Working conditions and psychosocial risk factors of employees in French electricity and gas company customer support departments.

OBJECTIVE: Little is known about the real impact of working conditions on the health of call center employees. The aim of this article is to describe the working conditions of French electricity and gas company customer service teams, especially those spending more than 75% of their working time handling calls in order to determine their subjective experience of their work and identify situations at risk of psychosocial constraints. METHODS: A cross-sectional study using a self-completion questionnaire was conducted on a representative sample of 2,000 employees working in customer service centers. The questions focused on the variety of tasks performed, the organization of working time, the physical environment of the workstation, violent situations and psychosocial factors (Job Content Questionnaire). Multivariate statistical analyses were performed to identify factors associated with the wish to leave the sector and with a high level of psychosocial constraints. RESULTS: Women made up 66% of the sample. Despite a high educational level, the average socio-professional level of the employees was relatively low. Although the vast majority of employees had chosen this career (74%), just over half would like to leave. The main factors associated with iso-strain were inadequate breaks (odds ratio (OR) = 2.0), low perceived quality of work (OR = 2.4), high proportion of working time spent handling calls (≥75% of working time: OR = 5.9, between 50 and <75%: OR = 5.2), exposure to violence either internally (often or very often: OR = 3.1) or from customers (often or very often: OR = 1.8) and an unsatisfactory workplace (OR = 2.0). CONCLUSIONS: Employees who spend more than 75% of their working time on the phone cumulate every factor linked with a high level of constraints, but all employees of the EDF and Gaz de France customer service centers are concerned. These workers share many characteristics with other call centers: predominantly female workforce; high educational level; wish to leave this sector despite the initial choice; high level of psychosocial risk factors.

Retroperitoneoscopic management of caliceal diverticular calculi.

INTRODUCTION: The management of caliceal diverticular calculi has changed from an open surgical approach to endoscopic management. TECHNICAL CONSIDERATIONS: Different minimally invasive treatment modalities, such as extracorporeal shock wave lithotripsy, ureteroscopy, percutaneous nephrolithotomy, laparoscopy, and retroperitoneoscopy, can be offered to the patient. We report on a retroperitoneoscopic operative technique using endosonography for location and performing nephrotomy with complete excision of the caliceal diverticulum and ligation of the diverticular neck with an Endo-loop. CONCLUSIONS: The advantages of this minimally invasive technique include total excision of the diverticulum with no risk of recurrence and easy and complete closure of the diverticular neck.

Retroperitoneoscopy-assisted cryoablation of renal tumors using multiple 1.5 mm ultrathin cryoprobes: a preliminary report.

OBJECTIVES: Laparoscopic cryoablation has recently been proposed as a minimally invasive nephron-sparing treatment for selected patients. We report on our experience with a retroperitoneoscopic technique using multiple ultrathin cryoprobes. METHODS: Seven patients underwent retroperitoneoscopic renal cryoablation for solid renal masses. Mean tumor size on the CT scan was 2.6 (1.5-3.5) cm. A double freeze-thaw cycle of renal cryoablation was performed under real-time ultrasound monitoring using a total of six 1.5-mm cryoprobes simultaneously. RESULTS: Cryoablation was technically successful in all patients without any need for conversion. Mean duration of surgery was 161 (130-195) minutes and mean blood loss was 107 (50-250) ml. Perioperative biopsy of the tumor confirmed renal cell carcinoma in four patients and angiomyolipoma in two patients; it was inconclusive in one case. Mean follow-up for 13.6 (4-22) months showed no evidence of residual tumor or recurrence. CONCLUSIONS: Retroperitoneoscopy-assisted cryosurgical ablation using multiple ultrathin 1.5-mm cryoprobes is a minimally invasive treatment that is suitable to treat small renal tumors.

[Localized cancer of the prostate: which treatment should be chosen?]. / Cancer localisé de la prostate: quel traitement choisir?

Prostate cancer is a frequent tumor. Nowadays, its diagnosis is often established when the tumor is localized, and curative treatment can be proposed to the patients. Systematic screening studies are under way. Although their conclusions are not yet known, some clues seem to show that early diagnosis and treatment may increase specific prostate cancer survival. Every patient over 50 years old and with a life expectancy of at least 10 years should benefit from a prostate specific antigen (PSA) blood testing and from a prostate rectal palpation every year. This paper reviews oncological and functional results of the established curative treatments of localized prostate cancer, namely radical prostatectomy, external beam radiation, and brachytherapy.