Impact of COVID-19 outbreak on ICU nurses' mental health. An Italian multicenter study. / Impatto dell'epidemia di COVID-19 sulla salute mentale degli infermieri di Terapia Intensiva. Uno studio multicentrico Italiano.

AIM: AIM: The aim of this study was to evaluate variations in ICU nurses ' mental health status over the COVID-19 outbreak by quantifying the extent of symptoms of depression, anxiety and PTSD over time. METHODS: METHODS: This study was an Italian multicenter prospective cohort study assessing caseness of anxiety, depression and PTSD at 6 and 12 months from the beginning of the COVID-19 outbreak in Italy. RESULTS: RESULTS: A total of 359 nurses, 233 (64.9%) were males and 126 (35.1%) were females were enrolled. At 6 months the caseness prevalence for anxiety, depression and PTSD were 31.3%, 32.1% and 18.7% respectively. At 12 months the caseness prevalence for anxiety, depression and PTSD were 34.8%, 36.4% and 24.1 % respectively. No statistically significant increase between 6 and 12 months was recorded for the caseness prevalence anxiety (p= .29) and depression (p= .19). However, an increase for the caseness prevalence PTSD at 12 months was observed (p= .049). The significant risk factors for the 221 patients with at least one disorders were age 31-40 (RR= 1.44, IC= 1.25-1.89; p < .001), female gender (RR= 1.31, IC= 1.02-1.51; p=. 042) and had 0-5 years of professional experience (RR= 1.36, IC= 1.02-1.63; p = .031). CONCLUSION: The results of our study may provide support for the implementation of some interventions for well-being in COVID-19 outbreak condition.

Analysis of incidents of violence in a large Italian hospital. / Analisi degli episodi di violenza in in grande ospedale italiano.

INTRODUCTION: An increase in the rate of non-fatal violence events, from 20.65/10,000 in 2012 to 22.81/10,000 in 2014, was observed at the IRCCS Ospedale Policlinico San Martino in Genoa. OBJECTIVES: To analyze the incidence and outcome of the phenomenon of violence, by identifying the type of aggressive event and the ward in which it occurred, assuming that the occurrence is evenly distributed and not only limited to the psychiatric or to the emergency department. The age and sex of both attackers and victims of aggression were also analyzed. METHODS: Retrospective analysis: study of injury trends related to episodes of violence between 2012 and 2015, incidence compared to other injuries and evaluation of the direct costs. Observational staff surveys with a questionnaire based on the Overt Aggression Scale and statistical data analysis. RESULTS: Following the aggressions, 36 injuries were identified over the study period (2012-2015), resulting in 431 days of absence from work. The direct estimated costs were € 64,170. The observational surveys of each ward showed a high concentration of events. Reports were received from 34 out of the 76 evaluated wards. Seventy-five percent of the reports concerned only four operative units: emergency room, intermediate care, psychiatry and geriatrics. Sixty-one percent of the questionnaires were filled out by nurses, 23% by support staff and the remaining 16% was provided by physicians and coordinators. CONCLUSIONS: Violence against healthcare workers is a well-known problem; action is required on the scheduling of activities, improvement of communication paths with users and the training of operators.

Association between levels of Toll-like receptors 2 and 4 and CD14 mRNA and allergy in pregnant women and their offspring.

The microbial environment in early infancy or even in utero may modulate the risk to develop allergic disease. Since Toll-like receptors (TLR) recognize microbial products, we hypothesized that maternal allergies may be associated with decreased levels of TLR2, TLR4 and CD14 mRNA in mothers and their offspring. 185 healthy pregnant women from Germany (n = 48), Hungary (n = 50) and Spain (n = 87) were enrolled in a European multicenter study. Levels of TLR2, TLR4 and CD14 mRNA were quantified in maternal peripheral blood samples taken at delivery and placental cord blood samples. Numbers of TLR2+, TLR4+ and CD14+ monocytes were quantified by flow cytometry in 42 cord blood samples obtained from the German participants. Bivariate and multivariate regression analyses were performed. Maternal allergies were associated with significantly lower levels of TLR2/4/CD14 mRNA in maternal blood and cord blood samples. Maternal and fetal TLR2/4/CD14 mRNA levels were significantly correlated with each other (TLR2 r = 0.42; TLR4 r = 0.58; CD14 r = 0.54). The results suggest that maternal allergy status may affect allergic risk in offspring through a decreased expression of fetal TLR2/4/CD14.