C. De Brouwer

Le bruit en néonatologie, impact du personnel hospitalier.

Resume Objectifs Identifier les differentes sources de bruit presentes dans une unite de soins intensifs neonatals d’un centre hospitalier universitaire et en evaluer le niveau sonore. Methodes Le personnel soignant a ete interroge pour obtenir une appreciation qualitative de l’environnement sonore du service. Des observations quantitatives a l’aide d’un sonometre et d’un dosimetre ont ete ensuite effectuees. Les mesures presentees ont ete realisees en deux emplacements de nouveau-nes : sur une table chauffante et dans un incubateur. Resultats De nombreuses sources de bruit ont ete identifiees dans le service. Elles etaient responsables d’un environnement sonore dont le niveau etait nettement superieur aux recommandations existantes et laissaient peu de periodes de calme. Les alarmes des divers appareils de surveillance et manutention, les pleurs des nouveau-nes et les activites du personnel etaient les principales sources de bruit. Conclusion L’impact du personnel hospitalier sur l’importance et la frequence des sources sonores est essentiel. Une strategie de sensibilisation devrait donc certainement etre prevue.

The use of the permanent sample (eps) to study the returnto- work after cancer. Challenges and opportunities for research

INTRODUCTION The introduction of early cancer detection and the improvement in treatment efficacy have led to a significant increase in the survival and the prevalence of (ex) cancer patients. Approximately 40 % of new cancer cases are diagnosed every year in the working age population (20-64 years). Maintaining their quality of life results, among others, in their retain on the labour market. Even though it is necessary to realize the scale of the phenomenon and to plan interventions, no measure allows assessing the rate of return to work among of (ex) cancer patients in Belgium nowadays. METHODS We observe during a five-year period the socio-professional status (inability, disability, unemployment or death) of 645 workers identified in the permanent sample (EPS), having had an oncological multidisciplinary consultation (MOC) in 2011. RESULTS By the end of follow-up, 24 % of the workers were deceased. Among those who survived 26 % are unable to work, 12 % are unemployed and 63 % do not receive any social benefit. Women and young workers (20-44 years) seemed to have encountered difficulties the most. CONCLUSIONS The results of this study allow giving a prudent first estimation of the return to work of socially insured Belgian citizens of almost 40 %, five years after the first MOC. Nevertheless, the structure of the EPS presents many limitations to the interpretation and reliability of results. We suggest some modifications of the EPS that might offer scientists better opportunities to improve the performance and reliability of such cohort studies.

694 Efficiency of vocational rehabilitation programs for workers with schizophrenia: a systematic literature review according to the prisma guidelines

Introduction Unemployment is common among people with schizophrenia and contributes most to the economic cost of the condition. This study was aimed at (1) reviewing the available tools to facilitate the vocational rehabilitation of workers with schizophrenia and (2) describing their specific opportunities. Methods A search of PubMed for original, peer-reviewed articles published from 2006 until January 31, 2016, yielded 643 citations. Exclusion criteria were patients less than 18 years or older than 65 years of age, patients with additional diagnoses, studies conducted in developing countries, lack of an adequate study design, systematic reviews or case studies, no work related studies, and other major analytic inadequacies. The remaining 24 articles were assessed in qualitative synthesis using the Scottish Intercollegiate Guidelines Network (score ≥2+), Critical Appraisal Skills Program or Prediction Model Risk of Bias Assessment Tool checklists. Results Only seven quantitative and one qualitative study could be included. The number of study participants with schizophrenia varied substantially (n=7 in the qualitative study, n=100 in the largest quantitative study). Most studies were conducted in the United States (n=5), as well as two in Canada and one in Japan. Cognitive remediation programs (Neurocognitive Enhancement Therapy) combined with supported employment were significantly more effective (p<0.005) than supported employment by itself. Next, Individual Placement and Support (the manual version of supported employment) and cognitive behavioural therapy (Indianapolis Vocational Intervention Program) were, by themselves, more effective than conventional vocational rehabilitation, regardless of whether it was for competitive employment. Discussion Combining cognitive remediation programs with supported employment programs significantly improved the vocational outcomes of workers with schizophrenia, especially for those with lower community functioning. Participation in competitive employment was also promoted by shorter initial working hours, higher education and disclosure of disabilities. Future prospective, longitudinal research with larger samples, in stratified baseline conditions, is needed.