Work-Related Stress Questionnaire: confirmatory factor analysis for construct validation by the PHRASI study.

OBJECTIVE: The purpose of this study is to validate the 13-item version of the Work-Related Stress Questionnaire (WRSQ) on a representative sample of Italian public health residents. MATERIALS AND METHODS: The WRSQ was administered as part of the Public Health Residents' Anonymous Survey in Italy (PHRASI) from 14 June to 26 July 2022. Collinearity between each questionnaire item was assessed with Kendall's τ statistic. The latent factors identified associating similar items based on the authors' observations were workplace, job demand, support and unpleasant workplace. Goodness-of-fit was assessed with confirmatory factor analysis calculating: Comparative Fit Index (CFI), Tucker-Lewis Index (TLI), Root Mean Square Error of Approximation (RMSEA), Standardized Root-Mean-Residual (SRMR). Cronbach's alpha (α) and Omega McDonald (ω) were calculated to evaluate the reliability of the questionnaire. R 4.2.2 was used to perform the analyses. RESULTS: 379 Public Health residents (58% women) responded to the questionnaire. No significant collinearity was found between the items (τ range -0.31 to 0.49). Confirmatory Factor Analysis showed CFI = 0.975, TLI = 0.967, RMSEA = 0.041 and SRMR = 0.051. Internal consistency of the WRSQ Total Score was α = 0.80 and ω = 0.85. CONCLUSIONS: Although validated in a sectorial subpopulation of healthcare workers, the WRSQ proved to be an excellent tool for assessing work-related stress. Unpleasant workplace latent factors showed lower factor loading and internal consistency than others. This could be due to the fact that topics investigated with unpleasant workplace items (e.g., abuse and discrimination) are experienced on a less regular basis than the ones assessed through the other items.

Impact of the Multidisciplinary Cancer Team on the Diagnostic and Therapeutic Care Pathway of Early Breast Cancer Patients and Perception of Team Members: The Experience of a Cancer Centre in Italy.

Literature on the role of multidisciplinary team (MDT) in cancer is still controversial. We aimed to investigate MDT impact on a panel of indicators in breast cancer care in a single-center retrospective study performed in a Cancer Reference Center in Italy. We analysed the diagnostic and therapeutic care pathway (DTCP) of 266 early breast cancer patients managed by our MDT during 2019-2020. Process indicators reflecting the change of the diagnostic and therapeutic care pathways occurred after the MDT discussion were computed. Further, the performance of some quality care indicators in breast cancer care since the establishment of the MDT activity and the breast cancer MDT members' perceptions were also investigated. According to our study, the MDT approach improves breast cancer management by increasing the completion of staging and by encouraging neo-adjuvant treatment and an appropriate and faster surgery. In MDT members' perspective it also improves decision-making and training and creates a positive work environment. Globally, our study encourages MDT rollout in breast cancer care. However, to enhance the reliability and comparability of the results of studies investigating MDT effectiveness in clinical practice, shared guidelines on its operationalisation are strongly desirable.

The Urbino Charter: a Declaration for the well-being of working people.

Abstract: The "Urbino Charter" is a document aimed at promoting the well-being of the working person that the Olympus Observatory of the University of Urbino Carlo Bo and the Rubes Triva National Foundation, a joint body in the field of environmental hygiene, presented in Bilbao at a public conference in March 2023. The Charter has the objective of stimulating reflection on the issues related to prevention while drawing attention to the essential values for the effective protection of workers' health, safety and well-being. This commentary has the aim of presenting the 10 statements of the Chart, from a perspective of Occupational health and safety.

Work-related stress costs assessment: a narrative review.

Background: Work-related stress represents a major health problem within most work environments and its rates of incidence are increasing as time goes by. Work-related stress is both detrimental for workers' psychophysical health and costly to societies. Besides the direct medical costs that represent only a fraction of the total cost, data is either lacking or unreliable to properly estimate the economic impact of occupational stress. Methods: This paper reviews international studies and organisational reports in order to highlight occupational stress economic impact on an international level. Results: The study shows that work-related stress imposes an undeniable financial burden on worldwide societies. Findings show estimations that vary from € 54 million up to € 280 billion depending on the country. Results suggest that productivity loss due to absenteeism and presenteeism has a greater economic impact compared to the medical expenses. Discussion: Generally speaking, the costs of work-related stress, also according to Europe, impact both on employers and welfare sy-stems, and from the point of view of prevention we should work hard to improve stress-management strategies. Conclusions: The discussion around this matter should be emphasized in order to properly address occupational stress and make implications for job redesign under the perspective that promoting and protecting workers' mental well-being will benefit the individual and allow cost containment benefitting the collective as well.

Certification and prescription in the diabetology field: occupational and medico-legal aspects.

Abstract: Diabetes mellitus is an ever-increasing disease and is defined as a "social disease" due to the significant economic damage it causes to the affected individuals and the community involved in its care. This paper presents the process of certification of diabetic disease and the application for invalidity in order to obtain welfare and economic benefits provided by law; it, also, describes the prescription process and the appropriateness of therapeutic prescription for the diabetic patient in terms of clinical-prescriptive appropriateness and economic-prescriptive appropriateness. Finally, it reports on the side effects of the most common antidi-abetics, the off-label use of metformin and the physician's responsibili-ties in the light of the Gelli-Bianco law.

Chemical-analytical characterization and leaching of heavy metals associated with nanoparticles and microplastics from commercial face masks and the abundance of personal protective equipment (PPE) waste in three metropolitan cities of South America.

In this study, we surveyed the presence of personal protective equipment (PPE) waste on the streets of Bogotá-Colombia, Lima-Perú, and Mar del Plata-Argentina. Furthermore, this work is also focused on the release capacity of Ag, Cu, and Zn metals associated with nanoparticles, and microplastics (MPs) from textile face masks (TFMs) and disposable face masks. According to our results, an association between low-income areas and PPE waste was found, which may be related to the periodicity of waste collection and economic activity. Polymers, like polypropylene, cotton-polyester, and additives, such as CaCO3, MgO, and Ag/Cu as nanoparticles, were identified. TFMs released high levels of Cu (35,900-60,200 µg·L-1), Zn (2340-2380 µg·L-1), and MPs (4528-10,640 particles/piece). Metals associated with nanoparticles leached by face masks did not present any antimicrobial activity against P. aeruginosa. Our study suggests that TFMs may leach large amounts of polluting nano/micromaterials in aquatic environments with potential toxicological effects on organisms.

"Fare male farsi male" project - Are cyberbullying and cyber victimisation associated with physical activity levels? a cross sectional study in a sample of Italian adolescents.

Background: The aim of this project is to study the prevalence of cyberbullies (CB) and cybervictims (CV) and cyberbully-victims(CBV) in Italian adolescent students and a possible correlation with physical activity (PA) levels and as potential protective factor. Methods: The Italian version of the European Cyberbullying Intervention Project Questionnaire (ECIPQ) was used for categorized cyberbullies (CB) and cybervictims (CV). Six items of the IPAQ-A Italian version were considered to measure the PA levels. Results: 2112 questionnaires were collected, with response rate of 80.5%. The sample reported 9% was CV only, 5% was CB only, and 6% was cyberbully-victims (CBV). The factors that are significant associated to the CV students were: female gender (OR=1.7; 95%CI:1.18-2.35); stay at middle school (OR=1.56; 95%CI:1.01-2.44); spent more than 2 hours on IT devices (OR=1.63; 95%CI:1.08-2.47). The variables significant associated to the CB students were: gender male (OR=0.51 95%CI:0.320.80); spent more than 2 hours on IT devices (OR=2.37; 95%CI:1.32-4.26); tobacco use (OR=2.55; 95%CI:1.63-3.98); an inverse proportion with the number of days spent in vigorous physical activities (OR=0.82; 95%CI:0.68-0.98). The CBV students were significant associated with a male gender (OR=0.58; 95%CI:0.38-0.89) and tobacco consumption (OR=2.22; 95%CI:1.46-3.37). Conclusions: The physical activity at vigorous level seem to be related to less involvement in cyberaggression, so it is recommended that those responsible for training adolescents' favour this aspect. Research on effective prevention is insufficient and evaluation of policy tools for cyberbullying intervention is a nascent research field an any prevention or intervention program could consider this factor.

What to remove from the work environment: the sick worker or the cause of his sickness? Workplace bullying, a form of violence that causes sickness.

Abstract: Although there are many different definitions of workplace bullying in the scientific literature, it can be defined as a form of psychological and relational violence conducted systematically and continuously by one or more individuals, towards another individual, with the aim of causing him physical and mental harm and exclude him from the workplace. The elements common to all definitions are the work context, the duration for at least six months, the frequency of bullying actions, which must occur at least once a week, the evolution in phases and the power differential between aggressor and victim. The purpose of this article is not only to provide the most important definitions of workplace bullying and to identify the common elements, but also to report the most recent findings concerning gender and personality differences of both victim and aggressor, to report the most investigated professional sectors, to describe the causes and the consequences on both the worker and the organization and to present the legislative framework. Workplace bullying can be considered an emerging public health problem that requires preventive interventions. Secondary and tertiary prevention interventions are important, but the aim is to prevent the phenomenon when it has not yet developed. Primary prevention interventions promote a healthy work environment that reduces the development of work-related violence, including workplace bullying.

Relationship between formaldehyde exposure, respiratory irritant effects and cancers: a review of reviews.

OBJECTIVES: Formaldehyde is an organic compound used in the production of resins, paper, wood plywood, solvents and cleaning products. Formaldehyde is also present when tobacco is smoked. Formaldehyde has been defined as an irritant and is classified as a human carcinogen by the International Agency for Research on Cancer. The purpose of this study was to demonstrate the following two distinct correlations: (1) the association between formaldehyde exposure and development of irritant diseases affecting the respiratory tract, mainly asthma; and (2) the association between formaldehyde exposure and development of neoplastic diseases. STUDY DESIGN: This was an umbrella review. METHODS: A search was conducted in the three main electronic databases of scientific literature: PubMed, Scopus and Web of Science. The search included systematic reviews and meta-analyses published in the previous 10 years. Initially, titles and abstracts of retrieved articles were evaluated, then full-text assessments of selected articles took place. Data extraction and quality assessment were performed according to Assessing the Methodological Quality of Systematic Reviews (AMSTAR) score. RESULTS: A total of 630 articles were initially collected. Nine articles concerning the association between formaldehyde exposure and asthma were included in the present review, and the majority of these reported good association. In addition, 27 articles investigating the association between formaldehyde exposure and neoplastic diseases were included in the review. These studies showed that nasopharyngeal cancer and leukaemia were the most represented neoplastic diseases; however, only a weak association was reported between formaldehyde exposure and cancer. CONCLUSIONS: Although the studies included in this review did not show a strong association between exposure to formaldehyde and irritant or neoplastic diseases, the World Health Organisation recommends that levels of formaldehyde do not exceed the threshold value of 0.1 mg/m3 (0.08 ppm) for a period of 30 min. It is recommended that preventive measures, such as ventilation in workplaces with high exposure to formaldehyde and environmental monitoring of formaldehyde concentrations, are implemented.

Investigating the synergistic effect of socio-demographic fac- tors on behaviors and attitudes concerning alcohol and illicit drug use among Italian students: a large cross-sectional study.

Background: Alcohol, drug consumption and polysubstance use are some of the most important causes of illnesses and mortality among adolescents, who have been identified as common users of these substances. Aim of this study was to assess and describe the current scenery of alcohol and other drugs consumption habits among a wide sample of Italian high school and university students. Methods: A cross-sectional study was carried out using an online survey. The questionnaire was developed and administered via an internet forum for middle school, high school and university students named "Skuola.net". The statistical analysis included descriptive statistics, univariate and multivariate analysis. Additive interactions were assessed by calculating the synergy index. Results: A total of 11,379 Italian students answered the questionnaire. The prevalence of alcohol drinkers was 34.2%; among these, 17.8% of the individuals showed unhealthy drinking behaviors (frequency of alcohol use of four times or more per week); 10.3% of individuals declared daily assumption of six or more glasses of alcohol. Concerning drugs, 15.7% of the responders classified themselves as illicit drug users, with cannabis getting the highest prevalence rates (6.9%). Finally, concerning alcohol, a synergistic effect was recorded for male and adult individuals (SI = 1.04); while concerning illicit drugs, a synergistic effect was found between male gender and older age (SI = 1.42), and between university students and male gender (SI = 1.10). Conclusions: This study gives an overview about the attitudes of a wide sample of Italian students concerning alcohol and drugs habits. These results are in line with evidences from the scientific literature and will be helpful for developing future prevention strategies towards this target population.

Lifestyle behaviors among Canadian nurses working night shifts in the COVID-19 era: a pilot study.

Abstract: Working night shifts has been associated with negative mental health consequences such as depression, anxiety, and sleep problems. The objectives of this study were to determine the lifestyle behaviors (prevalence of nicotine, caffeine, cannabis, sleep-promoting medication, and alcohol use) and the association between job stress, sleep quality, anxiety, and depression among registered nurses working night shifts in the Canadian province of Saskatchewan in the COVID-19 era. Twenty-two registered nurses ranging from ages 25-65 that work permanent or rotating night shifts participated in an online survey from April 11th to July 15th, 2022. The results showed a strong positive association between sleep disturbance, and depression r (19) = 0.50, [p = 0.029, 95% CI, 0.06, 0.78]. A positive correlation was found between higher levels of reported anxiety and sleep disturbance r (19) = 0.69, [p = 0.001, 95% CI, 0.34, 0.87]. There was a positive correlation between depression and occupational exhaustion r (17) = 0.56, [p = 0.021, 95% CI, 0.10, 0.82]. Anxiety was significantly related to occupational exhaustion r (17) = 0.65, [p = 0.005, 95% CI, 0.24, 0.86] and depersonalization r (17) = 0.52, [p = 0.005, 95% CI, 0.06, 0.80], but not significantly related to personal accomplishment r (17) = -0.34, [p = 0.185, 95% CI, -0.70, 0.17]. In conclusion, a sample of Canadian nurses working night shifts in the province of Saskatchewan during the COVID-19 pandemic showed a significant positive relationship among sleep disturbance, anxiety, and depression. Furthermore, most nurses reported using at least one or more of the following substances: sleep-promoting medication, nicotine, alcohol, and cannabis.

Extra-auditory effects of noise exposure in school workers and preventive measures: a systematic review.

OBJECTIVE: Noise is still today one of the main causes of occupational diseases; in fact, in Italy in the three-year period 2019-2022, hearing loss represented 15% of all occupational diseases recognized by the National Institute for Insurance against Accidents at Work. The extra-auditory effects related to noise exposure also require particular attention, because they can interfere with mental activities that require concentration, memory and ability to deal with complex problems, causing sleep and learning disorders. For this reason, acoustic comfort is considered a fundamental requirement for obtaining an optimal degree of well-being in closed environments. In schools, a high degree of noise pollution not only makes it difficult for students to listen and learn, but also affects school workers. The aim of this study was to perform a systematic review of international literature and analysis of the preventive measures of extra-auditory effects among school workers. MATERIALS AND METHODS: The presentation of this systematic review is in accordance with the PRISMA statement. The methodological quality of the selected studies was assessed with specific rating tools (INSA, Newcastle Ottawa Scale, JADAD, JBI scale and AMSTAR). Only publications in English were selected. No restrictions were applied for the publication type. We excluded articles not concerned with the extra-auditory effects of noise exposure in school workers and preventive measures, findings of less academic significance, editorial articles, individual contributions, and purely descriptive studies published in scientific conferences. RESULTS: Online research indicated 4,363 references: PubMed (2,319), Scopus (1,615) and Cochrane Library (429) have been consulted; 30 studies were included in this review (5 narrative or systematic reviews and 25 original articles). Regarding the scores of narrative reviews, the INSA score showed an average and a median value of 6.5, thus indicating an intermediate/high quality of the studies. Regarding the scores of systematic reviews, the AMSTAR score showed an average of 6.7 and a median and a modal value of 6, thus indicating a high quality of the studies. The scores assigned to the original articles have an average and median value of 7 and a modal value of 6 and this demonstrates an intermediate/high quality of the studies. CONCLUSIONS: We can assume that, as it is highlighted by this study, to date these consequences are not considered at the legislative level for the protection of exposed workers. The extra-auditory effects impacting health afterward environmental noise exposure are many and widespread. Therefore, there is a need for interventions to be carried out by institutions and that the physician of the schools, during health surveillance, investigates the effects and clinical manifestations, in order to prevent disorders and deficits highlighted by our study.

Total Worker Health®: knowledge of a sample of Occupational Physicians and Prevention and Protection Service Managers.

Background: In the workplace, it is increasingly important to promote interventions to improve the work environment that can combine compliance with regulations related to worker health and safety protection with health promotion interventions. The objective of our study is to investigate the status of the implementation of various health management measures through questionnaires submitted to Occupational Physicians (OPs) and Prevention and Protection Service Managers (PPSMs). Methods: This study was conducted between September 2022 and November 2022. Healthcare professionals were invited to voluntarily answer the questions, administered through a Google form, of a standardized questionnaire (Cronbach's alpha=0.887) based on the study made by Hoge et al. (2019): the first part collected demographic information and the other four were relating to the state of implementation of interventions attributable to the Total Worker Health® approach. Results: 89 OPs and PPSMs were involved. The univariate and multivariate analysis shows that, overall, women and PPSMs have a higher degree of dissatisfaction related to various health management measures within companies; most workers are fairly satisfied with health and safety protection in the workplace; finally, according to healthcare professionals, aspects of primary prevention and work management/organization would need to be improved. Conclusions: This study shows that in Italian companies there is often no full application of Total Worker Health® principles. The affirmation of this approach, awareness should be raised, first and foremost, among employers, but also among prevention figures and consultants about all the benefits of Total Worker Health®: one among all, an 'economic' advantage.

Can legionellosis be considered an occupational risk in the healthcare sector? A systematic review and meta-analysis.

OBJECTIVES: According to current knowledge about legionella transmission, healthcare workers (HCWs) are at an increased risk of exposure. The aim of this research was to systematically review the literature about HCWs' exposure to legionella and establish whether there is an occupational risk. STUDY DESIGN: This was a systematic review and meta-analysis. METHODS: PubMed, Scopus and Web of Science were searched to identify studies regarding the occupational risk of legionellosis for HCWs. Keywords used in the search were 'Legionella pneumophila', 'occupational medicine', 'occupational' and 'risk'. Selected studies were reviewed to assess the quality and meta-analysed. Finally, the nine epidemiological principles of Bradford-Hill criteria were used to assess whether legionellosis could be considered an occupational risk for HCWs. RESULTS: The search strategy retrieved 124 studies, and 10 studies were included in the present review. The overall study quality was low. The pooled odds ratio estimate was 2.45 (95% confidence interval: 1.52-3.96). The assessment using Bradford-Hill criteria showed that only two criteria (plausibility and coherence) were met, which is insufficient to establish an occupational risk. CONCLUSIONS: This systematic review suggests that there is a higher risk of legionella exposure for HCWs, but there is currently no clinical evidence. Further studies with appropriate study design are needed to determine whether legionella infection is an occupational risk for HCWs.

International Physical Activity Questionnaire for ITalian Elderly (IPAQ-EIT): reliability in an Italian sample.

Background: The aim of the paper was to perform an Italian version of the International Questionnaire of Physical Activity in the Elderly: IPAQ-EIT. Methods: Adults with age over 64 years with normal neurological status and without difficulty in ambulation were enrolled in opportunistic way and on voluntary basis in different Italian regions. Two independent researchers have translated the English version independently. The final IPAQ-EIT version was submitted twice, with an interval of one day between each administration (T0 and T1). McNemar's Test was used to assess the agreement between qualitative variables; Wilcoxon Signed Ranks Test and Spearman correlation coefficients were used for continuous data. Cronbach's alpha was used as a measure of the internal consistency. Results: Thirty-three questionnaires were collected at T0 and T1. 100% of response rate was obtained. The Cronbach's alpha at T0 was α= 0.79 and at T1 α= 0.84. The Spearman's coefficient reported significant associations (p<0.001) between the two administrations for all items. The test-retest analysis for two paired samples underlined for all items not significant differences. Conclusions: The IPAQ-EIT short form shown an acceptable consistency, feasibility to administer and easy to combine with other questionnaires. It is an additional valid measuring tool for physical activity levels in the elderly.

The third age: physical activity and culture over 65.

Abstract: The present research focuses on the delicate and complex process of senilization of the population, being one of the most important anthropological and social problems of our time. These considerations lead us to examine not so much the aging process itself, but the relationship between the third age and society, focusing on the factors that promote or inhibit well-being and the relative perceptions that emerged in the sample. In this sense, an online questionnaire was administered, by email and by telephone message, over a period of approximately 10 months starting from March 2021 until December 2021. The questionnaire included multiple choice questions that produced clear data and simple analysis, arriving at an accurate analysis (qualitative and quantitative), on the topics of interest: the role of nutrition and sport in the over 65s, not only by the subjects in question, but also the considerations and perceptions of subjects belonging to different age groups with reference to the topics of interest relating to the third age. The sample results, allow us to identify the appropriate interven-tion strategies and policies useful for eradicating the stereotype that accompanied the concept of old age until a few years ago, making it synonymous with illness, loneliness, fragility and uselessness. Finally, today, we have freed ourselves from the role of "sedentary elderly" and motor activity in the third age is increasingly widespread and relevant as can be seen from the data analysis. This research is the result of a program that has been in place for several years now to combat the hypokinesis diseases, through physical movement and particularly by examples of appropriate lifestyles. This initiative was conceived and implemented by C.I.S.C.O.D. (Comitato Italiano Sport Contro Droga) and CO.NA.P.E.F.S. (Collegio Nazionale Professori Educazione Fisica e Laureati in Scienze Motorie), two C.O.N.I. well-deserving associations, and carried out as part of a larger "Survey on nutrition and culture over 65" project, proclaimed by Sport & Salute S.p.A.

Contact tracing as an essential prevention tool for the spreading of COVID-19 among healthcare workers.

Abstract: Healthcare workers, since the beginning of the COVID-19 pandemic, have been universally recognized as especially susceptible, with infection risks higher than the general population. Therefore, it is important to apply infection prevention and control measures in healthcare institutions to limit infections associated with the provision of healthcare services. In this contest, contact tracing, in fact, is an essential public health measure to fight the COVID-19 pandemic, with active case finding and testing, and physical distancing. Globally, new weekly cases and deaths are decreased, but WHO emphasizes that cases and deaths should be interpreted with caution because several countries have been progressively changing COVID-19 testing strategies, resulting in lower overall numbers of tests performed and consequently lower numbers of cases detected. Health personnel, therefore, work at a high-risk department and this has been associated with a 2.13 times higher risk of COVID-19 compared to the general departments of any hospital and, if the healthcare workers had inability to continue working and if there was the possibility of hospitals turning into sources of infection, it could be an interruption in healthcare services. A coordination with the system of surveillance is important that remains in the hospital in order to fight COVID-19 and help restructure the response in the light of detected transmission and guarantee safe hospital care.

Knowledge on causes and consequences of Climate Change in a cohort of Italian students.

Background: Climate change (CC) is the greatest threat to the health of the planet. The scientific community has established its connection to human activities and its role in emerging and premature diseases. Our study helps to understand how students of various backgrounds and academic fields retrieve information on CC and highlights the knowledge on the main causes and consequences of global warming and on the role of healthcare workers in the fight towards this threat. Methods: A cross-sectional study was performed through an online questionnaire administered to university students between January and December 2020. Univariable analyses were performed, Chi-square was calculated and multivariable analysis was used to investigate the relationship between the answers and socio-demographic variables. Statistical significance was set at a p-value of less than 5%. Results: More than 80% of the sample correctly identifies as major consequences of CCs the increase in Earth's temperature (95.0%), melting of ice caps (89.4%), rising sea levels (81.8%), and the more frequent occurrence of climate-related natural disasters. Across courses of study, the frequency on how CC is addressed differs (p<0.001): 31.5% of the students from the medical field reported the topic to be taught in class, compared to 49.0% from humanities and 63.4% from science and technology. Conclusion: The study shows that medical students are less prepared and less aware of the consequences and causes of CC than students in other faculties. Since CC will play a role in every aspect of patients' lives, barriers to health care will have to be overcome through the knowledge and skills acquired during undergraduate courses.

Pilates-based exercise in the reduction of the low back pain: an overview of reviews.

OBJECTIVE: Pilates is a popular system of exercise that is recommended for healthy individuals and patients with low back pain (LBP). The restoration of muscle function in lumbopelvic stability and pelvic floor muscles has been fostered by practices based on this strategy. Restoring or sustaining the motor control of the lumbar spine and proper body posture during each exercise is very important. The aim of this umbrella review (UR) of systematic reviews and narrative reviews is to detect the effects of exercise on patients with chronic low back pain (CLBP). MATERIALS AND METHODS: Records were published in December 2019 and identified from Web of Science, PubMed, and Scopus. Studies that addressed this topic were included. The protocol was registered on PROSPERO (246510). RESULTS: The Pilates method, using functional exercises, improves muscular strength and endurance. Eleven studies were included in the UR. Nine reviews for chronic LBP concluded that there were pain relief and functional progression from the Pilates-based exercise intervention in the short-term. There was strong evidence that Pilates exercise improved flexibility and dynamic balance and enhanced muscular endurance among healthy people in the short-term. CONCLUSIONS: Pilates exercise improved dynamic balance and flexibility also raised muscular endurance in people in the short time. There was some evidence that admits this exercise as effective in body fat reduction and increasing fat-free mass in the short-term.

Workplace violence among healthcare workers, a multicenter study in Italy.

OBJECTIVES: The purpose of this study is to assess the prevalence and determinants of workplace violence and the sociodemographic risk factors associated. STUDY DESIGN: This was a multicenter cross-sectional study. METHODS: The study was performed using self-compiled Italian version of the World Health Organization's questionnaire on workplace violence online by filling in a Google form. The survey was opened from May 2018 to March 2020 and lasted 5-10 min. RESULTS: The sample consists of 3659 healthcare workers, of which 2525 (69%) are females, 1446 (39.5%) are nurses, and 2029 (55.5%) are health workers from northern Italy. The most frequent age group of the sample is 50-54 years (16.7%). A total of 366 (10%) healthcare workers are victims of physical aggression at work in the last 12 months, of which 6.3% with a weapon. The risk of being a victim of physical aggression at work in the last 12 months is significantly associated with the following independent variables: male gender (odds ratio [OR] 1.72, 95% confidence interval [CI]: 1.36-2.17), work in southern Italy (OR 1.59, 95% CI: 1.10-2.28), and being a nurse (OR 2.56, 95% CI: 2.01-3.25). The risk of being a victim of physical aggression at work with a weapon in the last 12 months is significantly associated with work in southern Italy (OR 9.33, 95% CI: 3.83-22.73). A total of 1723 (47.1%) of healthcare workers declare to be a victim of verbal aggression at work in the last 12 months. The risk of being a victim of verbal aggression at work in the last 12 months is significantly associated with the following independent variables: work in northern Italy (adjusted OR [aOR] 1.54, 95% CI: 1.32-1.81), work in southern Italy (aOR 3.68, 95% CI: 2.90-4.68), and be more than 55 years old (aOR 0.73, 95% CI: 0.63-0.85). CONCLUSIONS: The study underlines that the problem of verbal and physical aggression against healthcare workers is still central and is a further starting point for research. The prevalence of violence is difficult to assess because violent incidents are underreported or unreported. The results of the study suggest that increased awareness is needed to develop effective control strategies at the individual, hospital, and national levels to prevent aggression and improve the conditions of victims.