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Prestigiacomo C, Fan Y, Hornung U, Dahmen N, Scialdone O, Galia A. Hydrothermal liquefaction of sewage sludge: use of HCOOH and KOH to improve the slurry pumpability in a continuously operated plant. Heliyon 2024; 10:e26287. [PMID: 38390112 PMCID: PMC10881357 DOI: 10.1016/j.heliyon.2024.e26287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 01/30/2024] [Accepted: 02/09/2024] [Indexed: 02/24/2024] Open
Abstract
We studied the hydrothermal liquefaction (HTL) of digested sewage sludge (DSS) as model of waste biomass in batch and continuous reactors. HCOOH and KOH were used to improve the slurry pumpability. HTL experiments were conducted at the same kinetic severity factor in a batch reactor of 25 mL of volume and in a continuously operated tubular reactor with 350 mL of volume. The observed outcomes suggested that it was not possible to achieve the pumpability of native DSS when a high concentrated stream of suspended solid particles has been fed to the HTL continuous plant. Using acidic or basic homogeneous additives, as potassium hydroxide or formic acid, it was possible to enhance the pumpability of a concentrated slurry of DSS in the continuous plant achieving yields of heavy oil (fraction of biocrude) similar to those obtained in the batch reactor and with higher H/C ratios. Hence, we found that HCOOH and KOH are promising additives for the practical implementation of a continuous HTL process.
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Affiliation(s)
- C Prestigiacomo
- Dipartimento di Ingegneria, Università degli Studi di Palermo, Palermo, Italy
| | - Y Fan
- Institut für Katalyseforschung und -technologie, Karlsruher Institut für Technologie (IKFT), Karlsruhe, Germany
- Nanyang Institute of Technology, School of Civil Engineering, Nanyang, 473004, PR China
| | - U Hornung
- Institut für Katalyseforschung und -technologie, Karlsruher Institut für Technologie (IKFT), Karlsruhe, Germany
| | - N Dahmen
- Institut für Katalyseforschung und -technologie, Karlsruher Institut für Technologie (IKFT), Karlsruhe, Germany
| | - O Scialdone
- Dipartimento di Ingegneria, Università degli Studi di Palermo, Palermo, Italy
| | - A Galia
- Dipartimento di Ingegneria, Università degli Studi di Palermo, Palermo, Italy
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Dilaghi E, Marcolongo A, Anibaldi P, Simmaco M, Prestigiacomo C, Angeletti S, Corleto VD, D'Ambra G, Ruggeri M, Di Giulio E, Annibale B, Lahner E. Gastrointestinal endoscopy can be safely performed during pandemic SARS-CoV-2 infection in Central Italy. Eur J Gastroenterol Hepatol 2021; 33:e505-e512. [PMID: 33795580 DOI: 10.1097/meg.0000000000002155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVES Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is highly contagious; gastrointestinal endoscopies are considered risky procedures for the endoscopy staff. Data on the SARS-CoV-2-exposure/infection rate of gastrointestinal endoscopy staff is scarce. This study aimed to assess the SARS-CoV-2-exposure/infection rate among gastrointestinal endoscopists/nurses performing gastrointestinal endoscopies before and after the adoption of specific prevention measures. PATIENTS AND METHODS Cross-sectional study in a teaching hospital (Rome, Central Italy) on retrospective data (9 March-15 April 2020) of consecutive gastrointestinal endoscopies, characteristics of procedures, patients and endoscopy staff, SARS-CoV-2-exposure/positivity of patients and staff before and after adoption of prevention measures. Exposed staff tested for SARS-CoV-2 by nasopharyngeal swabs(RNA-PCR) and serology. RESULTS A total of 130 gastrointestinal endoscopies were performed in 130 patients (age 66 ± 14 years, 51% women, 51% inpatients, 56.9% lower). A total of 12 (9.2%) patients were SARS-CoV-2-positive and 14(10.8%) had a high risk of potential infection. Of the endoscopy staff (n = 16, 5 endoscopists, 8 nurses and 3 residents), 14 (87.5%) were exposed to SARS-CoV-2-infected and 16 (100%) to potentially infected patients. 3/5 and 5/5 endoscopists were exposed to actual and potential, 1/3 and 3/3 residents to actual and potential and 8/8 nurses to actual and potential infection, respectively. None of the staff was found to be infected with SARS-CoV-2. None experienced fever or any other suspicious symptoms of coronavirus disease 2019. Before the adoption of prevention measures, more endoscopists/nurses were in the endoscopy room than after (3.5 ± 0.6 vs. 2.1 ± 0.3, P < 0.0001). CONCLUSIONS Despite supposed high infection risk, gastrointestinal endoscopies may be safe for the endoscopy staff during the SARS-CoV-2 pandemic.
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Affiliation(s)
- Emanuele Dilaghi
- Department of Surgical-Medical Sciences and Translational Medicine, Digestive and Liver Disease Unit, Sant'Andrea Hospital, Sapienza University of Rome
| | | | | | - Maurizio Simmaco
- Department of Neurosciences, Mental Health and Sensory Organs, Sapienza University of Rome, via di Grottarossa 1035
| | | | - Stefano Angeletti
- Department of Surgical-Medical Sciences and Translational Medicine, Digestive Endoscopy Unit, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Vito D Corleto
- Department of Surgical-Medical Sciences and Translational Medicine, Digestive Endoscopy Unit, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Giancarlo D'Ambra
- Department of Surgical-Medical Sciences and Translational Medicine, Digestive Endoscopy Unit, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Maurizio Ruggeri
- Department of Surgical-Medical Sciences and Translational Medicine, Digestive Endoscopy Unit, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Emilio Di Giulio
- Department of Surgical-Medical Sciences and Translational Medicine, Digestive Endoscopy Unit, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Bruno Annibale
- Department of Surgical-Medical Sciences and Translational Medicine, Digestive and Liver Disease Unit, Sant'Andrea Hospital, Sapienza University of Rome
| | - Edith Lahner
- Department of Surgical-Medical Sciences and Translational Medicine, Digestive and Liver Disease Unit, Sant'Andrea Hospital, Sapienza University of Rome
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Lahner E, Dilaghi E, Prestigiacomo C, Alessio G, Marcellini L, Simmaco M, Santino I, Orsi GB, Anibaldi P, Marcolongo A, Annibale B, Napoli C. Prevalence of Sars-Cov-2 Infection in Health Workers (HWs) and Diagnostic Test Performance: The Experience of a Teaching Hospital in Central Italy. Int J Environ Res Public Health 2020; 17:ijerph17124417. [PMID: 32575505 PMCID: PMC7345358 DOI: 10.3390/ijerph17124417] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 06/15/2020] [Accepted: 06/17/2020] [Indexed: 02/05/2023]
Abstract
(1) Background: Health workers (HWs) are at high risk of acquiring SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) infections. Therefore, health authorities further recommend screening strategies for SARS-CoV-2 infection in exposed or high-risk HWs. Nevertheless, to date, the best/optimal method to screen HWs for SARS-CoV-2 infection is still under debate, and data on the prevalence of SARS-CoV-2 infection in HWs are still scarce. The present study aims to assess the SARS-CoV-2 infection rate amongst HWs in a teaching hospital in Central Italy and the diagnostic performance of SARS-CoV-2 serology (index test) in comparison with the SARS-CoV-2 RNA PCR assay (reference standard). (2) Methods: A cross-sectional study on the retrospective data of HWs tested for SARS-CoV-2 by RNA-RT-PCR on nasopharyngeal swabs and by an IgM/IgG serology assay on venous blood samples, irrespective of exposure and/or symptoms, was carried out. (3) Results: A total of 2057 HWs (median age 46, 19-69 years, females 60.2%) were assessed by the RNA RT-PCR assay and 58 (2.7%) tested positive for SARS-CoV-2 infection. Compared with negative HWs, SARS-CoV-2-positives were younger (mean age 41.7 versus 45.2, p < 0.01; 50% versus 31% under or equal to 40 years old, p < 0.002) and had a shorter duration of employment (64 versus 125 months, p = 0.02). Exposure to SARS-CoV-2 was more frequent in positive HWs than in negatives (55.2% versus 27.5%, p < 0.0001). In 44.8% of positive HWs, no exposure was traced. None of the positive HWs had a fatal outcome, none of them had acute respiratory distress syndrome, and only one required hospitalization for mild/moderate pneumonia. In 1084 (51.2%) HWs, nasopharyngeal swabs and an IgM/IgG serology assay were performed. With regard to IgM serology, sensitivity was 0% at a specificity of 98.99% (positive predictive value, PPV 0%, negative predictive value, NPV 99.2%). Concerning IgG serology and irrespective of the time interval between nasopharyngeal swab and serology, sensitivity was 50% at a specificity of 99.1% (PPV 28.6%, NPV 99.6%). IgG serology showed a higher diagnostic performance when performed at least two weeks after testing SARS-CoV-2-positive at the RNA RT-PCR assay by a nasopharyngeal swab. (4) Conclusions: Our experience in Central Italy demonstrated a low prevalence of SARS-CoV-2 infection amongst HWs, but higher than in the general population. Nearly half of the positive HWs reported no previous exposure to SARS-CoV-2-infected subjects and were diagnosed thanks to the proactive screening strategy implemented. IgG serology seems useful when performed at least two weeks after an RNA RT-PCR assay. IgM serology does not seem to be a useful test for the diagnosis of active SARS-CoV-2 infection. High awareness of SARS-CoV-2 infection is mandatory for all people, but especially for HWs, irrespective of symptoms, to safeguard their health and that of patients.
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Affiliation(s)
- Edith Lahner
- Department of Medical Surgical Sciences and Translational Medicine, “Sapienza” University of Rome, Via di Grottarossa 1035/1039, 00189 Rome, Italy; (E.D.); (C.P.); (B.A.); (C.N.)
- Hospital Direction and Clinical Departments, Sant’Andrea University Hospital, Via di Grottarossa 1035/1039, 00189 Rome, Italy; (G.A.); (L.M.); (M.S.); (I.S.); (G.B.O.); (P.A.); (A.M.)
- Correspondence:
| | - Emanuele Dilaghi
- Department of Medical Surgical Sciences and Translational Medicine, “Sapienza” University of Rome, Via di Grottarossa 1035/1039, 00189 Rome, Italy; (E.D.); (C.P.); (B.A.); (C.N.)
- Hospital Direction and Clinical Departments, Sant’Andrea University Hospital, Via di Grottarossa 1035/1039, 00189 Rome, Italy; (G.A.); (L.M.); (M.S.); (I.S.); (G.B.O.); (P.A.); (A.M.)
| | - Claudio Prestigiacomo
- Department of Medical Surgical Sciences and Translational Medicine, “Sapienza” University of Rome, Via di Grottarossa 1035/1039, 00189 Rome, Italy; (E.D.); (C.P.); (B.A.); (C.N.)
- Hospital Direction and Clinical Departments, Sant’Andrea University Hospital, Via di Grottarossa 1035/1039, 00189 Rome, Italy; (G.A.); (L.M.); (M.S.); (I.S.); (G.B.O.); (P.A.); (A.M.)
| | - Giuliano Alessio
- Hospital Direction and Clinical Departments, Sant’Andrea University Hospital, Via di Grottarossa 1035/1039, 00189 Rome, Italy; (G.A.); (L.M.); (M.S.); (I.S.); (G.B.O.); (P.A.); (A.M.)
| | - Laura Marcellini
- Hospital Direction and Clinical Departments, Sant’Andrea University Hospital, Via di Grottarossa 1035/1039, 00189 Rome, Italy; (G.A.); (L.M.); (M.S.); (I.S.); (G.B.O.); (P.A.); (A.M.)
| | - Maurizio Simmaco
- Hospital Direction and Clinical Departments, Sant’Andrea University Hospital, Via di Grottarossa 1035/1039, 00189 Rome, Italy; (G.A.); (L.M.); (M.S.); (I.S.); (G.B.O.); (P.A.); (A.M.)
- Department of Neurosciences, Mental Health, and Sensory Organs, “Sapienza” University of Rome, via di Grottarossa 1035-1039, 00189 Rome, Italy
| | - Iolanda Santino
- Hospital Direction and Clinical Departments, Sant’Andrea University Hospital, Via di Grottarossa 1035/1039, 00189 Rome, Italy; (G.A.); (L.M.); (M.S.); (I.S.); (G.B.O.); (P.A.); (A.M.)
- Department of Clinical and Molecular Medicine, “Sapienza” University of Rome, via di Grottarossa 1035-1039, 00189 Rome, Italy
| | - Giovanni Battista Orsi
- Hospital Direction and Clinical Departments, Sant’Andrea University Hospital, Via di Grottarossa 1035/1039, 00189 Rome, Italy; (G.A.); (L.M.); (M.S.); (I.S.); (G.B.O.); (P.A.); (A.M.)
- Department of Public Health and Infectious Diseases, “Sapienza” University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy
| | - Paolo Anibaldi
- Hospital Direction and Clinical Departments, Sant’Andrea University Hospital, Via di Grottarossa 1035/1039, 00189 Rome, Italy; (G.A.); (L.M.); (M.S.); (I.S.); (G.B.O.); (P.A.); (A.M.)
| | - Adriano Marcolongo
- Hospital Direction and Clinical Departments, Sant’Andrea University Hospital, Via di Grottarossa 1035/1039, 00189 Rome, Italy; (G.A.); (L.M.); (M.S.); (I.S.); (G.B.O.); (P.A.); (A.M.)
| | - Bruno Annibale
- Department of Medical Surgical Sciences and Translational Medicine, “Sapienza” University of Rome, Via di Grottarossa 1035/1039, 00189 Rome, Italy; (E.D.); (C.P.); (B.A.); (C.N.)
- Hospital Direction and Clinical Departments, Sant’Andrea University Hospital, Via di Grottarossa 1035/1039, 00189 Rome, Italy; (G.A.); (L.M.); (M.S.); (I.S.); (G.B.O.); (P.A.); (A.M.)
| | - Christian Napoli
- Department of Medical Surgical Sciences and Translational Medicine, “Sapienza” University of Rome, Via di Grottarossa 1035/1039, 00189 Rome, Italy; (E.D.); (C.P.); (B.A.); (C.N.)
- Hospital Direction and Clinical Departments, Sant’Andrea University Hospital, Via di Grottarossa 1035/1039, 00189 Rome, Italy; (G.A.); (L.M.); (M.S.); (I.S.); (G.B.O.); (P.A.); (A.M.)
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Messineo A, Cattaruzza MS, Prestigiacomo C, Giordano F, Marsella LT. Sustainability of prevention practices at the workplace: safety, simplification, productivity and effectiveness. Ann Ig 2018; 29:407-421. [PMID: 28715054 DOI: 10.7416/ai.2017.2173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Traditional full-time employment has evolved into various types of occupational situations, and, nowadays, new work organization strategies have been developed. Previously overlooked risk factors have emerged, such as traffic accidents while commuting or during work hours, poor work organization, and detrimental lifestyles (like alcohol and substance abuse, although recent statistics seem to show a declining trend for the latter). The global scenario shows greater attention to occupational risks, but also, to the reduced degree of protection. Moreover, the elevated costs, the unacceptably high fatal accident rates in some sectors, the complexity of the prevention systems, the lack of prevention training, the inadequate controls (despite the numerous independent supervisory bodies) and the obsolescence of certain precepts, call for a prompt review of the regulatory system. This is especially needed for general simplification, streamlining certification bodies and minimizing references to other provisions in the legislation that make it difficult for Italian and foreign workers to read and understand the rules "without legal interpreters". "New" occupational diseases and occupational risk factors have also been reported in addition to pollution. There are concerns for continued economic and social destabilization, unemployment, commuting, temporary and precarious contracts. All of these contribute to the lack of wellbeing in the working population. Thus, the timing, duration, and types of prevention training should be carefully assessed, making prevention more appealing by evaluating costs and benefits with a widespread use of indicators that make appropriate actions for health promotion "visible", thus encouraging awareness. Although reducing prevention is never justified, it should still be "sustainable" economically in order to avoid waste of resources. It is also essential to have laws which are easily and consistently interpreted and to work on the ethics of employers and employees to ensure that they conform to the standards of other European countries that currently operate with greater effectiveness and lower costs.
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Affiliation(s)
- A Messineo
- Department of Surgical and Medical Sciences and Translational Medicine, Sapienza University of Roma, Italy
| | - M S Cattaruzza
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
| | - C Prestigiacomo
- Department of Surgical and Medical Sciences and Translational Medicine, Sapienza University of Roma, Italy
| | - F Giordano
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
| | - L T Marsella
- Department of Biomedicine and Prevention, Section of Forensic Medicine, Social Security and Forensic Toxicology, Tor Vergata University of Rome, Italy
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Roma P, Monaco E, Prestigiacomo C, Innamorati M, De Mattia M, Ferracuti S. Psychopathological characteristics of adjustment disorder among outpatients with and without work related stress. G Ital Med Lav Ergon 2017; 39:72-77. [PMID: 29916595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 05/09/2017] [Indexed: 06/08/2023]
Abstract
OBJECTIVES Study's objective is to assess psychopathological profiles in outpatients with a diagnosis of Adjustment Disorder (AD) who had positive evaluations of work related stress (AD-W) versus those exposed to other stressful life events (AD-O). METHODS The participants were 70 outpatients with AD-W, compared to 71 outpatients with AD-O, admitted at the Unit of Psychiatry and Occupational Medicine, Sant'Andrea Hospital, Rome. Patients completed the Hamilton Rating Scale for Depression (HRSD), the Hamilton Anxiety Rating Scale (HAM-A), the Minnesota Multiphasic Personality Inventory - 2 (MMPI-2), and the Rorschach test. RESULTS The emerged data underline that patients with AD-W scored significantly higher than patients with AD-O in the MMPI-2 scales D, Pd, Pa, FAM, and in the Rorschach anxiety scale (Sum Y). CONCLUSIONS Finally patients with AD-W showed greater levels of psychopathology compared to patients with AD-O. Further studies assessing the harm associated with stress might allow a better understanding of the diagnosis and therapeutic implications of AD.
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Affiliation(s)
- Paolo Roma
- Sapienza University - Rome, Italy, School of Medicine and Psychology; Sant'Andrea Hospital, Rome
- NESMOS Department (Neurosciences, Mental Health, and Sensory Organs)
| | - Edoardo Monaco
- Sapienza University - Rome, Italy, School of Medicine and Psychology; Sant'Andrea Hospital, Rome
- Medical Surgical Sciences Translational Medicine Department; Occupational Medicine
| | - Claudio Prestigiacomo
- Sapienza University - Rome, Italy, School of Medicine and Psychology; Sant'Andrea Hospital, Rome
- Medical Surgical Sciences Translational Medicine Department; Occupational Medicine
| | - Marco Innamorati
- Sapienza University - Rome, Italy, School of Medicine and Psychology; Sant'Andrea Hospital, Rome
- Università Europea di Roma
| | - Martina De Mattia
- Sapienza University - Rome, Italy, School of Medicine and Psychology; Sant'Andrea Hospital, Rome
- NESMOS Department (Neurosciences, Mental Health, and Sensory Organs)
| | - Stefano Ferracuti
- Sapienza University - Rome, Italy, School of Medicine and Psychology; Sant'Andrea Hospital, Rome
- NESMOS Department (Neurosciences, Mental Health, and Sensory Organs)
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Monaco E, Girardi P, Falaschi P, Ferracuti S, Martocchia A, Battaglia V, Capitanelli I, Catarinozzi E, Piccari I, Rossi M, Prestigiacomo C. [Mobbing: ten-year evaluation experience in a University Hospital]. G Ital Med Lav Ergon 2017; 39:26-33. [PMID: 29916617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 05/09/2017] [Indexed: 06/08/2023]
Abstract
OBJECTIVES Bullying is a manifestation of occupational stress and can therefore be considered as a real "organizational pathology." Include the activities of the surgery dedicated to Mobbing, Unit of Occupational Medicine Sant'Andrea Hospital, which began operations in June 2001. METHODS In over ten years of operation (July 2012), the sample, consisting of 50.7% for men and 49.3% women, is heterogeneous in age. The schooling of the sample is medium-high as more than 82% have higher education level. The business sector is the service sector accounted for most (84%) than in industry (9%) and agriculture (2%). RESULTS Of the 1545 patients seen, 1320 completed the diagnostic path, while 225 have stopped. 814 users have been certified for compatibility bullying (63% of cases) with a net reduction of the awards from 2007 onwards. CONCLUSIONS Considerations are expressed about the possible intervention strategies: the presence of dedicated experts at the counters of listening and professionals as the trusted advisor, to which workers in distress can call on for advice and guidance on how to defend itself from, in accordance with the implemented for years at the Ministry of Health, the establishment of such figures as the manager rehability that in other European countries, are scheduled for some time in work organization.
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Affiliation(s)
- Edoardo Monaco
- Dipartimento di Scienze medico-chirurgiche e medicina traslazionale, Facoltà di Medicina e Psicologia, Università degli Studi di Roma "Sapienza", UO Medicina del Lavoro - Azienda Ospedaliera "Sant'Andrea"
| | - Paolo Girardi
- Dipartimento Neuroscienze, salute mentale e organi di senso - NESMOS, Facoltà di Medicina e Psicologia, Università degli Studi di Roma "Sapienza", UO Psichiatria - Azienda Ospedaliera "Sant'Andrea"
| | - Paolo Falaschi
- Dipartimento di Scienze medico-chirurgiche e medicina traslazionale, Facoltà di Medicina e Psicologia, Università degli Studi di Roma "Sapienza", UO Geriatria - Azienda Ospedaliera "Sant'Andrea"
| | - Stefano Ferracuti
- Dipartimento Neuroscienze, salute mentale e organi di senso - NESMOS, Facoltà di Medicina e Psicologia, Università degli Studi di Roma "Sapienza", UO Psichiatria - Azienda Ospedaliera "Sant'Andrea"
| | - Antonio Martocchia
- Dipartimento di Scienze medico-chirurgiche e medicina traslazionale, Facoltà di Medicina e Psicologia, Università degli Studi di Roma "Sapienza", UO Geriatria - Azienda Ospedaliera "Sant'Andrea"
| | - Valentina Battaglia
- Dipartimento di Scienze medico-chirurgiche e medicina traslazionale, Facoltà di Medicina e Psicologia, Università degli Studi di Roma "Sapienza", UO Medicina del Lavoro - Azienda Ospedaliera "Sant'Andrea"
| | - Ilaria Capitanelli
- Dipartimento di Scienze medico-chirurgiche e medicina traslazionale, Facoltà di Medicina e Psicologia, Università degli Studi di Roma "Sapienza", UO Medicina del Lavoro - Azienda Ospedaliera "Sant'Andrea"
| | - Elena Catarinozzi
- Dipartimento di Scienze medico-chirurgiche e medicina traslazionale, Facoltà di Medicina e Psicologia, Università degli Studi di Roma "Sapienza", UO Medicina del Lavoro - Azienda Ospedaliera "Sant'Andrea"
| | - Ines Piccari
- Dipartimento di Scienze medico-chirurgiche e medicina traslazionale, Facoltà di Medicina e Psicologia, Università degli Studi di Roma "Sapienza", UO Medicina del Lavoro - Azienda Ospedaliera "Sant'Andrea"
| | - Marina Rossi
- Dipartimento di Scienze medico-chirurgiche e medicina traslazionale, Facoltà di Medicina e Psicologia, Università degli Studi di Roma "Sapienza", UO Medicina del Lavoro - Azienda Ospedaliera "Sant'Andrea"
| | - Claudio Prestigiacomo
- Dipartimento di Scienze medico-chirurgiche e medicina traslazionale, Facoltà di Medicina e Psicologia, Università degli Studi di Roma "Sapienza", UO Medicina del Lavoro - Azienda Ospedaliera "Sant'Andrea"
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Amuluru K, Al-Mufti F, Prestigiacomo C, Gandhi C. P-017 Delayed Cerebral Ischemia Secondary to Arteriovenous Malformation Rupture. J Neurointerv Surg 2016. [DOI: 10.1136/neurintsurg-2016-012589.59] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Giorgi E, Marani A, Salvati O, Mangiaracina G, Prestigiacomo C, Osborn JF, Cattaruzza MS. Towards a smoke-free hospital: how the smoking status of health professionals influences their knowledge, attitude and clinical activity. Results from a hospital in central Italy. Ann Ig 2015; 27:447-459. [PMID: 26051143 DOI: 10.7416/ai.2015.2031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVES In Italy, the prevalence of smoking among health professionals is higher than in the general population and this might hamper their role in the promotion of health. This study aimed to investigate how the smoking status of healthcare professionals might influence knowledge, attitudes and clinical practice in a hospital in central Italy in order to enforce effective tobacco control measures. METHODS Physicians and professionals of the hospital were asked to complete an anonymous questionnaire which yielded epidemiological and environmental information on knowledge, attitude, clinical practice and quality of the hospital environments, in relation to smoking. RESULTS Overall, among the employees of the hospital, the smoking prevalence was 47%, (42% among physicians and 43% among nurses); 30% admitted smoking in the hospital and three quarters of the smokers would like to quit. Some knowledge, opinions and attitudes differ statistically among the smoking categories. For example, only 35% of the smokers admitted that smoking is more dangerous to health than atmospheric and car pollution compared with 60% of the ex or never smokers (p=0.04). Fewer smokers realize that their behavior is seen as a role model by patients. A greater percentage of smokers state that patients (34%) and visitors (43%) often smoke in hospital and these percentages are significantly higher than those reported by ex or never smokers (p≤0.05). All smokers claim that they never smoke in patient rooms, infirmaries and clinics, whereas over 20% of ex or never smokers report that smoking sometimes occurs in these places (p=0.015). The mean concentration of PM 2.5 in the 25 rooms was 2.4 μg/m3 with a range from 1 to 7 μg/m3. CONCLUSIONS This study implies that the prevalence of smoking among health professionals may be very high, and might be twice the rate observed in the general population. Generally, smokers report less knowledge compared with ex and never-smokers and it seems that they systematically underestimate the dangers related to smoking both in their knowledge and in their behavior, and try to socially "normalize" smoking. All this and the evidence of cigarette butts in hospital rooms and clinics, notwithstanding the good quality of the air thanks to the modern ventilation system, imply that there is still a long way to go towards a smoke-free hospital.
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Affiliation(s)
- E Giorgi
- Department of Public Health and Infectious Diseases, Pharmacy and Medicine Faculty, Sapienza University of Rome, Italy
| | - A Marani
- Department of Public Health and Infectious Diseases, Pharmacy and Medicine Faculty, Sapienza University of Rome, Italy
| | | | - G Mangiaracina
- Medicine and Psychology Faculty, Sapienza University of Rome, Italy
| | - C Prestigiacomo
- Department of Medical-Surgical Sciences and Traslational Medicine, Medicine and Psychology Faculty, Sapienza University of Rome, Italy
| | - J F Osborn
- Department of Public Health and Infectious Diseases, Pharmacy and Medicine Faculty, Sapienza University of Rome, Italy
| | - M S Cattaruzza
- Department of Public Health and Infectious Diseases, Pharmacy and Medicine Faculty, Sapienza University of Rome, Italy
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Prestigiacomo C, Catarinozzi E, Rossi M, Piccari I, Battaglia V, Monaco E. [The inclusion of the subject safety in the school curriculum;checking the validity of the hypothesis in schools in three provinces]. Ig Sanita Pubbl 2014; 70:211-222. [PMID: 25008226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
According to Italian Legislative Decree no. 81/2008, workplace safety will have to be introduced in school and university curricula. The main objectives of this study of the Italian Ministry of Labour were to verify knowledge about workplace safety among primary and secondary school students and evaluate the effectiveness of a training course in improving students' knowledge. Three provinces with an above average workforce/injuries ratio (with respect to the national average) were identified. An evaluation questionnaire was administered to students in the three provinces. Students then attended training courses about workplace safety and were then administered the same questionnaire. Primary school students improved by an average of 35.5%, middle school students by 33.3%, high school students by 18.6%. Results suggests that the training intervention was effective.
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Affiliation(s)
- Claudio Prestigiacomo
- Cattedra di Medicina del Lavoro, Dipartimento di Scienze medico-chirurgiche e medicina traslazionale, Facoltà di Medicina e Psicologia, Università degli Studi di Roma "Sapienza", UO Medicina del Lavoro - Azienda Ospedaliera "Sant'Andrea"
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Hetts SW, Turk A, English JD, Dowd CF, Mocco J, Prestigiacomo C, Nesbit G, Ge SG, Jin JN, Carroll K, Murayama Y, Gholkar A, Barnwell S, Lopes D, Johnston SC, McDougall C. Stent-assisted coiling versus coiling alone in unruptured intracranial aneurysms in the matrix and platinum science trial: safety, efficacy, and mid-term outcomes. AJNR Am J Neuroradiol 2013; 35:698-705. [PMID: 24184523 DOI: 10.3174/ajnr.a3755] [Citation(s) in RCA: 112] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Stent-assisted coiling may result in less aneurysm recanalization but more complications than coiling alone. We evaluated outcomes of coiling with and without stents in the multicenter Matrix and Platinum Science Trial. MATERIALS AND METHODS All patients in the Matrix and Platinum Science Trial with unruptured intracranial aneurysms treated per protocol were included. Baseline patient and aneurysm characteristics, procedural details, neurologic outcomes, angiographic outcomes, and safety data were analyzed. RESULTS Overall, 137 of 361 (38%) patients were treated with a stent. Stent-coiled aneurysms had wider necks (≥4 mm in 62% with stents versus 33% without, P < .0001) and lower dome-to-neck ratios (1.3 versus 1.8, P < .0001). Periprocedural serious adverse events occurred infrequently in those treated with and without stents (6.6% versus 4.5%, P = .39). At 1 year, total significant adverse events, mortality, and worsening of mRS were similar in treatment groups, but ischemic strokes were more common in stent-coiled patients than in coiled patients (8.8% versus 2.2%, P = .005). However, multivariate analysis confirmed that at 2 years after treatment, prior cerebrovascular accident (OR, 4.7; P = .0089) and aneurysm neck width ≥4 mm (OR, 4.5; P = .02) were the only independent predictors of ischemic stroke. Stent use was not an independent predictor of ischemic stroke at 2 years (OR, 1.1; P = .94). Stent use did not predict target aneurysm recurrence at 2 years, but aneurysm dome size ≥10 mm (OR, 9.94; P < .0001) did predict target aneurysm recurrence. CONCLUSIONS Stent-coiling had similar outcomes as coiling despite stented aneurysms having more difficult morphology than coiled aneurysms. Increased ischemic events in stent-coiled aneurysms were attributable to baseline risk factors and aneurysm morphology.
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Affiliation(s)
- S W Hetts
- From the Departments of Radiology and Biomedical Imaging (S.W.H., C.F.D.)
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Jethwa P, Punia V, Gandhi C, Prestigiacomo C. E-068 CT angiography in the diagnosis of non-aneurysmal spontaneous subarachnoid hemorrhage: a meta-analysis. J Neurointerv Surg 2012. [DOI: 10.1136/neurintsurg-2012-010455c.68] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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12
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Hetts S, Turk A, English J, Mocco J, Prestigiacomo C, Nesbit G, Ge S, Jin J, Murayama Y, Gholkar A, Barnwell S, Lopes D, Gobin Y, Johnston S, McDougall C. O-010 Stent assisted coiling versus coiling of unruptured intracranial aneurysms in the MAPS trial: safety, efficacy, and mid term outcomes. J Neurointerv Surg 2012. [DOI: 10.1136/neurintsurg-2012-010455a.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Prestigiacomo C, Mocco J, Hetts S, Nesbit G, Murayama Y, Macdougall C, Johnston S, Ge G, Jung S, Gholkar A, Lopes D, Perl J, Tampieri D, Turk A. O-025 Geographical influence on aneurysm treatment outcomes and retreatment rates. J Neurointerv Surg 2012. [DOI: 10.1136/neurintsurg-2012-010455a.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Gupta V, Gandhi C, Prestigiacomo C, Bhagat N, Turbin R, Gupta G. E-013 Coil herniation and retinal/vitreous hemorrhage in a patient with antiphospholipid antibody syndrome undergoing balloon assisted coil embolization of unruptured ICA aneurysm: Abstract E-013 Figure 1. J Neurointerv Surg 2012. [DOI: 10.1136/neurintsurg-2012-010455c.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Punia V, Jethwa P, Gandhi C, Prestigiacomo C. Utility of 3-Dimensional Reconstructions in Multiplanar CT Angiography Negative Spontaneous Subarachnoid Hemorrhage (S23.001). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.s23.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Jethwa P, Punia V, Gandhi C, Prestigiacomo C. Utility of Delayed Digital Subtraction Angiography (DSA) in CT Angiography or Immediate DSA Negative Spontaneous Subarachnoid Hemorrhage (P04.075). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p04.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Monaco E, Vicaro V, Catarinozzi E, Rossi M, Prestigiacomo C. [Musculoskeletal diseases among musicians of the "teatro dell'Opera" of Rome]. G Ital Med Lav Ergon 2012; 34:158-163. [PMID: 22888726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Musculo-skeletal injuries represent a significant medical problem in professional musicians for which was coined the following acronym PRMDs (that stands for Playing Related Musculoskeletal disorders). A little osteo-articular problem in the professional musicians can impact on a real decreasing performance activity. The purpose of this study is to quantify prevalence of PRMDs syntoms among the professional musicians and to verify their relative impact on quality lives. This study has investigated the orchestral staff of the principal lyric theatre of Rome to which it was distributed DASH OUTCOME and SF-36 questionnaires to identify the presence of musculoskeletal complaints for cervical brachial syndrome and the general quality of life respectively. The employment of the above methodology furnish statistically significant results, pointing out that the musicians quality life suffering from musculo-skeletal symptomatology (DASH SF > or = 15) was lower than ones without a clinical symptomatology. Subsequently these results were compared with the Italian population benchmarking values.
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Affiliation(s)
- Edoardo Monaco
- Cattedra di Medicina del Lavoro, Dipartimento di Scienze Medico-chirurgiche e medicina traslazionale, Facoltà di Medicina e Psicologia, Universith degli Studi di Roma "Sapienza", UO Medicina del Lavoro--Azienda Ospedaliera, Sant'Andrea, Italy.
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Blackham KA, Meyers PM, Abruzzo TA, Albuquerque FC, Alberquerque FC, Fiorella D, Fraser J, Frei D, Gandhi CD, Heck DV, Hirsch JA, Hsu DP, Hussain MS, Jayaraman M, Narayanan S, Prestigiacomo C, Sunshine JL. Endovascular therapy of acute ischemic stroke: report of the Standards of Practice Committee of the Society of NeuroInterventional Surgery. J Neurointerv Surg 2012; 4:87-93. [PMID: 22278933 DOI: 10.1136/neurintsurg-2011-010243] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To summarize and classify the evidence for the use of endovascular techniques in the treatment of patients with acute ischemic stroke. METHODS Recommendations previously published by the American Heart Association (AHA) (Guidelines for the early management of adults with ischemic stroke (Circulation 2007) and Scientific statement indications for the performance of intracranial endovascular neurointerventional procedures (Circulation 2009)) were vetted and used as a foundation for the current process. Building on this foundation, a critical review of the literature was performed to evaluate evidence supporting the endovascular treatment of acute ischemic stroke. The assessment was based on guidelines for evidence based medicine proposed by the Stroke Council of the AHA and the University of Oxford, Centre for Evidence Based Medicine (CEBM). Procedural safety, technical efficacy and impact on patient outcomes were specifically examined.
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Affiliation(s)
- K A Blackham
- Department of Radiology, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, OH 44106, USA.
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Petrov D, Hidalgo A, Gandhi C, Prestigiacomo C. O-007 Decreases in temperature and relative humidity leading to an increased incidence of ischemic stroke. J Neurointerv Surg 2011. [DOI: 10.1136/neurintsurg-2011-010097.7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Cornett O, El-Gengaihy A, Gandhi C, Prestigiacomo C. E-039 Coil packing volume in the treatment of ruptured intracranial aneurysms and the rate of recurrence. J Neurointerv Surg 2010. [DOI: 10.1136/jnis.2010.003251.39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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He W, Gandhi C, Quinn J, Karimi R, Catrambone J, Prestigiacomo C. E-062 True aneurysms of the posterior communicating artery: a systematic review and meta-analysis of individual patient data. J Neurointerv Surg 2010. [DOI: 10.1136/jnis.2010.003251.62] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Quinn J, He W, Gandhi C, Romano K, Pendergass J, Prestigiacomo C. 007 Biomorphometric markers for aneurysm rupture in posterior communicating artery aneurysms. J Neurointerv Surg 2009. [DOI: 10.1136/jnis.2009.000869g] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Shhadeh A, Hoover S, Gardner K, Cornett O, Gandhi C, Prestigiacomo C. 004 Aneurysm aspect ratio predicts the probability of recanalization after coil embolization. J Neurointerv Surg 2009. [DOI: 10.1136/jnis.2009.000869d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Shhadeh A, Hoover S, Gardner K, Cornett O, Prestigiacomo C, Gandhi C. 006 Aneurysm configuration predicts the probability of recanalization after coil embolization. J Neurointerv Surg 2009. [DOI: 10.1136/jnis.2009.000869f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Shhadeh A, Hoove S, Gardner K, Cornett O, ElpGengaihy A, El-Gengaihy A, Gandhi C, Prestigiacomo C. 002 Aneurysm location affects the durability of coil embolization. J Neurointerv Surg 2009. [DOI: 10.1136/jnis.2009.000869b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Quinn J, He W, Gandhi C, Romano K, Prendergass J, Prestigiacomo C. 007 Aneurysm angle and deflection as markers for aneurysm rupture in posterior communicating artery aneurysms: a biomorphometric analysis. J Neurointerv Surg 2009. [DOI: 10.1136/jnis.2009.000851g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Girardi P, Monaco E, Prestigiacomo C, Talamo A, Ruberto A, Tatarelli R. Personality and psychopathological profiles in individuals exposed to mobbing. Violence Vict 2007; 22:172-88. [PMID: 17479554 DOI: 10.1891/088667007780477320] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Increasingly, mental health and medical professionals have been asked to assess claims of psychological harm arising from harassment at the workplace, or "mobbing." This study assessed the personality and psychopathological profiles of 146 individuals exposed to mobbing using validity, clinical, and content scales of the Minnesota Multiphasic Personality Inventory 2. Profiles and factor analyses were obtained. Two major dimensions emerged among those exposed to mobbing: (a) depressed mood, difficulty in making decisions, change-related anguish, and passive-aggressive traits (b) somatic symptoms, and need for attention and affection. This cross-sectional pilot study provides evidence that personality profiles of mobbing victims and psychological damage resulting from mobbing may be evaluated using standardized assessments, though a longitudinal study is needed to delineate cause-and-effect relationships.
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Monaco E, Bianco G, Di Simone Di Giuseppe B, Prestigiacomo C. [Emergent pathology in occupational medicine: the mobbing]. G Ital Med Lav Ergon 2004; 26:28-32. [PMID: 15134396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
Mobbing constitutes a phenomenon not yet clearly defined. The activity, located in the II Faculty of Medicine and Surgery, is specifically dedicated to such phenomenon, which is the outcome of cooperation. The examined population is composed by a light prevalence of men (51.3%) respect to women (48.6%), aged around 42 years and employees (71.6%), workers (28.4%). All patients have been submitted to working anamnesis before being subjected to a psychiatric examination and psycodiagnostic tests. The emerged data underline a trouble of adaptation 55.4% of the cases, 40.5% is affected by psychiatric pathologies, 4.1% of the patients do not show mental disorders. A certification of compatibility with mobbing has been possible to be verified in 49% of the cases. Nevertheless, it is necessary a connection between a physician and business medical service. We hope a necessary enactment of a specific regulation.
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Affiliation(s)
- E Monaco
- Cattedra e Scuola di Specializzazione in Medicina del Lavoro, II Facoltà di Medicina e Chirurgia, Università di Roma "La Sapienza" - Azienda Ospedaliera Sant'Andrea, Roma.
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Monaco E, Bianco G, Ceppi Ratti E, Di Simone Di Giuseppe B, Risicato A, Prestigiacomo C. [Moral and psychological violence at work: assessment and certification]. G Ital Med Lav Ergon 2003; 25 Suppl:150-2. [PMID: 14979125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
Mobbing constitutes a phenomenon not yet clearly defined. The activity, located in the H Faculty of Medicine and Surgery, is specifically dedicated to such phenomenon, which is the outcome of cooperation. The examined population is composed by a light prevalence of women (54%) respect to men (46%), aged around 44 years and employees (73%), workers (27%). All patients have been submitted to working anamnesis before being subjected to a psychiatric examination and psycodiagnostic tests. The emerged data underline a trouble of adaptation 63% of the cases (to which we have released a certification of compatibility with mobbing), 28% is affected by psychiatric pathologies, 9% of the patients do not show mental disorders. Nevertheless, it is necessary a connection between a physician and business medical service.
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Affiliation(s)
- E Monaco
- Cattedra e Scuola di Specializzazione in Medicina del Lavoro, II Facoltà di Medicina e Chirurgia, Università di Roma La Sapienza
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