First responders are exposed to traumatic, nontraumatic and organisational stressors that conspire to create stress, potentially leading to emotional issues and/or physical or psychological illness. In addition to individual consequences, stress also takes a toll on the function of emergency departments and their communities. Fortunately, police, fire and ambulance agencies have initiated various preventive measures in an effort to mitigate the ill-effects of continued exposure to stressors by their personnel. However, combating stress effectively requires more than offering individual coping skills and access to counseling for first responders. To best preserve the wellbeing of their workers, emergency service administrators must recognise the impact of stress from a variety of sources, including organisational factors, and approach stress prevention in a multi-staged and comprehensive manner, paying special attention to primary stage interventions. When agencies embrace and act on a broad, holistic view of stress management that includes instituting cultural and organisational changes to support stress prevention, significant improvements in the stress level and health of first responders will be possible.

Despite growing recognition of the importance of psychosocial factors in reducing ongoing work disability, research into the psychological consequences for injured workers who remain at, or return to work is limited. This study compares injured workers who have returned to, or remained at, work with noninjured workers on measures of personality, trauma symptoms, and symptoms of psychological distress. Data from structured clinical interviews, psychological and self-report questionnaires were gathered from 29 workers, 14 of whom were recovering from an injury at the time of participation. Injured workers demonstrated higher levels of Neuroticism and lower Extraversion, indicating greater emotional instability and lower capacity for adaptively coping with stress when compared to noninjured workers. They also reported subclinical elevations on scales of trauma symptoms, and greater levels of depressive symptoms, somatic complaints, anxiety and sleep disturbance in comparison with noninjured workers. These results suggest that the psychological consequences for workers who return to, or remain at, work following injury may reduce adaptation and increase vulnerability to secondary work disability.

Attending physicians and medical advisors, physicians contracting their services to the Workers' Compensation Board, have key roles in assisting injured workers to return to work. A literature review of the role of the physician in the compensable return to work process reveals a lack of information regarding the experiences of medical advisors. This descriptive phenomenological study was undertaken to explore the lived experiences of four medical advisors in a northern rural service delivery location. The purpose of the research was to gain an understanding of the medical advisors' experiences in the compensable return to work process and in the compensation system. Analysis of the interview data revealed a central theme of commitment to quality medical care for injured workers, along with three major themes and several minor themes subsumed within the major concepts: providing medical opinions — requiring factual information, clarifying the diagnosis, no previous relationship with worker, categories of injuries; working with attending physicians and specialists — building relationships, evidence based treatment plans, role of the attending physician, role of the medical advisor; and, working within the workers' compensation environment — structure and policies, expedited services, and case management/team environment. This research report presents the central theme as the foundation through which the major themes are interconnected. This study does not generalise to all medical advisors, but relays stories that contain the essence of a lived experience.

In Norway various welfare state authorities assist in disability management (DM) of long-term sick workers. This study provides empirical-based knowledge about the Norwegian DM process. The data are based on focus-group interviews with health care providers and case-workers in welfare state authorities. A key issue outlined in this article is that long-term sick workers can easily become ‘stuck’ in the rehabilitation system. The focus is on topics that can explain difficulties of re-employing long-term sick workers. Furthermore, we look at what challenges are typical for DM of these workers in Norway, with respect to re-employment issues.

Purpose: This research project aimed to explore the views and perspectives of family physicians in regards to fulfilling their role in disability management (DM) — specifically, to examine the discrepancies between physicians' practice in DM and their professional guidelines, with special attention to physicians' experience in collaborating with key stakeholders. Methods: Seven family physicians were interviewed using a semi-structured interview format (8 evidence-based questions and 2 case examples). Interviews were recorded and transcribed. A content analysis of the interview data was conducted in addition to a thematic review of participant responses. Results: Data revealed that in accordance with previous literature, physicians' practice does not typically emulate Canadian Medical Association policy, and the participant physicians described several barriers as the reason for this discrepancy. This study revealed a multitude of frustrations encountered by physicians when interacting with other parties in DM. Participant physicians also reported potential solutions to these frustrations and other related issues. Conclusion: This qualitative study yields valuable insight into barriers, as well as facilitating factors, for physicians in the fulfillment of their DM role. Some practical recommendations for the DM community are presented, while noting that more research should be conducted, including input from key DM stakeholders, to both gain further understanding of physicians' DM function, and to identify viable interventions aimed at optimising their role.