Awareness and perception of accuracy of the Undetectable=Untransmittable message (U=U) in Italy: results from a survey among PLWHA, infectious-diseases physicians and people having unprotected sex.

Evidences on the absence of risk of sexual transmission of HIV by persons living with HIV/AIDS (PLWHA) with undetectable plasma HIV-RNA (HIV-RNA <200 copies/ml) led to the worldwide campaign "U = U" (undetectable = untransmittable). The purpose of this study was to evaluate the perceived accuracy of this message among PLWHA, HIV-negative people having unprotected sex (PHUS) and infectious diseases' (ID) physicians in Italy. A nationwide survey has been conducted using three different anonymous questionnaires (for ID physicians, PLWHA and PHUS). A total of 1121 participants filled the questionnaires: 397 PLWHA; 90 physicians; 634 PHUS. Awareness of U = U message has been reported in 74%, 92% and 47% of PLWHA, ID physicians and PHUS, respectively. The perception of accuracy of the U = U message among those aware was reported as high in 80.4%, 79.5% and 67.3% of PLWHA, ID physicians and PHUS, respectively. Physicians perceived that 11% of PLWHA have a high rate of perception of U = U, whereas among PLWHA, only 34% reported definitive positive messages from physicians. Discrepancies between awareness and perception of accuracy of the message U = U in PLWHA and physicians have been found, suggesting still low confidence in the community regarding the message itself.

The role of dieting, psychopathological characteristics and maladaptive personality traits in Orthorexia Nervosa.

BACKGROUND: Pursuing a healthy diet is not a dysfunctional behavior, but dieting could be an important etiological factor for Orthorexia Nervosa (ON). The aim of this study was to investigate the role of diet in groups with high/low orthorexic tendencies. Moreover, some psychopathological characteristics associated with ON and maladaptive personality traits were investigated. METHODS: The sample consisted of three groups: two were on a diet and had high (HIGH-D; n = 52) or low (LOW-D; n = 41) orthorexic tendencies. The other was composed of people with high orthorexic tendencies not on a diet (HIGH; n = 40). Participants filled out self-report questionnaires to investigate orthorexic tendencies, eating disorders features, obsessive-compulsive symptoms, perfectionism, depressive/anxious symptomatology, and maladaptive personality traits. RESULTS: The HIGH-D group showed more orthorexic tendencies than the HIGH group. More maladaptive personality traits and anxiety symptoms have been highlighted in HIGH and HIGH-D groups. The HIGH group had more eating disorder characteristics than other groups. Only the HIGH-D group showed more depressive symptoms than the LOW-D group. CONCLUSIONS: The features of HIGH and LOW-D groups suggest that diet alone could not explain ON, even if it could be a possible factor related to ON. Therefore, people with high orthorexic tendencies, psychopathological features, and maladaptive personality traits could be in a prodromic condition for disordered eating habits and deserve clinical attention.

Orthorexia Nervosa: differences between clinical and non-clinical samples.

BACKGROUND: Orthorexia Nervosa (ON) is a construct characterized by behaviors, emotions, and beliefs on eating healthy food and excessive attention to diet; moreover, dieting has been considered a risk factor in ON symptoms development. The principal aim of this study was to investigate the differences in clinical and non-clinical groups most at risk of ON. Aspects that could be associated with ON (Eating Disorders [EDs], obsessive-compulsive symptomatology, perfectionistic traits, anxiety, depression, Body Mass Index [BMI]) were investigated in all groups. METHODS: The sample consisted of 329 adults belonging to four different groups. Three were on a diet: Anorexia/Bulimia Nervosa group (N = 90), Obesity/Binge Eating Disorder group (N = 54), Diet group (N = 91). The Control group consisted of people who were not following a diet (N = 94). Participants completed several self-administered questionnaires (EHQ-21, EDI-3, OCI-R, MPS, BAI, BDI-II) to assess ON-related features in different groups. RESULTS: Analyses highlighted higher orthorexic tendencies in Anorexia/Bulimia Nervosa, Obesity/BED, and Diet groups than in the Control group. Moreover, results have shown that in the AN/BN group, eating disorders symptomatology and a lower BMI were related to ON and that in Obesity/Binge Eating Disorder and Diet groups, perfectionism traits are associated with ON. CONCLUSION: Individuals who pursue a diet share some similarities with those who have an eating disorder regarding emotions, behaviors, and problems associated with orthorexic tendencies. Moreover, perfectionistic traits seem to predispose to higher ON tendencies. In general, these results confirm the ON as an aspect of the main eating disorders category.

The surveillance of occupational diseases in Italy: the MALPROF system.

BACKGROUND: Occupational diseases data can guide efforts to improve worker's health and safety. AIMS: To describe MALPROF, the Italian system for surveillance of work-related diseases collected by the subregional Department of Prevention. METHODS: The MALPROF system started in 1999 with contributions from Lombardy and Tuscany and spread in the following years to collect contributions from 14 out of the 20 Italian regions. MALPROF data were explored to follow-up work-related diseases and to detect emerging occupational health risks by calculating proportional reporting ratio (PRR), as in pharmacosurveillance. It classified work-related diseases according to economic sector and job activity in which the exposure occurred. Occupational physicians of the Italian National Health Service evaluate the possible causal relationship with occupational exposures and store the data in a centralized database. RESULTS: From 1999 to 2012, the MALPROF system collected about 112000 cases of workers' diseases. In 2010, more than 13000 cases of occupational diseases were reported. The most frequently reported diseases were hearing loss (n = 4378, 32%), spine disorders (n = 2394, 17%) and carpal tunnel syndrome (n = 1560, 11%). The PRR calculated for cervical disc herniation, a disease whose occupational origin has to be studied, in 1999-2010 was 2.47 [95% confidence interval (CI) 1.76-3.47] for drivers and 36.64 (95% CI 22.03-60.93) for air transport workers. CONCLUSIONS: MALPROF is a sensitive system for identifying possible associations between occupational risks and diseases, it can contribute to the development of preventive measures, to evaluate the effectiveness of preventive interventions and to stimulate research on new occupational risks and diseases.

A review of occupational disease surveillance systems in Modernet countries.

BACKGROUND: To improve occupational health public policies and to facilitate coordinated research within the European Union to reduce the incidence of occupational diseases (ODs), it is important to know what OD surveillance systems exist and how they compare. Monitoring trends in occupational diseases and tracing new and emerging risks in a network (Modernet) participants are well placed to provide this information as most either contribute data to and/or are involved in the management of OD systems. AIMS: To identify and describe OD surveillance systems in Modernet countries with the longer-term objective of identifying a core template to be used on a large scale. METHODS: A questionnaire sent to Modernet participants, seeking structured information about the OD surveillance system(s) in their country. RESULTS: Overall 14 countries (70%) provided information for 33 OD systems, among them 11 compensation-based (CB) systems. Six countries provided information for non-CB systems reporting for any type of OD. The other systems reported either only ODs from a prescribed list, or specific diagnoses or diagnostic groups, with reports to most schemes being physician-based. Data collected varied but all systems collected diagnosis, age, gender, date reported and occupation (and/or industry) and most collected information on exposure. CONCLUSIONS: This review provides information beneficial to both policy makers and researchers by identifying data sources useable to measure OD trends in European countries and opening the way to future work, both on trend comparisons within Europe and on the definition of a core template to extend OD surveillance on a larger scale.

Migraine in health workers: working in a hospital can be considered an advantage?

Migraine is the most common form of headache, and is one of the most diffused pathologies in the world. Moreover, patients often lose years before obtaining a correct diagnosis. The aim of this study was to evaluate whether diagnostic delay differs between hospital workers, in theory more sensible to health problems, and common people. We compared our cohort of patients attending the headache center on which we put a diagnosis of migraine with and without aura with a sample of hospital workers investigated about headache presence and characteristics. Particularly, hospital workers were evaluated by ID-migraine test, a three-question test validated to formulate a migraine diagnosis. Continuous variables (age and diagnostic delay) were compared with t test for independent samples. Dichotomous and categorical variables were compared with Chi squared test. The mean difference between in-hospital workers and outpatients was analyzed with a GLM/multivariate model accounting for age and sex. The difference between the single subcategory of workers affected by migraine was explored with a GLM/multivariate model accounting of age and sex. Five hundred and ninety-nine patients affected by migraine with and without aura were enrolled. Demographical characteristics were comparable in the two study populations. In-hospital workers (99 patients) had a mean longer diagnostic delay (14.89 years; 95 % CI: 7.85-21.93 years) with respect to the outpatients (12.13 years; 95 % CI: 5.37-18.89 years). The difference resulted statistically significant at the multivariate model (p < 0.05). Single subpopulations of in-hospital workers did not have a statistically significant different delay in diagnosing migraine. Diagnostic delay was significantly longer in hospital workers with respect to outpatients. Then, we can conclude that our population of hospital workers did not present a particular attention to their headache, probably because of a tendency to self-treating. Moreover, we did not find differences among different typology of workers, underlining that different job experience and education did not contribute to a best management of headache. More information and informative initiatives are necessary to sensitize people about migraine, especially among hospital workers.

Prevalence and clinical picture of gastroesophageal prolapse in gastroesophageal reflux disease.

The prevalence of gastroesophageal (GE) mucosal prolapse in patients with gastroesophageal reflux disease (GERD) was investigated as well as the clinical profile and treatment outcome of these patients. Of the patients who were referred to our service between 1980 and 2008, those patients who received a complete diagnostic work-up, and were successively treated and followed up at our center with interviews, radiology studies, endoscopy, and, when indicated, esophageal manometry and pH recording were selected. The prevalence of GE prolapse in GERD patients was 13.5% (70/516) (40 males and 30 females with a median age of 48, interquartile range 38-57). All patients had dysphagia and reflux symptoms, and 98% (69/70) had epigastric or retrosternal pain. Belching decreased the intensity or resolved the pain in 70% (49/70) of the cases, gross esophagitis was documented in 90% (63/70) of the cases, and hiatus hernias were observed in 62% (43/70) of the cases. GE prolapse in GERD patients was accompanied by more severe pain (P < 0.05) usually associated with belching, more severe esophagitis, and dysphagia (P < 0.05). A fundoplication was offered to 100% of the patients and was accepted by 56% (39/70) (median follow up 60 months, interquartile range 54-72), which included two Collis-Nissen techniques for true short esophagus. Patients who did not accept surgery were medically treated (median follow up 60 months, interquartile range 21-72). Persistent pain was reported in 98% (30/31) of medical cases, belching was reported in 45% (14/31), and GERD symptoms and esophagitis were reported in 81% (25/31). After surgery, pain was resolved in 98% (38/39) of the operative cases, and 79% (31/39) of them were free of GERD symptoms and esophagitis. GE prolapse has a relatively low prevalence in GERD patients. It is characterized by epigastric or retrosternal pain, and the need to belch to attenuate or resolve the pain. The pain is allegedly a result of the mechanical consequences of prolapse of the gastric mucosa into the esophagus.

Fatty acid composition of meat and estimated indices of lipid metabolism in different poultry genotypes reared under organic system.

According to EC regulation 889/08, different European countries should draw up a list of slow-growing strains adapted to an organic system, and in the meantime, provide this information to operators and the European Union commission. Thus, the aim of the present work was to evaluate the effect of poultry genotype on fatty acid composition and lipid indices of poultry meat. Six poultry genotypes (100 birds each), each with a different growth rate (slow-growing: Leghorn, Ancona, Cornish×Leghorn; medium-growing: Kabir, Naked neck; fast-growing: Ross), were reared under an organic system. Breast meat fatness, fatty acid composition, and indices were largely related to genotype, as slow-growing strains had higher elongase, thioesterase, and Δ5/Δ6 desaturase indices accompanied by a lower Δ9. Differences in the fatty acid profiles were observed by varying contents of total saturated fatty acids, with a higher value seen in Leghorn chickens and a lower value seen in commercial lines. On the contrary, Leghorn and Ancona chickens exhibited higher amounts of stearic acid and total polyunsaturated fatty acids compared with commercial genotypes, both in the total content and in the different fractions (total n-3 and total n-6). Despite the increased consumption of fresh forage, the lower linolenic acid in meat of the slow-growing strain could be explained by the higher conversion of this fatty acid to its long-chain derivatives.

Assessment of fitness for work in health care workers: biomechanical risk factors.

In current practice the assessment of fitness for work in health care workers exposed to biomechanical risk factors is often based on conventional approaches rather than on evidence-based guidelines. However, an accurate evaluation of worker's psychophysical resources compared to job demand and potential occupational risk factors is essential in order to properly assess fitness for work. The latest published guidelines on the management of patients suffering from back pain reported that the evidence-based approach can minimize the period of inactivity by encouraging return to work (and to other non-dangerous physical activities) in a relatively short period of time. As for carpal tunnel syndrome, there is no scientific evidence supporting a restriction of physical activities requiring forceful movements of the hand/wrist.

Wireless phone use in childhood and adolescence and neuroepithelial brain tumours: Results from the international MOBI-Kids study.

In recent decades, the possibility that use of mobile communicating devices, particularly wireless (mobile and cordless) phones, may increase brain tumour risk, has been a concern, particularly given the considerable increase in their use by young people. MOBI-Kids, a 14-country (Australia, Austria, Canada, France, Germany, Greece, India, Israel, Italy, Japan, Korea, the Netherlands, New Zealand, Spain) case-control study, was conducted to evaluate whether wireless phone use (and particularly resulting exposure to radiofrequency (RF) and extremely low frequency (ELF) electromagnetic fields (EMF)) increases risk of brain tumours in young people. Between 2010 and 2015, the study recruited 899 people with brain tumours aged 10 to 24 years old and 1,910 controls (operated for appendicitis) matched to the cases on date of diagnosis, study region and age. Participation rates were 72% for cases and 54% for controls. The mean ages of cases and controls were 16.5 and 16.6 years, respectively; 57% were males. The vast majority of study participants were wireless phones users, even in the youngest age group, and the study included substantial numbers of long-term (over 10 years) users: 22% overall, 51% in the 20-24-year-olds. Most tumours were of the neuroepithelial type (NBT; n = 671), mainly glioma. The odds ratios (OR) of NBT appeared to decrease with increasing time since start of use of wireless phones, cumulative number of calls and cumulative call time, particularly in the 15-19 years old age group. A decreasing trend in ORs was also observed with increasing estimated cumulative RF specific energy and ELF induced current density at the location of the tumour. Further analyses suggest that the large number of ORs below 1 in this study is unlikely to represent an unknown causal preventive effect of mobile phone exposure: they can be at least partially explained by differential recall by proxies and prodromal symptoms affecting phone use before diagnosis of the cases. We cannot rule out, however, residual confounding from sources we did not measure. Overall, our study provides no evidence of a causal association between wireless phone use and brain tumours in young people. However, the sources of bias summarised above prevent us from ruling out a small increased risk.

A fuzzy quality index for the environmental assessment of a restored wetland.

This paper describes the feasibility study for the restoration of agricultural land with a tendency to become waterlogged into a natural wetland, conceived to mitigate floods and to remove nutrients from the water drained from the cultivated plots. The wetland model, developed in aquatox, includes the nutrient dynamics both in the water and in the sediment, and the vegetation that is expected to develop as a consequence of flooding. The model inputs were synthesized from historical time series of rainfall and chemical data collected over the last decade. The model outputs are used to compute a synthetic fuzzy quality index (FQI) to assess the removal efficiency of the wetland. This FQI is based on three main variables describing the ecosystem quality: chlorophyll-a, dissolved oxygen and total suspended solids. This index has the merit of being simple enough to be immediately grasped by non-technical people, like managers and stakeholders, to whom the restoration project is proposed. The simulations, performed under five differing loading scenarios demonstrate the feasibility of this solution, which is robust enough to accommodate a 50% increase in either nitrogen, phosphorous or organic matter.

Breast muscle and plasma metabolomics profile of broiler chickens exposed to chronic heat stress conditions.

Understanding the variations of muscle and plasma metabolites in response to high environmental temperature can provide important information on the molecular mechanisms related to body energy homeostasis in heat-stressed broiler chickens. In this study, we investigated the effect of chronic heat stress conditions on the breast muscle (Pectoralis major) and plasma metabolomics profile of broiler chickens by means of an innovative, high-throughput analytical approach such as the proton nuclear magnetic resonance (1H NMR) spectrometry. A total of 300 Ross 308 male chicks were split into two experimental groups and raised in either thermoneutral conditions for the entire rearing cycle (0-41 days) (TNT group; six replicates of 25 birds/each) or exposed to chronic heat stress conditions (30 °C for 24 h/day) from 35 to 41 days (CHS group; six replicates of 25 birds/each). At processing (41 days), plasma and breast muscle samples were obtained from 12 birds/experimental group and then subjected to 1H NMR analysis. The reduction of BW and feed intake as well as the increase in rectal temperature and heterophil: lymphocyte ratio confirmed that our experimental model was able to stimulate a thermal stress response without significantly affecting mortality. The 1H NMR analysis revealed that a total of 26 and 19 molecules, mostly related to energy and protein metabolism as well as antioxidant response, showed significantly different concentrations respectively in the breast muscle and plasma in response to the thermal challenge. In conclusion, the results obtained in this study indicated that chronic heat stress significantly modulates the breast muscle and plasma metabolome in fast-growing broiler chickens, allowing to delineate potential metabolic changes that can have important implications in terms of body energy homeostasis, growth performance and product quality.

Fatty acid profile, oxidative status, and content of volatile organic compounds in raw and cooked meat of different chicken strains.

Chicken meat is rich in unsaturated fatty acids. Therefore, it is more susceptible to lipid oxidation and production of volatile organic compounds (VOC). In this study, we evaluated the fatty acids, antioxidants, and VOC profiles of raw and cooked meat samples derived from 4 strains of chicken differing in their growth rates, which were as follows: slow-growing (SG, Leghorn), medium-growing (MG, Hubbard and Naked Neck), and fast-growing (FG, Ross). The VOC profile of meat was measured using proton-transfer reaction-mass spectrometry (PTR-MS). The VOC were identified using PTR-time of flight-MS (PTR-ToF-MS). The data were analyzed using both univariate and multivariate models. Twenty main VOC were identified, which were classified into the following chemical categories: aldehydes, alkadienes, alkenes, furans, amides, alcohols, and other compounds. Our results revealed that the chicken genotype and the method of cooking strongly influenced the VOC profile of the meat. Identifying the relationships between these traits allowed us to highlight the trade-off of the main substrates such as n-3 and n-6 polyunsaturated fatty acids (PUFA), protective substances (antioxidants), and degradation products (VOC) of the poultry meat produced during cooking. The extent of VOC production and n-3 loss was found to be higher for the SG genotype. Reduction of n-6 was higher in MG, whereas small losses in antioxidants and PUFA were observed in the FG genotype, consequently, resulting in the lowest production of VOC. The SG and MG are genotypes more active from a kinetic point of view respect to the FG ones. For this reason, in the FG genotypes, the antioxidants are less involved in the oxidative stress induced by the movement; thus, they were available to protect the lipid of the meat during the cooking process. These results suggested that the use of SG and MG genotypes requires a specific dietary protocol (i.e., increasing the antioxidants content) to counteract the lipid oxidations in all the phases: in vivo, postmortem, and during/after cooking.

Micropatterned hydrogenated amorphous carbon guides mesenchymal stem cells towards neuronal differentiation.

This study investigated how the design of surface topography may stimulate stem cell differentiation towards a neural lineage. To this end, hydrogenated amorphous carbon (a-C:H) groove topographies with width/spacing ridges ranging from 80/40µm, 40/30µm and 30/20µm and depth of 24 nm were used as a single mechanotransducer stimulus to generate neural cells from human bone marrow mesenchymal stem cells (hBM-MSCs) in vitro. As comparative experiments, soluble brain-derived neurotrophic factor (BDNF) was used as additional biochemical inducer agent. Despite simultaneous presence of a-C:H micropatterned nanoridges and soluble BDNF resulted in the highest percentage of neuronal-like differentiated cells our findings demonstrate that the surface topography with micropatterned nanoridge width/spacing of 40/30µm (single stimulus) induced hBM-MSCs to acquire neuronal characteristics in the absence of differentiating agents. On the other hand, the alternative a-C:H ridge dimensions tested failed to induce stem cell differentiation towards neuronal properties, thereby suggesting the occurrence of a mechanotransducer effect exerted by optimal nano/microstructure dimensions on the hBM-MSCs responses.

Thulium: YAG 2 mum cw laser prostatectomy: where do we stand?

INTRODUCTION: Tm:YAG 2 mum cw laser prostatectomy was introduced in the treatment of benign ptostatic obstruction (BPO). Since then numerous studies have been published proving efficacy during follow-up. However, different surgical techniques were introduced with different names for similar techniques that complicate comparison. This reviews aim was to compare published data and break down surgical techniques to core points. The authors define validate appellations for different surgical techniques and propose further use of these names to ensure homogenous nomenclature. MATERIALS AND METHODS: All publications on Thulium:YAG prostatectomy have been included in this review. Articles were reviewed and associated due to the nature of the surgical approach. A systematic review of published data was performed. RESULTS: Sixteen peer-reviewed publications dealing with Tm:YAG laser prostatectomy were printed since 2005. Four different surgical principles are described, including vaporization, resection and enucleation. Follow-up, up to 24 months, showed durable functional results. CONCLUSION: Efficacy of Tm:YAG prostatectomy was shown. Surgical techniques include "Tm:YAG Vaporization of the prostate (ThuVAP)", "Tm:YAG VapoResection of the prostate (ThuVaRP)" and "Tm:YAG VapoEnucleation of the prostate (ThuVEP)". The almost blunt enucleation is introduced as "Tm:YAG laser enucleation of the prostate (ThuLEP)". The authors recommend the use of this neologism in the future. Further, large-scale prospective studies are needed to prove long-term durability. To initiate and canalize these upcoming studies, the Urothulium Study Group was founded, combining international experts on Thulium:YAG laser prostatectomy under its roof.

Three-dimensional analysis of pulmonary nodules: variability of semiautomated volume measurements between different versions of the same software.

PURPOSE: This study was done to evaluate the variability of semiautomated volume measurements of solid pulmonary nodules between two different versions of the same volumetric software. MATERIALS AND METHODS: The volumes of 100 solid intraparenchymal nodules (mean volume 88.10 mm(3); range 7.36-595.25 mm(3)) studied with the same multidetector computed tomography (MDCT) protocol were determined using two different versions of the same volumetric software (LungCARE 2006G and LungCARE 2007S). The 2006G version is based on a single-segmentation algorithm, whereas the newer version features two algorithms: SmallSizeNodule and AllSizeNodule. The results obtained with the 2006G version were compared with those of the 2007S version with the SmallSizeNodule algorithm, as recommended by the user manual. In addition, we compared the volumetric measurements obtained by the two different algorithms of the 2007S version. RESULTS: The 2006G version and the 2007S version with the SmallSizeNodule algorithm agreed in only two of 100 cases and showed a mean variability of 1.66% (range 0%-8.78%). A more significant volumetric discrepancy was observed between the two different algorithms of the 2007S version, with the AllSizeNodule algorithm providing on average larger volumes (mean variability 71.08%; range 6.02%-218.80%) than SmallSizeNodule. Volume discrepancies were more pronounced in the subgroups of smaller nodules in all comparisons. CONCLUSIONS: There is variability also in the results provided by different versions of the same volumetric software, and this may affect the calculation of the nodule-doubling time. Computer-aided assessment of the growth of lung nodules should always be performed using the same version of volumetric software and the same segmentation algorithm.

Incidence rates of surgically treated idiopathic carpal tunnel syndrome in blue- and white-collar workers and housewives in Tuscany, Italy.

OBJECTIVES: Rates of surgically treated carpal tunnel syndrome (CTS) among blue- and white-collar workers and housewives in the general population were compared. METHODS: Surgically treated cases of idiopathic CTS were investigated among 25-59-year-old residents of Tuscany, Italy, during 1997-2000, based on obligatory discharge records from all Italian public/private hospitals, archived according to residence on Tuscany's regional database. Population data were extracted from the 2001 census. RESULTS: After excluding repeat admissions, 8801 eligible cases were identified. Age-standardised rates (per 100 000 person-years) of surgical CTS were: "blue-collar women", 367.8; "white-collar women", 88.1; "housewives", 334.5; "blue-collar men", 73.5; and "white-collar men", 15.3. Compared with reference categories (same-sex white-collar workers): female blue-collar workers experienced a 4.2-fold higher standardised rate; housewives, a 3.8-fold excess; and male blue-collar workers, a 4.8-fold excess (all p<0.001). Male and female blue-collar workers showed approximately three to sevenfold higher age-specific rates compared to their white-collar counterparts (all p<0.001). Housewives' rates were similar to those of blue-collar female workers up to 40-44 years of age, after which they were significantly lower (p<0.002). At all ages, housewives' rates were much higher (p<0.001) than those of white-collar women. CONCLUSIONS: Surgically treated CTS was three to seven times more common (depending on age/gender) in blue-collar than in white-collar workers, which is difficult to explain by differences in body weight or other individual factors. Thus, occupational risk factors seem relevant throughout working life. The high rates for full-time housewives suggest that domestic chores should be investigated as a possible risk factor for CTS.

[Low back pain among video-terminal workers: ergonomic postural interventions]. / Efficacia di un intervento ergonomico sulla postura lavorativa e sul mal di schiena nei videoterminalisti.

BACKGROUND: Several studies report a high prevalence of low back pain (LBP) among video-terminal (VDT) workers. Targeted ergonomic interventions can help reduce the burden. OBJECTIVES: We investigated the long-term efficacy of an ergonomic postural intervention to address LBP among VDT workers. STUDY DESIGN: Non-randomized, crossover trial. POPULATION AND SETTING: Four hundred employees working in the administrative offices of the two main buildings of the town hall ofForlì who used VDTs for at least 20 hours a week; we randomly selected 100 participants from each building. INTERVENTION: Ergonomic adjustment of the VDT workstation design. OUTCOME MEASURES: Changes in prevalence of LBP and work-related posture. RESULTS: The ergonomic adjustment of the workstation improved work-related posture and reduced LBP in VDT operators who benefited from the intervention. CONCLUSIONS: A personalized ergonomic prevention intervention can improve work-related posture and LBP for VDT workers.

[The contribution of the Italian scientific community to efficacy studies in Occupational Health (1990-2006)]. / L'apporto della comunità scientifica Italiana alle prove di efficacia in medicina del lavoro.

INTRODUCTION: Evidence-based prevention (EBP) is gaining growing interest among the international scientific community in the field of Occupational Health. In order to ascertain the commitment that has been made in Italy to participation in EBPR, we conducted a systematic review of scientific publications on efficacy evaluations in Italy. METHODS: We hand-searched journals and interrogated the PubMed database to identify reports of studies evaluating interventions designed to improve workers' health in Italy between 1990 and 2006. The selected articles were classified by institutional category (of the first author), intervention methodology, study design, type of risk factor, and occupational sector. RESULTS: We found 23 eligible publications in the Italian language and 9 in English. The most frequent study-design was pre-/post-intervention evaluation; 3 studies were randomized trials. The interventions were aimed mainly at controlling the effects of chemical hazards and noise; health-care settings were the most frequent. We found only 2 studies (1 in English) evaluating the efficacy of interventions targeting injury prevention. DISCUSSION: The systematic approach of EBP can be applied to most occupational health interventions. These results may contribute to the debate on methodology and outcomes in the scientific community.