Giornale italiano di medicina del lavoro ed ergonomia
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G Ital Med Lav Ergon · Feb 2018
[Care-Related intervention in Rehabilitative Pneumology: Pulmonary Rehabilitation in Chronic Obstructive Broncopneumopathies (COPD) can benefit from a multidisciplinary approach?]
Chronic Obstructive Pulmonary Disease (COPD) is a common, preventable and treatable disease that is characterized by persistent respiratory symptoms and airflow limitation. Cardiovascular diseases, osteoporosis, depression/anxiety, musculoskeletal impairment and obstructive sleep apnea are frequent and important comorbidities in COPD, often under-diagnosed, and associated with poor health status and prognosis. ⋯ In conclusion, an overarching approach to diagnosis, assessment of severity of COPD and its frequent comorbidities should guide to a multidisciplinary and synergic approach in terms of pharmacological and nonpharmacological management of a systemic inflammatory syndrome.
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G Ital Med Lav Ergon · Jan 2016
[Subjective and objective indicators of job stress and burnout in a residential home for the elderly].
Elderly care workers have a higher risk than other professionals of developing burnout. Despite literature has highlighted the methodological advantage resulting from an integration of subjective and objective measures of stressors, only few studies have investigated job stress and burnout in the Italian elderly care context using this kind of assessment. The aims of this study were: (a) to investigate the level of stress and burnout and their organizational sources in a sample of eldercare workers by means of subjective and objective tools, and b) to compare the stress and burnout levels between health care staff and nursing aides employed in a residential home for the, elderly. ⋯ This exploratory study supports the use of both subjective and objective method for the assessment of job stress risk as the most comprehensive approach for the implementation of preventive and corrective interventions.
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G Ital Med Lav Ergon · Jul 2015
[Mirror, mirror of the wall: mirror therapy in the treatment of phantom limbs and phantom limb pain].
Phantom limb and phantom limb pain control are pivotal points in the sequence of intervention to bring the amputee to functional autonomy. The alterations of perception and sensation, the pain of the residual limb and the phantom limb are therefore aspects of amputation that should be taken into account in the "prise en charge" of these patients. Within the more advanced physical therapies to control phantom and phantom limb pain there is the use of mirrors (mirror therapy). ⋯ Advice on the need to select patients before treatment decisions, with regard to their psychological as well as clinical profile (including time since amputation and clinical setting), and the need to be aware of the possible adverse effects matching different and somehow conflicting therapeutic approaches, are put forward. Thus a coordinated sequence of diagnostic, prognostic and therapeutic procedures carried out by an interdisciplinary rehabilitation team that works globally on all patients' problems is fundamental in the management of amputees and phantom limb pain. Further studies and the development of a multidisciplinary network to study this and other applications of mirror therapy are needed.
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G Ital Med Lav Ergon · Oct 2014
Review[Overdiagnosis and defensive medicine in occupational medicine].
In clinical medicine since some years overdiagnosis is giving rise to growing attention and concern. Overdiagnosis is the diagnosis of a "disease" that will never cause symptoms or death during a patient's lifetime. It is a side effect of testing for early forms of disease which may turn people into patients unnecessarily and may lead to treatments that do no good and perhaps do harm. ⋯ In Italy the National Insurance for occupational diseases (INAIL) regularly recognizes less than 50% of the notified diseases; this might suggest overdiagnosis and possibly overattribution in reporting. Physicians dealing with the diagnosis of occupational diseases are obviously requested to perform a careful, up-to-date and active investigation. When applying to the diagnosis of occupational diseases, proper logical criteria should be even antecedent to a good diagnostic technique, due to social outcome for the worker.
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G Ital Med Lav Ergon · Jul 2013
Excessive daytime sleepiness works together with other sleep disorders in determining sleepiness-related events in shift workers.
Shift-workers may experience sleep disturbances more frequently than day-workers. Interactions between obstructive sleep apnea (OSA), shift-work and other factors promoting sleepiness have never been studied. The present study was designed to assess the prevalence of excessive daytime sleepiness (EDS), high risk for OSA (HR) and insomnia in shift-workers and day-workers and to evaluate their mutual effects on the risk of home-to-work commuting car accidents or episodes of falling asleep during work. ⋯ Development of EDS in shift-workers is not only due to work schedule, but also to the presence of sleep disorders. OSA and insomnia co-promote falling asleep during work and sleepiness-related car accidents.