Deep Impact Research Articles

Translation essay: “the problems of onomatopoeia in manga” two chapter essays from the principles of manga (manga genron) by Yomota Inuhiko

Abstract One of Japan’s most versatile scholars of film, television, and manga (comic books), Yomota Inuhiko (1953–) made a deep impact on Manga Studies, where he engaged in a form of manga analysis commonly called “expression theory” (hyōgen-ron). In the present translated twin essays from Yomota’s now-classic study, The Principles of Manga (Manga Genron, 1994), he demonstrates his awareness of the possibilities of applying a linguistic lens to the study of Japanese comics. In Part One, Yomota explores the idea of onomatopoeia in manga, considering how they are very much cultural constructions that can be difficult to translate into other languages. In Part Two, Yomota delves deeper into the way onomatopoeia appear on the page, often creating impossible-to-utter expressions but ones easily understood nonetheless by readers. While there is already a great deal of research on onomatopoeia mimetics in spoken Japanese, Yomota here expounds on how manga artists have invented new ways of employing onomatopoeia outside of these established patterns in the spoken language. He gives clear examples of the evolution and representation of mimetics in manga, discusses several key features of comic-book mimetics, and makes a clear argument that they have spurred the evolution of modern-day manga.

Feasibility study and preliminary design of Bataan–Cavite interlink bridge, Philippines

The Bataan–Cavite interlink bridge (BCIB) is a proposed 32 km sea-crossing bridge at the mouth of Manila Bay, Philippines. The BCIB will connect Bataan to Cavite in order to unlock opportunities for economic growth and expansion outside Metro Manila. It comprises land viaducts, marine viaducts and two cable-stayed navigation bridges of 400 m and 900 m spans. The BCIC has to cater for extreme conditions of deep water, seismicity, typhoons and ship impact. Feasibility studies, the preliminary design of the link and how the bridge options were assessed in order to achieve an optimum solution are described in this paper.

Anti-Diabetic Drugs GLP-1 Agonists and DPP-4 Inhibitors may Represent Potential Therapeutic Approaches for COVID-19.

The fast spread of coronavirus 2019 (COVID-19) calls for immediate action to counter the associated significant loss of human life and deep economic impact. Certain patient populations like those with obesity and diabetes are at higher risk for acquiring severe COVID-19 disease and have a higher risk of COVID-19 associated mortality. In the absence of an effective and safe vaccine, the only immediate promising approach is to repurpose an existing approved drug. Several drugs have been proposed and tested as adjunctive therapy for COVID-19. Among these drugs are the glucagon-like peptide-1 (GLP-1) 2 agonists and the dipeptidylpeptidase-4 (DPP-4) inhibitors. Beyond their glucose-lowering effects, these drugs have several pleiotropic protective properties, which include cardioprotective effects, anti-inflammatory and immunomodulatory activities, antifibrotic effects, antithrombotic effects, and vascular endothelial protective properties. This narrative review discusses these protective properties and addresses their scientific plausibility for their potential use as adjunctive therapy for COVID-19 disease.

Compact and Smart Outdoor Medium/Low Voltage Substation for Energy Communities

Energy transition toward smart grids with deep impact of renewables, energy storage systems, and electric vehicle charging stations will increasingly promote the establishment of energy communities that own portions of the electricity grid. The energy communities will consist of clusters of multiunit buildings and or single residential units aggregated sharing a common or multiple medium and low voltage (MV/LV) electrical substations. The size and impact of the location of these MV/LV substations can constitute a barrier especially for highly urbanized contexts where it is very complicated to provide technical spaces inside buildings for large technical systems like transformers, MV switchgear, etc. The idea of this work consists of developing a compact outdoor MV/LV substation to reduce the overall dimensions and to make the execution modularized to facilitate management and maintenance. Also an investigation of energy exchange between multiunit buildings, which are considered as the real energy community case study. The main objective for this case study is to minimize the operation cost of the system by maximizing the self-consumption.

DAMPAK KEBIJAKAN PEMBATASAN SOSIAL TERHADAP KINERJA PENDAPATAN RESTORAN DI PROVINSI BALI

The Covid-19 pandemic has a major impact on the development of the Indonesian economic. Several business sectors, particularly in the industrial and service sectors, experienced a drastic decline in their performance due to the policy of restricting the mobility of goods and services. This policy was adopted by the government as a step to prevent and reduce the spread and number of Covid-19 cases. The province of Bali, which is synonymous with tourism industry and services is the area with the deepest impact in Indonesia. The Accommodation and Food and Drink Provision Sector, which has been the main contributor in terms of the business sector, experienced a contraction of -27.52%. The purpose of this study is to observe the extent of the impact of these restrictive policies on the performance of restaurant income as one of the main sub-sectors in Bali Province. The data analysis technique used is panel data regression using primary data and also data processing result using Google Mobility Index. The research sample was 97 restaurants spread across 9 regencies/cities in Bali Province. Meanwhile, for the social restriction policy variable, a dummy variable is used. The results showed that there were differences in restaurant performance when there was no restriction policy and when there was a restriction policy.

Wirtschaft—Reformation—Revolution, I: Vergleichende, soziohistorische Strukturgitteranalysen, and II: Wyclifs Sozialethik, der Aufstand von 1381 und Übergänge zur Moderne. Studien zur historischen Gesellschaftswissenschaft und zur Gesellschaftsgeschichte, by Norbert Fabian

This massive two-volume book is unusual in every way. It is the author’s 2019 Bochum University Ph.D. dissertation, and seeks nothing less than to craft a ‘pluralistically oriented, historical-theoretical approach thereby [combining] critical dialectical theory with historicised, functional-structural theory’ (author’s own English abstract, no pagination). Further, this new approach is heralded as having a deep impact on not only the writing of history but also on the general understanding of historical theory and, not least, its didactic implications. That is a huge claim indeed. As a case-study to support his claims, Fabian analyses the ‘transformational’ society or ‘mixed economy’ of late medieval England—more precisely, the beginning of the Lollard movement, the uprising of 1381 and its aftermath. The basic claim of this study concerns the regional and ‘meso-economic’ beginnings of larger transformations of societies, be that the transition from feudalism to capitalism or from agricultural to industrialised economies. That is certainly plausible, though nothing new. An interesting twist Fabian brings into this narrative, however, is the role of social movements which—at least on the surface—do not discuss poverty, hunger or other aspects of moral economies. In the Lollards he sees such a movement. Rather than presenting new historical findings, however, Fabian has produced a meta-study interested in historical sociology and patterns of historical progress, and thus he devotes the first volume of more than 500 pages solely to theoretical discussions; only in the second volume (another 700-plus pages) does he apply these ideas to his reading of contemporary sources and historical literature. Furthermore, his reading of Wyclif is explicitly inspired by ‘[p]aradigms of 20th-century socio-critical theology’ (author’s own English abstract, no pagination), which might add to its application in terms of democratisation and world societies, but remains rather vague in its impact on historical interpretation.

The acute phase management of spinal cord injury affecting polytrauma patients: the ASAP study

BackgroundFew data on the management of acute phase of traumatic spinal cord injury (tSCI) in patients suffering polytrauma are available. As the therapeutic choices in the first hours may have a deep impact on outcome of tSCI patients, we conducted an international survey investigating this topic.MethodsThe survey was composed of 29 items. The main endpoints of the survey were to examine: (1) the hemodynamic and respiratory management, (2) the coagulation management, (3) the timing of magnetic resonance imaging (MRI) and spinal surgery, (4) the use of corticosteroid therapy, (5) the role of intraspinal pressure (ISP)/spinal cord perfusion pressure (SCPP) monitoring and (6) the utilization of therapeutic hypothermia.ResultsThere were 171 respondents from 139 centers worldwide. A target mean arterial pressure (MAP) target of 80–90 mmHg was chosen in almost half of the cases [n = 84 (49.1%)]. A temporary reduction in the target MAP, for the time strictly necessary to achieve bleeding control in polytrauma, was accepted by most respondents [n = 100 (58.5%)]. Sixty-one respondents (35.7%) considered acceptable a hemoglobin (Hb) level of 7 g/dl in tSCI polytraumatized patients. An arterial partial pressure of oxygen (PaO2) of 80–100 mmHg [n = 94 (55%)] and an arterial partial pressure of carbon dioxide (PaCO2) of 35–40 mmHg [n = 130 (76%)] were chosen in most cases. A little more than half of respondents considered safe a platelet (PLT) count > 100.000/mm3 [n = 99 (57.9%)] and prothrombin time (PT)/activated partial thromboplastin time (aPTT) < 1.5 times the normal control [n = 85 (49.7%)] in patients needing spinal surgery. MRI [n = 160 (93.6%)] and spinal surgery [n = 158 (92.4%)] should be performed after intracranial, hemodynamic, and respiratory stabilization by most respondents. Corticosteroids [n = 103 (60.2%)], ISP/SCPP monitoring [n = 148 (86.5%)], and therapeutic hypothermia [n = 137 (80%)] were not utilized by most respondents.ConclusionsOur survey has shown a great worldwide variability in clinical practices for acute phase management of tSCI patients with polytrauma. These findings can be helpful to define future research in order to optimize the care of patients suffering tSCI.

COVID-19 and Death: The Never Ending Grief

COVID-19 has already killed more than two million people in the world. The pandemic had a deep impact on the emotional, social, and spiritual life of the public. Due to lockdown, self isolation, and quarantine protocols, hospital and health care facilities are closed to visitors due to which family members are unable to be with their closed ones in their final moments. Some are not able to see them personally, some are not able to bid goodbye to their loved ones, some cannot attend the funeral rights, and some cannot perform the final mourning rituals. Investigators are concerned that the coronavirus pandemic will give rise to serious and prolonged sorrow disorder. Death circumstances during COVID-19 pandemic (no moral or family support, or limited chances for death customs) can also gain the grief process, yet no research has specially label this issue. This article is all about the complicated process of death, dying, and grief and ways to learn dealing with the loss caused by the COVID-19 pandemic. Objective: To examine if severity of grief and sorrow was higher before or during the COVID-19 pandemic. Method: A survey that included questions on socio demographic and the terms related to loss quiz and a sorrow measure was managed in a group of 1,700 distressed persons, who took part previously or throughout this pandemic, including adults who have lost their closed ones before the pandemic or during the pandemic.

The transformative learning nature of malaysian homestay experiences

Travel can have a transformative power; that is, the possibility of generating deep change and impact on individuals’ self while on vacation. Transformative experiences could impact travellers at different levels and influence their understanding and interpretation of reality. Moving on from theoretical concepts, such as transformative learning, free choice learning and experiential learning together with adoption of an innovative mobile-enhanced data collection methodology in the field, this study investigates the Malaysian homestay tourism experience and its transformative power. It presents a preliminary framework to generate a better understanding of the anatomy of transformative travel, postulating that immersive and co-created experiences could trigger transformative learning processes in travellers, thereby impacting on their knowledge, skills and attitude towards generating a differential understanding and possible interpretation of the reality.

The challenges of the management of the incisional hernia in children and infants: a retrospective experience of a tertiary hospital

BackgroundIncisional hernia in children and infants represents a major complication following exploration. The condition is associated with prolonged hospital stay, readmission, and the need for another operation to treat the resulting incisional hernia. The incidence is variable worldwide. The leading causes are still indeterminate as well as the management strategy. We aimed at studying incisional hernia in children and infants at a tertiary level hospital as regards presenting symptoms, methods of management, and its impact on the quality of life of patients.ResultsA retrospective study included all infants and children presented with incisional hernia. Patients were categorized in to two groups according to the age of presentation, group A patients younger than 2 years of age and group B patients older than 2 years. All data related to the first operation in addition to data related to repair of the incisional hernia were collected in special charts. The study included 67 patients. the median age in group A was 6.5 months vs 10.5 years in group B. Urgent presentation was found in 35.4% of cases in group A vs 19.44% of cases in group B. Tissue repair was used as the definitive management in 64.5% of cases in group A and in 52.7% of cases in group B.ConclusionIncisional hernia in infants and children is a major complication. The management is associated with prolonged hospital stay, financial burden, and deep impact on the quality of life. It is to some extent difficult to predict its onset.

Stellar dating using chemical clocks and Bayesian inference

Context. Dating stars is a major challenge with a deep impact on many astrophysical fields. One of the most promising techniques for this is using chemical abundances. Recent space- and ground-based facilities have improved the quantity of stars with accurate observations. This has opened the door for using Bayesian inference tools to maximise the information we can extract from them. Aims. Our aim is to present accurate and reliable stellar age estimates of FGK stars using chemical abundances and stellar parameters. Methods. We used one of the most flexible Bayesian inference techniques (hierarchical Bayesian models) to exceed current possibilities in the use of chemical abundances for stellar dating. Our model is a data-driven model. We used a training set that has been presented in the literature with ages estimated with isochrones and accurate stellar abundances and general characteristics. The core of the model is a prescription of certain abundance ratios as linear combinations of stellar properties including age. We gathered four different testing sets to assess the accuracy, precision, and limits of our model. We also trained a model using chemical abundances alone. Results. We found that our age estimates and those coming from asteroseismology, other accurate sources, and also with ten Gaia benchmark stars agree well. The mean absolute difference of our estimates compared with those used as reference is 0.9 Ga, with a mean difference of 0.01 Ga. When using open clusters, we reached a very good agreement for Hyades, NGC 2632, Ruprecht 147, and IC 4651. We also found outliers that are a reflection of chemical peculiarities and/or stars at the limit of the validity ranges of the training set. The model that only uses chemical abundances shows slightly worse mean absolute difference (1.18 Ga) and mean difference (−0.12 Ga).

ЗАГАЛЬНІ КОНЦЕПТУАЛЬНО-ПРАКТИЧНІ АСПЕКТИ ВПЛИВУ ФІНАНСОВОГО РИНКУ НА РОЗВ’ЯЗАННЯ БОРГОВИХ ПРОБЛЕМ

The article is devoted to the justification of conceptual and practical grounds of financial market potential usage in debt problems solution. Emphasis is placed on the insufficient implementation of the dependence of the effectiveness of socio-economic development on the existing financial and economic space of the state, which, being included in one interaction, provide an opportunity to obtain synergistic effects. Among the important prerequisites for the conceptual and practical transformation of the financial and economic space of the state, which in its new quality will have an impact on development, the problems of public debt and the possibilities of the financial market to solve them are considered. Taking into consideration their deep impact on the dynamics of financial relations, the following chain is outlined: "development – space – debt problems – financial market", the imbalance of the latter can influence the effectiveness of change in society, economy and finance in a negative way. It is stated that each of the above-mentioned links with the condition of their own development makes the natural determinant of the other one. It is simultaneously substantiated that the general methodological and practical basis for achieving the appropriate balance is rooted in the spatial approach thus it lies in the matter of financial space formation. It is shown that knowledge of ways to optimize debt policy remains in the process of formation. Debt resolution continues to be dominated due to traditional factors and is not being sufficiently expanded for account of those that have an indirect impact, particularly connected with deeper infiltration into the multidimensional interrelations with the determining factors of the financial space. The factors that give the financial market a special place among the components of development and strengthening of the financial space are presented. The relevance of using the whole range of functional features of this market, which goes beyond the implementation of debt financing, and aimed at strengthening the financial space, is substantiated. The only basis that can optimize the development policy is schematically represented by the chain "financial market – debt problems – space – development". Increased attention to the role of the financial space in solving debt problems and shaping contribution of the financial market, changes the strategic approach to debt policy and further development in general.

COMPARATIVE STUDY OF THE FLEXURAL STRENGTH OF MAXILLARY DENTURE BASES MADE IN CONVENTIONAL AND HIGH IMPACT HEAT CURE ACRYLIC RESIN

OBJECTIVE: To compare the flexural strength of maxillary denture bases made in high impact and conventional heat cure acrylic resin. METHODS: This experimental laboratory-based study was conducted in Peshawar Dental College, Materials Research and Centralized Resource Laboratories University of Peshawar, Pakistan. Total 120 edentulous maxillary casts, sixty each of conventional acrylic (30 in subgroup-IA for shallow palate and 30 in subgroup-IB for deep palate and high impact acrylic (30 in subgroup II-A for shallow palate and 30 in subgroup II-B for deep palate) were made. These were then tested for flexural strength using universal testing machine. The load was applied at the rate of 5.0 mm/min. Independent samples t-test was applied for statistical analysis. RESULTS: Mean values of deflection at fracture, fracture load and flexure strength were 0.309±0.059 cm, 87.729±22.497 Kg and 13.645± 4.453 kg/cm² respectively. Mean Flexure Strength (kg/cm2) was 8.30±1.27, 16.54±1.77, 10.88±1.01 and 18.85±1 in subgroups I-A, I-B, II-A and II-B respectively (&lt;0.001). Mean deflection at fracture (cm) was 0.24±0.04, 0.29±0.03, 0.35±0.03 &amp; 0.368±0.03 in subgroups I-A, I-B, II-A and II-B respectively (&lt;0.001).Mean Fracture Load (Kg) was 69.97±3.12, 114.9±6.75, 63.28±7.05 &amp; 102.8±5.5 in in subgroups I-A, I-B, II-A and II-B respectively (&lt;0.001).CONCLUSION: High impact acrylic resin was found to have significantly higher flexure strength as compared to conventional acrylic resin

A comprehensive rehabilitation in a case and panfacial fracture with extensive oral soft tissue trauma of lip and tongue in a musician: a case report

&lt;p class="abstract"&gt;Pan facial fractures as the name suggest it involves multiple fractures of facial bones and so the management of such multiple fractures is also extremely complicated and the patient is generally left with residual deformities, which might leave a deep psychological impact on the individual’s life. Maxillofacial region also harbours organs which are very essential for the normal survival of the Individual such as eyes, organ for olfaction, respiration, mastication, deglutition and aesthetics and phonetics. All these factors put additional pressure in complexities of fracture management, also create a dilemma for surgeon. Another peculiarity of the panfacial fractures is the difficulty in accessing the fracture sites and because of that reduction and fixation are compromised often leading to secondary deformity. Determining the sequence of repairing of the pan facial fracture is the most challenging and requires great experience as well as knowledge of anatomy, as the approach varies with each case. All the vertical and horizontal pillars have to be restored to get the near-normal facial anatomy and aesthetic. Even after all the aggressive treatment, the residual deformity in cases of panfacial trauma is not uncommon, which often requires a second stage corrective surgery. This article briefs about the management and simple approaches used to reduce and fix a case of pan facial trauma in a -year-old male who underwent a road traffic accident.&lt;/p&gt;

Subject-Self Affecting on Teachers' Perceived ICT Usability

This study reports an empirical investigation of the effects of school teachers’ self-efficacy and self-concept on their perceived ICT usability. It employed a descriptive survey method within an ex-post-facto research design taking 300 teachers as samples from purposively selected 50 Indian schools. The findings revealed that self-efficacy and self-concept discretely had a positive effect on teachers’ perceived ICT usability although self-concept was found to have a deeper impact in comparison to self-efficacy. But the two variables operated simultaneously had a more significant and stronger positive effect on the teachers’ perceived ICT usability. For every 1 standard unit increase in self-efficacy and in self-concept, the perceived ICT usability will be increased by 0.95 standard units. Based on this regression output authors proposed the TAM3+ as an extension of the TAM3 by adding a new domain as users’ ‘subjective self’ encompassing self-efficacy and self-concept significantly affecting their perceived ease of technology use.

IoT Analytics and Agile Optimization for Solving Dynamic Team Orienteering Problems with Mandatory Visits

Transport activities and citizen mobility have a deep impact on enlarged smart cities. By analyzing Big Data streams generated through Internet of Things (IoT) devices, this paper aims to show the efficiency of using IoT analytics, as an agile optimization input for solving real-time problems in smart cities. IoT analytics has become the main core of large-scale Internet applications, however, its utilization in optimization approaches for real-time configuration and dynamic conditions of a smart city has been less discussed. The challenging research topic is how to reach real-time IoT analytics for use in optimization approaches. In this paper, we consider integrating IoT analytics into agile optimization problems. A realistic waste collection problem is modeled as a dynamic team orienteering problem with mandatory visits. Open data repositories from smart cities are used for extracting the IoT analytics to achieve maximum advantage under the city environment condition. Our developed methodology allows us to process real-time information gathered from IoT systems in order to optimize the vehicle routing decision under dynamic changes of the traffic environments. A series of computational experiments is provided in order to illustrate our approach and discuss its effectiveness. In these experiments, a traditional static approach is compared against a dynamic one. In the former, the solution is calculated only once at the beginning, while in the latter, the solution is re-calculated periodically as new data are obtained. The results of the experiments clearly show that our proposed dynamic approach outperforms the static one in terms of rewards.

Solidarity and collectivism in the context of COVID-19.

The coronavirus pandemic has impacted health care, economies and societies in ways that are still being measured across the world. To control the spread of the virus, governments continue to appeal to citizens to alter their behaviours and act in the interests of the collective public good so as to protect the vulnerable. Demonstrations of collective solidarity are being consistently sought to control the spread of the virus. Catchphrases, soundbites and hashtags such as ‘we’re all in this together’, ‘stronger together’ and other messages of unity are employed, invoking the sense of a collective struggle. However, this approach is fundamentally challenged as collectivist attitudes run contrary to the individualism of neoliberal ideology, to which citizens have been subjected. This paper argues that attempting to employ the concept of solidarity is inherently challenged by the deep impact of neoliberalism in health policies and draws on the work of Durkheim to examine the concept in a context in which health care has become established as an individual responsibility. The paper will argue that a dominant private-responsibility model and an underfunded public system have eroded solidarity weakening its effectiveness in generating concerns for the collective.

Assessment of a novel deep learning-based marker-less motion capture system for gait study

BackgroundMarker-less systems based on digital video cameras and deep learning for gait analysis could have a deep impact in clinical routine. A recently developed system has shown promising results in terms of joint center position but has not been yet evaluated in terms of gait outcomes. Research questionHow does this novel marker-less system compare to a marker-based reference system in terms of clinically relevant gait parameters? MethodsThe deep learning method behind the developed marker-less system was trained on a dedicated dataset consisting of forty-one asymptomatic and pathological subjects each performing ten walking trials. The system could estimate the three-dimensional position of seventeen joint centers or keypoints (e.g., neck, shoulders, hip, knee, and ankles). We evaluated the marker-less system against a marker-based system in terms of differences in joint position (Euclidean distance), detection of gait events (e.g., heel strike and toe-off), spatiotemporal parameters (e.g., step length, time), kinematic parameters (e.g., hip and knee extension-flexion), and inter-trial reliability for kinematic parameters. ResultsThe marker-less system was able to estimate the three-dimensional position of joint centers with a mean difference of 13.1 mm (SD = 10.2 mm). 99% of the estimated gait events were estimated within 10 ms of the corresponding reference values. Estimated spatiotemporal parameters showed zero bias. The mean and standard deviation of the differences of the estimated kinematic parameters varied by parameter (for example, the mean and standard deviation for knee extension flexion angle were −3.0° and 2.7°). Inter-trial reliability of the measured parameters was similar to that of the marker-based references. SignificanceThe developed marker-less system can measure the spatiotemporal parameters within the range of the minimum detectable changes obtained using the marker-based reference system. Moreover, except for hip extension flexion, the system showed promising results in terms of several kinematic parameters.

Teachers’ beliefs in ESP teaching for airline staff: Between hopes and realities

Teachers’ beliefs in ESP have been known as the basis for teachers’ application in their ESP teaching. Teacher beliefs are significant subjects in teacher education that have been designed to help teachers develop their thought and principles. Teachers’ beliefs have a deep impact on their classroom principles. However, facts show that many of what teachers believe fail to be implemented in real teaching activities due to some reasons. This study examines teachers involved in ESP teaching for Airlines Staff at pre-service airlines schools in Indonesian setting. This study aims at (1) knowing teachers’ beliefs in ESP teaching, (2) knowing whether what teacher’s beliefs are implemented in real ESP teaching for airlines staff, (3) knowing teachers’ recommendations for the improvement of the ESP teaching for airlines staff.This study employs qualitative research design. The research data are collected using open ended questionnaire. The collected data are analyzed using data reduction, data display, and conclusion drawing phases. The results of this research indicate that ESP for airlines staff applied in pre-service airlines training schools is still in line with the teachers’ expectations. The recommendations given by the teachers are based on their beliefs in the features or criteria of an ideal or good pre-service training school in ESP teaching for airlines staff.

One Year Facing COVID. Systematic Evaluation of Risk Factors Associated With Mental Distress Among Hospital Workers in Italy

IntroductionItaly was the first Western country affected by the COVID-19 pandemic that still constitutes a severe challenge for healthcare workers (HCWs), with a deep impact on their mental health. Several studies confirmed that a considerable proportion of HCW developed adverse psychological impairment (PsI). To focus on preventive and rehabilitation measures, it is fundamental to identify individual and occupational risk factors. We systematically assessed possible PsI among all employees in a large university hospital in Italy, using validated psychometric scales in the context of occupational health surveillance.MethodsIn the period of July 2020 to July 2021, we enrolled 990 HCWs. For each subject, the psychological wellbeing was screened in two steps. The first-level questionnaire collected gender, age, occupational role, personal and occupational COVID-19 exposure, general psychological discomfort (GHQ-12), post-traumatic stress symptoms (IES-R), and anxiety (GAD-7). Workers showing PsI (i.e., test scores above the cutoff in at least one among GHQ-12, IES-R, and GAD-7) have been further investigated by the second-level questionnaire (psycho-diagnostic) composed by PHQ-9, DES-II, and SCL-90 scales. If the second-level showed clinically relevant symptoms, then we offered individual specialist treatment (third level).ResultsThree hundred sixteen workers (32%) presented signs of PsI at the first-level screening questionnaire. Women, nurses, and subjects engaged in the COVID-19 area and with an infected family member showed significantly higher PsI risk. PsI prevalence was strongly associated with the pandemic trend in the region but sensibly decreased after January 2021, when almost all workers received the vaccination. A proportion of subjects with PsI presented clinically relevant symptoms (second-level screening) on PHQ-9 (35%), DES (20%), and SCL-90 (28%). These symptoms were associated neither to direct working experience with patients with COVID-19 nor to COVID-19 experience in the family and seemed not to be influenced by the pandemic waves or workers vaccination.ConclusionsThe evaluation of psychological wellbeing of all hospital workers, directly or indirectly exposed to pandemic consequences, constitutes a unique condition to detect individual, occupational, and non-occupational risk factors for PsI in situations of high stress and/or disasters, as well as variables associated with symptom chronicization.