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Get up to speed on the modelling, design, technologies, and applications of tunable circuits and reconfigurable mm-wave systems. Coverage includes smart antennas and frequency-agile RF components, as well as a detailed comparison of three key technologies for the design of tunable mm-wave circuits: CMOS, RF MEMS, and microwave liquid crystals, and measurement results of state-of-the-art prototypes. Numerous examples of tunable circuits and systems are included that can be practically implemented for the reader's own needs. Ideal for graduate students studying RF/microwave engineering, and researchers and engineers involved in circuit and system design for new communication platforms such as mm-wave 5G and beyond, high-throughput satellites in GSO, and future satellite constellations in MEO/LEO, as well as for automotive radars, security and biomedical mm-wave systems.
Money and credit are ubiquitous in actual economies, but there is an active theoretical debate on whether they are both necessary if they can both be used in all transactions. Recently, Gu et al. (2016) have shown that money and credit cannot be simultaneously essential and debt limits do not matter for the determination of real allocations in a class of monetary economies. In this paper, we revisit their irrelevance result in a monetary economy based on Lagos and Wright (2005), which exhibits a misallocation of liquidity that is common in search models of money. We show that monetary loans, which naturally require the use of both money and credit, implement Pareto superior allocations in which the size of debt limits matters.
Different coronavirus disease (COVID-19) testing approaches have been implemented among Italian regions, reflected in heterogeneous testing rates. We analyzed the number of COVID-19-related deaths in relation to the number of tests performed among the most affected Italian regions. We showed that regions with the highest number of tests performed (Veneto and Toscana) had the lowest 30-day crude mortality rate per 100 000 inhabitants. In addition, an inverse association between crude mortality rates and tests performed (mortality rate ratio for a unit increase in tests per 1000 inhabitants: 0.92; 95% CI: 0.89–0.94) was observed. Early identification and isolation of active cases (including asymptomatic or mildly symptomatic subjects) could have had an important effect in lowering COVID-19 mortality.
This Regulation shall apply, in situations involving a conflict of laws, to contractual obligations in civil and commercial matters. It shall not apply, in particular, to revenue, customs or administrative matters.
A contract shall be governed by the law chosen by the parties. The choice shall be made expressly or clearly demonstrated by the terms of the contract or the circumstances of the case. By their choice the parties can select the law applicable to the whole or to part only of the contract.
Obsessive-compulsive disorder (OCD) and tic disorder (TD) represent highly disabling, chronic and often comorbid psychiatric conditions. While recent studies showed a high risk of suicide for patients with OCD, little is known about those patients with comorbid TD (OCTD). Aim of this study was to characterize suicidal behaviors among patients with OCD and OCTD.
Three hundred and thirteen outpatients with OCD (n = 157) and OCTD (n = 156) were recruited from nine different psychiatric Italian departments and assessed using an ad-hoc developed questionnaire investigating, among other domains, suicide attempt (SA) and ideation (SI). The sample was divided into four subgroups: OCD with SA (OCD-SA), OCD without SA (OCD-noSA), OCTD with SA (OCTD-SA), and OCTD without SA (OCTD-noSA).
No differences between groups were found in terms of SI, while SA rates were significantly higher in patients with OCTD compared to patients with OCD. OCTD-SA group showed a significant male prevalence and higher unemployment rates compared to OCD-SA and OCD-noSA sample. Both OCTD-groups showed an earlier age of psychiatric comorbidity onset (other than TD) compared to the OCD-SA sample. Moreover, patients with OCTD-SA showed higher rates of other psychiatric comorbidities and positive psychiatric family history compared to the OCD-SA group and to the OCD-noSA groups. OCTD-SA and OCD-SA samples showed higher rates of antipsychotics therapies and treatment resistance compared to OCD-noSA groups.
Patients with OCTD vs with OCD showed a significantly higher rate of SA with no differences in SI. In particular, OCTD-SA group showed different unfavorable epidemiological and clinical features which need to be confirmed in future prospective studies.
This book offers an updated article-by-article commentary of the Rome I Regulation, applicable in the courts of nearly all European countries to identify the law applicable to international contracts. The commentary is authored by an international group of academics and practitioners, who all have practical experience with international contracts and, thus, were able to focus on the needs of practice. This volume will be not only a reference guide for judges and practitioners alike, but also a crucial resource for academics and researchers.
To evaluate the cognitive status in an elderly population including both community-dwellers and institutionalised subjects.
462 subjects (mean age 85.1±6.9 years, 53.2% females) living in the Faenza district (Ravenna, Northern Italy) were interviewed and clinically evaluated. The Cambridge Mental Disorders of the Elderly Examination (CAMDEX) was administered to all participants to collect socio-demographic and clinical information. The cognitive status was evaluated using the cognitive assessment included in the CAMDEX (CAMCOG) and the Mini-Mental State Examination (MMSE) (adjusted by sex and age). Cut-offs were as follow: CAMCOG scores < 80; MMSE scores < 24.
The CAMCOG identified 245 subjects (53.0%) as cognitively impaired; 132 persons (28.6%) had a MMSE score < 24 and were impaired in the activities of daily living. Prevalence of dementia (DSM-IV criteria) was 19.1% (N=88), including 11 cases of ‘questionable’ dementia. Demented subjects were more likely to be women (65.9%), were less educated (p< 0.05) and older than non-demented (p< 0.001). Demented subjects scored significantly lower than non-demented subjects in any cognitive domain at CAMCOG (p< 0.001).
Cognitive domains: mean score and standard deviation (p< 0.001).
Non-demented vs Demented
All subjects: 78.4(±15.9) vs 28.7(±21.7)
Males: 81.1(±13.0) vs 35.0(±19.9)
≤85: 83.3(±12.3) vs 38.0(±20.5)
>85: 75.7(±13.2) vs 34.0(±20.2)
Females all: 75.7(±18.0) vs 24.3(±21.9)
≤85: 82.5(±12.4) vs 58.5(±10.8)
>85: 67.0(±20.2) vs 18.4(±17.5)
Among demented subjects, only 4.5% were treated with acetylcholinesterase inhibitors (p=0.046); 10.2% used other anti-dementia medications (p=0.067).
Despite of the high prevalence of dementia, only few subjects affected by dementia were properly treated.
Sjögren's syndrome (SS) is a common medical condition which may produce psychiatric disturbances. Psychoactive medications treat psychiatric symptoms, but leave the underlying process unaffected.
To emphasize that psychiatric disorders in primary SS constitute an indisputable clinical reality that each practitioner must be able to recognize and treat.
A systematic review on psychiatric manifestations of SS and two case-reports of mental disorder as clinical presentation of primary SS.
Psychiatric manifestations in primary SS are common and can occur not only during its course, but also at onset of the autoimmune syndrome. A better adapted prescription of corticosteroids and/or immunosuppressive agents (together with specific psychotropic traetments) can induce to a rapid relief of psychiatric dysfunction.
Psychiatrists should keep in mind that primary SS is a potential cause of mental disorders when examining patients with multiple somatic complaints and psychiatric symptoms.
Teamwork in psychiatry is a very specific property of care organization, especially in the Italian tradition and daily practice. The purpose of the study was to define and describe the main variables that might influence and determine it.
A 15-item ad hoc questionnaire was specially designed and administered to health professionals of Modena Department of Mental Health. This questionnaire contained socio-demographic data (age, sex, longevity of service), professional characteristics, personal level of satisfaction and identification, and opinions on “ideality” and “reality” of teamwork. Statistical analysis was conducted to explore significant correlations.
Satisfaction rate was 46.2%, identification rate 59.1%. Teamwork seems to function well as far as “information circulation” and “making practical decisions”, but lacks in “reciprocal understanding” and “reciprocal emotional support”. The level of correspondence between ideal and real teamwork is strongly correlated to satisfaction (p = 0), identification (p = 0), but not to age, sex or duration of service. The priority of teamwork was “discussion of clinical cases”.
This study attempts to suggest difficulties and limits of contemporary care organization in Italian psychiatry, but also offers several ideas for organizational, administrative, clinical, and human improvements. It represents a first step to analyze and identify the qualitative determinants of psychiatric teamwork.
The ‘MORES’ (MOdena RESidenze) project was a naturalistic study designed to assess clinical outcomes and to investigate psychosocial needs in two groups of patients currently admitted in two residential facilities characterized by different intensity of care (“low protection” vs. “high protection”).
32 patients (62%) in a Sheltered Housing (SH, low protection) and 20 patients (38%) in a Psychiatric Residence (PR, high protection) were assessed by means of a multi-dimensional and multiaxial system. Socio-demographic and clinical data were collected from patient charts. Clinicianadministered instruments (BPRS, GAF, CAN) and self-rating scales (LQL, VSSS, Empowerment Scale) were administered to all 52 patients. Chi-squared test and Mann-Whitney U-test were used to compare the two groups.
The most frequent diagnosis was Schizophrenia (n=41; 79%). No differences were found in socio-demographic and clinical characteristics between the two groups, as well as in psychometric scores. Scores at the BPRS, GAF, CAN and Empowerment scales revealed in both groups a medium-low degree of psychiatric symptomatology, low global functioning, high level of care needs (many of them satisfied, 73%) and a low level of empowerment, respectively. Self-perceived quality of life was poor (LQL: SH=4,57±0,31; PR=4,4±0,33), specifically related to the housing situation and VSSS (SH=3,81±0,85; PR=3,52±0,82) suggested poor satisfaction with mental health services.
Though no difference were found between the two groups, patients’ needs emerged clearly, suggesting need for further investigation to tailor more specific rehabilitation programs.
The Social Skill Training is structured as a cognitive-behavioral therapy for rehabilitation plans whereby the patient can develop and recover social skills.
To verify the effects of a literary workshop for increase assertiveness in patients with eating disorders.
Thirty-two patients consequently admitted to the Ward for Eating Disorders at the Private Clinic “Villa Maria Luigia” in the North of Italy were recruited in the study, and all of them agreed to take part in it. Of the 32 patients, 8 were randomly assigned to treatment and 24 to care as usual, being the difference between treatment and care as usual only represented by the literary workshop. The Rathus Assertiveness Schedule and Verbal Fluency Test (phonemic and semantic) was administered to all patients in the first and last week of hospitalization. The literary workshop consists in 16 weekly 45-minute group sessions. Issues of expressiveness through the use of writing are addressed during the sessions.
A significant improvement of semantic skills (t=-5.60; p< 0.01 vs. t=1.43; p=0.17), phonetic skills (t=-3.66; p< 0.01 vs. t=1.35; p=0.19) and assertiveness (t=4.47; p< 0.01 vs. t=0.94; p=0.93) was registered in the literary workshop group.
Effectiveness of the literary workshop in a rehabilitation program for patients suffering from eating disorders is suggested: improved communication and language skills might have a positive and significant impact on patients’ levels of assertiveness.
To evaluate psychiatric features in liver post transplant HIV recipients.
An observational study was conducted. Different psychiatric rating scales to evaluate cognitive status (MMSE), anxiety and depressive symptoms (HAM-A, HAM-D), social phobia (BSPS), quality of life (SF-36), sexual satisfaction (ISS), coping strategies (Brief Cope) and alcohol-drug abuse (LDQ) were submitted to a population of 11 HIV outpatients that underwent to OLT (19% of the Italian HIV transplant recipients). Scores were statistically related to socio-demographic and clinical data.
All patients were male, aged between 33 and 54 years. In the past 8 patients were drug abusers, three suffered from depression. At the moment of the evaluation 8 patients didn't suffer from any psychiatric disease while the three youngest patients presented a mild depressive status. BASIS-32 scores were related to HAM-D and to a history of drug abuse (p< 0.01). SF-36 was related to age (p< 0.05), HAM-D (p< 0.01), BSPS and BASIS 32 (p< 0.02).
Despite the higher risk for a HIV patient of developing an anxious or mood disorder, our population isn’t affected by psychiatric diseases; this is an encouraging data considering that post transplant period can be very stressful. This result may be due to a personality organization or a coping style strengthened by a long term disease such as HIV. Further studies are needed to investigate psychosocial outcome of OLT in HIV and to improve our knowledge of this controversial issue and guarantee a better take in care of these complex patients.