Institute for Work and Health

Toronto, Canada

Institute for Work and Health

Toronto, Canada

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Dunstan D.A.,University of New England of Australia | MacEachen E.,Institute for Work and Health | MacEachen E.,University of Toronto
Journal of Occupational Rehabilitation | Year: 2013

Purpose Work disability research has found co-worker support to be a significant but under-recognised aspect of work reintegration (WR) processes. Although co-workers work alongside returning workers, their practical contribution to WR success or failure is often invisible to others. This study aimed to gain further insight into the role and contribution of co-workers in WR interventions. Method An exploratory qualitative pilot study was conducted in Toronto, Canada in 2011. Three focus groups were conducted with 13 co-workers, recruited for their direct experience of 'working alongside' a returning worker. An iterative data gathering and analysis process occurred. Themes were generated from categories in open-ended interview questions and new issues arising from the data. Findings The findings detail co-workers' practical experiences of WR processes and their reflections on social and work conditions that impacted their participation. Co-workers' capacity to support returning workers was related to the quality of the WR arrangements, the relationship with the returning worker, work culture, and the duration of the required support. Workplace privacy and confidentiality requirements were identified as a key challenge for co-worker participation. The effects on co-workers of WR processes ranged from the opportunity to learn new skills to disillusionment and withdrawal from the workplace. In worst case scenarios, 'ripple effects' including emotional distress, physical injury and termination of co-workers' employment had occurred. Conclusion Co-workers are not a neutral party in WR procedures. Formalizing the co-worker role to include communication, consideration and recognition might improve co-workers' WR experiences. © 2012 Springer Science+Business Media, LLC.


Dunstan D.A.,University of New England of Australia | Maceachen E.,Institute for Work and Health | Maceachen E.,University of Toronto
Journal of Occupational Rehabilitation | Year: 2014

Purpose: Emerging research has shown that co-workers have a significant influence on the return-towork outcomes of partially fit ill or injured employees. By drawing on theoretical findings from the human resource and wider behavioral sciences literatures, our goal was to formulate a theoretical model of the influences on and outcomes of co-worker responses within work reintegration. Methods: From a search of 15 data bases covering the social sciences, business and medicine, we identified articles containing models of the factors that influence co-workers' responses to disability accommodations; and, the nature and impact of co-workers' behaviors on employee outcomes. To meet our goal, we combined identified models to form a comprehensive model of the relevant factors and relationships. Internal consistency and externally validity were assessed. Results: The combined model illustrates four key findings: (1) co-workers' behaviors towards an accommodated employee are influenced by attributes of that employee, the illness or injury, the coworker themselves, and the work environment; (2) the influences-behaviour relationship is mediated by perceptions of the fairness of the accommodation; (3) co-workers' behaviors affect all work reintegration outcomes; and (4) co-workers' behaviours can vary from support to antagonism and are moderated by type of support required, the social intensity of the job, and the level of antagonism. Conclusions: Theoretical models from the wider literature are useful for understanding the impact of co-workers on the work reintegration process. To achieve optimal outcomes, co-workers need to perceive the arrangements as fair. Perceptions of fairness might be supported by coworkers' collaborative engagement in the planning, monitoring and review of work reintegration activities. © 2013 Springer Science+Business Media New York.


Tjulin A.,Linköping University | MacEachen E.,Institute for Work and Health | MacEachen E.,University of Toronto | Ekberg K.,Linköping University
Journal of Occupational Rehabilitation | Year: 2010

Introduction There is a limited body of research on how the actual social exchange among workplace actors influences the practice of return-to-work. The objective of this study was to explore how workplace actors experience social relations at the workplace and how organizational dynamics in workplace-based return-to-work extends before and beyond the initial return of the sick listed worker to the workplace. Method An exploratory qualitative method approach was used, consisting of individual open-ended interviews with 33 workplace actors at seven worksites that had re-entering workers. The workplace actors represented in these interviews include: re-entering workers, supervisors, co-workers, and human resource managers. Results The analysis identified three distinct phases in the return to work process: while the worker is off work, when the worker returns back to work, and once back at work during the phase of sustainability of work ability. The two prominent themes that emerged across these phases include the theme of invisibility in relation to return-to-work effort and uncertainty, particularly, about how and when to enact return-to-work. Conclusion The findings strengthen the notion that workplace-based return-to-work interventions need to take social relations amongst workplace actors into account. They also highlight the importance and relevance of the varied roles of different workplace actors during two relatively unseen or grey areas, of return-to-work: the pre-return and the post-return sustainability phase. Attention to the invisibility of return-to-work efforts of some actors and uncertainty about how and when to enact return-to-work between workplace actors can promote successful and sustainable work ability for the re-entering worker. © 2009 Springer Science+Business Media, LLC.


Sauvain J.-J.,Institute for Work and Health | Rossi M.J.,Paul Scherrer Institute | Riediker M.,Institute for Work and Health
Aerosol Science and Technology | Year: 2013

Great effort is put into developing reliable, predictive, highthroughput, and low-cost screening approaches for the toxicity evaluation of ambient and manufactured nanoparticles (NP). These tests often consider oxidative reactivity, as oxidative stress is a welldocumented pathway in particle toxicology. Based on a panel of six carbonaceous and five metal/metal oxide (Me/MeOx) nanoparticles, we: (i) compared the specifications (linearity, detection limits, repeatability) of three acellular reactivity tests using either dithiothreitol (DTT assay), dichlorofluorescein (DCFH assay), or ascorbic acid (AA-assay) as the reducing agent; and (ii) evaluated which physicochemical properties were important for explaining the observed reactivity. The selected AA assay was found to be neither sensitive nor robust enough to be retained. For the other tests, the surface properties of carbonaceous NP were of utmost importance for explaining their reactivity. In particular, the presence of "strongly reducing" surface functions explained most of its DCFH reactivity and a large part of its DTT reactivity. For the selected Me/MeOx, a different picture emerged. Whereas all particles were able to oxidize DCFH, dissolution and complexation processes could additionally influence the measured reactivity, as observed using the DTT assay. This study suggests that a combination of the DTT and DCFH assays provides complementary information relative to the quantification of the oxidative capacity of NP. Copyright © American Association for Aerosol Research.


Marendaz J.-L.,Ecole Polytechnique Federale de Lausanne | Suard J.-C.,Institute for Work and Health | Meyer T.,Ecole Polytechnique Federale de Lausanne
Safety Science | Year: 2013

Large organizations as technological universities comprise numerous laboratories which are very rarely audited by health and safety professionals due to limited manpower. Moreover, research activities are permanently progressing with a rapid hazard evolution hardly affordable for safety manager. The present paper proposes a methodology based on Assessment and Classification of Hazards in Laboratories (ACHiL). It allows professionals evaluating their laboratories' hazard level using an innovative platform. This tool includes a series of 28 specific hazards classified in a four level scale (from 0 to 3) allowing to identify laboratories with high level of danger or cumulative hazards. In fine, ACHiL, a hazard mapping platform, can be used as a safety management decision-making support tool for Safety Officers and Dean of School. © 2012 Elsevier Ltd.


Schutz C.A.,University of Lausanne | Juillerat-Jeanneret L.,University of Lausanne | Mueller H.,Swiss Federal Institute of Intellectual Property | Lynch I.,University College Dublin | Riediker M.,Institute for Work and Health
Nanomedicine | Year: 2013

This article reviews nanoparticulate-chemotherapeutic systems that have been developed for human therapy, considering the components of the nanoparticles, the therapeutic agents associated with the nanoparticles and the clinical indications these therapeutic nanoparticles have been developed for. In this evaluation we have put into perspective the types of nanomaterials and their therapeutic indications. We have reviewed the nanoparticulate- chemotherapeutic systems that have been published, approved and marketed and that are currently in clinical use. We have also analyzed the nanoparticulate-chemotherapeutic systems that are in clinical trials and under preclinical development. © 2013 Future Medicine Ltd.


Tang K.,University of Toronto | Tang K.,Li Ka Shing Knowledge Institute | Tang K.,Institute for Work and Health
Scandinavian Journal of Work, Environment and Health | Year: 2014

Objectives Work represents an important role in society, and the nature and consequences of job stress have garnered significant research interest. In recent years, considerable effort has been made to elucidate the occupational stressor-strain relationship, or the interplay between unfavorable working conditions (stressor) and worker well-being (strain). In line with Bandura's notion of "reciprocal determinism", a reciprocal occupational stressor-strain relationship is now increasingly postulated, where variables exert mutual influences on each other over time. The objective of this study was to determine the extent of empirical support for three specific "reversed" (strain-to-stressor) effects, guided by the Demand-Control-Support Model. Methods A systematic literature review was conducted (1996-2012 inclusive) through a search of databases. After relevant studies were identified, a methodological quality appraisal was performed based on four key criteria: sample size, measurement, non-spuriousness, and non-response bias. Subsequently, a quantitative synthesis of evidence from high-quality studies was performed by calculating a standardized index of convergence for each reversed effect. Results Twenty-three qualifying studies were found and evidence from ten high-quality studies ultimately contributed to the synthesis. Moderately strong evidence in support of a positive strain-to-job demands effect was found, but there was no evidence in support of either a strain-to-job control or a strain-to-workplace social support effect. Conclusions In conjunction with available evidence on the corresponding "normal" (stressor-to-strain) effect, this review gives credence to the possibility of a reciprocal stressor-strain relationship involving job demands and worker well-being.


Kulkarni A.V.,The Hospital for Sick Children | Aziz B.,The Hospital for Sick Children | Shams I.,The Hospital for Sick Children | Busse J.W.,Institute for Work and Health | Busse J.W.,McMaster University
PLoS ONE | Year: 2011

Background: Author self-citation contributes to the overall citation count of an article and the impact factor of the journal in which it appears. Little is known, however, about the extent of self-citation in the general clinical medicine literature. The objective of this study was to determine the extent and temporal pattern of author self-citation and the article characteristics associated with author self-citation. Methodology/Principal Findings: We performed a retrospective cohort study of articles published in three high impact general medical journals (JAMA, Lancet, and New England Journal of Medicine) between October 1, 1999 and March 31, 2000. We retrieved the number and percentage of author self-citations received by the article since publication, as of June 2008, from the Scopus citation database. Several article characteristics were extracted by two blinded, independent reviewers for each article in the cohort and analyzed in multivariable linear regression analyses. Since publication, author self-citations accounted for 6.5% (95% confidence interval 6.3-6.7%) of all citations received by the 328 articles in our sample. Self-citation peaked in 2002, declining annually thereafter. Studies with more authors, in cardiovascular medicine or infectious disease, and with smaller sample size were associated with more author self-citations and higher percentage of author self-citation (all p≤0.01). Conclusions/Significance: Approximately 1 in 15 citations of articles in high-profile general medicine journals are author self-citations. Self-citation peaks within about 2 years of publication and disproportionately affects impact factor. Studies most vulnerable to this effect are those with more authors, small sample size, and in cardiovascular medicine or infectious disease. © 2011 Kulkarni et al.


Chaparro L.E.,Hospital Pablo Tobon Uribe | Furlan A.D.,Institute for Work and Health | Deshpande A.,University of Western Ontario | Mailis-Gagnon A.,Toronto Western Hospital | And 2 more authors.
Spine | Year: 2014

STUDY DESIGN.: Systematic review and meta-analysis. OBJECTIVE.: To assess the efficacy of opioids in adults with chronic low back pain (CLBP). SUMMARY OF BACKGROUND DATA.: Opioids for CLBP has increased dramatically. However, the benefits and risks remain unclear. METHODS.: We updated a 2007 Cochrane Review through October 2012 of randomized controlled trials from multiple databases. Use of noninjectable opioids in CLBP for at least 4 weeks was compared with placebo or other treatments; comparisons with different opioids were excluded. Outcomes included pain and function using standardized mean difference (SMD) or risk ratios with 95% confidence intervals (CIs), and absolute risk difference with 95% CI for adverse effects. Study quality was evaluated using Grading of Recommendations Assessment, Development, and Evaluation criteria. RESULTS.: Fifteen trials (5540 participants), including twelve new, met the criteria. Tramadol was better than placebo for pain (SMD, -0.55; 95% CI, -0.66 to -0.44) and function (SMD, -0.18; 95% CI, -0.29 to -0.07). Compared with placebo, transdermal buprenorphine decreased pain (SMD, -2.47; 95% CI, -2.69 to -2.25), but not function (SMD, -0.14; 95% CI, -0.53 to 0.25). Strong opioids (morphine, hydromorphone, oxycodone, oxymorphone, and tapentadol), were better than placebo for pain (SMD, -0.43; 95% CI, -0.52 to -0.33) and function (SMD, -0.26; 95% CI, -0.37 to -0.15). One trial demonstrated little difference with tramadol compared with celecoxib for pain relief. Two trials (272 participants) found no difference between opioids and antidepressants for pain or function. Reviewed trials had low to moderate quality, high drop-out rates, short duration, and limited interpretability of functional improvement. No serious adverse effects, risks (addiction or overdose), or complications (sleep apnea, opioid-induced hyperalgesia, hypogonadism) were reported. CONCLUSION.: There is evidence of short-term efficacy (moderate for pain and small for function) of opioids to treat CLBP compared with placebo. The effectiveness and safety of long-term opioid therapy for treatment of CLBP remains unproven. © 2014, Lippincott Williams & Wilkins.


Rueda S.,University of Toronto | Rueda S.,Institute for Work and Health | Law S.,McGill University | Rourke S.B.,University of Toronto | Rourke S.B.,Li Ka Shing Knowledge Institute
Current Opinion in HIV and AIDS | Year: 2014

PURPOSE OF REVIEW: People with HIV continue to live with the health consequences of an episodic illness that limits their ability to fully participate in society, particularly for the growing number of older people living with HIV. The present review describes the recent evidence exploring the psychosocial challenges facing older adults living with HIV. RECENT FINDINGS: Aging for people with HIV may be more challenging than for the general population because of HIV-related stigma, loss of friends and social networks, and the detrimental effects that HIV and antiretroviral treatment have on normal aging processes. Older people with HIV are more likely to experience mental health and neurocognitive impairment than their HIV-negative counterparts, as well as more social isolation as a result of decreased social participation and engagement. People develop different approaches for coping with the challenges associated with aging with HIV. SUMMARY: As this field of research evolves, many research gaps need to be addressed, including a better conceptualization and measurement of successful aging and the development of high-quality integrated care, programs, and services tailored to the needs of older people with HIV. A more integrated policy response is needed to improve the psychosocial and economic well being of older people with HIV. © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins.

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