Analysis and design of a high efficiency 2A step-up charge pump

This charge pump is realized with 0.13um BCD technology and the specifications required are: • input voltage 2.5-3.4 V • charge pump ratio 1.5 • charge pump required efficiency (above 95% if possible otherwise just adjust the requirement). • max output current 2A • soft start-up with current limiter • occupation area comparable with the boost converter`s area • switch frequency 1/2MH

Sexual masochism disorder with asphyxiophilia: a deadly yet underrecognized disease

DSM-5 distinguishes between paraphilias and paraphilic disorders. Paraphilias are defined as atypical, yet not necessarily disordered, sexual practices. Paraphilic disorders are instead diseases, which include distress, impairment in functioning, or entail risk of harm one's self or others. Hence, DSM-5 new approach to paraphilias demedicalizes and destigmatizes unusual sexual behaviors, provided they are not distressing or detrimental to self or others. Asphyxiophilia, a dangerous and potentially deadly form of sexual masochism involving sexual arousal by oxygen deprivation, are clearly described as disorders. Although autoerotic asphyxia has been associated with estimated mortality rates ranging from 250 to 1000 deaths per year in the United States, in Italy, knowledge on this condition is very poor. Episodes of death caused by autoerotic asphyxia seem to be underestimated because it often can be confounded with suicide cases, particularly in the Italian context where family members of the victim often try to disguise autoerotic behaviors of the victims. The current paper provides a review on sexual masochism disorder with asphyxiophilia and discusses one specific case as an example to examine those conditions that may or may not influence the likelihood that death from autoerotic asphyxia be erroneously reported as suicide or accidental injury

L'impatto della pandemia Covid-19 sulle nuove strutture psichiatrico-forensi in Italia

After the closure of Psychiatric Hospitals (OPs), in 2012 the Italian Government decided to close the High Security Psychiatric Hospitals (OPGs). Law 81/2014 established that each region would provide smaller forensic psychiatry facilities, theREMS (Residence for the Execution of the Security Measures), to accommodate socially dangerous NGRI (Not Guilty by Reason of Insanity) offenders. The main characteristic of a REMS is that it is purely therapeutic and rehabilitative in naturewhile remaining a custodial safety measure. The COVID-19 pandemic undoubtedly tested the organization of these new Italian forensic psychiatry facilities whose practices were not yet fully established, forcing them to ensure patient safety during lockdown amidst the epidemic. The Chapter V Constitutional reform which assigned each region exclusive competence for health policies in its own territory, once the prerogative of the central government, was also put to the test. To assess the impact of the pandemic on the new forensic care system in Italy, we conducted a semi-structured interview with REMS health professionals from various regions with differing levels of contagion: the Poli REMS di Castiglione delle Stiviere; the REMS of Volterra; the REMS of Carovigno and the REMS of Pisticci. The interview assessed how the rehabilitation objectiveshad been met notwithstanding the serious operational limitations consequent to COVID-19 related decisions by the authorities.Dopo la chiusura degli Ospedali Psichiatrici (OP), nel 2012 il Governo Italiano ha deciso di chiudere gli Ospedali Psichiatrici Giudiziari, gli OPG. La legge 81/2014 stabiliva che ogni regione avrebbe dovuto prevedere l’istituzione di strutture psichiatrico-forensi più piccole, le REMS (Residenze per la Esecuzione delle Misure di Sicurezza), per accogliere gli autori di reatonon imputabili, socialmente pericolosi. La caratteristica principale delle REMS è quella di avere una natura prettamente terapeutica e riabilitativa pur rimanendo una misura di sicurezza detentiva. Non c’è dubbio che la pandemia COVID-19 abbia messo alla prova l’organizzazione delle nuove strutture psichiatrico-forensi italiane, con prassi ancora non del tutto consolidate, costringendo le REMS durante il lock-down ad adoperarsi per gestire l’epidemia, garantendo al tempo stesso la sicurezza dei pazienti. In questo contesto è stata messa alla prova anche la riforma del Capitolo V della Costituzione, che assegnava a ciascuna Regione la competenza esclusiva per le politiche sanitarie del proprio territorio, un tempo prerogativa del governo centrale. Alla luce di ciò, per valutare l’impatto della pandemia sul nuovo sistema di assistenza forense in Italia, abbiamo condotto un’intervista strutturata con gli operatori sanitari delle REMS di diverse regioni con diversi livelli di diffusione della malattia: la Poli REMS di Castiglione delle Stiviere; la REMS di Volterra; la REMS di Carovigno e la REMS di Pisticci. L’intervista ha valutato come gli obiettivi riabilitativi fossero stati garantiti nonostante i gravi limiti operativi conseguenti alle decisioni delle autorità determinate dal COVID-19

Drinking wine to "get high": the influence of awareness of the negative effects among young adults.

Introduction In a group of university students, the current study investigated the relationship between drinking wine to get high and the awareness about its characteristics, composition, positive and negative effects on health. Methods Through a web-based survey, 1685 students at the University of Siena completed a self-report questionnaire to assess consumption behaviours, knowledge about wine and the awareness about its effects. Results Seventy-three percent reported drinking wine. Males were more frequently wine consumers (p = 0.037). Among the students who reported drinking, 69.3% engaged this habit during the weekend. Almost 12% reported drinking wine to get high. Drinking wine to get high correlated with the consideration of its consumption: using this beverage to get high was strongly associated with considering wine like other spirits (p = 0.033). Conclusions Older age, female gender, and considering wine as a part of the diet were found to be protective factors against wine drinking-to get high. In contrast with some literature, awareness of the negative effects correlated with higher propensity to use wine to get high. Potential interpretations and limitations are addressed

Neuroticism and Conscientiousness Moderate the Effect of Oral Medication Beliefs on Adherence of People with Mental Illness during the Pandemic

Background. After the declaration of the pandemic status in several countries, the continuity of face-to-face visits in psychiatric facilities has been delayed or even interrupted to reduce viral spread. Little is known about the personality factors associated with medication beliefs and adherence amongst individuals with mental illness during the COVID-19 pandemic. This brief report describes a preliminary naturalistic longitudinal study that explored whether the Big Five personality traits prospectively moderate the effects of medication beliefs on changes in adherence during the pandemic for a group of outpatients with psychosis or bipolar disorder. Methods. Thirteen outpatients undergoing routine face-to-face follow-up assessments during the pandemic were included (41 observations overall) and completed the Revised Italian Version of the Ten-Item Personality Inventory, the Beliefs about Medicines Questionnaire, the Morisky Medication Adherence Scale-8-item and the Beck Depression Inventory-II. Results. Participants had stronger concerns about their psychiatric medications rather than beliefs about their necessity, and adherence to medications was generally low. Participants who had more necessity beliefs than concerns had better adherence to medications. People scoring higher in Conscientiousness and Neuroticism traits and more concerned about the medication side effects had poorer adherence. Conclusions. These preliminary data suggest the importance of a careful assessment of the adherence to medications amongst people with psychosis/bipolar disorder during the pandemic. Interventions aimed to improve adherence might focus on patients' medication beliefs and their Conscientiousness and Neuroticism personality traits

The PANGEA project: a qualitative analysis for Intimate Partner Violence through anti violence workers during COVID-19 pandemic : Il progetto PANGEA: un’analisi qualitativa dell’Intimate Partner Violence attraverso i lavoratori della rete antiviolenza durante la pandemia da COVID-19

Intimate Partner Violence (IPV) is the most difficult gender-based violence’s form to identify and to stop. The pandemic conditions may have caused an increase of this form but it is difficult to measure. The anti-violence workers could be a valuable and reliable source to obtain informations about women and working conditions during the pandemic. Tuscany region is suitable to conduct this study because has an high rate of IPV and had a long period of lockdown. Thanks to the regional interest it was possible to make a project able to study many aspects of this phenomenon. In the first phase, described in this article, it was possible to understand the major sentiments, emotions, feelings and moods of the anti-violence workers respect of the issues in question.La violenza di genere è un fenomeno molto frequente e l’Intimate Partner Violence (IPV) è la forma più difficile da identificare e contrastare. Le condizioni pandemiche potrebbero aver causato un incremento di questa forma, ma misurarla risulta estremamente complesso. Gli operatori anti violenza sono delle valide ed affidabili risorse per ottenere informazioni riguardo alle condizioni delle donne, ma anche riguardo alle condizioni lavorative durantela pandemia. Considerando che la regione toscana ha un alto tasso di IPV e che in questa regione il lockdown è durato a lungo, è una delle migliori regioni in Italia dove condurre uno studio di questo tipo. Grazie all’interesse mostrato dalla regione è stato possibile iniziare un progetto in grado di valutare molti aspetti di questo fenomeno. Nella prima fase, che sarà descritta in questo articolo, è possibile comprendere i principali sentimenti, emozioni,stati d’animo e atteggiamenti degli operatori anti violenza rispetto alle tematiche in questione

Patterns of recurrences in sinonasal cancers undergoing an endoscopic surgery-based treatment: Results of the MUSES* on 940 patients: *MUlti-institutional collaborative Study on Endoscopically treated Sinonasal cancers

The improvements in survival with expansion of the survivors' population, along with evolution of endoscopically-based treatment modalities, have contributed to emphasize the clinical relevance of recurrences in sinonasal cancers. However, at present, literature is scant regarding the pattern of recurrences and the therapeutic strategies available to manage long survivors who experienced single or multiple failures. The aim of the present study was to analyze sinonasal cancers recurrences to provide data regarding rates and patterns of relapse, predictors of failure and prognostic impact of the recurrence

Mobile opportunity against stress: Open study protocol on the effectiveness of a mobile platform for stress self-management in the post-pandemic era

Mobile health platforms have shown promise in the management of various mental health conditions (including stress, anxiety, and depression) and cognitive behavioral strategies emerged as a popular and effective option offered by the platforms. This paper presents the protocol of a study aimed to test the effectiveness of a mobile platform that uses cognitive-behavioral strategies for stress self-management in the Tuscany region (Italy). The mobile app is adapted to the specific needs of each vulnerable population for which it is designed: young and older people, healthcare professionals, entrepreneurs. The app will be evaluated on the following outcomes: (i) perceived susceptibility and severity of the pandemic situation, perceived benefits, and costs of preventive health behaviors, (ii) knowledge about Covid-19 preventive behaviors and negative consequences of social distancing, (iii) stress and psychopathological symptoms (i.e., anxiety, depression, and post-traumatic stress symptoms) and cognitive distortions. If successful, we expect that the platform could give various groups clinical benefits by providing symptom self-monitoring and early intervention, consolidating the number of mental health programs available, and decreasing barriers to treatment-seeking. This population-level approach has the potential to improve mental health outcomes in pandemic periods for many people

Capitolo 8: Informazione del paziente e consenso informato.

Il consenso informato è la manifestazione della volontà, consapevole e giuridicamente valida, con la quale l'individuo rinuncia alla tutela di un diritto del quale dispone, escludendo così la punibilità di chi lo sta per violare, esprimendo il proprio consenso all'esecuzione di un trattamento diagnostico terapeutico; ma affinche possa disporre di questo diritto, deve averne la piena disponibilità, deve quindi essere maggiore di età e capace di intendere e di volere