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Prevention of post-traumatic stress symptoms (PTSS) in healthcare workers (HCWs) facing the current COVID-19 pandemic is a challenge worldwide as HCWs are likely to experience acute and chronic, often unpredictable, occupational stressors leading to PTSS. This review aims to analyze the literature to discover which topics have been focused on and what the latest developments are in managing the occupational risk of PTSS in HCWs during the current pandemic. For the purpose of this review, we searched for publications in MEDLINE/Pubmed using selected keywords. The articles were reviewed and categorized into one or more of the following categories based on their subject matter: risk assessment, risk management, occurrence rates. A total of 16 publications matched our inclusion criteria. The topics discussed were: “Risk Assessment”, “Occurrence Rates”, and “Risk Management”. Young age, low work experience, female gender, heavy workload, working in unsafe settings, and lack of training and social support were found to be predictors of PTSS. This review’s findings showed the need for urgent interventions aimed at protecting HCWs from the psychological impact of traumatic events related to the pandemic and leading to PTSS; healthcare policies need to consider preventive and management strategies toward PTSS, and the related psychic sequelae, in HCWs.

To investigate relevant biomarkers that might aid in the diagnosis and monitoring of long COVID (LC), an analysis of IFN-α, IFN-β, ISG15, and ISG56 transcripts was performed by Real-Time PCR among people of working age who had been infected with SARS-CoV-2 one year prior to the study [LC and non-long COVID (NLC)]. Despite no differences in the transcript levels of IFN-α, IFN-β, ISG15, and ISG56 between LC and NLC, higher IFN-β mRNA levels were observed among LC compared to NLC individuals who were hospitalized for more than 10 days during acute SARS-CoV-2 infection. Moreover, previously SARS-CoV-2 infected participants that did not require respiratory support and developed LC exhibited higher levels of IFN-α and IFN-β compared to NLC with the same clinical characteristics. These results highlight that SARS-CoV-2 infection leads to changes in peripheral innate immune pathways, which could have implications for the development of LC.

In confirmation of this, interestingly, a number of ILI-related viral pathogens (i.e. respiratory syncytial virus and influenza virus) have been reported to cause a significant downregulation of ACE2 in the upper and lower respiratory tract, since the early stage after the onset of infection [5]. The consequent reduction of ACE2 activity has been found potentially contributing to severe lung injury and may predispose to a later more severe clinical course of COVID-19 [6]. [...]considering that intercurrent viral respiratory infections are a trigger of upper airway mucosal damage and local immune impairment, previous ILI could therefore represent a predisposing factor for subsequent COVID-19 infection. Angiotensin-converting enzyme 2 inhibits lung injury induced by respiratory syncytial virus.

Teaser The management of the coronavirus disease pandemic in reception centres for migrants is burdened by significant critical issues mainly due to linguistic, cultural and social differences related to the heterogeneity of the migrants hosted. Here we reported the field analysis of these critical issues and adopted solutions.

Background: Prevention of latent tuberculosis infection (LTBI) in healthcare workers (HCWs) to ensure the “Right to Occupational Safety” is a special challenge globally, as HCWs have a higher risk of acquiring the infection in hospital settings because of frequent close exposure to patients suffering from tuberculosis (TB). Methods: Aretrospective study was performed with the aim of assessing the prevalence of LTBI related to demographical and occupational risk factors among HCWs employed in a large hospital in Italy. The study involved 1461 HCWs screened for LTBI by Mantoux tuberculin skin test (TST) and then confirmed with Interferon Gamma Release Assay (IGRA) test in case of positivity. Immunosuppressed and BGC-vaccinated workers were tested directly with IGRA. Results: LTBI was diagnosed in 4.1% of the HCWs and the prevalence resulted lower than other studies conducted in low TB incidence countries. The variables significantly linked with higher frequency of the infection were: age ≥40 years (OR = 3.14; 95% CI: 1.13–8.74; p < 0.05), length of service ≥15 years (OR = 4.11; 95% CI: 1.48–11.43; p < 0.05) and not being trained on TB prevention (OR = 3.46; 95% CI: 1.85–6.46; p < 0.05). Not trained HCWs presented a higher risk of LTBI also after adjustment for age and length of service, compared to trained HCWs. Conclusions: screening of HCWs for LTBI should be always considered in routinely occupational surveillance in order to early diagnose the infection and prevent its progression. Safety policies in hospital settings centered on workers’ training on TB prevention is crucial to minimize LTBI occurrence in HCWs.

Recent changes in the organization of the healthcare system, triggered by the current economic crisis in Italy, require interventions aimed at minimizing the impact of work-related stress (WRS) on healthcare workers' health status and well-being. Emergency department (ED) personnel appear to be particularly vulnerable to WRS as a consequence of specific occupational risk factors. The aim of this retrospective observational study was to analyze the level of WRS after improvement interventions implemented by the management staff of the ED and focused on work context factors. The assessment of WRS showed that nurses and physicians of the ED are exposed to a medium level of risk; the improvement interventions aimed at reducing WRS were focused on: (1) function and organizational culture; (2) role within the occupational organization; and (3) relationships at work policy. These interventions were found to be significantly effective in reducing the risk of WRS.

According to epidemiologic data, HCWs are particularly exposed to the risk of MSDs, and low back pain (LBP) is the most common cause of work-related disabilities among nurses.1-4 The literature reveals a trend toward increased rates of LBP in HCWs in Western countries due to both: (1) aging of the general population and, consequently, an increased number of people needing healthcare; and (2) a demographic change that is resulting in people working to a greater age and consequent high risk for intervertebral disk degeneration in older workers.5-7 A growing literature points to the need for workplace policy development related to organizational issues as a strategy that can help to minimize the occurrence of LBP in the healthcare sector. Many authors have shown that, among other psychosocial risks, shiftwork, including night work, is linked with the occurrence of LBP in registered nurses (RNs).9-11 Hopcia et al.12 observed an increased risk of injury (not including needlestick and sharps injuries) in RNs with more consecutive work days and longer cumulative working hours, and demonstrated the need for organizational interventions targeted to shifts as a strategic way to better protect the safety and health of workers. [...]increased odds ratios for WRLBP were found for RNs working night shifts more than 3 or 9 nights, respectively, in 7 and 28 days. According to the World Health Organization, constructing healthy workplaces, including in the healthcare sector, is a goal that may be reached through collaboration between workers and managers, with the aim of promoting and protecting the health, safety, and well-being of all workers and the sustainability of the workplace.31 The study has some limitations: - The period investigated is too short to draw strong conclusions about the relationship between shiftwork schedules and occurrence of WRLBP. -

Background/Objectives: Despite medical advances, stigma remains a major challenge for people living with HIV (PLWH). This study examined clinical, sociodemographic, and psychological predictors of HIV-related stigma, and explored whether affective temperament moderates the impact of depression on stigma. Methods: This cross-sectional observational study included 97 PLWH attending a tertiary infectious disease unit in Rome, Italy. Participants completed a battery of validated psychometric instruments assessing depressive symptoms, anxiety, manic symptoms, mixed affective states, general psychopathology, impulsivity, and affective temperament. HIV-related stigma was evaluated using the Berger HIV Stigma Scale, which measures personalized stigma, disclosure concerns, negative self-image, and concerns with public attitudes. Descriptive statistics were used to characterize the sample. Univariate linear regressions were conducted to explore associations between clinical, psychometric, and sociodemographic variables and each stigma subdimension, as well as the total stigma score. Variables significant at p < 0.05 were included in five multivariate linear regression models. Moderation analyses were subsequently performed to assess whether affective temperaments moderated the relationship between significant psychopathological predictors and stigma. Bonferroni correction was applied where appropriate. Results: Higher depressive symptom scores are significantly associated with greater internalized stigma (B = 0.902, p = 0.006) and total stigma (B = 2.603, p = 0.008). Furthermore, moderation analyses showed that anxious temperament significantly intensified the relationship between depressive symptoms and both negative self-image (interaction term B = 0.125, p = 0.001) and total stigma (B = 0.336, p = 0.002). Conclusions: Depressive symptoms and anxious temperament are associated with HIV-related stigma. Integrating psychological screening and targeted interventions for mood and temperament vulnerabilities may help reduce stigma burden in PLWH and improve psychosocial outcomes.

ABSTRACT AL‐amyloidosis is caused by deposition of pathological insoluble proteins in organs and tissues. HIV infection is a multi‐system disorder causing chronic inflammation. We report a case of AL‐amyloidosis associated with HIV suggesting that HIV‐associated immune dysregulation might be critical for pathogenesis of plasma cells dyscrasias and then AL amyloidosis.