"Delirium Day": A nationwide point prevalence study of delirium in older hospitalized patients using an easy standardized diagnostic tool

Background: To date, delirium prevalence in adult acute hospital populations has been estimated generally from pooled findings of single-center studies and/or among specific patient populations. Furthermore, the number of participants in these studies has not exceeded a few hundred. To overcome these limitations, we have determined, in a multicenter study, the prevalence of delirium over a single day among a large population of patients admitted to acute and rehabilitation hospital wards in Italy. Methods: This is a point prevalence study (called "Delirium Day") including 1867 older patients (aged 65 years or more) across 108 acute and 12 rehabilitation wards in Italian hospitals. Delirium was assessed on the same day in all patients using the 4AT, a validated and briefly administered tool which does not require training. We also collected data regarding motoric subtypes of delirium, functional and nutritional status, dementia, comorbidity, medications, feeding tubes, peripheral venous and urinary catheters, and physical restraints. Results: The mean sample age was 82.0 \ub1 7.5 years (58 % female). Overall, 429 patients (22.9 %) had delirium. Hypoactive was the commonest subtype (132/344 patients, 38.5 %), followed by mixed, hyperactive, and nonmotoric delirium. The prevalence was highest in Neurology (28.5 %) and Geriatrics (24.7 %), lowest in Rehabilitation (14.0 %), and intermediate in Orthopedic (20.6 %) and Internal Medicine wards (21.4 %). In a multivariable logistic regression, age (odds ratio [OR] 1.03, 95 % confidence interval [CI] 1.01-1.05), Activities of Daily Living dependence (OR 1.19, 95 % CI 1.12-1.27), dementia (OR 3.25, 95 % CI 2.41-4.38), malnutrition (OR 2.01, 95 % CI 1.29-3.14), and use of antipsychotics (OR 2.03, 95 % CI 1.45-2.82), feeding tubes (OR 2.51, 95 % CI 1.11-5.66), peripheral venous catheters (OR 1.41, 95 % CI 1.06-1.87), urinary catheters (OR 1.73, 95 % CI 1.30-2.29), and physical restraints (OR 1.84, 95 % CI 1.40-2.40) were associated with delirium. Admission to Neurology wards was also associated with delirium (OR 2.00, 95 % CI 1.29-3.14), while admission to other settings was not. Conclusions: Delirium occurred in more than one out of five patients in acute and rehabilitation hospital wards. Prevalence was highest in Neurology and lowest in Rehabilitation divisions. The "Delirium Day" project might become a useful method to assess delirium across hospital settings and a benchmarking platform for future surveys

Electrochemistry for atom transfer radical polymerization: from mechanism to more controlled synthesis

Living/controlled radical polymerizations (L/CRPs) have been developed in the second half of the nineties and nowadays are among the most powerful and effective polymerization techniques for the preparation of advanced polymeric materials with well defined properties and high value. Atom Transfer Radical Polymerization (ATRP) has recorded the highest success in the field of L/CRP, thanks to its versatility and easiness of application. The first goal of this Ph.D. thesis is to understand and develop Cu-catalyzed ATRP through an electrochemical approach, with particular regard to the properties of the catalysts, initiators and propagating radicals, and the rationalization of the activation mechanism. Besides these fundamental aspects, a second important goal is to open a new way to enhance the control of the polymeric synthesis and allow the catalyst regeneration by means of electrochemical tools.Le polimerizzazioni radicaliche controllate (Controlled radical polymerization, CRP) sono state sviluppate a partire dalla metà degli anni '90, e attualmente sono tra le più potenti ed efficaci metodologie di polimerizzazione per ottenere materiali polimerici avanzati con proprietà ben definite ed alto valore aggiunto. La polimerizzazione radicalica a trasferimento di atomo (Atom Transfer Radical Polymerization, ATRP) è la tecnica che ha riscontrato il maggior successo nel campo delle CRP grazie alla sua versatilità e facilità di applicazione. Scopo di questa tesi di dottorato è di fornire un contributo alla comprensione e allo sviluppo di ATRP catalizzata da rame attraverso un approccio elettrochimico, con particolare riguardo alle proprietà di: catalizzatore, specie dormiente e radicali propaganti, e alla comprensione del meccanismo di attivazione. Inoltre, un secondo importante obbiettivo è quello di sviluppare nuove metodologie elettrochimiche atte ad aumentare il controllo delle sintesi polimeriche e permettere la rigenerazione del catalizzatore

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Elettro-fenton per l'abbattimento di inquinanti organici

Ottimizzazione nel processo di elettrogenerazione di acqua ossigenata con elettrodo a diffusione di Gas, studio del sistema catalitico Fe3+/Fe2+, degradazione di substrati organic