

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.

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/

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.

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.

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. 

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

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.

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

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

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.

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. 

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.

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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.

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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.

Click to download

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.

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

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.

 Click to read