Defining and Evaluating a Decision Support System (DSS) for the Precise Pest Management of the Mediterranean Fruit Fly, Ceratitis capitata, at the Farm Level

A Decision Support System (DSS) was developed and evaluated to control the Mediterranean fruit fly (medfly), Ceratitis capitata (Wiedermann), by incorporating a semi-automatic pest monitoring and a precision targeting approach in multi-varietal orchards. The DSS consists of three algorithms. DSS1, based on the degree days calculation, defines when the traps should be deployed in the field initiating the medfly population monitoring. DSS2 defines the areas to be treated and the type of treatment based on the number of adult medfly captures, harvesting time, and phenological stage of the host cultivar. DSS3 defines the spraying procedure considering the technical registration properties of the selected insecticide (e.g., withholding period and efficacy duration time) and weather conditions. The DSS was tested in commercial orchard conditions near Rome, central Italy, with a randomized complete blocks experimental design, comparing DSS-assisted and conventional management. In the DSS-assisted plots, a semi-automatic adult medfly monitoring system was deployed, composed of real-time, wireless electronic traps. The output of the functioning DSS is a map of spraying recommendation, reporting the areas to be treated and the treatment type (bait or cover insecticide spraying). The farmer was left free to follow, or not, the DSS indications. The first medfly captures were observed on June 30, whereas the DD threshold was reached on July 3 when the DSS started to operate. The field test produced 29 DSS decisions from July 3 to September 1 and confirmed that medfly management using the DSS substantially reduced the number of pesticide applications, the treated area, and the volumes of pesticide utilization. No significant differences in infested fruit were observed between DSS-assisted and conventional management. The level of acceptance of the DSS by the farmer was 78%. This evidence confirmed the requirement of fully involving farmers and pest managers during the evaluation process of DSS

The role of attitudes toward medication and treatment adherence in the clinical response to LAIs: findings from the STAR Network Depot Study

Background: Long-acting injectable (LAI) antipsychotics are efficacious in managing psychotic symptoms in people affected by severe mental disorders, such as schizophrenia and bipolar disorder. The present study aimed to investigate whether attitude toward treatment and treatment adherence represent predictors of symptoms changes over time. Methods: The STAR Network "Depot Study" was a naturalistic, multicenter, observational, prospective study that enrolled people initiating a LAI without restrictions on diagnosis, clinical severity or setting. Participants from 32 Italian centers were assessed at three time points: baseline, 6-month, and 12-month follow-up. Psychopathological symptoms, attitude toward medication and treatment adherence were measured using the Brief Psychiatric Rating Scale (BPRS), the Drug Attitude Inventory (DAI-10) and the Kemp's 7-point scale, respectively. Linear mixed-effects models were used to evaluate whether attitude toward medication and treatment adherence independently predicted symptoms changes over time. Analyses were conducted on the overall sample and then stratified according to the baseline severity (BPRS < 41 or BPRS ≥ 41). Results: We included 461 participants of which 276 were males. The majority of participants had received a primary diagnosis of a schizophrenia spectrum disorder (71.80%) and initiated a treatment with a second-generation LAI (69.63%). BPRS, DAI-10, and Kemp's scale scores improved over time. Six linear regressions-conducted considering the outcome and predictors at baseline, 6-month, and 12-month follow-up independently-showed that both DAI-10 and Kemp's scale negatively associated with BPRS scores at the three considered time points. Linear mixed-effects models conducted on the overall sample did not show any significant association between attitude toward medication or treatment adherence and changes in psychiatric symptoms over time. However, after stratification according to baseline severity, we found that both DAI-10 and Kemp's scale negatively predicted changes in BPRS scores at 12-month follow-up regardless of baseline severity. The association at 6-month follow-up was confirmed only in the group with moderate or severe symptoms at baseline. Conclusion: Our findings corroborate the importance of improving the quality of relationship between clinicians and patients. Shared decision making and thorough discussions about benefits and side effects may improve the outcome in patients with severe mental disorders

Tolerability and efficacy of vortioxetine versus SSRIs in elderly with major depression. Study protocol of the VESPA study: a pragmatic, multicentre, open-label, parallel-group, superiority, randomized trial

Depression is a highly prevalent condition in the elderly, with a vast impact on quality of life, life expectancy, and medical outcomes. Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed agents in this condition and, although generally safe, tolerability issues cannot be overlooked. Vortioxetine is an antidepressant with a novel mechanism of action. Based on studies to date, it may have a promising tolerability profile in the elderly, as it does not adversely affect psychomotor or cognitive performance and does not alter cardiovascular and endocrine parameters. The present study aims to assess the tolerability profile of vortioxetine in comparison with the SSRIs considered as a single group in elderly participants with depression. The rate of participants withdrawing from treatment due to adverse events after 6 months of follow up will be the primary outcome

Erratum to nodal management and upstaging of disease. Initial results from the Italian VATS Lobectomy Registry

[This corrects the article DOI: 10.21037/jtd.2017.06.12.]

The Role of Attitudes Toward Medication and Treatment Adherence in the Clinical Response to LAIs: Findings From the STAR Network Depot Study

Background: Long-acting injectable (LAI) antipsychotics are efficacious in managing psychotic symptoms in people affected by severe mental disorders, such as schizophrenia and bipolar disorder. The present study aimed to investigate whether attitude toward treatment and treatment adherence represent predictors of symptoms changes over time. Methods: The STAR Network \u201cDepot Study\u201d was a naturalistic, multicenter, observational, prospective study that enrolled people initiating a LAI without restrictions on diagnosis, clinical severity or setting. Participants from 32 Italian centers were assessed at three time points: baseline, 6-month, and 12-month follow-up. Psychopathological symptoms, attitude toward medication and treatment adherence were measured using the Brief Psychiatric Rating Scale (BPRS), the Drug Attitude Inventory (DAI-10) and the Kemp's 7-point scale, respectively. Linear mixed-effects models were used to evaluate whether attitude toward medication and treatment adherence independently predicted symptoms changes over time. Analyses were conducted on the overall sample and then stratified according to the baseline severity (BPRS < 41 or BPRS 65 41). Results: We included 461 participants of which 276 were males. The majority of participants had received a primary diagnosis of a schizophrenia spectrum disorder (71.80%) and initiated a treatment with a second-generation LAI (69.63%). BPRS, DAI-10, and Kemp's scale scores improved over time. Six linear regressions\u2014conducted considering the outcome and predictors at baseline, 6-month, and 12-month follow-up independently\u2014showed that both DAI-10 and Kemp's scale negatively associated with BPRS scores at the three considered time points. Linear mixed-effects models conducted on the overall sample did not show any significant association between attitude toward medication or treatment adherence and changes in psychiatric symptoms over time. However, after stratification according to baseline severity, we found that both DAI-10 and Kemp's scale negatively predicted changes in BPRS scores at 12-month follow-up regardless of baseline severity. The association at 6-month follow-up was confirmed only in the group with moderate or severe symptoms at baseline. Conclusion: Our findings corroborate the importance of improving the quality of relationship between clinicians and patients. Shared decision making and thorough discussions about benefits and side effects may improve the outcome in patients with severe mental disorders

Diagramma: uno strumento di rivoluzione metodologica

Il volume è la raccolta degli Atti del Simposio “Big Ben. Il lavoro di UNStudio”, tenutosi a Roma il 4 Maggio 2014 presso il MAXXI Museo nazionale delle Arti del XXI secolo. Il volume condivide la medesima struttura del Simposio, articolandosi intorno a cinque blocchi tematici individuati da altrettante parole chiave: diagramma, struttura, modello, pelle e ibridazione. Le sezioni introduttive riferite a ciascun argomento sono a firma di autori di volumi monografici su UNStudio mentre gli scritti che sviluppano i singoli temi sono redatti dagli architetti del corso di Dottorato di ricerca

Il Diagramma nel lavoro di UNStudio

Gli architetti del dottorato di ricerca in Architettura - Teorie e progetto, insieme a FILIPPO LODI di Un Studio e agli autori ALESSANDRO D’ONOFRIO, ANTONELLO MAROTTA, ANDREA SOLLAZZO affrontano il lavoro e le opere più significative dello studio in un simposio e conferenza pubblica al MAXXI di Roma COORDINA prof. arch. ANTONINO SAGGI

Factors associated with medication adherence to long-acting injectable antipsychotics: results from the STAR Network Depot Study

Introduction: Long-acting injectable (LAI) antipsychotics are prescribed to people with severe psychiatric disorders who show poor adherence to oral medication. The present paper examined factors potentially associated with medication adherence to LAI treatment. Methods: The STAR (Servizi Territoriali Associati per la Ricerca) Network Depot Study was a multicenter, observational, prospective study that enrolled 461 subjects initiating a LAI from 32 Italian centers. After 6 and 12 months of treatment, we evaluated differences between participants with high (≥5 points) and low (<5 points) medication adherence using Kemp's 7-point scale in sociodemographic, clinical, psychopathological, and drug-related variables. Factors that differed significantly between the two groups were entered for multivariate logistic regression. Results: Six months after enrollment, participants with high medication adherence were younger, living with other people, had lower Brief Psychiatric Rating Scale (BPRS) total scores, lower adverse events, and a more positive attitude toward medication than participants with low adherence. Multivariate regression confirmed lower BPRS resistance and activation scores, absence of adverse events, and positive attitude toward medication as factors significantly associated with good adherence. After 12 months, all BPRS subscales were significantly lower in the high adherence group, which also showed a more positive attitude toward medication. BPRS resistance and attitude toward medication were confirmed as factors associated with medication adherence. Discussion: Our findings suggest that adherence to LAI is principally related to attitude toward medication and traits of suspiciousness/hostility. Quality of patient-clinician relationship and tailored psychoeducational strategies may positively affect adherence in people undergoing psychopharmacological treatment, including LAI