Psychotropic medication of acute episodes of mood disorders: Current prescription attitude in two psychiatric wards in Cagliari, Italy

Background: Medication of acute episodes of mood disorders has changed over the last decades following the results of randomized clinical trials. Objective: The aim of this study was to analyze medication prescribed at discharge from two psychiatric wards. We focused on hospitalization as one of the best opportunities to start prophylaxis. Methods: We examined retrospectively the clinical records of 357 patients hospitalized for mood episodes in two psychiatric wards in the Cagliari area (SPDC-1 and SPDC-2) between 1 January and 31 December 2016. We focused on the psychotropic medication prescribed at discharge from the hospital. Results: Most patients were discharged with antipsychotics (86%) and/or benzodiazepines (89%). Combined medication was frequent, including various co-administration of first-generation and/or second-generation antipsychotics (26% of patients), or antipsychotics combined with mood-stabilizers (51% of patients). There was a preferential prescription of first-generation antipsychotics in SPDC-1, and of second-generation antipsychotics in SPDC-2. Prescription of lithium was significantly more frequent in SPDC-1. Conclusion: Although the treatment was in line with randomized clinical trials, the choice of individual psychotropic agents differed significantly between the two wards. Different prescription attitudes can have consequences on the long-term outcome of patients discharged from the hospital after an acute mood episode

ARTIFICIAL AIR CAVITY AS ENERGY SAVING TECHNOLOGY

At a time when \u2018greenships\u2019 are going to become a must according to IMO requirements and looming restrictions against pollution at sea are entering into force, energy saving solutions are recommended. Minimization of environmental impact from ships is expected as a result of applied research in different fields: hull form design and propulsion, hybrid engine technology and fuel cells. The present paper is totally devoted to the reduction of resistance and powering obtained via hydrodynamic solution. Based on the results of thelatest investigations carried out at KSRC, pros and cons of the present level of Air Cavity System (ACS) technology are discussed. Economic advantage yielded by higher propulsion efficiency on an ACS-fitted ship is demonstrated through application on a standard container ship developed at conceptual design level.Two design solutions, that is, the \u2018standard ship\u2019 and the \u2018ACS-fitted ship\u2019, are then compared according to criteria such as powering performance, fuel consumption and shipping economics by simulating a round-voyage route

The role of set-shifting in auditory verbal hallucinations

BACKGROUND: Auditory verbal hallucinations (AVHs) are a cardinal characteristic of psychosis. Recent research on the neuropsychological mechanism of AVHs has focused on source monitoring failure, but a few studies have suggested the involvement of attention, working memory, processing speed, verbal learning, memory, and executive functions. In this study we examined the neuropsychological profile of patients with AVHs, assuming that the mechanism underlying this symptom could be a dysfunction of specific cognitive domains. METHODS: A large neuropsychological battery including set-shifting, working memory, processing speed, attention, fluency, verbal learning and memory, and executive functions was administered to 90 patients with psychotic disorders and 44 healthy controls. The group of patients was divided into two groups: 46 patients with AVHs in the current episode and 44 who denied auditory hallucinations or other modalities in the current episode. AVHs were assessed with the Psychotic Symptom Rating Scales (PSYRATS); the Launay-Slade Hallucination Scale was used to measure long-term propensity to auditory verbal hallucination-like experiences (HLEs) in the sample. RESULTS: Patients showed poorer performances on all neuropsychological measures compared to the healthy controls' group. In the original dataset without missing data (n=58), patients with AVHs (n=29) presented poorer set shifting and verbal learning, higher levels of visual attention, and marginally significant poorer semantic fluency compared to patients without AVHs (n=29). In the logistic model on the multiple imputed dataset (n=90, 100 imputed datasets), lower capacity of set shifting and semantic fluency distinguished patients with AVHs from those without them. CONCLUSIONS: Patients experiencing persistent AVHs might fail to shift their attention away from the voices; poorer semantic fluency could be a secondary deficit of set-shifting failure

Deficits in metaphor but not in idiomatic processing are related to verbal hallucinations in patients with psychosis

There is scant evidence that the verbal cognitive deficits observed in patients with psychosis are related to auditory verbal hallucinations. The understanding of metaphors and idiomatic expressions was investigated in a cohort of 90 patients with active psychosis, and in 44 healthy controls. The Psychotic Symptom Rating Scales (PSYRATS: verbal hallucinations subscale) was used to measure the current verbal hallucinations episode; a subscore of the Launay-Slade Hallucination Scale was used to measure long-term propensity to auditory verbal hallucination-like experiences (HLEs) in the sample. The concurrent influence of education, IQ, and cognitive functioning in memory, attention, fluency, and processing speed on metaphor and idioms processing was investigated. Patients performed worse than healthy controls on all neuropsychological measures. Metaphor, but not idioms processing was poorer in patients with verbal hallucinations (n=46) when compared to patients without verbal hallucinations in the current episode (n=44). By taking into account confounding variables, the ability to produce explanations of metaphors was related to scores on the verbal HLEs in the whole sample of patients. Metaphor-comprehension deficit was related to the occurrence of auditory verbal hallucinations in patients with psychosis, suggesting that abnormal pragmatic inferential abilities have an impact on the mechanisms that cause hallucinatory experience

"VelaMente?!" - Sailin in a crew to improve self-efficacy in people with psychosocial disabilities: A randomized controlled trial

Introduction: It has been proposed that sailing can improve quality of life, personal and social skills of people with severe psychosocial disabilities. This study aimed to assess the efficacy of a psychosocial rehabilitative intervention focused on sailing on quality of life, self-efficacy and sense of coherence in people with severe psychosocial disabilities. Methods: The study was a randomized, with parallel groups, waiting-list controlled trial. Participants were 51 people with severe psychosocial disabilities. The intervention was a structured course to learn sailing in a crew lasting three months. A randomized group began the sailing course immediately after a pre-treatment assessment; the waitlist group began the sailing course after a three months period of treatments as usual. Participants were assessed before and after the sailing course, or the waiting list period, on the General Self- Efficacy scale (GSES), Sense Of Coherence scale (SOC) and Health Survey-short form (SF-12). Results: Self-efficacy significantly increased after the sailing course and decreased after treatment as usual (p=0.015). Sense of coherence and the levels of quality of life tended to improve after the sailing course, albeit below levels of statistical significance. Conclusion: When compared to more traditional psychosocial rehabilitative activities, an intervention focused on sailing in a crew positively impacts the sense of coherence and the levels of quality of life and significantly improves self-efficacy of people with severe psychosocial disabilities. Further longitudinal research is required