[Preconceptuel evaluation and treatement of intercurrent diseases-follow up of pregnancies in the doctor's office]. / Du bilan préconceptionnel à la prise en charge des pathologies intercurrentes: suivi des grossesses au cabinet.

Preconceptional evaluation should be extended to all women in reproductive age. It includes, among others, screening for infections, evaluation of immunity against infectious agents detrimental to the fetus and, in high risk cases, detection of genetically transmitted diseases. Furthermore, any medication needs to be evaluated for potential embryotoxicity and teratogenicity. During pregnancy, diseases that may appear trivial in other circumstances can become complex due to the potentially harmful secondary effects of medication and radiodiagnostic tests on the motherand fetus. Knowledge not only of the list of drugs that can be safely used during pregnancy, but also of their special dosages, as well as of the potential risks of radiation of radiologic tests is essential to good clinical management.

Context specificity in the assessment of psychosocial risk at work: an empirical study on Italian call centre workers.

BACKGROUND: Following EU requirements, in recent years standard procedures for the assessment of work-related stress have been developed in Italy. However, while such standardization has facilitated the spread and use of these procedures, it has brought a lack of specificity in risk assessment. OBJECTIVES: To exemplify a method for the assessment of work-related stress that was developed by the University of Milan to allow the definition of risk profiles tailored to the different organizational settings. METHODS: We examined risk factors for work-related stress in call centre operators employed by two separate Italian companies. At an early stage of the assessment procedure, we conducted a wide series of consultation and training activities that allowed the identification of context-specific risk factors and homogeneous groups, which fuelled the preparation of both the "objective" and the "subjective" evaluation instruments. RESULTS: Results obtained by means of the standardized "Effort-Reward Imbalance Questionnaire" and "Job Content Questionnaire", interpreted in the light of consultations with key organizational figures and individual interviews with employees, have allowed the detection of different risk profiles and priorities for intervention at both the group and the organizational levels. CONCLUSIONS: Findings demonstrated the existence of both common and specific risk factors in the two companies, which would have remained undetected with the exclusive use of standardized approaches.

[Job Demands-Resources, exhaustion and work engagement in a long-term care institution]. / Modello Job Demands-Resources, esaurimento psico-fisico e coinvolgimento lavorativo nel personale di una casa di cura per lungodegenti.

In this study, we aimed at testing the main hypotheses of the Job Demands-Resources model (JD-R) in a sample of employees (n = 205, mainly healthcare workers) of a long-term care institution located in Northern Italy. Hierarchical linear regression analyses show that almost all job demands considered were significantly associated with higher general psycho-physical exhaustion (beta ranging from 0.14 to 0.29), whereas more unfavourable scores in all job resources were associated with lower work engagement (from -0.27 to -0.51). However, also significant cross-over associations were observed, mainly between job resources and exhaustion, with effect sizes comparable with those found for the relationships between job demands and exhaustion. Hence, our study only partially supports the JD-R model. Implications of results for work-related stress management are finally discussed.

[Work-related stress in nursery school educators in the Venice and Marghera districts]. / Rischio stress tra il personale degli asili nido/scuole dell'infanzia della Municipalità di Venezia e Marghera.

BACKGROUND: Based on an investigation on organizational well-being in the Municipality of Venice (2009), we examined 110 public nursery school and preschool teachers working in the Venice and Marghera districts. OBJECTIVES: The aim of this study was to develop and implement a procedure for work-related stress assessment and management in Municipality of Venice, in the light of Law 81/2008. METHODS: Occupational stress and its impact on teachers' well-being and health were assessed by means of self-administered questionnaires and semi-structured interviews. Descriptive analyses were conducted to compare teachers' data with those concerning employees operating in other services in the Venice and Marghera districts. RESULTS: According to the results, while nursery school and preschool teachers work with considerable commitment, vigor, dedication and involvement, problems were observed related to: assignment of administrative tasks without appropriate support from the district offices; difficult access to support services; shortage of temporary teachers and auxiliary personnel and, limited to some facilities, lack of adequate physical space devoted to teaching activities. Such adverse conditions result in an increase in vigilance levels required to ensure children's safety. Personnel also suffer from a lack of career prospects, with scarce opportunities for contact with other facilities in the area and inadequate involvement in the decisional processes at Municipality level. CONCLUSIONS: Improving such adverse conditions could solve the current marginalization of public nursery school and preschool teachers and encourage mutual exchange of information, which would in turn favour more appropriate methods of managing each single facility.

[Role of "gender" and "age" factors in the assessment of psychosocial risk and in prevention interventions of hospital personnel]. / Ruolo dei fattori "genere" ed "età" nella valutazione del rischio psicosociale e negli interventi di prevenzione del personale ospedaliero.

Gender, age and psychosocial risks. The paper reports research experience on nurses with special reference to "gender" and "age". Parameters such as "affectivity" and "work-family conflict" indicate the insufficiency of policies and actions to limit staff shortage and safeguard health till retirement age.

Main and interactive effects of shiftwork, age and work stress on health in an Italian sample of healthcare workers.

Among healthcare workers, shiftwork (mostly if nightwork is also included), ageing and work-related stress may be factors leading to impaired health. Such risk factors may also operate in interaction, resulting in an even increased harm for health. The present study aims at evaluating these relationships in a sample of 1842 hospital workers in Northern Italy. Subjects were mainly women, 33.1% were aged > or = 45 yr, and they were almost evenly distributed between dayworkers and rotating shiftworkers (nights included). Shiftwork was associated with poor sleep, while it was protective against gastrointestinal disorders, poor work ability and job dissatisfaction. Work stress was the risk factor with the highest relevance for poor health. Ageing was associated with lower physical health. Few significant interactions were observed. Shiftwork with nights and high work stress significantly interacted in increasing the risk for poor sleep. The "healthy worker effect" may have played a strong role in study findings.

[Gender differences in workplace bullying]. / Le differenze di genere nelle situazioni di mobbing.

BACKGROUND: Despite the attention that international Agencies give to the gender issue in situations of workplace bullying, few investigations have been performed on this topic. OBJECTIVES: The aim of the study is describe the gender differences in victims of workplace bullying observed in an Italian survey. METHODS: A total of 243 subjects (124 males and 119 females) were examined at the Centre for Occupational Stress and Harassment of the "Clinica del Lavoro Luigi Devoto" (University of Milan and IRCCS Foundation); they were selected among patients who met the criteria for being considered victims of negative actions at work leading to workplace bullying. Data regarding the person, workplace and the workplace bullying situation were collected by means of an ad hoc questionnaire. RESULTS: Analysis of the data, compared with those of IS-TAT 2002, showed a higher prevalence of females subjected to negative actions at work. In women, the risk of being subjected to negative actions leading to workplace bullying was shown to increase in the 34-44 age range and to decrease in higher age ranges; in men the risk remained elevated also after 55 years of age. CONCLUSIONS: In general, women were victims of negative actions regarding personal values related to emotional-relational factors, while men were attacked on their work performance. Sexual harassment, may mark the onset of other types of psychological harassment or can be one of its components.

Emerging aspects of psychosocial risks: violence and harassment at work.

In the last twenty years, psychosocial risks have become crucial in Occupational Health. Particularly, there is an increasing interest about psychological and physical violence at the workplaces. Psychological violence (mobbing or workplace bullying) is described as a situation in which the person has been the victim of negative acts directed to the person and work, with offences, discriminations and isolation. Physical violence at work, still underestimated in many parts of the world, is becoming a topical subject both for its frequency and its pathogenic potential and consist of violence among workers (internal violence) and between workers and external persons (external violence). Examples of external violence are bank robberies, which are prevalent in many European countries, particulary in Italy. The costs of psychological and physical workplace violence are very high at all levels; individual, for the implication of violence for health and quality of life as well as organizational, for the increase of absenteeism, turnover and health care demands and claims. The Medical Centre for Occupational Stress and Harassment (CDL) of the "Clinica de Lavoro Luigi Devoto" was set up in 1996 with a day-hospital service for the diagnosis, rehabilitation and prevention of work related psychological diseases. From its opening, about 5000 patients have been examined.

[Questionnaire for the mobbing risk: CDL2.0]. / Uno strumento per la valutazione del rischio mobbing: CDL2.0.

The aim of the study is to develop and validate a questionnaire able to evaluate the risk of mobbing at the workplace. A multiple-choice questionnaire has been developed which contains, among the different items, only one revealing a mobbing situation. The questionnaire has been administered to two groups (group A--243 subjects in a mobbing situation and group B--63 subjects without exposure to mobbing) and the differences in the scores obtained have been analysed. The questionnaire has proved to be valid and reliable. The results show that the presence of five mobbing actions is sufficient to define the workplace situation as potentially at risk for mobbing. The study reveals some limits in the selection of the two samples thus needing some adjustment. However, the questionnaire, also in the present form, can be considered a tool able to detect the mobbing situations.