Effects of Temperatures and Heatwaves on Occupational Injuries in the Agricultural Sector in Italy.

The effects of heat on health have been well documented, while less is known about the effects among agricultural workers. Our aim is to estimate the effects and impacts of heat on occupational injuries in the agricultural sector in Italy. Occupational injuries in the agricultural sector from the Italian national workers' compensation authority (INAIL) and daily mean air temperatures from Copernicus ERA5-land for a five-year period (2014-2018) were considered. Distributed lag non-linear models (DLNM) were used to estimate the relative risk and attributable injuries for increases in daily mean air temperatures between the 75th and 99th percentile and during heatwaves. Analyses were stratified by age, professional qualification, and severity of injury. A total of 150,422 agricultural injuries were considered and the overall relative risk of injury for exposure to high temperatures was 1.13 (95% CI: 1.08; 1.18). A higher risk was observed among younger workers (15-34 years) (1.23 95% CI: 1.14; 1.34) and occasional workers (1.25 95% CI: 1.03; 1.52). A total of 2050 heat-attributable injuries were estimated in the study period. Workers engaged in outdoor and labour-intensive activities in the agricultural sector are at greater risk of injury and these results can help target prevention actions for climate change adaptation.

Association between extreme temperature exposure and occupational injuries among construction workers in Italy: An analysis of risk factors.

BACKGROUND/AIM: Extreme temperatures have impact on the health and occupational injuries. The construction sector is particularly exposed. This study aims to investigate the association between extreme temperatures and occupation injuries in this sector, getting an insight in the main accidents-related parameters. METHODS: Occupational injuries in the construction sector, with characteristic of accidents, were retrieved from Italian compensation data during years 2014-2019. Air temperatures were derived from ERA5-land Copernicus dataset. A region based time-series analysis, in which an over-dispersed Poisson generalized linear regression model, accounting for potential non-linearity of the exposure- response curve and delayed effect, was applied, and followed by a meta-analysis of region-specific estimates to obtain a national estimate. The relative risk (RR) and attributable cases of work-related injuries for an increase in mean temperature above the 75th percentile (hot) and for a decrease below the 25th percentile (cold) were estimated, with effect modifications by different accidents-related parameters. RESULTS: The study identified 184,936 construction occupational injuries. There was an overall significant effect for high temperatures (relative risk (RR) 1.216 (95% CI: (1.095-1.350))) and a protective one for low temperatures (RR 0.901 (95% CI: 0.843-0.963)). For high temperatures we estimated 3,142 (95% CI: 1,772-4,482) attributable cases during the studied period. RRs from 1.11 to 1.30 were found during heat waves days. Unqualified workers, as well as masons and plumbers, were found to be at risk at high temperatures. Construction, quarry and industrial sites were the risky working environments, as well as specific physical activities like working with hand-held tools, operating with machine and handling of objects. Contact with sharp, pointed, rough, coarse 'Material Agent' were the more risky mode of injury in hot conditions. CONCLUSIONS: Prevention policies are needed to reduce the exposure to high temperatures of construction workers. Such policies will become a critical issue considering climate change.

Agent-oriented Decision Support System for Business Processes Management with Genetic Algorithm Optimization: an Application in Healthcare.

Agent-based approaches have been known to be appropriate as systems and methods in medical administration in recent years. The increased attention to processes led to the recent growth of Business Process Management discipline, which quite exclusively adopt discrete-event modeling and simulation. This paper proposes a medical agent-oriented decision support system to integrate the achievements from management science, agent-based modeling, and artificial intelligence. In particular, we performed a practical application concerning a hospital emergency department medical system. We adopt the widely used multi-agent programmable modeling environment NetLogo. First, we demonstrated the ability to perform a clear representation of healthcare processes where agents (i.e., patients and hospital staff) operate in a 3D environment. This model allows performing a traditional what-if scenario analysis. Second, we explore how performing intelligent management of patients by applying genetic algorithms to find the criteria for the selection process of the subjects in the admission procedure. The results are encouraging towards a more extensive application of agent-oriented methodologies in healthcare management.

Nationwide epidemiological study for estimating the effect of extreme outdoor temperature on occupational injuries in Italy.

BACKGROUND: Despite the relevance for occupational safety policies, the health effects of temperature on occupational injuries have been scarcely investigated. A nationwide epidemiological study was carried out to estimate the risk of injuries for workers exposed to extreme temperature and identify economic sectors and jobs most at risk. MATERIALS AND METHODS: The daily time series of work-related injuries in the industrial and services sector from the Italian national workers' compensation authority (INAIL) were collected for each of the 8090 Italian municipalities in the period 2006-2010. Daily air temperatures with a 1 × 1 km resolution derived from satellite land surface temperature data using mixed regression models were included. Distributed lag non-linear models (DLNM) were used to estimate the association between daily mean air temperature and injuries at municipal level. A meta-analysis was then carried out to retrieve national estimates. The relative risk (RR) and attributable cases of work-related injuries for an increase in mean temperature above the 75th percentile (heat) and for a decrease below the 25th percentile (cold) were estimated. Effect modification by gender, age, firm size, economic sector and job type were also assessed. RESULTS: The study considered 2,277,432 occupational injuries occurred in Italy in the period 2006-2010. There were significant effects for both heat and cold temperatures. The overall relative risks (RR) of occupational injury for heat and cold were 1.17 (95% CI: 1.14-1.21) and 1.23 (95% CI: 1.17-1.30), respectively. The number of occupational injuries attributable to temperatures above and below the thresholds was estimated to be 5211 per year. A higher risk of injury on hot days was found among males and young (age 15-34) workers occupied in small-medium size firms, while the opposite was observed on cold days. Construction workers showed the highest risk of injuries on hot days while fishing, transport, electricity, gas and water distribution workers did it on cold days. CONCLUSIONS: Prevention of the occupational exposure to extreme temperatures is a concern for occupational health and safety policies, and will become a critical issue in future years considering climate change. Epidemiological studies may help identify vulnerable jobs, activities and workers in order to define prevention plans and training to reduce occupational exposure to extreme temperature and the risk of work-related injuries.

Versiones fuerte y débil del modelo de informaciónmotivación- habilidadesconductuales en la predicción del uso del preservativo / Strong and weak versions of the Information- Motivation-Behavioral Skills model in prediction of condom use

Desde el modelo de la información-motivación-habilidades conductuales, se propone que el efecto de variablescomo el conocimiento y actitudes hacia el VIH/sida y la vulnerabilidad se ven mediados por la autoeficacia en el usodel preservativo. En este estudio se somete a prueba esta hipótesis con una muestra de adolescentes de Colombia.Los participantes fueron 599 adolescentes colombianos, sexualmente activos, de enseñanza secundaria. El 65.94% eran varones. La edad media fue de 15.58 años (DT = 1.41). Se trata de un estudio que utiliza un diseño ex-postfacto retrospectivo factorial. Los instrumentos utilizados fueron: El Cuestionario VIH/SIDA-65; la adaptación española abreviada del Inventario de Roles Sexuales de Bem(BSRI) y la adaptación española del Cuestionario SOS (Sexual Opinion Survey). Los resultados indican que las variables referidas a los componentes información y motivación tienen un efecto directo sobre el uso del preservativo y, éste no se ve mediado por la autoeficacia.

The Information-Motivation-Behavioral Skills model suggests that the effect of variables such as knowledge and attitudes towards HIV/AIDS and vulnerability are influenced by self-efficacy in condom use. This currentstudy tests this hypothesis with a sample of adolescents in Colombia. The participants were 599 Colombianadolescents sexually active, from Secondary Education. The 65.94% of the sample were males. The averageage was 15.58 years (TD=1.41). We used a factorial retrospective ex-post-facto design. The instrumentsused were HIV/AIDS-65 Questionnaire, the Spanish abbreviated adaptation of Bem Sexual Roles Inventory(BSRI) and the Spanish adaptation of the Sexual Opinion Survey (SOS). The results obtained shows thatthe variables related to information and motivation have a direct effect on condom use, which is not influencedby self-efficacy.

El parámetro de desviación discriminante en la Ley del Juicio Comparativo / Discriminal desviation parameter in the Law of Comparative Judgment

En diferentes publicaciones (López e Hidalgo, 2001, p. 331; Luce et al., 1990; Cliff, 1993; Lee, 2001) se ha ofrecido evidencia acerca de las limitaciones que las pruebas de ajuste presentan a la hora de comprobar los supuestos un modelo que utiliza una representación funcional. Un ejemplo de tales tipos de modelos son los basados en la Ley del Juicio Comparativo de Thurstone (1927a). Los resultados de este estudio no recomiendan interpretar el parámetro de desviación discriminante de la Ley del Juicio Comparativo como un índice del grado de confusión que provocan los estímulos en los jueces y a su vez abre la posibilidad de que realmente sean los valores escalares obtenidos con dicho modelo los que se deban interpretar como un índice del grado confusión que provocan en los sujetos (AU)

In different publications (López & Hidalgo, 2001, p. 331; Luce et al., 1990; Cliff, 1993; Lee, 2001) it has offered itself evidence brings over of the limitations that the tests of adjustment present at the moment of verify the suppositions of a model that uses a functional representation. An example of such types of models they are the based ones on the Law of the Thurstone’s comparative Judgment. The results of this study do not recommend to interpret the parameter of disciminal desviation of the Law of the Comparative Judgment, as an index of the degree of confusion that provoke the stimuli in the judges and in turn will be the possibility that really they are the scale values obtained with the above mentioned model, which should be interpreted as an index of the degree confusion that they provoke in the subjects (AU)

Fibrobroncoscopia en terapia intensiva / Fiberbronchoscopy in intensive care

The 90 patients data have retrospectively been studied for one year in an intensive care unit. The reasons why the bronchoscopies were than, as well as the contraindications of this method, have all been analysed.

Fibrobroncoscopia en terapia intensiva / Fiberbronchoscopy in intensive care

The 90 patients data have retrospectively been studied for one year in an intensive care unit. The reasons why the bronchoscopies were than, as well as the contraindications of this method, have all been analysed. (AU)