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The Psychiatric Emergency Service (PES) is an important part of the mental health care system for the management of acute conditions requiring prompt intervention representing also a significant part of workload of specialists and trainees. The objective of this study was to characterize the clinical features of patients observed in PES of Coimbra University Hospitals.
During the first 6 months of 2008, demographic and clinical data were obtained for all patients observed by the first author of the study, together with a specialist in Psychiatry.
The sample consisted of 159 patients, 103 females and 56 males. Mean age was 45,9 ± 18,367 years. The majority of patients presented in the emergency room either alone (56,6%) or with a first degree relative (34,6%) by self-initiative and having a past psychiatric history (71,1%). Disturbing mood symptoms (depression, anxiety or both) were the motive of assessment in 58% of patients but several other causes were reported including behavioural symptoms, agitation, psychosis, drug or alcohol related disorders, sleep and cognitive disorders. Average Clinical Global Impression was 4,12 ± 1,177. After the psychiatric assessment, several diagnosis were made namely Major Depressive Episode (14,5%), Adaptation Disorders (13,9%), Schizophrenia and related disorders (13,8%), Anxiety Disorder Not Otherwise Specified (11,9%) and Drug or Alcohol related disorders (8,2%). Most patients were discharged without referral (50,3%).
A significant percentage of patients went to the PES for conditions that could have been treated by a primary care physician or in an outpatient clinic setting.
Non-specific chronic low back pain is one of common causes of disability and a recurrent medical complaint with high costs. From rehabilitative medicine, physiotherapy programs and general postural recommendations are offered. Although this treatment is aimed to reduce disability, severity of pain and anxiety-depressive symptoms, many patients report partial improvements and recurrence of pain. Therefore, a new approach to treat this pathology with a broaden focus on psychososocial issues that might modulate pain and its evolution is required.
Aims and hypothesis
To assess the effectiveness of two complementary interventions to physiotherapy, such as relaxation techniques (specifically, sophrology) and cognitive behavioral intervention. It is hypothesized that intervention groups will significantly improve their adherence to physiotherapy and will gain control over their pain. Ultimately, this will foster better quality of life.
Longitudinal design with pre-post intervention measures and follow-up appointments (at 6 and 12 months) carried out in a sample of 66 participants. The sample will be divided into three groups: control (physiotherapy), intervention group 1 (physiotherapy & sophrology) and intervention group 2 (physiotherapy & cognitive behavioral intervention). In all groups biomedical aspects regarding type, evolution and characterization of pain as well as several psychosocial factors will be assessed.
Preliminary results are expected by December 2013.
If hypotheses are confirmed, we will be able to provide empirical evidences to justify a multidisciplinary care model for chronic low back pain, which will favor a significant cost reduction in terms of health care and human suffering.
A previous study, conducted in the province of Novara stated that, from an epidemiological and clinical point of view, being a female, being a migrant, as well as being in the warmer months of the year, or suffering from an untreated psychiatric disease are associated with suicide attempts. Literature suggests there is a positive relation between negative life events and suicidal behaviours. In this study, we intend to deepen knowledge, individuating motivations and meanings underlying suicidal behaviours. This appears a meaningful approach to integrate studies and initiatives in order to prevent suicide and suicidal behaviours.
To examine possible correlation between socio-demographic and clinical characteristics and motivations underlying suicide attempts.
Patients aged > 16 years admitted for attempted suicide in the Emergency Room of the AOU Maggiore della Carità Hospital, Novara, Italy, were studied retrospectively from the 1st January 2015 to the 31st December 2016. Each patient was assessed by an experienced psychiatrist with a clinical interview; socio-demographic and clinical features were gathered. Analysis were performed with SPSS.
Results and discussion
Data collection are still ongoing; results and implications will be discussed. We expect to find different motivations in relation to socio-demographic and clinical characteristics [1,2].
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Identifying factors predictive of long-term morbidity should improve clinical planning limiting disability and mortality associated with bipolar disorder (BD).
We analyzed factors associated with total, depressive and mania-related long-term morbidity and their ratio D/M, as %-time ill between a first-lifetime major affective episode and last follow-up of 207 BD subjects. Bivariate comparisons were followed by multivariable linear regression modeling.
Total % of months ill during follow-up was greater in 96 BD-II (40.2%) than 111 BD-I subjects (28.4%; P = 0.001). Time in depression averaged 26.1% in BD-II and 14.3% in BD-I, whereas mania-related morbidity was similar in both, averaging 13.9%. Their ratio D/M was 3.7-fold greater in BD-II than BD-I (5.74 vs. 1.96; P < 0.0001). Predictive factors independently associated with total %-time ill were: [a] BD-II diagnosis, [b] longer prodrome from antecedents to first affective episode, and [c] any psychiatric comorbidity. Associated with %-time depressed were: [a] BD-II diagnosis, [b] any antecedent psychiatric syndrome, [c] psychiatric comorbidity, and [d] agitated/psychotic depressive first affective episode. Associated with %-time in mania-like illness were: [a] fewer years ill and [b] (hypo)manic first affective episode. The long-term D/M morbidity ratio was associated with: [a] anxious temperament, [b] depressive first episode, and [c] BD-II diagnosis.
Long-term depressive greatly exceeded mania-like morbidity in BD patients. BD-II subjects spent 42% more time ill overall, with a 3.7-times greater D/M morbidity ratio, than BD-I. More time depressed was predicted by agitated/psychotic initial depressive episodes, psychiatric comorbidity, and BD-II diagnosis. Longer prodrome and any antecedent psychiatric syndrome were respectively associated with total and depressive morbidity.
Due to population aging, the health system will face increasing challenges in the next years. Concerning mental disorders, they are major public health issues in late life, with mood and anxiety disorders being some of the most common mental disorder among the elderly. For this reason, increasing attention has to be paid to the evaluation of the elderly in psychiatry emergency settings.
To evaluate the socio-demographic and clinical features of over 65 patients referred to psychiatric consultations in the ER of “Maggiore della Carità” Hospital in Novara, in a 7 years period.
The analysis of the characteristics of the study sample could be potentially useful in resource planning in order to better serve this important segment of the general population.
Determinants of ER visits for over 65 patients referred to psychiatric evaluation were studied retrospectively from 2008 to 2015.
Elderly patients made up 14,7% (n = 458) of all psychiatric evaluation in the ER (n = 3124). About two thirds (65,9%) were females and one third were males (34,1%). The mean age of patients recruited was 75.11 years. The majority of subjects (68.6%) presented without a diagnosis of Axis I according to DSM-IV. The other most frequent diagnosis was “cognitive disorders” (11.4%) and “mood disorders” (10.9%).
The large proportion of patients without a diagnosis of Axis I, could be related to the misunderstanding of the psychosocial aspects of aging. Preliminary results highlight the importance of research on this topic, considering population aging and the impact of mental disorders in late-life.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
The wide geographical distribution and genetic diversity of bat-associated lyssaviruses (LYSVs) across Europe suggest that similar viruses may also be harboured in Italian insectivorous bats. Indeed, bats were first included within the passive national surveillance programme for rabies in wildlife in the 1980s, while active surveillance has been performed since 2008. The active surveillance strategies implemented allowed us to detect neutralizing antibodies directed towards European bat 1 lyssavirus in six out of the nine maternity colonies object of the study across the whole country. Seropositive bats were Myotis myotis, M. blythii and Tadarida teniotis. On the contrary, the virus was neither detected through passive nor active surveillance, suggesting that fatal neurological infection is rare also in seropositive colonies. Although the number of tested samples has steadily increased in recent years, submission turned out to be rather sporadic and did not include carcasses from bat species that account for the majority of LYSVs cases in Europe, such as Eptesicus serotinus, M. daubentonii, M. dasycneme and M. nattereri. A closer collaboration with bat handlers is therefore mandatory to improve passive surveillance and decrypt the significance of serological data obtained up to now.
Subcutaneous fat thickness and fatty acid composition (FAC) play an important role on seasoning loss and organoleptic characteristics of seasoned hams. Dry-cured ham industry prefers meats with low contents of polyunsaturated fatty acids (PUFA) because these negatively affect fat firmness and ham quality, whereas consumers require higher contents in those fatty acids (FA) for their positive effect on human health. A population of 950 Italian Large White pigs from the Italian National Sib Test Selection Programme was investigated with the aim to estimate heritabilities, genetic and phenotypic correlations of backfat FAC, Semimembranosus muscle intramuscular fat (IMF) content and other carcass traits. The pigs were reared in controlled environmental condition at the same central testing station and were slaughtered at reaching 150 kg live weight. Backfat samples were collected to analyze FAC by gas chromatography. Carcass traits showed heritability levels from 0.087 for estimated carcass lean percentage to 0.361 for hot carcass weight. Heritability values of FA classes were low-to-moderate, all in the range 0.245 for n-3 PUFA to 0.264 for monounsaturated FA (MUFA). Polyunsaturated fatty acids showed a significant genetic correlation with loin thickness (0.128), backfat thickness (−0.124 for backfat measured by Fat-O-Meat’er and −0.175 for backfat measured by calibre) and IMF (−0.102). Obviously, C18:2(n-6) shows similar genetic correlations with the same traits (0.211 with loin thickness, −0.206 with backfat measured by Fat-O-Meat’er, −0.291 with backfat measured by calibre and −0.171 with IMF). Monounsaturated FA, except with the backfat measured by calibre (0.068; P<0.01), do not show genetic correlations with carcass characteristics, whereas a negative genetic correlation was found between MUFA and saturated FA (SFA; −0.339; P<0.001). These results suggest that MUFA/SFA ratio could be increased without interfering with carcass traits. The level of genetic correlations between FA and carcass traits should be taken into account in dealing with the development of selection schemes addressed to modify carcass composition and/or backfat FAC.
We describe the performance of the Boolardy Engineering Test Array, the prototype for the Australian Square Kilometre Array Pathfinder telescope. Boolardy Engineering Test Array is the first aperture synthesis radio telescope to use phased array feed technology, giving it the ability to electronically form up to nine dual-polarisation beams. We report the methods developed for forming and measuring the beams, and the adaptations that have been made to the traditional calibration and imaging procedures in order to allow BETA to function as a multi-beam aperture synthesis telescope. We describe the commissioning of the instrument and present details of Boolardy Engineering Test Array’s performance: sensitivity, beam characteristics, polarimetric properties, and image quality. We summarise the astronomical science that it has produced and draw lessons from operating Boolardy Engineering Test Array that will be relevant to the commissioning and operation of the final Australian Square Kilometre Array Path telescope.
I deficiency is still a worldwide public health problem, with children being especially vulnerable. No nationwide study had been conducted to assess the I status of Spanish children, and thus an observational, multicentre and cross-sectional study was conducted in Spain to assess the I status and thyroid function in schoolchildren aged 6–7 years. The median urinary I (UI) and thyroid-stimulating hormone (TSH) levels in whole blood were used to assess the I status and thyroid function, respectively. A FFQ was used to determine the consumption of I-rich foods. A total of 1981 schoolchildren (52 % male) were included. The median UI was 173 μg/l, and 17·9 % of children showed UI<100 μg/l. The median UI was higher in males (180·8 v. 153·6 μg/l; P<0·001). Iodised salt (IS) intake at home was 69·8 %. IS consumption and intakes of ≥2 glasses of milk or 1 cup of yogurt/d were associated with significantly higher median UI. Median TSH was 0·90 mU/l and was higher in females (0·98 v. 0·83; P<0·001). In total, 0·5 % of children had known hypothyroidism (derived from the questionnaire) and 7·6 % had TSH levels above reference values. Median TSH was higher in schoolchildren with family history of hypothyroidism. I intake was adequate in Spanish schoolchildren. However, no correlation was found between TSH and median UI in any geographical area. The prevalence of TSH above reference values was high and its association with thyroid autoimmunity should be determined. Further assessment of thyroid autoimmunity in Spanish schoolchildren is desirable.
Cacajao calvus ucayalii (Thomas, 1928) (Primates: Pitheciidae), a subspecies endemic to the Peruvian Amazon, occurs in patchy and sometimes isolated populations in north-eastern Peru and is in a vulnerable situation, mainly due to habitat loss and hunting. This rareness and remote distribution means that, until now, parasitical studies have been limited. Based on optical and scanning electron microscopy of specimens of both sexes, we report two new species of Trypanoxyuris pinworms occurring in the large intestine of the Peruvian red uakari, namely Trypanoxyuris (Trypanoxyuris) cacajao and Trypanoxyuris (Trypanoxyuris) ucayalii. Both species showed a distinct morphology of the lips and cephalic structure. Sexual dimorphism in the lateral alae was observed in both male and the female worms, with ventral ornamentation being shown in the oesophageal teeth. The finding of these new pinworm species highlights the possibility of discovering other species.
This study was conducted to determine the effects of feeding olive cake and linseed to lambs on the volatile organic compounds (VOCs) in raw and cooked meat. Four groups of eight male Appenninica lambs each were fed: conventional cereal-based concentrates (diet C), concentrates containing 20% on a dry matter (DM) basis of rolled linseed (diet L), concentrates containing 35% DM of stoned olive cake (diet OC), or concentrates containing both rolled linseed (10% DM) and stoned olive cake (17% DM; diet OCL). The longissimus dorsi muscle of each lamb was sampled at slaughter and was subjected to VOC profiling through the use of SPME-GC-MS. In the raw meat, the concentration of 3-methylpentanoic acid was higher in treatment C as compared with treatments L, OC and OCL (P<0.01). Moreover the level of nonanoic acid was greater in treatments C and OC than in treatment L (P<0.05). With respect to alcohols, in raw meat the amount of 2-phenoxyethanol in treatment OCL was lower than in treatments C (P<0.01) and OC (P<0.05), while in cooked meat the amount of 1-pentanol was higher in treatment C than in treatment OC (P<0.05). Apart from these compounds, none of the lipid oxidation-derived volatiles was significantly affected by the dietary treatment. Therefore, the results suggest that the replacement of cereal concentrates with linseed and/or olive cake did not cause appreciable changes in the production of volatile organic compounds in lamb meat.
Although the thick disk in our Galaxy was revealed more than thirty years ago, its formation scenario is still unclear. Here, we analyze a chemo-dynamical simulation of a primordial disk population representative of the Galactic thick disk and investigate how the spatial, kinematic, and chemical properties are affected by the presence of a central bar.
The aim of the present study was to evaluate the effect of the inclusion of stoned olive cake and rolled linseed in a concentrate-based diet for lambs on the fatty-acid composition of polar and non-polar intramuscular lipids of the longissimus dorsi muscle. To achieve this objective, 32 Appenninica lambs were randomly distributed into four groups of eight lambs each and were fed conventional cereal-based concentrates (diet C); concentrates containing 20% on a dry matter (DM) basis of rolled linseed (diet L); concentrates containing 35% DM of stoned olive cake (diet OC); and concentrates containing both rolled linseed (10% DM) and stoned olive cake (17% DM; diet OCL). The concentrates were administered together with grass hay at a 20:80 forage:concentrate ratio. Growing performances and carcass traits were evaluated. The fatty-acid composition was analysed in the total intramuscular lipids, as well as in the polar and neutral lipids. The average feed intake and the growth performance of lambs were not affected by the dietary treatments, as a consequence of similar nutritional characteristics of the diets. The inclusion of rolled linseed in the L and OCL diets increased the content of C18:3 n-3 in intramuscular total lipids, which was threefold higher in meat from the L lambs and more than twofold higher in meat from the OCL lambs compared with the C and OC treatments. The n-6:n-3 ratio significantly decreased in the meat from lambs in the L and OCL groups, reaching values below 3. The L treatment resulted in the highest level of trans-18:1 fatty acids in the muscle. Regardless of the dietary treatment, the t10-18:1 was the major isomer, representing 55%, 45%, 49% and 45% of total trans-18:1 for C, L, OC and OCL treatments, respectively. Neutral lipids from the OC-fed lambs contained the highest amount of c9-18:1 (more than 36% of total fatty acids); however, the content of c9-18:1 did not differ between the OC and C lambs, suggesting an intensive biohydrogenation of dietary c9-18:1 in the case of OC treatment. The highest content of c9,t11-18:2 was detected in the intramuscular fat from the L-fed lambs, followed by the OCL treatment. A similar trend was observed in the neutral lipid fraction and, to a lower extent, in the polar lipids.
Although white-matter abnormalities have been reported in middle-aged patients with major depressive disorder (MDD), few data are available on treatment-resistant MDD and the influence of relevant variables related to clinical burden of illness is far from being well established.
The present study examined white-matter microstructure in a sample of 52 patients with MDD in different stages (treatment-resistant/chronic MDD, n = 18; remitted-recurrent MDD, n = 15; first-episode MDD, n = 19) and 17 healthy controls, using diffusion tensor imaging with a tract-based spatial statistics approach. Groups were comparable in age and gender distribution, and results were corrected for familywise error (FWE) rate.
Widespread significant reductions of fractional anisotropy (FA) – including the cingulum, corpus callosum, superior and inferior longitudinal fascicule – were evident in treatment-resistant/chronic MDD compared with first-episode MDD and controls (p < 0.05, FWE-corrected). Decreased FA was observed within the ventromedial prefrontal region in treatment-resistant/chronic MDD even when compared with the remitted-recurrent MDD group (p < 0.05, FWE-corrected). Longer duration of illness (β = –0.49, p = 0.04) and higher depression severity (at a trend level: β = –0.26, p = 0.06) predicted lower FA in linear multiple regression analysis at the whole-brain level. The number of previous episodes and severity of symptoms were significant predictors when focused on the ventromedial prefrontal area (β = −0.28, p = 0.04; and β = −0.29, p = 0.03, respectively). Medication effects were controlled for in the analyses and results remained unaltered.
Our findings support the notion that disruptions of white-matter microstructure, particularly in fronto-limbic networks, are associated with resistance to treatment and higher current and past burden of depression.
Tomography is a standard and invaluable technique that covers a large range of length scales. It gives access to the inner morphology of specimens and to the three-dimensional (3D) distribution of physical quantities such as elemental composition, crystalline phases, oxidation state, or strain. These data are necessary to determine the effective properties of investigated heterogeneous media. However, each tomographic technique relies on severe sampling conditions and physical principles that require the sample to be adequately shaped. For that purpose, a wide range of sample preparation techniques is used, including mechanical machining, polishing, sawing, ion milling, or chemical techniques. Here, we focus on the basics of tomography that justify such advanced sample preparation, before reviewing and illustrating the main techniques. Performances and limits are highlighted, and we identify the best preparation technique for a particular tomographic scale and application. The targeted tomography techniques include hard X-ray micro- and nanotomography, electron nanotomography, and atom probe tomography. The article mainly focuses on hard condensed matter, including porous materials, alloys, and microelectronics applications, but also includes, to a lesser extent, biological considerations.
We describe a simple method to determine the reliability of source finders based on the detection of sources with both positive and negative total flux. Under the assumption that the noise is symmetric and that real sources have positive total flux, negative detections can be used to assign to each positive detection a probability of being real. We discuss this method in the context of upcoming, interferometric Hi surveys.
This paper presents and discusses the results of basic source finding tests in three dimensions (using spectroscopic data cubes) with duchamp, the standard source finder for the Australian Square Kilometre Array Pathfinder. For this purpose, we generated different sets of unresolved and extended Hi model sources. These models were then fed into duchamp, using a range of different parameters and methods provided by the software. The main aim of the tests was to study the performance of duchamp on sources with different parameters and morphologies and assess the accuracy of duchamp's source parametrisation. Overall, we find duchamp to be a powerful source finder capable of reliably detecting sources down to low signal-to-noise ratios and accurately measuring their position and velocity. In the presence of noise in the data, duchamp's measurements of basic source parameters, such as spectral line width and integrated flux, are affected by systematic errors. These errors are a consequence of the effect of noise on the specific algorithms used by duchamp for measuring source parameters in combination with the fact that the software only takes into account pixels above a given flux threshold and hence misses part of the flux. In scientific applications of duchamp these systematic errors would have to be corrected for. Alternatively, duchamp could be used as a source finder only, and source parametrisation could be done in a second step using more sophisticated parametrisation algorithms.
The large size of the ASKAP Hi surveys DINGO and WALLABY necessitates automated 3D source finding. A performance difference of a few percent corresponds to a significant number of galaxies being detected or undetected. As such, the performance of the automated source finding is of paramount importance to both of these surveys. We have analysed the performance of various source finders to determine which will allow us to meet our survey goals during the DINGO and WALLABY design studies. Here we present a comparison of the performance of five different methods of automated source finding. These source finders are duchamp, gamma-finder, a cnhi finder, a 2d–1d wavelet reconstruction finder and a sigma clipping method (s + c finder). Each source finder was applied to the same three-dimensional data cubes containing (a) point sources with a Gaussian velocity profile and (b) spatially extended model-galaxies with inclinations and rotation profiles. We focus on the completeness and reliability of each algorithm when comparing the performance of the different source finders.