Post-traumatic stress disorder among bank employee victims of robbery.

BACKGROUND: Post-traumatic stress disorder (PTSD) in the occupational context, especially following workplace robbery, is still under-investigated. AIMS: To evaluate PTSD incidence and risk factors among bank employee victims of robbery voluntarily joining an employer-sponsored post-robbery support programme. METHODS: The programme entailed a structured support interview with robbery victims within 15 days of the robbery and a follow-up psychological assessment 45 days after. A self-reported questionnaire on personal variables and robbery characteristics was administered to participants at the first support session (T1). Interviews on employees' psychophysical health and their opinion about the support programme were administered individually at follow-up (T2). The Impact of Event Scale (IES) was administered both at T1 and T2. RESULTS: There were 383 participants. At T2, 13% of subjects had an IES score >34, a cut-off suggestive of PTSD. In a multi-variate model, feelings of helplessness and terror during the robbery and the number of previous robberies were associated with a PTSD diagnosis. After including IES score at T1, other variables lost statistical significance. CONCLUSIONS: Our findings showed that PTSD is common among employee victims of workplace robbery. Our results also suggest the importance of subjective variables, such as personal perception of robbery severity and early emotional reaction, in identifying people at higher risk of developing PTSD.

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.

Novelties in slipped capital femoral epiphysis imaging: A narrative review.

Rationale and objectives: Imaging plays a key role in Slipped Capital Femoral Epiphysis diagnosis and severity assessment. In the last two decades, signs and measurements emerged in literature showed potential to help in SCFE diagnosis and tailoring treatment. The purpose of this review is to collect and discuss new imaging signs, measurements, and techniques according to investigations published after 2000 to improve SCFE diagnosis. Material and methods: The PubMed, Scopus, and Science Direct databases were used to search for relevant articles related to imaging in SCFE diagnosis from January 2000 to March 2023. Article selection and review was performed by two board-certified radiologists). Article quality assessment were conducted by authors using QUADAS-2 and SANRA evaluation tools. Results: The research resulted in a total of 2577 articles. After duplicates removal and abstract analysis, 28 articles were finally selected for full-text analysis. Seventeen articles were focused on Radiographs, 6 on CT, 1 on both Radiographs and CT, 4 on MRI. No study focused on ultrasound was selected. Conclusions: Use of modified Klein's line and S-sign may improve radiographs accuracy in daily routine. Lucency sign may help in early diagnosis on radiographs. Preoperative CT may be useful in planning a tailored treatment predicting SCFE severity and instability. MRI is the most accurate modality to diagnose SCFE at early stage. Nevertheless, it cannot be used to predict the risk of contralateral SCFE. Risk prediction can be assessed with radiographs, using a new rapid mOBS. Further investigation and validation of these sign is needed.

The HSE indicator tool, psychological distress and work ability.

BACKGROUND: The Health and Safety Executive (HSE) indicator tool is one of the most commonly used tools for assessing the risk of work-related stress. Few studies, however, have investigated whether and how its scales are related to psychological distress or other work-related health outcomes. AIMS: To investigate the relationship between the HSE indicator tool, psychological distress, as measured by the General Health Questionnaire (GHQ)-12, and work ability, assessed by the Work Ability Index (WAI). METHODS: All the employees of a mid-sized bank in Italy were asked to fill in an anonymous cross-sectional questionnaire. The questionnaire was structured in four sections: the first one comprised socio-demographic questions and the other three corresponded, respectively, to the Italian translations of the GHQ-12, the HSE and the WAI questionnaires. RESULTS: Four hundred and thirteen employees completed the questionnaire. The response rate was 99%. Controlling for age and gender, the indicator subscales were negatively associated with the adopted measures of psychological distress and work ability. The GHQ score was also highly correlated with the WAI score and able to explain ≈ 47% of its variance. The only subscale that was still significantly associated with the WAI after removing the effect of psychological distress was 'control'. CONCLUSIONS: The study presents new evidence for the validity of the HSE indicator tool to estimate the risk of work-related stress and suggests that most but not all the effects of psychosocial conditions on work ability might be mediated by the level of psychological distress induced by these conditions.

[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.

[Progress of PTSD symptoms following workplace robbery: gender and age differences in a sample of bank employees]. / Decorso della sintomatologia psichica post-traumatica conseguente a rapina sul lavoro: differenze di genere e di età in un campione di bancari esposti.

This study is aimed at assessing gender-and age-related differences in PTSD symptoms in bank employees exposed to robbery and subsequently involved in Psychological Debriefing (PD). The study included 49 females and 51 males (average age 40.9). Impact of Event Scale (IES) was administered before PD (T0) and after 45 days (T1); Post-traumatic Checklist (PCL) only at T1. The sample exhibited a significant decrease in IES score regardless of gender. Female employees obtained higher IES and PCL scores. No age differences were observed. Consistent with most studies, our results may be explained by a higher susceptibility in women.

[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.

Short-term effects of the activator in skeletal class II division 1 patients with different vertical skeletal pattern. A retrospective study.

AIM: The aim of this retrospective study was to analyse the effectiveness of Andresen appliance in inducing an increased mandibular dimension and, above all, to test the "null" hypotesis that the patients' vertical skelettofacial morfology could influence this increase using the Ricketts' method of VERT. METHODS: Cephalometric records of 42 skeletal class II patients treated at the Orthodontic Department of Catania University were randomly selected. The sample was divided for vertical facial patterns, according to the facial classification method of Ricketts (VERT), into three groups: brachyfacial, mesiofacial and dolicofacial. Ten landmarks were located on the lateral cephalometric radiographs; growth in the horizontal-sagittal direction and in the vertical direction was evaluated using the measurements of total mandibular length (Co-Gn, Co-Pg, Ar-Pg, Ar-Gn), mandibular sagittal position (SNB, ANB) and mandibular ramus height (S-Go, Ar-Go, Co-Go). The intragroup comparisons were made using two tailed t-tests, while the intergroup comparisons were analyzed statistically using the Kruskal-Wallis test. RESULTS: The cephalometric values before (T0) and after (T1) treatment showed significant changes for the majority of the cephalometric variables in each group. Our findings demonstrated a statistically significant greater increase of mandibular dimension in the brachyfacial group, while similar results were found for mesiofacial and dolichofacial groups. CONCLUSION: The "null" hypothesis, that the skeletal pattern of subjects could influence the increase of mandibular dimension after Andresen treatment, had to be accepted: the brachyfacial patients showed a greater anterior mandibular displacement when compared to mesiofacial or dolichofacial group.

[Post-traumatic stress disorder following robbery at the workplace: a pilot study on 136 pharmacy workers]. / Disturbo post-traumatico da stress conseguente a rapina sul lavoro: studio pilota su 136 farmacisti.

INTRODUCTION: Robbery at the place of work is one of the most common traumatic events in both developed and developing countries. Italy is one of the European countries with a medium-to-high prevalence and pharmacy and bank employees are particularly at risk. Research on the psychological effects on workers who are victims of robbery is scarce when compared with traditional trauma studies. OBJECTIVE: To assess the association between workplace robbery, Post-traumatic Stress Disorder (PTSD), quality of life and work ability in a sample of Italian pharmacy workers. METHODS: 136 pharmacy workers--90 robbery victims and 46 non-victims--were recruited from the Milan area. They completed a questionnaire including: socio-demographic characteristics, robbery history and description, a self-report version of the Clinician Administered PTSD Scale (CAPS-I), General Health Questionnaire (GHQ), Beck Depression Inventory (BDI), Work Ability Index (WAI), Short Form 36 Health Survey Questionnaire (SF-36). RESULTS: No differences were found between victims and non-victims for GHQ and BDL; WAI scores of victims were significantly lower than non-victims. Exposure to robberies was associated with lower WAI in a multivariate analysis; 10 victims reported PTSD and much lower WAI and SF-36, higher GHQ and BDI than non-PTSD victims. CONCLUSIONS: Workplace robbery has a mild but long-lasting effect on workers' ability to work. For a significant proportion of victims, robbery exposure is associated with the onset of PTSD, with increased risk for severe and long-lasting impairment of emotional well-being, quality of life and work ability. Early intervention programmes at the workplaces aimed at promoting a more rapid recovery after a traumatic event are needed.

[Buschke Scleredema, case report]. / Scleredema di Buschke, contributo casistico.

Buschke Scleredema is a rare connective tissue disorder of unknown aetiology, characterized by thickening of the dermis whose characteristics may mainly to mime systemic sclerosis, eosinophilic fasciitis and cutaneous amyloidosis. Scleredema may be associated with a history of an antecedent febrile illness, diabetes mellitus, or blood dyscrasia. Scleredema can be classified into three clinical groups; each has a different history, course, and prognosis. Each one of these share reduction in chest articular movements and limitation of limbs movements. The skin histology is characterised by thickened dermis and increased spaces between large collagen bundles due to increased deposition of mucopolysaccharide in the dermis. Differential diagnosis can be made considering the typical clinical features and the histologic peculiarity. No therapy has been found effective. The authors describe a case of Buschke Scleredema successfully treated by steroids and colchicine. Clinical evaluation of skin induration and thickness as well as ultrasonography were performed at baseline and after treatment.

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.

Non-immunologically-mediated cytotoxicity of Lactobacillus casei and its derivative peptidoglycan against tumor cell lines.

Lactobacillus casei, which shows antitumoral activity mediated by the stimulation of cellular defence mechanisms, and its peptidoglycan were tested for their ability to inhibit in vitro the viability of various murine (Yac-1, P815, Ehrlich ascites tumor, mammary carcinoma) and human (K562, KB) tumor cell lines through primary cytotoxic activity. Treatment of these tumor line with L. casei or its peptidoglycan at different doses and for different times demonstrated a decrease in viability by 25-30%. This cytotoxic activity was revealed by 51Cr release, succinate dehydrogenase (SDH) activity, ATP assays and morphological alterations in the treated tumor cells. Immunoenzymatic assays (ELISA) showed a precise ratio of binding between Ehrlich ascites or YAC-1 cell membranes and peptidoglycan. This binding is discussed with regard to the structure of the peptidoglycan molecule. The results suggest that L. casei and its derivative peptidoglycan have both a stimulating activity in normal cells and an inhibiting activity in tumor cells, as has been found for other immunomodulatory complexes.

Endoscopic study of the gastro-intestinal tolerance of glucamethacin.

A gastroscopic study was carried out in patients with rheumatic disorders to investigate the gastric tolerance of glucamethacin, a new, non-steroidal anti-inflammatory agent. The first stage was a double-blind crossover comparison of the effects of glucamethacin (420 mg/day) and indomethacin (100 mg/day), each given for 15 days in random order to 30 patients. In the second, open stage, 70 such patients, most of whom also had gastrointestinal pathology, received glucamethacin (420 mg/day) for 25 days. The results of endoscopic findings showed that significantly fewer (p less than 0.05) gastric lesions were produced after treatment with glucamethacin than after indomethacin. In the patients with gastro-duodenal pathology treated only with glucamethacin there was no change in endoscopy findings in 74% of the patients and only slight changes in the others.

Unusual presentation of Addison's disease in Schmidt's syndrome.

A patient with Schmidt's syndrome and atypical symptoms of Addison's disease is presented. Autoimmune thyroiditis was diagnosed at the age of 12 years and then at 15 years; a diagnosis of migraine was made following 10 days of headache, visual field defects and dysarthria. One week later the patient was admitted to hospital in critical condition. Addison's disease was diagnosed and replacement therapy was introduced which brought about a rapid clinical improvement. Positive adrenal autoantibodies confirmed the diagnosis. We suggest that patients with organ-specific autoimmune disease undergo annual screening for adrenal activity, and in the event of abnormal results, adrenal autoantibody evaluation should be carried out, to avoid a life-threatening crisis caused by Addison's disease, which is often difficult to recognize due to atypical clinical presentation, as in the patient reported here.

The effects of L-sulpiride on reflux oesophagitis.

Prokinetic drugs are commonly used for treatment of reflux oesophagitis. Although much data has been collected in clinical trials, their therapeutic effects are still uncertain. In this study the effects of L-sulpiride, if any, were examined when used to treat reflux oesophagitis in thirty patients. The patients were divided into two groups: a control group and a group given 25 mg t.i.v./day, p.o. of L-sulpiride for 30 days. They were treated as outpatients and had endoscopic, histological and ultrastructural examinations on the 30th and 60th days of treatment. It was found that the symptoms of patients with reflux oesophagitis were alleviated and the endoscopic and ultrastructural lesions of patients with minor oesophagitis were also decreased. In other patients, symptoms improved without resolution of the lesions. The authors conclude, therefore, that L-sulpiride would be appropriate treatment for Grade I cases.

[Endoscopic study on the gastric tolerance of antalgic-antirheumatic substances:parsalmide]. / Studio endoscopico sulla tollerabilità gastrica di sostanze antalgico-antireumatiche: la parsalmide.

The gastric tolerance of parsalmide, a new analgesic, antirheumatic and sedative substance was tested on a group of 50 arthrorheumatic patients with the purpose of assessing gastric damage if any. It was also compared with the tolerance of the better known antitrheumatic drugs in current use. The study was conducted with the endoscopic method, parsalmide being administered in quantities of 600 mg/die per os, broken up into 3 doses, for a period of 20 days. Unlike phenylbutazone, indomethacin and cortisone, parsalmide showed no ulcerogenous effect nor haemorrhage type alterations at gastroduodenal level, at least in the cases treated. Furthermore, the slight surface oedematous gastropathies that appeared during the research were not important enough to demand suspension of the treatment. Endoscopically this picture can be judged of little clinical importance (as with the majority of well known analgesic-antirheumatic drugs) and its incidence came within the mean. A fair tranquillizing action, detectable in the particularly amenable behaviour of the subjects undergoing endoscopy, is also worth reporting.

[Target cimetidine treatment of peptic ulcer. Considerations and assessment of a new dosage]. / Terapia cimetidinica mirata dell'ulcera peptica. Considerazioni e valutazioni su un nuovo dosaggio.

32 patients suffering from peptic ulcer have been selected. Of these 12 formed part of a previous series treated with cimetidine and subsequently relapsed; the other 20 were selected on the basis of endoscopic and functional examinations and were treated for the first time with cimetidine. The drug doses used were 1.2 g for 30 days and 0.3 g for a further 60 days. The purpose of the study was to check for possible recurrences by comparing the results obtained and their maintenance in the long term using these doses. 2 months after suspension of maintenance treatment there has not been any recurrence of the acute pain and dyspeptic symptomatology.

Pilo-sebaceous cystic ectopy of the uterine cervix.

The infrequent finding of pilo-sebaceous cysts in an uterine cervix is presented. The different histopathogenetic hypothesis and Literature reports are critically reviewed. The histogenesis can be referred to ectodermic embryonal germs which come in the ectopic site following an abnormal cephalic migration. Also stressed is the possibility that neoplasms of the pilo-sebaceous structures could arise in the ectopic site and, thereafter, due to their rarity, might be under-diagnosed at the histology.

[Acquired deficiency of von Willebrand factor (wWF) associated with intestinal angiodysplasia. An unusual clinical case]. / Deficit acquisito di fattore di von Willebrand (FvW) associato ad angiodisplasia intestinale. Una insolita presentazione clinica.

A rare case of acquired von Willebrand's disease associated with intestinal angiodysplasia is described. The case is very interesting because it clinically mimicked an intestinal neoplasm.

[Psychometric evaluation of the effects of an almitrine-raubasine combination in the intellectual deterioration of aged subjects. A double-blind controlled trial versus placebo]. / Evaluation psychométrique des effets de l'association almitrine-raubasine dans l'affaiblissement intellectuel du sujet âgé. Essai contrôlé à double insu contre placebo.

The clinical and psychometric evaluation of a drug to be used against the intellectual deterioration associated with cerebral aging is of obvious interest when carried out on ambulatory subjects, since the symptoms likely to be reduced are found in elderly people usually living at home. Thirty-six patients (18 male, 18 female; mean age 65.5 +/- 1.7 years) were selected and allocated at random to two treatment groups. They received during 2 months 80 drops per day in two doses of either an almitrine-raubasine combination or a placebo. Patients definitely entered the trial when Hachinski's score for ischaemia was equal or inferior to 7. They were evaluated at zero, 1 and 2 months by means of 3 performance tests (Toulouse-Pieron test, Tapping test, numbers memorization test) and 2 mood tests (Hamilton's scale, Zung's questionnaire). All mean scores of recognition tests were statistically improved in the almitrine-raubasine group after 2 months of treatment. Compared with the placebo group, the improvement in the almitrine-raubasine group was significant at 1 month for 3 medium scores (symbols omitted, taping, numbers in normal order) and for all scores at 2 months. The psycho-behavioural symptoms evaluated by the two mood scores were significantly improved in the almitrine-raubasine group (P less than 0.001) and in comparison to the placebo group after 1 and 2 months (P less than 0.001). These results concerning intellectual performance and mood demonstrate that the almitrine-raubasine combination is useful in the treatment of intellectual deterioration in elderly people living at home.