Occupational hazards and risk management in academic research: an emerging working population with unusual scenario

Since Vannevar Bush’s “Endless Frontier” 1948 report, academic research has greatly expanded its goals, well beyond training next-generation scholars and professionals. Long-term governmental and private funding, especially in the most developed nations, increased the number of academic workforces and of long-term, non-tenure track research professionals in academic and no-profit research institutions (Higher Education Institutions, HEI), especially, but not only in the STEM. An emerging working population with an unusual occupational scenario thus emerged in the late XX and early XXI century, spreading from traditionally advanced Countries to an increasingly large number of quickly developing ones. Academic workforce often overlaps with non-academic, especially in the STEM sector, which includes high-end healthcare and technological spinoffs. A new specific occupational scenario thus emerged, and makes the academic research workforce a specific population for which tailored protection of basic workers’ rights needs research-based evidence. Research in the STEM often involves work at knowledge frontiers, where materials, methods, equipment, are by definition not tested for safety, including new, previously unknown molecules, living organisms and techniques. Flexible occupational relationships have developed well beyond the traditional short-term mentorship. An increasingly large proportion of the academic research workforce is female in their life-determining passages that involve relationship, family building, childbearing. Academic institutions attract an ethnically and otherwise diverse young workforce that does not coincide with the traditional migrant working population. Awareness of entitlement to workers’ health protection may be limited especially for younger academic research workforce, due to specific characteristics of job relationships, such as fixed-term, fixed-project hiring, lack of protection in contracts, vertical and peer pressure. Top-ranked scholarly journals, such as the behemoths Science and Nature, often address specific issues in editorials and policy discussions, such as protection from physical and psychological harassment, demeaning, discrimination on non-professional grounds. Thus, the academic research workforce is twice “new and emerging”. First, this population of workers has been little considered or has been grouped, for risk assessment, in broader, poorly discriminating categories and job titles. Since the numbers are steadily increasing, it is worthwhile to address them better as a separate workforce from others that perform analogous tasks in different environments, such as in the corresponding industrial companies that necessarily adopt stringent safety and health management measures. Second, workers face specific risks that have not been addressed before, due to the novelty of the agents and of the scenarios. Traditional approaches to hazard assessment for new entities may fail due to the novelty of the involved materials and are not generally performed, basing on the assumption that very low amounts are produced and handled by a small number of trained and well-protected operators. Occupational hazards that can be efficiently tackled in different working compartments, such as physical, sensorial, mental and psychological stress from repetitive actions that need sustained and meticulous attention, cannot benefit from automation due to the reduced size of workload. Research in this field is thus needed to rationally address response to a phenomenon for which steady increase is expected in the forthcoming years

Un sistema analitico GC-MS di produzione nazionale nella strumentazione del DISS: ruolo epistemologico e sviluppo tecnologico nel Centenario di UniMI

Un Sistema analitico di gas cromatografia-spettrometria di massa di produzione nazionale Carlo Erba Strumentazione – Fisons TRIO-1000 venne acquistato verso il 1995 e rimase operativo per un decennio nel laboratorio di ricerca della Cattedra di Pediatria presso l’Ospedale San Paolo di Milano. La sua dismissione ha offerto l’opportunità a un quarantennale cultore di spettrometria di massa per esaminare la storia scientifico-industriale, tra metà ‘900 e il nuovo secolo, che questo manufatto materializza nel rappresentare i progressi nella costruzione dell’immagine olistica contemporanea del mondo, e il ruolo che la scienza e l’industria nazionale hanno potuto ricoprire in questo processo. Questa tipologia strumentale, già disponibile con modelli commerciali da metà anni ’60, venne sviluppata per venire incontro alle necessità di caratterizzazione dell’inquinamento chimico ambientale da parte dell’Ente statunitense EPA, fondato nel 1970, ed estese velocemente la sua applicazione ai settori dell’analisi industriale, della tutela della salute e della ricerca accademica. L’espansione e il miglioramento delle prestazioni strumentali venne conseguito essenzialmente negli USA, ove una combinazione keynesiana storicamente unica di richieste di mercato garantite dal sistema pubblico e di collaborazione accademico-industriale rese, già dagli anni ’80, l’industria statunitense oligopolista nella fornitura e il suo sistema normativo egemone nel richiedere i livelli di prestazione degli strumenti. Solo pochi Paesi europei, tra cui l’Italia, parteciparono inizialmente allo sviluppo industriale della strumentazione analitica, fin dalla comparsa, nei primi anni ’50, della gas-cromatografia come soluzione kuhnianamente “rivoluzionaria” alla risoluzione della complessità chimica nei campioni ambientali e biologici. In mancanza di un interesse -ovvero di un mercato garantito per la strumentazione- alla tutela dell’ambiente nell’Europa occidentale (e un’analoga, assai più grave carenza si verificò nel blocco sovietico, ma non in Giappone), le industrie europee, tra cui l’italiana Carlo Erba Strumentazione, piccola unità della galassia industriale Montedison, vennero acquistate, accorpate e finalmente chiuse dai colossi statunitensi già a partire dagli anni ‘80. La diffusione della spettrometria di massa in Italia deve molto, nel periodo pionieristico degli anni ’70, alla traduzione del testo seminale di Fred McLafferty “Guida all’interpretazione degli spettri di massa”, voluta nel 1972 dai chimici della Facoltà di Medicina del nostro ateneo, subito adottato da due giovani, Bruno Danieli e Riccardo Stradi, che avevano introdotto, non senza ostacoli, l’insegnamento delle tecniche spettroscopiche nei corsi di laurea in Chimica e CTF. Nell’ambito degli Science and Technology Studies, questo strumento, già in condizioni musealizzabili, materializza relazioni intellettuali e storiche italiane e internazionali le cui conseguenze siamo in grado di rintracciare nel presente.A gas chromatography-mass spectrometry analytical system of national production Carlo Erba Instrumentation – Fisons TRIO-1000 was purchased around 1995 and remained operational for about a decade in the research laboratory of the Chair of Pediatrics at the San Paolo Hospital in Milan. Its decommissioning offered the opportunity to a forty-year expert in mass spectrometry to examine the scientific and industrial history, between the second half of the 20th century and the new century, which this artefact materializes in representing the progress in the construction of the holistic image contemporary world, and the role that science and national industry have been able to play in this process. This instrumental typology, already available with commercial models since the mid-1960s, was developed to meet the needs of the characterization of environmental chemical pollution by the US EPA, founded in 1970, and quickly extended its application to the sectors industrial analysis, health protection and academic research. The expansion and improvement of instrumental performance was achieved essentially in the USA, where a historically unique combination of market demands guaranteed by the public system and academic-industrial collaboration made the US industry an oligopolist in the supply of instrumental systems and its hegemonic regulatory system in requiring performance levels. Only a few European countries, including Italy, initially participated in the industrial development of analytical instrumentation, since the appearance, in the early 1950s, of gas chromatography as a Kuhnian "revolutionary" solution to the resolution of chemical complexity in environmental and biological samples. In the absence of an interest - that is, a guaranteed market for equipment - in environmental protection in Western Europe (and a similar, much more serious lack occurred in the Soviet bloc, but not in Japan), European industries, including the Italian Carlo Erba Strumentazione, a small subsidiary of the Montedison industrial galaxy, were purchased, merged and finally closed by the US giants as early as the 1980s. The diffusion of mass spectrometry in Italy owes much, in the pioneering period of the 1970s, to the translation of Fred McLafferty's seminal text "Guide to the interpretation of mass spectra", commissioned in 1972 by the chemists of the Faculty of Medicine of our university, immediately adopted by two young professors, Bruno Danieli and Riccardo Stradi, who had introduced, not without obstacles, the teaching of spectroscopic techniques in the degree courses in Chemistry and CTF. This instrument is therefore placed at the centre of intellectual and historical relations in recent Italian and international history, the consequences of which we are able to trace in today's events

Global, regional, and national incidence, prevalence, and mortality of HIV, 1980–2017, and forecasts to 2030, for 195 countries and territories: a systematic analysis for the Global Burden of Diseases, Injuries, and Risk Factors Study 2017

Background Understanding the patterns of HIV/AIDS epidemics is crucial to tracking and monitoring the progress of prevention and control efforts in countries. We provide a comprehensive assessment of the levels and trends of HIV/AIDS incidence, prevalence, mortality, and coverage of antiretroviral therapy (ART) for 1980–2017 and forecast these estimates to 2030 for 195 countries and territories. Methods We determined a modelling strategy for each country on the basis of the availability and quality of data. For countries and territories with data from population-based seroprevalence surveys or antenatal care clinics, we estimated prevalence and incidence using an open-source version of the Estimation and Projection Package—a natural history model originally developed by the UNAIDS Reference Group on Estimates, Modelling, and Projections. For countries with cause-specific vital registration data, we corrected data for garbage coding (ie, deaths coded to an intermediate, immediate, or poorly defined cause) and HIV misclassification. We developed a process of cohort incidence bias adjustment to use information on survival and deaths recorded in vital registration to back-calculate HIV incidence. For countries without any representative data on HIV, we produced incidence estimates by pulling information from observed bias in the geographical region. We used a re-coded version of the Spectrum model (a cohort component model that uses rates of disease progression and HIV mortality on and off ART) to produce age-sex-specific incidence, prevalence, and mortality, and treatment coverage results for all countries, and forecast these measures to 2030 using Spectrum with inputs that were extended on the basis of past trends in treatment scale-up and new infections. Findings Global HIV mortality peaked in 2006 with 1·95 million deaths (95% uncertainty interval 1·87–2·04) and has since decreased to 0·95 million deaths (0·91–1·01) in 2017. New cases of HIV globally peaked in 1999 (3·16 million, 2·79–3·67) and since then have gradually decreased to 1·94 million (1·63–2·29) in 2017. These trends, along with ART scale-up, have globally resulted in increased prevalence, with 36·8 million (34·8–39·2) people living with HIV in 2017. Prevalence of HIV was highest in southern sub-Saharan Africa in 2017, and countries in the region had ART coverage ranging from 65·7% in Lesotho to 85·7% in eSwatini. Our forecasts showed that 54 countries will meet the UNAIDS target of 81% ART coverage by 2020 and 12 countries are on track to meet 90% ART coverage by 2030. Forecasted results estimate that few countries will meet the UNAIDS 2020 and 2030 mortality and incidence targets. Interpretation Despite progress in reducing HIV-related mortality over the past decade, slow decreases in incidence, combined with the current context of stagnated funding for related interventions, mean that many countries are not on track to reach the 2020 and 2030 global targets for reduction in incidence and mortality. With a growing population of people living with HIV, it will continue to be a major threat to public health for years to come. The pace of progress needs to be hastened by continuing to expand access to ART and increasing investments in proven HIV prevention initiatives that can be scaled up to have population-level impact

Divergent functional isoforms drive niche specialisation for nutrient acquisition and use in rumen microbiome

Many microbes in complex competitive environments share genes for acquiring and utilising nutrients, questioning whether niche specialisation exists and if so, how it is maintained. We investigated the genomic signatures of niche specialisation in the rumen microbiome, a highly competitive, anaerobic environment, with limited nutrient availability determined by the biomass consumed by the host. We generated individual metagenomic libraries from 14 cows fed an ad libitum diet of grass silage and calculated functional isoform diversity for each microbial gene identified. The animal replicates were used to calculate confidence intervals to test for differences in diversity of functional isoforms between microbes that may drive niche specialisation. We identified 153 genes with significant differences in functional isoform diversity between the two most abundant bacterial genera in the rumen (Prevotella and Clostridium). We found Prevotella possesses a more diverse range of isoforms capable of degrading hemicellulose, whereas Clostridium for cellulose. Furthermore, significant differences were observed in key metabolic processes indicating that isoform diversity plays an important role in maintaining their niche specialisation. The methods presented represent a novel approach for untangling complex interactions between microorganisms in natural environments and have resulted in an expanded catalogue of gene targets central to rumen cellulosic biomass degradation

Past, present, and future of global health financing: a review of development assistance, government, out-of-pocket, and other private spending on health for 195 countries, 1995–2050

Background: Comprehensive and comparable estimates of health spending in each country are a key input for health policy and planning, and are necessary to support the achievement of national and international health goals. Previous studies have tracked past and projected future health spending until 2040 and shown that, with economic development, countries tend to spend more on health per capita, with a decreasing share of spending from development assistance and out-of-pocket sources. We aimed to characterise the past, present, and predicted future of global health spending, with an emphasis on equity in spending across countries. Methods: We estimated domestic health spending for 195 countries and territories from 1995 to 2016, split into three categories—government, out-of-pocket, and prepaid private health spending—and estimated development assistance for health (DAH) from 1990 to 2018. We estimated future scenarios of health spending using an ensemble of linear mixed-effects models with time series specifications to project domestic health spending from 2017 through 2050 and DAH from 2019 through 2050. Data were extracted from a broad set of sources tracking health spending and revenue, and were standardised and converted to inflation-adjusted 2018 US dollars. Incomplete or low-quality data were modelled and uncertainty was estimated, leading to a complete data series of total, government, prepaid private, and out-of-pocket health spending, and DAH. Estimates are reported in 2018 US dollars, 2018 purchasing-power parity-adjusted dollars, and as a percentage of gross domestic product. We used demographic decomposition methods to assess a set of factors associated with changes in government health spending between 1995 and 2016 and to examine evidence to support the theory of the health financing transition. We projected two alternative future scenarios based on higher government health spending to assess the potential ability of governments to generate more resources for health. Findings: Between 1995 and 2016, health spending grew at a rate of 4·00% (95% uncertainty interval 3·89–4·12) annually, although it grew slower in per capita terms (2·72% [2·61–2·84]) and increased by less than $1 per capita over this period in 22 of 195 countries. The highest annual growth rates in per capita health spending were observed in upper-middle-income countries (5·55 in lower-middle-income countries (3·71$8·0 trillion (7·8–8·1) in 2016 (comprising 8·6% [8·4–8·7] of the global economy and $10·3 trillion [10·1–10·6] in purchasing-power parity-adjusted dollars), with a per capita spending of US$5252 (5184–5319) in high-income countries, $491 (461–524) in upper-middle-income countries,$81 (74–89) in lower-middle-income countries, and $40 (38–43) in low-income countries. In 2016, 0·4 countries, despite these countries comprising 10·0 DAH targeted HIV/AIDS ($9·5 billion, 24·3% of total DAH), although spending on other infectious diseases (excluding tuberculosis and malaria) grew fastest from 2010 to 2018 (6·27% per year). The leading sources of DAH were the USA and private philanthropy (excluding corporate donations and the Bill & Melinda Gates Foundation). For the first time, we included estimates of China’s contribution to DAH ($644·7 million in 2018). Globally, health spending is projected to increase to$15·0 trillion (14·0–16·0) by 2050 (reaching 9·4% [7·6–11·3] of the global economy and $21·3 trillion [19·8–23·1] in purchasing-power parity-adjusted dollars), but at a lower growth rate of 1·84% (1·68–2·02) annually, and with continuing disparities in spending between countries. In 2050, we estimate that 0·6% (0·6–0·7) of health spending will occur in currently low-income countries, despite these countries comprising an estimated 15·7% of the global population by 2050. The ratio between per capita health spending in high-income and low-income countries was 130·2 (122·9–136·9) in 2016 and is projected to remain at similar levels in 2050 (125·9 [113·7–138·1]). The decomposition analysis identified governments’ increased prioritisation of the health sector and economic development as the strongest factors associated with increases in government health spending globally. Future government health spending scenarios suggest that, with greater prioritisation of the health sector and increased government spending, health spending per capita could more than double, with greater impacts in countries that currently have the lowest levels of government health spending Interpretation: Financing for global health has increased steadily over the past two decades and is projected to continue increasing in the future, although at a slower pace of growth and with persistent disparities in per-capita health spending between countries. Out-of-pocket spending is projected to remain substantial outside of high-income countries. Many low-income countries are expected to remain dependent on development assistance, although with greater government spending, larger investments in health are feasible. In the absence of sustained new investments in health, increasing efficiency in health spending is essential to meet global health targets. Funding: Bill & Melinda Gates Foundatio

Past, present, and future of global health financing : a review of development assistance, government, out-of-pocket, and other private spending on health for 195 countries, 1995-2050

Background Comprehensive and comparable estimates of health spending in each country are a key input for health policy and planning, and are necessary to support the achievement of national and international health goals. Previous studies have tracked past and projected future health spending until 2040 and shown that, with economic development, countries tend to spend more on health per capita, with a decreasing share of spending from development assistance and out-of-pocket sources. We aimed to characterise the past, present, and predicted future of global health spending, with an emphasis on equity in spending across countries. Methods We estimated domestic health spending for 195 countries and territories from 1995 to 2016, split into three categories-government, out-of-pocket, and prepaid private health spending-and estimated development assistance for health (DAH) from 1990 to 2018. We estimated future scenarios of health spending using an ensemble of linear mixed-effects models with time series specifications to project domestic health spending from 2017 through 2050 and DAH from 2019 through 2050. Data were extracted from a broad set of sources tracking health spending and revenue, and were standardised and converted to inflation-adjusted 2018 US dollars. Incomplete or low-quality data were modelled and uncertainty was estimated, leading to a complete data series of total, government, prepaid private, and out-of-pocket health spending, and DAH. Estimates are reported in 2018 US dollars, 2018 purchasing-power parity-adjusted dollars, and as a percentage of gross domestic product. We used demographic decomposition methods to assess a set of factors associated with changes in government health spending between 1995 and 2016 and to examine evidence to support the theory of the health financing transition. We projected two alternative future scenarios based on higher government health spending to assess the potential ability of governments to generate more resources for health. Findings Between 1995 and 2016, health spending grew at a rate of 4.00% (95% uncertainty interval 3.89-4.12) annually, although it grew slower in per capita terms (2.72% [2.61-2.84]) and increased by less than $1 per capita over this period in 22 of 195 countries. The highest annual growth rates in per capita health spending were observed in upper-middle-income countries (5.55$ 8.0 trillion (7.8-8.1) in 2016 (comprising 8.6% [8.4-8.7] of the global economy and $10.3 trillion [10.1-10.6] in purchasing-power parity-adjusted dollars), with a per capita spending of US$ 5252 (5184-5319) in high-income countries, $491 (461-524) in upper-middle-income countries,$ 81 (74-89) in lower-middle-income countries, and $40 (38-43) in low-income countries. In 2016, 0.4$ 9.5 billion, 24.3% of total DAH), although spending on other infectious diseases (excluding tuberculosis and malaria) grew fastest from 2010 to 2018 (6.27% per year). The leading sources of DAH were the USA and private philanthropy (excluding corporate donations and the Bill & Melinda Gates Foundation). For the first time, we included estimates of China's contribution to DAH ($644.7 million in 2018). Globally, health spending is projected to increase to$ 15.0 trillion (14.0-16.0) by 2050 (reaching 9.4% [7.6-11.3] of the global economy and $ 21.3 trillion [19.8-23.1] in purchasing-power parity-adjusted dollars), but at a lower growth rate of 1.84% (1.68-2.02) annually, and with continuing disparities in spending between countries. In 2050, we estimate that 0.6% (0.6-0.7) of health spending will occur in currently low-income countries, despite these countries comprising an estimated 15.7% of the global population by 2050. The ratio between per capita health spending in high-income and low-income countries was 130.2 (122.9-136.9) in 2016 and is projected to remain at similar levels in 2050 (125.9 [113.7-138.1]). The decomposition analysis identified governments' increased prioritisation of the health sector and economic development as the strongest factors associated with increases in government health spending globally. Future government health spending scenarios suggest that, with greater prioritisation of the health sector and increased government spending, health spending per capita could more than double, with greater impacts in countries that currently have the lowest levels of government health spending. Interpretation Financing for global health has increased steadily over the past two decades and is projected to continue increasing in the future, although at a slower pace of growth and with persistent disparities in per-capita health spending between countries. Out-of-pocket spending is projected to remain substantial outside of high-income countries. Many low-income countries are expected to remain dependent on development assistance, although with greater government spending, larger investments in health are feasible. In the absence of sustained new investments in health, increasing efficiency in health spending is essential to meet global health targets.Peer reviewe

Mortality, morbidity, and hospitalisations due to influenza lower respiratory tract infections, 2017: an analysis for the Global Burden of Disease Study 2017

Background Although the burden of influenza is often discussed in the context of historical pandemics and the threat of future pandemics, every year a substantial burden of lower respiratory tract infections (LRTIs) and other respiratory conditions (like chronic obstructive pulmonary disease) are attributable to seasonal influenza. The Global Burden of Disease Study (GBD) 2017 is a systematic scientific effort to quantify the health loss associated with a comprehensive set of diseases and disabilities. In this Article, we focus on LRTIs that can be attributed to influenza.Methods We modelled the LRTI incidence, hospitalisations, and mortality attributable to influenza for every country and selected subnational locations by age and year from 1990 to 2017 as part of GBD 2017. We used a counterfactual approach that first estimated the LRTI incidence, hospitalisations, and mortality and then attributed a fraction of those outcomes to influenza.Findings Influenza LRTI was responsible for an estimated 145 000 (95% uncertainty interval [UI] 99 000–200 000) deaths among all ages in 2017. The influenza LRTI mortality rate was highest among adults older than 70 years (16·4 deaths per 100 000 [95% UI 11·6–21·9]), and the highest rate among all ages was in eastern Europe (5·2 per 100 000 population [95% UI 3·5–7·2]). We estimated that influenza LRTIs accounted for 9 459 000 (95% UI 3 709 000–22 935 000) hospitalisations due to LRTIs and 81 536 000 hospital days (24 330 000–259 851 000). We estimated that 11·5% (95% UI 10·0–12·9) of LRTI episodes were attributable to influenza, corresponding to 54 481 000 (38 465 000–73 864 000) episodes and 8 172 000 severe episodes (5 000 000–13 296 000).Interpretation This comprehensive assessment of the burden of influenza LRTIs shows the substantial annual effect of influenza on global health. Although preparedness planning will be important for potential pandemics, health loss due to seasonal influenza LRTIs should not be overlooked, and vaccine use should be considered. Efforts to improve influenza prevention measures are neede

The impact of sexual harassment on job satisfaction, turnover intentions, and absenteeism: findings from Pakistan compared to the United States

The purpose of this study was to compare and contrast how differences in perceptions of sexual harassment impact productive work environments for employees in Pakistan as compared to the US; in particular, how it affects job satisfaction, turnover, and/or absenteeism. This study analyzed employee responses in Pakistan (n = 146) and the United States (n = 102, 76) using questionnaire data. Significant results indicated that employees who were sexually harassed reported (a) a decrease in job satisfaction (b) greater turnover intentions and (c) a higher rate of absenteeism. Cross-cultural comparisons indicated that (a) Pakistani employees who were sexually harassed had greater job dissatisfaction and higher overall absenteeism than did their US counterparts and (b) Pakistani women were more likely to use indirect strategies to manage sexual harassment than were US targets