Return to work after robot-assisted laparoscopic prostatectomy versus radical retro-pubic prostatectomy.

INTRODUCTION: We compared the return-to-work interval (RTWI) after radical retro-pubic prostatectomy (RRP) and robot-assisted laparoscopic prostatectomy (RALP) in men being treated for early-stage prostate cancer. MATERIALS AND METHODS: We mailed a 28-item questionnaire to a random sample of 2,696 patients who either had RRP from 1995 to 2004 or RALP from 2004 to 2011. RESULTS: We received analyzable questionnaires from 315 patients; 178 had RALP and 137 had RPP. The median RTWI was shorter in the RALP group than in the RRP group (3 versus 4 weeks, p = .016). The percent of subjects who had not returned to work 4 weeks after surgery was 23.6% for RALP and 38.2% for RRP (p = .010). In multivariate regression analysis, surgical approach was a significant predictor of RTWI independent of other social/clinical variables that were associated with either surgical approach or RTWI (p = .014). CONCLUSION: Our data support a shortening of RTWI by RALP.

Initial steps towards a theory and praxis of person-environment interaction in disability.

BACKGROUND: Recent disability studies and classifications use a simple concept of person-environment interaction. Further advances in theory and praxis may require a more complex understanding of that interaction. OBJECTIVES: To present (1) a framework for person-environment interactions that highlights their diversity and (2) initial steps in applying it to theory and practice. METHOD: For the person, we focus on the identities that the person may assume over time. For the environment, we focus on the initial state and change in reaction to the person or to the effects of the interaction. We take into account overlaps between the person and the environment. THE FRAMEWORK: The framework includes four components of the person's identity: non-disabled, disabled, identity project and identity imputed by others and four components of the environment: the given, the reactive during interaction, modified after interaction and internalised. We also include interactions of the person in different environments that may influence each other, and, do the same for interactions among key actors. APPLICATIONS: An example is given in detail. The praxis of rehabilitation may be enhanced by taking into account the relations among these subsets of personal identity and environment in programme planning, for instance, in the matching of person and assistive technology or in home support services. DISCUSSION: The framework may serve to build a theory of person-environment interaction in disability that is compatible with interaction in other forms of difference among individuals. Thus, further social theoretical studies would encompass three distinct theories of impairment disability and person-environment interaction, respectively.

Corporation-induced diseases, upstream epidemiologic surveillance, and urban health.

Corporation-induced diseases are defined as diseases of consumers, workers, or community residents who have been exposed to disease agents contained in corporate products. To study the epidemiology and to guide expanded surveillance of these diseases, a new analytical framework is proposed. This framework is based on the agent-host-environment model and the upstream multilevel epidemiologic approach and posits an epidemiologic cascade starting with government-sanctioned corporate profit making and ending in a social cost, i.e., harm to population health. Each of the framework's levels addresses a specific level of analysis, including government, corporations, corporate conduits, the environment of the host, and the host. The explained variable at one level is also the explanatory variable at the next lower level. In this way, a causal chain can be followed along the epidemiologic cascade from the site of societal power down to the host. The framework thus describes the pathways by which corporate decisions filter down to disease production in the host and identifies opportunities for epidemiologic surveillance. Since the environment of city dwellers is strongly shaped by corporations that are far upstream and several levels away, the framework has relevance for the study of urban health. Corporations that influence the health of urban populations include developers and financial corporations that determine growth or decay of urban neighborhoods, as well as companies that use strategies based on neighborhood characteristics to sell products that harm consumer health. Epidemiological inquiry and surveillance are necessary at all levels to provide the knowledge needed for action to protect the health of the population. To achieve optimal inquiry and surveillance at the uppermost levels, epidemiologists will have to work with political scientists and other social scientists and to utilize novel sources of information.