Work activities at increased risk of traumatic injuries: an integrated preventive approach

Included in the scope of workplace safety is that relating to potential accidents, i.e. the harmful consequences for human health crossed with the work environment factor. In the study of the determinism of these accidental events, it is important to achieve a biomechanical balance between two main elements: the human and the work environment (consisting of the physical, chemical and environmental factors, i.e. the equipment and what generates its use). Considering the most recent statistically recorded incidents, our analysis has focused on the accident sphere proper, where an imbalance in the above-mentioned binomial triggers the activation of multiple disciplines that actively and pro-actively study the event and assess its sequelae, in all possible facets (economic, engineering, clinical, medical-legal)

Acute pulmonary edema induced by non-ionic low-osmolar radiographic contrast media.

Non-cardiogenic pulmonary edema (NCPE) after intravenous (iv) administration of non-ionic radiocontrast media (RCM) is a rare but life-threatening complication. In a context of emergency, its diagnosis is difficult. We report the case of a 55-year-old woman who developed an acute pulmonary edema following iv infusion of non-ionic, low-osmolar RCM during abdominal CT scan. She needed a 24-hour hospitalization in intensive care unit for an acute hypoxemic dyspnea. She was falsely treated at first for an anaphylactic reaction, and then for a cardiac failure. She improved with cortisone and diuretic treatment. Although NCPE has been rarely reported after RCM injection, it remains an acute severe complication that has to be considered. The differential diagnosis involves multiple pathogenic patterns giving furthermore complexity in choosing an appropriate treatment

Sex-specific tonic 2-arachidonoylglycerol signaling at inhibitory inputs onto dopamine neurons of Lister Hooded rats

Addiction as a psychiatric disorder involves interaction of inherited predispositions and environmental factors. Similarly to humans, laboratory animals self-administer addictive drugs, whose appetitive properties result from activation and suppression of brain reward and aversive pathways, respectively. The ventral tegmental area (VTA) where dopamine (DA) cells are located is a key component of brain reward circuitry, whereas the rostromedial tegmental nucleus (RMTg) critically regulates aversive behaviors. Reduced responses to either aversive intrinsic components of addictive drugs or to negative consequences of compulsive drug taking might contribute to vulnerability to addiction. In this regard, female Lister Hooded (LH) rats are more vulnerable than male counterparts to cannabinoid self-administration. We, therefore, took advantage of sex differences displayed by LH rats, and studied VTA DA neuronal properties to unveil functional differences. Electrophysiological properties of DA cells were examined performing either single cell extracellular recordings in anesthetized rats or whole-cell patch-clamp recordings in slices. In vivo, DA cell spontaneous activity was similar, though sex differences were observed in RMTg-induced inhibition of DA neurons. In vitro, DA cells showed similar intrinsic and synaptic properties. However, females displayed larger depolarization-induced suppression of inhibition (DSI) than male LH rats. DSI, an endocannabinoid-mediated form of short term plasticity, was mediated by 2-arachidonoylglycerol (2-AG) activating type 1-cannabinoid (CB1) receptors. We found that sex-dependent differences in DSI magnitude were not ascribed to CB1 number and/or function, but rather to a tonic 2-AG signaling. We suggest that sex specific tonic 2-AG signaling might contribute to regulate responses to aversive intrinsic properties to cannabinoids, thus resulting in faster acquisition/initiation of cannabinoid taking and, eventually, in progression to addiction

Cardiac output monitoring during abdominal aortic cross clamping: a comparison between Vigileo/FloTrac system and transoesophageal Doppler

Cardiac output (CO) monitoring is one of the key points in the hemodynamic evaluation of critically ill patients, and can be useful in various settings of high-risk surgery. There is a lack of evidence that the extensive use of invasive devices in the hemodynamic monitoring has a good impact in terms of outcome [1], and less invasive systems have been proposed. Our aim was to compare the CO estimated by Vigileo/FloTrac with the blood flow in thoracic aorta as measured by transoesophageal Doppler in patients undergoing open abdominal aortic aneurysm repair, during the aortic cross-clamping (AoX) phase. We have measured the Augmentation Index (AI), a parameter related to vascular stiffness, using the applanation tonometry method, in order to have a better understanding of the effect of AoX on blood pressure waves. Methods We enrolled 10 consecutive patients (10 men; age 66 \ub1 6 years) undergoing elective open AAA repair (ASA II to III) under general anesthesia. Radial arterial access was used for semi-invasive determination of blood pressures and CO (APCO) with the Vigileo. An esophageal Doppler was positioned after clinical stabilization. Applanation tonometry was measured just before and after the aortic clamping. Results We found a significant (P < 0.05) increase in CO reported by Vigileo/FloTrac system in the post-clamping phase, when compared with the pre-clamping and basal phases, while the blood flow in thoracic aorta resulted decreased, according with the theory of redistribution of fluids in the splanchnic venous vasculature [2]. There was an important contribution of the wave reflection to the aortic pulse pressure wave after the AoX, as expressed by a significant increase in the AI. Conclusions The Vigileo/FloTrac system appears to overestimate CO after AoX when compared with the measure of blood flow in thoracic aorta, and this result could be influenced by the pulse pressure wave reflection occurring after clamping. In high-risk surgical settings, other situations of rapid change of systemic resistance vessels could be similarly misread, thus suggesting the necessity of a more tailored Vigileo algorithm

The JDCS model and blue-collar bullying: Decent working conditions for a healthy environment

Violence in the workplace and its health consequences still represent one of the main obstacles to obtaining decent working conditions. In particular, blue-collar workers run a greater risk of experiencing episodes of violence, also because of a lack of autonomy and fewer social interactions. According to the work environment hypothesis, factors such as high workload, lack of social support and lack of job control represent the antecedents of workplace bullying. Following the job demand-control-support model (JDCS), violence can be the symptom of a high-strain environment. Moreover, it is still unclear if workplace bullying can mediate the effects of work-related stress on workers&rsquo; health outcomes. The aim of the present study is to analyse the relationship between the components of the JDCS and the health of the workers considering workplace bullying as a mediating variable. By a cross sectional study design, we tested the following theoretical hypotheses: first, JDCS components (conceptualized as stress) are supposed to significantly predict the level of workers&rsquo; health. Second, workplace bullying is supposed to mediate the relationship between the JDCS components and the level of health. The sample consists of 400 blue-collars from three different Italian companies. Work-related stress, health outcomes and workplace bullying were measured by specific self-administered questionnaires and the relationships between the variables of interest were tested through a structural equation model (SEM) analysis. The results showed that while the direct relationship between the components of the JDCS and the level of psychological health is weaker (standardized path coefficients SPC = 0.21), the partial mediation hypothesis shows that workplace bullying mediate the relationship between JDCS components and health outcomes (&chi;2/df ratio = 2.70; path from stress to workplace bullying SPC = 0.78; path from workplace bullying to general health SPC = 0.51; p = 0.01). The JDCS components (workload, lack of control, lack of support) are useful predictors for workplace bullying. On the other hand, bullying plays a mediating role between the stress experienced and the health consequences. The present study adds new insights into the relationship between violence seen as a form of social behavioural strain and the psychological health of workers. The theoretical and practical implications are discussed. Future research on blue-collars could use longitudinal designs in order to analyse the relationship between social environment, job design and strain reactions

Submarine Geomorphology of the Southwestern Sardinian Continental Shelf (Mediterranean Sea): Insights into the Last Glacial Maximum Sea-Level Changes and Related Environments

During the lowstand sea-level phase of the Last Glacial Maximum (LGM), a large part of the current Mediterranean continental shelf emerged. Erosional and depositional processes shaped the coastal strips, while inland areas were affected by aeolian and fluvial processes. Evidence of both the lowstand phase and the subsequent phases of eustatic sea level rise can be observed on the continental shelf of Sardinia (Italy), including submerged palaeo-shorelines and landforms, and indicators of relict coastal palaeo-environments. This paper shows the results of a high-resolution survey on the continental shelf off San Pietro Island (southwestern Sardinia). Multisensor and multiscale data\u2014obtained by means of seismic sparker, sub-bottom profiler chirp, multibeam, side scan sonar, diving, and uncrewed aerial vehicles\u2014made it possible to reconstruct the morphological features shaped during the LGM at depths between 125 and 135 m. In particular, tectonic controlled palaeo-cliffs affected by landslides, the mouth of a deep palaeo-valley fossilized by marine sediments and a palaeo-lagoon containing a peri-littoral thanatocenosis (18,983 \ub1 268 cal BP) were detected. The Younger Dryas palaeo-shorelines were reconstructed, highlighted by a very well preserved beachrock. The coastal paleo-landscape with lagoon-barrier systems and retro-littoral dunes frequented by the Mesolithic populations was reconstructed

COVID-19-related mental health effects in the workplace: A narrative review

The Coronavirus Disease 2019 (COVID-19) pandemic has deeply altered social and working environments in several ways. Social distancing policies, mandatory lockdowns, isolation periods, and anxiety of getting sick, along with the suspension of productive activity, loss of income, and fear of the future, jointly influence the mental health of citizens and workers. Workplace aspects can play a crucial role on moderating or worsening mental health of people facing this pandemic scenario. The purpose of this literature review is to deepen the psychological aspects linked to workplace factors, following the epidemic rise of COVID-19, in order to address upcoming psychological critical issues in the workplaces. We performed a literature search using Google Scholar, PubMed, and Scopus, selecting papers focusing on workers' psychological problems that can be related to the workplace during the pandemic. Thirty-five articles were included. Mental issues related to the health emergency, such as anxiety, depression, post-traumatic stress disorder (PTSD), and sleep disorders are more likely to affect healthcare workers, especially those on the frontline, migrant workers, and workers in contact with the public. Job insecurity, long periods of isolation, and uncertainty of the future worsen the psychological condition, especially in younger people and in those with a higher educational background. Multiple organizational and work-related interventions can mitigate this scenario, such as the improvement of workplace infrastructures, the adoption of correct and shared anti-contagion measures, including regular personal protective equipment (PPE) supply, and the implementation of resilience training programs. This review sets the basis for a better understanding of the psychological conditions of workers during the pandemic, integrating individual and social perspectives, and providing insight into possible individual, social, and occupational approaches to this "psychological pandemic"

Emerging Issues in Occupational Disease: Mental Health in the Aging Working Population and Cognitive Impairment - A Narrative Review

Cognitive impairment has often been reported in scientific literature as a concern derived from chronic exposure to work-related stress. Organizational factors can contribute to the onset of this concern especially in a susceptible population such as elderly workers. The aim of our study was to review the last five years of scientific literature, focusing on experimental and epidemiological studies, possible mechanisms implicated in the onset of cognitive decline due to work-related stress, and the recent organizational strategies to prevent detrimental effects of stress on cognitive processes. A literature search was performed in scientific platforms Medline and Web of Science, by means of specific string search terms, restricting the search to the years of publication 2014–2019. Thirty-three articles were identified and qualitatively evaluated, reporting narratively the main point of interest. At this stage, six articles were excluded because they did not meet the inclusion criteria. Only a few articles considered the population of the elderly workers, often with a short follow-up period. Strategies to manage stress with organizational procedures are scarce. Mechanisms implicated in the development of cognitive impairment due to stress are not fully explained and seem to include a chronical decrease in the inhibitory process of neurological pathways. Further research that focused on strategies to manage stress in elderly workers, with the aim of preventing cognitive impairment processes, is warranted

Emerging Issues in Occupational Disease: Mental Health in the Aging Working Population and Cognitive Impairment - A Narrative Review

Cognitive impairment has often been reported in scientific literature as a concern derived from chronic exposure to work-related stress. Organizational factors can contribute to the onset of this concern especially in a susceptible population such as elderly workers. The aim of our study was to review the last five years of scientific literature, focusing on experimental and epidemiological studies, possible mechanisms implicated in the onset of cognitive decline due to work-related stress, and the recent organizational strategies to prevent detrimental effects of stress on cognitive processes. A literature search was performed in scientific platforms Medline and Web of Science, by means of specific string search terms, restricting the search to the years of publication 2014-2019. Thirty-three articles were identified and qualitatively evaluated, reporting narratively the main point of interest. At this stage, six articles were excluded because they did not meet the inclusion criteria. Only a few articles considered the population of the elderly workers, often with a short follow-up period. Strategies to manage stress with organizational procedures are scarce. Mechanisms implicated in the development of cognitive impairment due to stress are not fully explained and seem to include a chronical decrease in the inhibitory process of neurological pathways. Further research that focused on strategies to manage stress in elderly workers, with the aim of preventing cognitive impairment processes, is warranted