A Cross-Sectional Survey on Burnout Prevalence and Profile in the Sicilian Population of Ambulance Driver-Rescuers

Introduction: Burnout is present at a high rate in emergency medicine. The ambulance driver-rescuers, who furnish first aid to the victims, are the non-medical part of the Italian 118-service staff. There is a lack of research on burnout risk in Italian Emergency Medical Services and, particularly, for this category of workers. The two Italian studies, including a little group of ambulance driver-rescuers, reported inconsistent findings. Hypothesis: This survey investigated for the first time the prevalence and exact profile of burnout in a large sample of Italian driver-rescuers. As a secondary aim, the study described how the items of the Italian version of the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) cluster in components in this sample. Methods: This cross-sectional census survey was conducted from June 2015 through May 2016 and involved all the driver-rescuers operating in Sicily, the biggest and most southern region of Italy. The subjects received a classification according to different profiles of burnout by using the Italian version of the MBI-HSS (burnout, engagement, disengagement, over-extension, and work-inefficacy). In order to explore the existence of independent factors, a Principal Component Analysis (PCA) was conducted on the survey to obtain eigenvalues >one for each component in the data. Results: The final sample comprised 2,361 responders (96.6% of the initial sample). Of them, 29.8% were in burnout (95% confidence interval [CI], 27.8% to 31.8%) and 1.7% presented a severe form (95% CI, 1.1% to 2.3%); 30.0% were engaged in their work (95% CI, 21.0% to 34.8%), 24.7% of responders were disengaged (95% CI, 22.9% to 26.5%), 1.2% presented an over-extension profile (95% CI, 0.8% to 1.7%), and 12.6% felt work-inefficacy (95% CI, 11.3% to 14.1%). The factors loaded into a five-factor solution at PCA, explaining 48.1% of the variance and partially replicating the three-factor structure. The Emotional Exhaustion (EE) component was confirmed. New dimensions from Personal Accomplishment (PA) and Depersonalization (DP) sub-scales described empathy and disengagement with patients, respectively, and were responsible for the increased risk of burnout. Conclusions: These results endorse the importance of screening and psychological interventions for this population of emergency workers, where burnout could manifest itself more insidiously. It is also possible to speculate that sub-optimal empathy skills could be related to the disengagement and work-inefficacy feelings registered

Chemometric Approaches to Analyse the Composition of a Ewe’s Colostrum

Colostrum is a major source of immunity in lambs and, in general, in all newborn ruminants. It allows the transfer of antibodies from the ewe to the lamb, and it becomes the exclusive source of nutrients for a newborn. Among the most significant Pearson correlations, the positive correlation between the Brix refractive index (Brix) and protein (0.90) should be noted. Both parameters (protein percentage and Brix) were then positively correlated with the percentage of fat (0.38 and 0.41), urea (0.81 and 0.67), calcium (0.39 and 0.29), and magnesium (0.58 and 0.59), as well as the yellowness (0.78 and 0.75). Somatic cell count (SCC) and pH, parameters which are indicators of subclinical mastitis, were positively correlated (0.49), and SCC was positively correlated with sodium (0.37) and negatively correlated with potassium (−0.28). Among the macroelements in colostrum—calcium, potassium, magnesium, and sodium—the correlations were largely positive. With respect to the colour parameters, yellowness was negatively correlated with lightness (−0.41) and redness (−0.45). The factor analysis split the total of variance into three latent factors. The first factor was named “Colostrum quality of grazing sheep” because it was positively correlated primarily with SCC, pH, Poly Unsatured Fatty Acids (PUFA), and the sum of the omega-3 Fatty Acids (FAs). The second factor, named “Good quality colostrum”, was positively correlated primarily with the refractive index, protein and fat percentages, urea content, phosphorus, Mono Unsatured Fatty Acids (MUFA), and yellowness. The third factor was positively correlated primarily with calcium, potassium, magnesium, and sodium, and it was therefore termed “Mineral component of colostrum”. Stepwise discriminant analysis showed that the protein percentage, calcium, and magnesium were able to explain more than 85% of the Brix refractive index, which remains a good parameter for simply evaluating the nutritional quality of sheep colostrum at the level of a farm

Psychological assessment in pathological gamblers treated with escitalopram

Pathological Gambling (PG) is classified as a "Disorder of Impulse Control", but due to similarities with drug addiction is frequently described as a drug-free addiction (Potenza et al., 2012). PG is conceptualized as a behavioural addiction because of its neurobiologic, neurophysiologic and psychological features. Current therapeutical approaches seem unsatisfactory as they do not achieve definitive positive outcomes. Considering the well known psycopathological comorbidities, PG represents both a social (impact on relatives money/life) and a sanitary cost, in terms of pharmacological and psychological support. The compulsive behaviour detectable in PG, is a disease with neurophysiopathological basis now fairly well-defined which affects particularly vulnerable people. PG is linked to important changes in brain systems such as the prefrontal cortex, the nucleus accumbens, the endogenous opioid system and the extended amygdale. Recent fMRI studies associate PG with blunted mesolimbic activation to non-specific rewards, whereas increased prefrontal cortex, anterior cingulate and ventral striatum activation is observed during gambling-related cue-exposure paradigms. Several neuropsychological studies show higher impulsivity in PG (Odlaug BL. et al., 2013) that, together with specific psychopathological symptoms, such as anxiety and depressed mood, characterize different PG subtypes (Blaszczynski A, Nower L. 2002). Impulsivity transcends multiple psychiatric disorders and is thought to be central to impulse control disorders such as PG. Furthermore, many PGs suffers from depression and decreased mood

Helix aspersa aspersa flour: An evaluation for dietary supplementation

This study assesses the nutritional composition and safety of lab-produced snail flour derived from Helix aspersa aspersa, an herbivorous pulmonated gastropod mollusc that occupies various trophic levels in food chains. Our analysis focused on key nutritional aspects, including moisture, ash, protein, and fat contents. Contaminant analysis on the powder showed levels below detectable limits for PAHs, PCBs, PBDEs. The heavy metal concentration was found to be either on par with or lower than values reported in existing literature, indicating the safety of these snail powders for human consumption. Our results revealed a notable presence of polyunsaturated fatty acids and essential amino acids and strongly support the idea that snail powders can serve as sustainable protein sources in both human and animal diets

A 3-week feed restriction after weaning as an alternative to a medicated diet: effects on growth, health, carcass and meat traits of rabbits of two genotypes

Feed restriction after weaning is widely used in meat rabbit farms to promote health and reduce mortality, but this practice impacts negatively on rabbit growth and slaughter performance. This study compared a 3-week post-weaning feed restriction with ad libitum medicated feeding, evaluating effects on feed intake, growth, health, carcass and meat quality of rabbits of two genotypes: Italian White pure breed and Hycole hybrid×Italian White crossbred. A total of 512 rabbits at 36 days of age, of both sexes and two genotypes, were divided into four homogeneous groups assigned, from 36 to 57 days of age, to different feeding programmes (FP): restricted non-medicated (R-N), ad libitum non-medicated (L-N), restricted medicated (R-M) and ad libitum medicated (L-M). The diets were medicated with oxytetracycline (1540 mg/kg) and colistin sulphate (240 mg/kg). The restriction, performed by giving 70, 80 and 90 g/day of feed for the 1st, 2nd and 3rd week, was followed by ad libitum feeding in the successive 5 weeks, up to slaughter at 92 days of age. Restricted feeds were ingested at a level of 64% of the feed intake recorded in the ad libitum fed rabbits; it was significantly associated, regardless of medication and rabbit genotype, with a lower feed intake (−22 to −24 g dry matter/day) during the entire experiment, compensatory growth and a lower feed conversion ratio in the ad libitum period, and a lower final live weight (−150 g) than ad libitum feeding (P<0.001). During restriction, mortality was lower in the restricted rabbits (6.25%, 5.47% v. 12.5%, 14.8% for R-N, R-M, L-N and L-M; P<0.05), whereas in the ad libitum period mortality did not differ among the groups (9.23%, 9.90%, 11.0% and 4.59% for R-N, R-M, L-N and L-M). Dressing out percentage was not affected by FP or genotype; heavier carcasses were produced by rabbits fed ad libitum (+100 g; P<0.001) and crossbred rabbits (+122 g; P<0.001). Restriction did not alter meat quality, except for a tendency towards a higher cooking loss and less fat; crossbred meat was higher in L* (+1.3; P<0.01) and b* (+0.51; P<0.05) colour indexes and tenderness (−0.14 kg/cm2; P<0.05) than pure breed meat. Under the conditions of this study, a 3-week restricted feeding after weaning resulted to be a suitable alternative, also for high growth potential genotypes, to the antibiotics to preserve rabbit health. The production of lighter carcasses could be compensated partly by the lower feed conversion ratio showed by restricted rabbits

Effects of Grazing on the Behaviour, Oxidative and Immune Status, and Production of Organic Dairy Cows

Abstract: This study compared the eects of a short daily grazing time with those of permanent free-stall housing on the behaviour, oxidative status, immune response, and milk production of organically reared cows. During a 63-day period, two homogeneous groups of eight lactating Brown cows were allocated to either housing (H) in a free-stall building for 24 h/day. Feeding was based on a total mixed ration or grazing (G) on barley grass for 5 h/day, and housing in a free-stall structure with feeding was based on the same total mixed ration oered to the H group. With regard to behaviour, H cows spent more time idling, walking, drinking, and self-grooming, whereas G cows showed a greater intent to eat and interact socially. Moreover, G cows exhibited slightly higher reactive oxygen metabolites and similar biological antioxidant potential concentrations than the H group, which indicates that short grazing resulted in an almost negligible increase in oxidative stress and an unchanged antioxidant capacity. Skin tests, performed by injecting phytohemoagglutinin intradermally, indicated that G cows had thicker skin than H cows at the end of the trial, an index of a better cell-mediated immune response. Grazing did not aect milk yield but improved milk quality in terms of an increase in fat and a reduction in urea content, somatic cell count, and total microbial count. Milk from G cows was richer in saturated fatty acids, likely because of the contribution of palmitic acid present in the grazed barley grass, and also showed higher contents of some healthy fatty acids, such as rumenic acid and -linolenic acid, and a lower omega-6/omega-3 ratio. These results show that including a short grazing time in the diets of organic dairy cows does not have negative consequences for milk production and contributes to improved milk quality as well as to a more ecient immune response in the cow

Current challenges in the diagnosis and treatment of obstructive sleep apnea syndrome in the elderly

Obstructive sleep apnea syndrome (OSAS) is a respiratory sleep disorder characterized by repeated episodes of partial or complete obstruction of the upper airway that occur during the night. OSAS is a common disease in the elderly population with an estimated incidence of between 20% and 60% in people over the age of 65. Due to the high prevalence of OSAS in older people and considering the increase in the average age of the world population, it is essential to know how to diagnose and treat this disease in elderly patients

Effects of the foal at the milking and dietary supplementation with extra virgin olive oil on jennet milk production

The effects of the foal at the milking and the extra virgin olive oil supplementation in the diet, on the milk obtained by 12 Ragusana jennets were studied. The jennets were each fed 3.5+1.5 kg/d of concentrate+bran, and hay ad libitum. They were divided into 2 equal groups with one group receiving an additional dietary supplement of 100 ml/d of olive oil. Milk was collected at day 20 post foal- ing and every 15-18 d for 5 times. At each collection period jennets were milked 4-times per day. At 07:30 h foals were separated from the jennets and after a 4 hour interval were milked manually (1MNF;1st milking, foal absent). At the end of the 1MNF, each jennet was milked again, with the foals kept near the udder, but prevented from suckling (2MYF; 2nd milking, foal present). After 2MYF, foals were removed a second time and the sequence repeated after another 4 hour interval for the 3rd (3MNF) and 4th (4MYF) milkings. Milk yield was recorded at each milking and samples analyzed for qualitative variables. The milk yield was 26% higher than that reported by Giosue et al. (2008) in similar conditions. The milk fat content were positively influenced by the presence of the foal at the milking but was not effect by the dietary supplement of olive oil

PATHOLOGICAL GAMBLING: AN ASSOCIATION WITH ALEXITHYMIA, PERSONALITY DISORDERS AND CLINICAL SYNDROMES

Pathological gambling (PG) is a disorder recently conceptualized as a behavioural addiction, because of its neurobiological, neurophysiological and psychological features (American Psychiatric Association. Diagnostic and statistical manual of mental disorders - 5th ed., 2013; Potenza et al., 2012). PG represents both a social and a sanitary cost, in terms of pharmacological and psychological therapies. The aim of this study was to examine the correlation between personality disorders, clinical syndromes and alexithymia levels in a group of pathological gamblers. Furthermore this study aimed at highlighting a relationship between PG and alexithymia, over and above the relationship between personality disorders, clinical syndromes and PG. Sixty treatment- seeking pathological gamblers and 60 healthy controls were included in the study. Psychological assessment included the South Oaks Gambling Screen (SOGS), the Millon Clinical Multiaxial Inventory (MCMI-III) and the Toronto Alexithymia Scale (TAS-20). Pathological gamblers displayed Axis I disorders, such as anxiety, somatoform symptoms, bipolar symptoms, dysthymia, thought disorders and major depression, as well as Axis II disorders such as depressive, antisocial, sadistic, passive-aggressive, self-defeating and paranoid disorders, and greater alexithymia levels. Alexithymia was detected in PG independently from the presence of other psychiatric disorders. Our data show that comorbid psychiatric disorders have been evidentiated in PG. Interestingly alexithymia is related to PG indipendently from other psychopathological disorders, representing a relevant feature, helpful for assessing PG diagnosis and for orienting to the correct therapeutical strategy. REFERENCES American Psychiatric Association. 2013. American Psychiatric Publishing Potenza et al.,2012Psychoph219(2):469-49