Background. Although the prevalence of work-limiting diseases is increasing, the interplay between occupational exposures and chronic medical conditions remains largely uncharacterized. Research has shown the detrimental effects of workplace bullying but very little is known about the humanistic and productivity cost in victims with chronic illnesses. We sought to assess work productivity losses and health disutility associated with bullying among subjects with chronic medical conditions. Methods. Participants (N = 1717) with chronic diseases answered a self-administered survey including sociodemographic and clinical data, workplace bullying experience, the SF-12 questionnaire, and the Work Productivity Activity Impairment questionnaire. Results. The prevalence of significant impairment was higher among victims of workplace bullying as compared to nonvictims (SF-12 PCS: 55.5% versus 67.9%, p < 0.01; SF-12 MCS: 59.4% versus 74.3%, p < 0.01). The adjusted marginal overall productivity cost of workplace bullying ranged from 13.9% to 17.4%, corresponding to Italian Purchase Power Parity (PPP) 2010 US$ 4182–5236 yearly. Association estimates were independent and not moderated by concurrent medical conditions. Conclusions. Our findings demonstrate that the burden on workers' quality of life and productivity associated with workplace bullying is substantial. This study provides key data to inform policy-making and prioritize occupational health interventions.

Background: In order to ensure quality and safety of prescriptions, electronic medication management system needs to comply with medication safety requirements and human factors principles. The design of such a system can make the difference on physician acceptance and consequently on medication safety. The aim of the study is to evaluate to what extent the changes in the design of the electronic medication management system may affect the rate of medication errors. Materials and method:In light of the growing development of computerized systems in health services it has become necessary to design electronic medication management system for drug prescription and administration compliant with the requirements of medication safety practices.Prescription data relative to 100 patients admitted to the Cardiothoracic Department of the Gabriele Monasterio Foundation Heart Hospital (FTGM) were extracted from the computerized medical notes from March 2013 until May 2013. The prescriptions examined had been written using the electronic documentation prompt without structured entry fields. All prescriptions were evaluated using the medication safety requirements of the medication safety practice developed by the Centre for Patient Safety of the Regional Department of Health in Tuscany, Italy. The same prescriptions were then simulated using the novel electronic medication management module and reassessed according to the safety requirements. Results:Of the 4112 prescriptions pertaining to the 100 study patients analyzed, 88.5% were found to be erroneous or incomplete. In particular 46.8% did not include the route of administration, 29.4% the pharmaceutical form, 10.6% the number of administrations per day and/or the time of administration, in 8.2% the dose was not defined and 4.9% did not include the active pharmaceutical agent or trade name. 14.9% were considered with high potential for harm. The same prescriptions simulated through the novel electronic module were 99.1% correct and complete. Conclusions:The ergonomic design of the module for electronic prescription meets the medication safety requirements and has a role in reducing drug errors and enhancing the safety of the workflow. The module introduced structured fields pertaining the type of drug being prescribed which were positively embodied in the routine and produced a significant reduction of prescription errors. Journal of PharmacovigilanceJou rn a l o f P harma c o v ig il a nc e