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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.

27 obese women (relative body weight 191 +/- 27%), aged 35 +/- 11, underwent a 15 day very low calorie diet (VLCD: 1337 kJ/day). Mean body weight loss was 6 +/- 1.5 kg. Resting metabolic rate (RMR), measured by indirect calorimetry, showed a significant decrease both in absolute values (from 1793 +/- 225 to 1569 +/- 231 kcal/day; P less than 0.001), and in keal/kg body weight/day (from 17 +/- 2, to 16 +/- 2, P less than 0.001). Serum triiodothyronine (T3) significantly decreased from 1.1 +/- 0.2 to 1 +/- 0.2 microgram/1 (P less than 0.001). Before VLCD the differences between measured RMR and theoretical RMR (RMR-T) were not significant. After VLCD RMR values were significantly (P less than 0.001) lower than RMR-T. It was concluded that fat-free mass loss, combined with periferic thyroxin (T4) reduced monodeiodination in its more active form mainly due to low calorie intake T3 could be responsible for the important reduction observed in the resting metabolic rate.

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.

Introduction: Occupational safety and health (OSH) have a remarkable impact on the sustainability of firms and organizations. However, the sustainability perspective has often focused primarily on environmental and economic concerns, leaving key social and workplace aspects, such as OSH, underemphasized. The link between all these aspects is particularly relevant in agriculture. Method: In the present study we analyzed the paths by which the worker's age, participation in safety training, and previous history of accidents and near misses can influence the adoption of safety behaviors in agriculture through the mediation of attitudes towards safety and perceived behavioral control. Three hundred and ten Italian agricultural operators were administered an ad-hoc questionnaire. Results: Having attended safety training courses, having been exposed to previous accidents and near misses, and age showed a positive association with the adoption of on-farm safety behaviors, through the mediation of perceived behavioral control. In more detail, participation in training courses and age showed a positive association with perceived behavioral control, while the previous history of accidents and near misses showed a negative association with behavioral control. In turn, perceived behavioral control was positively associated with the adoption of safety behaviors. Conclusions: The present study focused on the chain of events leading to the adoption of on-farm safety behaviors, which can prevent an accidents, pointing out the more critical variables and the level at which they intervene, identifying possible areas of targeted interventions. Practical applications: Implications for the development of targeted interventions may deal with: (a) training activities increasing farm operators’ sense of control over their safety, (b) older farmers involvement in mentoring initiatives, and (c) systematic recording and use of previous history of accidents and near misses as inputs for training activities to discuss their implications for on-farm safety.

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.

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.

Objectives Migrant farmworkers report higher rates of work-related illnesses, injuries and fatalities compared with local workers. Language and cultural barriers represent a relevant source of risk, which can be reduced by means of targeted training interventions. However, very little evidence is available about the effectiveness of Occupational Safety and Health (OSH) training programmes addressing migrant farmworkers. Study design We carried out a scoping review. Methods Currently available literature about the effectiveness of OSH training for migrant farmworkers—in terms of improvements in at least one of the following: safety knowledge, behaviours, attitudes and beliefs and health outcomes—was searched from four databases: PubMed, PsycINFO, Scopus and Web of Science. The screening was performed independently by two authors, and any disagreement was resolved through discussion until consensus was achieved. Once the articles eligible for inclusion were selected, the objectives, design, sample and setting, interventions and findings of each study were recorded. No quality assessment tool for publications considered by this study has been used because a scoping review does not aim for critical appraisal. Results Twenty-nine publications met the inclusion criteria. Of these, nine cross-sectional studies discussed the effectiveness of training activities in terms of whether participating in any programme had or did not have a significant effect on the dependent variables, when training was considered along with other sociodemographic factors. In the majority of these studies, training appeared to have low or no effect on the dependent variables considered. Twenty mainly within-subject experimental studies addressed the effectiveness of specific training methods, reporting significant improvements especially for interventions based on a participatory approach. Conclusions Training could greatly contribute to an effective attainment of OSH information, but the present review shows that more evidence is needed to guide the future development of effective training activities.

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: 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