Caffeine Behind a California Man’s DUI

4 Things to Know About Caffeine, the Surprising Substance Behind a California Man’s DUI

by Parminder Deo and John Torres, M.D.

photo of coffee cup shaped car on the highwayA California has been charged with driving under the influence … of caffeine.

Wait, what?

Given that Americans consume an average of 3.1 cups of coffee a day, it’s unlikely he’s the only driver on the road to have ever enjoyed such a seemingly innocent pick-me-up. So, how in the world could caffeine impair a driver’s capability behind the wheel?

According to NBC medical contributor Dr. John Torres, it wouldn’t. “Studies have shown that caffeine actually helps ones driving abilities. The only way that it might have an effect is if a person overdoses on caffeine or uses it to cover fatigue and then it wears off,” Torres said.

One man’s legal issues aside, caffeine does come with some surprising truths that many people may not know.

Light Roast Has More Caffeine Than Dark

When you go bean to bean, light roasts win in holding more caffeine. Why? The beans are exposed to less heat than dark blends, so more caffeine is not lost during the roasting process. The difference in caffeine between light and dark roasts isn’t enough for most to notice, but there are other ways to reduce caffeine, if that’s what you’re going for.

If you’re trying to cut down, Torres suggests switching to cold brew coffees, since they contain less caffeine. You could also switch to tea, which cup for cup contains less than half the caffeine of coffee. Barring that, there’s always decaf.

Caffeine Might Be More Effective in the Afternoon

Contrary to what many coffee aficionados believe, you don’t need a hit of caffeine as soon as you wake up. The reason behind this has to do with your cortisol levels.
Continue reading Caffeine Behind a California Man’s DUI

New Knee Cartilage Surgery Shortens RTW Time

By |  December 28, 2016

illustration of MACI knee surgeryChicago, IL.( – A new study published in the American Journal of Sports Medicine and summarized in a report by Reuters Health claims that patients receiving a graft of their own knee cartilage cells may be better off returning to full weight bearing after six weeks instead of the standard eight.

Knee surgery patients put on a six-week recovery track were able to get back to work and other activities like sports more quickly, and even reported slightly better results at 24 months than those who had followed an eight-week recovery plan after surgery, researchers report in the American Journal of Sports Medicine.

People with damaged cartilage in their knees can undergo so-called matrix-induced autologous chondrocyte implantation, or MACI, surgery to fix the defects that cause pain and swelling.
 In the two-stage MACI surgery, healthy cartilage is collected from unaffected parts of the damaged knee and sent to a lab where it’s used to grow more cartilage on a scaffold-like material. The surgeon then implants this graft into the damaged parts of the knee where it’s expected to integrate with surrounding cartilage.

Standard practice has been to keep weight off the knee for at least eight weeks and up to three months for fear of damaging the delicate new tissue. But there’s evidence that the forces of weight and movement promote growth by the cartilage cells, the authors write, so putting some weight on the implant earlier might help speed recovery of the knee.
 Continue reading New Knee Cartilage Surgery Shortens RTW Time

Hospital ICUs Overused

Biomedical Research Institute (LA BioMed)

Intensive Care Units (ICUs), which provide the most expensive and invasive forms of care in a hospital setting, are being used too often for patients who don’t need that level of care, according to a new study by LA BioMed and UCLA researchers published in the Journal of the American Medical Association Internal Medicine today.

The researchers studied 808 ICU admissions from July 1, 2015 to June 15, 2016 at Harbor-UCLA Medical Center and found that more than half the patients could have been cared for in less expensive and invasive settings.

Of the patients in the study, 23.4% were in need of close monitoring but not ICU-level care. Another 20.9% of the patients were critically ill but unlikely to recover because they had underlying illnesses or severity of acute illness. For another 8%, death was imminent or the same outcomes were expected in non-ICU care.

“Our study found over 50% of patients admitted to the ICU were categorized into groups suggesting that they were potentially either too well or too sick to benefit from ICU care or could have received equivalent care in non-ICU settings,” said Dong W. Chang, MD, an LA BioMed researcher and the corresponding author for the study.

“This research indicates that ICU care is inefficient because it is devoting substantial resources to patients who are less likely to benefit from this level of care. These findings are a concern for patients, providers and the health care system because ICU care is frequently invasive and comes at a substantial cost.”


3 Ways to Make Your Worksite Injury-Free

By 12/20/2016

black and white photo of Flying WallendasKeeping workers safe on the job doesn’t need to entail major expense, and it’s the best way to keep your workers’ compensation costs down. But it’s easy to overlook the steps needed to prevent on-the-job accidents, no matter what type of work being done. Employers can take a cue from the person who has, arguably, the most dangerous job in the world.

Nik Wallenda, of the famed Flying Wallendas, walks a tightrope. But he considers himself an artist rather than a daredevil because of the safety measures he takes. Before each walk, he spends months preparing for the worst case scenario — having the local fire department douse him and the wire with gallons of water before going over Niagara Falls, or generating 90-mile-an-hour winds with airboats pointed at him as he practices for a walk above the Grand Canyon. He even rehearses his rescue plan — if it’s ever needed — where he kneels down to the wire while rescuers can get to him within 90 seconds.

While the dangers he faces are much more than those for most workers, his methods are best practices that everyone can use: understanding the risks, training all involved, prepping for the actual event.

Assess the risks

Before sending workers into areas with known or unknown hazards, companies should be very familiar with the risks involved. For Nik Wallenda, that means researching the area where he plans to do a wire walk from all angles — including below, where onlookers could be at risk.
Continue reading 3 Ways to Make Your Worksite Injury-Free

What Apple Taught Us About Mastering Workers Comp (Video)

December 19, 2016 by Michael B. Stack [Leave a Comment]
Watch video here  – Run time 2:06 Transcript below:

Hey, Michael Stack here with Amaxx. We’re getting down to crunch time. It’s six days to Christmas. It’s about the holiday pageants and the parties and leveraging the overnight and priority shipping, to get everything ready and prepared for the big day.

Now in my family we have four young kids, aged two to six years old. It’s a lot of fun for us, very exciting time of course for them, and really enjoyable for us to really share in that experience with them. But of course it’s a lot of work and it’s very busy, so one of the things that we like to do to enjoy this time of year is to sit down and watch holiday movies.

Apple Removed “Swipe” on iPhone

We are through on the movie Christmas with the Kranks this weekend, nice Tim Allen family comedy Christmas movie. As we’re sitting on the couch my wife is sitting next to me and she takes out her phone and she swipes, she’s, “Oh man. Shoot.” She just updated her iPhone operating system. Of course with new operating system they eliminated the swipe, and she hadn’t yet learned that new habit. I’d updated mine a couple of weeks before and it took me probably maybe 30 or so swipes before I learned that new process that I didn’t have to do that anymore.

Return To Work Success Happens One Worker At A Time

It got me thinking about our work comp programs and the goals that we set for the new year in 2017. Let’s say you want to be one of the best in class providers and return to work, and you want to get 95% of your employees back to work within zero to four days as your goal. What’s important to remember is that that old habits, that old process, that old culture, same as when we’re learning to use our new phones, exists in a much larger scale at our organizations. That goal of 95% of your employees back to work in zero to four days starts with getting one employee back to work just one day sooner. It puts you on that path to achieve that significant goal.


iPrescribe Exercise – Free App Combats Sedentary Lifestyle

Douglas Maurer, DO/MPH/FAAFP | October 12, 2016

iPrescribe Exercise: Helping Your Patients Meet Recommended Fitness GoalsAs of 2014, there were over 165,000 health apps available for download in the iOS and Android app stores (duplicates excluded).

There are over 500 million people using them—1 in 3 patients seen in primary care. This explosion of health apps has created an entire cottage industry that is projected to pull in over $8 billion by 2018.

But few apps for health are evidence based and less than 1% are FDA regulated. A 2016 study by the Commonwealth Fund performed a systematic review of 946 iOS apps and 1,173 Android apps and evaluated them on their merits regarding patient engagement. Of the apps that met the reviewers inclusion criteria, only 161 (43%) of iOS apps and 152 (27%) of Android apps were assessed as “possibly useful”, of which 126 apps existed on both platforms. A 2015 systematic scoping review of 457 articles and 800 apps for weight loss found that only 28 met inclusion criteria for quality and behavior change principles. Continue reading iPrescribe Exercise – Free App Combats Sedentary Lifestyle

Pop Quiz; Are Soda Taxes Changing America?

By Judge David Langham 12/06/2016

illustration of soda equal to eathing 22 packs of sugarA few years back, I introduced the sugary soda debate in Get Me a Huge Soda Please. There is co-morbidity in workers’ compensation. One that has attracted discussion and attention is obesity.

It turns out that those of us with a few extra pounds can be more challenging to treat following an injury. Months later, New York encountered legal issues with its effort to tax soft drinks, noted in Can I get a Team Gulp with that Please.

In the last election, voters in four cities were confronted with whether to impose a tax on soft drinks and other “sugar-sweetened beverages. According to CNN, in early November, ballot initiatives were proposed in “San Francisco, Oakland and Albany, California; and Boulder, Colorado.”

The purported drive behind the taxation effort is to discourage consumption. If the cost of the soft drink is increased sufficiently by the taxation, then people will consume less of the soft drink. CNN says that “soda beverages have been associated with an increased risk of obesity, type 2 diabetes, heart disease and possibly heart failure.” Proponents claim that their efforts are not directed at revenue from taxes, but at improved health. There are claims that such taxation detriment works in that regard.
Continue reading Pop Quiz; Are Soda Taxes Changing America?

Incorporating Telemedicine into Workers’ Compensation Care

By Safety National 12/02/2016

telemedcine logo graphicTelemedicine is a hot topic with lots of discussion around its potential to favorably impact workers’ compensation by improving medical care access, but to what extent is it actually feasible today? This session at the 2016 National Workers’ Compensation & Disability Conference featured viewpoints from an employer, vendor and carrier.

Speakers included: Ann Schnure, VP Risk Management – Claims, Macy’s, Jill Allen, President & CEO, Consumer Health Connections and Paul Morizzo, Provider Networks Manager, Missouri Employers Mutual

Telemedicine is the next generation of managing injured workers’ medical care and claims. In fact, the telehealth industry is predicted to grow to $34 billion by 2020. Industry experts also estimate that, by 2018, 80% of employers will be offering a telehealth benefit to employees.

The industry has been slow to embrace telehealth, possibly due to worries that employees will not want to do it, the installation of equipment will be costly, or the preconceived notion that today’s telemedicine product are only for triage.

Employer’s Viewpoint

Macy’s uncovered that injured employees sent to occupational clinics were returning to work without attending follow-up visits. Employee excuses ranged from no time, limited transportation and that they were recovered, so did not feel the need. Macy’s wanted to fix these problems. They reviewed several telehealth options that either did not work for their employee population or to where they couldn’t justify the ROI. Continue reading Incorporating Telemedicine into Workers’ Compensation Care

Understand The Work Comp Heart Attack Presumption

By 12/01/2016

Painting of a firefighterThe grand bargain of the workers’ compensation system requires employees who allege work injuries or conditions to prove compensability of their claim.

This includes the initial threshold question that it “arose out of” and occurred within the “course of” their employment activities.  While this threshold question applies to all employees equally, there are various presumptions that allow firefighters, police officers and other emergency personal to obtain compensation for heart attacks or other exposures with a lesser degree of evidence.

This is known as the “heart attack presumption,” and is something all members of the claims management team should understand.  They should also be aware as to how to deal with these cases and rebut the presumption when appropriate.

Origins of the Heart Attack Presumption

Employees that work in emergency situations deal with a constant flow of stressful situations during the course of every workday.  This includes rushing to various emergencies, working prolonged and abnormal hours and being subject to constant peril.  The result was a recognition in multiple jurisdictions that these professionals should receive additional protections that while rebuttable, allow them to peruse legitimate claims without having to prove issues of causation to the extent that other employees are required.

Application of the Presumption

It is important to note that the occurrence of a heart attack by a firefighter, police officer or other emergency responders does not automatically trigger compensability.  In order for the presumption to be successful, there is typically a requirement of “an absence of contrary or conflicting evidence on the point and the circumstances which form the basis of the presumption must be of sufficient strength from which the only rational inference to be drawn….”[1]  In other words: Continue reading Understand The Work Comp Heart Attack Presumption

Medical Marijuana – Without Any Marijuana!

By 11/29/2016

Medical Marijuana logoSacramento, CA – The workers’ compensation community is bracing for the potential, and some say eventual, tidal wave of claims for medical marijuana as a form of treatment for pain related industrial injuries. But soon it may be possible to provide the claimed benefits of “medical” marijuana – without any marijuana at all!

Science Daily reports that Indiana University neuroscientist Andrea Hohmann took the stage at a press conference Nov. 14 in San Diego to discuss research conducted at IU that has found evidence that the brain’s cannabis receptors may be used to treat chronic pain without the side effects associated with opioid-based pain relievers or medical marijuana.

The study was discussed during the annual meeting of the Society for Neuroscience, the world’s largest source of emerging news about brain science and health. Hohmann was joined by three other international researchers whose work focuses on similar topics.

“The most exciting aspect of this research is the potential to produce the same therapeutic benefits as opioid-based pain relievers without side effects like addiction risk or increased tolerance over time,” said Hohmann, a Linda and Jack Gill Chair of Neuroscience and professor in the IU Bloomington College of Arts and Sciences’ Department of Psychological and Brain Sciences.

Chronic pain is estimated to affect nearly 50 million adults in the United States. The rise in opioid-based pain relievers to treat chronic pain has also contributed to an opioid addiction epidemic in the United States, with 19,000 deaths linked to prescription opioid abuse in 2014. In Indiana, the use of needles associated with prescription opioid abuse led to a major HIV outbreak in the state’s southeastern region, prompting the governor to declare a public health emergency in 2015.

 Continue reading Medical Marijuana – Without Any Marijuana!