Temporary Benefit Research Articles

Do Opioids Help Injured Workers Recover and Get Back to Work? The Impact of Opioid Prescriptions on Duration of Temporary Disability

We estimate the effect of opioid prescriptions on the duration of temporary disability benefits among workers with work‐related low‐back injuries, based on variation in local opioid prescribing patterns, which predict whether injured workers receive opioid prescriptions. More longer term opioid prescribing leads to considerably lengthier durations of temporary disability.

Surgical management of invasive fungal infections in adult leukemia patients: experience from a large tertiary center in Southeast-Asia.

Objectives:Invasive fungal infections (IFIs) are a major cause of morbidity and mortality in acute leukemia patients undergoing chemotherapy or hematopoietic stem cell transplantation (HSCT). Surgical interventions may be necessary to improve the survival outcomes of these patients. The aim of this study is to report a single-center experience using surgical intervention as adjunctive treatment for IFI in adult leukemia patients.Methods:A retrospective review was conducted to obtain clinical characteristics and outcomes of surgically managed IFI patients diagnosed between January 2005 and December 2015 in our center.Results:Nineteen acute leukemia patients, median age 46 years (range 19–65), underwent 20 surgical procedures as management for IFI. Three patients had proven IFI diagnoses prior to surgery. Sixteen patients underwent surgery for both diagnostic and therapeutic purposes. Post-surgery, the diagnostic yield for proven IFI increased by a factor of 5, and 15 patients had definitive IFI diagnoses. Surgical complications included 2 pleural effusions, 4 pneumothoraxes, and 1 hydropneumothorax. The median duration of hospitalization for patients with complications was 9 days (range 3–64). Thirteen patients benefited overall from the procedure, 3 had temporary clinical benefits, and 2 had progression of IFI. After surgery, the 3-month and 2-year overall survival rates were 89.5% and 57.9%, respectively. The median time from surgery to resumption of chemotherapy or HSCT was 25 days.Conclusions:Surgical interventions for IFI are feasible in selected leukemia patients, as they yield valuable information to guide antifungal therapy or enable therapeutic outcomes with acceptable risk, thereby allowing patients to proceed with curative chemotherapy and HSCT.

The effect of temporary parental benefit on children’s antibiotics use: Evidence from a natural field experiment

Prudent use of antibiotics is important to delay the spread of resistance. This paper analyses the effect on children’s antibiotics use of a reform of the temporary parental benefit in Sweden. The reform increased the maximum compensation for this benefit. The level of compensation for social security may affect the propensity of a patient or parent to push for a prescription for antibiotics, as a less generous compensation makes it more expensive to be absent from work and since there is widespread overconfidence in the effectiveness of antibiotics. Using municipality level data, we show that the reform resulted in a reduction in children’s antibiotics use by about five per cent. The result is fairly robust to alternative empirical strategies, suggesting that welfare policies can have important indirect effects that should be taken into account.

Changes in left and right ventricular two-dimensional echocardiographic speckle-tracking indices in pediatric LVAD population: A retrospective clinical study.

Echocardiographic strain and strain-rate imaging is a promising tool for the evaluation of myocardial segmental function, for the early detection of myocardial dysfunction, and for the prediction of reverse remodeling. We aimed at studying the changes in left and right ventricular function in pulsatile left ventricular assist device pediatric patients by two-dimensional echocardiography and two-dimensional speckle-tracking echocardiography. Echocardiographic and clinical data of patients implanted with a pulsatile-flow left ventricular assist device from 2011 to 2018 were retrospectively reviewed before and after implantation at 1, 3, and 6 months. A total of 18 patients were enrolled. Median age and weight at implantation were 9 months (5-23 months) and 5.85 kg (4.85-8.75 kg), respectively; median left ventricular assist device support was 181 (114.5-289.5) days. 13 patients (73%) were transplanted and 5 patients (27%) died. At follow-up: left ventricular ejection fraction increase at 1 month (p = 0.001) and 3 months (p = 0.01), left ventricular global longitudinal strain improvement at 1 month (p = 0.0008) and 3 months (p = 0.02), and right ventricular free-wall longitudinal strain increase at 1 month (p = 0.01). At short term after left ventricular assist device implantation, both left ventricular and right ventricular mechanics improved. The temporary benefit seems to decrease over time. The worsening of left ventricular function has been followed by a worsening of right ventricular function probably due to the ventricular interdependence.

Individual placement and support for young adults at risk of early work disability (the SEED trial). A randomized controlled trial.

Objectives Individual placement and support (IPS) is an effective approach for helping people with severe mental illness gain employment. This study aimed to investigate if IPS can be effectively repurposed to support young adults at risk of early work disability due to various social and health related problems. Methods A randomized controlled trial including 96 young adults (18‒29 years; 68% men) was conducted in Norway. Participants were not in employment, education, or training, received temporary benefits due to social or health-related problems, and were eligible for traditional vocational rehabilitation (TVR). Participants were randomized to IPS (N=50) or TVR (N=46). Self-reported data were collected at baseline and at 6- and 12-months follow-up. The primary outcome was obtaining any paid employment in the competitive labor market during follow-up. Secondary outcomes were physical and mental health, well-being, coping, alcohol consumption, and drug use. Results Significantly more IPS participants obtained competitive employment compared to TVR participants during 12-months follow-up (48% versus 8%; odds ratio 10.39, 95% confidence interval 2.79‒38.68). The IPS group reported significantly better outcomes than the TVR group in subjective health complaints, helplessness, and hopelessness. In post hoc analyses adjusted for baseline and missing data, the IPS group reported significantly better outcomes on these measures in addition to level of disability, optimism about future well-being, and drug use. Conclusions IPS is effective for young adults at risk of early work disability. IPS was superior to TVR in increasing competitive employment and promoted improvements in some non-vocational outcomes. IPS services should be offered to improve employment rates in this vulnerable group.

Too sick to work, too healthy to qualify: a cross-country analysis of the effect of changes to disability benefits

BackgroundDenmark and Sweden have implemented reforms that narrowed disability benefit eligibility criteria. Such reforms in combination with increasing work demands create a pincer movement where in particular those with moderate...

Biochar provided limited benefits for rice yield and greenhouse gas mitigation six years following an amendment in a fertile rice paddy

Biochar soil amendment has been increasingly recommended for enhancing soil fertility and crop productivity while reducing greenhouse gas emissions in agricultural soils. However, a clear understanding of the cost benefits and longevity of the positive effects over long term would be a prerequisite for large scale biochar production and application in agriculture. In this study, the long-term effects of a single biochar amendment on soil fertility, crop yield and greenhouse gas emissions were assessed in a six-year field experiment of a fertile rice paddy from Southwest China. The field trial was established in 2010 and was managed under a rice-winter wheat rotation system throughout six years until 2016. The experiment employed a nested design with biochar soil amendment at application rates of 0, 20 and 40 t ha−1 without N fertilization, and 150 kg ha−1 with N fertilization, respectively. Soil properties and crop yields were measured and the emissions of CH4 and N2O were monitored during the rice cultivation period in the 1st, 2nd and 5th year since 2010. Soil pH, organic carbon, total N and available potassium content were all increased under biochar amendment and persisted throughout the six years. However, grain yields across the years were generally not affected by biochar amendment except a yield increase in 2015. This grain yield increase (18.3%) was reported in the wheat season of 2015, when biochar had been applied at 40 t ha−1 in plots along with N fertilizer. Biochar amendment reduced N2O emissions from the rice paddies only for the first two seasons following the single amendment. In conclusion, a single but high rate of biochar amendment provided limited and temporary benefits for improving grain yields and reduction of greenhouse gases in the fertile paddy soil.

Long/Short-Term Utility Aware Optimal Selection of Manufacturing Service Composition Toward Industrial Internet Platforms

As numerous Industrial Internet platforms emerge, manufacturing services are shared among multiple stakeholders more frequently than ever before. The optimal selection of shared manufacturing service composition (MSC) should promise both the task completion and the stakeholders’ satisfaction. However, as commercial entities, stakeholders concentrate on not only the temporary benefits but also the long-term acquisitions. Most of the existing MSC problems neglect the stakeholders’ prospect on the manufacturing service sharing. This leads to the disappointment and dissatisfaction of the stakeholders with long-term expectations, who will abandon the participation in Industrial Internet platforms. Therefore, the long/short-term preferences of various stakeholders should be satisfied and balanced. In this paper, the long/short-term utilities of three parties (provider, consumer, and operator) are first defined and discussed, and the models considering short-term utility of a consumer and long-term utility of providers are established. The potential tasks assigned to providers are taken into account to estimate the long-term utility if the current task is accepted. Then, to solve the biobjective optimization problem, an improved Nondominated Sorting Genetic Algorithm-II algorithm, combining Tabu search and improved K-means mechanism, is proposed to find the optimal solution set. Finally, the effectiveness of the method is verified by the experimental results in terms of solution diversity, astringency, and stability, in which a finding is further observed that the changes of consumers’ preferences have little impact on the long-term utility of providers.

Clinical Practice Guidelines for the management of Dissociative disorders in children and adolescents.

Clinical Practice Guidelines for the management of Dissociative disorders in children and adolescents.

Social security benefits for mental and behavioral disorders among workers in Piaui, Brazil, in 2014.

The characteristics of social security benefits changed over time as a function of modifications in the patterns of work organization. This process gave rise to new social vulnerabilities which include aspects visibly related to occupational health, as is the case of mental and behavioral disorders. To describe temporary social security benefits granted by the National Social Security Institute (INSS) to workers with mental and behavioral disorders in Piaui, Brazil, in 2014. Cross-sectional, descriptive and retrospective study based on INSS data collected in November 2015 relative to 2014. 1,473 benefits were granted along the analyzed period, 50.4% of which corresponded to male workers. Most beneficiaries resided in the state capital and had urban jobs. Mood disorders accounted for 47.7% of sick leaves. The mean duration of benefits was 112.6 days. There was significant difference in the duration of benefits according to their type (p<0.012), urban versus rural jobs (p<0.015) and sex (p=0.010). Mood disorders were the most frequent reason for sick leaves due to mental and behavioral disorders and the affected workers were granted social security benefits. The duration of leaves significantly differed as a function of the type of benefits, urban versus rural jobs and sex.

Migrant extractability: Centring the voices of egg providers in cross-border reproduction.

This paper explores reproductive justice from the perspective of those at the beginning of the value chain of reproduction. This vantage point of egg providers can help lend important insights into the wider processes of family-making across borders today. It centres on ethnographic research conducted on contemporary cross-border egg provision performed by female migrant workers in Spain. Through this intersectional perspective, we stand to gain deeper insights into cross-border reproduction more widely. Egg provision can be a way for migrant women to gain temporary financial benefit. In a system that does not provide equal access for migrants to work and care, female migrants make themselves extractable commodities. As such, they are both a commodity and a worker at the same time. The example of female migrant workers providing eggs can be used to reflect more generally on egg provision, and on cross-border reproduction and reproductive justice models as used in queer cross-border family-building. Taken within the broader framework of reproductive justice, and with the struggles of lesbian, gay, bisexual and transgender cross-border reproduction in mind, the paper begins by asking how three intersecting inequalities due to (1) migration/citizenship, (2) joblessness/contract working and (3) race facilitate the industry of cross-border reproduction? In what ways do female migrant workers mobilize their reproductive potential, including time, whiteness, other racial/phenotypic similarity to commissioning parents, and unstable work lives in cross-border egg donation? The paper ends with an argument for focusing analytical and political attention on the needs of those providing eggs; the most prized material resources for cross-border reproduction.

Therapeutic plasma exchange as a novel treatment for severe intrahepatic cholestasis of pregnancy: Case series and mechanism of action.

Intrahepatic cholestasis of pregnancy is characterised by pruritus and elevated serum bile acids. The pruritus can be severe, and pharmacological options achieve inconsistent symptomatic improvement. Raised bile acids are linearly associated with adverse fetal outcomes, with existing management of limited benefit. We hypothesised that therapeutic plasma exchange removes pruritogens and lowers total bile acid concentrations, and improves symptoms and biochemical abnormalities in severe cases that have not responded to other treatments. Four women with severe pruritus and hypercholanemia were managed with therapeutic plasma exchange. Serial blood biochemistry and visual analogue scores of itch severity were obtained. Blood and waste plasma samples were collected before and after exchange; individual bile acids and sulfated progesterone metabolites were measured with HPLC-MS, autotaxin activity and cytokine profiles with enzymatic methods. Results were analysed using segmental linear regression to describe longitudinal trends, and ratio t tests. Total bile acids and visual analogue itch scores demonstrated trends to transiently improve following plasma exchange, with temporary symptomatic benefit reported. Individual bile acids (excluding the drug ursodeoxycholic acid), and the sulfated metabolites of progesterone reduced following exchange (P = .03 and P = .04, respectively), whilst analysis of waste plasma demonstrated removal of autotaxin and cytokines. Therapeutic plasma exchange can lower potentially harmful bile acids and improve itch, likely secondary to the demonstrated removal of pruritogens. However, the limited current experience and potential complications, along with minimal sustained symptomatic benefit, restrict its current use to women with the most severe disease for whom other treatment options have been exhausted.

The Relationship between Punishment Sensitivity to Affection to School and School Burnout

This study investigated whether sensitivity to punishment that students develop in the academic context is a predictor of school burnout syndrome, and whether students’ sensitivity to punishment show a significant difference based on their feelings toward school and sense of belonging. The present study employed a correlational research model. The participants of the study were 243 5th, 6th, 7th and 8th graders studying at three state middle schools in the city of Eskisehir. For analysis, Multiple Regression Analysis and One-Way ANOVA for Unrelated Samples were employed. In the regression analysis, the factors of punishment sensitivity together were moderately and significantly related to the students’ burnout scores, and these three variables together explained 40% of the variance in the students’ school burnout. ANOVA and Shefee test results showed that the punishment sensitivity of the students who had positive feelings towards school and those who felt they belong in the school were higher than the students who had negative feelings and did not feel they belong in the school. This study also shows parents, teachers and school administrators that they should not be deceived by the short-term and temporary benefits of punishment.

Hidradenitis suppurativa treated with secukinumab

Hidradenitis suppurativa (HS) is a serious skin disease. The cause of HS not known, but it is thought that a disturbance in the immune system's response plays an important role. Studies have found elevated levels of small proteins called cytokines in HS skin. Cytokines are signalling molecules that cells of the immune system use to communicate with each other. Some cytokines cause more inflammation in the skin and others reduce it. IL‐17A is one of the cytokines that cause inflammation, and it was found to be elevated in HS skin. If you remove IL‐17A from the skin tissue, inflammation is reduced and may even disappear. Secukinumab is an antibody that binds and destroys IL‐17A. Because there is a lot of IL‐17A in the skin of HS patients, we have tried this new treatment in a patient with severe disease. Our patient is a 47‐year‐old man, with severe HS. He has been treated for many years and only had temporary benefit from several other treatments that have been tried. We carefully recorded the patient's experience of the treatment, comparing the results at the start of treatment with those after 12 weeks of treatment. After treatment with secukinumab the patient reported fewer boils (going from 23 to 7); less pain (going from 5 to 3 on a ten point scale) and less pain/utility loss/handicap (going from 7 to 4 on a ten point scale). The results may be taken to imply that medications targeting IL‐17A could provide a possible treatment approach for HS in the future.

Acquired resistance in oncogene-addicted non-small-cell lung cancer.

The advance of tyrosine kinase inhibitors has profoundly changed the therapeutic algorithm of non-small-cell lung cancer in molecularly selected patients. However, benefit from these agents is often transient and usually most patients progress within 12months from treatment. Novel and more potent and selective tyrosine kinase inhibitors have been developed to overcome acquired resistance; however, these agents are once again associated with only temporary benefit and patients frequently develop secondary resistance, a heterogeneous phenomenon that involves different molecular mechanisms simultaneously. The aim of our paper is to provide a comprehensive overview of the mechanisms of acquired resistance in oncogene-addicted non-small-cell lung cancer, focusing on the two most studied target, EGFR mutations and ALK translocation, and reviewing the main challenges in clinical practice.

Temporary investment incentives and divestment by foreign firms

Many countries provide temporary incentives to attract foreign investment, in the belief that these temporary benefits may entice firms to remain in the country. We study the exit decision by multinationals, which were established in Puerto Rico under a temporary incentive program. Under this program, benefits were reduced every 5 years. Our results indicate that whenever benefits are reduced, the probability of firm exit increases. This effect is more pronounced for firms using less skill-intensive technologies, for those investing in areas that do not develop agglomerations, and for firms coming from regions that are well acquainted with Puerto Rico. Our evidence shows that US and Spanish firms are more sensitive to the reduction of benefits than firms from other countries. In addition, US firms coming from states where Puerto Rican communities are large are particularly sensitive to the reduction of benefits.

Reducing soil loss using surface application of stem juices

AbstractControlling soil erosion is essential in maintaining and sustaining soil and water resources. Soil amendment is recognized to be an efficient approach for erosion limit. So far, very few studies quantified the effectiveness of plant stem juice, a natural by‐product from fibre extraction, as a soil amendment. The purpose of the research was to assess the effect of corn stem juice (CSJ) and grape stem juice (GSJ) on soil aggregation (mean weight diameter [MWD] and water stable aggregate), soil organic carbon, total nitrogen, runoff, and soil loss using a sequence of simulated rains at 60 min 50 mm hr−1, 20 min 25 mm hr−1, 10 min 75 mm hr−1, and 10 min 100 mm hr−1. Both CSJ and GSJ were uniformly applied on the 3 air‐dried soil surface of 0.96‐m2 soil boxes with 2 L of, respectively, 25% and 50% stem juice solution. All stem juice treatments increased soil MWD, water stable aggregate, soil organic carbon, and total nitrogen but reduced runoff and soil loss. CSJ was more effective than GSJ. As for instance, as compared with the control, CSJ increased MWD by 170%, and soil loss decreased from 82% to 95%, whereas GSJ increased MWD by 109–131% and reduced soil loss by 27–36% during the 60 min 50 mm hr−1 rain. The stronger effect of CSJ might have been caused by higher carbon and nutrient contents than those from GSJ. The results also pointed to temporary benefits of stem juice applications, which pointed to the need of reapplying CSJ after a period or targeting application during critical period for soil conservation.

Maximum Medical Improvement: Jurisdictional Perspectives

Abstract Maximum medical improvement (MMI) and its multiple synonyms are important terms to understand because one cannot determine permanent impairment until a condition has resolved or reached a stable plateau with respect to improvement. Further, in many jurisdictions MMI represents the date beyond which temporary or all benefits cease or time-loss compensation (temporary disability benefits) may be terminated. Because each arena is to some extent unique, evaluating physicians should become familiar with MMI or the term used and its definition in the applicable federal, state, or provincial law or insurance policy. A table shows the terminology used by various US workers’ compensation jurisdictions, but there is no universal definition for MMI. The fourth edition of the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) says only that “an impairment should not be considered ‘permanent’ until the clinical findings, determined during a period of months, indicate that the medical condition is static and well stabilized. The AMA Guides, Fifth Edition, defines MMI as “a condition or state that is well stabilized and unlikely to change substantially in the next year, with or without medical treatment” but acknowledges the possibility of “some change.” Similarly the sixth edition states that MMI is the “point at which a condition has stabilized and is unlikely to change (improve or worsen) substantially in the next year, with or without treatment”; signs and symptoms may wax and wane, but further recovery or deterioration is not anticipated.

Economic Crisis, Mortality and Health Status. A New Perspective

We investigate the health impacts of unemployment during the Great Recession and are the first to focus on incidence of chronic diseases in a unique individual-level longitudinal database of Electronic Health Records. We exploit the exogenous shock in the economic conditions occurred in 2008 in Italy to estimate heterogenous effects of unemployment in an individual fixed effects model. Our results document that economic downturns have a long-lasting effect on the incidence of cardiovascular diseases and a temporary effect on depression. The effects increase with age and are stronger right before retirement age. Women are disproportionally affected by cardiovascular diseases, while men are disproportionately affected by depression. An important recommendation emerging from this study is that policy makers should bear in mind that prolonged economic downturns constitute an additional external risk for individual health and not a temporary benefit.

Resilience of riparian vegetation after restoration measures on River Inn

AbstractRiver restoration is widely applied, although its effects are poorly understood, and degraded habitats might be difficult to improve. Moreover, there is a lack of monitoring as well as few systematic comparisons of restoration methods. This study presents results of a 4‐year monitoring on River Inn (southern Germany) investigating restoration by gravel or sand addition or embankment removal. The results were compared with reference sites that represent the pre‐restoration conditions. At the landscape scale, we analysed vegetation types based on aerial photographs, whereas at a smaller scale, we undertook vegetation surveys and evaluated species composition, growth, and life form, as well as the proportion of the target vegetation. After 4 years, the data indicated a “negative resilience” of the vegetation back to the state prior to restoration. The structural analysis revealed an extensive spread of reed at expense of bare soil. Thus, the species composition largely regressed to the pre‐restoration conditions, and neither annuals nor other pioneer species showed a long‐term benefit of river restoration. There were differences among the three restoration treatments after 2 years, but no longer after 4 years. However, the river restoration had three positive outcomes: (a) There was a temporary benefit for pioneer vegetation that most likely replenished the seed bank of the respective species, (b) the valuable reed communities showed resilience, and (c) the measures allowed some practical learning as expected for adaptive restoration.