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Close association of occupational intervention with clinical care is of primary importance in impeding progression toward chronicity of low back pain.

Despite lower indices of injury severity, even after taking account of comorbidities, mortality was significantly increased in elderly patients admitted to a trauma center with rib fractures.

Prooxidant additives represent a promising solution to the problem of the environment contamination with polyethylene film litter. Prooxidants accelerate photo- and thermo-oxidation and consequent polymer chain cleavage rendering the product apparently more susceptible to biodegradation. The question not fully resolved remains the biodegradation itself, its mechanism and especially the factors influencing the time-frame in which it can occur. The presented review is aimed to provide comprehensible information for both microbiologists and polymer scientists, who need participate in the research leading to an understanding of the microorganism action on the oxidized polyethylene and to design of new materials.

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Aims: To test the long term cost-benefit and cost-effectiveness of the Sherbrooke model of management of subacute occupational back pain, combining an occupational and a clinical rehabilitation intervention. Methods: A randomised trial design with four arms was used: standard care, occupational arm, clinical arm, and Sherbrooke model arm (combined occupational and clinical interventions). From the Quebec WCB perspective, a cost-benefit (amount of consequence of disease costs saved) and cost-effectiveness analysis (amount of dollars spent for each saved day on full benefits) were calculated for each experimental arm of the study, compared to standard care. Results: At the mean follow up of 6.4 years, all experimental study arms showed a trend towards cost benefit and cost effectiveness. These results were owing to a small number of very costly cases. The largest number of days saved from benefits was in the Sherbrooke model arm. Conclusions: A fully integrated disability prevention model for occupational back pain appeared to be cost beneficial for the workers' compensation board and to save more days on benefits than usual care or partial interventions. A limited number of cases were responsible for most of the long term disability costs, in accordance with occupational back pain epidemiology. However, further studies with larger samples will be necessary to confirm these results.

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