Papers by rodolfo buselli
and drugs 6.6 Complementary medicines and the gender approach Chapter 7-Gender-based violence, tr... more and drugs 6.6 Complementary medicines and the gender approach Chapter 7-Gender-based violence, trafficking, mistreatment, and abuse 7.1 Gender-based violence in Tuscany 7.2 Codice rosa 7.3 Mistreatment and abuse of women and little girls: the experience of the Regional Reference Centre for the prevention and treatment of violence and abuse cases 7.4 Human trafficking and exploitation in Tuscany 7.5 Mistreatment and abuse of minors 7.6 General outcomes of the Group for the prevention and treatment of abuse on children and adolescents Chapter 8-Training on gender medicine Foreword In reality, until a few decades ago, medical books described disease development in men and women based on the study of genetics, to provide clarity and understanding of the diversity that exists between the sexes. However, knowledge of genetic diversity has yet to provide substantial change in both the clinical description and treatment of many disease states. Scientific knowledge has increased exponentially, and with it, the awareness that the role of gender, or better, the continuum of human sexuality, has profound influence. Therefore, it would be much more appropriate to speak of gender identity and its impact on the practice of medicine and the construction of the "health system". Our book presents the results of the collaboration of a large and extremely experienced group. It is edited and published by the Regional Health Agency of Tuscany and is based on the concerted efforts of a working committee of Tuscan experts, under the direction of Annamaria Celesti, a gynaecologist, who convinced the Tuscan Councillor for Health to include gender issues in the Tuscan Health Plan.
International Journal of Environmental Research and Public Health
The adult autism subthreshold spectrum model appears to be a useful tool for detecting possible v... more The adult autism subthreshold spectrum model appears to be a useful tool for detecting possible vulnerability factors in order to develop mental disorders in the contest of work-related stress. The aim of the present study is to analyze the relationship between autism, mood, and post-traumatic spectrum in a cohort of subjects complaining of work-related stress before the COVID-19 pandemic. The authors carried out a retrospective investigation of both medical records and self-assessment tools of a sample of subjects evaluated at the Occupational Health Department of a University hospital in central Italy. Data showed significant correlations between the AdAS spectrum, TALS-SR, and MOODS total and domain scores. A multiple linear regression evidenced that both the AdAS spectrum and TAL-SR significantly predict the MOODS scores. In particular, mediation analysis showed both a direct and indirect, mediated by TALS-SR, effect of the AdAS Spectrum on the MOODS-SR. These results corroborat...
Psychology, Health & Medicine, 2021
Work-related stress is an emerging risk for psychiatric occupational disorders including Adjustme... more Work-related stress is an emerging risk for psychiatric occupational disorders including Adjustment Disorders (AD). The aim of this study was to investigate in workers exposed to occupational stress suffering from AD about putative indices of stress and mental health resilience such as serum cortisol (seC) levels, Heart Rate Variability (HRV) and affective temperaments. We consecutively recruited 15 male and 15 female AD patients between workers evaluated for occupational stress at an Italian Occupational Medicine Unit. SeC levels were measured by specific immunoassay. HRV indices were recorded using Task Force® Monitor system (CNSystems, Graz, Austria). Specific questionnaires were used to measure perceived and occupational stress, psychopathological symptoms and temperament. Women presented higher levels of occupational stress, higher High-Frequency HRV (HF-HRV) and lower Low-Frequency HRV (LF-HRV) than men. SeC levels were positively correlated with LF-HRV values and negatively with HF-HRV values. The LF/HF ratio resulted to be inversely correlated with the score of Harm Avoidance temperament dimension and directly with the score of Reward Dependence temperament dimension. In conclusion, in AD patients exposed to occupational stress high seC levels and reward dependence appear to be associated with a pattern of HRV reflecting less mental health resilience.
European Journal of Psychotraumatology, 2021
ABSTRACT Background: Peritraumatic distress as assessed by the Peritraumatic Distress Inventory (... more ABSTRACT Background: Peritraumatic distress as assessed by the Peritraumatic Distress Inventory (PDI), has been consistently shown to predict the development of Posttraumatic Stress Disorder (PTSD) after the exposure to a potentially traumatizing event. Objective: The present study aims to validate the Italian version of the PDI in a sample of Healthcare Workers (HCWs) exposed to COVID-19 related potentially traumatizing events. Method: N = 265 HCWs who repeatedly experienced the deaths of patients during COVID-19 emergency in Italy, were enrolled from the Azienda Ospedaliero-Universitaria Pisana (Pisa, Italy). They completed the PDI, Impact Event Scale – revised (IES-R) and the reactions to losses or upsetting events Trauma and Loss Spectrum – Self Report (TALS-SR) domain. Results: Internal consistency was good with a Cronbach’s alpha coefficient was .874. The PDI correlated strongly with measures that was conceptually close (TALS-SR reactions to losses or upsetting events domain; r = .723, p < .001). Participants who scored above the cut-off for PTSD reported significantly higher PDI scores than those who did not (6.47 ± 5.25 vs. 19.11 ± 8.291, p < 0.001). The one-month test–retest reliability (n = 21) was excellent (ICC = .997). Finally, factor analyses revealed that the PDI exhibited a single-factor structure. Conclusions: the Italian version of the PDI showed good psychometric proprieties and may be used to detect those at risk for developing PTSD.
La Medicina del Lavoro, 2020
Parole chiave: Disabilità psichica; sorveglianza sanitaria; medicina del lavoro; disturbi mentali... more Parole chiave: Disabilità psichica; sorveglianza sanitaria; medicina del lavoro; disturbi mentali riassunto Introduzione: La gestione dei lavoratori portatori di disabilità psichica rappresenta un argomento attuale e di grande interesse. L' obiettivo dell'articolo è quello di presentare l'esperienza di gestione dei casi di disabilità psichica presenti all'interno del personale dipendente di una azienda ospedaliero-universitaria italiana e di descrivere gli interventi relativi alle tutele preventive adottate e ai percorsi terapeutici specialistici intrapresi. Metodi: Un gruppo di 100 lavoratori affetti da disturbi psichiatrici è stato inserito in un programma di sorveglianza medica della durata di almeno 6 mesi. I lavoratori sono stati seguiti nell'ambito di un protocollo che ha incluso visite psichiatriche, interventi psicoterapici, visite del medico competente e valutazioni medico-legali. Sono state somministrate scale di valutazione della gravità di malattia e dell'efficacia dei trattamenti (CGI) e del funzionamento globale (GAF) al baseline e dopo 6 mesi di follow-up. Risultati: Il campione è risultato composto principalmente da infermieri (44%) e da Operatori Socio Sanitari (24%) e i più comuni disturbi diagnosticati sono stati i disturbi dell'umore e d'ansia. La partecipazione al programma di sorveglianza medica con la messa in atto di strategie terapeutiche specialistiche e di interventi organizzativi ha comportato una riduzione statisticamente significativa della gravità di malattia e un miglioramento del funzionamento globale e ha consentito di conservare mansione e sede lavorativa nella quasi totalità dei casi. Discussione: I risultati di questa esperienza consentono di affermare che l'integrazione delle competenze costituisce un valido strumento sia per l'inquadramento diagnostico multidisciplinare che per il monitoraggio e la gestione dei lavoratori con disabilità psichica nell'ambito della sorveglianza sanitaria periodica. The management of workers with mental disability is a current topic of great interest. The aim of the article is to report the experience of
Rivista di psichiatria, 2021
BACKGROUND Evidence highlights healthcare workers (HCWs) facing outbreaks, particularly the ongoi... more BACKGROUND Evidence highlights healthcare workers (HCWs) facing outbreaks, particularly the ongoing covid-19 pandemic, are at increased risk of negative mental health outcomes, particularly post-traumatic stress symptoms (PTSS), anxiety and depression. Data from previous outbreaks highlighted the risk for a negative impact on HCWs' social and occupational functioning, but scant data have investigated this issue in the framework of the covid-19 pandemic. A number of effective interventions have been proposed to support mental health and well-being of HCWs in emerging infectious outbreaks, but it is important to acknowledge the differential impact of mental disorders on different dimensions of functioning. METHODS The study explored the associations between work and social functioning and PTSS, depression and anxiety in a sample of 265 frontline HCWs employed at a major university hospital in Italy (Pisa), facing the first period of the covid-19 pandemic. Individuals were assessed...
Journal of Psychosomatic Research, 2021
OBJECTIVE Occupational stress represents a significant precipitating factor in different diseases... more OBJECTIVE Occupational stress represents a significant precipitating factor in different diseases but its role in Irritable Bowel Syndrome (IBS) needs to be clarified. The present cross-sectional study aimed at investigating the prevalence of IBS diagnosis in a sample of health workers and exploring the potential relationships between IBS, work-related stress levels and work ability. METHODS 653 health workers undergoing periodical occupational health surveillance at the Occupational and Preventive Medicine Unit of a major University Hospital in central Italy, were consecutively recruited and screened for IBS diagnosis, according to ROMA IV criteria. The rating scales IBS Severity Scoring System (IBS-SSS), Demand-Control-Support Questionnaire (DCSQ) and Work Ability Index (WAI) were used to assess respectively IBS severity, occupational stress and work ability levels. RESULTS IBS prevalence in the sample was 16.8%. Participants suffering from IBS were characterized by a higher prevalence of psychiatric diagnosis and sleep disturbances, higher levels of job strain and isostrain as well as by lower levels of work ability compared to non affected subjects. Moreover, the severity of IBS correlated positively with occupational stress and both were negatively associated with work ability. CONCLUSIONS The present results suggest the need for preventive, organizational and management strategies at workplace aimed at protecting the health and well-being but also productivity of the worker with IBS.
Journal of Affective Disorders, 2021
Currently soybean is one of the most important crops for agribusiness, Brazil being the 2nd large... more Currently soybean is one of the most important crops for agribusiness, Brazil being the 2nd largest producer of this grain. The soybean is responsible for much of the base of industrial foods. The state of Rio Grande do Sul ranks third in production in Brazil , behind only the state of Mato Grosso and Paraná . Noting that soybean production in recent years is largely responsible for meeting the huge demand for food. The Campanha Gaúcha region located in the west of Rio Grande do Sul, is ina a moment of adaptation and migration of producers for this culture, because the region was characterized by rice monoculture and extensive livestock. The soybean crop in Dom Pedrito is undergoing expansion, but the soil and climate of the region are not suitable for such a culture because ease of waterlogged soils and dry periods in summer. This paper aims to identify new management techniques for soybean production in Dom Pedrito / RS. Was analyzed on a farm two forms of managements (subsoiling and ridges) in order to verify the viability technique of this culture in the region. The results showed that these production systems are suitable for the production of soybeans in the county, stressing management with ridges excelled in productivity on the property studied. This management requires a structured property with manpower, machinery and proper management to allow one producer achieving greater productivity.
Italian Journal of Pediatrics, 2021
Context The literature agrees on the impact of post-traumatic stress symptoms in parents of serio... more Context The literature agrees on the impact of post-traumatic stress symptoms in parents of seriously ill children but there is less clarity about the real extent and gender differences of this psychopathological risk. The recent Covid-19 outbreak highlighted new burdens for researchers on Post Traumatic Stress Disorder (PTSD) and clear evidence-based knowledge on this issue is timely needed. Objective In this review, we present a synthesis of the updated evidence on PTSD rates in parents of children with severe diseases. We also aim to try to understand if research in this field has been refined over time with the long-term intent to better face the new challenges of Covid-19 in the paediatric field. Data sources The PubMed database was searched. Study selection Studies were included if they assessed PTSD in parents of children diagnosed with physical illnesses. Data extraction Of 240 studies, 4 were included. Results Analysis of the 4 studies revealed 2 studies with PTSD rates aro...
Sustainability, 2020
The recent worldwide COVID-19 outbreak provided a timely demonstration of the mental health needs... more The recent worldwide COVID-19 outbreak provided a timely demonstration of the mental health needs of health care workers on the front lines of the response to the pandemic. In addition to international guidelines, local institutions demand rapid and practical approaches easily replicable in different populations and contests. The principal aim of this paper is to highlight and share the experience of an Occupational Health Department responsible for monitoring hospital staff conditions during the SARS-COV-2 pandemic phase 1. The multidisciplinary team of the Occupational Health Department of a major university hospital in central Italy (AOUP) developed a specific protocol called PsicoCovid19 in order to provide targeted help, based on new psychosocial risk factors, to workers involved in the COVID-19 emergency to preserve hospital staff health. As of the date of this report, 106 workers (79 female, 27 male, mean age respectively, 51 ± 9.8, 45.7± 10.1) requested this service, reporti...
Psychiatry Research, 2021
International Journal of Environmental Research and Public Health, 2020
The novel coronavirus disease 2019 (COVID-19) is a global pandemic spreading worldwide, and Italy... more The novel coronavirus disease 2019 (COVID-19) is a global pandemic spreading worldwide, and Italy represented the first European country involved. Healthcare workers (HCWs) facing COVID-19 pandemic represented an at-risk population for new psychosocial COVID-19 strain and consequent mental health symptoms. The aim of the present study was to identify the possible impact of working contextual and personal variables (age, gender, working position, years of experience, proximity to infected patients) on professional quality of life, represented by compassion satisfaction (CS), burnout, and secondary traumatization (ST), in HCWs facing COVID-19 emergency. Further, two multivariable linear regression analyses were fitted to explore the association of mental health selected outcomes, anxiety and depression, with some personal and working characteristics that are COVID-19-related. A sample of 265 HCWs of a major university hospital in central Italy was consecutively recruited at the outpat...
CNS Spectrums, 2020
Objective. Work-related stress presents a significant impact on work performance and physical hea... more Objective. Work-related stress presents a significant impact on work performance and physical health. It has been associated with the onset of a multitude of symptoms. The main aim of this investigation is to better understand the impact of post-traumatic stress symptomatology, using a specific self-assessment questionnaire, in subjects experiencing occupational stress with the rationale to address the variegated symptoms expressed by this particular population in a post-traumatic dimensional perspective. Methods. Authors collected socio-demographic, occupational, and clinical data. They utilized Trauma and Loss Spectrum Self Report (TALS-SR), a questionnaire investigating post-traumatic stress symptoms. The population size was 345 subjects who presented at the Occupational Health Department of a university hospital over a 3 years period (2016–2018). Results. Data analysis revealed 33.9% of subjects who met post-traumatic stress disorder (PTSD) criteria. Gender distribution of this ...
La Medicina del lavoro, Jan 24, 2016
Putative occupational stress-related psychiatric disorders are Adjustment Disorders (AD) and Post... more Putative occupational stress-related psychiatric disorders are Adjustment Disorders (AD) and Post-Traumatic Stress Disorder (PTSD). Mood Disorders (MD) are not excluded but are unlikely to be identified as occupational diseases. The differential diagnosis between AD and MD is not easy and is based on strict categorical criteria. The aim of this study was to explore differences in personality and mood spectrum symptoms among workers investigated for occupational stress suffering from AD or MD. Sixty-two patients with AD and 43 with MD were recruited and evaluated by means of rating scales for psychosocial occupational risk and work-related stress (WHS, CDL, OSQ), for sleep disturbances (PSQI), for personality disorders (SCID-II) and for mood spectrum symptoms (MOODS-SR). The diagnostic groups did not differ for WHS, OSQ and PSQI scores. The duration of exposure to stressful/adversative work situations was significantly higher in the MD group (p=0.03). Positive family psychiatric his...
Giornale italiano di medicina del lavoro ed ergonomia
The rising awareness of psychosocial risks at workplace means that it is ever more important to p... more The rising awareness of psychosocial risks at workplace means that it is ever more important to prepare methods to assess psychosocial factors in occupational environment. This project of north west tuscany area has the aim to realize an instrument for a gradual risk assessment for this kind of factors without the support of specialists. A decisional flow chart helps to approach the risk assessment step by step on the basis of company features, management and organization problems and company symptoms of stress. The final assessment combines the evaluation of perceived risks with job analysis realizing a matrix containing 5 risk levels, which suggests the priority of preventive measures. The intermediate level (level three) represents the activation level for the medical surveillance. This experience means a proposal for a quantitative assessment of psychosocial risks at workplace.
Giornale italiano di medicina del lavoro ed ergonomia
Recently, the number of previously asbestos-exposed workers performing, at our department, medica... more Recently, the number of previously asbestos-exposed workers performing, at our department, medical exams aimed at an early diagnosis of asbestos-related tumors, has been progressively increasing. The diagnostical protocol we propose to these subjects include both radiological exams and some serum markers such as mesothelin and osteopontin. In this case-report we illustrate the history of a worker who, after having diagnosed a pulmonary asbestosis, developed a Lung Cancer. The significance of this case is based on the importance of the high mesothelin dosage which prompted further radiological exams resulting into the final diagnosis. In spite of the early diagnosis and treatment the patient finally died. Nevertheless, serum markers like mesothelin and osteopontin (especially the first) may result very helpful in monitoring and screening the population of workers previously exposed to asbestos.
Giornale italiano di medicina del lavoro ed ergonomia
High dosages of Serum Mesothelin have been demonstrated to be significantly associated to Pleural... more High dosages of Serum Mesothelin have been demonstrated to be significantly associated to Pleural Malignant Mesothelioma. We recently demonstrated that Serum Mesothelin may be clinically helpful both for diagnostic and prognostic purposes, with the best cut-off corresponding to 1 nM. We also discovered that high levels of Serum Mesothelin are significantly associated to Lung Cancer. The usefulness of this marker in secondary prevention has been suggested, though never demonstrated. We therefore started a long-term prospective cohort study including previously asbestos-exposed workers. These subjects periodically underwent both radiological tests and serum mesothelin dosages. As a mid-term goal of this longitudinal study we decided to check the variability of mesothelin dosages, comparing baseline and follow-up values, as well as the possible correlation with age, duration of exposure, smoking, any abnormality of respiratory functional tests (RFT) and/or radiological tests. At baseli...
Giornale italiano di medicina del lavoro ed ergonomia
Pleural Malignant Mesothelioma (MM) is a highly aggressive neoplasm with a poor survival rate, ha... more Pleural Malignant Mesothelioma (MM) is a highly aggressive neoplasm with a poor survival rate, hard diagnosis and treatment. The incidence of MM in Western Europe countries is expected to increase drammatically in the next 10-15 years. In spite of this drammatic scenario, at this time the only instruments for screening and early diagnosis are based on radiological tests with evident ethical and economical problems. For this reason, some authors are evaluating biological indicators with the significance of screening and early diagnosis markers. One of the most promising marker is serum mesothelin (SMRP). SMRP levels appeares to be significantly related to MM and its clinical (diagnostic/prognostic) usefulnes has been suggested. The purpose of this research is to show SMRP trend in relation both to the course of the disease and the response to therapies in some Epithelioid MM patients. The analysis of SMRP levels in these patients suggests that it may be a useful marker for monitoring...
Giornale italiano di medicina del lavoro ed ergonomia
A Questionnaire on sleep and vigilance disorders has been developed by the Italian Association of... more A Questionnaire on sleep and vigilance disorders has been developed by the Italian Association of Sleep Medicine to help the occupational health physicians in screening for sleep disorders. Aim of this study was to compare the Questionnaire with standardized questionnaires for sleepiness and sleep apnea and with a polysomnographic evaluation. Four hundred sixty-three (463#) commercial bus drivers (454M, 9F; mean age +/- S.D. 41.6 +/- 8.1 yrs; mean body mass index 26.2 +/- 3.6 kg/m2) underwent clinical evaluation that included the Italian Association of Sleep Medicine Questionnaire on sleep and vigilance disorders and two standardized questionnaires (Berlin Questionnaire and Epworth Sleepiness Scale). According to the Italian Association of Sleep Medicine Questionnaire on sleep and vigilance disorders 40 subjects presented an high risk for sleep disturbance and in 28 subject the questionnaires were concordant. Preliminary results (16 patients) showed an high rate of concordance betwe...
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Papers by rodolfo buselli