Perceived work ability at return to work in women treated for breast cancer: a questionnaire-based study.

BACKGROUND: Breast cancer survivors often perceive reduced work ability upon returning to work. OBJECTIVES: To identify predictors of perceived reduced work ability following return to work among women treated for breast cancer and to describe workplace interventions and support after returning to work. METHODS: A questionnaire was sent to 18-65 years-old women (no. 1578) treated for breast cancer and residing in the catchment area of the Bologna Local Health Authority between 2010 and 2012. The study population was identified through a Hospital Discharge Database. The questionnaires included items about personal characteristics, cancer and work-related factors, perceived work ability and the return to work process. A multivariable logistic regression analysis was performed to identify predictors of reduced work ability upon returning to work. RESULTS: Among the 841 respondents, 503 questionnaires were evaluable. In the study, 43.5% of the respondents reported reduced work ability with respect to the pre-diagnosis period. Reduced work ability was more common in non-cohabiting (OR=1.81, 95%CI 1.10-2.98) than in cohabiting/married women, and after mastectomy (OR=2.77, 95%CI 1.26-6.11) than after breast-conserving surgery. Office staff/sales assistants and managers were less likely to report reduced work ability (OR=0.51, 95%CI 0.30-0.88 and OR=0.21, 95%CI 0.06-0.76, respectively) than labourers. Women who perceived reduced work ability reported more frequently adjustment of work assignments, consultation of an occupational physician, insufficient support from employers and colleagues and discrimination. CONCLUSIONS: Reduced work ability is commonly perceived among women who return to work after treatment for breast cancer. Occupational physicians and general practitioners should be aware of a wide range of factors influencing this perception in order to facilitate a successful return to work.

Safety and efficacy of the endoscopic duodenal-jejunal bypass liner prototype in severe or morbidly obese subjects implanted for up to 3 years.

BACKGROUND: The duodenal-jejunal bypass liner (DJBL) is an endoscopic device that mimics the duodenal-jejunal exclusion component of the Roux-en-Y gastric bypass. Previous studies assessing the efficacy of the DJBL have shown 10-40% excess weight loss (%EWL) and improvements in obesity-associated comorbidities. The aim of this study was to evaluate the safety and efficacy of a new DJBL prototype over a 3-year period. METHODS: Morbidly obese subjects were enrolled in a single-arm, open-label, prospective trial. The subjects were offered the opportunity to continue with the trial annually and signed a new consent form. The primary endpoint was safety. The secondary endpoints were changes in weight and biochemical parameters from baseline. RESULTS: The DJBL was implanted endoscopically in 80 subjects (age: 35±10 years; 69% female; weight: 109±17 kg; BMI: 42±5.4 kg/m2). Seventy-two severe adverse events (AEs) were observed in 55 patients (68%), of which nine subjects required a prolonged hospital stay and three subjects required major interventions. Overall, 23 subjects (29%) underwent early device removal due to AEs. Additionally, 95% of the patients experienced mild AEs that mainly consisted of abdominal pain. The severe AEs included a liver abscess (3), upper GI bleeding (4), cholangitis (1), and acute pancreatitis (1) and mostly occurred after 12 months of follow-up. Two patients presented a short esophageal perforation during explantation. These perforations were successfully managed with endoscopic closure in one subject and medical treatment in the other subject. In the completer population at 52 weeks (71 patients), 104 weeks (40 patients), and 156 weeks (11 patients), the mean %EWL were 44 ± 16, 40 ± 22, and 39 ± 20, respectively (p < 0.001). CONCLUSION: This study shows significant and sustained weight loss after 3 years of treatment with the new DJBL. However, the high frequency and severity of AEs preclude the use of this prototype for periods longer than 1 year.

[Evaluation of work-related stress in call-center workers: application of a methodology]. / Valutazione dello stress lavoro correlato in lavoratori di call-center: applicazione di una metodologia operativa.

BACKGROUND: Several studies highlighting a correlation between call-center working conditions and psychosocial and ergonomic hazards. OBJECTIVES AND METHODS: The aim of this study is to provide an operating methodology for the risk assessment of work-related stress. The study involved 554 call-centre workers employed in three insurance organizations and a mixed work group (worker, company and public health representative) for the study management was defined. We experimented an objective self-made checklist and then we administered a modified version of the OSI (Occupational Stress Indicator) questionnaire. We obtained complementary information from the two different data collection methods. RESULTS AND CONCLUSIONS: The findings highlight a low level of perceived stress and health complaints compared with other studies previously carried out mainly in 'outsourcing' call centres: workers don't show stress symptoms without adopting coping strategies. Moreover the study underlines an acceptable level of work satisfaction, although there are low career opportunities. These results are probable due to the low job seniority associated to the high job security--the large majority of respondents, 87%, consisted of permanent workers--and the working time mainly consisted of daily shifts five days a week. Our methodology seems to be able to detect the level of work-related stress with a good degree of coherence. Furthermore the presence of a mixed work group determined a good level of involvement among the workers: 464 out of 554 operators completed and returned the questionnaire, representing a response rate of about 84%.