The autistic phenotype in Down syndrome: differences in adaptive behaviour versus Down syndrome alone and autistic disorder alone

The autistic phenotype in Down syndrome (DS) is marked by a characteristic pattern of stereotypies, anxiety and social withdrawal. Our aim was to study adaptive behaviour in DS with and without autistic comorbidity using the Vineland Adaptive Behaviour Scales(VABS), the Childhood Autism Rating Scales (CARS and the DSM IV-TR criteria. We assessed 24 individuals and established three groups: Down syndrome (DS), DS and autistic disorder(DS-AD), and autistic disorder (AD). The DS and DS-AD groups showed statistically significantly similar strengths on the VABS (in receptive and domestic skills). The DS and DS-AD subjects also showed similar strengths on the CARS (in imitation and relating), differing significantly from the AD group. The profile of adaptive functioning and symptoms in DS-AD seemed to be more similar to that found in DS than to the profile emerging in AD. We suggest that the comorbidity of austistic symptoms in DS hampered the acquisition of adaptive skills more than did the presence of DS alone

Use of different subjective health indicators to assess health inequalities in an urban immigrant population in north-western Italy: a cross-sectional study

BACKGROUND: Despite the steady growth of the immigrant population in Italy, data on the health status of immigrants are scarce. Our main goals were to measure Health-Related Quality of Life (HRQoL), Self-Rated Health (SRH) and morbidity among immigrants in Genoa. We aimed to assess the relative contribution of some social, structural and behavioral determinants to “within-group” health disparities. METHODS: We enrolled 502 subjects by means of snowball sampling. The SF-12 questionnaire, integrated with socio-demographic and health-related items, was used. Multivariate logistic and Poisson regression models were applied in order to identify characteristics associated with poor SRH, lower SF-12 scores and prevalence of self-reported morbidities. RESULTS: Subjects showed relatively moderate levels of HRQoL (median physical and mental scores of 51.6 and 47.3, respectively) and about 15% of them rated their health as fair or poor. Lower scores in the physical dimension of HRQoL were associated with the presence of morbidities and immigration for work and religious reasons, while those who had migrated for religious and family reasons displayed a lower probability of lower scores in the mental dimension of HRQoL. Poor SRH was associated with female gender, overweight/obesity and presence of morbidities. Moreover, compared with immigrants from countries with a low human development index, immigrants from highly developed societies showed significantly lower odds of reporting poor SRH. About one-third of respondents reported at least one medical condition, while the prevalence of multi-morbidity was 10%. Females, over 45-year-olds, overweight and long-term immigrants had a higher prevalence of medical conditions. CONCLUSIONS: Our study confirms the presence of health inequalities within a heterogeneous immigrant population. HRQoL, SRH and morbidity are valid, relatively rapid and cheap tools for measuring health inequalities, though they do so in different ways. These indicators should be used with caution and, if possible, simultaneously, as they could help to identify and to monitor more vulnerable subjects among immigrants

Applicazione dell'approccio BIM sul patrimonio costruito: il caso della Facoltà di Ingegneria

La metodologia BIM è ancora poco sviluppata nell’ambito strutturale, anche se ad oggi rappresenta un settore in forte sviluppo. L’obiettivo della tesi è quello di definire una metodologia di lavoro, che parte dalla fase di rilievo di una struttura esistente ed arriva sino alle verifiche dei suoi elementi, condotta attraverso la creazione di un modello BIM che verrà infine esportato ed elaborato in un software di calcolo agli elementi finiti. All'interno del modello BIM sono stati inseriti tutti i dati provenienti dalle indagini diagnostiche e dagli studi sulla vulnerabilità sismica dell'edificio, al fine di rendere il modello informativo la base conoscitiva, sia meccanica che diagnostica, della struttura affrontata nel caso studio, in modo tale da disporre di dati organizzati e completi per eventuali interventi futuri. Argomento rilevante quando si parla di BIM strutturale è il tema dell’interoperabilità, ovvero la possibilità di esportazione di un modello BIM in software BIM differenti o in software agli elementi finiti; in questo elaborato sono stati utilizzati i software Autodesk Revit per la modellazione BIM e Midas GEN per la modellazione FEM, e sono state affrontate le maggiori criticità riguardanti l'esportazione del modello e la lettura dei parametri creati su Revit una volta importato il modello su Midas Gen

Vision problems in Down syndrome adults do not hamper communication, daily living skills and socialisation

Vision problems in Down syndrome adults do not hamper communication, daily living skills and socialisatio

Stroke incidence and 30-day and six-month case fatality rates in Udine, Italy:a population-based prospective study

Background Stroke incidence in high-income countries is reported to decrease, and new data on stroke incidence and outcome are needed to design stroke services and to ameliorate stroke management. Methods This study is part of a two-year prospective community-based registry of all cerebrovascular events in the district of Udine (153 312 inhabitants), Friuli-Venezia Giulia region, northeast of Italy, between 1 April 2007 and 31 March 2009. Overlapping sources for case finding were used, combining hot and cold pursuit. Results We identified 784 stroke cases, 640 (81·6%) incident. The crude overall annual incidence rate per 100 000 residents was 256 (95% confidence interval 241–271) for all strokes and 209 (95% confidence interval 195–223) for first-ever strokes. Incidence rate for first-ever strokes was 181 (95% confidence interval 155–211) after adjustment to the 2007 Italian population and 104 (95% confidence interval 88–122) compared with the European standard population. Incidence rates for first-ever strokes was 215 (196–235) for women, 202 (183–223) for men. Crude annual incidence rates per 100 000 population were 167 (153–178) for ischemic stroke, 31 (26–37) for intracerebral hemorrhage, 8·1 (5·7–11·4) for sub-arachnoid hemorrage, and 4·6 (2·8–7·1) for undetermined stroke. Overall case fatality rates for first-ever stroke were 20·6% at 28 days and 30·2% at 180 days. Conclusions Our study shows incidence rates higher than previously reported in our region but not supporting the view of higher incidence rates in Northern than in Southern Italy. Results contribute to time-trends analysis on epidemiology, useful for dimensioning services in Italy and show the persistence of a gap between the outcome of stroke in Italy and that of the best performing European countries, urging to adopt better stroke management plans. </jats:sec

Incidence of transient ischemic attack and early stroke risk:validation of the ABCD2 score in an Italian population-based study

BACKGROUND AND PURPOSE: The importance of transient ischemic attack (TIA) lies on the short-term risk of stroke, and the ABCD2 score may improve early stroke risk prediction. However, population-based studies are still needed. We aimed to provide data on TIA incidence and to evaluate the ABCD2 predictive ability for early recurrent stroke in a population-based study. METHODS: This study is part of a 2-year prospective community-based registry of all cerebrovascular events in the district of Udine (153 312 inhabitants), Friuli Venezia Giulia region, northeast of Italy, between April 1, 2007 and March 31, 2009. Multiple overlapping sources for finding cases were used, combining hot and cold pursuit. RESULTS: We identified 178 TIA, 161 (90.4%) of which were incident. The crude overall annual TIA incidence rate per 1000 residents was 0.52 (95% confidence interval [CI], 0.45-0.61). Incidence rate was 0.45 (95% CI, 0.31-0.65) when standardized to the 2007 Italian population and 0.25 (95% CI, 0.16-0.39) when standardized to the European standard population. Estimates of stroke risk after the index TIA within 2, 7, 30, and 90 days were, respectively, 2.5% (95% CI, 0.7-6.2), 5.6% (95% CI, 2.6-10.3), 6.2% (95% CI, 3.0-11.1), and 11.2% (95% CI, 6.8-17.1). ABCD2 score was strongly associated with stroke occurrence after index TIA: the areas under the receiver operating characteristic curve at 2, 7, 30, and 90 days were, respectively, 0.85 (95% CI, 0.72-0.97), 0.69 (95% CI, 0.56-0.82), 0.69 (95% CI, 0.56-0.85), and 0.76 (95% CI, 0.67-0.86). No patients with an ABCD2 score <4 had a stroke within the 90-day follow-up period. CONCLUSIONS: This study adds new data on TIA incidence and prognosis and it further validates the ability of the ABCD2 score to identify patients at early risk for stroke

Vision problems in Down syndrome adults do not hamper communication, daily living skills and socialisation

Vision problems in Down syndrome adults do not hamper communication, daily living skills and socialisatio