Main clinical features in patients at their first psychiatric admission to Italian acute hospital psychiatric wards. The PERSEO study

BACKGROUND: Few data are available on subjects presenting to acute wards for the first time with psychotic symptoms. The aims of this paper are (i) to describe the epidemiological and clinical characteristics of patients at their first psychiatric admission (FPA), including socio-demographic features, risk factors, life habits, modalities of onset, psychiatric diagnoses and treatments before admission; (ii) to assess the aggressive behavior and the clinical management of FPA patients in Italian acute hospital psychiatric wards, called SPDCs (Servizio Psichiatrico Diagnosi e Cura = psychiatric service for diagnosis and management). METHOD: Cross-sectional observational multi-center study involving 62 Italian SPDCs (PERSEO – Psychiatric EmeRgency Study and EpidemiOlogy). RESULTS: 253 FPA aged <= 40 were identified among 2521 patients admitted to Italian SPDCs over the 5-month study period. About half of FPA patients showed an aggressive behavior as defined by a Modified Overt Aggression Scale (MOAS) score greater than 0 Vs 46% of non-FPA patients (p = 0.3651). The most common was verbal aggression, while about 20% of FPA patients actually engaged in physical aggression against other people. 74% of FPA patients had no diagnosis at admission, while 40% had received a previous psychopharmacological treatment, mainly benzodiazepines and antidepressants. During SPDC stay, diagnosis was established in 96% of FPA patients and a pharmacological therapy was prescribed to 95% of them, mainly benzodiazepines, antipsychotics and mood stabilizers. CONCLUSION: Subjects presenting at their first psychiatric ward admission have often not undergone previous adequate psychiatric assessment and diagnostic procedures. The first hospital admission allows diagnosis and psychopharmacological treatment to be established. In our population, aggressive behaviors were rather frequent, although most commonly verbal. Psychiatric symptoms, as evaluated by psychiatrists and patients, improved significantly from admission to discharge both for FPA and non-FPA patients

Clinical features and therapeutic management of patients admitted to Italian acute hospital psychiatric units: the PERSEO (psychiatric emergency study and epidemiology) survey

<p>Abstract</p> <p>Background</p> <p>The PERSEO study (psychiatric emergency study and epidemiology) is a naturalistic, observational clinical survey in Italian acute hospital psychiatric units, called SPDCs (Servizio Psichiatrico Diagnosi e Cura; in English, the psychiatric service for diagnosis and management). The aims of this paper are: (i) to describe the epidemiological and clinical characteristics of patients, including sociodemographic features, risk factors, life habits and psychiatric diagnoses; and (ii) to assess the clinical management, subjective wellbeing and attitudes toward medications.</p> <p>Methods</p> <p>A total of 62 SPDCs distributed throughout Italy participated in the study and 2521 patients were enrolled over the 5-month study period.</p> <p>Results</p> <p>Almost half of patients (46%) showed an aggressive behaviour at admission to ward, but they engaged more commonly in verbal aggression (38%), than in aggression toward other people (20%). A total of 78% of patients had a psychiatric diagnosis at admission, most frequently schizophrenia (36%), followed by depression (16%) and personality disorders (14%), and no relevant changes in the diagnoses pattern were observed during hospital stay. Benzodiazepines were the most commonly prescribed drugs, regardless of diagnosis, at all time points. Overall, up to 83% of patients were treated with neuroleptic drugs and up to 27% received more than one neuroleptic either during hospital stay or at discharge. Atypical and conventional antipsychotics were equally prescribed for schizophrenia (59 vs 65% during stay and 59 vs 60% at discharge), while atypical drugs were preferred in schizoaffective psychoses (72 vs 49% during stay and 70 vs 46% at discharge) and depression (41 vs 32% during stay and 44 vs 25% at discharge). Atypical neuroleptics were slightly preferred to conventional ones at hospital discharge (52 vs 44%). Polypharmacy was in general widely used. Patient attitudes toward medications were on average positive and self-reported compliance increased during hospital stay.</p> <p>Conclusion</p> <p>Results confirm the widespread use of antipsychotics and the increasing trend in atypical drugs prescription, in both psychiatric in- and outpatients.</p

Observations of correlated behaviour of stratospheric ozone and aerosol at Thule during winter 1991-1992

A lidar has been installed in Thule, Greenland, by the University of Rome in the fall of 1990. Intensive series of aerosol measurements have been carried out in the period early December 1991 – early March 1992, in the context of the European Arctic Stratospheric Ozone Experiment (EASOE). In the same period, several ozonesondes have been launched by the Danish Meteorological Institute. The arctic stratosphere appears loaded with aerosol following the Mt. Pinatubo eruption of June 1991. Scattering ratios as high as 5 have been observed. Both the aerosol and ozone profiles display a layered structure, with a large variability: the aerosol and ozone contents in the layers frequently appear to be negatively correlated, particularly in the height region around 16 km. Fluctuations of the ozone content as high as 50% of the average value have been observed in levels where aerosol layers are present. These results bear a relation to those obtained in past studies of the Mount Agung and El Chichón eruptions, and in observations of Polar Stratospheric Clouds obtained at South Pole

Backscatter measurements of stratospheric aerosols at Thule during January-February 1992

Within the European Arctic Stratospheric Ozone Experiment (EASOE) aerosols from the volcanic eruption of Mt. Pinatubo have been observed during 6 balloonborne backscatter soundings in January and February 1992 under different polar vortex conditions from Thule, Greenland. The vortex boundary seemed to retard stratospheric aerosol mixing into the inner parts of the vortex from lower latitudes; however, when Thule was outside the vortex large aerosol loadings were measured. The aerosols were simultaneously observed by groundbased lidar, whereby aerosol backscatter measurements in three different wavelengths made it possible to obtain information about the particle sizes. Parameters of lognormal distributions have been derived, using a least square approach between observed and calculated backscatter coefficients from Mie theory. The aerosol surface area density was increased by factors 10–50, compared to the background levels at pre‐volcanic conditions

50 Years of Teaching and Research Trends at the Faculty of Economics of the Università Politecnica delle Marche

The chapter aims to provide an overview of the research and teaching activities carried out at the Faculty of Economics of the Università Politecnica delle Marche over the last 50 year

Productivity Differentiation and International Specialization of Firms and Districts

This paper provides an overview of three lines of research that have been developed under an empirical micro-level perspective by scholars of the Ancona school of economics. First, the tendency toward an endogenous productivity dispersion in later developing economies is assessed from an entrepreneurial perspective, i.e. the amount and distribution of organizational and entrepreneurial abilities during the catching-up process. Second, the features and dynamics of a country specialization pattern are analyzed within the processes of upgrading of the production structures toward more complex and growth-generating models. Finally, the role and influence on firm performance of localization economies and different styles of corporate governance have been studied by framing them into the wider picture of firm organizational models and the hierarchical structure of market transactions. The paper concludes with a brief discussion of potential avenues for future research