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The aim of this study is to examine the associations between lag times following occupational low back injury and the length of work disability. In a retrospective cohort study using workers' compensation claims, random effects Tobit models were used to explore how disability length relates to three lag times: the number of days from the date of injury to reporting the injury, the number of days from the date of injury to medical care, and the number of days from the date of injury to initiating work disability. In general, shorter lag times for each of the different lags were related to shorter lengths of disability. Decreasing the length of the lag times in reporting injuries, receiving medical care, and missing work may help to decrease the length of work disability for workers after low back injury.

Infection in health workers (HWs) has characterized outbreaks of Ebola virus disease (EVD) and Marburg virus disease (MVD). We conducted a systematic review to investigate infection and mortality rates and common exposure risks in HWs in EVD and MVD outbreaks. We searched the EMBASE and PubMed databases to identify articles posted before 27 December 2017, with no language restrictions. Data on the number, frequency, and mortality of HW infection and exposure risks were extracted. Ninety-four articles related to 22 outbreaks were included. HW infections composed 2%-100% of cases in EVD and 5%-50% of cases in MVD outbreaks. Among exposed HWs, 0.6%-92% developed EVD, and 1%-10% developed MVD. HW infection rates were consistent through outbreaks. The most common exposure risk situations were inadequate personal protective equipment and exposure to patients with unrecognized EVD/MVD. Similar risks were reported in past EVD/MVD outbreaks and in the recent outbreak in West Africa. Many outbreaks reported high proportions of infected HWs. Similar HW infection rates and exposure risk factors in both past and recent EVD and MVD outbreaks emphasize the need to improve the implementation of appropriate infection control measures consistently across all healthcare settings.

The occupational hazards of health workers (HWs) in standard work environments have been well defined in both the developed and developing world during routine working conditions. Less defined are the hazards to HWs during pandemics, epidemics, natural disasters, wars, conflicts, and other crises. How do crises affect the infrastructure of medical systems? What are the distinct needs of the patient population during crises? What are the peculiarities of the Crisis Health Worker (CHW)? What are the known CHWs’ occupational risks? What are the protective factors? By means of a PubMed search, we synthesized the most relevant publications to try to answer these questions. Failures of healthcare infrastructure and institutions include CHW shortages, insufficient medical supplies, medications, transportation, poorly paid health workers, security concerns, and the absence of firm guidance in health policy. Healthcare needs affecting the patient population and CHWs include crisis-induced injury and illness, hazardous exposures, communicable diseases, mental healthcare, and continuity of care for pre-crisis medical conditions. CHWs’ occupational hazards include supply deficiencies, infectious disease transmission, long working hours, staff shortages, financial reimbursements, mental fatigue, physical exhaustion, and inconsistent access to clean water, electricity, and Internet. CHWs suffer from injuries and illnesses that range from immediate, debilitating injuries to chronic, unforeseen effects like mental fatigue, physical exhaustion, anxiety, burnout, and even post-traumatic stress syndrome (PTSD). Protective factors include personal traits such as adaptability and resilience as well as skills learned through structured education and training. Success will be achieved by constructively collaborating with local authorities, local health workers, national military, foreign military, and aid organizations.

Background Studies show smoking and vaping behaviors increase risk of contracting and worse symptoms of COVID-19. This study examines whether past 30-day youth and young adult users of marijuana, e-cigarettes, and cigarettes self-reported changes in their use of these substances due to the COVID-19 pandemic; and cross-sectional associations between perceived stress, nicotine or marijuana dependence, and COVID-19–related changes in use. Methods Participants were 709 past 30-day self-reported substance users from the Texas Adolescent Tobacco and Marketing Surveillance study (TATAMS; mean age = 19; 58% female; 38% Hispanic, 35% white). Multiple logistic regression models assessed cross-sectional associations between perceived stress and dependence and increased, decreased, or sustained past 30-day use of marijuana, e-cigarettes, and cigarettes due to COVID-19 (e.g., “Has your marijuana use changed due to the COVID-19 outbreak?”). Covariates included age, race/ethnicity, socio-economic status (SES), dependence (exposure: stress), and stress (exposure: dependence). Results Most participants reported sustained (41%, 43%, 49%) or increased (37%, 34%, 25%) use of marijuana, e-cigarettes, and cigarettes due to COVID-19, respectively. Participants who reported symptoms of dependence were significantly more likely than their non-dependent peers to report increasing their marijuana (AOR: 1.66; 95% CI: 1.15–2.39) and e-cigarette (AOR: 2.57; 95% CI: 1.38–4.77) use. Those who reported higher perceived stress were significantly more likely to report increasing their marijuana use (AOR: 1.55; 95% CI: 1.01–2.42). Conclusions Most youth and young adults did not decrease their substance use amid a global, respiratory disease pandemic. Health messaging and interventions that address the health effects of smoking and vaping as well as factors like stress and dependence that may be barriers to decreasing use are vital in curbing the COVID-19 pandemic.

U.S. Secretary of Transportation Anthony Foxx was in Richmond recently to make a major announcement. The city of Richmond and Henrico County have been awarded a $24.9 million grant toward design and construction of a bus rapid transit line. The project is being hailed as a \"game changer\" and could be operational by late 2018. These rapid transit buses will run along a 7.6-mile route with 14 stations, with a projected 65 percent improvement in bus travel times compared to regular bus route service. The funding for this project was made possible through the federal Transportation Investment Generating Economic Recovery, or TIGER, program, which provides funding nationwide to help meet the overwhelming need for infrastructure investment. We congratulate the Richmond-area leaders on their success; they are taking important next steps toward improving transportation options. Bus rapid transit, by definition, features dedicated lanes for buses, signal priority, high-quality transit stops and frequent rapid service to connect major employment and activity centers. In addition to improving transportation options for our residents and visitors, the economic development potential of bus rapid transit is enormous. A recent Forbes article highlighted the success of the HealthLine bus rapid transit system in Cleveland. Since opening in 2008, more than $5.8 billion in economic development has occurred, equating to more than $114 of return for each transit dollar invested.

\"The Changing Family in Comparative Perspective: Asia and the United States\" edited by Karen Oppenheim Mason, Noriko O. Tsuya and Minja Kim Choe is reviewed.