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Despite long-term care (LTC) workers having been identified as particularly subject to chronic stress, only a few studies evaluated the impact of the COVID-19 pandemic on stress in this population. As far as the authors know, no studies have investigated the relationship between work-related stress and chronic stress in the LTC setting. This retrospective observational study aimed to assess the level of chronic stress in LTC workers, to identify some possible predictors and vulnerability factors, and to measure the impact of the COVID-19 pandemic on work-related stress. The study was based on the information gathered from two different questionnaires administered before and one year after the beginning of the pandemic, to a cohort of Italian LTC workers. We found that chronic stress was associated with lower resilience to stress scores (57.42 vs. 60.66) and with higher work-related stress scores (30.48 vs. 20.83). Interestingly, the overall level of work-related stress did not differ between the two questionnaires (27.84 vs. 29.08). However, the main components of the questionnaires changed; fatigue and burnout symptoms became more relevant after the pandemic. Results of this study suggests deepening knowledge of the components of stress to develop and implement effective stress mitigation interventions. ispartof: INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH vol:19 issue:10 ispartof: location:Switzerland status: published

Introduction While some stress is a common part of everyday work for most people, higher or prolonged levels of stress might be harmful. Work-related stress is becoming a study subject because of its important implications: it is related to coronary heart disease and health in general and it also influences employee satisfaction and productivity. Because of this, workers should be aware of their stress levels in order to prevent disease and increase performance levels. Therefore, the aim of our study was to evaluate stress levels among employees. Methods We conducted an observational study in collaboration with Anteo, an onlus society based in Biella which employs more than 1000 workers. The first step of our study ran from December 2019 to February 2020, and included 300 workers. Informed consent was gathered trough structure chiefs prior to the intervention. We administered an online questionnaire based on the Kessler Psychological Distress Scale (K10) for screening than, subjects with a high perceived stress level were invited for a personal interview with our medical and psychological staff. Results The response rate was 31% with 94 questionnaires completed by the end of February 2020. 80% of respondents were women (75 out of 94). 17% of the employees presented a moderate to high level of stress (16 total, 72% women). Only 5% of workers presented a high level of stress (4 total, 50% women). All Patients presenting a high level of perceived stress went through medical and psychological evaluation, which confirmed the results in 88% cases (14 out of 16). Conclusions Our study evidenced that workers are often exposed to high levels of stress, which can influence health, everyday life as well as productivity. The introduction of stress management programs in companies could improve workers health and productivity having a positive impact on one's health, company productivity and society in general. Key messages The introduction of stress management programs might improve workers health and productivity. The introduction of stress management programs might have a positive impact on one’s health, company productivity and society in general.

Fil: Opizzi, Hernán Luis. Universidad de San Andrés. Escuela de Negocios; Argentina. En el ámbito de la Universidad de San Andrés, en la Maestría de Recursos Humanos, se establece como requisito de aprobación de la misma un trabajo final. El trabajo seleccionado por el suscripto aborda la problemática surgida tras la aprobación de un nuevo convenio sectorial que viene a cambiar el plan de carrera al Personal Civil de Ejército y con él las condiciones de idoneidad para acceder a los cargos jerárquicos. Este cambio ha afectado, mayoritariamente, a quienes sin una formación educativa profesional han accedido a puestos de relevancia dentro de la organización. Surge así el planteo de ¿cómo impacta la nueva normativa en quienes han alcanzado las máximas jerarquías bajo el viejo Estatuto del Personal Civil (como Superiores y Supervisores), y no poseen un título terciario o universitario? A consecuencia de ello, los principales hallazgos del trabajo de investigación, con relación al impacto de la nueva normativa sobre quienes son objeto de estudio, se relacionan en primera instancia con la ruptura del contrato psicológico y sus consecuencias. En segundo lugar; mostraremos como afecta al personal, la aplicación del nuevo Plan de Carreras desde el punto de vista de la jerarquía, el salario y la moral.

The relation between alcohol consumption and mortality is a J-shaped curve in most of the many studies published on this topic. The Copenhagen Prospective Population Studies demonstrated in the year 2000 that wine intake may have a beneficial effect on all cause mortality that is additive to that of alcohol. Wine contains various poliphenolic substances which may be beneficial for health and in particular flavonols (such as myricetin and quercetin), catechin and epicatechin, proanthocyanidins, anthocyanins, various phenolic acids and the stilbene resveratrol. In particular, resveratrol seems to play a positive effect on longevity because it increases the expression level of Sirt1, besides its antioxidant, anti-inflammatory and anticarcinogenic properties. Moderate wine drinking is part of the Mediterranean diet, together with abundant and variable plant foods, high consumption of cereals, olive oil as the main (added) fat and a low intake of (red) meat. This healthy diet pattern involves a "Mediterranean way of drinking," that is a regular, moderate wine consumption mainly with food (up to two glasses a day for men and one glass for women). Moderate wine drinking increases longevity, reduces the risk of cardiovascular diseases and does not appreciably influence the overall risk of cancer.

The aim of this study is to evaluate the efficacy of a dietary supplementation with an extract from Cynara scolymus (Cs) on the glucose pattern in a group of patients with naive impaired fasting glycaemia (IFG). A randomized, double-blind, placebo-controlled trial has been performed in 55 overweight subjects with IFG (fasting blood glucose [FBG]: 6.11 ± 0.56 mmol/l). These subjects were randomly assigned to supplement their diet with either an extract from Cs (600 mg/d) (26 subjects) or placebo (29 matched subjects) for 8 weeks. The decrease of FBG was the primary endpoint. The assessment of Homeostatic Metabolic Assessment (HOMA), glycosylated haemoglobin, A1c-Derived Average Glucose (ADAG), lipidic pattern and anthropometric parameters were the secondary endpoints. The within groups and percent changes from baseline were analyzed by the signed rank test. The comparison between groups was performed by Wilcoxon's two sample test. The supplemented group had significant decreases of: FBG (-9.6%), HOMA (-11.7%), glycosylated haemoglobin (-2.3%), ADAG (-3.1%) and lipidic pattern. The placebo group did not show any significant difference. Compared with the placebo, the supplemented group showed a significant difference in FBG, HOMA and lipidic pattern. These data demonstrate the efficacy of Cs extract on the reduction of glycometabolic parameters in overweight subjects with IFG.

Introduction: Aging is associated with decreases in muscle mass, strength, power (sarcopenia) and bone mineral density (BMD). The aim of this study was to investigate the role of sarcopenia in BMD loss in the elderly. Materials and Methods: Body composition and BMD were measured by dual-energy x-ray absorpti -ometry in 159 elderly subjects (52 men and 107 women; mean age 80.3 years). Muscle strength was determined with a dynamometer. Canonical correlation analysis examined the effect of sarcopenia on osteoporosis. Results: After adjustment for gender and age, sarcopenia and osteoporosis were found to be cor-related (canonical correlation ρ : +0.252, p=0.001). Conclusion: This study showed that sarcopenia was associated with BMD in a group of elderly people. KEY WORDS: Bone mineral density, Elderly, Relative skeletal muscle mass, Sarcopenia, Canonical correlation analysis Received: November 26, 2012; Accepted: February 12, 2013 SHORT COMMUNICATION considering that muscle contraction is the dominant source of skeletal loading that provides the mechanical stimulus to increase bone mass (12). In addition, the catabolic-inflammatory process underlying sarcopenia in chronic inflammatory diseases might also be associated with bone loss in the elderly (13).The decrease in bone mineral density (BMD) with increasing age can lead to a condition of osteopenia that in more extreme cases can turn into osteoporosis. Bone fractures are the most common complications of osteoporosis and are a significant cause of disability and premature death among older women and men (14). Especially the incidence of proximal femur fractures increases dramatically with advancing age and has become a worldwide problem that is relevant to public health from the clinical, economic and

This randomized, double blind, placebo-controlled, 8 week trial assessed the efficacy on metabolic changes produced by a consumption of a combination of bioactive food ingredients (epigallocatechin gallate, capsaicins, piperine and l-carnitine) versus a placebo, as part of a therapeutic ‘lifestyle change’ diet, in 86 overweight subjects. Forty-one patients (2/14 F/M; age 43.7 ± 8.5; BMI 30.3 ± 3.5 kg/m2) were randomized to the supplemented group and 45 (29/16; age 40.7 ± 10.2; BMI 30.0 ± 2.7) to the control group. We observed that consumption of the dietary supplement was associated with a significantly greater decrease in insulin resistance, assessed by homostasis model assessment (p

The aim of this study was to evaluate the effects of artichoke leaf extract (ALE) supplementation (250 mg, 2 b.i.d.) on the lipid pattern. A randomized, double-blind, placebo-controlled clinical trial was performed on 92 overweight subjects with primary mild hypercholesterolaemia for 8 weeks. Forty-six subjects were randomized to supplementation (age: 54.2 ± 6.6 years, body mass index (BMI): 25.8 ± 3.9 kg/m(2), male/female: 20/26) and 46 subjects to placebo (age: 53.8 ± 9.0 years, BMI: 24.8 ± 1.6 kg/m(2), male/female: 21/25). Verum supplementation was associated with a significant increase in mean high-density lipoprotein (HDL)-cholesterol (p0.001) and in mean change in HDL-cholesterol (HDL-C) (p = 0.004). A significantly decreased difference was also found for the mean change in total cholesterol (p = 0.033), low-density lipoprotein (LDL)-cholesterol (p0.001), total cholesterol/HDL ratio (p0.001) and LDL/HDL ratio (p0.001), when verum and placebo treatment were compared. These results indicate that ALE could play a relevant role in the management of mild hypercholesterolaemia, favouring in particular the increase in HDL-C, besides decreasing total cholesterol and LDL-cholesterol.

Objective Malnutrition and sarcopenia in institutions are very common and significantly affect the prognosis. Aging is characterized by weight and lean body mass losses. Accordingly, in elderly patients, body mass index (BMI) is considered a marker of protein stores rather than of adiposity. Current guidelines suggest a BMI 21 kg/m 2 or lower as major trigger for nutritional support. We evaluated the association between BMI and mortality in institutionalized elderly. Methods This was a multicentric prospective cohort study involving 519 long-term care resident elderly individuals. Risk for mortality across BMI tertiles was estimated by the Cox hazards regression model adjusted for potential confounders recorded at inclusion and collected during the follow-up. Results During a median follow-up of 5.7 years (25th to 75th percentile, 5.2–8.2], 409 (78.8%) elderly patients died. In primary analyses, based on variables collected at inclusion, patients in the first tertile of BMI (≤21 kg/m 2 ) were at higher risk for all-cause (hazard ratio [HR] 1.38; 95% confidence interval [CI] 1.04–1.84; P = .025) and cardiovascular mortality (HR = 1.49; 95% CI, 1.00–2.08; P = .045). Increased risk was confirmed even after adjusting for nutritional support during the follow-up (all-cause HR = 1.53; 95% CI, 1.13–2.06; P = .006; cardiovascular HR = 1.62; 95% CI, 1.09–2.40; P = .018), which in turn was associated with a reduced risk (all-cause HR = 0.74; 95% CI, 0.55–0.97; P = .035; cardiovascular HR = 0.62; 95% CI, 0.42–0.91; P = .016). Conclusion BMI is significantly associated with all-cause and cardiovascular mortality in institutionalized elderly patients. A value of 21 kg/m 2 or lower can be considered a useful trigger for nutritional support. These results support intending BMI as nutritional reserve in institutionalized elderly patients.

The management of overweight may include the use of dietary supplements targeted to favour the increase of the satiation associated with a decrease in blood glucose and lipid levels. The aim of this study was to evaluate the efficacy of a dietary supplementation with an extract from Phaseolus vulgaris and Cynara scolymus, on satiation, the glucose and lipid pattern. A randomized, double-blind, placebo-controlled clinical trial was performed in 39 overweight subjects (20 supplemented group, 19 placebo group) for 2 months. The modification of satiation, by Haber's scale, was the primary end-point, and the variation of the glucose and lipid pattern, of the anthropometric parameters and of the psychodynamic tests score were the secondary end-points. At the end of treatment, the net change of the Haber's mean score increased significantly in the intervention group. The net change of the glycaemia and of the dietary restriction score of the three factor eating questionnaire (TFEQ), were reduced significantly only in the intervention group. Moreover, in the supplemented group, the homeostasis model assessment, the body mass index and the susceptibility-to-hunger score of the TFEQ, decreased significantly after intervention; these parameters did not change in the controls. This treatment appears potentially useful in the management of overweight and dysglycaemia. Copyright © 2011 John Wiley & Sons, Ltd.

OBJECTIVES: To determine whether nightly administration of melatonin, magnesium, and zinc improves primary insomnia in long-term care facility residents. DESIGN: Double-blind, placebo-controlled clinical trial. SETTING: One long-term care facility in Pavia, Italy. PARTICIPANTS: Forty-three participants with primary insomnia (22 in the supplemented group, 21 in the placebo group) aged 78.3 � 3.9. INTERVENTION: Participants took a food supplement (5mg melatonin, 225mg magnesium, and 11.25mg zinc, mixed with 100g of pear pulp) or placebo (100g pear pulp) every day for 8 weeks, 1 hour before bedtime. MEASUREMENTS: The primary goal was to evaluate sleep quality using the Pittsburgh Sleep Quality Index. The Epworth Sleepiness Scale, the Leeds Sleep Evaluation Questionnaire (LSEQ), the Short Insomnia Questionnaire (SDQ), and a validated quality-of-life instrument (Medical Outcomes Study 36-item Short Form Survey (SF-36)) were administered as secondary end points. Total sleep time was evaluated using a wearable armband-shaped sensor. All measures were performed at baseline and after 60 days. RESULTS: The food supplement resulted in considerably better overall PSQI scores than placebo (difference between groups in change from baseline PSQI score 56.8; 95% confidence interval 55.4‐8.3, Po.001). Moreover, the significant improvements in all four domains of the LSEQ (ease of getting to sleep, Po.001; quality of sleep, Po.001; hangover on awakening from sleep, P 5.005; alertness and behavioral integrity the following morning, P 5.001), in SDQ score (Po.001), in total sleep time (Po.001), and in SF-36 physical score (P 5.006) suggest that treatment had a beneficial effect on the restorative value of sleep. CONCLUSION: The administration of nightly melatonin, magnesium,andzincappearstoimprovethequalityofsleep and the quality of life in long-term care facility residents with primary insomnia. J Am Geriatr Soc 59:82–90, 2011.