1,721,044 research outputs found
Evidence-based approach for continuous improvement of Occupational Health
No full textIntroduction. It was recognized early on that an Evidence-Based Medicine (EBM) approach could be applied to Public Health (PH), including the area of Occupational Health (OH). The aim of Evidence-Based Occupational Health (EBOH) is to ensure safety, health, and well-being in the workplace. Currently, high-quality research is necessary in order to provide arguments and scientific evidence upon which effective, efficient, and sustainable preventive measures and policies are to be developed in the workplace in Western countries. Occupational physicians need to integrate available scientific evidence and existing recommendations with a framework of national employment laws and regulations. Objective. This paper addresses the state of the art of scientific evidence available in the field (i.e., efficacy of interventions, usefulness of education and training of workers, and need of a multidisciplinary strategy integrated within the national PH programs) and the main critical issues for their implementation. Conclusions. Promoting good health is a fundamental part of the smart, inclusive growth objectives of Europe 2020 - Europe's growth strategy: keeping people healthy and active for longer has a positive impact on productivity and competitiveness. It appears clear that health quality and safety in the workplace play a key role for smart, sustainable, and inclusive growth in Western countries
The diagnosis of latent tuberculosis infection (Ltbi): Currently available tests, future developments, and perspectives to eliminate tuberculosis (tb)
No full textIntroduction: Despite great efforts, tuberculosis (TB) is still a major public health threat worldwide. For decades, TB control programs have focused almost exclusively on infectious TB active cases. However, it is evident that this strategy alone cannot achieve TB elimination. To achieve this objective a comprehensive strategy directed toward integrated latent tuberculosis infection (LTBI) management is needed. Recently it has been recognized that LTBI is not a stable condition but rather a spectrum of infections (e.g., intermittent, transient or progressive) which may lead to incipient, then subclinical, and finally active TB disease. Aim: Provide an overview of current available LTBI diagnostic test including updates, future developments and perspectives. Results: There is currently no test for the direct identification of live MT infection in humans. The diagnosis of LTBI is indirect and relies on the detection of an immune response against MT antigens, assuming that the immune response has developed after a contact with the biological agent. Tuberculin skin test (TST) and interferon gamma release assays (IGRAs) are the main diagnostic tools for LTBI, however, both present strengths and limitations. The most ancient diagnostic test (TST) can be associated with several technical errors, has limited positive predictive value, is being influenced by BCG vaccination and several conditions can reduce the skin reactivity. Notwithstanding these limitations, prompt identification of TST conversion, should orientate indications for preventive therapy of LTBI. IGRAs have superior specificity, are not af-fected by M. bovis, BCG vaccination and other environmental mycobacteria. However, they present some logistical and organisational constraints and are more expensive. Currently, the WHO guidelines recommend that either a TST or an IGRA can be used to detect LTBI in high-income and upper middle-income countries with estimated TB incidences less than 100 per 100,000 population. Two skin tests (C-TB and Diaskintest), using only two specific M. tuberculosis antigens (ESAT-6 and CFP-10) instead of the tuberculin solution, have recently been developed but, to date, none of these tests is available on the European market. Conclusion: Early identification and treatment of individuals with LTBI is an important priority for TB control in specific groups at risk within the population: this is of crucial meaning in recently infected cases both at the community level and in some occupational settings. Currently there is no gold standard test for LTBI: an improved understanding of the available tests is needed to develop better tools for diagnosing LTBI and predicting progression to clinical active disease
The diagnosis of latent tuberculosis infection (LTBI): currently available tests, future developments, and perspectives to eliminate tuberculosis (TB)
No full textEffetti osservati sulla salute umana.
No full textSono stati riportati in letteratura una serie di case report e di casi aneddotici che descrivono effetti avversi sulla salute umana attribuiti al gruppo delle palitossine (PLTX) e/o ad alcuni analoghi strutturali, a seguito di esposizioni attraverso varie vie. I segni e sintomi registrati indicano l’insorgenza di effetti locali al sito di contatto, generalmente riconducibili a reazioni di carattere irritativo e infiammatorio, ai quali in alcuni casi si aggiunge una sintomatologia sistemica. Gli scenari espositivi più rilevanti associati ad attività ricreative prevedono un contatto diretto durante la balneazione, attraverso la cute e le mucose, con le tossine disciolte in acqua e/o con le specie algali produttrici. Alcune segnalazioni di effetti avversi su addetti e hobbisti coinvolti nella pulizia di acquari e il ritrovamento di livelli non trascurabili di PLTX in coralli da acquario indicano che anche tali categorie sono da considerarsi a rischio. L’altro scenario da considerare prevede l’inalazione di aerosol di acqua marina durante fioriture di Ostreopsis spp., prodotto a seguito di movimenti forzati dell’acqua marina per specifiche attività (es. nel caso di attività sportive in acque contaminate) e/o in concomitanza di condizioni meteoclimatiche favorevoli (es. vento forte e mareggiate). Quest’ultima via di esposizione coinvolge quindi non solo i ‘bagnanti’ propriamente detti ma anche soggetti che sostano in prossimità della spiaggia e/o sul lungomare.
A queste vie di esposizione si aggiunge quella orale, associata sia all’ingestione involontaria di acqua durante attività ricreative (es. durante il nuoto) che al consumo di prodotti ittici contaminati. Le PLTX possono, infatti, accumularsi nei molluschi marini eduli, nei crostacei e nei pesci: sindromi di avvelenamento talvolta letali, note col nome di clupeotoxismo, sono state descritte in regioni tropicali anche se spesso l’identificazione della tossina è risultata incompleta o mancante e, in questi casi, l’attribuzione dell’avvelenamento all’ingestione di PLTX (relazione causa-effetto) è stata fatta sulla base del quadro clinico, dell’anamnesi e dell’ingestione di alimenti di origine marina. Nonostante alcuni prodotti ittici, quali sardine, acciughe e granchi, parte integrante della dieta mediterranea, possano accumulare PLTX in alte concentrazioni e rappresentino quindi l’anello della catena alimentare attraverso cui l’uomo è potenzialmente esposto, finora non sono stati riportati nel bacino del Mediterraneo effetti associati all’ingestione di prodotti ittici contaminati dalle tossine prodotte da Ostreopsis cf. ovata
Tackling biological risk in the workplace: updates and prospects regarding vaccinations for subjects at risk of occupational exposure in Italy
No full textOccupational activities may expose workers to a variety of risks. Exposure to biological agents constitutes a traditional risk in numerous occupational settings. Legislative Decree (D.Lgs.) 81/2008 constitutes the main Italian legislative basis for the management and the prevention of biological risk in occupational settings and lists the available vaccinations against each single biological agent. The 2017-2019 National Vaccination Prevention Plan (PNPV) identifies some categories of workers for whom specific vaccinations are indicated. In this context, the occupational physician identifies work processes that are at risk-identifying susceptible workers and providing information on health monitoring-and is responsible for ensuring that vaccinations are carried out. Adequate and thorough evaluation of risk are indispensable to appropriate consultation by the occupational physician in order to enable the employer to provide efficacious vaccinations. Close collaboration among the services of occupational medicine, vaccination clinics, and healthcare management together with the implementation of vaccination programs that are agreed upon at the institutional level provides an opportunity to reduce the number of workers who are susceptible to vaccine-preventable diseases, thereby yielding benefits in terms of biological risk management in the workplace and contributing to increasing vaccination coverage rates, which in many cases are currently unsatisfactory
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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