Search

Our objective was to assess the effects of acetyl-L-carnitine (ALC) with riluzole on disability and mortality of amyotrophic lateral sclerosis (ALS). Definite/probable ALS patients, 40-70 years of age, duration 6-24 months, self-sufficient (i.e. able to swallow, cut food/handle utensils, and walk), and with forced vital capacity (FVC) > 80% entered a pilot double-blind, placebo-controlled, parallel group trial and were followed for 48 weeks. ALC or placebo 3 g/day was added to riluzole 100 mg/day. Primary endpoint: number of patients no longer self-sufficient. Secondary endpoints: changes in ALSFRS-R, MRC, FVC and McGill Quality of Life (QoL) scores. Analysis was made in the intention-to-treat (ITT) and per-protocol (PP) population, completers and completers/compliers (i.e. taking > 75% of study drug). Forty-two patients received ALC and 40 placebo. In the ITT population, 34 (80.9%) patients receiving ALC and 39 (97.5%) receiving placebo became non-self-sufficient (p = 0.0296). In the PP analysis, percentages were 84.4 and 100.0% (p = 0.0538), respectively. Mean ALSFRS-R scores at 48 weeks were 33.6 (SD 10.4) and 27.6 (9.9) (p = 0.0388), respectively, and mean FVC scores 90.3 (32.6) and 58.6 (31.2) (p = 0.0158), respectively. Median survival was 45 months (ALC) and 22 months (placebo) (p = 0.0176). MRC, QoL and adverse events were similar. In conclusion, ALC may be effective, well-tolerated and safe in ALS. A pivotal phase III trial is needed.

The objective of this study was to investigate correlates of risk for having microalbuminuria in individuals with one or more cardiovascular risk factors.The study involved 1919 individuals who attended general practice settings, were aged 55 to 75 yr, and did not have a history of cardiovascular events or diabetes but had one or more cardiovascular risk factors. A tree-based regression technique and multivariate analysis were used to identify distinct, homogeneous subgroups of patients with different likelihood of having microalbuminuria; interaction between correlates of microalbuminuria and risk for microalbuminuria was also investigated.The prevalence of microalbuminuria was 5.9%. Patients who did not have hypertension and had postload glycemia140 mg/dl showed the lowest prevalence of microalbuminuria (1.9%) and represented the reference class. The likelihood of microalbuminuria was seven times higher in men with hypertension and homeostatic model assessment levels in the upper tertile and four times higher in women with the same characteristics. Individuals with hypertension and lower homeostatic model assessment levels and normotensive individuals with postload glycemiaor = 140 mg/dl had a more than three-fold increased likelihood of having microalbuminuria. Treatment with statins was associated with a 54% reduction in the likelihood of having microalbuminuria, whereas levels of triglycerides150 mg/dl and fibrinogen levels in the upper tertile were associated with a significantly higher risk for microalbuminuria.The likelihood of having microalbuminuria in a population-based study of elderly individuals is strongly related to the interaction between the components of the metabolic syndrome, particularly hypertension, insulin resistance, and impaired glucose tolerance.

This study investigated the extent to which a sample of Italian users comprehended safety pictorials used on agricultural machinery. A questionnaire with 12 safety pictorials was administered to 248 users of agricultural machinery. For each of the pictorials, the participants were asked to select the most appropriate description of four written choices. The investigated safety pictorials were, in general, not well comprehended. Two different classes of participants were identified, each with a different level of comprehension. The participants with better comprehension were characterized by the regular use of agricultural machinery and frequent previous exposure to pictorials. The need for training courses focusing on safety pictorials and their meanings, as well as the need for improvement to the pictorials themselves to make them more easily comprehended, is discussed.

Aim of study: We tested the perceived quality in use of a prototype of a handling supporting device, developed through a user-centred design process intended for rear-mounted foldable rollover protective-structures (FROPSs).Area of study: The study was performed in the Province of Cuneo, which has the largest number of farms and the highest share of utilized agricultural area (UAA) in Piedmont Region, NW Italy.Material and methods: Three groups of users, novice-novice (NN), novice-expert (NE) and expert-expert (EE) were asked to raise two rear-mounted FROPSs: a traditional one and a second one equipped with a supporting device which consisted of a gas spring and a rod. A questionnaire has been used to record the perceived quality in use of both FROPSs (effort, physical discomfort, temporal demand and ease of use) and perceived usefulness and attitudes toward the adoption of the supporting device.Main results: All groups reported less physical effort, more stable postures, higher ease of use in handling the FROPS equipped with the supporting device; NN users, in particular, declared to be willing to adopt the supporting device in the future on their tractors when commercially available.Research highlights: Previous studies reported discomfort in operating the FROPS as the main cause of its improper use. A solution to improve FROPS reachability was developed and tested with users. Benefits were perceived by both novice users and expert users.

Smart Farming Technologies (SFTs) can increase the sustainability of agricultural production, based on a more precise and resource-efficient approach. According to the European Union (EU) policies, the adoption of SFTs represents a key factor for the future of the European farming and a thematic network has been developed and funded by the Horizon 2020 program to identify and deliver new Smart Farming solutions to fit farmers' needs. However, previous studies pointed out a low level of SFTs adoption, often highlighting that successfully adopted technologies and innovations may be nevertheless rejected by the users, who go back to the traditional practices even where benefits were being enjoyed. A limited amount of empirical research is available on the reasons of farmers' attitudes toward the adoption of such new technologies and innovations. This study aimed at investigating the role played by sociodemographic variables, farming system characteristics, and perceived barriers in affecting the adoption of SFTs in a sample of Italian farmers. Three-hundred and ten farm operators were administered a paper-and-pencil questionnaire addressing perceived economic and commercial barriers in the use of SFTs and a set of user and farm-related variables (i.e. education, farm size, being a sole farmer). The analyses showed that education and working alone on-farm influenced the perception of economic barriers, which in turn played the major role in affecting the adoption of SFTs. Larger farms were more likely to adopt the SFTs investigated. The present results pointed out some critical aspects which may benefit from tailor-made interventions in terms of policies, work re-organization and/or operators' training, to support and widen the use of SFTs in the Italian context.

The comprehension of safety signs affixed to agricultural machinery is fundamental to warning users about the residual risks which cannot be eliminated with machinery design and the adoption of protections. This is particularly relevant for the migrant workforce, which may encounter some language barriers with written safety communication. The present study aimed to investigate the comprehension of safety signs affixed to agricultural machinery in a group of migrants from both European and non-European countries employed in Italian agriculture. Thirty-seven migrant farmworkers (12 Indians, 17 Pakistanis, and eight Romanians) were individually interviewed to test the comprehension of four safety signs referring to the main causes of fatal and non-fatal injuries caused by interactions with farm machinery. Romanians obtained the highest comprehension performance (68.8% of correct answers), followed by Indians (35.4%), with Pakistanis being last (32.4%). The nationality and the previous experience as a farmworker significantly affected the comprehension of safety signs. The results pointed out the importance of adequately training migrants on the meaning of safety signs. Beside this, the study suggests a redesign of the signs, considering some signs&rsquo, features to enhance pictorials&rsquo, cross-cultural comprehension.

Tractor overturn is the main cause of injuries and fatal accidents in agriculture. Rollover Protective Structures (ROPS) showed to be effective in reducing fatalities during tractor overturn. Foldable ROPS (FROPS) have been developed to offer greater mobility when working in low overhead clearance zones and more storage options. However, many fatalities and serious injuries in tractor overturn accidents occur for a misuse of the FROPS. The study proposed a multidimensional ergonomic investigation of FROPS handling to identify criticalities in the human-machine interaction which prevent farmers from raising the roll-bar. An observation of users’ behaviors while operating the FROPS and a collection of subjective ratings about perceived effort were performed, considering also tractor objective features. Eleven operators and nine tractors were involved in the study. The results showed that the participants exposed themselves to different safety (e.g. falls) and health (e.g. biomechanical overload of the spine) risks when raising the FROPS, even though they did not perceive any intense effort in handling the roll-bar. The vertical distance between the FROPS pivot pin and the ground affected participants’ gestures and postures. To facilitate the actual use of the FROPS and to prevent injuries or fatal consequences in case of tractor overturn, some technical solutions to enhance the accessibility of the FROPS may be developed. Furthermore, the correct postures and gestures to handle the roll-bar should be addressed during safety and health training courses.

Objectives: Safety pictograms are important graphic elements that are useful for rapidly conveying messages in workplaces. The purpose of this study was to investigate the comprehension of safety pictograms affixed to agricultural machinery among a group of Pakistani migrant farmworkers employed in Italy. Methods: Interviews about the meanings attributed to four standardized safety pictograms affixed to agricultural machinery depicting the most frequent causes of farm accidents were administered to 29 Pakistani migrant farmworkers employed on Italian farms. Results: There was high variability in pictogram comprehension. None of the participants interpreted all the pictograms in accordance with the definitions provided by the international standards. Higher comprehension rates were reported for pictograms related to the risks of tractor rollover and foot injury, while pictograms referring to the need to consult a technical manual and the risk of entanglement yielded lower comprehension scores. Previous farming experience in the country of origin and the number of years of education were significantly associated with comprehension scores. Conclusion: A discussion of pictogram features that may be critical for comprehension is provided, and (re)design suggestions are given to improve the cross-cultural comprehension of these safety signs.

The analysis of the postural attitude of workers during the interaction with workstation&rsquo, s elements and working environment is essential in the evaluation and prevention of biomechanical overload risk in workplaces. RULA (Rapid Upper Limb Assessment) and REBA (Rapid Entire Body Assessment) are the two easiest methods for postural risk assessment in the workplace. Few studies investigated postural risk in forestry sector with regard to human&ndash, machine interaction, in particular manually fed wood-chippers. The aim of this study was to evaluate the postures assumed by an operator during the manual feeding of a wood-chipper, and to compare RULA and REBA, in order to identify the more effective and appropriate method for the assessment of the risk of biomechanical postural overload. The results pointed out several postural issues of the upper limbs, and showed that RULA is a more precautionary method to protect operator&rsquo, s health during the targeted tasks. Implications to improve the human&ndash, wood-chipper interaction are discussed.

Steep slopes are the main cause of rollover incidents in agriculture. Targeted safety signs have been developed to warn machinery operators against risky slopes. However, machinery user&rsquo, s manuals and road signs report information regarding slope steepness in two different ways, by using the tilt angle in degrees and the slope percentage, respectively. In this study, we investigated the comprehension of safety signs depicting critical slopes, either in degrees or as percent values in a group of Italian agricultural machinery operators while considering the possible influence of previous experience with agricultural machinery, previous incidents, and on-farm occupation. Eighteen tractor and self-propelled machinery operators were administered graphical representations of seven slope angles in a randomized order and then were asked to estimate the slope steepness as both a tilt angle and a slope percentage. The participants tended to overestimate slope steepness in degrees, whereas the opposite was true for percentages. Farmers who were previously involved in a machinery-related incident were more accurate in their estimates. The present results raise some considerations regarding the need to redesign safety communication and to promote targeted training interventions.

The present study aimed at investigating perceptions and preferences about the use and the chemical characteristics of pellets made from composted animal manure in a sample of Italian farmers and agricultural advisors (Piedmont region, Northwestern Italy). The study encompassed two different steps: At first, the participants were administered a questionnaire about their actual use of pellets and preferences about their chemical characteristics. Then, a subgroup participated into a hands-on experience with different pelletized animal manures and some final questions. Concerning the use of pellets made from composted animal manure, even if the participants affirmed to be interested in using organic pellets and declared to own the appropriate equipment needed for their application, the results indicated that pelletized compost utilization had not yet become a common practice for agricultural crops. The obtained results highlighted a lack of knowledge, especially among farmers, about the importance of some chemical properties of this pelletized organic material. The participants, both farmers and advisors, were particularly attracted by the total nitrogen content of organic pelletized fertilizers, probably because the supplying of nutrients, nitrogen particularly, is the function of fertilizers they were interested in the most due to its direct connection with crop production. The hands-on session allowed the participants to better understand the benefits of the principal chemical properties&mdash, organic matter and carbon to nitrogen ratio&mdash, of pelletized animal manure compost. On the other hand, organic matter content and carbon to nitrogen ratio, more related with biological fertility and biodiversity of soils, are immediately less interesting and, as the hands-on experience pointed out, require more effort to be appreciated by agricultural operators. Targeted information campaigns and training activities may be developed among the agricultural community to make them aware of the importance of increasing soil organic matter content, and the possible use of pelletized composted animal manure. Further studies should be addressed toward gaining more insights into the beneficial effects of the information and training activities for pelletized compost adoption.

At the end of the 20th century the adoption of the Continuously Variable Transmission (CVT) was one of the disruptive technological advances in agricultural tractors. Several changes in the Human Machine Interface (HMI) of the tractor cab have been introduced to accommodate this technology. HMIs are known to raise issues about their ease of use; however, this topic has been under-investigated in the agricultural sector. The present study introduces a method to investigate the perceived ease of use of the HMI of agricultural tractors equipped with technological innovations. The HMI required to manage a CVT tractor was evaluated by sixteen tractor drivers (8 novices and 8 experts). During the first contact with the machine and after having performed two targeted tasks with the tractor, participants filled in a questionnaire about the ease of use of the controls and of the touch-screen display, and evaluated the general perception of ease of use, safety, quality and solidity of the machine. The trial pointed out some significant differences between novices and experts, thus confirming the validity of the proposed method. In particular, novice users showed some difficulties when interacting for the first time with the HMI of the CVT tractor working station, whereas experts did not report similar difficulties. Thus, expertise seems to play a role in determining the quality of the interaction with the HMI. Training interventions should be designed to help novices in increasing their expertise effectively, avoiding effort and errors and improving user’s comfort and system performance.

Pictorials affixed to agricultural machinery are important tools to warn the user about the risks that can arise from the intended use or any foreseeable misuse of the machine; however, in the U.S. there is no legal requirement regarding the adoption of safety pictorials on agricultural machinery. This study investigated comprehension of safety pictorials in a sample of U.S. agricultural machinery users. Two hundred and eight Pennsylvanian participants were asked to indicate the meaning of 12 frequent safety pictorials by choosing one among 4 alternative labels. The results showed that pictorials referring to the most common risks in agriculture were not necessarily the best comprehended images, and two out of five participants have never seen the pictorials included in the study. Years of experience with the machinery enhanced comprehension, whereas ‘part-time’ farming and occasional use of machinery were related to poorer comprehension. Implications for operators’ safety and solutions to improve pictorial noticeability and comprehension are discussed.

Agricultural and earth-moving machinery operators are particularly exposed to whole body vibration (WBV), which has severe effects on health and affects comfort and performance. Few studies have investigated vibrational safety and comfort issues in telescopic handlers. These vehicles are widespread in many off-road applications--such as construction, agriculture and mining--used to handle loads and to lift persons and equipment. This study investigated the effects of an active hydro-pneumatic cabsuspension system fitted to a telehandler on a driver's vibration exposure along the x-, y- and z-axes, through both objective and subjective assessments. Sixteen healthy professional telehandler drivers took part in the study. Objective measurements were acquired at the operator's seat, and subjective ratings were taken while participants drove the telehandler with either a deactivated or activated suspension system at 12 kph on an ISO 5008 smooth track. The results showed that the activation of the cab-suspension system reduced the root-mean-square acceleration along the x- and z-axes. (p=.038 and p=.000, respectively). Moreover, the frequency analysis showed a reduction in the acceleration along the z-axis in the range of 2-25 Hz (p

Agriculture is among the most hazardous productive sectors, and farm machinery is a major source of injury. In the present study, a mediated model was used to test the role played by workers’ characteristics, work environment factors, and near misses in predicting agricultural machinery-related accidents in a sample of Italian users (n=290). Hours worked per week (via the mediation of an adverse work environment) showed a positive association and years of work experience (via the mediation of risk perception) showed a negative association with the probability of being involved in a near miss, which in turn showed a positive association with the probability of being involved in a machinery-related accident. Implications for tailored preventive interventions are discussed.

Introduction Exposure to whole body vibration (WBV) is one of the most important risks for musculoskeletal disorders (MSDs). The objective of the study was to investigate whether an active cab suspension system fitted on a telehandler was effective in reducing WBV and in improving comfort. Method Sixteen male healthy professional operators drove a telehandler on a 100 m ISO 5008 smooth track at two different speeds (5 and 12 kph) with activated and deactivated cab suspension system. Adopting an ergonomic approach, different aspects of the human-machine interaction were analyzed: 1) vibration transmissibility, 2) subjective ratings of general comfort and local body discomfort, and 3) anthropometric characteristics of the users. Results A series of ANCOVAs showed that the suspension system was effective in reducing WBV at both speeds but did not affect the perception of comfort by the operators. Moreover, individuals with higher Body Mass Index (BMI) experienced more comfort. Some neck/shoulder and lumbar complaints and perceived hard jolts seemed to remain even when the system was activated. No correlations were found between objective and subjective measures. Practical applications Results suggest that the operators, given their wide range of physical variability, may need more adjustable or customizable WBV reduction systems.

INTRODUCTION: Pictograms affixed to agricultural machinery are important tools to reduce the occurrence of accidents and injuries when correctly noticed, comprehended, and followed. This study investigated the knowledge of safety pictograms used in agricultural machinery in a sample of farmers and farm workers and examined the factors influencing their comprehension. METHOD: A questionnaire with 12 safety pictograms used for agricultural machinery was administered to 281 owners or users of agricultural machinery. For each of the pictograms, the participants had to select the most appropriate verbal description from among four choices. RESULTS: The pictograms examined yielded poor comprehension scores, including warnings related to the most frequent accidents involving agricultural machinery. Familiarity with the pictograms and years of experience with agricultural machinery significantly increased users' comprehension of the meaning of the pictograms. CONCLUSIONS: Specific training programs should be designed to draw attention to safety pictograms and to instill their meaning. Language: en