Anxiety and Depression Short Scale: norms for its use in rehabilitation

In the rehabilitation setting it is important to identify clinically significant conditions of distress so as to be able to provide, in addition to the conventional multidisplinary rehabilitation treatment, specific psychotherapeutic interventions targeted to the individual’s problems. This paper presents the findings from a psychometric test for the measurement of anxiety and depression (AD-R Scale) administered at the start and end of a rehabilitation program in patients with cardiopulmonary disease. The study population consisted of 765 patients affected by cardiac and pulmonary disease undergoing an in-hospital course of intensive rehabilitation. We observed that AD-R scores are related to sex, age and diseases. Among anxiety and depression scores there are statistically significant differences regarding sex: women achieved higher AD-R scores compared with men. Depression scores are influenced by age: younger subjects reached lower scores compared with the older ones. Among patients with respiratory disease, the subjects affected by chronic respiratory failure showed statistically significant higher depression scores compared to subjects affected by chronic obstructive pulmonary disease and bronchial asthma. Anxiety and depression scores among subjects affected by cardiac diseases did not show important differences. At the end of the multidisciplinary rehabilitation program, a significant reduction in both anxiety and depression scores was observed, compared to values at the start, particularly for those that, at the beginning of the rehabilitation program, reached clinically remarkable AD-R scores and in general for the youngest subjects. The paper also presents the means, standard deviations and percentile range of scores for anxiety and depression in the population studied, according to age, sex, underlying pathology or hospital division. The Scale AD-R appears to be a valid instrument for the screening of patients undergoing cardio-pulmonary rehabilitation and as an outcome index

Anxiety and Depression Short Scale: norms for its use in rehabilitation

In the rehabilitation setting it is important to identify clinically significant conditions of distress so as to be able to provide, in addition to the conventional multidisplinary rehabilitation treatment, specific psychotherapeutic interventions targeted to the individual's problems. This paper presents the findings from a psychometric test for the measurement of anxiety and depression (AD-R Scale) administered at the start and end of a rehabilitation program in patients with cardiopulmonary disease. The study population consisted of 765 patients affected by cardiac and pulmonary disease undergoing an in-hospital course of intensive rehabilitation. We observed that AD-R scores are related to sex, age and diseases. Among anxiety and depression scores there are statistically significant differences regarding sex: women achieved higher AD-R scores compared with men. Depression scores are influenced by age: younger subjects reached lower scores compared with the older ones. Among patients with respiratory disease, the subjects affected by chronic respiratory failure showed statistically significant higher depression scores compared to subjects affected by chronic obstructive pulmonary disease and bronchial asthma. Anxiety and depression scores among subjects affected by cardiac diseases did not show important differences. At the end of the multidisciplinary rehabilitation program, a significant reduction in both anxiety and depression scores was observed, compared to values at the start, particularly for those that, at the beginning of the rehabilitation program, reached clinically remarkable AD-R scores and in general for the youngest subjects. The paper also presents the means, standard deviations and percentile range of scores for anxiety and depression in the population studied, according to age, sex, underlying pathology or hospital division. The Scale AD-R appears to be a valid instrument for the screening of patients undergoing cardio-pulmonary rehabilitation and as an outcome index

Study on the Pneumatic Lime Injection in the Electric Arc Furnace Process: An Evaluation on the Performance Benefits

The pneumatic lime injection during the electric arc furnace (EAF) process by insufflation lances mounted on the furnace walls has gained much interest in the latest years. The main advantages, in comparison to the traditional procedure of lime lumps addition within the scrap bucket, can be summarized in raw materials consumption reduction, foaming benefits, operational cost benefits, and improvement in environmental aspects. In the proposed work, the advantages of a new lime injection system developed by Unicalce S.p.A. and installed on a 90 t EAF of Acciaierie di Calvisano are analyzed. Data from more than 1200 heats are acquired and compared with the traditional practice from an energetically and emissions point of view. To evaluate the benefits on the slag foamability, several slag samples, taken at the beginning and at the end of refining stage, are analyzed through isothermal solubility diagrams (ISDs). The ISD analysis results are then compared and validated with the total harmonic distortion (THD) of the arc in the corresponding heat. The upgrade to lime injection drives to considerable savings in electrical consumptions, oxygen, methane, and lime, with an overall save of more than 4,000 t year−1 of equivalent CO2

A revised short version of the Depression Questionnaire (QD/R)

Background The Depression Questionnaire (QD) is an instrument designed to measure depression in an inpatientrehabilitation setting. This study proposes a reduced version of the original 24-item QD, to make it better suited to the characteristics of patients in this setting. Methods The study population consisted of 801 individuals admitted to cardiac rehabilitation (564 males and 237 females) who had validly completed the original version of the QD. Data were analyzed first through confirmatory factor analysis and then using logistic models. Results Factor analysis of QD-24 items form, confirmed the plausibility of the monofactorial solution, both for males and females. Factor analysis combined with clinical observation suggested the possibility of reducing the QD to 17 items. Two further items were eliminated through use of simple logistic models. We thus obtained a shortened 15-item version of the QD (QD-R) that maintains a good index of separation (0.80), that is, good capacity to discriminate between individuals with different levels of depression, and a good item-trait interaction (v2 153 = 165.37, P > 0.05). A second confirmatory factor analysis applied to the 15-item monofactorial model confirmed the validity of this shortened version of the instrument. The QD-R scores significantly correlated with metres walked during the 6 minute walking test (r = \u2013 0.316; P < 0.01). Conclusion Combined use of confirmatory factor analysis and simple logistic models together with observations drawn from clinical experience constitutes a valid method for shortening a questionnaire while at the same time maintaining, if not improving, its psychometric properties. The QD-R, seems adequate to how much is required in rehabilitation to point out the outcome, in case of variation of depression, easily to fill in by the debilitated individual or elderly, mainly because some item excessively influenced by the pathology or the hospital context were removed

Evaluation of the effects of lime injection on the Electric Arc Furnace performances

In recent years, the pneumatic injection of lime in Electric Arc Furnaces by the use of insufflation lances has acquired interest in becoming a viable tool for the steelmaking industry, thanks to its surprising results in terms of raw materials consumption reduction, foaming benefits, operational cost benefits and improvement in environmental aspects. Acciaierie di Calvisano steelmaking plant, in collaboration with Unicalce S.p.A., decided to implement a new system of lime injection, in place of the traditional procedure, which is based on lime addition in lumps within the scrap bucket. The benefits of injecting lime in fine particles, compared to the standard technique were evaluated from energy, consumptions and emissions point of view. Data for more than 1200 heats was acquired and several slag samples were analyzed. Results showed considerable savings in electrical consumptions, oxygen, methane and lime, with an overall save of more than 4,500 t/year of equivalent CO2

Italian registry of patients with alpha-1 antitrypsin deficiency: General data and quality of life evaluation

Alpha1-antitrypsin Deficiency (AATD) is a rare hereditary disorder with an estimated prevalence of about 1/5000 individuals in Italy. Deficient patients are at a higher risk of developing lung emphysema and chronic liver disease. The low estimated prevalence of AATD prompted the establishment of a registry with the aim of learning more about the natural history and the quality of care of these patients. The Italian registry for AATD was established in 1996. In this study, genetic and clinical findings of Italian AATD patients are presented. Moreover, we also evaluated the changes in health-related quality of life (HRQoL) in patients with COPD and AAT deficiency over a three-year period, in relation to augmentation therapy. In a period spanning 18 years (1996-2014) a total of 422 adult subjects with severe AATD were enrolled, namely 258 PI*ZZ, 74 PI*SZ, 4 PI*SS and 86 patients with at least one rare deficient allele. The 21.3% frequency for AATD patients with at least one deficient rare variant is the highest so far recorded in national registries of AATD. The registry data allow a detailed characterization of the natural course of the disease and the level of patient care, as well as confirm the usefulness of early AATD detection