Breastfeeding And The Risk Of Breast Cancer In Brca1 And Brca2 Mutation Carriers

INTRODUCTION: Breastfeeding has been inversely related to breast cancer risk in the general population. Clarifying the role of breastfeeding among women with a BRCA1 or BRCA2 mutation may be helpful for risk assessment and for recommendations regarding prevention. We present an updated analysis of breastfeeding and risk of breast cancer using a large matched sample of BRCA mutation carriers. METHODS: We conducted a case-control study of 1,665 pairs of women with a deleterious mutation in either BRCA1 (n = 1,243 pairs) or BRCA2 (n = 422 pairs). Breast cancer cases and unaffected controls were matched on year of birth, mutation status, country of residence and parity. Information about reproductive factors, including breastfeeding for each live birth, was collected from a routinely administered questionnaire. Conditional logistic regression was used to estimate the association between ever having breastfed, as well as total duration of breastfeeding, and the risk of breast cancer. RESULTS: Among BRCA1 mutation carriers, breastfeeding for at least one year was associated with a 32% reduction in risk (OR = 0.68; 95% CI 0.52 to 0.91; P = 0.008); breastfeeding for two or more years conferred a greater reduction in risk (OR = 0.51; 95% CI 0.35 to 0.74). Among BRCA2 mutation carriers, there was no significant association between breastfeeding for at least one year and breast cancer risk (OR = 0.83; 95% CI 0.53 to 1.31; P = 0.43). CONCLUSIONS: These data extend our previous findings that breastfeeding protects against BRCA1-, but not BRCA2-associated breast cancer. BRCA mutation carriers should be advised of the benefit of breastfeeding in terms of reducing breast cancer risk.published_or_final_versio

Soluble and Cell-Associated Insulin Receptor Dysfunction Correlates with Severity of HAND in HIV-Infected Women

Blood sugar metabolism abnormalities have been identified in HIV-infected individuals and associated with HIV-associated neurocognitive disorders (HAND). These abnormalities may occur as a result of chronic HIV infection, long-term use of combined antiretroviral treatment (CART), aging, genetic predisposition, or a combination of these factors, and may increase morbidity and mortality in this population.To determine if changes in soluble and cell-associated insulin receptor (IR) levels, IR substrate-1 (IRS-1) levels, and IRS-1 tyrosine phosphorylation are associated with the presence and severity of HAND in a cohort of HIV-seropositive women.This is a retrospective cross-sectional study using patient database information and stored samples from 34 HIV-seropositive women and 10 controls without history of diabetes from the Hispanic-Latino Longitudinal Cohort of Women. Soluble IR subunits [sIR, ectodomain (α) and full-length or intact (αβ)] were assayed in plasma and CSF samples by ELISA. Membrane IR levels, IRS-1 levels, and IRS-1 tyrosine phosphorylation were analyzed in CSF white cell pellets (WCP) using flow cytometry. HIV-seropositive women had significantly increased levels of intact or full-length sIR in plasma (p<0.001) and CSF (p<0.005) relative to controls. Stratified by HAND, increased levels of full-length sIR in plasma were associated with the presence (p<0.001) and severity (p<0.005) of HAND. A significant decrease in IRS-1 tyrosine-phosphorylation in the WCP was also associated with the presence (p<0.02) and severity (p<0.02) of HAND.This study provides evidence that IR secretion is increased in HIV-seropositive women, and increased IR secretion is associated with cognitive impairment in these women. Thus, IR dysfunction may have a role in the progression of HAND and could represent a biomarker for the presence and severity of HAND

Workplace Incivility and Employee Sleep: The Role of Rumination and Recovery Experiences

This study examines the role of negative work rumination and recovery experiences in explaining the association between workplace incivility and employee insomnia symptoms. Drawing on the perseverative cognition model of stress and the effort–recovery model, we hypothesize a moderated mediation model in which workplace incivility is associated with insomnia symptoms via negative work rumination. This indirect effect is proposed to be conditional on employees’ reported level of recovery experiences (i.e., psychological detachment from work and relaxation during nonwork time). In examining this model, we further establish a link between workplace incivility and sleep and identify one pathway to explain this relationship, as well as resources that may be used to halt the negative spillover of workplace incivility on sleep. Based on a sample of 699 U.S. Forest Service employees, we find support for a moderated mediation model in which the association between workplace incivility and increased insomnia symptoms via increased negative work rumination was weakest for employees reporting high levels of recovery experiences during nonwork time. Findings from the current study contribute to our understanding of why workplace incivility is associated with nonwork outcomes, as well as point to implications for interventions aimed at promoting employees’ recovery from work

Linking Workplace Aggression to Employee Well-Being and Work: The Moderating Role of Family-Supportive Supervisor Behaviors (FSSB)

Purpose: The present study examined the moderating effects of family-supportive supervisor behaviors (FSSB) on the relationship between two types of workplace aggression (i.e., patient-initiated physical aggression and coworker-initiated psychological aggression) and employee well-being and work outcomes. Methodology: Data were obtained from a field sample of 417 healthcare workers in two psychiatric hospitals. Hypotheses were tested using moderated multiple regression analyses. Findings: Psychiatric care providers’ perceptions of FSSB moderated the relationship between patient-initiated physical aggression and physical symptoms, exhaustion and cynicism. In addition, FSSB moderated the relationship between coworker-initiated psychological aggression and physical symptoms and turnover intentions. Implications: Based on our findings, family-supportive supervision is a plausible boundary condition for the relationship between workplace aggression and well-being and work outcomes. This study suggests that, in addition to directly addressing aggression prevention and reduction, family-supportive supervision is a trainable resource that healthcare organizations should facilitate to improve employee work and well-being in settings with high workplace aggression. Originality: This is the first study to examine the role of FSSB in influencing the relationship between two forms of workplace aggression: patient-initiated physical and coworker-initiated psychological aggression and employee outcomes

Better Work for a Better Weekend: Relationships Between Job Performance, Positive Affect, and Pleasurable Weekend Experiences

Weekends provide many employees with opportunities to unwind from work demands and replenish resources, thereby fostering well-being and enhancing performance capacity. Despite some organizations’ efforts to facilitate employee unwinding during weekends, the choice and responsibility over weekend experiences lies with employees themselves. The current study draws on the success resource model of job stress and work-family enrichment theory to explore links between employee job performance, positive affect, and pleasurable weekend experiences. A time-lagged mediation model in which self-reported task performance and proactive performance during the workweek were associated with weekend positive affect and pleasurable weekend experiences via positive affect during the workweek was hypothesized. Results from 229 preschool teachers indicated support for the proposed mediation model. Task performance and proactive performance were significantly directly associated with pleasurable weekend experiences, although not significantly associated with weekend positive affect. Task performance and proactive performance were both significantly positively associated with weekend positive affect and pleasurable weekend experiences via positive affect during the workweek. Thus, creating opportunities for employees to experience achievement during the workweek and reflect on work accomplishments at the end of the workweek may facilitate positive affect and pleasurable experiences during the weekend