Diversity & Inclusion: Fitness for Work Through a Personalized Work Plan For Workers With Disabilities and Chronic Diseases According to the Iso 30415/2021.

The recent standard ISO 30415-2021 - Human resources management - Diversity and inclusion -  was developed internationally within the technical committee ISO/TC 260 "Human resources management" (Working group WG 8 "Diversity and inclusion") and underlines the need for actions to create a work environment that is inclusive of diversity (e.g. in terms of health, gender, age, ethnicity, culture). Developing an inclusive work environment requires ongoing commitment and input from the entire organization regarding policies, processes, organizational practices, and individual behavior. As far as the role of occupational medicine is concerned, this direction can be supported by the correct management of disabled workers and workers with chronic pathologies that affect their fitness for duty. The "reasonable accommodation" is the way by which the European Union first, and the United Nations then intended to support the inclusion of disabled people in the world of work. The Personalized Work Plan includes different approaches (organizational, technical, procedural) meant for modifying the work activity envisaged for the disabled worker or for any worker suffering from chronic diseases or dysfunctions. The adoption of the Personalized Work Plan implies the effort of redesigning the workstation, the work procedures, or even the planning of different micro and macro tasks etc., in order to prioritize the adaptation of the working environment to the worker, safeguarding the value of the worker's productivity according to the principle of reasonable accommodation.

Evaluation of Flu Vaccination Coverage among Healthcare Workers during a 3 Years' Study Period and Attitude towards Influenza and Potential COVID-19 Vaccination in the Context of the Pandemic.

(1) Background: vaccination of healthcare workers (HCWs) against seasonal influenza is considered the most effective way to protect HCWs, ensure patient's safety and to maintain essential health care services during influenza epidemics. With the present study we aimed to evaluate the efficacy of incremental bundles of measures implemented during the last three flu campaigns and to assess the attitudes towards influenza vaccination and a potential vaccine against COVID-19 among HCWs, in a large university hospital in Pisa, Italy. (2) Methods: We described measures implemented during 2018/2019, 2019/2020 and 2020/2021 and assessed their impact on flu vaccine coverage (VC) among employees and residents in Pisa university hospital. We considered sex, profession and ward to investigate differences in uptake. In addition, in 2020 a survey was developed and distributed to all employees to evaluate flu and COVID-19 vaccines attitudes. (3) Results: during the 2018/19 and 2019/20 flu campaigns the overall VC rate among HCWs was, respectively, 10.2% and 11.9%. In 2020/21 the overall VC rate jumped to 39.3% (+ 230.6%). Results from the survey indicated a more positive attitude towards flu vaccine as compared to COVID-19 vaccines among the 10.6% of the staff members who responded to the survey. In addition, 70.97% of HCWs totally agreed that being vaccinated against influenza would be more important than the previous years because of COVID-19 emergency. (4) Conclusions: a significant increase in VC was observed in 2020/21, especially among those sub-groups with consistently lower uptake in previous years. The COVID-19 pandemic positively influenced flu vaccination uptake during the 2020/21 season.

Improvement of periulcer skin condition in venous leg ulcer patients: prospective, randomized, controlled, single-blinded clinical trial comparing a biosynthetic cellulose dressing with a foam dressing.

OBJECTIVES: The aim of this study was to investigate the influence of a biosynthetic cellulose wound dressing (BWD) to stimulate wound healing in patients with a venous leg ulcer on periulcer skin condition when compared with standard care using a foam dressing. METHODS: Each patient with a venous ulcer received compression therapy with a short stretch bandage system and either a BWD + foam (study group [SG]) or foam (control group [CG]). Periulcer skin condition was compared with the untreated lower leg skin and the forearm skin, using noninvasive parameters, comparing day 0 versus day 28 results. Ulcers were further evaluated for healing rate. The study period was 28 days, and the follow-up period was 12 weeks. Fifty patients were recruited to the study, of which N = 46 (SG, n = 26; CG, n = 20) completed the 28-day study period and were included in the analysis. RESULTS: The BWD showed a more improved periulcer skin condition versus the CG. Transepidermal water loss was significantly less in the SG (P = .003), as well as the results shown with the chromatometer (P =. 05). Ulcer healing rate was also statistically significant in favor of the SG (P = .0001). CONCLUSION: Treatment for the BWD + foam group was shown to be safe and significantly improved periwound skin condition, leading to more expeditious wound healing than treatment with foam alone.

Instrumental evaluation of the protective effects of a barrier film on surrounding skin in chronic wounds.

UNLABELLED:  Objective. This study investigated the effects of Cavilon® No Sting Barrier Film ([NSBF], 3M Healthcare, St. Paul, Minn) on skin surrounding chronic wounds by means of monitoring transepidermal water loss (TEWL). METHODS: Forty patients were examined; 20 patients had pressure ulcers and the other 20 patients had venous leg ulcers. The patients were divided into 2 groups, the first group (treatment group) was treated with NSBF and the second group (control group) was treated with zinc oxide ointment applied to surrounding skin. TEWL values on surrounding skin were monitored before and after the therapy. RESULTS: Statistical evaluation showed an overall reduction of 45% in TEWL values in both groups by the conclusion of the study period when compared to baseline values (P < 0.01). The NSBF application was a quick and simple process. Removal of residue was not necessary. An additional benefit is that the skin can be seen through the film. CONCLUSION: The study objectively demonstrated that the NSBF can help in the management of the skin surrounding chronic wounds.

OASIS wound matrix versus Hyaloskin in the treatment of difficult-to-heal wounds of mixed arterial/venous aetiology.

Mixed arterial/venous (A/V) ulcers are difficult to treat and slow to heal likely as a result of deficiencies in molecular and cellular elements in the wound bed. Recently, biomaterials have been developed that replace extracellular matrix (ECM) molecules and growth factors critical to the normal healing process. In this study, the effects of OASIS and Hyaloskin were evaluated to compare the effectiveness of these two ECM-based products in their ability to achieve complete wound healing of mixed A/V ulcers. After 16 weeks of treatment, patients in each group were evaluated on four criteria: complete wound healing, time to dressing change, pain and comfort. Complete wound closure was achieved in 82.6% of OASIS-treated ulcers compared with 46.2% of Hyaloskin-treated ulcers (P < 0.001). Statistically significant differences favouring the OASIS treatment group were also reported for time to dressing change (P < 0.05), pain (P < 0.05) and patient comfort (P < 0.01). Overall, OASIS was superior to Hyaloskin for the treatment of patients with mixed A/V ulcers, a population in which standard treatment options largely consist of moist wound dressings and compression therapy is typically not an option. OASIS is a useful and well-tolerated treatment for mixed A/V ulcers that has the potential to improve quality of life and reduce costs associated with standard of care.

Measuring wound outcomes.

Chronic cutaneous wounds include leg ulcers, pressure ulcers, and diabetic foot ulcers. Each of these conditions is difficult to heal within an acceptably short time, and to maintain as healed. Patients suffer tremendous discomfort and pain, and are often socially deprived as a result. The financial consequences of this medical problem are enormous. Chronic or nonhealing ulcers are characterized by defective remodeling of the extracellular matrix, a failure to reepithelialize, and prolonged inflammation. In order to obtain biochemical and physical information about the wound bed and the surrounding skin, different options of noninvasive and invasive measurements have been developed and tested. Monitoring of acute and chronic wounds can be performed by measuring in an objective, precise, and reproducible way and by simply adapting existing validated technologies. When speaking of cutaneous wounds, one refers to defects in the skin surface. It is generally believed that a full and correct characterization of the level of tissue damage must be carried out by analyzing 2 distinct groups of parameters: dimensional parameters and chromatic parameters. Recently, the concept of wound bed preparation has been introduced and classified according to the clinical parameters of chronic wounds. In order to monitor the different aspects of wound bed preparation, various instrumental techniques are now under investigation, allowing improved, more objective characterization of the tissue repair process. The advantage of this new scientific discipline is the ability to study living skin in real time. The main physical wound parameters that have received the most attention over the past few years in terms of outcome in wound measurement are: area and volume, color, surface pH, temperature, wound fluid analysis, odor, pain, and tissue perfusion.