Quality of Life, Insomnia and Coping Strategies during COVID-19 Pandemic in Hospital Workers. A Cross-Sectional Study

COVID-19 became a pandemic in a few months, leading to adverse health outcomes, reducing the quality of life, affecting the sleep/wake cycle, and altering coping strategies, especially among hospital personnel. Life quality, insomnia, and coping strategies were thus assessed among hospital personnel during the first wave of the COVID-19 pandemic in Italy. This cross-sectional study was conducted from May to November 2020 through an online survey. There were 558 participants (28.5% males and 71.5% females) enrolled in two different metropolitan areas (in North and South of Italy, respectively). Three standardized questionnaires were administered: European Quality of life–5 Dimensions (EQ-5D), Athens Insomnia Scale (AIS), and Brief COPE. Differences in sociodemographic characteristics and work-related factors were also investigated in order to identify possible predictors through a generalized linear model and logistic regression analysis. Results showed good perceived life quality and high insomnia prevalence. After sample stratification, the statistical analysis highlighted that personal (gender, age, educational level) and work-related factors (employment in COVID wards, remote working) played different roles in predicting quality of life, insomnia, and coping attitude. Active, Planning, and Acceptance were the most frequently adopted coping strategies. Despite women confirming their attitude in reacting to the difficulties, adopting emotion-focused coping strategies, they showed a higher probability to develop insomnia, so a gender perspective should be considered in the health protection of this working category. An integrated approach should be implemented at individual, interpersonal and organizational levels aiming to monitor psychological distress, favor regular sharing and communication between peers, and also allow conciliation of work with family life. At the organizational level, preventive and protective measures adequate to work-related risk to COVID-19 should be adopted

Per l'edizione critica di "In portineria" di Giovanni Verga. I manoscritti conservati presso il Fondo Verga dea Biblioteca Regionale Universitaria di Catania

In merito al tema della valorizzazione del patrimonio culturale presente negli Archivi e nelle Fondazioni del territorio siciliano, questo progetto studia i manoscritti teatrali di Giovanni Verga inerenti al dramma In portineria, acquisiti dalla Regione Siciliana e conservati in originale presso la Biblioteca Regionale Universitaria di Catania e in copia presso la Fondazione G. Verga , istituita nel 1978. Considerato pertanto il Teatro quale bene culturale immateriale , il punto naturale di arrivo di una rivalutazione complessiva di questo materiale è l edizione critica delle opere per il teatro, edizione che ambisce a confluire nel più ampio progetto dell Edizione Nazionale delle opere di Verga, promossa dalla Fondazione G. Verga . Il dramma In portineria è uno dei testi più ricco di testimoni manoscritti, sebbene pervenutici in uno stato di disordine. La Biblioteca Regionale Universitaria di Catania possiede sei manoscritti autografi ma non integrali e tre copie di altra mano con correzioni d autore; tutti testimoni attendibili . La ricerca si è concentrata sull archivio dei documenti presenti presso la Biblioteca Regionale Universitaria di Catania e, in copia, presso la Fondazione G. Verga . Condizione preliminare è stata la conoscenza della tradizione di ogni singolo testo oggetto della ricerca al fine di individuare nell immediato i termini concreti delle problematiche relative ai manoscritti da esaminare e di tracciare un piano specifico per poterle affrontare. Seguendo questa metodologia è possibile stabilire il numero e le caratteristiche dei differenti stati redazionali, la loro rappresentanza nella tradizione superstite, il loro valore di testimoni in direzione e della restituzione del testo e di una storia dell elaborazione testuale sub specie philologica

Granular cell tumor of the appendix: a new case and review of the literature

Granular cell tumor (GCT) is a rare and usually benign lesion of neural / schwannian origin, most frequently found in middle-age women. The appendicular involvement is extremely rare: in over half a century only twelve cases have been reported in the literature, the patients living in America and Europe. Hitherto, no cases are documented from Africa, Asia and Oceania and no cases of malignant GCTs of the appendix have been reported. Most patients were diagnosed preoperatively as having acute appendicitis, whereas in three patients the tumor was incidentally detected during major abdominal surgery. The GCTs were equally distributed between mid-appendix and tip, where lymphoid tissue is more abundant and the anatomical nerve supply is progressively reduced. Moreover, the appendix surrounding the GCTs is characterized by the presence of chronic inflammatory cells (histiocytes, plasmocytes, eosinophils, mastocytes) and, therefore, a chronic inflammation of the appendix may be an antecedent condition favouring the appearance of GCTs. The GCT of the appendix appears so to be a lesion that reflects local reactive changes in the neural / schwannian cells, rather than being a genuine neoplasm. We describe the smallest GCT of the appendix ever reported, with a detailed literature review supporting its reactive origin in the lymphatic tissue-rich sites, such as ileo cecal appendix

On The Synchronic Structure of Transition Systems

Net Theory was introduced in the early sixties by Carl Adam Petri [Pet] as a form of general system theory based on the notion of concurrency. Net Theory has been widely developed during these years, becoming very popular as a framework for the analysis and specification of concurrent systems. Among the basic notions of the theory, stands the synchronic structure of a system. It characterizes dependencies between sets of its events in terms of a distance measuring their degree of synchronization. In this paper we show that a natural generalization of regions introduced by Ehrenfeucht and Rozenberg exactly corresponds to synchronic distances and that this notion of region can be used to axiomatise a class of transition systems corresponding to bounded place/transition nets without loops. 1 Introduction Net theory has been introduced in the early sixties by Carl Adam Petri [Pet] with the purpose of providing a conceptual tool to derive "global system properties from given local properti..

Salivary Biomarkers and Work-Related Stress in Night Shift Workers

Work organization, such as shifts and night work, can interfere with the perception of work-related stress and therefore on the development of pathological conditions. Night shift work, particularly, can have a negative impact on workers’ wellbeing by interfering with the biological sphere. The aim of this study is to evaluate the associations between work activities, shift work effects and stress-related responses in 106 dock workers enrolled in southeast Italy. Dock workers’ tasks consist of complex activities that seemed to affect more sleep quality than work-related stress. An analysis of salivary biomarkers such as cortisol, α-amylase, melatonin and lysozyme was performed along with validated psycho-diagnostic questionnaires. Alpha-amylase showed a significant negative correlation with the effort/reward imbalance score; thus, the measurement of salivary α-amylase is proposed as a sensitive and non-invasive biomarker of work-related stress. This study may provide new insights into developing strategies for the management of night shift work. Salivary biomarkers should be further investigated in the future in order to develop simple and effective tools for the early diagnosis of work-related stress or its outcomes

Commento di Sebastiano Taccola a Un’età contro la storia. Saggio sulla rivoluzione del XXI secolo

“Where can we possible deduce the coherent systematic dialectical nature, of the historical time from? what aspects can we infer the dialectical status of the historical time, without which it could be normalized and assumed as a nature law from?” In his comment to Giuseppe Carlo Marino’s essay about the globalization and crisis of “historical thought”, Sebastiano Taccola asks these questions by giving us important starting points of the changes and developments of the relationships between men thought and sense of history

A machine learning approach to predict healthcare-associated infections at intensive care unit admission: findings from the SPIN-UTI project

BACKGROUND: Identifying patients at higher risk of healthcare-associated infections (HAIs) in intensive care unit (ICU) represents a major challenge for public health. Machine learning could improve patient risk stratification and lead to targeted infection prevention and control interventions.AIM: To evaluate the performance of the Simplified Acute Physiology Score (SAPS) II for HAIs risk prediction in ICUs, using both traditional statistical and machine learning approaches.METHODS: We used data of 7827 patients from the "Italian Nosocomial Infections Surveillance in Intensive Care Units" project. The Support Vector Machines (SVM) algorithm was applied to classify patients according to sex, patient origin, non-surgical treatment for acute coronary disease, surgical intervention, SAPS II at admission, presence of invasive devices, trauma, impaired immunity, antibiotic therapy in 48 hours before ICU admission.FINDINGS: The performance of SAPS II for predicting the risk of HAIs provides a ROC (Receiver Operating Characteristics) curve with an AUC (Area Under the Curve) of 0.612 (p<0.001) and an accuracy of 56%. Considering SAPS II along with other characteristics at ICU admission, we found an accuracy of the SVM classifier of 88% and an AUC of 0.90 (p<0.001) for the test set. In line, the predictive ability was lower when considering the same SVM model but removing the SAPS II variable (accuracy= 78% and AUC= 0.66).CONCLUSIONS: Our study suggested the SVM model as a tool to early predict patients at higher risk of HAI at ICU admission

Effects on the incidence of cardiovascular events of the addition of pioglitazone versus sulfonylureas in patients with type 2 diabetes inadequately controlled with metformin (TOSCA.IT): a randomised, multicentre trial

Background The best treatment option for patients with type 2 diabetes in whom treatment with metformin alone fails to achieve adequate glycaemic control is debated. We aimed to compare the long-term effects of pioglitazone versus sulfonylureas, given in addition to metformin, on cardiovascular events in patients with type 2 diabetes. Methods TOSCA.IT was a multicentre, randomised, pragmatic clinical trial, in which patients aged 50\ue2\u80\u9375 years with type 2 diabetes inadequately controlled with metformin monotherapy (2\ue2\u80\u933 g per day) were recruited from 57 diabetes clinics in Italy. Patients were randomly assigned (1:1), by permuted blocks randomisation (block size 10), stratified by site and previous cardiovascular events, to add-on pioglitazone (15\ue2\u80\u9345 mg) or a sulfonylurea (5\ue2\u80\u9315 mg glibenclamide, 2\ue2\u80\u936 mg glimepiride, or 30\ue2\u80\u93120 mg gliclazide, in accordance with local practice). The trial was unblinded, but event adjudicators were unaware of treatment assignment. The primary outcome, assessed with a Cox proportional-hazards model, was a composite of first occurrence of all-cause death, non-fatal myocardial infarction, non-fatal stroke, or urgent coronary revascularisation, assessed in the modified intention-to-treat population (all randomly assigned participants with baseline data available and without any protocol violations in relation to inclusion or exclusion criteria). This study is registered with ClinicalTrials.gov, number NCT00700856. Findings Between Sept 18, 2008, and Jan 15, 2014, 3028 patients were randomly assigned and included in the analyses. 1535 were assigned to pioglitazone and 1493 to sulfonylureas (glibenclamide 24 [2%], glimepiride 723 [48%], gliclazide 745 [50%]). At baseline, 335 (11%) participants had a previous cardiovascular event. The study was stopped early on the basis of a futility analysis after a median follow-up of 57\uc2\ub73 months. The primary outcome occurred in 105 patients (1\uc2\ub75 per 100 person-years) who were given pioglitazone and 108 (1\uc2\ub75 per 100 person-years) who were given sulfonylureas (hazard ratio 0\uc2\ub796, 95% CI 0\uc2\ub774\ue2\u80\u931\uc2\ub726, p=0\uc2\ub779). Fewer patients had hypoglycaemias in the pioglitazone group than in the sulfonylureas group (148 [10%] vs 508 [34%], p<0\uc2\ub70001). Moderate weight gain (less than 2 kg, on average) occurred in both groups. Rates of heart failure, bladder cancer, and fractures were not significantly different between treatment groups. Interpretation In this long-term, pragmatic trial, incidence of cardiovascular events was similar with sulfonylureas (mostly glimepiride and gliclazide) and pioglitazone as add-on treatments to metformin. Both of these widely available and affordable treatments are suitable options with respect to efficacy and adverse events, although pioglitazone was associated with fewer hypoglycaemia events. Funding Italian Medicines Agency, Diabete Ricerca, and Italian Diabetes Society

Antihypertensive treatment changes and related clinical outcomes in older hospitalized patients

Background: Hypertension management in older patients represents a challenge, particularly when hospitalized. Objective: The objective of this study is to investigate the determinants and related outcomes of antihypertensive drug prescription in a cohort of older hospitalized patients. Methods: A total of 5671 patients from REPOSI (a prospective multicentre observational register of older Italian in-patients from internal medicine or geriatric wards) were considered; 4377 (77.2%) were hypertensive. Minimum treatment (MT) for hypertension was defined according to the 2018 ESC guidelines [an angiotensin-converting-enzyme-inhibitor (ACE-I) or an angiotensin-receptor-blocker (ARB) with a calcium-channel-blocker (CCB) and/or a thiazide diuretic; if >80 years old, an ACE-I or ARB or CCB or thiazide diuretic]. Determinants of MT discontinuation at discharge were assessed. Study outcomes were any cause rehospitalization/all cause death, all-cause death, cardiovascular (CV) hospitalization/death, CV death, non-CV death, evaluated according to the presence of MT at discharge. Results: Hypertensive patients were older than normotensives, with a more impaired functional status, higher burden of comorbidity and polypharmacy. A total of 2233 patients were on MT at admission, 1766 were on MT at discharge. Discontinuation of MT was associated with the presence of comorbidities (lower odds for diabetes, higher odds for chronic kidney disease and dementia). An adjusted multivariable logistic regression analysis showed that MT for hypertension at discharge was associated with lower risk of all-cause death, all-cause death/hospitalization, CV death, CV death/hospitalization and non-CV death. Conclusions: Guidelines-suggested MT for hypertension at discharge is associated with a lower risk of adverse clinical outcomes. Nevertheless, changes in antihypertensive treatment still occur in a significant proportion of older hospitalized patients