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

Parâmetros de rugosidade aerodinâmica sobre vegetação esparsa em região semi-árida Aerodynamic roughness parameters over sparse vegetation in a semi-arid region

Utilizando observações micrometeorológicas e da estrutura física da vegetação do experimento HAPEX-Sahel foi possível avaliar alguns métodos para determinar o comprimento de rugosidade (z0) e o deslocamento do plano zero (d). Propõe-se também uma alternativa para estimar esses parâmetros em escoamentos atmosféricos sobre vegetação esparsa em região semi-árida. O método proposto combinou o perfil logarítmico do vento com z0 = lambda (h - d), em que, h é a altura da vegetação e lambda depende de sua estrutura física. Valores de lambda foram estimados em função da estrutura física da vegetação ou obtido na literatura. A altura média da vegetação era 2,06 (&plusmn; 0,47) m. O perfil do vento foi caracterizado por medidas a quatro níveis acima da superfície (3,0; 4,1; 5,3 e 8,5 m), com a velocidade de fricção (u*) determinada por correlações dos turbilhões a 9 m. O método proposto estimou adequadamente a rugosidade aerodinâmica da superfície com lambda = 0,188 e 0,190, determinados pela estrutura da vegetação local, o que não ocorreu para lambda = 0,166, da literatura. Os parâmetros de rugosidade determinados pelos métodos que utilizam u* na solução da lei logarítmica do vento descreveram melhor a rugosidade da superfície. Nos períodos de observações a rugosidade da área foi descrita satisfatoriamente por d = 0,95 m = 0,46 h e z0 = 0,204 m = 0,1 h.<br>Using micrometeorological observations and the physical structure of the vegetation during the HAPEX-Sahel experiment it was possible to evaluate some methods to determine the roughness length (z0) and the zero-plane displacement (d). It is also proposed an alternative to estimate such parameters for the atmospheric flow over sparse vegetation in a semi-arid region. It combines the wind logarithmic profile with z0 = lambda (h - d), where, h is the vegetation height, and lambda is a coefficient determined by the physical structure of the vegetation. Here, lambda values were determined for the site and also taken from the literature. The average vegetation height in the site was 2.06 (&plusmn; 0.47) m. The wind logarithmic profiles were defined by measurements at four level above the surface (at 3.0, 4.1, 5.3 and 8.5m), and the friction velocity (u*) determined by eddy correlations at 9 m. The proposed method estimated well the surface roughness with lambda = 0.188 and 0.190, both determined by the structure of the vegetation in the site, but failed with lambda = 0.166, the average value of literature. The roughness parameters determined by methods that used u* in the solution of the wind logarithmic law better described the surface roughness. The aerodynamic roughness of the site was described well by d = 0.95 m = 0.46 h and z0 = 0.204 m = 0.1 h