On March 12, 2020, the World Health Organization (WHO) declared the outbreak of a new Coronavirus disease (COVID-19), to be a pandemic. From the beginning, Italy (in particular the Northern regions) ...was the first large European country to be hit and one of the most affected countries worldwide. This had a significant impact on the workload and psychological health of health workers. The aim of this web-based cross-sectional study is to assess the consequences of the COVID-19 pandemic on Italian doctors' well-being and psychological distress, in respect of demographic and occupational characteristics, lifestyle and habits during the lockdown period.
We conducted a web-based cross-sectional survey based on Google® Forms to collect data. The participation was available during the lockdown period that started in Italy on March 9, 2020 and it was voluntary and anonymous. The questionnaire explored demographic and occupational variables, lifestyle and habits during the lockdown, perceived well-being and psychological distress. Multivariate logistic regression models were fitted.
Our study reported the very alarming psychological conditions of Italian doctors, especially among those who worked in the most affected regions, where a level of psychological distress of 93.8% and poor well-being of 58.9% were registered. These percentages were even higher in the case of female hospital workers with low job seniority, and those caring for COVID-19 patients.
Our findings reported a significant psychosocial impact of the COVID-19 outbreak on Italian doctors, particularly among those working in the most affected regions of the country. Further studies are necessary to better understand the effects of the COVID-19 pandemic on doctors' well-being and mental health over time, in order to implement effective prevention measures.
The purpose of this study is to validate the 13-item version of the Work-Related Stress Questionnaire (WRSQ) on a representative sample of Italian public health residents.
The WRSQ was administered ...as part of the Public Health Residents' Anonymous Survey in Italy (PHRASI) from 14 June to 26 July 2022. Collinearity between each questionnaire item was assessed with Kendall's τ statistic. The latent factors identified associating similar items based on the authors' observations were workplace, job demand, support and unpleasant workplace. Goodness-of-fit was assessed with confirmatory factor analysis calculating: Comparative Fit Index (CFI), Tucker-Lewis Index (TLI), Root Mean Square Error of Approximation (RMSEA), Standardized Root-Mean-Residual (SRMR). Cronbach's alpha (α) and Omega McDonald (ω) were calculated to evaluate the reliability of the questionnaire. R 4.2.2 was used to perform the analyses.
379 Public Health residents (58% women) responded to the questionnaire. No significant collinearity was found between the items (τ range -0.31 to 0.49). Confirmatory Factor Analysis showed CFI = 0.975, TLI = 0.967, RMSEA = 0.041 and SRMR = 0.051. Internal consistency of the WRSQ Total Score was α = 0.80 and ω = 0.85.
Although validated in a sectorial subpopulation of healthcare workers, the WRSQ proved to be an excellent tool for assessing work-related stress. Unpleasant workplace latent factors showed lower factor loading and internal consistency than others. This could be due to the fact that topics investigated with unpleasant workplace items (e.g., abuse and discrimination) are experienced on a less regular basis than the ones assessed through the other items.
Ruthenium extraction by tri-n-butylphosphate (TBP) from nitric acid was studied and modelled in the conditions of the PUREX process. Experimental distribution ratios obtained for water, nitric acid ...and ruthenium were described with a physicochemical model based on the application of the mass action law on each extraction equilibrium and by taking into account deviations from thermodynamic ideal behaviour both in aqueous and organic phase using Mikulin and Sergievskii-Dannus equations. The best agreement between experimental and calculated ruthenium extraction isotherms was obtained by considering the formation of two complexes TBP2RuNO(NO3)3(H2O)2̅ and TBP3RuNO(NO3)3(H2O)2̅ in organic phase. This model was implemented in the CEA-AREVA PAREX process simulation code and used to simulate ruthenium behaviour in a counter-current PUREX hot test performed in mixer-settlers.
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•Extraction of ruthenium from nitric acid media by TBP/TPH was studied at lab-scale.•A thermodynamic model based on Mikulin equation and Sergievskii-Dannus model was developed.•Good agreement between experimental and calculated distribution ratios was obtained.•Mathematical model was tested successfully during a counter-current PUREX hot test performed in mixer-settlers.•The model is not yet able to simulate the retention of ruthenium in the irradiated organic solvent.
Chronic exposure to work-related stress (WRS) stimulates the hypothalamic-pituitary-adrenal (HPA) axis to increase glucocorticoid secretion, including cortisol, and these hormones can be measured ...both in serum and urine. The Health Safety Executive Toolkit (HSE) questionnaire is used to assess WRS risk objectively. The scope of our study is to investigate whether serum or urinary cortisol levels could be used as alternative objective indicators of WRS, specifically in those subjects who are chronically exposed to it.
130 patients (75 males and 55 females, mean age 47.7 ± 11.3 years) were evaluated at a specialized Centre for Secondary Hypertension, where both their serum (8 AM) and 24-hours urinary cortisol were measured and they were asked to complete two questionnaires: one questionnaire to collect data about their socio-demographic and job characteristics, and the HSE questionnaire to evaluate WRS.
Multiple linear regression analysis showed an association of urinary cortisol with several variables: tobacco smoke (β = 69.6; p = 0.003); female gender (β = -37.3; p = 0.041); exposure to physical risks (β = 51.8; p = 0.032); control score (β = -22.7; p = 0.039); role score (β= 39.3; p = 0.020). Age was the only variable associated with serum cortisol levels (β = -3.6; p = 0.042).
Urinary cortisol levels, but not serum levels, are associated with variables linked to WRS (score control and role) and to socio-demographic variables, namely gender and tobacco smoke. Thus, urinary cortisol can be considered a useful and non-invasive biological indicator to quantify WRS.
Work-related stress (WRS) is widespread among medical doctors. WRS not only affects the physician's mental and physical well-being, but also patient care quality and the overall efficiency of the ...healthcare system. The aim of this study is to conduct a systematic review of the current preventive measures against mental disorders, work-related stress, and burnout among physicians.
The presentation of this systematic review is in accordance with the PRISMA statement. The methodological quality of the selected studies was assessed with specific rating tools: INSA, Newcastle Ottawa Scale, JADAD scale, and AMSTAR. English publications only were selected. No restrictions applied for publication type. Reviewers excluded articles not concerning the following topics: WRS prevention, WRS risk factors and mental disorders among physicians. Reviewers also excluded findings of less academic significance, editorial articles, individual contributions, purely descriptive studies published in scientific conferences.
Online search returned 4748 references on the following databases: PubMed (1638), Scopus (3108) and Cochrane Library (2). 36 studies were included in this review (thereof, 13 reviews and 23 original articles). Narrative reviews were rated on the INSA scale. The mean, median, and modal rating was 6. This indicates an intermediate-high quality of these studies. Systematic reviews were rated on the AMSTAR scale. The mean and median rating was 9, and the modal rating was 8. This indicates a high quality of these studies. The scores assigned to the original articles have a mean, median, and modal rating of 7. This also indicates an intermediate-high quality of these studies.
Work-related stress and mental disorders seem to be widespread among medical practitioners. It is already a priority to adopt preventive measures against these phenomena. However, there is still no consensus on what the most effective measures are. Additional research is needed to formulate evidence-based recommendations.
The purpose of this study is to assess the prevalence and determinants of workplace violence and the sociodemographic risk factors associated.
This was a multicenter cross-sectional study.
The study ...was performed using self-compiled Italian version of the World Health Organization's questionnaire on workplace violence online by filling in a Google form. The survey was opened from May 2018 to March 2020 and lasted 5–10 min.
The sample consists of 3659 healthcare workers, of which 2525 (69%) are females, 1446 (39.5%) are nurses, and 2029 (55.5%) are health workers from northern Italy. The most frequent age group of the sample is 50–54 years (16.7%). A total of 366 (10%) healthcare workers are victims of physical aggression at work in the last 12 months, of which 6.3% with a weapon. The risk of being a victim of physical aggression at work in the last 12 months is significantly associated with the following independent variables: male gender (odds ratio OR 1.72, 95% confidence interval CI: 1.36–2.17), work in southern Italy (OR 1.59, 95% CI: 1.10–2.28), and being a nurse (OR 2.56, 95% CI: 2.01–3.25). The risk of being a victim of physical aggression at work with a weapon in the last 12 months is significantly associated with work in southern Italy (OR 9.33, 95% CI: 3.83–22.73). A total of 1723 (47.1%) of healthcare workers declare to be a victim of verbal aggression at work in the last 12 months. The risk of being a victim of verbal aggression at work in the last 12 months is significantly associated with the following independent variables: work in northern Italy (adjusted OR aOR 1.54, 95% CI: 1.32–1.81), work in southern Italy (aOR 3.68, 95% CI: 2.90–4.68), and be more than 55 years old (aOR 0.73, 95% CI: 0.63–0.85).
The study underlines that the problem of verbal and physical aggression against healthcare workers is still central and is a further starting point for research. The prevalence of violence is difficult to assess because violent incidents are underreported or unreported. The results of the study suggest that increased awareness is needed to develop effective control strategies at the individual, hospital, and national levels to prevent aggression and improve the conditions of victims.
Noise is still today one of the main causes of occupational diseases; in fact, in Italy in the three-year period 2019-2022, hearing loss represented 15% of all occupational diseases recognized by the ...National Institute for Insurance against Accidents at Work. The extra-auditory effects related to noise exposure also require particular attention, because they can interfere with mental activities that require concentration, memory and ability to deal with complex problems, causing sleep and learning disorders. For this reason, acoustic comfort is considered a fundamental requirement for obtaining an optimal degree of well-being in closed environments. In schools, a high degree of noise pollution not only makes it difficult for students to listen and learn, but also affects school workers. The aim of this study was to perform a systematic review of international literature and analysis of the preventive measures of extra-auditory effects among school workers.
The presentation of this systematic review is in accordance with the PRISMA statement. The methodological quality of the selected studies was assessed with specific rating tools (INSA, Newcastle Ottawa Scale, JADAD, JBI scale and AMSTAR). Only publications in English were selected. No restrictions were applied for the publication type. We excluded articles not concerned with the extra-auditory effects of noise exposure in school workers and preventive measures, findings of less academic significance, editorial articles, individual contributions, and purely descriptive studies published in scientific conferences.
Online research indicated 4,363 references: PubMed (2,319), Scopus (1,615) and Cochrane Library (429) have been consulted; 30 studies were included in this review (5 narrative or systematic reviews and 25 original articles). Regarding the scores of narrative reviews, the INSA score showed an average and a median value of 6.5, thus indicating an intermediate/high quality of the studies. Regarding the scores of systematic reviews, the AMSTAR score showed an average of 6.7 and a median and a modal value of 6, thus indicating a high quality of the studies. The scores assigned to the original articles have an average and median value of 7 and a modal value of 6 and this demonstrates an intermediate/high quality of the studies.
We can assume that, as it is highlighted by this study, to date these consequences are not considered at the legislative level for the protection of exposed workers. The extra-auditory effects impacting health afterward environmental noise exposure are many and widespread. Therefore, there is a need for interventions to be carried out by institutions and that the physician of the schools, during health surveillance, investigates the effects and clinical manifestations, in order to prevent disorders and deficits highlighted by our study.
The aim of our meta-analysis is to evaluate the association between the modifications of the cardiovascular system and chronic exposure to noise in occupationally exposed subjects.
We considered the ...articles published from 1950 to May 2008. Only 15 papers were conforming to the inclusion criteria identified for this meta-analysis. A total of 18,658 workers were divided in three groups according to the level of noise exposure as measured in the original studies (High Exposure, HE, Intermediate Exposure, IE, Low Exposure, LE). A preliminary evaluation of the type of data allowed for a classification of the type of performed measurements. Two classes of variables were identified: Class I, composed by continuous variables (systolic blood pressure, SBP, diastolic blood pressure, DBP, and heart rate, HR) and Class II, composed by not continuous variables (prevalence of hypertension and prevalence of ECG abnormalities). For each variable the calculation of heterogeneity was performed. For continuous variables the calculation of ES and its significance were performed while Odds Ratio (OR) and its significance were calculated for not continuous variables.
The results show a statistically significant increase of SBP and DBP in HE workers compared to LE and IE workers while HR is statistically higher in HE participants compared to LE participants. The prevalence of both hypertension and ECG abnormalities is statistically higher in HE workers compared to LE and IE workers.
Taking into account both the extremely high heterogeneity among studies and the ES/OR values we suggest a particular attention to the measurement and evaluation of SBP, DBP and HR in workers with chronic exposure to noise. Also ECG for workers with chronic exposure to noise is suggested in order to identify and evaluate possible abnormalities noise could be a concurrent cause of.
Speciation in aqueous solutions of nitric acid Hlushak, S; Simonin, J P; De Sio, S ...
Dalton transactions : an international journal of inorganic chemistry,
01/2013, Letnik:
42, Številka:
8
Journal Article
Recenzirano
In this study, speciation in aqueous solutions of nitric acid at 25 °C was assessed in two independent ways. First, Raman experiments were carried out and interpreted in terms of free nitrate ions, ...ion pairs and neutral HNO(3) molecules. In parallel, a model was developed to account for the formation of these two kinds of pairs. It was based on an extension of the binding mean spherical approximation (BiMSA), or associative MSA (AMSA), in which the size and the charge of the ions in the chemical pair may differ from those of the free ions. A simultaneous fit of the osmotic coefficient and of the proportion of free ions (obtained from Raman spectroscopy experiments) led to an estimation of the speciation in nitric acid solutions. The result obtained using this procedure was compared with the estimation obtained from the Raman experiments.
A commonly recognized complication of intravitreal steroids is ocular hypertension (OHT).The aim of this study was to investigate the effectiveness of pharmacotherapy in controlling this side effect, ...even in patients receiving sequential injections.
A total of 146 injections were performed on 78 patients over 3 years. 78 eyes were treated with 1 injection, 44 eyes were treated with 2 injections; 24 eyes were treated with 3 injections. The intravitreal corticosteroid used in this observational study is 0.7mg dexamethasone, commercially known as 0.7mg Ozurdex®.
Following the first injection, mean intraocular pressure (IOP) increased by 1,90 mmHg. Following the second injection, mean IOP increased by 0.23 mmHg. Following the third injection, there was no statistically significant change. Patients with IOP >= 21mmHg (7% of all participants) were started on topical pressure-lowering medications.
Intravitreal dexamethasone implants increased IOP of variable degrees in different patients. However, secondary OHT was effectively controlled with pharmacotherapy alone. This allowed for continuation of dexamethasone therapy.
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