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Since 2003 the national research program for solid organ transplantation in HIV patients is active at the Liver Transplantation Centre of Modena. HIV patients who enter this protocol are assessed by the CLP Service. The aim of the present study is to evaluate their psychiatric comorbidity.
An observational prospective study was conduced comparing ESLD patients with and without HIV. After the assessment, the psychiatrist compiled the TERS and the MADRS. Baseline (B) evaluation was made before the inclusion in the OLTx waiting list and the Follow-Up (FU) one was made 12 months later.
From January 2003 to December 2006 we assessed 553 patients: 39 (6%) with HIV and 361 (94%) without HIV. The two groups were homogeneous for gender (75% of male patients; p = ns) but not for age (46 ± 5 vs 56 ± 9; p = ns). Psychiatric anamnesis was negative in 176 (49%) patients without HIV and in 6 (15%) patients with HIV, p<0.001.
At baseline psychiatric comorbidity was present in 33 HIV patients (85%) and in 148 non HIV patients (41%), p<0.001.
At the follow-up MADRS highlights an improvement at all the items for HIV patients. In the non-HIV group score variation was: B = 7.10, FU = 8.15; in the HIV group: B = 10.20, FU = 4.09 (p<0.001).
The average score at TERS was higher in patients with HIV (43 ± 9 vs 35 ± 9, p = ns).
At B HIV patients with ESLD show a greater frailty to psychopathology but they quite improved during FU. The contrary happen in non-HIV group.
The aim of our study is the investigation of burn-out indexes in public mental health services employees (psychiatrists, psychologists, nursing staff, care providers) working with patients affected by Bipolar Disorder in order to correlate them with patients’ indexes of satisfaction about received treatment and care.
A sample of 20 employees of mental health services (psychiatrists, psychologists, nurses) and one consisting of 22 patients with a diagnosis of Bipolar Disorder have been recruited at the Bipolar Disorders Unit of the Day Hospital of Psychiatry of the A. Gemelli Hospital in Rome. Operators have been submitted the Maslach Burnout Inventory (Emotional distress, Depersonalization, Personal satisfaction/achievement/fulfilment) while patients have been submitted the Questionnaire on Satisfaction of patient (QS)
By calculating the Spearman Correlation Coefficient the Depersonalization dimension proves highly correlated with the three subscales of QS: Doctor-Patient relationship quality (-.51); Information Quality and Doctor's therapeutic competence (-.48); Efficiency of service organization (-.58)
In our sample high levels of Depersonalization are correlated to a low satisfaction of patients. We therefore expect low levels of Depersonalization to be correlated with a higher satisfaction of the patient. Although it is not possible to generalize these results we can hypothesize that burn out negatively influences patients’ satisfaction.
We report on multi-wavelength ultraviolet (UV) high-resolution observations taken with the IRIS satellite during the emergence phase of an emerging flux region embedded in the unipolar plage of active region NOAA 12529. These data are complemented by measurements taken with the spectropolarimeter aboard the Hinode satellite and by observations from SDO.
In the photosphere, we observe the appearance of opposite emerging polarities, separating from each other, and cancellation with a pre-existing flux concentration of the plage.
In the upper atmospheric layers, recurrent brightenings resembling UV bursts, with counterparts in all UV/EUV filtergrams, are identified in the EFR site. In addition, plasma ejections are observed at chromospheric level. Most important, we unravel a signature of plasma heated up to 1 MK detecting Fe XII emission in the core of the brightening sites.
Comparing these findings with previous observations and numerical models, we suggest evidence of several long-lasting, small-scale magnetic reconnection episodes between the new bipolar EFR and the ambient field.
Sunspots are the most prominent feature of the solar magnetism in the photosphere. Although they have been widely investigated in the past, their structure remains poorly understood. Indeed, due to limitations in observations and the complexity of the magnetic field estimation at chromospheric heights, the magnetic field structure of sunspot above the photosphere is still uncertain. Improving the present knowledge of sunspot is important in solar and stellar physics, since spot generation is seen not only on the Sun, but also on other solar-type stars. In this regard, we studied a large, isolated sunspot with spectro-polarimeteric measurements that were acquired at the Fe I 6173 nm and Ca II 8542 nm lines by the spectropolarimeter IBIS/DST under excellent seeing conditions lasting more than three hours. Using the Non-LTE inversion code NICOLE, we inverted both line measurements simultaneously, to retrieve the three-dimensional magnetic and thermal structure of the penumbral region from the bottom of the photosphere to the middle chromosphere. Our analysis of data acquired at spectral ranges unexplored in previous studies shows clear spine and intra-spine structure of the penumbral magnetic field at chromopheric heights. Our investigation of the magnetic field gradient in the penumbra along the vertical and azimuthal directions confirms results reported in the literature from analysis of data taken at the spectral region of the He I 1083 nm triplet.
Introduction: In Ontario, Advanced Care Paramedics (ACPs) are required to perform a minimum of 24 educational credits per year of Continuing Medical Education (CME). Of these 24 credits, 12 are chosen by the paramedic, while 12 credits are mandated by the Base Hospital. The combined mandatory and optional CME frame is used so paramedics can target their personal needs appropriately, while ensuring new medical directives and global knowledge deficits identified by Quality Assurance (QA) means can be addressed by the Base Hospital. Objective: To determine if there is a difference between what ACPs identify as their knowledge deficits and what CME they complete. Methods: Methods: Request for participation in a written survey was delivered to all ACPs in an Ontario Base Hospital, prior to the CME cycle for the year. Respondents were asked to identify deficits from a 37-point, organ systems-based list, with free-text option for any deficits not itemized. Following the annual cycle, CME credits were evaluated by the Regional Base Hospital education coordinator, and Base Hospital medical directors for content. The deficits identified prior to the CME cycle were then compared to the CME attended for each respondent. In order to best represent the individual ACP response to their perceived deficits, a percentage of deficits identified and addressed was chosen. Respondents were not aware that their responses would be compared to the credits obtained for the year, to minimize bias in CME selection. Results: Of the 140 ACPs in the region, 42 (30%) completed the survey. From the 37-point list, the median number of perceived deficits identified was 7.00 (IQR 3.00-10.00). The median number of CME events that addressed perceived deficits was 2.00 (IQR 1.00-3.00). The median number of perceived deficits addressed by either paramedic-chosen or mandatory CME were identical at 1.00 (IQR 0.00-2.00). The percentage of perceived deficits identified and addressed via CME was 35.07% (range 0-100%). Paramedic-chosen CME covered 22.48% (range 0-100%) of perceived deficits, while mandatory CME covered 20.14% (range 0-100%) of perceived deficits. Conclusion: In the current system, only 35.07% of perceived deficits were addressed through mandatory and paramedic-chosen CME. Further information regarding barriers to paramedics obtaining CME that meets their perceived deficits needs to be elucidated.
Introduction: Objective: To identify self-perceived knowledge deficits of paramedics, barriers to training and desired methods of self-directed continuing education. Methods: A written 58 question survey was delivered to all 1262 paramedics under the jurisdiction of a single base-hospital in Ontario, Canada. Respondents were asked to select deficit, no deficit or not applicable from a 37-point, anatomic systems-based list. They were then asked to identify from a 15-point list which educational modalities they would choose to address any knowledge deficits. Finally, they were asked which factors they took into consideration when choosing their self-directed continuing education. Results: Seven hundred forty-six of 1262 paramedics (59.11%) completed the surveys. Of these respondents, 82 (10.99%) were advanced care paramedics, while 664 (89.01%) were primary care paramedics. Of the 645 who responded with their primary geographical setting: 136 (21.09%) listed a primary urban practice, 126 (19.53%) listed a primary rural practice and 287 (44.50%) reported a split urban and rural practice. The most common perceived deficits (respondent number, percentage); were electrolyte disturbance (418, 56.03%), neonatal resuscitation (386, 51.74%), pediatric respiratory disorder (381, 51.07%), arrhythmia (377, 50.53%), and pediatric cardiac arrest (317, 42.49%). The top 5 educational opportunities they were most likely to choose included online module (464, 62.20%), in-class lecture (423, 56.70%), web-based review (403, 54.02%), webinar (301, 40.35%) and peer consult (237, 31.77%). The top 3 barriers to choosing continuing education were work scheduling (479, 64.21%), location/ease of attending (382, 51.21%), and cost (305, 40.88%). Conclusion: Paramedics in this base hospital system identified pediatric critical care situations, electrolyte abnormalities and cardiac arrhythmia as self-perceived deficits. The most commonly selected educational opportunities included online learning, in-person training and peer consult. These preferred modalities are consistent with the identified barriers of work scheduling, ease of attending and cost. Targeted educational needs based assessments can help ensure that appropriate topics are delivered in a fashion that help overcome identified barriers to self-directed learning.
Introduction: To determine trends in identified self-perceived knowledge deficits of paramedics, training barriers and desired methods of self-directed education. Methods: A written survey was delivered to all paramedics in an Ontario base-hospital. Respondents were asked to identify deficits from a 37-point, anatomic systems-based list. Preferred educational modalities to address knowledge deficits and factors taken into consideration when choosing self-directed education were captured. Top 5 perceived deficit topics, number of perceived deficits, top 5 factors associated with training modality chosen and factors taken into consideration for choosing training modalities, were compared against paramedic age, training (Advanced Care Paramedic; ACP, or Primary Care Paramedic; PCP) and primary location of practice (urban, rural, mixed setting). Results: Of 1262 paramedics, 746 (59.11%) completed the survey. PCPs had a higher report of deficit in both neonatal resuscitation and arrhythmia than ACPs (48.3% vs 58.8%, p=0.015; 40.3% vs 58.5%, p<0.001). Paramedics who listed rural as their primary practice location were more likely to report a deficit in pediatric respiratory disorder than those with a mixed urban/rural and primary urban practice (65.9% vs 46.3%, p=0.000; 65.9% vs 45.9%, p=0.001;) as well as a higher median number of listed deficits (9.00 vs 6.00 vs 6.00, p<0.001). ACPs were more likely to consider scheduling, location/ease of attending and cost as barriers than PCPs (85.4% vs 63.8%, p=0.000; 69.5% vs 51.4%, p=0.002; 69.5% vs 39.5%, p=0.000) while reporting an increased desire for webinar material than PCPs (56.1% vs 40.4%, p=0.007). There were no significant differences found by age. Conclusion: Targeted educational needs-based assessments can help ensure appropriate topics are delivered in a fashion that overcomes identified barriers to self-directed learning. From our analysis, increased awareness of ease of attending sessions and preferred modalities, such as webinars may be beneficial; especially for ACPs who require more annual continuing educational hours. Paramedics in rural locations may require increased continuing education, especially for rarely encountered, high risk situations, such as pediatric critical care. These findings can help direct future education in our system and others.
Probably, the long-term monitoring of the solar atmosphere started in Italy with the first telescopic observations of the Sun made by Galileo Galilei in the early 17th century. His recorded observations and science results, as well as the work carried out by other following outstanding Italian astronomers inspired the start of institutional programs of regular solar observations at the Arcetri, Catania, and Rome Observatories.
These programs have accumulated daily images of the solar photosphere and chromosphere taken at various spectral bands over a time span larger than 80 years. In the last two decades, regular solar observations were continued with digital cameras only at the Catania and Rome Observatories, which are now part of the INAF National Institute for Astrophysics. At the two sites, daily solar images are taken at the photospheric G-band, Blue (λ = 409.4 nm), and Red (λ = 606.9 nm) continua spectral ranges and at the chromospheric Ca II K and Hα lines, with a 2″ spatial resolution.
Solar observation in Italy, which benefits from over 2500 hours of yearly sunshine, currently aims at the operational monitoring of solar activity and long-term variability and at the continuation of the historical series as well. Existing instruments will be soon enriched by the SAMM double channel telescope equipped with magneto-optical filters that will enable the tomography of the solar atmosphere with simultaneous observations at the K I 769.9 nm and Na I D 589.0 nm lines. In this contribution, we present the available observations and outline their scientific relevance.
The increased use of the MATRICS Consensus Cognitive Battery (MCCB) to investigate cognitive dysfunctions in schizophrenia fostered interest in its sensitivity in the context of family studies. As various measures of the same cognitive domains may have different power to distinguish between unaffected relatives of patients and controls, the relative sensitivity of MCCB tests for relative–control differences has to be established. We compared MCCB scores of 852 outpatients with schizophrenia (SCZ) with those of 342 unaffected relatives (REL) and a normative Italian sample of 774 healthy subjects (HCS). We examined familial aggregation of cognitive impairment by investigating within-family prediction of MCCB scores based on probands’ scores.
Multivariate analysis of variance was used to analyze group differences in adjusted MCCB scores. Weighted least-squares analysis was used to investigate whether probands’ MCCB scores predicted REL neurocognitive performance.
SCZ were significantly impaired on all MCCB domains. REL had intermediate scores between SCZ and HCS, showing a similar pattern of impairment, except for social cognition. Proband's scores significantly predicted REL MCCB scores on all domains except for visual learning.
In a large sample of stable patients with schizophrenia, living in the community, and in their unaffected relatives, MCCB demonstrated sensitivity to cognitive deficits in both groups. Our findings of significant within-family prediction of MCCB scores might reflect disease-related genetic or environmental factors.
The Cambridge Handbook of International Prevention Science offers a comprehensive global overview on prevention science with the most up-to-date research from around the world. Over 100 scholars from 27 different countries (including Australia, Bhutan, Botswana, India, Israel, Mexico, Singapore, South Korea, Spain and Thailand) contributed to this volume, which covers a wide range of topics important to prevention science. It includes major sections on the foundations of prevention as well as examples of new initiatives in the field, detailing current prevention efforts across the five continents. A unique and innovative volume, The Cambridge Handbook of International Prevention Science is a valuable resource for established scholars, early professionals, students, practitioners and policy-makers.