Prevalence of depression and its associated factors among elderly patients in outpatient clinic of Universiti Sains Malaysia Hospital.

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Imran, A; Azidah, A K; Asrenee, A R; Rosediani, M

2009-06-01

Depression among elderly primary care patients is a serious problem with significant morbidity and mortality. This is a cross sectional study to determine the prevalence of depression and its associated factors among the elderly patients attending the outpatient clinic, Universiti Sains Malaysia Hospital. This study utilized Malay version Geriatric Depression Scale 14 (M-GDS 14) to screen for elderly depression among Malaysian population. It also looked into associated risk factors for elderly depression using sociodemographic, family dynamics, and medically related questionnaires. Out of 244 subjects, 34 or 13.9% were found to have depression. Three variables were found to be significantly associated with depression. Elderly patient with any illness that limits the patient's activity or mobility has more risk of developing depression (OR 2.68 CI 1.15 - 6.24). Elderly patients who were satisfied with their personal incomes (OR 0.29 CI 0.10 - 0.85), and who had children or son/daughter-in-law to take care of them when they are sick (OR 0.10 CI 0.01 - 0.83) have a lower chance of having depression. Screening the elderly for depression, would help in diagnosing the elderly depression better and offer them the treatment needed.

Clinical manifestations of primary hyperthyroidism in the elderly patients at the out-patient clinic of Srinagarind Hospital.

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Limpawattana, Panita; Sawanyawisut, Kittisak; Mahankanukrau, Ajanee; Wongwipaporn, Chaiyasit

2006-02-01

The authors reviewed the outpatient charts diagnosed as hyperthyroidism at Srinagarind Hospital from June 1998-June 2004. The objective was to compare the clinical features of hyperthyroidism in patients older and younger than 60 years old. There were 922 cases enrolled, 84 cases (9.11%) were 60 years old and above. The female: male ratio was 3.4:1 and 4:1 and the mean ages were 64.2 +/- 3.7 and 37.4 +/- 11.2 years old in the elder and younger group, respectively. The common presentations were dyspnea (94.1, 96.5%), weight loss (93.8, 87.9%) and palpitation (83.3, 93.1%) in the elder and younger, respectively. The more significant clinical presentations in the elder group were atrial fibrillation, weakness and anorexia whereas exophthalmos, goiter, heat intolerance and hyperhidrosis were not as frequent. Thus, the classic presentations often lacked in the elder group. Therefore, unexplained AF, weakness and anorexia should not exclude hyperthyroidism even with paucity of typical clinical features.

Prediction of critical illness in elderly outpatients using elder risk assessment: a population-based study

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Biehl M

2016-06-01

receiver operating characteristic curve was 0.75, which indicated good discrimination. Conclusion: A simple model based on easily obtainable administrative data predicted critical illness in the next 2 years in elderly outpatients with up to 14% of the highest risk population suffering from critical illness. This model can facilitate efficient enrollment of patients into clinical programs such as care transition programs and studies aimed at the prevention of critical illness. It also can serve as a reminder to initiate advance care planning for high-risk elderly patients. External validation of this tool in different populations may enhance its generalizability. Keywords: aged, prognostication, critical care, mortality, elder risk assessment

The influence of patients' complexity and general practitioners' characteristics on referrals to outpatient health services in an Italian region

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Francesca Valent

2015-09-01

Full Text Available BACKGROUND. Patient referrals to outpatient health services may affect both health outcomes and health expenditures. General practitioners (GP have a crucial role in driving the use of outpatient services and recognizing factors which affect referrals is important for health managers and planners. OBJECTIVES. We investigated patient- and physician-related determinants of patient referrals in an Italian region. METHODS. This was cross-sectional study based on the individual linkage of administrative databases from the health information system of the Friuli Venezia Giulia region. For each GP of the region, the association of the number of patient referrals to different types of outpatient services with the proportion of patients with chronic conditions, with the number of hospital admissions and drug prescriptions in 2012, and with GP's characteristics was investigated through multilevel multivariable Poisson regression models. RESULTS. Some chronic conditions (e.g., cancer, autoimmune diseases, endocrine diseases, digestive system diseases were positively associated with the number of referrals, as were hospital admissions and drug prescriptions. Time since GP's graduation was inversely related with referrals. CONCLUSION. Patient complexity and GP's experience affect referral rates. These factors should be considered in case of a reorganization of the general practice structure in Friuli Venezia Giulia.

Delirium assessment in hospitalized elderly patients: Italian translation and validation of the nursing delirium screening scale.

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Spedale, Valentina; Di Mauro, Stefania; Del Giorno, Giulia; Barilaro, Monica; Villa, Candida E; Gaudreau, Jean D; Ausili, Davide

2017-08-01

Delirium has a high incidence pathology associated with negative outcomes. Although highly preventable, half the cases are not recognized. One major cause of delirium misdiagnosis is the absence of a versatile instrument to measure it. Our objective was to translate the nursing delirium screening scale (Nu-DESC) and evaluate its performance in Italian settings. This was a methodological study conducted in two sequential phases. The first was the Italian translation of Nu-DESC through a translation and back-translation process. The second aimed to test the inter-rater reliability, the sensibility and specificity of the instrument on a convenience sample of 101 hospitalized elderly people admitted to relevant wards of the San Gerardo Hospital in Monza. To evaluate the inter-rater reliability, two examiners tested Nu-DESC on 20 patients concurrently without comparison. To measure the sensibility and specificity of Nu-DESC, the confusion assessment method was used as a gold standard measure. The inter-rater reliability (Cohen Kappa) was 0.87-an excellent agreement between examiners. The study of the ROC curve showed an AUC value of 0.9461 suggesting high test accuracy. Using 3 as a cut-off value, Nu-DESC showed 100 % sensibility and 76 % specificity. Further research is needed to test Nu-DESC on a larger sample. However, based on our results, Nu-DESC can be used in research and clinical practice in Italian settings because of its very good and similar performances to previous validation studies. The value of 3 appears to be the optimal cut-off in the Italian context.

Prevalence and conversion to dementia of Mild Cognitive Impairment in an elderly Italian population.

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Limongi, Federica; Siviero, Paola; Noale, Marianna; Gesmundo, Antonella; Crepaldi, Gaetano; Maggi, Stefania

2017-06-01

Mild Cognitive Impairment (MCI) represents a significant risk factor for dementia but there are only a few Italian population studies on its prevalence and its rate of conversion to dementia. Aim of this study was to assess the prevalence of MCI, its subtypes, and rates of conversion to dementia 1 year later in an elderly Italian population. The data are based on an Italian multicenter population-based cohort study with both cross-sectional and longitudinal components. Two thousand three hundred thirty-seven individuals over 65 underwent screening, clinical confirmation and 1-year follow-up. The prevalence of MCI was 21.6% and the amnestic multiple domain was the most frequent subtype (63.2%). The conversion rate to dementia was 4.1% and was found only in the amnestic multiple domain and in the unclassifiable subjects, persons with cognitive deficit but neither demented nor with MCI. The prevalence of MCI in this population sample was similar to that found in other population studies using Petersen's modified MCI criteria as well as his original criteria. With regard to conversion to dementia, our results emphasize the importance to better classify the unclassifiable subjects at high risk of progression to dementia and also at risk of being undiagnosed and untreated. MCI is characterized by extreme variability and instability. Data on the prevalence and the rate of conversion from MCI to dementia are difficult to compare given the important differences from study to study especially with regard to the diagnostic criteria utilized and their operationalization.

Urban-hazard risk analysis: mapping of heat-related risks in the elderly in major Italian cities.

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Morabito, Marco; Crisci, Alfonso; Gioli, Beniamino; Gualtieri, Giovanni; Toscano, Piero; Di Stefano, Valentina; Orlandini, Simone; Gensini, Gian Franco

2015-01-01

Short-term impacts of high temperatures on the elderly are well known. Even though Italy has the highest proportion of elderly citizens in Europe, there is a lack of information on spatial heat-related elderly risks. Development of high-resolution, heat-related urban risk maps regarding the elderly population (≥ 65). A long time-series (2001-2013) of remote sensing MODIS data, averaged over the summer period for eleven major Italian cities, were downscaled to obtain high spatial resolution (100 m) daytime and night-time land surface temperatures (LST). LST was estimated pixel-wise by applying two statistical model approaches: 1) the Linear Regression Model (LRM); 2) the Generalized Additive Model (GAM). Total and elderly population density data were extracted from the Joint Research Centre population grid (100 m) from the 2001 census (Eurostat source), and processed together using "Crichton's Risk Triangle" hazard-risk methodology for obtaining a Heat-related Elderly Risk Index (HERI). The GAM procedure allowed for improved daytime and night-time LST estimations compared to the LRM approach. High-resolution maps of daytime and night-time HERI levels were developed for inland and coastal cities. Urban areas with the hazardous HERI level (very high risk) were not necessarily characterized by the highest temperatures. The hazardous HERI level was generally localized to encompass the city-centre in inland cities and the inner area in coastal cities. The two most dangerous HERI levels were greater in the coastal rather than inland cities. This study shows the great potential of combining geospatial technologies and spatial demographic characteristics within a simple and flexible framework in order to provide high-resolution urban mapping of daytime and night-time HERI. In this way, potential areas for intervention are immediately identified with up-to-street level details. This information could support public health operators and facilitate coordination for heat

Urban-hazard risk analysis: mapping of heat-related risks in the elderly in major Italian cities.

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Marco Morabito

Full Text Available Short-term impacts of high temperatures on the elderly are well known. Even though Italy has the highest proportion of elderly citizens in Europe, there is a lack of information on spatial heat-related elderly risks.Development of high-resolution, heat-related urban risk maps regarding the elderly population (≥ 65.A long time-series (2001-2013 of remote sensing MODIS data, averaged over the summer period for eleven major Italian cities, were downscaled to obtain high spatial resolution (100 m daytime and night-time land surface temperatures (LST. LST was estimated pixel-wise by applying two statistical model approaches: 1 the Linear Regression Model (LRM; 2 the Generalized Additive Model (GAM. Total and elderly population density data were extracted from the Joint Research Centre population grid (100 m from the 2001 census (Eurostat source, and processed together using "Crichton's Risk Triangle" hazard-risk methodology for obtaining a Heat-related Elderly Risk Index (HERI.The GAM procedure allowed for improved daytime and night-time LST estimations compared to the LRM approach. High-resolution maps of daytime and night-time HERI levels were developed for inland and coastal cities. Urban areas with the hazardous HERI level (very high risk were not necessarily characterized by the highest temperatures. The hazardous HERI level was generally localized to encompass the city-centre in inland cities and the inner area in coastal cities. The two most dangerous HERI levels were greater in the coastal rather than inland cities.This study shows the great potential of combining geospatial technologies and spatial demographic characteristics within a simple and flexible framework in order to provide high-resolution urban mapping of daytime and night-time HERI. In this way, potential areas for intervention are immediately identified with up-to-street level details. This information could support public health operators and facilitate coordination for heat

[Kennedy V Axis assessment in an Italian outpatient and inpatient population].

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Mundo, Emanuela; Bonalume, Laura; Del Corno, Franco; Madeddu, Fabio; Lang, Margherita

2010-01-01

Kennedy Axis V or K Axis acts is an alternative tool to the DSM-IVTR Global Assessment of Functioning (GAF) Scale, that many researchers describe as a scale with poor inter-rater reliability and clinical utility. Unlike the GAF scale, K Axis provides a multidimensional and multiaxial approach to measure personal, social and interpersonal functioning in psychiatric outpatients and inpatients. In this study, we examined K Axis's inter-raters reliability by using it with an Italian clinical population. Clinicians used Kennedy Axis V to assess global functioning among 180 inpatients, in 9 psychiatric services in Lombardia and Piemonte. Patients were divided into 4 different diagnostic groups, according to the DSM-IV-TR criteria. Intraclass correlations between two independent raters's scores reveal high level of interrater reliability for all K Axis scales (0,633 < ICC < 0,813). Highly significant results in the Kruskal-Wallis test demonstrate that the patient diagnosis influence all the scales scores. Significant differences in patients functioning profiles in all K Axis scales, apart from Violence one, were noted between different diagnosis groups. In this study high level of raters agreement was noted, even if K Axis scales were used in different mental health services from different clinicians. K Axis scales provide a useful profile of patient global functioning, in line with the specific pathology.

Interrelationship among the health-related and subjective quality of life, daily life activities, instrumental activities of daily living of community-dwelling elderly females in orthopedic outpatients.

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Takemasa, Seiichi; Nakagoshi, Ryoma; Uesugi, Masayuki; Inoue, Yuri; Gotou, Makoto; Naruse, Susumu; Nanba, Yoshihumi

2017-05-01

[Purpose] This study aimed to examine the health-related and subjective quality of life of community-dwelling elderly females in orthopedic outpatients, and also examined how such quality of life correlate with their daily life activities and instrumental activities of daily living. [Subjects and Methods] Subjects were 27 community-dwelling elderly females in orthopedic outpatients (mean age: 76.3 ± 7.4 years). Their health-related quality of life and subjective quality of life, life-space assessment, frenchay activities index were researched. [Results] For the relationships between the total subjective quality of life scores and health-related quality of life scores, significant positive correlations were observed for body pain, general health, vitality, social functions and mental health. The correlations were not statistically significant between the subjective quality of life scores and the life-space assessment and frenchay activities index scores. The correlations were statistically significant between some health-related quality of life scores and the life-space assessment and frenchay activities index scores. [Conclusion] The results suggest that supporting community-dwelling elderly females in orthopedic outpatients to improve their sense of physical and mental well-being, and prevent and reduce their depression and physical pain, is required in order to improve their QOL.

Blood pressure associates with standing balance in elderly outpatients.

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Jantsje H Pasma

Full Text Available OBJECTIVES: Assessment of the association of blood pressure measurements in supine and standing position after a postural change, as a proxy for blood pressure regulation, with standing balance in a clinically relevant cohort of elderly, is of special interest as blood pressure may be important to identify patients at risk of having impaired standing balance in routine geriatric assessment. MATERIALS AND METHODS: In a cross-sectional cohort study, 197 community-dwelling elderly referred to a geriatric outpatient clinic of a middle-sized teaching hospital were included. Blood pressure was measured intermittently (n = 197 and continuously (subsample, n = 58 before and after a controlled postural change from supine to standing position. The ability to maintain standing balance was assessed during ten seconds of side-by-side, semi-tandem and tandem stance, with both eyes open and eyes closed. Self-reported impaired standing balance and history of falls were recorded by questionnaires. Logistic regression analyses were used to examine the association between blood pressure and 1 the ability to maintain standing balance; 2 self-reported impaired standing balance; and 3 history of falls, adjusted for age and sex. RESULTS: Blood pressure decrease after postural change, measured continuously, was associated with reduced ability to maintain standing balance in semi-tandem stance with eyes closed and with increased self-reported impaired standing balance and falls. Presence of orthostatic hypotension was associated with reduced ability to maintain standing balance in semi-tandem stance with eyes closed for both intermittent and continuous measurements and with increased self-reported impaired standing balance for continuous measurements. CONCLUSION: Continuous blood pressure measurements are of additional value to identify patients at risk of having impaired standing balance and may therefore be useful in routine geriatric care.

Age- and risk-related appropriateness of the use of available influenza vaccines in the Italian elderly population is advantageous: results from a budget impact analysis.

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Barbieri, M; Capri, S; Waure, C DE; Boccalini, S; Panatto, D

2017-12-01

Nowadays, four different types of influenza vaccines are available in Italy: trivalent (TIV), quadrivalent (QIV), MF59-adjuvanted (aTIV) and intradermal TIV (idTIV) inactivated vaccines. Recently, a concept of the appropriateness (i.e. according to the age and risk factors) of the use of different vaccines has been established in Italy. We conducted a budget impact analysis of switching to a policy, in which the Italian elderly (who carry the major disease burden) received the available vaccines according to their age and risk profile. A novel budget impact model was constructed with a time horizon of one influenza season. In the reference scenario the cohort of Italian elderly individuals could receive either available vaccine according to 2017/18 season market share. The alternative scenario envisaged the administration of TIV/QIV to people aged 65-74 years and at low risk of developing influenza-related complications, while aTIV/idTIV were allocated to high-risk 65-74-year-olds and all subjects aged ≥ 75 years. Switching to the alternative scenario would result in both significant health benefits and net budget savings. Particularly, it would be possible to prevent an additional 8201 cases of laboratory-confirmed influenza, 988 complications, 355 hospitalizations and 14 deaths. Despite the alternative strategy being associated with slightly higher vaccination costs, the total savings derived from fewer influenza events completely resets this increase with net budget savings of € 0.13 million. An immunization policy in which influenza vaccines are administered according to the age and risk profile of Italian elderly individuals is advisable.

Validity of the Italian telephone version of the mini-mental state examination in the elderly healthy population.

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Vanacore, Nicola; De Carolis, Antonella; Sepe-Monti, Micaela; Bomboi, Giuseppe; Stazi, Antonia; Bianchetti, Angelo; Giubilei, Franco

2006-09-01

The biggest challenge regarding cognitive prospective evaluations in the elderly is the identification of subjects that go on to develop cognitive impairment. In this study, we compared the Italian telephone version of the MMSE (Itel-MMSE) with both the MMSE and a battery of neuropsychological tests in a group of 107 healthy elderly subjects. The aim of the study was to identify a subset of subjects who, despite having an overall score within the normal range, performed poorly in the cognitive neuropsychological evaluation. The Itel-MMSE score showed a good internal consistency as well as a significant correlation with the MMSE score, age and education. A score of < or = 21 on the Itel-MMSE was the score which reflected the highest degree of sensitivity in the neuropsychological tests. There was a statistically significant difference between subjects with an Itel-MMSE score of < or = 21 and those with a score of 22 in age, education, Attentional Matrices and Copying Drawings. Despite some potential limitations, our results strongly suggest that the Itel-MMSE may be used as a screening test to identify healthy elderly subjects whose cognitive performance is poor.

BMI, life-style and psychological conditions in a sample of elderly Italian men and women.

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Marcellini, F; Giuli, C; Papa, R; Gagliardi, C; Malavolta, M; Mocchegiani, E

2010-08-01

To identify the relationship among cognitive status, psychological conditions, anthropometric measurements and life-style in a sample of elderly Italian men and women. Three hundred and six volunteers for ZINCAGE Project recruited. The sample was made up of healthy older adults living in the Marche Region aged 65 and over. All elderly were given a complete medical, anthropometric assessment, and psycho-social evaluation. Overall, the participants perceived themselves to be in very good or good (22%) or fair (69%) health; only 9% reported a poor health status. The 46% of the sample fell within the normal body mass index (BMI) range, though 38% were overweight, 12% were obese, and only 4% were underweight. In both sexes, BMI significantly decreased with age (psedentary activities (r=0.188; psedentary (r=0.221; psedentary (r=0.258; p<0.001) leisure activities were positively associated with education level (p<0.05). It was found that lower scores of physical activity were associated to higher scores of Geriatric Depression Scale (r=-0.425; p<0.01), lower scores of Mini Mental State Examination (r=0.266; p<0.001) and higher score of Perceived Stress Scale (r=-0.131; p<0.05). Men and women lead different lifestyles and have a different psychological status, with advancing age consequently stressing the need for healthy lifestyle programmes particularly in the case of overweight and obese elderly people.

Ambulatory surgery center market share and rates of outpatient surgery in the elderly.

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Hollenbeck, Brent K; Hollingsworth, John M; Dunn, Rodney L; Zaojun Ye; Birkmeyer, John D

2010-12-01

Relative to outpatient surgery in hospital settings, ambulatory surgery centers (ASCs) are more efficient and associated with a lower cost per case. However, these facilities may also spur higher overall procedure utilization and thus lead to greater overall health care costs. The authors used the State Ambulatory Surgery Database from the State of Florida to identify Medicare-aged patients undergoing 4 common ambulatory procedures in 2006, including knee arthroscopy, cystoscopy, cataract removal, and colonoscopy. Hospital service areas (HSAs) were characterized according to ASC market share, that is, the proportion of residents undergoing outpatient surgery in these facilities. The authors then examined relationships between ASC market share and rates of each procedure. Age-adjusted rates of ambulatory surgery ranged from 190.5 cases per 1000 to 320.8 cases per 1000 in HSAs with low and high ASC market shares, respectively (P market share. The greatest difference, both in relative and absolute terms, was observed for patients undergoing cystoscopy. In areas of high ASC market share, the age-adjusted rate of cystoscopy was nearly 3-fold higher than in areas with low ASC market share (34.5 vs 11.9 per 1000 population; P elderly. Whether ASCs are meeting unmet clinical demand or spurring overutilization is not clear.

Bullying and Victimization in Overweight and Obese Outpatient Children and Adolescents: An Italian Multicentric Study.

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Dario Bacchini

Full Text Available Being overweight or obese is one of the most common reasons that children and adolescents are teased at school. We carried out a study in order to investigate: i the relation between weight status and school bullying and ii the relation between weight status categories and types of victimization and bullying in an outpatient sample of Italian children and adolescents with different degrees of overweight from minimal overweight up to severe obesity.Nine-hundred-forty-seven outpatient children and adolescents (age range 6.0-14.0 years were recruited in 14 hospitals distributed over the country of Italy. The participants were classified as normal-weight (N = 129, overweight (N = 126, moderately obese (N = 568, and severely obese (N = 124. The nature and extent of verbal, physical and relational bullying and victimization were assessed with an adapted version of the revised Olweus bully-victim questionnaire. Each participant was coded as bully, victim, bully-victim, or not involved.Normal-weight and overweight participants were less involved in bullying than obese participants; severely obese males were more involved in the double role of bully and victim. Severely obese children and adolescents suffered not only from verbal victimization but also from physical victimization and exclusion from group activities. Weight status categories were not directly related to bullying behaviour; however severely obese males perpetrated more bullying behaviour compared to severely obese females.Obesity and bullying among children and adolescents are of ongoing concern worldwide and may be closely related. Common strategies of intervention are needed to cope with these two social health challenges.

Urban-Hazard Risk Analysis: Mapping of Heat-Related Risks in the Elderly in Major Italian Cities

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Morabito, Marco; Crisci, Alfonso; Gioli, Beniamino; Gualtieri, Giovanni; Toscano, Piero; Di Stefano, Valentina; Orlandini, Simone; Gensini, Gian Franco

2015-01-01

Background Short-term impacts of high temperatures on the elderly are well known. Even though Italy has the highest proportion of elderly citizens in Europe, there is a lack of information on spatial heat-related elderly risks. Objectives Development of high-resolution, heat-related urban risk maps regarding the elderly population (≥65). Methods A long time-series (2001–2013) of remote sensing MODIS data, averaged over the summer period for eleven major Italian cities, were downscaled to obtain high spatial resolution (100 m) daytime and night-time land surface temperatures (LST). LST was estimated pixel-wise by applying two statistical model approaches: 1) the Linear Regression Model (LRM); 2) the Generalized Additive Model (GAM). Total and elderly population density data were extracted from the Joint Research Centre population grid (100 m) from the 2001 census (Eurostat source), and processed together using “Crichton’s Risk Triangle” hazard-risk methodology for obtaining a Heat-related Elderly Risk Index (HERI). Results The GAM procedure allowed for improved daytime and night-time LST estimations compared to the LRM approach. High-resolution maps of daytime and night-time HERI levels were developed for inland and coastal cities. Urban areas with the hazardous HERI level (very high risk) were not necessarily characterized by the highest temperatures. The hazardous HERI level was generally localized to encompass the city-centre in inland cities and the inner area in coastal cities. The two most dangerous HERI levels were greater in the coastal rather than inland cities. Conclusions This study shows the great potential of combining geospatial technologies and spatial demographic characteristics within a simple and flexible framework in order to provide high-resolution urban mapping of daytime and night-time HERI. In this way, potential areas for intervention are immediately identified with up-to-street level details. This information could support public

Does social desirability influence psychological well-being: perceived physical health and religiosity of Italian elders? A developmental approach.

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Fastame, Maria Chiara; Hitchcott, Paul Kenneth; Penna, Maria Pietronilla

2017-04-01

This study was mainly aimed at exploring the relationship between psychological well-being and lifestyle, religion, perceived physical health and social desirability of Italian elders. Four hundred and six cognitively healthy 65-99 years old participants were recruited from the Italian isle of Sardinia, where a high prevalence of centenarians is registered. Participants were presented with several tools assessing psychological well-being, lifestyle, social desirability, religiosity and subjective physical health. A hierarchical regression analysis revealed that the social desirability measure is the best predictor of general subjective well-being, whereas further predictors are age, perceived physical health and gardening. A significant but moderate relationship was also found between psychological well-being, subjective physical health and religiosity, while controlling for social desirability. Social desirability seems to contaminate the self-rating of psychological well-being in late adulthood. Moreover, from a developmental perspective, age-related factors, life style and perceived physical health are strictly related to and therefore influence the perception of life quality in the third and fourth age.

Use of the International Classification of Functioning, Disability and Health Generic-30 Set for the characterization of outpatients: Italian Society of Physical and Rehabilitative Medicine Residents Section Project.

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Gimigliano, Francesca; De Sire, Alessandro; Gastaldo, Marco; Maghini, Irene; Paoletta, Marco; Pasquini, Andrea; Boldrini, Paolo; Selb, Melissa; Prodinger, Birgit

2018-06-11

The International Classification of Functioning, Disability and Health (ICF) Generic- 30 Set (previously referred to as Rehabilitation Set) is a minimal set of ICF categories for reporting and assessing functioning and disability in clinical populations with different health conditions along the continuum of care. Recently, the Italian Society of Physical and Rehabilitation Medicine (SIMFER) developed an Italian modification of the simple and intuitive descriptions (SID) of these categories. This study was the first one to implement the use of the SID in practice. 1) To implement the use of the ICF in clinical practice and research among Italian Residents in PRM. 2) To verify if the SID made the application of ICF Generic 30 Set more user-friendly than the original descriptions. 3) To examine the prevalence of functioning problems of patients accessing Rehabilitation Services to serve as reference for the development of an ICF-based clinical data collection tool. Multicenter cross-sectional study. Italian Physical Medicine and Rehabilitation (PRM) outpatient rehabilitation services. Patients referring to Italian PRM outpatient rehabilitation services and Italian Residents in PRM. Each School of Specialization involved, randomly, received the ICF Generic-30 Set with the original descriptions or with the SID. Residents collected over a 4-month period (April-July 2016) patients data related to the ICF Generic-30 Set categories. Moreover, the residents self- assessed their difficulty in using the ICF Generic-30 Set with the original descriptions or with the SID, through a Numeric Rating Scale (NRS). Ninety-three residents collected functioning data of 864 patients (mean aged 57.7±19.3) with ICF Generic-30 Set: 304 with the original descriptions and 560 with SID. The difficulty in using the ICF Generic-30 Set with SID was rated as lower than using the original descriptions (NRS = 2.8±2.5 vs 3.5±3.1; p<0.001). The most common disease was the back pain (9.6%) and

Validation study of the Italian Addenbrooke's Cognitive Examination Revised in a young-old and old-old population.

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Pigliautile, M; Ricci, M; Mioshi, E; Ercolani, S; Mangialasche, F; Monastero, R; Croce, M F; Federici, S; Mecocci, P

2011-01-01

The main aims of the study were the translation and the subsequent validation in Italian of the Addenbrooke's Cognitive Examination Revised (ACE-R), and the evaluation of its usefulness in discriminating cognitively normal subjects from patients with mild dementia in an elderly population. The ACE-R was translated and adapted into Italian. The Italian ACE-R was administered to a group of 179 elderly subjects (72 cognitively healthy and 107 subjects with mild dementia, mean age 75.4±6.4 years). The group was stratified into two subsamples according to age, i.e. a young-old (<75 years) and an old-old (≥75 years) group, in order to evaluate the sensitivity and specificity of the test in detecting dementia in different age strata of elderly subjects. The reliability of the Italian ACE-R was extremely good (α-coefficient=0.85). Two different cutoffs were identified for young-old (cutoff 79; sensitivity 90% and specificity 80%) and old-old subjects (cutoff 60; sensitivity 82% and specificity 100%). The Italian ACE-R is a valid screening tool to detect dementia, especially in the old-old population, which represents not only the fastest growing age group but also the group at the highest risk of dementia in Western countries. Copyright © 2012 S. Karger AG, Basel.

An outpatient multifactorial falls prevention intervention does not reduce falls in high-risk elderly Danes

DEFF Research Database (Denmark)

Vind, Ane B; Andersen, Hanne E; Pedersen, Kirsten D

2009-01-01

, mean age 74, 73.7%women, who had visited the emergency department or had been hospitalized due to a fall. INTERVENTION: Identification of general medical, cardiovascular, and physical risk factors for falls and individual intervention in the intervention group. Participants in the control group....... Followup exceeded 90.0%. A total of 422 falls were registered in the intervention group, 398 in the control group. Intention-to-treat analysis revealed no effect of the intervention on fall rates (relative risk=1.06, 95%confidence interval (CI)=0.75 -1.51), proportion with falls (odds ratio (OR)=1.20, 95......OBJECTIVES: To evaluate the effect of multifactorial fall prevention in community-dwelling people aged 65 and older in Denmark. DESIGN: Randomized, controlled clinical trial. SETTING: Geriatric outpatient clinic at Glostrup University Hospital. PARTICIPANTS: Three hundred ninety-two elderly people...

Volume, structure and funding of specialized outpatient care at the outpatient Advisory Department of Mariinskaya hospital

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E. M. Kutyrev

2015-01-01

Full Text Available With the development of technologies, and discovery of new methods of diagnostics and treatment of diseases, a shift of the disease towards chronic disease is observed. Growth in prosperity will increase average life expectancy and mean age of population. Year after year, the elderly sector grows, with several chronic diseases per person. This is especially true for St. Petersburg, where 25 % of the populations of over working age. Thus, the demand for specialized medical care, particularly outpatient, will increase. Given that outpatient care is more profitable than hospital care, particular attention should be paid to its organization and expansion (increase in area, number of personnel, logistics, and so on. The article attempts to analyze changes in the volume of specialized outpatient medical care delivered at the outpatient Advisory Department of St. Petersburg state establishment of healthcare Mariinsky hospital in the period from 2008 through 2013.

Headache in elderly patients with chronic cerebral ischemia: outpatient diagnosis and treatment

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M. P. Platov

2018-01-01

Full Text Available Chronic cerebral ischemia (CCI is one of the most common diagnoses in middle-aged and elderly patients in the practice of an outpatient neurologist. Unfortunately, the diagnosis of CCI in these patients is often established only on the basis of complaints of headache, dizziness, instability during walking, and lower mood. At the same time, other diseases that cause these symptoms are not diagnosed, patients do not receive treatment, which considerably worsens quality of life and leads to anxiety and depression.A variety of diseases, such as headache, peripheral vestibular vertigo, depression, Alzheimer's disease, and Parkinson's syndrome, are frequently hidden under the diagnosis of CCI. The leading neurological syndrome in CCI is cognitive impairment that can be both moderate and reach the level of dementia. Approximately 40% of patients with chronic cerebrovascular disease complain of headache that is usually caused by mixed primary headache. The management tactics for a CCI patient suffering from headache is aimed at treating primary headache, modifying vascular risk factors, and managing cognitive impairment. The paper discusses the use of choline alphoscerate in patients diagnosed with CCI. 

Quality of life of elderly people living with HIV/AIDS in outpatient follow-up

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Juliano de Souza Caliari

Full Text Available ABSTRACT Objective: To analyze factors related to the quality of life of elderly people living with HIV/AIDS. Method: A cross-sectional study was carried out with people aged 50 years or more in a specialized outpatient clinic. The data collection was by means of an interview. For the analysis of data and characterization of the sample, descriptive statistics and comparison tests were used. The project met the ethical requirements. Results: Participants were 81 users aged 50 to 75 years, mean age was 57.8 (± 6.1 years, 71.6% of whom were men. There was a statistically significant relationship with the quality of life, the following variables: gender, children, occupation, religion, diagnosis time, HIV exposure, adverse effects, treatment interruption, viral load counts, hospitalization, dependence for daily activities and use of drugs. Conclusion: The results suggest that the quality of life deficit is related not only to physical changes, but to the anguish and stigma related to HIV/AIDS.

Depressive morbidity among elderly individuals who are hospitalized, reside at long-term care facilities, and are under outpatient care in Brazil: a meta-analysis

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Luís Fernando S. Castro-de-Araújo

2013-06-01

Full Text Available Objectives: i To investigate studies published between 1991 and 2010 on the prevalence of depressive morbidity (major depressive disorder [MDD], dysthymia and clinically significant depressive symptoms [CSDS] among elderly Brazilians assisted at healthcare facilities; ii to establish the prevalence of depression and identify its related factors; and iii to conduct a meta-analysis to assess the prevalence of depressive syndrome among elderly individuals assisted or hospitalized at healthcare facilities. Methods: Studies were selected from articles dated between January 1991 and June 2010 and extracted from the MEDLINE, LILACS, and SciELO databases. Results: The final analysis consisted of 15 studies, distributed as follows: i four sampled hospitalized patients, totaling 299 individuals, and found a prevalence of CSDS varying between 20 and 56%; ii four sampled outpatients, totaling 1,454 individuals; the prevalence of CSDS varied between 11 and 65%, and the prevalence of MDD varied between 23 and 42%; and iii seven sampled elderly individuals residing in long-term care facilities (LTCF, totaling 839 individuals, and the prevalence of CSDS varied between 11 and 65%. Conclusion: The present review indicated a higher prevalence of both MDD and CSDS among elderly Brazilians assisted at healthcare facilities.

Health Services OutPatient Experience questionnaire: factorial validity and reliability of a patient-centered outcome measure for outpatient settings in Italy

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Coluccia A

2014-09-01

Full Text Available Anna Coluccia, Fabio Ferretti, Andrea PozzaDepartment of Medical Sciences, Surgery and Neurosciences, Santa Maria alle Scotte University Hospital, University of Siena, Siena, ItalyPurpose: The patient-centered approach to health care does not seem to be sufficiently developed in the Italian context, and is still characterized by the biomedical model. In addition, there is a lack of validated outcome measures to assess outpatient experience as an aspect common to a variety of settings. The current study aimed to evaluate the factorial validity, reliability, and invariance across sex of the Health Services OutPatient Experience (HSOPE questionnaire, a short ten-item measure of patient-centeredness for Italian adult outpatients. The rationale for unidimensionality of the measure was that it could cover global patient experience as a process common to patients with a variety of diseases and irrespective of the phase of treatment course.Patients and methods: The HSOPE was compiled by 1,532 adult outpatients (51% females, mean age 59.22 years, standard deviation 16.26 receiving care in ten facilities at the Santa Maria alle Scotte University Hospital of Siena, Italy. The sample represented all the age cohorts. Twelve percent were young adults, 57% were adults, and 32% were older adults. Exploratory and confirmatory factor analyses were conducted to evaluate factor structure. Reliability was evaluated as internal consistency using Cronbach’s α. Factor invariance was assessed through multigroup analyses.Results: Both exploratory and confirmatory analyses suggested a clearly defined unidimensional structure of the measure, with all the ten items having salient loadings on a single factor. Internal consistency was excellent (α=0.95. Indices of model fit supported a single-factor structure for both male and female outpatient groups. Young adult outpatients had significantly lower scores on perceived patient-centeredness relative to older adults. No

Ambient Assisted Living : Italian forum 2013

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Siciliano, Pietro; Germani, Michele; Monteriù, Andrea

2014-01-01

This book presents the refereed proceedings of the Fourth Italian Forum on Ambient Assisted Living (AAL), held in Ancona, Italy, in October 2013. A wide range of issues are covered, and new technological developments are described which will support the autonomy and independence of individuals with special needs through an innovative and integrated approach, designed to respond to the socio-economic challenges of an aging population. Topics addressed include: health and well-being, prevention and rehabilitation, and support for care providers; active aging and its social implications; services for the frail elderly with health problems and their families; nutrition; ICT platforms/technologies for the benefit of the elderly; home automation and control technologies (autonomy, safety, and energy saving); smart cities and smart communities; telemedicine, telerehabilitation, and telecare; mobility, participation, and social inclusion; games and fun for the elderly; building design; social housing; interface desig...

5th Italian Forum on Ambient Assisted Living

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Siciliano, Pietro; Marletta, Vincenzo; Monteriù, Andrea

2015-01-01

This book documents the state of the art in the field of ambient assisted living (AAL), highlighting the impressive potential of novel methodologies and technologies to enhance well-being and promote active ageing. The coverage is wide ranging, with sections on assistive devices, elderly people monitoring, home rehabilitation, ICT solutions for AAL, living with chronic conditions, robotic assistance for the elderly, sensing technologies for AAL, and smart housing. The book comprises a selection of the best papers presented at the Fifth Italian Forum on Ambient Assisted Living, which was held in Catania, Italy, in September 2014 and brought together end users, technology teams, and policy makers to develop a consensus on how to improve provision for elderly and impaired people. Readers will find that the expert contributions offer clear insights into the ways in which the most recent exciting advances may be expected to assist in addressing the needs of the elderly and those with chronic conditions.

7th Italian Forum on Ambient Assisted Living

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Marletta, Vincenzo; Monteriù, Andrea; Siciliano, Pietro

2017-01-01

This book documents the state of the art in the field of ambient assisted living (AAL), highlighting the impressive potential of novel methodologies and technologies to enhance well-being and promote active ageing. The coverage is wide ranging, with sections on assistive devices, elderly people monitoring, home rehabilitation, ICT solutions for AAL, living with chronic conditions, robotic assistance for the elderly, sensing technologies for AAL, and smart housing. The book comprises a selection of the best papers presented at the 7th Italian Forum on Ambient Assisted Living (ForitAAL 2016), which was held in Pisa, Italy, in June 2016 and brought together end users, technology teams, and policy makers to develop a consensus on how to improve provision for elderly and impaired people. Readers will find that the expert contributions offer clear insights into the ways in which the most recent exciti ng advances may be expected to assist in addressing the needs of the elderly and those with chronic conditions.

Factors Influencing Quality of Life for Disabled and Nondisabled Elderly Population: The Results of a Multiple Correspondence Analysis

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M. Avolio

2013-01-01

Full Text Available Objectives. The aim of our study is to examine the role of some factors (sociodemographic patterns, social relationship support, and trust in healthcare actors on structure of quality of life among the Italian elderly population, by stratifying according to presence or absence of disability. Methods. Using data of the Italian National Institute of Statistics (ISTAT survey, we obtained a sample of 25,183 Italian people aged 65+ years. Multiple Correspondence Analysis (MCA was used to test such a relationship. Results. By applying the MCA between disabled and nondisabled elderly population, we identified three dimensions: “demographic structure and social contacts,” “social relationships,” “trust in the Italian National Health Services (INHS.” Furthermore, the difference in trust on the INHS and its actors was seen among disabled and non-disabled elderly population. Conclusions. Knowledge on the concept of quality of life and its application to the elderly population either with or without disability should make a difference in both people’s life and policies and practices affecting life. New domains, such as information and trusting relationships both within and towards the care network’s nodes, are likely to play an important role in this relationship.

The Eating Disorder Examination Questionnaire: reliability and validity of the Italian version.

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Calugi, Simona; Milanese, Chiara; Sartirana, Massimiliano; El Ghoch, Marwan; Sartori, Federica; Geccherle, Eleonora; Coppini, Andrea; Franchini, Cecilia; Dalle Grave, Riccardo

2017-09-01

To examine the validity and reliability of a new Italian language version of the latest edition of the Eating Disorder Examination Questionnaire (EDE-Q 6.0). The sixth edition of the EDE-Q was translated into Italian and administered to 264 Italian-speaking inpatient and outpatient (257 females in their mid-20s) with eating disorder (75.4% anorexia nervosa) and 216 controls (205 females). Internal consistency was high for both the global EDE-Q and all subscale scores. Test-retest reliability was good to excellent (0.66-0.83) for global and subscale scores, and for items assessing key behavioral features of eating disorders (0.55-0.91). Patients with an eating disorder displayed significantly higher EDE-Q scores than controls, demonstrating the good criterion validity of the tool. Confirmatory factor analysis revealed a good fit for a modified seven-item three-factor structure. The study showed the good psychometric properties of the new Italian version of the EDE-Q 6.0, and validated its use in Italian eating disorder patients, particularly in young females with anorexia nervosa.

[Role of clinical pharmacist in the therapeutical optimization in geriatric outpatient hospital].

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Jean-Bart, E; Faure, R; Omrani, S; Guilli, T; Roubaud, C; Krolak-Salmon, P; Mouchoux, C

2014-05-01

Cares in outpatient hospital for elderly patients is a period of interest for multidisciplinary reassessment and pharmaceutical care of the prescription. The objective is to present the implementation of the pharmaceutical care activity at the outpatient hospital. Between August and October 2011, elderly patients hospitalized in the outpatient hospital for a brief appraisal had a pharmaceutical care. The clinician introduced pharmaceutical reviews in the synthesis letter for general practitioner. An analysis of the activity was carried out over 3 months. A pharmaceutical care had been realized for 67 patients, mean age of 81.7 years. Among medical related problems identified, 39.6% were for potentially unnecessary medication. A stop was proposed for 44% of pharmaceutical interventions. A total of 91 pharmaceutical interventions and 13 recommendations were made and 34% of patients had potentially inappropriate medication. According to the objective to reduce the therapeutics contributing to the iatrogenesis, this approach allowed us to undertake a multidisciplinary collaboration oriented toward the relay between hospital and city cares. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Antidepressant efficacy of sertraline and imipramine for the treatment of major depression in elderly outpatients

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Orestes Vicente Forlenza

2000-07-01

Full Text Available CONTEXT: Most double-blind studies of efficacy and tolerability of sertraline as compared to tricyclics in the treatment of late-life major depression have used amitriptyline as a standard, leading to the inevitable conclusion that the former drug is better tolerated than the latter, with both being equally efficacious. OBJECTIVE: To compare the antidepressant efficacy and tolerability of sertraline (50 mg/day and imipramine (150 mg/day in the first 6 weeks of the treatment of major depression in the elderly. DESIGN: A randomized double-blind parallel study with 6 weeks of follow-up. SETTING: The psychogeriatric clinic at the Institute of Psychiatry, Hospital das Clínicas, Faculty of Medicine of the University of São Paulo. PARTICIPANTS: 55 severe and moderately depressed non-demented outpatients aged 60 years or more. INTERVENTION: Patients were assigned to sertraline 50 mg/day or imipramine 150 mg/day. MAIN MEASUREMENTS: CAMDEX interview. Psychiatric diagnosis followed the guidelines for "Major Depressive Episode" according to DSM-IV criteria. Severity of symptoms was evaluated using the "CGI" and "MADRS" scales. Cognitive state was assessed using the Mini-Mental State Examination. Side effects were assessed using the "Safetee-Up" schedule. RESULTS: Both groups had a significant decrease in depressive symptoms according to the MADRS scores after 6 weeks of treatment (P = 0.01. No significant differences between groups were detected regarding treatment outcome (t = 0.4; P = 0.7. Although the dropout rate was greater in the imipramine group, the overall tolerability among patients who completed the 6-week trial was similar in both test groups. CONCLUSIONS: Both sertraline and imipramine exhibited good efficacy and an acceptable side-effect profile for elderly depressed patients after 6 weeks of antidepressant treatment.

[A national survey on the activities performed by nurses and aids in Italian outpatients' services].

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Destrebecq, A; Lusignani, M; Terzoni, S

2009-01-01

In Italy, the National Health System (SSN) grants healthcare to the citizens; its realization is up to the Government, the Regions and local institutions, with the participation of citizens. The Health Ministry determines the essential levels of care, and dictates the general guidelines for the activities of the SSN. On the whole national territory, a network of Local Healthcare Units (ASL) is present; such institutions, although belonging to the SSN, have local autonomy. Their activity is based upon principles of efficacy and efficiency; each one includes one or more Districts, which usually group a minimum of 60,000 citizens. Until 1999, Italian nurses have based their activity on a law that enumerated their tasks (DPR 225/74); nowadays, they work according to the indications of a professional profile (DM 739/94), a code of deontology, a law (L. 42/99) that has eliminated the old DPR, and university programmes. Apart from nurses, both in public and private healthcare facilities it is possible to find aids called OSS; their education consists of a twelve months programme, for which the regional institutions are responsible. Specific laws define their field of activity. For all these reasons, and also because of a major nursing shortage, in Italy it is not possible to talk about tasks delegations from doctors to nurses; we can, however, think about this process from nurses to aids and employees. Italy has the highest number of doctors in the world, with more than 6 every 1000 citizens in 2005 (approximately 370,000 units); nurses suffer from the opposite problem; nurses were 348,415 in 2005 and 360,874 in 2007, that is to say 5.4 nurses each 1000 citizens. This means a shortage of 60,000 nurses. Our research is aimed at: Studying the activities deployed by nurses in outpatients' facilities, that could be assigned to aids,; Identifying the tasks currently deployed by nurses, that are beyond their competence; Estimating how much time nurses could save, if they were

Patterns of outpatient care utilization by seniors under the National Health Insurance in Taiwan

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Wen-Chin Hsu

2016-05-01

Conclusion: This study employed nationally representative data in the detection of patterns in outpatient care utilization by elderly individuals in Taiwan. Medical care providers and policymakers should be fully aware of the complex patterns unique to older patients. The results of this study could be used as a benchmark with which to assess the impact of future medical care policy on elderly people.

Very poor agreement between routine outpatient clinic office and ambulatory blood pressure: time to improve an old hospital outpatient clinic routine?

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Reinhard, Mark; Poulsen, Per L; Christensen, Kent L

2016-12-01

We investigated the agreement between elevated outpatient clinic office blood pressure (OC-OBP) as measured in the daily routine in our University Hospital Cardiology Outpatient Clinic and subsequent awake ambulatory blood pressure (AABP). In all patients referred for ambulatory blood pressure monitoring from our Cardiology Outpatient Clinic, we identified OC-OBP and changes in medication in the period from 1 January 2014 to 15 September 2015. The AABP was used as a reference measurement for the OC-OBP. A total of 183 patients were included in the study. Their mean age was 62.1±14.0 years and 49% were women. The mean systolic OC-OBP was 166.8±17.9 mmHg and the difference between the mean systolic OC-OBP and AABP was 28.0±19.5 mmHg (Pclinic agrees poorly with AABP and may lead to unnecessary treatment and pharmacologically induced symptomatic hypotension, particularly in elderly patients. The results of this study urgently call for alternative solutions to routine OC-OBP in hospital outpatient clinics.

Suicide Risk, Meaning in Life, and Need for Life Respect in Adults and Elderly Among Public Hospital Outpatients in South Korea: A Cross-Sectional Survey.

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Kang, Kyung-Ah; Kim, Shin-Jeong; Kim Ellis, Hyon

2017-01-01

The purpose of this study was to identify the differences in suicide risk, meaning in life, and need for life respect among three age groups (young adults, the middle aged, and the elderly) of 540 public hospital outpatients in South Korea. This was a cross-sectional study. Among these 3 age groups, we observed significant differences in suicide risk, meaning in life, and need for life respect according to education level, marital status, living arrangements, type of disease, gender, and monthly income. These findings might contribute to the prevention of suicide in the future and the implementation of better community-based nursing care.

Preoperative therapeutic exercise in frail elderly scheduled for total hip replacement: A randomized pilot trial

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Hoogeboom, T.J.; Dronkers, J.J.; Ende, C.H.M. van den; Oosting, E.; Meeteren, N.L.U. van

2010-01-01

Objective: To evaluate the feasibility and preliminary effectiveness of therapeutic exercise before total hip replacement in frail elderly. Design: A single-blind, randomized clinical pilot trial. Setting: Outpatient physiotherapy department. Subjects: Frail elderly with hip osteoarthritis awaiting

Oral health status and treatment needs of elderly people in Ile-ife ...

African Journals Online (AJOL)

Background: Oral health is an important and often neglected component of an older person's general health and well- being. Objectives: To determine the oral health status of elderly persons in Ile-Ife, Nigeria. Methods: The oral health status of 95 elderly patients who presented at the General outpatient clinic of the Obafemi ...

Estimating Renal Function in the Elderly Malaysian Patients Attending Medical Outpatient Clinic: A Comparison between Creatinine Based and Cystatin-C Based Equations.

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Jalalonmuhali, Maisarah; Elagel, Salma Mohamed Abouzriba; Tan, Maw Pin; Lim, Soo Kun; Ng, Kok Peng

2018-01-01

To assess the performance of different GFR estimating equations, test the diagnostic value of serum cystatin-C, and compare the applicability of cystatin-C based equation with serum creatinine based equation for estimating GFR (eGFR) in comparison with measured GFR in the elderly Malaysian patients. A cross-sectional study recruiting volunteered patients 65 years and older attending medical outpatient clinic. 51 chromium EDTA ( 51 Cr-EDTA) was used as measured GFR. The predictive capabilities of Cockcroft-Gault equation corrected for body surface area (CGBSA), four-variable Modification of Diet in Renal Disease (4-MDRD), and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations using serum creatinine (CKD-EPIcr) as well as serum cystatin-C (CKD-EPIcys) were calculated. A total of 40 patients, 77.5% male, with mean measured GFR 41.2 ± 18.9 ml/min/1.73 m 2 were enrolled. Mean bias was the smallest for 4-MDRD; meanwhile, CKD-EPIcr had the highest precision and accuracy with lower limit of agreement among other equations. CKD-EPIcys equation did not show any improvement in GFR estimation in comparison to CKD-EPIcr and MDRD. The CKD-EPIcr formula appears to be more accurate and correlates better with measured GFR in this cohort of elderly patients.

Undernutrition, risk of malnutrition and obesity in gastroenterological patients: A multicenter study

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Massimiliano Rizzi; Silvia Mazzuoli; Nunzia Regano; Rosa Inguaggiato; Margherita Bianco; Gioacchino Leandro; Elisabetta Bugianesi; Donatella Noè; Nicoletta Orzes; Paolo Pallini; Maria Letizia Petroni; Gianni Testino; Francesco William Guglielmi

2016-01-01

AIM: To investigate the prevalence of undernutrition, risk of malnutrition and obesity in the Italian gastroenterological population. METHODS: The Italian Hospital Gastroenterology Association conducted an observational, cross-sectional multicenter study. Weight, weight loss, and body mass index were evaluated. Undernutrition was defined as unintentional weight loss > 10% in the last threesix months. Values of Malnutrition Universal Screening Tool(MUST) > 2, NRS-2002 > 3, and Mini Nutritional Assessment(MNA) from 17 to 25 identified risk of malnutrition in outpatients, inpatients and elderly patients, respectively. A body mass index ≥ 30 indicated obesity. Gastrointestinal pathologies were categorized into acute, chronic and neoplastic diseases. RESULTS: A total of 513 patients participated in the study. The prevalence of undernutrition was 4.6% in outpatients and 19.6% in inpatients. Moreover, undernutrition was present in 4.3% of the gastrointestinal patients with chronic disease, 11.0% of those with acute disease, and 17.6% of those with cancer. The risk of malnutrition increased progressively and significantly in chronic, acute and neoplastic gastrointestinal diseases in inpatients and the elderly population. Logistical regression analysis confirmed that cancer was a risk factor for undernutrition(OR = 2.7; 95%CI: 1.2-6.44, P = 0.02). Obesity and overweight were more frequent in outpatients. CONCLUSION: More than 63% of outpatients and 80% of inpatients in gastroenterological centers suffered from significant changes in body composition and required specific nutritional competence and treatment.

Venlafaxine versus nortriptyline in the treatment of elderly depressed inpatients : a randomised, double-blind, controlled trial

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Kok, Rob M.; Nolen, Willem A.; Heeren, Thea J.

2007-01-01

Background The majority of the trials in the elderly are outpatient trials which excluded psychotic patients and patients with common comorbid physical disorders. Consequently information is lacking about the more complex cases of elderly depressed patients, as found in inpatient wards. Objective To

Mini-Exame do Estado Mental: características psicométricas em idosos ambulatoriais Mini-Mental State Examination: psychometric characteristics in elderly outpatients

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Roberto A Lourenço

2006-08-01

Full Text Available OBJETIVO: Avaliar as características de medida do Mini-Exame do Estado Mental em idosos atendidos em um ambulatório geral. MÉTODOS: O total de 303 indivíduos (>65 anos foi submetido à avaliação geriátrica com vários instrumentos, inclusive o Mini-Exame do Estado Mental. Foram calculadas a sensibilidade, a especificidade, os valores preditivos positivo e negativo e a curva ROC. RESULTADOS: A sensibilidade, a especificidade, os valores preditivos positivo e negativo e a área sob a curva ROC foram 80,8%, 65,3%, 44,7%, 90,7% e 0,807, respectivamente (ponto de corte 23/24. O melhor ponto de corte para indivíduos analfabetos foi 18/19 (sensibilidade =73,5%; especificidade =73,9%, e para aqueles com instrução escolar foi 24/25 (sensibilidade =75%; especificidade =69,7%. CONCLUSÕES: Para o rastreamento cognitivo de idosos atendidos em ambulatórios gerais pelo Mini-Exame do Estado Mental, a escolaridade deverá ser considerada para a adoção do ponto de corte mais adequado.OBJECTIVE: To assess the psychometric characteristics of the Mini-Mental State Examination in elderly outpatients who seek primary health care. METHODS: A total of 303 subjects (>65 years underwent comprehensive geriatric assessment with functional tools, including Mini-Mental State Examination. Sensitivity, specificity, positive predictive value, negative predictive value, and ROC curve were calculated. RESULTS: Sensitivity, specificity, positive and negative predictive values, and area under ROC curve were 80.8%, 65.3%, 44.7%, 90.7% and 0.807 respectively (cutoff point =23/24. The best cutoff point for illiterate was 18/19 (sensitivity =73.5%; specificity =73.9%; and for literate was 24/25 (sensitivity =75%; specificity =69.7%. CONCLUSIONS: While screening elderly outpatients for dementia, schooling must be considered in the choice of the best cutoff point in the Mini-Mental State Examination.

Estimating Renal Function in the Elderly Malaysian Patients Attending Medical Outpatient Clinic: A Comparison between Creatinine Based and Cystatin-C Based Equations

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Maisarah Jalalonmuhali

2018-01-01

Full Text Available Background. To assess the performance of different GFR estimating equations, test the diagnostic value of serum cystatin-C, and compare the applicability of cystatin-C based equation with serum creatinine based equation for estimating GFR (eGFR in comparison with measured GFR in the elderly Malaysian patients. Methods. A cross-sectional study recruiting volunteered patients 65 years and older attending medical outpatient clinic. 51 chromium EDTA (51Cr-EDTA was used as measured GFR. The predictive capabilities of Cockcroft-Gault equation corrected for body surface area (CGBSA, four-variable Modification of Diet in Renal Disease (4-MDRD, and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI equations using serum creatinine (CKD-EPIcr as well as serum cystatin-C (CKD-EPIcys were calculated. Results. A total of 40 patients, 77.5% male, with mean measured GFR 41.2±18.9 ml/min/1.73 m2 were enrolled. Mean bias was the smallest for 4-MDRD; meanwhile, CKD-EPIcr had the highest precision and accuracy with lower limit of agreement among other equations. CKD-EPIcys equation did not show any improvement in GFR estimation in comparison to CKD-EPIcr and MDRD. Conclusion. The CKD-EPIcr formula appears to be more accurate and correlates better with measured GFR in this cohort of elderly patients.

Classical Hodgkin's lymphoma in adults: guidelines of the Italian Society of Hematology, the Italian Society of Experimental Hematology, and the Italian Group for Bone Marrow Transplantation on initial work-up, management, and follow-up.

Science.gov (United States)

Brusamolino, Ercole; Bacigalupo, Andrea; Barosi, Giovanni; Biti, Giampaolo; Gobbi, Paolo G; Levis, Alessandro; Marchetti, Monia; Santoro, Armando; Zinzani, Pier Luigi; Tura, Sante

2009-04-01

The Italian Society of Hematology (SIE), the Italian Society of Experimental Haematology (SIES) and the Italian Group for Bone Marrow Transplantation (GITMO) commissioned a project to develop practice guidelines for the initial work-up, therapy and follow-up of classical Hodgkin's lymphoma. Key questions to the clinical evaluation and treatment of this disease were formulated by an Advisory Committee, discussed and approved by an Expert Panel (EP) composed of senior hematologists and one radiotherapist. After a comprehensive and systematic literature review, the EP recommendations were graded according to their supporting evidence. An explicit approach to consensus methodologies was used for evidence interpretation and for producing recommendations in the absence of a strong evidence. The EP decided that the target domain of the guidelines should include only classical Hodgkin's lymphoma, as defined by the WHO classification, and exclude lymphocyte predominant histology. Distinct recommendations were produced for initial work-up, first-line therapy of early and advanced stage disease, monitoring procedures and salvage therapy, including hemopoietic stem cell transplant. Separate recommendations were formulated for elderly patients. Pre-treatment volumetric CT scan of the neck, thorax, abdomen, and pelvis is mandatory, while FDG-PET is recommended. As to the therapy of early stage disease, a combined modality approach is still recommended with ABVD followed by involved-field radiotherapy; the number of courses of ABVD will depend on the patient risk category (favorable or unfavorable). Full-term chemotherapy with ABVD is recommended in advanced stage disease; adjuvant radiotherapy in patients without initial bulk who achieved a complete remission is not recommended. In the elderly, chemotherapy regimens more intensive than ABVD are not recommended. Early evaluation of response with FDG-PET scan is suggested. Relapsed or refractory patients should receive high

Cardiovascular function in elderly patients with chronic chagasic cardiopathy

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Rocha Manoel Otávio Costa

2003-01-01

Full Text Available The objective of this work was to verify the degree and type of heart damage of elderly chagasic patients seen at an outpatient referral center and to compare them with the changes found in young chagasic patients with a similar degree of heart damage. Elderly and young patients without advanced cardiopathy presented good functional behavior. Elderly patients with advanced cardiopathy had more ventricular premature beats (VPB in 24 h and less functional capacity in the exercise test than young patients of the same subgroup. There was a higher occurrence of effort-induced VPB and a lower prevalence of severe forms in elderly men, suggesting that Chagas' disease may have a worse evolution in males. The association of cardiac damage characteristic of aging with the secondary damage due to Chagas' disease could explain the greater functional damage found in elderly chagasic patients. Thus, it appears that the physiopathological components of Chagas' disease do have an influence on the clinical course of cardiopathy in the elderly population.

Beverage Consumption Habits in Italian Population: Association with Total Water Intake and Energy Intake

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Lorenza Mistura

2016-10-01

Full Text Available Background: The aim of this study was to investigate total water intake (TWI from water, beverages and foods among Italian adults and the elderly. Methods: Data of 2607 adults and the elderly, aged 18–75 years from the last national food consumption survey, INRAN-SCAI 2005-06, were used to evaluate the TWI. The INRAN-SCAI 2005-06 survey was conducted on a representative sample of 3323 individuals aged 0.1 to 97.7 years. A 3-day semi-structured diary was used for participants to record the consumption of all foods, beverages and nutritional supplements. Results: On average, TWI was 1.8 L for men and 1.7 L for women. More than 75% of women and 90% of men did not comply with the European Food Safety Authority (EFSA Adequate Intake. The contribution of beverages to the total energy intake (EI was 6% for the total sample. Water was the most consumed beverage, followed by alcoholic beverages for men and hot beverages for women. Conclusion: According to the present results, adults and elderly Italians do not reach the adequate intake for water as suggested by the EFSA and by the national reference level of nutrient and energy intake. Data on water consumption should also be analyzed in single socio-demographic groups in order to identify sub-groups of the population that need more attention and to plan more targeted interventions.

Time trends of cancer mortality among elderly in Italy, 1970–2008: an observational study

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Bidoli Ettore

2012-10-01

Full Text Available Abstract Background The aging of the Italian population will unavoidably lead to a growing number of persons diagnosed and living with cancer. A comprehensive description of the burden of cancer mortality among Italian elderly (65-84 years of age in the last four decades has not been carried out yet. Cancer mortality rates were used to describe time trends between 1970-2008. Methods Mortality counts, provided by the Italian National Institute of Statistics, were grouped according to data availability: in quinquennia from 1970-74 through 1995-99, and in 2000-03 and 2006-08 groups. Age-standardized rates (world population were computed by calendar periods while annual percent changes (APCs were computed for elderly and middle aged (35-64 years people for the period 1995-2008. Results The number of cancer deaths in elderly nearly doubled between 1970-74 (31,400 deaths/year in men, and 24,000 in women and 2006-08 (63,000 deaths/year in men, and 42,000 in women. Overall cancer mortality rates peaked during the quinquennia 1985-89 and 1990-94 (about 1,500/100,000 in men and 680 in women and declined thereafter. Throughout 1995-2008 cancer mortality rates decreased by -1.6%/year in men and -0.9%/year in women. These decreases were mainly driven by cancers of the stomach, bladder, prostate, and lung (APC = -3.3%, -2.7%, -2.5%, -2.2%, respectively in men, and by cancers of the stomach, bladder, and breast (APC = -3.5%, -1.9%, -1.1%, respectively in women. Conversely, increases in mortality rates between 1995 and 2008 were recorded for lung cancer (APC = +0.6% in women, cutaneous melanoma (APC = +1.7% in men, and pancreatic cancer (APC = +0.6% in men and +0.9% in women. Conclusions Overall favorable trends in cancer mortality were observed among Italian elderly between 1995 and 2008. Early diagnosis, improved efficacy of anti-cancer treatments and management of comorbidities are the most likely explanations of these positive

[The prevalence of heartburn in the elderly patients in urban outpatient clinics in Russia].

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Morozov, S V; Stavraki, E S; Isakov, V A

2010-01-01

Heartburn is the most common symptom of GERD. It's prevalence among different age groups of Russian population has not been studied yet. To study the prevalence of heartburn and its influence on the quality of life patterns in Russian urban primary care patients. The data presented in the article is a part of ARIADNE study on epidemiology of heartburn in Russian urban population. A cross-sectional survey, using a reliable and validated self-filled questionnaire was performed on randomly selected 18706 primary care patients in the 11 largest cities of Russia. The data of 14,521 respondents were available to the final analysis. Among the respondents 8,643 (59.5%) reported heartburn, among them elderly (> or = 60 y. o.) 2,017. Heartburn was more prevalent in elderly (61.87%) compared to younger people (59.29%), p = 0.028. Frequent (> or = 2 times a week) heartburn was found in 3,295 respondents. The prevalence of frequent symptom was also higher in elderly then in people less than 60 y. o.: 30.59% compared to 21.42%, p heartburn on the quality of life of the elderly respondents was found compared to younger patients, especially in regard to necessity to avoid favorite dishes and beverages (40.95% vs 37.52% in younger, p = 0.021), sleep disturbance (29.41% vs 19.22% respectively, p = 0.00001), need to limit physical activity (16.99% vs 13.61%, p = 0.0015). CONCLUSIONS; Heartburn is the prevalent symptom among Russian urban primary care patients. The prevalence of heartburn in patients 60 y. o. and older is higher than in younger people. Frequent heartburn is more prevalent in elderly people compared to younger. The quality of life is significantly decreased in patients experiencing heartburn. The impact of heartburn on the quality of life changes is stronger in elderly people.

Benefit of slow titration of paroxetine to treat depression in the elderly.

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Olgiati, Paolo; Bajo, Emanuele; Serretti, Alessandro

2014-11-01

Paroxetine is commonly used to treat depression in the elderly; however, titration issues have been raised. Rapid titration may lead to increased anxiety and early dropout. The aim of this cost-utility analysis was to compare the potential benefit of standard (10 mg the first day) versus slow titration (2.5 mg gradually increased). Clinical analysis was based on a naturalistic trial integrated with a decision-analytic model representing second treatments for those who initially did not respond and for dropout cases. Treatment setting was a public outpatient center for mental disorders in Italy. Service use data were estimated from best practice guidelines, whereas costs (Euros; 2012) were retrieved from Italian official sources. Slow titration approach produced 0.031 more quality-adjusted life years (remission rate: 57% vs 44% in standard titration group) at an incremental cost of €5.53 (generic paroxetine) and €54.54 (brand paroxetine syrup). Incremental cost-effectiveness ratio (ICER) values were €159 and €1768, respectively, in favor of slow titration approach. Cost-effectiveness threshold, defined as ICER titration of paroxetine in older depressed patients. However, these findings, in part based on simulated data, need to be replicated in clinical trials. Copyright © 2014 John Wiley & Sons, Ltd.

[Health and disability in the elderly: old paradigms and future prospects].

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Liotta, Giuseppe; Mancinelli, Sandro; Scarcella, Paola; Pompei, Daniela; Mastromattei, Antonio; Cutini, Rita; Marazzi, Maria Cristina; Buonomo, Ersilia; Palombi, Leonardo; Gilardi, Francesco

2012-01-01

The projections regarding the ageing of the Italian population are cause for great concern; however, the ageing scenario may actually be interpreted in a more optimistic way. Theories formulated in the 80s envisaging a decline of mortality, morbidity and disability in the elderly are now confirmed and prefigure an unexpected decrease in disability rates in the elderly population. The aim of this review is to attempt to explain the reasons for this by analyzing the role played by the various determinants of health, in particular social isolation, which are likely to play an important role in the future as well.

Metabolic syndrome and cognitive performance in the elderly

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Marianna Rinaldi

2014-01-01

Full Text Available Metabolic syndrome (MetS is a cluster of conditions, each of which represents a risk factor for cardiovascular disease: central obesity, hyperglycemia, dyslipidemia and hypertension. In different recent studies, MetS has been associated with an accelerate cognitive decline in the elderly. The aim of our research was to investigate the relationship between MetS and cognitive performance in 174 Italian elderly people living in Val Cenischia (Piedmont, Italy. Mini mental state examination (MMSE has been administered to assess the cognitive status of all participants. The prevalence of MetS is 50.3% (51.3 and 49.5% for males and females, respectively. Our results confirm the association between MetS and worse cognitive performance in the elderly: an increased number of MetS components is associated with an increased risk of developing cognitive impairment (odds ratio=1.54; confidence interval 95%:1.04-2.28; P<0.05.

Crimes against the elderly in Italy, 2007-2014.

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Terranova, Claudio; Bevilacqua, Greta; Zen, Margherita; Montisci, Massimo

2017-08-01

Crimes against the elderly have physical, psychological, and economic consequences. Approaches for mitigating them must be based on comprehensive knowledge of the phenomenon. This study analyses crimes against the elderly in Italy during the period 2007-2014 from an epidemiological viewpoint. Data on violent and non-violent crimes derived from the Italian Institute of Statistics were analysed in relation to trends, gender and age by linear regression, T-test, and calculation of the odds ratio with a 95% confidence interval. Results show that the elderly are at higher risk of being victimized in two types of crime, violent (residential robbery) and non-violent (pick-pocketing and purse-snatching) compared with other age groups during the period considered. A statistically significant increase in residential robbery and pick-pocketing was also observed. The rate of homicide against the elderly was stable during the study period, in contrast with reduced rates in other age groups. These results may be explained by risk factors increasing the profiles of elderly individuals as potential victims, such as frailty, cognitive impairment, and social isolation. Further studies analysing the characteristics of victims are required. Based on the results presented here, appropriate preventive strategies should be planned to reduce crimes against the elderly. Copyright © 2017 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

The relationship between accessibility of healthcare facilities and medical care utilization among the middle-aged and elderly population in Taiwan.

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Yang, Ya-Ting; Iqbal, Usman; Ko, Hua-Lin; Wu, Chia-Rong; Chiu, Hsien-Tsai; Lin, Yi-Chieh; Lin, Wender; Elsa Hsu, Yi-Hsin

2015-06-01

The purpose of this study was to explore the relationship between accessibility of healthcare facilities and medical care utilization among the middle-aged and elderly population in Taiwan. Cross-sectional study from 2007 Taiwan Longitudinal Study on Ageing (TLSA) survey. Community-based study. A total of 4249 middle-aged and elderly subjects were recruited. None. Outpatient visits within 1 month, and hospitalization, emergency visits as well as to shop in pharmacy stores within 1 year, respectively. Adjusting for important confounding variables, the middle-aged and elderly with National Health Insurance (NHI) and commercial insurance compared with those with NHI alone tended to have outpatient visits. The middle-aged and elderly with longer time to access healthcare facilities were less likely to shop in pharmacy stores compared with those with shop in pharmacy stores compared with those with perceived convenience. Our study of Taiwan's experience could provide a valuable lesson for countries that are planning to launch universal health insurance system, locate budgets in health care and transportation. The middle-aged and elderly who were facing more challenges in accessing health care, no matter in perceived accessibility or real time to access health care, had less outpatient visits and more drug stores shopping. Strategic policies are needed to improve accessibility in increasing patients' perception on access and escalating convenience of transportation system for improving accessibility. © The Author 2015. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

Validation of the Italian Version of the Caregiver Abuse Screen among Family Caregivers of Older People with Alzheimer's Disease.

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Melchiorre, Maria Gabriella; Di Rosa, Mirko; Barbabella, Francesco; Barbini, Norma; Lattanzio, Fabrizia; Chiatti, Carlos

2017-01-01

Introduction . Elder abuse is often a hidden phenomenon and, in many cases, screening practices are difficult to implement among older people with dementia. The Caregiver Abuse Screen (CASE) is a useful tool which is administered to family caregivers for detecting their potential abusive behavior. Objectives . To validate the Italian version of the CASE tool in the context of family caregiving of older people with Alzheimer's disease (AD) and to identify risk factors for elder abuse in Italy. Methods . The CASE test was administered to 438 caregivers, recruited in the Up-Tech study. Validity and reliability were evaluated using Spearman's correlation coefficients, principal-component analysis, and Cronbach's alphas. The association between the CASE and other variables potentially associated with elder abuse was also analyzed. Results . The factor analysis suggested the presence of a single factor, with a strong internal consistency (Cronbach's alpha = 0.86). CASE score was strongly correlated with well-known risk factors of abuse. At multivariate level, main factors associated with CASE total score were caregiver burden and AD-related behavioral disturbances. Conclusions . The Italian version of the CASE is a reliable and consistent screening tool for tackling the risk of being or becoming perpetrators of abuse by family caregivers of people with AD.

Impaired mobility, depressed mood, cognitive impairment and polypharmacy are independently associated with disability in older cancer outpatients: The prospective Physical Frailty in Elderly Cancer patients (PF-EC) cohort study.

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Pamoukdjian, Frederic; Aparicio, Thomas; Zelek, Laurent; Boubaya, Marouane; Caillet, Philippe; François, Veronique; de Decker, Laure; Lévy, Vincent; Sebbane, Georges; Paillaud, Elena

2017-05-01

To assess the prevalence of disability and the oncologic factors associated with disability in older outpatients with cancer. The Physical Frailty in Elderly Cancer patients (PF-EC) study (France) is a prospective bicentric observational cohort study. Two hundred and ninety outpatients with cancer were included. A cross-sectional analysis of oncologic factors and geriatric variables associated with disability that were collected using a comprehensive geriatric assessment (CGA) was conducted. Disability was defined as impairment in activities of daily living (ADL) and/or instrumental activities of daily living (IADL), simplified to four items. Univariate and multivariate logistic models of disabled patients were performed. The three final multivariate models were compared using the area under the receiver operating characteristic curve (AUC/ROC) of the logistic model. The mean age was 80.6years, and 51% of the patients were women with various types of cancer. The prevalence of disability was 67.6%. No oncologic factors (cancer site, cancer extension) were associated with disability. Impaired mobility, poor functional status, depressive mood, cognitive impairment and polypharmacy were independently associated with disability (PDisability was highly prevalent in older cancer outpatients before cancer treatment but was not associated with oncologic factors. Impaired mobility, depressed mood, cognitive impairment and polypharmacy were the geriatric variables significantly and independently associated with disability. Identifying these factors prior to cancer treatment could enable the implementation of corrective actions to improve patient autonomy before treatment and during follow-up. Copyright © 2017 Elsevier Ltd. All rights reserved.

Italian and Italian American Identity: A Visual Approach | Krase ...

African Journals Online (AJOL)

This essay is a brief exploration of the related concepts of Italian Ethnicity and Italian Ethnic Identity via a Visual Sociological study of two geographically different venues — Italian American neighbourhoods in the United States and neighbourhoods in Rome, Italy. By studying the Vernacular Landscape (Jackson, 1984) via ...

Dietary Modification Trial in Community-Dwelling Japanese Elderly: A Pilot Study.

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Momoki, Chika; Tsuji, Taeko; Shikata, Yukina; Urade, Hana; Morimoto, Hideki; Nakajima, Shinya; Habu, Daiki

2017-07-01

This study examined the effects of 6-month nutrition education programs for community-dwelling elderly. This study enrolled 50 community-dwelling elderly who regularly visit outpatient clinics. The programs had three goals: salt reduction, increase in dietary fiber, and adequate protein intake. Since it would be difficult for elderly to achieve all goals concurrently, a single goal was chosen by participants themselves. Anthropometric measurements, blood sampling, and assessment of dietary intake were performed at baseline, 3 months, and 6 months. The nutrition education program for salt reduction was well accepted by the participants and the amount of daily salt intake showed median value of 9.6 g at baseline, 8.0 g at 3 months and 8.1 g at 6 months (P = 0.005). The amount of dietary fiber intake only slightly increased after taking the nutrition program (median value of 13.4 g at baseline, 15.3 g at 3 months and 15.5 g at 6 months; P = 0.695), because of difficulties in introducing new food options to the diet. After taking the adequate protein intake program, participants showed small decreases in protein (a modification from 1.24 g/kg IBW to 1.20 g/kg IBW) and salt intake (8.2 to 7.3 g) at 3 months, but the effects were not sustained at 6 months. This nutrition education program focusing on a single nutrient may serve as a strategy to successfully reduce salt intake and improve systolic blood pressure control in community-dwelling elderly individuals who regularly visit outpatient clinics. In our view, dietary and lifestyle habits should be taken into account as much as possible in nutrition education for elderly individuals.

Physicians' age and sex influence breaking bad news to elderly cancer patients. Beliefs and practices of 50 Italian oncologists: the G.I.O.Ger study.

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Locatelli, C; Piselli, P; Cicerchia, M; Repetto, L

2013-05-01

We attempt to shed light on the truth-telling attitudes and practices of oncologists working with a geriatric population in Italy. Physicians caring for cancer patients were asked to complete a specific survey centred on their beliefs, attitudes and practices towards truth telling to elderly cancer patients. Of 50 physicians surveyed, 68% were men. Physicians practising in the south of Italy were significantly older and more likely to be of male gender in comparison with physicians practising from the north and central areas. Eighty-four per cent of physicians consider the family to be an obstacle to a direct communication with the elderly. Forty-four per cent of male physicians who are faced with a family's request of nondisclosure talk with the patient, whereas 37.5% of female physicians talk with the family. For 60% of interviewed physicians, the reason underpinning the caregiver's choice of nondisclosure is to delay the emotional confrontation. We observed that variability of disclosure is related not only to the patient's age but also to the physicians' age and sex and to the geographic area where physicians work. The results also show that both caregivers and physicians are concerned by the emotional aspects related to clinical information. Italian oncologists have to learn and implement 'comprehensive' communication skills and have to promote an integration of the information needs of patient and caregivers, according to their socio-cultural affiliation, within the communication techniques. Copyright © 2012 John Wiley & Sons, Ltd.

Cross-sectional study on differences in pain perception and behavioral distress during venipuncture between Italian and Chinese children

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Sofia Bisogni

2014-12-01

Full Text Available Venipuncture is perhaps the scariest aspect of hospitalization for children as it causes pain and high levels of behavioral distress. Pain is a complex experience which is also influenced by social factors such as cultural attitudes, beliefs and traditions. Studies focusing on ethnic/cultural differences in pain perception and behavioral distress show controversial results, in particular with regards to children. The aim of this paper is to evaluate differences in pain perception and behavioral manifestations between Italian and Chinese children undergoing a venipuncture, through a cross-sectional study. Behavioral distress and self-reported pain were measured in Chinese and Italian outpatient children during a standardized blood-drawing procedure, using the Observational Scale of Behavioral Distress (OSBD and pain scales. We observed 332 children: 93 Chinese and 239 Italian. Chinese children scored higher than Italians on pain scales − mean scores 5.3 (95%CI 4.78-5.81 vs. 3.2 (95%CI 2.86-3.53 − but lower mean OSBD scores − mean 4.1 (95%CI 3.04-5.15 vs. 8.1 (95%CI 7.06-9.14. Our data suggest that Chinese children experience higher levels of pain than their Italian peers, although they show more self-control in their behavioral reaction to pain when experiencing venipuncture.

Validation of the Italian Version of the Caregiver Abuse Screen among Family Caregivers of Older People with Alzheimer’s Disease

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Maria Gabriella Melchiorre

2017-01-01

Full Text Available Introduction. Elder abuse is often a hidden phenomenon and, in many cases, screening practices are difficult to implement among older people with dementia. The Caregiver Abuse Screen (CASE is a useful tool which is administered to family caregivers for detecting their potential abusive behavior. Objectives. To validate the Italian version of the CASE tool in the context of family caregiving of older people with Alzheimer’s disease (AD and to identify risk factors for elder abuse in Italy. Methods. The CASE test was administered to 438 caregivers, recruited in the Up-Tech study. Validity and reliability were evaluated using Spearman’s correlation coefficients, principal-component analysis, and Cronbach’s alphas. The association between the CASE and other variables potentially associated with elder abuse was also analyzed. Results. The factor analysis suggested the presence of a single factor, with a strong internal consistency (Cronbach’s alpha = 0.86. CASE score was strongly correlated with well-known risk factors of abuse. At multivariate level, main factors associated with CASE total score were caregiver burden and AD-related behavioral disturbances. Conclusions. The Italian version of the CASE is a reliable and consistent screening tool for tackling the risk of being or becoming perpetrators of abuse by family caregivers of people with AD.

[Development and reliability evaluation of an instrument to measure health-related quality of life in independent elderly].

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Lima, Maria José Barbosa de; Portela, Margareth Crisóstomo

2010-08-01

This study presents an instrument, the health-related quality of life (HRQOL) profile for independent elderly, to measure the health-related quality of life of the functionally independent elderly assisted in the outpatient setting, based on the adaptation of four validated scales: Short-Form Health Survey (SF-36), Duke-UNC Health Profile (DUHP), Sickness Impact Profile (SIP), and Nottingham Health Profile (NHP). The study also evaluates the instrument's reliability based on its use by two different observers with a 15-day interval. The instrument includes five dimensions (health perception, symptoms, physical function, psychological function, and social function) and 45 items. Reliability evaluation of the QUASI instrument was based on interviews with 142 elderly outpatients in the city of Rio de Janeiro, Brazil. Prevalence-adjusted kappa statistic was used to assess all 45 items. Correlation was also calculated between overall scores and scores on individual dimensions. In the reliability evaluation, 39 of the 45 items showed prevalence-adjusted kappa greater than 0.60.

[Health impact of ozone in 13 Italian cities].

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Mitis, Francesco; Iavarone, Ivano; Martuzzi, Marco

2007-01-01

to estimate the health impact of ozone in 13 Italian cities over 200,000 inhabitants and to produce basic elements to permit the reproducibility of the study in other urban locations. the following data have been used: population data (2001), health data (2001 or from scientific literature), environmental data (2002-2004), from urban background monitoring station and concentration/response risk coefficients derived from recent metanalyses. The indicators SOMO35 and SOMO0 have been used as a proxi of the average exposure to calcolate attributable deaths (and years of life lost) and several causes of morbility for ozone concentrations over 70 microg/m3. acute mortality for all causes and for cardiovascular mortality, respiratory-related hospital admissions in elderly, asthma exacerbation in children and adults, minor restricted activity days, lower respiratory symptoms in children. over 500 (1900) deaths, the 0.6% (2.1%) of total mortality, equivalent to about 6000 (22,000) years of life lost are attributable to ozone levels over 70 microg/m3 in the 13 Italian cities under study. Larger figures, in the order of thousands, are attributable to less severe morbidity outcomes. The health impact of ozone in Italian towns is relevant in terms of acute mortality and morbidity, although less severe than PM10 impact. Background ozone levels are increasing. Abatement strategies for ozone concentrations should consider the whole summer and not only "peak" days and look at policies limiting the concentration of precursors produced by traffic sources. Relevant health benefits can be obtained also under levels proposed as guidelines in the present environmental regulations.

Dropout rates and factors associated with dropout from treatment among elderly patients attending the outpatient services of a tertiary care hospital.

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Grover, Sandeep; Dua, Devakshi; Chakrabarti, Subho; Avasthi, Ajit

2018-01-01

This study aimed to evaluate the "dropout" rates from treatment and associated factors among elderly patients attending a tertiary care psychiatry outpatient facility. Data of 1422 patients aged ≥60 years, attending the walk-in clinic were evaluated. Out of 1422 patients, 406 (28.55%) belonged to the "dropout" group. In the "dropout" group, the age of patients was significantly higher than the followed-up group, and a higher proportion of patients were >70 years old. Significantly lower proportion of patients with diagnosis of depressive disorders belonged to the "dropout" group and significantly higher proportion of patients with "other" diagnoses belonged to the dropped out group. In patients with depressive disorders, a higher proportion of the patients in the "dropout" group were Hindu by religion (68.7% vs. 58.7%; χ 2 = 4.26; P = 0.03). In patients with bipolar disorder, patients in the "dropout" group had significantly higher income (Rs. 13,323 [standard deviation [SD] = 16,769] vs. 5681 [SD = 9422]; t -test value: 2-25; P = 0.028) and lesser proportion of patients were of the male gender (63.15 vs. 86.95%; Mann-Whitney U value = 257.5; P = 0.039). In the group of other diagnoses, a higher proportion of patients in the "dropout" group were currently single (32.3% vs. 18.7%; χ 2 = 4.12; P = 0.042), from rural locality (63.1% vs. 46.72%; χ 2 = 4.33; P = 0.037) and were not prescribed medications (40% vs. 22.4%; χ 2 = 6.05; P = 0.04). Dropout from treatment among elderly patients is associated with higher age, not being prescribed medications, and diagnosis other than the affective disorders, psychotic disorders, and the cognitive disorders.

[Risk scores for community acquired pneumonia in elderly and geriatric patients].

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Pflug, M A; Wesemann, T; Heppner, H J; Thiem, U

2015-10-01

Community-acquired pneumonia (CAP) is still an important and serious disease for elderly and geriatric patients. For epidemiological and clinical reasons it is important to collate the frequencies of the various degrees of severity of CAP and to obtain information on the spread and degree of the threat to the various risk groups by CAP. In outpatient treatment a simple to execute prognosis score can be used to objectify the assessment of the clinical status of a patient and to support therapeutic decision-making. For this purpose knowledge of the appropriate instruments should be available to potential users. Since the 1990s a variety of risk scores for stratification of CAP have been developed and evaluated. This article presents the content and value of the available risk scores whereby the advantages and disadvantages of the individual scores are critically compared. Special emphasis is placed on the importance of the risk scores for geriatric patients. At present the decision about outpatient or inpatient treatment is primarily based on the risk score CRB-65. Criteria for intensive care unit admissions are provided by the modified American Thoracic Society (ATS) set of criteria. Overall, risk scores are less reliable for elderly patients than for younger adults. For treatment decisions for the elderly, functional aspects should also be considered in addition to the aspects of risk scores discussed here. In particular, the decision about inpatient admission for elderly, geriatric CAP patients should be made on an individual basis taking the benefit-risk relationship into consideration.

Effect of pharmaceutical care intervention on blood pressure of elderly outpatients with hypertension Efeito de intervenções de atenção farmacêutica na pressão arterial de pacientes idosos com hipertensão

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Divaldo Pereira de Lyra Júnior

2008-09-01

Full Text Available The purpose of this study was to evaluate the effect of pharmacist intervention on the prevention and solution of drug therapy-problems (DTP, Body Mass Index (BMI, and blood pressure control in elderly outpatients with hypertension. The instruments were applied to 30 elderly outpatients assisted at the pharmacy of a primary health care unit in Ribeirão Preto (SP, Brazil. The group of patients received follow-up during a period of 12 months. It was observed that Pharmaceutical Care intervention optimized the medication use; reduced symptoms caused by drug therapy and improved the elderly patients' health conditions. The Pharmaceutical Care intervention influenced the care given to elderly people as well as the achievement of positive health outcomes. After this study, the researcher gave training about practice of Pharmaceutical Care to 38 dispensing pharmacists from the Public Health-System of Ribeirão Preto. Nowadays, these pharmacists are perpetuating the practice introduced in the region.O objetivo deste estudo foi avaliar o efeito das intervenções farmacêuticas na prevenção e solução de problemas relacionados à farmacoterapia, ao índice de massa corporal e ao controle da pressão arterial de um grupo de pacientes idosos portadores de hipertensão arterial. O grupo de 30 pacientes assistidos na farmácia de uma unidade básica de saúde, em Ribeirão Preto (SP, Brasil, foi acompanhado por 12 meses. No estudo foi observado que as intervenções do programa de Atenção Farmacêutica otimizaram o uso dos medicamentos, reduziram os problemas de saúde causados pelos medicamentos e melhoraram as condições de saúde dos pacientes. As intervenções influenciaram tanto no cuidado prestado aos idosos como na obtenção de resultados de saúde positivos. Depois deste estudo, o pesquisador ministrou um curso de capacitação sobre a prática da Atenção Farmacêutica para 38 farmacêuticos da Secretaria Municipal de Saúde de Ribeir

Lymphogranuloma venereum in an Italian MSM: concurrent pharyngeal and rectal infection.

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Foschi, Claudio; Filippini, Andrea; D'Antuono, Antonietta; Compri, Monica; Macca, Francesca; Banzola, Nicoletta; Marangoni, Antonella

2014-07-01

An Italian HIV-positive man having sex with men (MSM) attended the STIs Outpatients Clinic of Sant'Orsola Hospital in Bologna complaining of anal pain and constipation. According to patient's sexual history and repertoires, NAAT testing for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) was performed. Pharyngeal and anal swabs resulted positive for CT DNA detection and the following molecular genotyping identified a L2 serovar, coming to the final diagnosis of pharyngeal and rectal lymphogranuloma venereum (LGV) infection. After an antibiotic therapy with doxycycline 100 mg twice a day for 3 weeks, the patient completely recovered and the test of cure was negative for LGV infection.

Italian information geographies

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Maria Paradiso

2013-05-01

Full Text Available Introduction A range of papers focusing on Italian cases of ICTs use and changes in society are presented here in this NETCOM issue. A national research group on Geography of Information Society was founded in 2007 and hosted by the Italian Geographical Society later evolved in a specialty group within AgeI, the Association of Italian Geographers. This issue brings together papers from members of the Italian specialty group along the general theme of Internet mediation in everyday life. A pre...

Long-term pharmacotherapy for obesity in elderly patients: a retrospective evaluation of medical records from a specialized obesity outpatient clinic.

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Horie, Nídia Celeste; Cercato, Cintia; Mancini, Marcio C; Halpern, Alfredo

2010-06-01

Obesity is a serious chronic disease and the prevalence of this condition is increasing among the elderly. Although the benefits of weight loss to improve control of associated diseases are well known in young adults, they are not in older patients. The use of anti-obesity drugs to promote weight loss is widespread in Brazil and other countries, and obesity specialists frequently prescribe medicines in doses and for durations previously unreported in the literature. Sibutramine, orlistat and amfepramone (diethylpropion) have been evaluated in clinical trials of more than 2 years' duration in adults, demonstrating safety and efficacy, but long-term studies in obesity treatment are absent for other drugs. The efficacy and safety of obesity pharmacotherapy among the elderly is unknown. To describe the experience of obesity pharmacotherapy in the elderly in a specialized obesity care setting in Brazil, with a focus on efficacy and safety. A retrospective evaluation was conducted on medical charts from an outpatient clinic of a specialized tertiary centre for the treatment of obesity. We included patients who had had at least one consultation between January and December 2007, were aged > or =60 years at the beginning of the treatment, had had at least 6 months of follow-up and had received a prescription of at least one potential weight-loss drug. Diagnoses reported on medical records were documented. Age, weight, height and body mass index (BMI) were recorded at admission, after 6, 12, 18 and 24 months, and at the last available visit. The medicines prescribed, together with the dose, duration of use, adverse effects and reasons for discontinuation, were documented. The group consisted of 44 women (86%) and 7 men (14%), with a mean +/- SD age of 65.2 +/- 4.5 years, weight of 95.3 +/- 12.5 kg and BMI of 38.5 +/- 4.3 kg/m2. The mean +/- SD time of follow-up was 39.3 +/- 26.4 months, and the mean weight loss was 6.65 kg (p or =5% was achieved by 64.71%, 63.64%, 62

Exploring American and Italian consumer preferences for Californian and Italian red wines.

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Torri, Luisa; Noble, Ann Curtis; Heymann, Hildegarde

2013-06-01

To increase the market share of Californian wines in other countries, wine preferences need to be explored in potential markets. This work studied the preferences of American and Italian consumers for red wines produced in California and Italy, focusing on wines made from the same varieties in each location. Descriptive analysis and consumer preference tests were performed. Americans scored each of the Californian wines significantly higher in preference than the Italian wines. In contrast, the Italian consumer preference scores for many Italian and Californian wines overlapped. By external preference mapping of the American consumer segments, the ideal flavour of one cluster was closest to the Californian Zinfandel, Merlot and Syrah, which had the 'most balanced' flavour profiles. Another cluster of Italians also preferred the Californian wines. In addition, one Italian cluster was driven by a dislike of the leather, band-aid and medicinal aromas of the Italian Merlot and Refosco. The results provided information that can contribute to wine marketing research necessary for successfully exporting Californian red wines to Italy and vice versa. © 2012 Society of Chemical Industry.

Drug prescribing and use among elderly people in Spain.

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Mas, X; Laporte, J R; Frati, M E; Busquet, L; Arnau, J M; Ibañez, L; Séculi, E; Capellà, D; Arbonés, G

1983-05-01

As a result of the lack of an adequate regulation, the supply and the use of medicines is irrational in Spain. In order to know the characteristics of the prescription and use of drugs among the elderly, two drug utilization studies were carried out. The first study was an analysis of 981 prescriptions from an outpatient clinic of the Spanish Social Security. The results show that a high proportion of fixed-dose combinations were prescribed and that drugs without any demonstrated therapeutic value are often prescribed for the elderly. The second study was a survey of 389 individuals randomly chosen among people affiliated with a pensioners' club. The results show that drug use is highly prevalent among the elderly, that many medicines without any demonstrated benefit are being taken, and that potentially harmful drugs were being used by a high proportion of patients without medical follow-up. The prevalence of the use of some particular groups of drugs is also presented.

Frailty profile for geriatric patients in outpatient clinic of RSUP H. Adam Malik Medan

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Permatasari, T. D.; Sihombing, B.; Arianto, P.

2018-03-01

Frailty is a circumstance of increased vulnerability to bad resolution of homeostasis after a stressor occasion, which increases the risk of adverse outcomes. Early detection of frailty in elderly patients is a must but is rarely in the Geriatric Outpatient settings. We conducted a study to see the frailty profile for geriatric patients in the outpatient clinic of RSUP H. Adam Malik Medan. A cross-sectional research with a descriptive method was in the Geriatric Outpatient Clinic of Adam Malik Hospital from July-September 2016. The population of this study was patients from the Geriatric Outpatient Clinic, and sampling was by using consecutive methods. Samples were by questionnaires assessing (FRAIL Scale).This study was140 patients. Based on age, the age group of 81-90 years was dominantly frail (53.8%). Most of the subjects worked as government employees (109 subjects), and most of them were robust (42.2%). Based on income, both groups were dominated by robust (38.3% and 41.3%, respectively). Based on BMI, most were robust with underweight 33.5%, normoweight 37.8%, and obese 44.7%. Among the 140 patients, frailty was in the 27.1% of the subjects and the contributing factors were Age, Gender, and Obesity.

Physiotherapeutic intervention on chronic lumbar pain impact in the elderly

OpenAIRE

Jorge, Matheus Santos Gomes; Zanin, Caroline; Knob, Bruna; Wibelinger, Lia Mara

2015-01-01

ABSTRACT BACKGROUND AND OBJECTIVES: Geriatric population is considerably increasing. However, musculoskeletal disorders, especially chronic low back pain, which is one of the most common complaints during outpatient assistance, seem to grow together with this phenomenon and physiotherapy may be an alternative to treat such pathology. This study aimed at reviewing in the literature information about physiotherapeutic management for chronic low back pain in the elderly. CONTENTS: Twenty-six a...

Website design: technical, social and medical issues for self-reporting by elderly patients.

Science.gov (United States)

Taylor, Mark J; Stables, Rod; Matata, Bashir; Lisboa, Paulo J G; Laws, Andy; Almond, Peter

2014-06-01

There is growing interest in the use of the Internet for interacting with patients, both in terms of healthcare information provision and information gathering. In this article, we examine the issues in designing healthcare websites for elderly users. In particular, this article uses a year-long case study of the development of a web-based system for self-reporting of symptoms and quality of life with a view to examine the issues relating to website design for elderly users. The issues identified included the technical, social and medical aspects of website design for elderly users. The web-based system developed was based on the European Quality of Life 5-Dimensions health-status questionnaire, a commonly used tool for patient self-reporting of quality of life, and the more specific coronary revascularisation outcome questionnaire. Currently, self-reporting is generally administered in the form of paper-based questionnaires to be completed in the outpatient clinic or at home. There are a variety of issues relating to elderly users, which imply that websites for elderly patients may involve different design considerations to other types of websites.

Influence of diabetes on physical function among the elderly persons

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Farzana Tabassum

2009-07-01

Full Text Available There is growing recognition that the complications associated with type-2 diabetes may translate into functional impairments in older people.This cross sectional study was conducted between January and June 2008 to determine the influence of diabetes on physical functions in an elderly (³55 years population. Fifty-five elderly diabetics attending the out-patient department of a diabetic centre were selected by convenient sampling and compared with fifty-five non-diabetic elderly persons of the near-by community. Their physical functions were assessed by Barthel Index, SF-36 Health Survey and Modified Physical Performance test. Diabetic elderly persons, on average, obtained lower scores in all these three tests. After removing the effect of socio-demographic variables, influence of diabetes on level of independence measured by Barthel Index did not persist. However, the difference in SF-36 health survey and Modified Physical Performance test scores between diabetics and non-diabetics remained significant after controlling for socio-demographic variables. The current study showed influence of diabetes on physical functions in the elderly. People should be motivated and guided properly to practice a healthy lifestyle in order to prevent and control diabetes and thus avoid complications of diabetes mellitus and disabilities in later life. Ibrahim Med. Coll. J. 2009; 3(2: 45-49

Italian intersociety consensus on DOAC use in internal medicine.

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Prisco, Domenico; Ageno, Walter; Becattini, Cecilia; D'Angelo, Armando; Davì, Giovanni; De Cristofaro, Raimondo; Dentali, Francesco; Di Minno, Giovanni; Falanga, Anna; Gussoni, Gualberto; Masotti, Luca; Palareti, Gualtiero; Pignatelli, Pasquale; Santi, Roberto M; Santilli, Francesca; Silingardi, Mauro; Tufano, Antonella; Violi, Francesco

2017-04-01

The direct oral anticoagulants (DOACs) are drugs used in clinical practice since 2009 for the prevention of stroke or systemic embolism in non-valvular atrial fibrillation, and for the treatment and secondary prevention of venous thromboembolism. The four DOACs, including the three factor Xa inhibitors (rivaroxaban, apixaban and edoxaban) and one direct thrombin inhibitor (dabigatran) provide oral anticoagulation therapy alternatives to Vitamin K antagonists (VKAs). Despite their clear advantages, the DOACs require on the part of the internist a thorough knowledge of their pharmacokinetic and pharmacodynamic characteristics to ensure their correct use, laboratory monitoring and the appropriate management of adverse events. This document represents a consensus paper on the use of DOACs by representatives of three Italian scientific societies: the Italian Society of Internal Medicine (SIMI), the Federation of the Associations of Hospital Managers (FADOI), and the Society for the Study of Haemostasis and Thrombosis (SISET). This document formulates expert opinion guidance for pragmatic managing, monitoring and reversing the anticoagulant effect of DOACs in both chronic and emergency settings. This practical guidance may help the internist to create adequate protocols for patients hospitalized ion internal medicine wards, where patients are often elderly subjects affected by poly-morbidities and renal insufficiency, and, thus, require particular attention to drug-drug interactions and peri-procedural protocols.

Delayed diagnosis in pediatric headache: an outpatient Italian survey.

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Colombo, Bruno; Dalla Libera, Dacia; De Feo, Donatella; Pavan, Giulia; Annovazzi, Pietro Osvaldo; Comi, Giancarlo

2011-09-01

The aim of this prospective study is to assess the time lapse between the onset of recurring headache and the correct diagnosis in a cohort of pediatric patients attending an Italian children's headache center for the first time. One hundred and one patients and parents, referred to the Pediatric Headache Centre of San Raffaele Hospital in Milan, Italy, underwent a semi-structured interview to ascertain features of headache since onset (clinical and family history, presence of childhood periodic syndromes, previously undergone instrumental exams and specialists' examinations before the correct diagnosis, past and current treatment). All patients were evaluated by expert neurologists and their headache was classified according to the International Classification of Headache Disorders II (2004). The median time delay from the onset of the first episode of recurrent headache to definite diagnosis was 20 months (interquartile range 12 to 36 months). A correlation with younger age and a more delayed headache diagnosis was found (r Spearman = 0.25; P = .039). An association between diagnostic delay and positive family history (median 24 months [12 to 48] vs 12 [6 to 24]; P = .014) or female gender (median 18 months [12 to 42] vs. 12 [5 to 30]; P trend = .070) was also evident. Notably, 76 out of 101 patients referred to our Center received an appropriate diagnosis according to International Classification of Headache Disorders II at the time of our visit only. Of note, up to 21% of this group were previously misdiagnosed (for epilepsy 43%, sinusitis 38%, or other diseases 19%), a fact that contributed to a longer time of clinical assessment (median 39 months) before reaching a correct diagnosis. The other group of 80 patients (79%) did not receive a specific diagnosis and treatment, and were not studied until their symptom became chronic and disabling. Pediatric headache is still under-diagnosed and not adequately considered as a health problem in the

[Psychodynamic hypothesis about suicidality in elderly men].

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Lindner, Reinhard

2010-08-01

Old men are overrepresented in the whole of all suicides. In contrast, only very few elderly men find their way to specialised treatment facilities. Elderly accept psychotherapy more rarely than younger persons. Therefore presentations on the psychodynamics of suicidality in old men are rare and mostly casuistical. By means of a stepwise reconstructable qualitative case comparison of five randomly chosen elderly suicidal men with ideal types of suicidal (younger) men concerning biography, suicidal symptoms and transference, psychodynamic hypothesis of suicidality in elderly men are developed. All patients came into psychotherapy in a specialised academic out-patient clinic for psychodynamic treatment of acute and chronic suicidality. The five elderly suicidal men predominantly were living in long-term, conflictuous sexual relationships and also had ambivalent relationships to their children. Suicidality in old age refers to lifelong existing intrapsychic conflicts, concerning (male) identity, self-esteem and a core conflict between fusion and separation wishes. The body gets a central role in suicidal experiences, being a defensive instance modified by age and/or physical illness, which brings up to consciousness aggressive and envious impulses, but also feelings of emptiness and insecurity, which have to be warded off again by projection into the body. In transference relationships there are on the one hand the regular transference, on the other hand an age specific turned around transference, with their counter transference reactions. The chosen methodological approach serves the systematic finding of hypotheses with a higher degree in evidence than hypotheses generated from single case studies. Georg Thieme Verlag KG Stuttgart - New York.

EHR adoption among doctors who treat the elderly.

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Yeager, Valerie A; Menachemi, Nir; Brooks, Robert G

2010-12-01

The purpose of this study is to examine Electronic Health Record (EHR) adoption among Florida doctors who treat the elderly. This analysis contributes to the EHR adoption literature by determining if doctors who disproportionately treat the elderly differ from their counterparts with respect to the utilization of an important quality-enhancing health information technology application. This study is based on a primary survey of a large, statewide sample of doctors practising in outpatient settings in Florida. Logistic regression analysis was used to determine whether doctors who treat a high volume of elderly (HVE) patients were different with respect to EHR adoption. Our analyses included responses from 1724 doctors. In multivariate analyses controlling for doctor age, training, computer sophistication, practice size and practice setting, HVE doctors were significantly less likely to adopt EHR. Specifically, compared with their counterparts, HVE doctors were observed to be 26.7% less likely to be utilizing an EHR system (OR=0.733, 95% CI 0.547-0.982). We also found that doctor age is negatively related to EHR adoption, and practice size and doctor computer savvy-ness is positively associated. Despite the fact that EHR adoption has improved in recent years, doctors in Florida who serve the elderly are less likely to adopt EHRs. As long as HVE doctors are adopting EHR systems at slower rates, the elderly patients treated by these doctors will be at a disadvantage with respect to potential benefits offered by this technology. © 2010 Blackwell Publishing Ltd.

Elder abuse awareness in Italy: analysis of reports to the Prosecutor Office of Bologna.

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Salsi, Giancarlo; Mazzotti, Maria Carla; Carosielli, Grazia; Ingravallo, Francesca; Pelotti, Susi

2015-06-01

In Italy, the prevalence of elder abuse is estimated from 10 to 12.7 %. Even if the elderly are not specifically protected by the Italian Penal Code, it contains several articles punishing crimes against disadvantaged groups in which elders may be included. Article 572 about mistreatment of family members or cohabitants, and article 643 about circumvention of incapable best fit elder abuse or neglect and financial fraud and exploitation, respectively. To evaluate the prevalence of reported elder abuse in Bologna and province (Italy) compared to available data on prevalence obtained by population-based surveys. Reports to the Prosecutor Office about articles 572 and 643 in the period from 2000 to 2013 were collected and analyzed according to victim's age at the report time. For article 572 a total of 3,713 reports were found. The prevalence of reports ranged from 0.005 to 0.024 % for victims older than 65 years. Concerning article 643 a total of 786 reports were detected, with a prevalence ranging from 0.007 to 0.016 % for victims older than 65 years. A large gap was found between reported crimes related to elder abuse and the estimated prevalence of elder abuse in Italy. Our results showed that in Italy efforts to improve strategic approach on elder abuse as well as research at various levels following the examples of other abusive situations are needed in both health and legal systems.

Italian: Area Background Information.

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Defense Language Inst., Washington, DC.

This booklet has been assembled in order to provide students of Italian with a compact source of cultural information on their target area. Chapters include discussion of: (1) introduction to Italian; (2) origins of the Italian population; (3) geography; (4) history including the Roman Era, the Middle Ages, the Renaissance, the "Risorgimento," and…

Pure analgesics in a rheumatological outpatient clinic

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M.A. Cimmino

2011-09-01

Full Text Available Objective: Pure analgesics are only rarely used by Italian clinicians and this holds true also for rheumatologists. This work is concerned with an evaluation of the use of analgesics in a rheumatological outpatient clinic during the period 1989-1999. Methods: The records of 1705 patients consecutively seen at the clinic were downloaded on a specifically built website. Results: 4469 visits were considered. In 260 of them (5.8%, analgesics were prescribed to 234 (13.7% patients. The number of patients with a prescription of analgesics steadily increased during the years 1989-1999. The diagnoses in patients assuming analgesics were: osteoarthritis (47.1%, inflammatory arthritis (24.2%, soft tissue rheumatisms (13.7%, nonspecific arthralgia/myalgia (7.5%, and connective tissue diseases (2.6%. Peripheral analgesics were used in 188 (82.5% patients and central analgesics were used in the remaining 40 patients (17.5%. Analgesic drugs were used mainly in degenerative joint conditions. The indications for analgesics in the 55 patients with inflammatory arthrits were: (a partial or total remission of arthritis; for this reason non-steroidal anti-inflammatory drugs were no longer required in 18 patients; (b to increase the analgesic effect of NSAIDs in 23 patients; (c contraindications to NSAIDs in 14 patients (renal failure in 2 patients, gastritis in 10, allergy and bleeding in the remaining two. Conclusions: About 14% of our outpatients were treated with analgesics with an increasing trend in the examined period. The main indications for analgesics are degenerative conditions but they can be used also in selected patients with arthritis.

Compliance and Cognitive Function: A Methodological Approach to Measuring Unintentional Errors in Medication Compliance in the Elderly.

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Isaac, Lisa M.; And Others

1993-01-01

Assessed multiple aspects of cognitive performance, medication planning ability, and medication compliance in 20 elderly outpatients. Findings suggest that aspects of attention/concentration, visual and verbal memory, and motor function which are untapped by simple mental status assessment are related to medication access, planning, and compliance…

Factorial validity of the Childhood Trauma Questionnaire in Italian psychiatric patients.

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Innamorati, Marco; Erbuto, Denise; Venturini, Paola; Fagioli, Francesca; Ricci, Federica; Lester, David; Amore, Mario; Girardi, Paolo; Pompili, Maurizio

2016-11-30

Early adverse experiences are associated with neurobiological changes and these may underlie the increased risk of psychopathology. The Childhood Trauma Questionnaire (CTQ-SF) is the most commonly used instrument for assessing childhood maltreatment. Thus, the aim of our study was to investigate the factorial validity of an Italian version of the CTQ-SF in a sample of psychiatric inpatients by means of confirmatory and exploratory factor analyses. The sample was composed of 471 psychiatric in-patients and out-patients (206 males and 265 females) aged 16-80 years (mean age=34.4 years [SD=16.3]) consecutively admitted to two psychiatric departments. All patients were administered the Italian version of the CTQ-SF. We tested five different factor models which lacked good fit, while the exploratory factor analysis supported the adequacy of a solution with three factors (Emotional Neglect/Abuse, Sexual Abuse, Physical Neglect/Abuse). The three factors had satisfactory internal consistency (ordinal Cronbach alphas >0.90). Our study supports results from previous research indicating the lack of structural invariance of the CTQ-SF in cross-cultural adaptations of the test, and the fact that, when measuring different types of childhood maltreatment, the difference between abuse and neglect may be not valid. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Study management – process experiences form The Elderly Study

DEFF Research Database (Denmark)

Bilberg, Randi Marie; Andersen, Kjeld; Bogenschutz, Michael P

and prevention of sites that drift away. Implications The Elderly Study is multi-nationally, including three universities and research center in USA, Germany and Denmark together with a lot of outpatient treatment facilities. The study aims at including 1,000 patients aged 60 and older to examine two therapies......Description An essential, but often not described, part of multisite research projects is the process of managing the overall project per se. The Elderly have implemented strategies and tools used across sites in order to ensure intervention fidelity, uniformness in collection of data...... targeting seniors with alcohol problems. A lot of information, documentations, materials and agreements within and between sites are common phenomenons in the study. Therefore we are using Internet solutions as much as possible. Document management: To avoid having to many different versions of the same...

[Violence against elderly people. Recognize--Sensitize--Act!].

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Hirsch, Rolf D

2016-01-01

Elder abuse is--especially in view of the demographic development--a topic that is still neglected socially and in health policy, but also in terms of scientific research. There are different definitions of violence and these can be difficult to formulate, depending on the field. In gerontology, a rather broad frame is usually used to describe the phenomenon of violence. Its shapes are multilayered and diverse (e.g., physical, psychological, restriction of freedom, neglect, financial exploitation, and structural and cultural). In principle, any act of violence is also a breach of the law. Violence can occur in public places and in family and institutional settings (e.g., hospital and outpatient and inpatient care for the elderly). The statistical occurence in family settings is around 25% and in institutional settings between 11 and 24%. Acts of violence are usually an expression of helplessness, shame, overwork, poor support and lack of knowledge of alternatives. Often there is a pathological relationship, in which the roles of "perpetrators" and "victims" can change. Acts of violence have massive consequences for those affected. Preventative measures to reduce violence have various points of departure (e.g., company, region, institution, professional). So far, there are hardly any points of contact and professional assistance for elderly victims.

Affective Responses to Acute Exercise in Elderly Impaired Males: The Moderating Effects of Self-Efficacy and Age.

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McAuley, Edward; And Others

1995-01-01

Examined relationships between perceptions of personal efficacy and affective responsibility to acute exercise in elderly male inpatients and outpatients at a Veterans Administration Medical Center. A significant change in feelings of fatigue was revealed over time but exercise effects on affect were shown to be moderated by perceptions of…

NutriCancer: A French observational multicentre cross-sectional study of malnutrition in elderly patients with cancer.

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Lacau St Guily, Jean; Bouvard, Éric; Raynard, Bruno; Goldwasser, François; Maget, Brigitte; Prevost, Alain; Seguy, David; Romano, Olivier; Narciso, Bérengère; Couet, Charles; Balon, Jean-Michel; Vansteene, Damien; Salas, Sébastien; Grandval, Philippe; Gyan, Emmanuel; Hebuterne, Xavier

2018-01-01

To compare the prevalence of malnutrition and nutritional management between elderly (≥70years old) and younger patients (malnutrition in adult patients with cancer in France. Patients diagnosed with cancer at the study date in both inpatient and outpatient settings were included. Data collection was performed by means of questionnaires completed by the physician, the patient and the caregiver. This post-hoc analysis compared 578 elderly patients (27.6%) vs. 1517 younger patients (72.4%). There were significant differences in cancer localization between the groups particularly in gastrointestinal cancer (27% in younger patients vs. 42% in elderly), breast cancer (17% vs 8% in elderly) and oropharyngeal (15% vs. 9% in elderly). Weight loss was significantly more reported in the elderly than in younger patients (73.6% vs. 67.6%, p=0.009). Elderly patients were more frequently malnourished than younger patients (44.9% vs. 36.7%, p=0.0006). Food intake was comparable between the groups; however, physicians overestimated the food intake, particularly in the elderly. The malnutrition management was more frequently proposed in elderly, as dietary advice and oral nutritional supplements, than in younger patients; however, enteral nutrition was significantly less undertaken in the elderly. Malnutrition is prevalent in elderly patients with cancer, and more frequent than in younger patients. There is a need for an early integration of the nutritional counselling in patients with cancer, and particularly in the elderly. Copyright © 2017 Elsevier Ltd. All rights reserved.

Management of hemodynamically unstable pelvic trauma: results of the first Italian consensus conference (cooperative guidelines of the Italian Society of Surgery, the Italian Association of Hospital Surgeons, the Multi-specialist Italian Society of Young Surgeons, the Italian Society of Emergency Surgery and Trauma, the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care, the Italian Society of Orthopaedics and Traumatology, the Italian Society of Emergency Medicine, the Italian Society of Medical Radiology -Section of Vascular and Interventional Radiology- and the World Society of Emergency Surgery)

Science.gov (United States)

2014-01-01

Hemodynamically Unstable Pelvic Trauma is a major problem in blunt traumatic injury. No cosensus has been reached in literature on the optimal treatment of this condition. We present the results of the First Italian Consensus Conference on Pelvic Trauma which took place in Bergamo on April 13 2013. An extensive review of the literature has been undertaken by the Organizing Committee (OC) and forwarded to the Scientific Committee (SC) and the Panel (JP). Members of them were appointed by surgery, critical care, radiology, emergency medicine and orthopedics Italian and International societies: the Italian Society of Surgery, the Italian Association of Hospital Surgeons, the Multi-specialist Italian Society of Young Surgeons, the Italian Society of Emergency Surgery and Trauma, the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care, the Italian Society of Orthopaedics and Traumatology, the Italian Society of Emergency Medicine, the Italian Society of Medical Radiology, Section of Vascular and Interventional Radiology and the World Society of Emergency Surgery. From November 2012 to January 2013 the SC undertook the critical revision and prepared the presentation to the audience and the Panel on the day of the Conference. Then 3 recommendations were presented according to the 3 submitted questions. The Panel voted the recommendations after discussion and amendments with the audience. Later on a email debate took place until December 2013 to reach a unanimous consent. We present results on the 3 following questions: which hemodynamically unstable patient needs an extraperitoneal pelvic packing? Which hemodynamically unstable patient needs an external fixation? Which hemodynamically unstable patient needs emergent angiography? No longer angiography is considered the first therapeutic maneuver in such a patient. Preperitoneal pelvic packing and external fixation, preceded by pelvic binder have a pivotal role in the management of these patients

Diagnostic Distribution of Mental Disorders in Geril Atric Outpatients Tehran 2002

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Mahshid Foroughan

2007-01-01

Full Text Available Objectives: Reports on the epidemiology of mental disorders in the elderly mostly arise from the studies on the populations of the western developed countries. Due to gross social and cultural differences, these findings may not be generalizable to the oriental countries and the need for native studies is increasingly felt. to determine a primary estimate of the prevalence of mental disorders in elderly people with health problems residing in the community. Methods & Materials: probable psychiatric cases among 314 patients successively presented to the only outpatient geriatric clinic in Tehran, after careful examination by a physician, referred for psychiatric evaluation. These subjects were examined by a psychiatrist and 100 of them received a diagnosis according to DSMb4 criteria. Data about related factors gathered and analyzed by the software SPSSb Version 10th. Results: 31.8% of the original sample received a psychiatric diagnosis. Depressive disorders (58%, cognitive disorders (29% and anxiety disorders (12% were most frequent diagnosis. Symptoms had been appeared after a life event in 52% of cases. Conbcurrent physical problems were prevalent. Hypertension was the most frequent physical problem (31% and Poly-pharmacy found in many cases  (m=1.4±2.89 Conclusion: The need for psycho-geriatric services is widespread among elderly living in Tehran and the con-current physical problems and poly pharmacy complicate the situation.

Restless Legs Syndrome in a Nigerian Elderly Population

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Fawale, Michael B.; Ismaila, Isiaka Alani; Mustapha, Adekunle F.; Komolafe, Morenikeji A.; Adedeji, Tewogbade A.

2016-01-01

Study Objectives: The prevalence of restless legs syndrome (RLS) is highest in the elderly in Caucasian populations; the prevalence of RLS in elderly Africans is not known. This study aimed at determining the frequency and associations of RLS in a Nigerian elderly population. Methods: The study population comprised of 633 consecutive elderly individuals aged 65–105 years attending the general outpatient clinic of the State Hospital, Ilesa, for minor complaints and routine check-up. The diagnosis of RLS was made using the 2003 minimal criteria of the International Restless Legs Syndrome Study Group. Relevant sociodemographic and clinical data, including sleep duration, were also obtained. Results: Restless legs syndrome was found in 3.5% of the study population with a male-female ratio of 2:1. There was no significant age (p = 0.427) or gender (p = 0.178) influence on the prevalence of RLS except in the 75- to 84-year age group where there was significant male preponderance (p = 0.044). A strong independent association between RLS and sleep duration (OR, 3.229; 95% CI, 1.283–8.486; p = 0.013) and past history of head injury (OR, 4.691; 95% CI, 1.750–12.577; p = 0.002) was found. Conclusions: Our finding support previous reports of a possible lower prevalence of RLS in Africans. Restless legs syndrome independently increases the odds of habitual sleep curtailment in elderly individuals. Head injury may be a risk factor for future RLS; this requires further investigation as indirect evidence for a possible link between RLS and traumatic brain injury exists. Citation: Fawale MB, Ismaila IA, Mustapha AF, Komolafe MA, Adedeji TA. Restless legs syndrome in a Nigerian elderly population. J Clin Sleep Med 2016;12(7):965–972. PMID:27070251

Apologizing in Italian and English.

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Lipson, Maxine

1994-01-01

Compared apology exchanges in Italy and the United States by having 10 Italian university students view American situation comedy television programs and rewrite particular conflict and apology exchanges in an Italian context. The status and role of the programs' participants affected the Italian students' choice of apology strategies more so than…

Italian in the Modern World.

Science.gov (United States)

Adorno, Elvira, Ed.

This booklet of 15 reprinted letters sent in response to a query concerning the actual use of Italian in the United States designates various areas of professional application. Some reference to current Italian publications is included. It is hoped that these letters will help promote the study of Italian in American schools. (RL)

Dietary exposure to trace elements and radionuclides: the methodology of the Italian total diet study 2012-2014

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Marilena D'Amato

2013-09-01

Full Text Available This article presents the methodology of the Italian Total Diet Study 2012-2014 aimed at assessing the dietary exposure of the general Italian population to selected non-essential trace elements (Al, inorganic As, Cd, Pb, methyl-Hg, inorganic Hg, U and radionuclides (40K, 134Cs, 137Cs, 90Sr. The establishment of the TDS food list, the design of the sampling plan, and details about the collection of food samples, their standardized culinary treatment, pooling into analytical samples and subsequent sample treatment are described. Analytical techniques and quality assurance are discussed, with emphasis on the need for speciation data and for minimizing the percentage of left-censored data so as to reduce uncertainties in exposure assessment. Finally the methodology for estimating the exposure of the general population and of population subgroups according to age (children, teenagers, adults, and the elderly and gender, both at the national level and for each of the four main geographical areas of Italy, is presented.

Bilateral calf chronic compartment syndrome in an elderly male: a case report.

LENUS (Irish Health Repository)

Siau, Keith

2009-01-01

Leg pain is a common presentation to the outpatient department. Bilateral calf chronic compartment syndrome is a rare cause of bilateral calf pain. Although this condition has been well documented in young athletes, it has rarely been reported in the elderly. We present the case of a 68-year-old male bodybuilder with bilateral calf chronic compartment syndrome, describe the presentation and evaluation of the condition, and provide a review of the literature herewith.

The TARGET project in Tuscany: the first disease management model of a regional project for the prevention of hip re-fractures in the elderly.

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Piscitelli, Prisco; Brandi, Maria Luisa; Nuti, Ranuccio; Rizzuti, Carla; Giorni, Loredano; Giovannini, Valtere; Metozzi, Alessia; Merlotti, Daniela

2010-09-01

The official inquiry on osteoporosis in Italy, promoted by the Italian Senate in 2002 concluded that proper preventive strategies should be adopted at regional level in order to prevent osteoporotic fractures. Tuscany is the first Italian region who has promoted an official program (the TARGET project) aimed to reduce osteoporotic fractures by ensuring adequate treatment to all people aged ≥65 years old who experience a hip fragility fracture. this paper provides information concerning the implementation of TARGET project in Tuscany, assuming that it may represent an useful model for similar experiences to be promoted in other Italian Regions and across Europe. we have examined the model proposed for the regional program, and we have particularly analyzed the in-hospital and post-hospitalization path of hip fractured patients aged >65 years old in Tuscany after the adoption of TARGET project by Tuscany healthcare system and during its ongoing start-up phase. orthopaedic surgeons have been gradually involved in the project and are increasingly fulfilling all the clinical prescriptions and recommendations provided in the project protocol. Different forms of cooperation between orthopaedic surgeons and other clinical specialists have been adopted at each hospital for the treatment of hip fractured elderly patients. GPs involvement needs to be fostered both at regional and local level. The effort of Tuscany region to cope with hip fractures suffered from elderly people must be acknowledged as an interesting way of addressing this critical health problem. Specific preventive strategies modelled on the Tuscany TARGET project should be implemented in other Italian regions.

Relações entre o bem-estar subjetivo e a funcionalidade em idosos em seguimento ambulatorial Relationship between subjective well-being and the functionality of elderly outpatients

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Giovana Sposito

2010-02-01

Full Text Available OBJETIVO: Este estudo teve como objetivo verificar a relação entre o bem-estar subjetivo, independência funcional e desempenho de membros inferiores (força muscular, velocidade de marcha e equilíbrio de idosos em seguimento ambulatorial, em relação ao sexo e a grupos etários. MÉTODOS: Foram avaliados 125 idosos de ambos os sexos com idade mínima de 60 anos, atendidos em um ambulatório de geriatria. Os instrumentos utilizados foram: 1 Medida da Independência Funcional (MIF para avaliar a dependência funcional; 2 Short Physical Performance Battery (SPPB para medir o desempenho físico; 3 Bem-Estar Subjetivo (BES: questões sobre a saúde e satisfação com a vida. RESULTADOS: A amostra utilizada foi de conveniência, com predomínio do sexo feminino, que apresentou maior comprometimento funcional. As correlações do bem-estar subjetivo com o teste de desempenho não demonstraram diferenças entre os sexos, contudo os idosos mais velhos apresentaram maior nível de satisfação que os idosos mais jovens. A saúde percebida também foi mais satisfatória entre os idosos mais velhos. Entretanto, a saúde percebida comparada mostrou melhores resultados nos idosos com moderado a bom desempenho físico. CONCLUSÃO: Os resultados sugerem que indivíduos mais velhos apresentam maior satisfação com a vida e melhor saúde percebida. Além disso, o bom desempenho físico foi uma variável de relevância para melhor saúde percebida quando comparada a outras pessoas.OBJECTIVE: The aim of this study was to investigate the relationship between subjective well-being, functional independence and lower-limb performance (muscle strength, gait velocity and balance among elderly people undergoing outpatient follow-up, stratified by sex and age groups. METHODS: We evaluated 125 elderly people, aged 60 years and over, who received care at a geriatric outpatient clinic. The instruments used were: 1 Functional Independence Measure (FIM to evaluate

Ensuring an Italian Renaissance

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Hallock, Ann H.

1978-01-01

Factors contributing to the renaissance of Italian and the goals of students who study the language are discussed. Alternatives to rote learning in the classroom and ways to generate interest in Italian in the community are suggested. (SW)

SECONDARY PREVENTION OF CARDIOVASCULAR DISEASES AMONG PATIENTS OF DIFFERENT AGE GROUPS WITH A HISTORY OF MYOCARDIAL INFARCTION BY THE EXAMPLE OF OUTPATIENT CARDIOLOGY INSTITUTION

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S. B. Fitilev

2017-01-01

Full Text Available Aim. To study secondary prevention of cardiovascular diseases among patients of different age groups with a history of myocardial infarction by the example of outpatient cardiology institution.Material and methods. Retrospective pharmacoepidemiological study was conducted by analyzing the medical records of 825 patients with a history of myocardial infarction, who visited the outpatient cardiology institution for the first time in 2011. Patients were divided into two groups according to their age: younger than 60 years (n=308, and 60 years and older (n=517.Results. The population of elderly patients was more severe: significantly more often patients had disability and comorbidities. The prevalence of the main modifiable risk factors could not be assessed fully due to the lack of information in patients’ medical records. Elderly patients were significantly less likely to receive β-blockers (80.3% and statins (63.8%. No significant differences were found in daily doses of the main prescribed preventive drugs between two groups.Conclusion. Secondary prevention of cardiovascular diseases among patients of different age groups could not be considered proper, as there is low level of attention to the modifiable risk factors and recommendation on their correction. A tendency to under-prescription of angiotensin converting enzyme inhibitors was revealed, as well as significantly lower number of recommendations for taking statins and β-adrenoblockers in the group of elderly patients.

Visit of the Italian President

CERN Multimedia

2003-01-01

"CERN stands as the demonstration of the great results that science can achieve [...] when it succeeds in getting all the main players in international scientific cooperation involved," stated the President of the Italian Republic, Carlo Azeglio Ciampi, in front of an overcrowded and enthusiastic Main Auditorium. The President visited CERN on 2nd December, and met the CERN directorate as well as the Italians at CERN. With about 1500 Italians working at CERN, which is one sixth of the total personnel, they are the second largest nationality at CERN. The Italian President visited the CMS assembly hall and the LHC superconducting magnet test hall before meeting the CERN community, in particular Italian personnel, in the main auditorium. There he emphasised the role of CERN as a transnational model for research which not only achieved great results in science but is also a powerful vehicle for progress in other fields. President Ciampi visits the LHC superconducting test hall together with Luciano Maiani and Lu...

The Se.Ko.Ph. study: a European multicentre study on falls in elderly subjects living in residential homes

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Aladar Bruno Ianes

2017-05-01

Full Text Available The aim was to investigate risk factors for falls in elderly people living in residential nursing homes. An observational, prospective, multicentre study was conducted between March 2010 and March 2011 investigating falls in elderly residents living in residential nursing homes (4 Italian¸ 4 French and 5 German nursing homes. A number of risk factors were assessed as well as details of the fall (dynamics, reasons, location and time of occurrence. Differences were observed between the countries related to different nursing practices. Fallers comprised 36.5% of all residents and approximately 40% were injured as a consequence. Six logistic regression models were created to assess which fallrelated variables had the most impact, and showed subjects with faecal incontinence had a lower risk of falling, while subjects afflicted with dementia and visual impairment showed an increased risk of falling. Higher Tinetti scores were found to be related to an increased fall risk. Falls in the elderly occur due to complex interactions between demographic, physical, behavioural and environmental risk factors. Differences between countries in fall rates were seen, probably due to different medical practices, use of aids and restraints, and characteristics of the populations (i.e. the Italian residents tended to be more cognitively impaired and more impaired in balance and gait compared to the French and German residents. There was evidence that subjects with a better clinical status fall more frequently, whereas non-fallers had a worse clinical status and therefore tended to be more bedridden.

The Italian energy sector

International Nuclear Information System (INIS)

Anon.

1997-01-01

The energy sector in Italy, as in Europe and in many other areas of the world, is undergoing rapid and profound changes. The 1986 ratification of the European Single Act was intended to create a European internal market, where circulation of people, capital, goods, and services would reach the highest possible liberalization. In 1988, in the document The Energy Internal Market, the European Union (EU) commission stressed the need for creation of an internal energy market--free of obstacles--to increase security of supply, to reduce costs, and to strengthen the competitiveness of the European economic system. In 1990, the Community Council adopted directives to implement the EU energy sector. This article describes Italy's role as part of the EU energy sector. It covers the following topics: the Italian energy sector; electricity vs gas transportation; project finance; recent developments advance Italian power industry; specifying powerplant components -- Italian stype; buyers' guide to Italian equipment, services

Bright light treatment in elderly patients with nonseasonal major depressive disorder: a randomized placebo-controlled trial.

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Lieverse, Ritsaert; Van Someren, Eus J W; Nielen, Marjan M A; Uitdehaag, Bernard M J; Smit, Jan H; Hoogendijk, Witte J G

2011-01-01

Major depressive disorder (MDD) in elderly individuals is prevalent and debilitating. It is accompanied by circadian rhythm disturbances associated with impaired functioning of the suprachiasmatic nucleus, the biological clock of the brain. Circadian rhythm disturbances are common in the elderly. Suprachiasmatic nucleus stimulation using bright light treatment (BLT) may, therefore, improve mood, sleep, and hormonal rhythms in elderly patients with MDD. To determine the efficacy of BLT in elderly patients with MDD. Double-blind, placebo-controlled randomized clinical trial. Home-based treatment in patients recruited from outpatient clinics and from case-finding using general practitioners' offices in the Amsterdam region. Eighty-nine outpatients 60 years or older who had MDD underwent assessment at baseline (T0), after 3 weeks of treatment (T1), and 3 weeks after the end of treatment (T2). Intervention Three weeks of 1-hour early-morning BLT (pale blue, approximately 7500 lux) vs placebo (dim red light, approximately 50 lux). Mean improvement in Hamilton Scale for Depression scores at T1 and T2 using parameters of sleep and cortisol and melatonin levels. Intention-to-treat analysis showed Hamilton Scale for Depression scores to improve with BLT more than placebo from T0 to T1 (7%; 95% confidence interval, 4%-23%; P = .03) and from T0 to T2 (21%; 7%-31%; P = .001). At T1 relative to T0, get-up time after final awakening in the BLT group advanced by 7% (P hour urinary free cortisol level was 37% lower (P = .003) compared with the placebo group. The evening salivary cortisol level had decreased by 34% in the BLT group compared with an increase of 7% in the placebo group (P = .02). In elderly patients with MDD, BLT improved mood, enhanced sleep efficiency, and increased the upslope melatonin level gradient. In addition, BLT produced continuing improvement in mood and an attenuation of cortisol hyperexcretion after discontinuation of treatment. clinicaltrials

Expression of calpain-calpastatin system (CCS) member proteins in human lymphocytes of young and elderly individuals; pilot baseline data for the CALPACENT project.

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Mikosik, Anna; Foerster, Jerzy; Jasiulewicz, Aleksandra; Frąckowiak, Joanna; Colonna-Romano, Giuseppina; Bulati, Matteo; Buffa, Silvio; Martorana, Adriana; Caruso, Calogero; Bryl, Ewa; Witkowski, Jacek M

2013-07-08

Ubiquitous system of regulatory, calcium-dependent, cytoplasmic proteases - calpains - and their endogenous inhibitor - calpastatin - is implicated in the proteolytic regulation of activation, proliferation, and apoptosis of many cell types. However, it has not been thoroughly studied in resting and activated human lymphocytes yet, especially in relation to the subjects' ageing process. The CALPACENT project is an international (Polish-Italian) project aiming at verifying the hypothesis of the role of calpains in the function of peripheral blood immune cells of Polish (Pomeranian) and Italian (Sicilian) centenarians, apparently relatively preserved in comparison to the general elderly population. In this preliminary report we aimed at establishing and comparing the baseline levels of expression of μ- and m-calpain and calpastatin in various, phenotypically defined, populations of human peripheral blood lymphocytes for healthy elderly Sicilians and Poles, as compared to these values observed in young cohort. We have found significant differences in the expression of both μ- and m-calpain as well as calpastatin between various populations of peripheral blood lymphocytes (CD4+, CD8+ and CD19+), both between the age groups compared and within them. Interestingly, significantly higher amounts of μ- and m-calpains but not of calpastatin could be demonstrated in the CD4+CD28- and CD8+CD28- lymphocytes of old subjects (but not in the cells of young individuals), as compared to their CD28+ counterparts. Finally, decreased expression of both calpains in the elderly T cells is not related to the accumulation of effector/memory (CD45RO+) cells in the latter, as the expression of both calpains does not differ significantly between the naïve and memory T cells, while is significantly lower for elderly lymphocytes if both populations are taken separately. Observed differences in the amounts of CCS member proteins between various populations of lymphocytes of young and elderly

The economic burden of influenza-associated outpatient visits and hospitalizations in China: a retrospective survey.

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Yang, Juan; Jit, Mark; Leung, Kathy S; Zheng, Ya-Ming; Feng, Lu-Zhao; Wang, Li-Ping; Lau, Eric H Y; Wu, Joseph T; Yu, Hong-Jie

2015-10-06

,800 vs. US$ 1,189). In the baseline analysis, inpatients reported costs were 18 % higher than those found in the accounts review (n = 38). The economic burden of influenza-associated outpatient and inpatient visits in China is substantial, particularly for young children, the elderly, and patients with underlying medical conditions. More widespread influenza vaccination would likely alleviate the economic burden of patients. The actual impact and cost-effectiveness analysis of the influenza immunization program in China merits further investigation.

Prevalence and Risk Factors of Obesity among Elderly Attending Geriatric Outpatient Clinics in Mansoura City

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Shebl, Amany Mohamed; Hatata, El Sayed Zaki; Boughdady, Aziza Mahmoud; El-Sayed, Sally Mohammed

2015-01-01

Obesity is a major public health problem affecting all ages in both developed and developing countries. It is considered the fifth leading risk factor for deaths all over the world as about 2.8 million people die due to obesity each year directly or indirectly. Obesity in elderly is considered one of the most serious public health challenges for…

42 CFR 419.21 - Hospital outpatient services subject to the outpatient prospective payment system.

Science.gov (United States)

2010-10-01

... outpatient prospective payment system. 419.21 Section 419.21 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEM... Excluded From the Hospital Outpatient Prospective Payment System § 419.21 Hospital outpatient services...

The Italian gas market

International Nuclear Information System (INIS)

Ferrari, A.

2004-01-01

The first meeting of the French gas association (AFG) of the year 2004 was devoted to the Italian gas market. Two experts of this market were invited: A. Ferrari, general director of the Italian gas and electricity regulation authority, and D. Dispenza, vice-general director of Eni Division Gas and Power. This conference was the occasion to compare the French and Italian gas industries. France and Italy have a border in common and also a series of common structural characteristics: the dependence with respect to foreign supplies, the position of the public company, the sensitiveness with respect to the security of supplies, to the role of storage and to the public utility. The French and Italian decisions are inter-dependent. The liberalization taking place with an unpredictable rate, it is necessary for the gas industry to anticipate its effects. When the political, legal and regulatory decisions are enforced, the initiative comes back to the hands of the industry. In this context, the trend of the transfrontier industries becomes particularly important for the regulatory authority. (J.S.)

Bipolar disorder: The importance of clinical assessment in identifying prognostic factors - An Audit. Part 3: A comparison between Italian and English mental health services and a survey of bipolar disorder.

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Verdolini, Norma; Dean, Jonathon; Massucci, Giampaolo; Elisei, Sandro; Quartesan, Roberto; Zaman, Rashid; Agius, Mark

2014-11-01

Most of the prognostic factors of bipolar disorder, which determine disease course and outcome, could be detected from simple but often-unrecorded questions asked during the psychiatric clinic assessments. In previous parts of this research, we analysed various prognostic factors and focused on mixed states and rapid cycling subsets. We now compare our sample in England with a small sample from Italy to demonstrate the utility of focused prognostic questioning and of international comparison. We collected data from the clinical notes of 70 English bipolar and 8 Italian bipolar outpatients seen at the initial psychiatric assessment clinic about socio-demographic and clinical factors to determine whether various factors had relevance to prevalence, prognosis, or outcome. The sample comprised 16 bipolar I (22.9%) and 54 bipolar II (77.1%) English outpatients and 7 bipolar I (87.5%) and 1 bipolar II (12.5%) Italian outpatients. Differences between the groups are seen mainly in terms of age of onset, duration of both depressive and hypomanic episodes, presence of psychiatric family history, incidence of mixed state features and rapid cycling, presence of elated mood in response to past antidepressant treatment, and misuse of illicit drugs and alcohol. In order to promote improved mental health primary care, mental health systems in all countries should develop standardized epidemiological tools that are shared between countries. We recommend the use of a questionnaire that reminds clinicians of potentially prognostic information and suggest that this might identify important components of a potential standardized diagnostic and prognostic tool.

Potentially inappropriate medication prescribed to elderly outpatients at a general medicine unit

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Christine Grützmann Faustino

2011-03-01

Full Text Available Objective: To establish the prevalence of potentially inappropriate medications prescribed for elderly patients, to identify the most commonly involved drugs, and to investigate whether age, sex and number of medications were related with the prescription of these drugs. Methods: Prescriptions for 1,800 elderly patients (≥ 60 years were gathered from a database. These prescriptions were written by general physicians at a tertiary level university hospital in the city of Sao Paulo, Brazil, from February to May 2008. Only one prescription per patient was considered. The prescriptions were classified according to sex and age (60-69, 70-79 and ≥ 80. The Beers criteria (2003 version were used to evaluate potentially inappropriate medications. Results: Most of the sample comprised women (66.6% with a mean age of 71.3 years. The mean prevalence of potentially inappropriate medication prescriptions was 37.6%. The 60-69 age group presented the highest prevalence (49.9%. The most frequently prescribed potentially inappropriate medications to women were carisoprodol, amitriptyline, and fluoxetine; amitriptyline, carisoprodol, fluoxetine and clonidine were prescribed more often to men. The female sex (p<0.001; OR=2.0 and number of medications prescribed (p<0.001 were associated with prescription of potentially inappropriate medications. The chance of having a prescription of these drugs was lower among patients aged over 80 years (OR=0.7. The mean number of prescribed medications for both sexes and all age groups was 7.1. The mean number of medications per patient was higher among females (p<0.001; this result was not age-dependent (p=0.285. Conclusion: The prevalence of potentially inappropriate medications was similar to previously reported values in the literature and was correlated with the female sex. The chance of having a potentially inappropriate medication prescription was lower among patients aged over 80 years. The chance of having a

Impact of a program to promote health and quality of life of elderly

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Silvia Affini Borsoi Tamai

2011-03-01

Full Text Available Objective: To evaluate the effect on quality of life of elderly people enrolled in GAMIA – Multidisciplinary Care Group to Outpatient Elderly Subjects (Grupo de Assistência Multidisciplinar ao Idoso Ambulatorial of the Geriatric Department, Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo. Methods: Between 2000 and 2002, 83 elderly participants of GAMIA were assessed by the World Health Organization Quality of Life scale (WHOQOL-bref at the beginning and the end of the program. Functionality was assessed by Katz and Lawton scales and sociodemographic data were obtained from medical charts. Results: Females predominated (79.5% and overall mean age was 69.30 years. Data analysis showed a reduction in the physical domain of WHOQOL-bref (p = 0.014 and increased psychological health and environment domains (p = 0.029 and p = 0.007, respectively, detecting a trend of increase in social relationships and in general domains (p = 0.062 and p = 0.052, respectively. Conclusions: The clinical evaluation of the elderly detected previously unknown diseases and determination of the use of new drugs, which might have been the predominant factor for the deterioration of their perception in the physical domain. Improvement in psychological health and the environment can be related to psychological and social support that the elderly received from peers and professionals and the benefits of group activities, as well as the upward trend observed in social relationships and general domains. Participation in a program to promote healthy aging was effective in improving the quality of life of the elderly.

Impact of a program to promote health and quality of life of elderly.

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Tamai, Silvia Affini Borsoi; Paschoal, Sergio Márcio Pacheco; Litvoc, Julio; Machado, Adriana Nunes; Curiati, Pedro Kallas; Prada, Luis Felipe; Jacob-Filho, Wilson

2011-03-01

To evaluate the effect on quality of life of elderly people enrolled in GAMIA - Multidisciplinary Care Group to Outpatient Elderly Subjects (Grupo de Assistência Multidisciplinar ao Idoso Ambulatorial) of the Geriatric Department, Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo. Between 2000 and 2002, 83 elderly participants of GAMIA were assessed by the World Health Organization Quality of Life scale (WHOQOL-bref) at the beginning and the end of the program. Functionality was assessed by Katz and Lawton scales and sociodemographic data were obtained from medical charts. Females predominated (79.5%) and overall mean age was 69.30 years. Data analysis showed a reduction in the physical domain of WHOQOL-bref (p = 0.014) and increased psychological health and environment domains (p = 0.029 and p = 0.007, respectively), detecting a trend of increase in social relationships and in general domains (p = 0.062 and p = 0.052, respectively). The clinical evaluation of the elderly detected previously unknown diseases and determination of the use of new drugs, which might have been the predominant factor for the deterioration of their perception in the physical domain. Improvement in psychological health and the environment can be related to psychological and social support that the elderly received from peers and professionals and the benefits of group activities, as well as the upward trend observed in social relationships and general domains. Participation in a program to promote healthy aging was effective in improving the quality of life of the elderly.

Nonalcoholic Fatty Liver Disease in Italian Children with Down Syndrome: Prevalence and Correlation with Obesity-Related Features.

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Valentini, Diletta; Alisi, Anna; di Camillo, Chiara; Sartorelli, Maria Rita; Crudele, Annalisa; Bartuli, Andrea; Nobili, Valerio; Villani, Alberto

2017-10-01

To assess the prevalence of overweight/obesity in a cohort of Italian children with Down syndrome (DS) and to investigate the correlation of both obesity and DS with nonalcoholic fatty liver disease (NAFLD). We enrolled 280 children with DS (age range 5-18 years), who were referred to the DS outpatient clinic of the Bambino Gesù Children's Hospital in Rome. For all children, we collected the clinical history and measured anthropometric variables. Eighty-four of 280 children with DS were selected to undergo liver ultrasound scanning to evaluate the presence of NAFLD. Italian children with DS exhibited a prevalence of 19.64% for overweight and 12.14% for obesity. The prevalence of NAFLD in nonobese (45%) and overweight/obese (82%) children with DS is greater than in the European pediatric nonobese (5.7%) or obese population (33%). Moreover, the severity of liver brightness on ultrasound scan correlated positively with body mass index, triglycerides, low-density lipoprotein-cholesterol, and leptin levels and negatively with adiponectin. We demonstrated that, independently from the obese phenotype, children with DS display a greater risk to develop NAFLD than the general pediatric population. Copyright © 2017 Elsevier Inc. All rights reserved.

Fall episodes in elderly patients with asthma and COPD - a pilot study.

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Bozek, Andrzej; Jarzab, Jerzy; Hadas, Ewa; Jakalski, Marek; Canonica, Giorgio Walter

2018-05-08

Evidence of an increased risk of falls in patients with chronic obstructive pulmonary disease (COPD) exists; however, this has not been studied in elderly asthmatic patients. The aim of the study was to determine the incidence of falls in elderly patients who were diagnosed with bronchial asthma compared to subjects with COPD. A 12 - month prospective observational study in elderly outpatients with diagnosis of either asthma or COPD was conducted. All of the participants were monitored on the following parameters: falls, comorbidities, drug therapy and The Berg Balance Scale. The rate of falls was shown as an incidence ratio. Cluster analysis for subgroups with similar features was performed on all patients included in the study. Two clusters of frequent fallers were determined. The fall incidence rate in falls per person per year was 1.41 (95% CI: 0.86-1.96) in asthmatic patients and 1.49 (95% CI: 1.05-2.11) in the COPD group. Frequent fallers were more prevalent in the COPD group, with 32% in this group compared to 28% in the groups of patients with asthma. In cluster analysis, frequent fallers were grouped into two models characterized by polytherapy, depression symptoms, hospitalizations, coronary disease, dementia and diagnosis of COPD or asthma. Elderly asthmatic patients presented a high rate of falls, which is comparable to that of patients with COPD.

Orthostatic Hypotension and Mortality in Elderly Frail Patients

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Freud, Tamar; Punchik, Boris; Yan, Press

2015-01-01

Abstract Orthostatic hypotension (OH) is a common problem in the elderly age group, and some studies have reported an association between OH and increased mortality. We evaluated possible associations between OH and mortality in a retrospective study of frail elderly patients who came for a comprehensive geriatric assessment. The study included all patients ≥65 years who were assessed in the outpatient Comprehensive Geriatric Assessment Unit. Data were collected from the computerized medical record, including blood pressure, sociodemographic data, lifestyle, falls, pulse rate, body mass index, functional and cognitive status, and comorbidity. Data on mortlaity were also collected. The study population consisted of 571 patients who underwent assessment over a 9-year study period. The mean age was 83.7 ± 6.1, 35.9% were males, and 183 (32.1%) were diagnosed with OH. Systolic OH (OHS) was more common than diastolic OH (25.2% vs 15.6%). In univariate analyses, OHS was associated with increased overall mortality. Over the follow-up period, 30.2% of the OHS patients died compared with 22.3% (P = 0.037), but in the Cox models there was no statistically significant associations between OHS and overall mortality. In contrast, age, burden of comorbidity, a low high-density lipoprotein level, and low creatinine clearance were independent predictors of increased overall mortality. In a population of frail elderly patients with a high burden of comorbidity, OH was not an independent risk factor for overall mortality. PMID:26091470

Anorexia and eating patterns in the elderly.

Directory of Open Access Journals (Sweden)

Lorenzo Maria Donini

Full Text Available To evaluate the change in eating habits occurring in community-dwelling and institutionalized elderly subjects with senile anorexia.Cross-sectional, observational.Community, nursing homes and rehabilitation or acute care facilities in four Italian regions.A random sample of 526 subjects, aged 65 years and older (217 free living individuals, 213 residents in nursing homes, and 93 patients in rehabilitation and acute wards.All subjects underwent a multidimensional geriatric evaluation of: nutritional status, anthropometric parameters, health and cognitive status, depression, taste, chewing and swallowing function, and some hormones related to appetite. Diet variety was assessed, considering the frequency of consumption of different food groups (milk and dairy products; meat, fish, and eggs; cereals and derivatives; fruit and vegetables.In anorexic elderly subjects the global food intake was reduced, and the eating pattern was characterized by the reduced consumption of certain food groups ("meat, eggs and fish" and "fruit and vegetables" whereas the frequency of consumption of milk and cereals remained almost unchanged. Nutritional parameters were significantly better in normal eating subjects and correlated with diet variety.Because of the high prevalence of senile anorexia in the geriatric population and its impact on the nutritional status, further research should be prompted to establish an intervention. protocol allowing the early diagnosis of anorexia of aging, aimed at identifying its causes and at optimizing treatment of anorexic patients.

The Italian version of the 92-item Prodromal Questionnaire: Concurrent validity with the SIPS and factor analysis in a sample of 258 outpatients aged 11-36years.

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Kotzalidis, Georgios D; Solfanelli, Andrea; Piacentino, Daria; Savoja, Valeria; Fiori Nastro, Paolo; Curto, Martina; Lindau, Juliana Fortes; Masillo, Alice; Brandizzi, Martina; Fagioli, Francesca; Raballo, Andrea; Gebhardt, Eva; Preti, Antonio; D'Alema, Marco; Fucci, Maria Rosa; Miletto, Roberto; Andropoli, Daniela; Leccisi, Donato; Girardi, Paolo; Loewy, Rachel L; Schultze-Lutter, Frauke

2017-11-01

Current early screeners for psychosis-risk states have still to prove ability in identifying at-risk individuals. Among screeners, the 92-item Prodromal Questionnaire (PQ-92) is often used. We aimed to assess the validity of its Italian translation in a large Italian adolescent and young adult help-seeking sample. We included all individuals aged 12-36years seeking help at psychiatric mental health services in a large semirural Roman area (534,600 population) who accepted to participate. Participants completed the Italian version of the PQ-92 and were subsequently assessed with the Structured Interview of Prodromal/Psychosis-Risk Syndromes (SIPS). We examined diagnostic accuracy (sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios) and content, concurrent, and convergent validity between PQ-92 and SIPS using Cronbach's alpha, Cohen's kappa, and Spearman's rho, respectively. We tested the validity of adopted cut-offs through Receiver Operating Characteristic (ROC) curves plotted against SIPS diagnoses and the instrument's factor-structure through Principal Component Analysis. PQ-92 showed high internal consistency, acceptable diagnostic accuracy and concurrent validity, and excellent convergent validity. ROC analyses pointed to scores of 18 on the Positive subscale and 36 on the total PQ-92 as best cut-offs. The Scree-test identified a four-factor solution as fitting best. Psychometric properties of Italian PQ-92 were satisfactory. Optimal cut-offs were confirmed at ≥18 on the positive subscale, but at ≥36 on the total scale was able to identify more SIPS-positive cases. Copyright © 2017 Elsevier B.V. All rights reserved.

Language Policy and Planning: The Case of Italian Sign Language

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Geraci, Carlo

2012-01-01

Italian Sign Language (LIS) is the name of the language used by the Italian Deaf community. The acronym LIS derives from Lingua italiana dei segni ("Italian language of signs"), although nowadays Italians refers to LIS as Lingua dei segni italiana, reflecting the more appropriate phrasing "Italian sign language." Historically,…

Italian Mediterranean Index and risk of colorectal cancer in the Italian section of the EPIC cohort.

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Agnoli, Claudia; Grioni, Sara; Sieri, Sabina; Palli, Domenico; Masala, Giovanna; Sacerdote, Carlotta; Vineis, Paolo; Tumino, Rosario; Giurdanella, Maria Concetta; Pala, Valeria; Berrino, Franco; Mattiello, Amalia; Panico, Salvatore; Krogh, Vittorio

2013-03-15

Colorectal cancer is among the commonest cancers worldwide. Dietary factors have been linked to colorectal cancer risk, however, few studies have evaluated the relationship between a priori dietary patterns and colorectal cancer risk. We evaluated the effect of adherence to a Mediterranean dietary pattern, as measured by the Italian Mediterranean Index, on the risk of colorectal cancer in the 45,275 participants of the Italian section of the EPIC study who completed a dietary questionnaire. Hazard ratios (HRs) with 95% confidence intervals (CIs) for colorectal cancer in relation to categories of Italian Mediterranean Index score were estimated by multivariate Cox models adjusted for known risk factors, on the whole cohort, on men and women and according to cancer subsite. During a mean follow-up of 11.28 years, 435 colorectal cancer cases were identified. The Italian Mediterranean Index was inversely associated with colorectal cancer risk (HR: 0.50; 95% CI: 0.35-0.71 for the highest category compared to the lowest, P-trend: 0.043). Results did not differ by sex. Highest Italian Mediterranean Index score was also significantly associated with reduced risks of any colon cancer (HR: 0.54, 95% CI: 0.36-0.81), distal colon cancer (HR: 0.44, 95% CI: 0.26-0.75) and rectal cancer (HR: 0.41, 95% CI: 0.20-0.81), but not of proximal colon cancer. These findings suggest that adherence to a Mediterranean diet (as measured by the Italian Mediterranean Index) protects against colorectal cancer in general but not against cancer developing in the proximal colon. Copyright © 2012 UICC.

Psychotropic medicine prescriptions in Italian youths: a multiregional study.

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Piovani, Daniele; Clavenna, Antonio; Cartabia, Massimo; Bonati, Maurizio

2016-03-01

The aim of the study was to evaluate the trend of paediatric psychotropic drug prescriptions in Italy. Data sources were regional, outpatient prescription databases. Seven Italian regions, covering 50 % of the Italian population, provided data from 2006 to 2011. Prevalence and incidence of prescriptions by age and gender were evaluated for psychotropic, antidepressant, antipsychotic, and attention-deficit/hyperactivity disorders (ADHD) medications. The hospital admission rate for psychiatric conditions was calculated, also at the local health unit (LHU) level. The presence of trends in prescription prevalence and incidence during the 6 year period was assessed. Finally, the correlation between prevalence, prescription, hospital admission rates, latitude, longitude, and average annual income at the LHU level was also investigated. In 2011, 8834 youths received at least one psychotropic drug prescription, with a prevalence of 1.76 ‰ (95 % CI 1.72-1.80). The incidence of new psychotropic drug users was 1.03 ‰ (1.00-1.06). The prevalence of antidepressants was 1.02 ‰ (0.99-1.04), while that of antipsychotics was 0.70 ‰ (0.68-0.72), and that of ADHD medications 0.19 ‰ (0.18-0.21). The psychotropic drug prevalence increased with increasing age. Males were more exposed to psychotropic drugs than females (AUC0-17 male/female = 1.23). Antipsychotics were the most prescribed psychotropic drugs in males, while antidepressants were in females. Between-region prevalence ranged from 1.56 to 2.17 ‰. The overall prevalence of psychotropic drug from 2006 to 2011 was stable (χ(t)2 ≤ 0.001, p = 0.97). No correlation was found between prevalence and the variables investigated. Psychotropic drug prescription was very limited and stable. No geographical patterns were found.

Colostomy irrigation in the elderly. Effective recovery regardless of age.

Science.gov (United States)

Venturini, M; Bertelli, G; Forno, G; Grandi, G; Dini, D

1990-12-01

One hundred forty elderly cancer outpatients with colostomy in the authors' rehabilitation department were included in an analysis of the feasibility, effectiveness, and safety of periodic irrigation of remaining colon with lukewarm tap water with the aim of regaining full continence. Sixteen patients did not have a sufficiently long remaining bowel (cecostomy, transverse colostomy) and 17 were considered unsuitable to learn the technique because of advanced neoplastic disease with poor life expectancy, intercurrent disease, or stomal problems. One hundred seven patients were proposed to perform the irrigation: 17 refused to do so with the remaining 90 able to learn the method without problems. Nearly all patients achieved full continence for at least 24 hours. Three patients refused to continue, and nine interrupted for minor complications. The median duration of irrigation in the whole group is 257 days (range, 1 to 2669 days): 32 patients have been irrigating from one to five years, and 9 patients for more than 5 years. Based on these results, we recommend irrigation as standard rehabilitative treatment for elderly patients.

Validation of Montgomery-Åsberg Rating Scale and Cornell Scale for Depression in Dementia in Brazilian elderly patients.

Science.gov (United States)

Portugal, Maria da Glória; Coutinho, Evandro Silva Freire; Almeida, Cloyra; Barca, Maria Lage; Knapskog, Anne-Brita; Engedal, Knut; Laks, Jerson

2012-08-01

There are few studies on validation of depression scales in the elderly in Latin America. This study aimed to assess the validity of Montgomery-Åsberg. Depression Rating Scale (MADRS) and Cornell Scale for Depression in Dementia (CSDD) in Brazilian elderly outpatients. A convenience sample of 95 outpatients was diagnosed for dementia and depression according to DSM-IV-TR, ICD-10, and PDC-dAD criteria. Receiver Operating Curves (ROC) were used to calculate the area under the curve (AUC) and to assess MADRS and CSDD cut-offs for each diagnostic criterion. Dementia was diagnosed in 71 of 95 patients. Depression was diagnosed in 35, 30, and 51 patients by ICD-10, DSM-IV, and PDC-dAD, respectively. MADRS cut-off score of 10 correctly diagnosed 67.4% and 66.3% patients as depressed according to DSM-IV and ICD-10. A cut-off of 9 correctly identified 74.7% by PDC-dAD criteria; a CSDD cut-off score of 13 best recognized depression according to DSM-IV and ICD-10. A score of 11 diagnosed depression according to PDC-dAD, while MADRS = 9 recognized depression in dementia. CSDD was more efficient in showing depression in mild than in moderate/severe dementia according to DSM-IV/ICD-10. PDC-dAD behaved nicely for any severity stage. MADRS and CSDD cut-offs of 10 and 13 were the optimal ones to diagnose depression in elderly, respectively. CSDD cut-offs are higher than those found in other countries. Other Latin American studies are needed to compare results with our study.

Elders Health Empowerment Scale

Science.gov (United States)

2014-01-01

Introduction: Empowerment refers to patient skills that allow them to become primary decision-makers in control of daily self-management of health problems. As important the concept as it is, particularly for elders with chronic diseases, few available instruments have been validated for use with Spanish speaking people. Objective: Translate and adapt the Health Empowerment Scale (HES) for a Spanish-speaking older adults sample and perform its psychometric validation. Methods: The HES was adapted based on the Diabetes Empowerment Scale-Short Form. Where "diabetes" was mentioned in the original tool, it was replaced with "health" terms to cover all kinds of conditions that could affect health empowerment. Statistical and Psychometric Analyses were conducted on 648 urban-dwelling seniors. Results: The HES had an acceptable internal consistency with a Cronbach's α of 0.89. The convergent validity was supported by significant Pearson's Coefficient correlations between the HES total and item scores and the General Self Efficacy Scale (r= 0.77), Swedish Rheumatic Disease Empowerment Scale (r= 0.69) and Making Decisions Empowerment Scale (r= 0.70). Construct validity was evaluated using item analysis, half-split test and corrected item to total correlation coefficients; with good internal consistency (α> 0.8). The content validity was supported by Scale and Item Content Validity Index of 0.98 and 1.0, respectively. Conclusions: HES had acceptable face validity and reliability coefficients; which added to its ease administration and users' unbiased comprehension, could set it as a suitable tool in evaluating elder's outpatient empowerment-based medical education programs. PMID:25767307

Italian singer Annalisa at CERN for a week of filming

CERN Multimedia

Stefania Pandolfi

2015-01-01

CERN welcomed Italian singer-songwriter Annalisa for a week-long visit to the Laboratory to shoot an Italian television production about the Laboratory.   Annalisa in the CERN Control Centre.   The Italian artist has a degree in physics from the University of Turin, Italy. She is a singer and songwriter, famous for her successful participation in the Italian talent show, Amici di Maria De Filippi. She has recorded four albums as solo artist and has participated twice in the Sanremo Music Festival, the most important Italian song contest. She has also received numerous Italian music awards, and has earned international recognition. Thanks to her knowledge of physics and her great influence with the Italian youth, Annalisa was selected to host an Italian television production about CERN aimed at young people. 

Authentic Italian food as Mamma used to make it!

DEFF Research Database (Denmark)

Madsen, Jan Halberg; d'Ambrosio, Luigi

2015-01-01

The purpose of this investigation is to explore how Italian restaurants define authentic Italian culinary experiences and how these experiences are designed and rendered to the restaurants’ guests.......The purpose of this investigation is to explore how Italian restaurants define authentic Italian culinary experiences and how these experiences are designed and rendered to the restaurants’ guests....

The Italian version of cognitive function instrument (CFI): reliability and validity in a cohort of healthy elderly.

Science.gov (United States)

Chipi, Elena; Frattini, Giulia; Eusebi, Paolo; Mollica, Anita; D'Andrea, Katia; Russo, Mirella; Bernardelli, Alice; Montanucci, Chiara; Luchetti, Elisa; Calabresi, Paolo; Parnetti, Lucilla

2018-01-01

The Alzheimer's disease Cooperative Study (ADCS)-Cognitive Function Instrument (CFI) is a 14-item questionnaire administered to the subject and the referent, aimed at detecting early changes in cognitive and functional abilities in individuals without clinical impairment. It is used for monitoring annual variations in cognitive functioning in prevention trials. The aim of the present study was to validate the Italian version of the CFI. A consecutive series of 257 functionally independent subjects was recruited among relatives of patients or as volunteers. They were administered CFI and global cognition measurements: Mini-Mental Status Examination (MMSE) and Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). The reliability and criterion validity were comparable to the original in both self- and partner-report. Similarly to what reported in the original version, we found a corrected item-total correlation ranging between 0.38 and 0.54 in self-report and between 0.33 and 0.64 in partner-report. Cronbach's α was 0.77 (95% CI 0.72-0.83) in self-report and 0.78 (95% CI 0.73-0.84) in partner-report. Total partner- and self-report scores were significantly correlated (rS = 0.31, p reliability and validity of the Italian version of CFI. In order to definitely propose the use of CFI for tracking longitudinal changes of cognitive and functional abilities in subjects without clinical impairment, data from the follow-up of this cohort are needed.

Predictors of the risk of falls among elderly with chronic atrial fibrillation

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Angela Cristina Silva dos Santos

2012-01-01

Full Text Available OBJECTIVES: Though elderly persons with chronic atrial fibrillation have more comorbidities that could limit indications for the chronic use of anticoagulants, few studies have focused on the risk of falls within this particular group. To evaluate the predictors of the risk of falls among elderly with chronic atrial fibrillation, a cross-sectional, observational study was performed. METHODS: From 295 consecutive patients aged 60 years or older with a history of atrial fibrillation who were enrolled within the last 2 years in the cardiogeriatrics outpatient clinic of the Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, 107 took part in this study. Their age was 77.9±6.4 years, and 62 were female. They were divided into two groups: a no history of falls in the previous year and b a history of one or more falls in the previous year. Data regarding the history of falls and social, demographic, anthropometric, and clinical information were collected. Multidimensional assessment instruments and questionnaires were applied. RESULTS: At least one fall was reported in 55 patients (51.4%. Among them, 27 (49.1% presented recurrent falls, with body lesions in 90.4% and fractures in 9.1% of the cases. Multivariate logistic regression showed that selfreported difficulty maintaining balance, use of amiodarone, and diabetes were independent variables associated with the risk of falls, with a sensitivity of 92.9% and a specificity of 44.9%. CONCLUSION: In a group of elderly patients with chronic atrial fibrillation who were relatively independent and able to attend an outpatient clinic, the occurrence of falls with recurrence and clinical consequences was high. Difficulty maintaining balance, the use of amiodarone and a diagnosis of diabetes mellitus were independent predictors of the risk for falls. Thus, simple clinical data predicted falls better than objective functional tests.

Outpatient presentations to burn centers: data from the Burns Registry of Australia and New Zealand outpatient pilot project.

Science.gov (United States)

Gabbe, Belinda J; Watterson, Dina M; Singer, Yvonne; Darton, Anne

2015-05-01

Most studies about burn injury focus on admitted cases. To compare outpatient and inpatient presentations at burn centers in Australia to inform the establishment of a repository for outpatient burn injury. Data for sequential outpatient presentations were collected at seven burn centers in Australia between December 2010 and May 2011 and compared with inpatient admissions from these centers recorded by the Burns Registry of Australia and New Zealand for the corresponding period. There were 788 outpatient and 360 inpatient presentations. Pediatric outpatients included more children burns (39% vs 24%). Adult outpatients included fewer males (58% vs 73%) and intentional injuries (3.3% vs 10%), and more scald (46% vs 30%) and contact burns (24% vs 13%). All pediatric, and 98% of adult, outpatient presentations involved a %TBSAburns presenting to burn centers differed to inpatient admission data, particularly with respect to etiology and burn severity, highlighting the importance of the need for outpatient data to enhance burn injury surveillance and inform prevention. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

The Italian LPG market

International Nuclear Information System (INIS)

Anon.

1998-01-01

As happened in other European countries, the Italian LPG consumption market narrowed in 1997 for climatic reasons. Still, with some 3,5 million tones it is the first LPG market in Europe thanks to automotive LPG which represents some 1,2 million tones, for 1,4 million tones for the bulk and 760, 000 tonnes for bottled products. Another characteristic of the Italian market: demand is slightly lowering in the North while increasing in the South and in the large islands. (author)

Funding fears spark Italian protests

CERN Multimedia

Abbott, A

2001-01-01

150 Italian scientists took part in a symbolic funeral in Milan for Italian research. Scientists are worried that the new government will reduce support for basic research. Rumours that budgets will be cut are being confirmed and last week the government rejected the 3-year plan of the National Research Council, which had proposed an expansion of staff (1/2 page).

Disability, poverty, and role of the basic livelihood security system on health services utilization among the elderly in South Korea.

Science.gov (United States)

Jeon, Boyoung; Noguchi, Haruko; Kwon, Soonman; Ito, Tomoko; Tamiya, Nanako

2017-04-01

With rapid aging, many of the elderly suffer from poverty and high healthcare needs. In Korea, there is a means-tested and non-contributory public assistance, the National Basic Livelihood Security System (NBLSS). The purpose of this study is to show older population's condition of disability and poverty, to evaluate the impact of NBLSS on health services utilization, and to examine the differential effect of the NBLSS by disability status among the elderly. This study used the Korea Welfare Panel Study data 2005-2014 with the final sample of 40,365, who were 65 years and older. The participants were divided into people with mild disability, severe disability, and without disability according to the Korean disability registration system. The income-level was defined to the low-income with NBLSS, the low-income without NBLSS, and the middle and high income, using the relative poverty line as a proxy of the low-income. The dependent variables were the number of outpatient visits and inpatient days, experience of home care services, total healthcare expenditure, and financial burden of healthcare expenditure. We performed Generalized Estimating Equations population-averaged model using the ten years of panel data. The result showed that within the same disability status, the low-income without NBLSS group used the least amount of inpatient care, but their financial burden of health expenditure was the highest among the three income groups. The regression model showed that if the elderly with severe disability were in the low-income without NBLSS, they reduced the outpatient and inpatient days; but their financial burden of healthcare became intensified. This study shows that the low-income elderly with disability but without adequate social protection are the most disadvantaged group. Policy is called for to mitigate the difficulties of this vulnerable population. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

A re-evaluation of the Italian historical geomagnetic catalogue: implications for paleomagnetic dating at active Italian volcanoes

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F. D'Ajello Caracciolo

2011-06-01

Full Text Available Paleomagnetism is proving to represent one of the most powerful dating tools of volcanics emplaced in Italy during the last few centuries/millennia. This method requires that valuable proxies of the local geomagnetic field (paleosecular variation ((PSV are available. To this end, we re-evaluate the whole Italian geomagnetic directional dataset, consisting of 833 and 696 declination and inclination measurements, respectively, carried out since 1640 AD at several localities. All directions were relocated via the virtual geomagnetic pole method to Stromboli (38.8° N, 15.2° E, the rough centre of the active Italian volcanoes. For declination-only measurements, missing inclinations were derived (always by pole method by French data (for period 1670–1789, and by nearby Italian sites/years (for periods 1640–1657 and 1790–1962. Using post-1825 declination values, we obtain a 0.46 ± 0.19° yr⁻¹ westward drift of the geomagnetic field for Italy. The original observation years were modified, considering such drift value, to derive at a drift-corrected relocated dataset. Both datasets were found to be in substantial agreement with directions derived from the field models by Jackson et al. (2000 and Pavon-Carrasco et al. (2009. However, the drift-corrected dataset minimizes the differences between the Italian data and both field models, and eliminates a persistent 1.6° shift of 1933–1962 declination values from Castellaccio with respect to other nearly coeval Italian data. The relocated datasets were used to calculate two post-1640 Italian SV curves, with mean directions calculated every 30 and 10 years before and after 1790, respectively. The curve comparison suggests that both available field models yield the best available SV curve to perform paleomagnetic dating of 1600–1800 AD Italian volcanics, while the Italian drift-corrected curve is probably preferable for the 19th century. For the 20th century, the global model by

QT interval prolongation in users of selective serotonin reuptake inhibitors in an elderly surgical population

DEFF Research Database (Denmark)

van Haelst, Ingrid M M; van Klei, Wilton A; Doodeman, Hieronymus J

2014-01-01

OBJECTIVE: To investigate the association between the use of a selective serotonin reuptake inhibitor (SSRI) and the occurrence of QT interval prolongation in an elderly surgical population. METHOD: A cross-sectional study was conducted among patients (> 60 years) scheduled for outpatient...... preanesthesia evaluation in the period 2007 until 2012. The index group included elderly users of an SSRI. The reference group of nonusers of antidepressants was matched to the index group on sex and year of scheduled surgery (ratio, 1:1). The primary outcome was the occurrence of QT interval prolongation shown...... on electrocardiogram. The QT interval was corrected for heart rate (QTc interval). The secondary outcome was the duration of the QTc interval. The outcomes were adjusted for confounding by using regression techniques. RESULTS: The index and reference groups included 397 users of an SSRI and 397 nonusers, respectively...

Effect of multi-sensory balance training for unsteady elderly people: pilot study of the "Reykjavik model".

Science.gov (United States)

Kristinsdottir, Ella Kolbrun; Baldursdottir, Bergthora

2014-01-01

To evaluate effects of combined mechano- and proprioceptive, vestibular and fall-prevention training on postural control, functional ability, confidence in activities of daily living (ADL) and frequency of falls among unsteady elderly people. Subjects were 37 elderly outpatients attending physiotherapy because of instability. Treatment consisted of 18 multisensory balance training sessions. RESULTS from Sensory Organization Test, Five-Times-Sit-to-Stand Test, 30-m normal and fast walk with a turn, Ascending-Descending 11 steps and Activities-specific Balance Confidence Scale were compared before and after training. Information was gathered about number of falls 1 year prior to training, during training period and for 6 months after completion of training. Significant improvement was observed in all measured parameters (p falls in the year prior to the study. Six subjects reported seven falls during the training period and seven subjects reported 17 falls in the 6 months follow-up period. Combined vestibular, proprioceptive and fall-prevention training improve postural control, functional ability, confidence in ADL and might even decrease the risk of falling among elderly people.

Randomized, double-blind, placebo-controlled trial of fluoxetine treatment for elderly patients with dysthymic disorder.

Science.gov (United States)

Devanand, D P; Nobler, Mitchell S; Cheng, Jocelyn; Turret, Nancy; Pelton, Gregory H; Roose, Steven P; Sackeim, Harold A

2005-01-01

The authors compared the efficacy and side effects of fluoxetine and placebo in elderly outpatients with dysthymic disorder. Patients were randomly assigned to fluoxetine (20 mg-60 mg/day) or placebo for 12 weeks in a double-blind trial. Of 90 randomized patients, 71 completed the trial. In the intent-to-treat sample, random regression analyses of the Hamilton Rating Scale for Depression (Ham-D; 24-item) and Cornell Dysthymia Rating Scale (CDRS) scores at each visit produced significant time x treatment group interactions favoring the fluoxetine group. Analysis of percentage change in Ham-D scores yielded no effect for treatment group, but a similar analysis of percentage change in CDRS scores yielded a main effect for treatment group, favoring fluoxetine over placebo. In the intent-to-treat sample, response rates were 27.3% for fluoxetine and 19.6% for placebo. In the completer sample, response rates were 37.5% for fluoxetine and 23.1% for placebo. Fluoxetine had limited efficacy in elderly dysthymic patients. The clinical features of elderly dysthymic patients are typically distinct from those of dysthymic disorder in young adults, and the findings suggest that treatments effective for young adult dysthymic patients may not be as useful in elderly dysthymic patients. Further research is needed to identify efficacious treatments for elderly patients with dysthymic disorder, and investigative tools such as electronic/computerized brain scans and neuropsychological testing may help identify the factors that moderate antidepressant treatment response and resistance.

Overweight and obesity among elderly in an urban slum of Puducherry: A facility-based descriptive study

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Bijaya Nanda Naik

2018-01-01

Full Text Available Background: Overweight and obesity are important addendum to the pool of risk factors for noncommunicable disease (NCD among the elderly. Objectives: The objectives of this study were to find (1 the proportion of overweight and obesity and (2 the distribution of overweight and obesity based on sociodemographic characteristics and four major risk factors for NCDs (smoking, alcohol consumption, unhealthy diet, and physical inactivity among the elderly attending the out-patient department/NCD clinic of a Urban Health and Training Centre (UHTC. Materials and Methods: This facility-based descriptive study was conducted among 181 elderly attending one UHTC, in Puducherry during June and July 2015. A pretested interview schedule was used to obtain information on sociodemographic details and history of NCD risk factors after obtaining verbal informed consent. Anthropometric measurements were taken as per standard procedures prescribed by the World Health Organization. Body mass index (BMI was calculated and classified using BMI classification for the Asian population. Results: Among the elderly, 18% were overweight and 51% were obese. The proportion of obesity was more among females than males. Obesity was found to be decreasing with increase in age. Overweight and obesity were found to be significantly inversely related to chronic disease status. Overweight and obesity were proportionately more among elderly who were consuming alcohol and doing less physical activity than prescribes. However, the proportion of overweight/obees elderly with no tobacco use and not having unhealthy diet was found to be more than their counterpart. Conclusion: Overweight and obesity are important public health problems in the study population. Hence, interventions should be implemented targeting elderly as well as the adult to decrease the obesity and overweight among the elderly.

Horizontal Inequity in Health Care Utilization among the Middle-Aged and Elderly in China.

Science.gov (United States)

Li, Chaofan; Dou, Lei; Wang, Haipeng; Jing, Shanshan; Yin, Aitian

2017-07-26

Equitable utilization of health care is a primary goal of the Chinese health system. This study aimed to examine horizontal inequity in health care utilization and identify the factors resulting in inequity among the middle-aged and elderly in China. The data were obtained from the China Health and Retirement Longitudinal Study (CHARLS). We employed the concentration index (CI) and horizontal inequity (HI) to measure inequity in health care utilization. Non-linear regression models were used to decompose the CI into the contribution of each factor. The CIs for the probability of and total number of outpatient visits were 0.0642 and 0.0780, respectively, and those for inpatient visits were 0.1418 and 0.1471, respectively. The HIs were also significantly positive. Living standard was the most important contributor. The contribution of health insurance varied between plans. This study supported the presence of pro-rich inequity in health care utilization for both probability and frequency among the middle-aged and elderly in China. Narrowing the living standard gap and improving the health insurance benefit package for the elderly should help to resolve these inequities.

The history of Italian psychiatry during Fascism.

Science.gov (United States)

Piazzi, Andrea; Testa, Luana; Del Missier, Giovanni; Dario, Mariopaolo; Stocco, Ester

2011-09-01

Specific features characterized Italian psychiatry during Fascism (1922-45), distinguishing it from Nazi psychiatry and giving rise to different operational outcomes, so we have investigated the state of Italian psychiatry during this period. We review the historical situation that preceded it and describe the social and health policies that Fascism introduced following new legislative and regulatory acts. We examine the preventive and therapeutic role played by psychiatry (the electric shock was an Italian invention) and, thanks to the Enciclopedia Italiano published during those years, we are able to highlight psychiatry's relationship to psychology, psychoanalysis, philosophy and religion. The shortcomings of Italian psychiatric research and practice are also seen in terms of what the State failed to do rather than what it did.

Safety and tolerability of 13-valent pneumococcal conjugate vaccine in the elderly

Science.gov (United States)

Durando, Paolo; Rosselli, Roberto; Cremonesi, Ilaria; Orsi, Andrea; Albanese, Erika; Barberis, Ilaria; Paganino, Chiara; Trucchi, Cecilia; Martini, Mariano; Marensi, Lorenzo; Turello, Valter; Study Group, the Ligurian Pneumococcal; Bregante, Alessandro; Cacciani, Roberto; Iudici, Rocco; La Marca, Diego; Pedano, Leonardo; Petrucci, Amadio Franco; Santolini, Maria; Sbisà, Valentina; Zacconi, Monica

2014-01-01

Background In September 2011 the European Medical Agency authorized the use of 13-valent pneumococcal conjugate vaccine (PCV13) in adults aged ≥50 years. The same occurred in the US in December 2011 when the Food and Drug Administration approved the use of PCV13 in the same target age-group with indication for the prevention of invasive pneumococcal diseases and community acquired pneumonia sustained by the serotypes contained in the vaccine. The Liguria Region, in Italy, implemented in 2013 an active and free of charge immunization strategy with PCV13 among adults affected by specific risk conditions and the elderly aged ≥70 years. Methods An observational study was performed in order to assess the safety and tolerability of PCV13 among elderly dwelling in the metropolitan area of Genoa, the capital city of Liguria Region. Eligible subjects, who received PCV13 following the public health immunization campaign at the Local Health Unit 3 of Genoa, provided a written informed consent to take part in the study. Eight-hundred-seventy-one subjects were enrolled between October 2013 and May 2014: all were monitored by qualified healthcare personnel for at least 30 min after vaccination at the outpatient clinics, in order to assess any possible sudden reaction. The occurrence of a series of local and systemic solicited reactions and of any unsolicited Adverse Events (AEs) was monitored using a self-administered clinical diary and by regular phone contacts up to 14 and 21 d following immunization, respectively. Moreover, a 6-months follow-up following vaccination was planned in order to monitor Severe Adverse Events (SAEs). Results No sudden reaction occurred in vaccinees at the outpatient clinics. Pain (27.4%) was the most frequent reaction reported by subjects at the injection site, while new muscle pain (13.6%), fatigue (10.7%), and headache (9.9%) resulted the most common systemic reactions. Rates of the main reactions reported in this on-field study resulted

Chemotherapy options for the elderly patient with advanced non-small cell lung cancer.

LENUS (Irish Health Repository)

Hennessy, B T

2012-02-03

Combination chemotherapy has been shown to improve overall survival compared with best supportive care in patients with advanced non-small cell lung cancer (NSCLC). The survival advantage is modest and was initially demonstrated with cisplatin-containing regimens in a large meta-analysis of randomized trials reported in 1995. Newer chemotherapy combinations have been shown to be better tolerated than older cisplatin-based combinations, and some trials have also shown greater efficacy and survival benefits with these newer combinations. Combination chemotherapy is, therefore, the currently accepted standard of care for patients with good performance statuses aged less than 70 years with advanced NSCLC. However, there are limited data from clinical trials to support the use of combination chemotherapy in elderly patients over 70 years of age with advanced NSCLC. Subgroup analyses of large randomized phase III trials suggest that elderly patients with good performance statuses do as well as younger patients treated with combination chemotherapy. There are few randomized trials reported that evaluate chemotherapy in patients aged greater than 70 years only. Based on data from trials performed by an Italian group, single-agent vinorelbine has been shown to have significant activity in elderly patients with advanced NSCLC and to be well tolerated by those patients with Eastern Cooperative Oncology Group performance statuses of two or less, with associated improvements in measures of global health.

The Impact of Different Diagnostic Criteria on the Prevalence of Sarcopenia in Healthy Elderly Participants and Geriatric Outpatients

NARCIS (Netherlands)

Reijnierse, E.M.; Trappenburg, M.C.; Leter, M.J.; Blauw, G. J.; Sipila, S.; Sillanpaa, E.; Narici, M.V.; Hogrel, J.Y.; Butler-Browne, G.; McPhee, J.S.; Gapeyeva, H.; Paasuke, M.; van Bokhorst-de van der Schueren, M.A.E.; Meskers, C.G.M.; Maier, A.B.

2015-01-01

Background: A consensus on the diagnostic criteria for sarcopenia, a common syndrome in the elderly, has not been reached yet. Prevalence rates vary between studies due to the use of different criteria encompassing different measures, correction factors and cutoff points. Objective: This study

Correlation between two physical activity programs in the gait of sedentary elderly subjects

Directory of Open Access Journals (Sweden)

Mariana Varkala Lanuez

2010-09-01

Full Text Available Objectives: To assess the effect of exercise on gait using two different programs: a group of aerobic exercises (Group A, n = 18 and a group of flexibility and balance exercises (Group B, n = 19. Methods: A casualized controlled study, in which each sample controlled itself, was undertaken. The sample comprised 37 male and female subjects, aged from 60 to 90 years, from the outpatient clinic of the Geriatrics Unit of Hospital das Clínicas of Faculdade de Medicina of Universidade de São Paulo; the patients were sedentary and had not exercised regularly during the past six months. Results: Improvement of gait was seen mainly in the group that did specific exercises. Conclusion: The results of this study underline the importance of physical exercises in sedentary elderly subjects, but show the need for programming the exercises towards specific goals, which can optimize the results of this tool of health promotion for the elderly.

[Prevalence of sarcopenia in geriatric outpatients and nursing homes. The ELLI study].

Science.gov (United States)

Osuna-Pozo, Carmen María; Serra-Rexach, José Antonio; Viña, José; Gómez-Cabrera, María del Carmen; Salvá, Antoni; Ruiz, Domingo; Masanes, Ferrán; Lopez-Soto, Alfonso; Formiga, Francesc; Cuesta, Federico; Cruz-Jentoft, Alfonso

2014-01-01

There are few systematic studies on the prevalence of sarcopenia using the new diagnostic criteria in different geriatric care settings. To estimate the prevalence of sarcopenia, using the European Working Group on Sarcopenia in Older People (EWGSOP) criteria in older subjects living in nursing homes and in those who attend geriatric outpatient clinics. A single country multicentre study in two samples of older subjects: patients cared for in outpatient geriatric clinics, and individuals living in nursing homes. Data collected will include demographic variables, medical history, medication, geriatric syndromes, functional status (assessment of basic and instrumental activities of daily living), mobility, cognitive status, comorbidity, quality of life, nutritional status, and laboratory parameters. For the diagnosis of sarcopenia, 4m walking speed, handgrip strength, and body composition measured by bioelectrical impedance analysis will be assessed. Using the EWGSOP algorithm, the prevalence of sarcopenia in an elderly Spanish population will be estimated. In addition, concordance and correlation between the three parameters included in the definition (muscle mass, muscle strength, and physical performance) will be analysed, using the different existing cut-off points, and examining the diagnostic accuracy of each. Finally, demographic, anthropometric and functional data that define subjects with sarcopenia will be investigated. The ELLI study should improve knowledge on the prevalence and characteristics of sarcopenia in older people in our population. Copyright © 2012 SEGG. Published by Elsevier Espana. All rights reserved.

[Geographical differences in clinical characteristics and management of stable outpatients with coronary artery disease: comparison between the Italian and international population included in the Worldwide CLARIFY registry].

Science.gov (United States)

Pozzoli, Massimo; Tavazzi, Luigi

2014-04-01

Limited data are available regarding specific differences among countries in demographic and clinical characteristics and treatment of patients with stable coronary artery disease. CLARIFY is an international, prospective and longitudinal registry including more than 33 000 patients with stable coronary artery disease enrolled in 45 countries worldwide. Data were used to compare the characteristics of patients enrolled in Italy with those enrolled in Europe and in the rest of the world. Baseline data were available for 33 283 patients, 2112 of whom from Italy and 12 614 from the remaining western European countries. Italian patients were found to be older, more frequently smoker, hypertensive and with sedentary habits. In addition, they presented more frequently a history of myocardial infarction, carotid arterial disease and chronic obstructive pulmonary disease. In addition, when compared with patients of both European and international cohorts, more Italian patients had undergone coronary angiography and angioplasty. As far as treatment was concerned, a greater number of Italian patients were taking ivabradine, angiotensin-converting enzyme inhibitors and/or angiotensin receptor blockers, nitrates, thienopyridines, while those taking beta-blockers, calcium antagonists and other antianginal medications were fewer. Among ambulatory patients with stable coronary artery disease, there are important geographic differences in terms of risk factors, clinical characteristics, surgical and pharmacological treatment.

Anorexia and Eating Patterns in the Elderly

Science.gov (United States)

Donini, Lorenzo Maria; Poggiogalle, Eleonora; Piredda, Maria; Pinto, Alessandro; Barbagallo, Mario; Cucinotta, Domenico; Sergi, Giuseppe

2013-01-01

Objectives To evaluate the change in eating habits occurring in community- dwelling and institutionalized elderly subjects with senile anorexia. Design Cross- sectional, observational. Setting Community, nursing homes and rehabilitation or acute care facilities in four Italian regions. Participants A random sample of 526 subjects, aged 65 years and older (217 free living individuals, 213 residents in nursing homes, and 93 patients in rehabilitation and acute wards). Measurements All subjects underwent a multidimensional geriatric evaluation of: nutritional status, anthropometric parameters, health and cognitive status, depression, taste, chewing and swallowing function, and some hormones related to appetite. Diet variety was assessed, considering the frequency of consumption of different food groups (milk and dairy products; meat, fish, and eggs; cereals and derivatives; fruit and vegetables). Results In anorexic elderly subjects the global food intake was reduced, and the eating pattern was characterized by the reduced consumption of certain food groups (“meat, eggs and fish” and “fruit and vegetables”) whereas the frequency of consumption of milk and cereals remained almost unchanged. Nutritional parameters were significantly better in normal eating subjects and correlated with diet variety. Conclusion Because of the high prevalence of senile anorexia in the geriatric population and its impact on the nutritional status, further research should be prompted to establish an intervention. protocol allowing the early diagnosis of anorexia of aging, aimed at identifying its causes and at optimizing treatment of anorexic patients. PMID:23658838

Medicare Provider Utilization and Payment Data - Outpatient

Data.gov (United States)

U.S. Department of Health & Human Services — The Outpatient Utilization and Payment Public Use File (Outpatient PUF) presents information on common outpatient services provided to Medicare fee-for-service...

Life expectancy inequalities in the elderly by socioeconomic status: evidence from Italy.

Science.gov (United States)

Lallo, Carlo; Raitano, Michele

2018-04-12

60 differs by five years between individuals with opposite socioeconomic statuses. Our study is the first that links results based on a micro survival analysis on subgroups of the elderly population with results related to the entire Italian population. The extreme differences in mortality risks by socioeconomic status found in our study confirm the existence of large health inequalities and strongly question the fairness of the Italian public pension system.

Italian Modernities

DEFF Research Database (Denmark)

Thomassen, Bjørn; Forlenza, Rosario

assumptions that have substituted for thought and that have perpetuated prejudices both within and outside Italy’s borders. Grounded in meticulous historical and ethnological research, Italian Modernities deserves as wide an audience as its scholarship is deep.” (Michael Herzfeld, Ernest E. Monrad Professor...

Outpatient management of pediatric acute mastoiditis.

Science.gov (United States)

Alkhateeb, Ahmed; Morin, Francis; Aziz, Haya; Manogaran, Mayuri; Guertin, William; Duval, Melanie

2017-11-01

Evaluate the Montreal Children's Hospital experience with outpatient management of uncomplicated acute mastoiditis with parenteral antibiotic therapy alone and determine if it is a safe alternative to inpatient management. A retrospective review of pediatric patients diagnosed with acute mastoiditis at a tertiary care pediatric hospital between 2013 and 2015 was performed. Patients with syndromes, immunodeficiency, cholesteatoma, chronic otitis media, cochlear implant in the affected ear, or incidental mastoid opacity were excluded. 56 children age 6 months to 15 years old were treated for acute mastoiditis, including 29 hospitalizations and 27 outpatients. Patients managed as outpatient with daily intravenous ceftriaxone had a 93% cure rate. Eighteen hospitalized and one outpatient had complications of acute mastoiditis. Children with complications were more likely to be febrile (p = 0.045). Two patients failed outpatient therapy and were admitted; one for myringotomy and piperacillin-tazobactam treatment and one required a mastoidectomy. 4/27 children treated as outpatient underwent myringotomy and tube insertion, 2 underwent myringotomy and tube along with admission and 21 did not require tube insertion. The average total duration of intravenous antibiotic therapy was respectively 4.9 and 18.9 days in the outpatient and hospitalized group. The average duration of admission was 5.9 days. Outpatient medical therapy of uncomplicated pediatric mastoiditis is safe, successful, and efficient. Benefits include efficient use of surgical beds, cost savings and patient and family convenience. Careful patient selection and close monitoring are keys for successful outcome. Copyright © 2017 Elsevier B.V. All rights reserved.

ITALIAN AND ITALIAN AMERICAN IDENTITY: A VISUAL APPROACH

African Journals Online (AJOL)

User

It is flexible without overall plan and contains spaces .... of Symbolic Capital, defined by Bourdieu as “The collection of luxury goods attesting to the taste and distinction of the owner” (1977: 188), ... Since “the most successful ideological effects are those which have no words ..... a market dominated by non-Italian proprietors.

Italian and Russian Verse: Two Cultures and Two Mentalities

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Stefano Garzonio

2006-12-01

Full Text Available Italian and Russian Verse: Two Cultures and Two Mentalities The present text was given as a talk at Stanford University in 2003. Here the author presents a comparative analysis of Russian and Italian versification and pays attention to the cultural contacts between these two poetical traditions in an effort to define the role played by Italian patterns in Russian verse. In this perspective the author offers a history of Russian poetical translation of Italian texts pointing out the different opinions of Russian poets about the “musicality” of Italian verse. The combined influence of language and culture in modelling different Russian poetical forms in a chronological perspective is underlined.

Energy efficiency: The Italian situation and opportunities

Energy Technology Data Exchange (ETDEWEB)

Clerici, Alessandro; Beccarello, Massimo; Gallanti, Massimo

2010-09-15

The paper reports the results of a study led by Confindustria (Italian Federation of Industrial Associations) on the Italian situation with respect to energy efficiency policies and their effective implementations. The study is being continuously updated with the contributions of ENEA (Italian National Agency for New Technologies, Energy and Sustainable Economic Development) and ERSE (previously CESI Ricerca) and highlights the obtainable savings through efficient technologies now already available for applications in the final uses of energy for both the industrial, commercial and domestic sectors.

Profile and analysis of diabetes chronic complications in Outpatient Diabetes Clinic of Cipto Mangunkusumo Hospital, Jakarta

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Tri J.E. Tarigan

2015-11-01

Full Text Available Background: Chronic complications of diabetes mellitus have a significant role in increasing morbidity, mortality, disability, and health cost. In the outpatient setting, the availability of data regarding to the chronic complications of type 2 diabetes is useful for evaluation of prevention, education, and patient’s treatment. This study aimed to describe the characteristic of type 2 diabetes chronic complications in outpatient diabetes clinic.Methods: A cross-sectional study was done using 155 patients in Outpatient Diabetes Clinic of Cipto Mangunkusumo Hospital (RSCM, Jakarta in 2010. Secondary data were used from medical record based on history taking, physical examination, diabetic foot assessment, laboratory, neurologic, cardiology, opthalmology, ankle brachial index, and electrography of the patients. Characteristic profiles of the subjects, prevalence of the chronic complications, and its association with diabetes risk factors, such as glycemic control using HbA1c, fasting blood glucose, duration of diabetes, and LDL cholesterol were analyzed using chi square test.Results: Among 155 subjects participated in the study, most of them were women (59% and elderly (46%. The prevalence of diabetes chronic complications was 69% from all subjects. These chronic complications included microangiopathy, macroangiopathy and mixed complications, with prevalence of 56%, 7% and 27% respectively. Microangiopathy included nephropathy (2%, retinopathy (7%, neuropathy (38% and mixed complications (53%. Macroangiopathy included coronary heart disease (46%, peripheral arterial disease (19%, stroke (18%, and mixed complication (17%. From the analysis, we found significant association between duration of diabetes and diabetic neuropathy (p = 0.003.Conclusion: Prevalence of diabetes chronic complications in Outpatient Diabetes Clinic of Cipto Mangunkusumo Hospital, mainly dominated by microvascular-related complications including nephropathy, retinopathy

Causes of decreased activity of daily life in elderly patients who need daily living care.

Science.gov (United States)

Yoshino, Hiroshi; Sakurai, Takashi; Hasegawa, Kazuo; Yokono, Koichi

2011-07-01

The causes of decreased activity of daily life (ADL) in elderly patients include cerebrovascular diseases, bone fracture by falls, and dementia. The present study was conducted among elderly patients with decreased ADL who were hospitalized in nursing wards in order to investigate the causes of becoming early bedridden and to determine precautionary measures against decreased ADL. The study subjects were 224 elderly patients with decreased ADL (mean age: 83.3 ± 8.0 years) and 49 outpatients without decreased ADL (mean age: 76.8 ± 5.3 years). Current age, age at the start of ADL decrease, medical history and history of smoking were investigated. In the groups with decreased ADL, current age and the age of becoming bedridden in non-diabetic versus diabetic groups were 84.7 ± 7.9 versus 80.3 ± 7.5 and 82.7 ± 8.3 versus 77.6 ± 8.0 years, respectively, both showing significantly lower values in the diabetic group (P bedridden. Diabetic patients with smoking habit were significantly younger than diabetic and non-diabetic patients without smoking habit. Sex difference, smoking habit and presence of diabetes mellitus are independent risk factors of becoming early bedridden. Therefore, the major targets of medical care among elderly should be diabetic men with a smoking habit to lower the risks of decreased ADL. © 2011 Japan Geriatrics Society.

The prevalence of personality disorders in psychiatric outpatients with borderline intellectual functioning: Comparison with outpatients from regular mental health care and outpatients with mild intellectual disabilities.

Science.gov (United States)

Wieland, Jannelien; Van Den Brink, Annemarie; Zitman, Frans G

2015-01-01

There is little research on the subject of personality disorder (PD) in individuals with borderline intellectual functioning (BIF). Unlike in most countries, in the Netherlands, patients with BIF are eligible for specialized mental health care. This offers the unique possibility of examining the rates of PDs in patients, who in other countries are treated relatively invisibly in regular mental health care. To compare, in a naturalistic setting, the frequency of PD diagnoses in outpatients with BIF with outpatients from regular mental health care and outpatients with mild ID. We compared the rates of all DSM-IV-TR axis II PDs in outpatients with BIF (BIF group; n = 235) with rates of the same disorders in outpatients from regular mental health care (RMHC group; n = 1026) and outpatients with mild intellectual disability (ID) (mild ID group; n = 152) in a naturalistic cross-sectional anonymized medical chart review. Over half of the patients with BIF (52.8%) were diagnosed with a PD, compared with one in five in the RMHC group (19.3%) and one in three of the mild ID group (33.6%). All PD diagnoses, except for cluster A PDs and histrionic PDs, were most frequently diagnosed in the BIF group. PD NOS and borderline PD were the most frequently diagnosed PDs in BIF. The majority of PD patients had one or more comorbid axis I disorder. There is a high frequency of PD diagnoses in BIF outpatients in daily clinical practice. In anticipation of further scientific research, results suggest that PDs should not be overlooked in patients with BIF.

European energy policy and Italian industry

International Nuclear Information System (INIS)

Cardinale, A.; Verdelli, A.

2008-01-01

The competitiveness of the Italian industry is very sensitive to the rising costs of energy. The European energy policy, if intended as an additional constraint, could deteriorate the situation. It could be, however, a good opportunity for the Italian industry to become more independent from fossil fuels, through an innovatory project at country level [it

Association between vitamin D deficiency and heart failure risk in the elderly.

Science.gov (United States)

Porto, Catarina Magalhães; Silva, Vanessa De Lima; da Luz, João Soares Brito; Filho, Brivaldo Markman; da Silveira, Vera Magalhães

2018-02-01

The aim of this study was to evaluate the association between vitamin D deficiency and risk of heart failure in elderly patients of cardiology outpatient clinics. A cross-sectional study with an analytical approach was employed. Clinical data were collected from the elderly from August 2015 to February 2016. The dependent variable was the risk of heart failure; the independent variable was vitamin D deficiency; and intervening factors were age, gender, education, ethnicity, hypertension, diabetes mellitus, hypothyroidism, renal failure, dementia, stroke, dyslipidaemia, depression, smoking, alcoholism, obesity, andropause, and cardiac arrhythmia. To analyse the association between vitamin D deficiency and risk of heart failure, we used the bivariate logistic analysis, followed by analysis through the multivariate logistic regression model. Of the 137 elderly, the study found the following: women (75.9%); overweight (48.2%); obese (30.6%); increase in the index waist/hip (88.3%); dyslipidaemia (94.2%) and hypertension (91.2%); coronary artery disease (35.0%); and 27.7% with cardiac arrhythmia or left ventricular hypertrophy. Sixty-five per cent of the elderly were deficient in vitamin D. The risk of heart failure was significantly associated with vitamin D deficiency [odds ratio (OR): 12.19; 95% confidence interval (CI) = 4.23-35.16; P = 0.000], male gender (OR: 15.32; 95% CI = 3.39-69.20, P = 0.000), obesity (OR: 4.17; 95% CI = 1.36-12.81; P = 0.012), and cardiac arrhythmia (OR: 3.69; 95% CI = 1.23-11.11; P = 0.020). There was a high prevalence of vitamin D deficiency in the elderly, and the evidence shows a strong association between vitamin D deficiency and increased risk of heart failure in this population. © 2017 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.

1861-1981: Statistics teaching in Italian universities

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Donata Marasini

2013-05-01

Full Text Available This paper aims to outline the development of Statistics from 1861 to 1981 with respect to its contents. The paper pays particular attention to some statistical topics which have been covered by basic introductory courses in the Italian Universities since the beginning of the Italian unification. The review takes as its starting point the well-known book “Filosofia della Statistica” of Melchiorre Gioja. This volume was published 35 years before Italian unification but it already contains the fundamental topics of exploratory and inductive Statistics. These topics give the opportunity to mention Italian statisticians who are considered the pioneers of this discipline. In particular, the attention is focused on four statisticians: Corrado Gini, well-known for its modern insights; Marcello Boldrini, high cultured man also in the epistemological field; Bruno de Finetti, founder of subjective school and Bayesian reasoning; Giuseppe Pompilj, precursor of random variables and sampling theory. The paper browses the indexes of three well-known Italian handbooks that, although published after the period 1861-1981, deal with topics covered in some basic teachings of exploratory statistics, statistical inference and sampling theory from finite population.

The fastest of three trials is recommended for Timed Up & Go testing of functional mobility in an outpatient geriatric setting

DEFF Research Database (Denmark)

Bloch, Mette Linding

trials are needed to produce the best performance. Purpose: To examine if the fastest of three timed TUG trials producesbetter (faster) results than the recording of the second trial in elderly people when following an outpatient geriatric rehabilitation programme. Material and Methods: A total of 32...... to 5.5 seconds in difference between the two recordings. Subjects using walking aids (n=10) were the oldest (P=0.057, mean age of 87.7 versus 81.5 years), and performed worse (P=0.033, 26.3 versus 17.3seconds) when using the best of the three TUG trials. Also, this score was significantly correlated...... elderly people (20 women), at a mean (SD) age of 83.4 (8.6) years were included. All subjects performed three timed TUG trials as fast as safely possible with their normal walking aid (if using). In addition, 30 of the 32 subjects performed the Chair Stand Test (CST) (number of sit to stands in 30 seconds...

Second-line therapy in diffuse large B-cell lymphoma (DLBCL): treatment patterns and outcomes in older patients receiving outpatient chemotherapy.

Science.gov (United States)

Danese, Mark D; Griffiths, Robert I; Gleeson, Michelle L; Dalvi, Tapashi; Li, Jingyi; Mikhael, Joseph R; Deeter, Robert; Dreyling, Martin

2017-05-01

Using SEER-Medicare linked data we identified elderly patients diagnosed with diffuse large B-cell lymphoma (DLBCL) between January 2000 and December 2007 who received second-line outpatient chemotherapy for relapsed or refractory disease. Second-line regimens were classified into three mutually exclusive groups: aggressive, conventional, and palliative. Of the 632 (426 relapsed, 206 refractory) patients in the cohort, 27.8% received aggressive second-line therapy, 39.1% received conventional therapy, and 33.1% received palliative therapy. There were no differences in survival by type of therapy received, either for relapsed or refractory patients, although the patient risk profile differed significantly. However, duration of remission, male gender, and anemia at diagnosis were important predictors in relapsed patients, and male gender, B-symptoms, comorbidity burden, and poverty status were important predictors in refractory patients. Survival in elderly patients receiving second-line therapy remains poor, and the 24-month cost of all care exceeds $97,000. Patients would benefit from improved treatment options.

Online Italian fandoms of American TV shows

Directory of Open Access Journals (Sweden)

Eleonora Benecchi

2015-06-01

Full Text Available The Internet has changed media fandom in two main ways: it helps fans connect with each other despite physical distance, leading to the formation of international fan communities; and it helps fans connect with the creators of the TV show, deepening the relationship between TV producers and international fandoms. To assess whether Italian fan communities active online are indeed part of transnational online communities and whether the Internet has actually altered their relationship with the creators of the original text they are devoted to, qualitative analysis and narrative interviews of 26 Italian fans of American TV shows were conducted to explore the fan-producer relationship. Results indicated that the online Italian fans surveyed preferred to stay local, rather than using geography-leveling online tools. Further, the sampled Italian fans' relationships with the show runners were mediated or even absent.

Semen quality of Italian local pig breeds

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G. Gandini

2010-01-01

Full Text Available From 1996 to 1999 a conservation programme was carried out within the framework of EC contract “European gene banking project for the pig genetic resources” (Ollivier et al., 2001 in the Italian local pig breeds. The aims of the program included the primary characterization of the breeds, i.e. information on the organization in charge of the breed, breeding population numbers, breed description and qualifications, and field trials on productive and reproductive performances. In this context the “Semen Bank of Italian local pig breeds” was built. A total of 30,835 straws of four Italian local pig breeds (Cinta Senese, Casertana, Mora Romagnola and Nero Siciliano, collected from 42 sires, have been stored. In this work semen quality traits, lipid composition and freezability of the four Italian local pig breeds are reported.

Comprehensive Outpatient Rehabilitation Program: Hospital-Based Stroke Outpatient Rehabilitation.

Science.gov (United States)

Rice, Danielle; Janzen, Shannon; McIntyre, Amanda; Vermeer, Julianne; Britt, Eileen; Teasell, Robert

2016-05-01

Few studies have considered the effectiveness of outpatient rehabilitation programs for stroke patients. The objective of this study was to assess the effectiveness of a hospital-based interdisciplinary outpatient stroke rehabilitation program with respect to physical functioning, mobility, and balance. The Comprehensive Outpatient Rehabilitation Program provides a hospital-based interdisciplinary approach to stroke rehabilitation in Southwestern Ontario. Outcome measures from physiotherapy and occupational therapy sessions were available at intake and discharge from the program. A series of paired sample t-tests were performed to assess patient changes between time points for each outcome measure. A total of 271 patients met the inclusion criteria for analysis (56.1% male; mean age = 62.9 ± 13.9 years). Significant improvements were found between admission and discharge for the Functional Independence Measure, grip strength, Chedoke-McMaster Stroke Assessment, two-minute walk test, maximum walk test, Timed Up and Go, Berg Balance Scale, and one-legged stance (P rehabilitation program was effective at improving the physical functioning, mobility, and balance of individuals after a stroke. A hospital-based, stroke-specific rehabilitation program should be considered when patients continue to experience deficits after inpatient rehabilitation. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Tuning Nursing Educational in an Italian academic context.

Science.gov (United States)

Marchetti, Anna; Venturini, Giulia; Virgolesi, Michele; Gobbi, Mary; Rocco, Gennaro; Pulimeno, Ausilia Maria Lucia; Stievano, Alessandro; Piredda, Michela; De Marinis, Maria Grazia

2015-09-01

The European Union Bologna Process has laid the foundation for a common European competence-based educational framework. In many countries, nursing education is in transition from vocational to higher education, with many diverse systems. The competence-based approach provided by the project Tuning Educational Structures offers a common and coherent framework able to facilitate the implementation of the principles underpinning the Bologna Process reform. This study aimed to ascertain the relevance that Italian nursing university lecturers attributed to the 40 competences of the Italian version of the nursing Bachelor's and Master's Degrees. These competences were developed through adoption of the Tuning Methodology in the nursing context. The study was conducted in the 4 universities of one region of Italy which offer nursing Bachelor's and Master's Degrees. A total of 164 Italian university nursing lecturers. Using a four point scale, a cross sectional survey was conducted from March 2011 to April 2012. Participants evaluated each competence according to its relevance for Bachelor's or Master's Education. Frequency analysis was conducted. The significance for each competence of Tuning was rated very high by Italian lecturers and appeared to overlap partially with the original European study. In Italy, the most relevant competences for Bachelor's Degree were the skills associated with the use of appropriate interventions, activities and skills in nursing and the skills associated with nursing practice and clinical decision-making. For Master's Degree, leadership, management and team competences were the most important. The Tuning Nursing Project was accepted by the Italian lecturers. The competence-based approach was considered by Italian lectures as a support enabling to reflect on the current Italian nursing education cycles of study and to ensure shared visions and common approaches between Italian and European lecturers. Copyright © 2015 Elsevier Ltd. All

Mobile information and communication in the hospital outpatient service.

Science.gov (United States)

Jen, Wen-Yuan; Chao, Chia-Chen; Hung, Ming-Chien; Li, Yu-Chuan; Chi, Y P

2007-08-01

Most healthcare providers provide mobile service for their medical staff; however, few healthcare providers provide mobile service as part of their outpatient service. The mobile outpatient service system (MOSS) focuses on illness treatment, illness prevention and patient relation management for outpatient service users. Initiated in a local hospital in Taiwan, the MOSS pilot project was developed to improve outpatient service quality and pursue higher patient safety. This study focuses on the development of the MOSS. The workflow, architecture and target users of the MOSS are delineated. In addition, there were two surveys conducted as part of this study. After a focus group of medical staff identified areas in which outpatient services might be improved by the MOSS, the first survey was administered to outpatients to confirm the focus group's intuitions. The second administration of the survey explored outpatient satisfaction after they used the MOSS service. With regard to outpatient attitudes, about 93% of participants agreed that the mobile outpatient service improved outpatient service quality. In the area of outpatient satisfaction, about 89% of participants indicated they were satisfied with the mobile outpatient service. Supported by our study finding, we propose that more diverse mobile outpatient services can be provided in the future.

[Italian Thesaurus of Bioethics, TIB].

Science.gov (United States)

Navarini, Claudia; Poltronieri, Elisabetta

2004-01-01

The article aims at illustrating the characteristics and functions of a monolingual thesaurus, focusing on the Italian Thesaurus of Bioethics (Thesaurus Italiano di Bioetica, TIB) the controlled vocabulary used to index and retrieve documents within SIBIL (Italian Online Bioethics Information System). TIB includes controlled terms (descriptors) translated from the Bioethics Thesaurus adopted by the Kennedy Institute of Ethics of the Georgetown University of Washington and revised according to the Italian context of study and scientific debate in the field of bioethics. The overall amount of TIB terms consists in over 1600 headings. Methods to link thesaurus terms hierarchically, by association and by showing synonyms as recommended in ISO standards are applied with reference to descriptors drawn from TIB. Future plans to make the English version of TIB available online within European networks are also illustrated, aiming at spreading information relating to bioethics at an international level.

Delivering an effective outpatient service in gynaecology. A randomised controlled trial analysing the cost of outpatient versus daycase hysteroscopy.

Science.gov (United States)

Marsh, Fiona; Kremer, Christian; Duffy, Sean

2004-03-01

To examine the cost implications of outpatient versus daycase hysteroscopy to the National Health Service, the patient and their employer. Randomised controlled trial. The gynaecology clinic of a large teaching hospital. Ninety-seven women with abnormal uterine bleeding requiring investigation. Women were randomly allocated to either outpatient or daycase hysteroscopy. They were asked to complete diaries recording expenses and time off work. The National Health Service costs were calculated for a standard outpatient and daycase hysteroscopy. Costs to the National Health Service, costs to the employer, loss of income, childcare costs and travel expenses. The outpatient group required significantly less time off work compared with the daycase group (0.8 days vs 3.3 days), P Service approximately pound 53.88 more per patient, than performing an outpatient hysteroscopy. Purchasing the hysteroscopes necessary to perform an outpatient hysteroscopy is a more expensive outlay than those required for daycase hysteroscopy. However, there are so many other savings that only 38 patients need to undergo outpatient hysteroscopy (even with a 4% failure rate) rather than daycase hysteroscopy in order to recoup the extra money required to set up an outpatient hysteroscopy service. Outpatient hysteroscopy offers many benefits over its traditional counterpart including faster recovery, less time away from work and home and cost savings to the woman and her employer and the National Health Service. Resources need to be made available to rapidly develop this service across the UK in order to better serve both patient and taxpayer.

[A comparison of the associations of dynapenia and sarcopenia with fear of falling in elderly diabetic patients].

Science.gov (United States)

Ida, Satoshi; Murata, Kazuya; Ishihara, Yuki; Imataka, Kanako; Kaneko, Ryutaro; Fujiwara, Ryoko; Takahashi, Hiroka

2017-01-01

To comparatively investigate whether dynapenia and sarcopenia, as defined by the Asian Working Group for Sarcopenia (AWGS), are associated with fear of falling in elderly patients with diabetes. The subjects were outpatients with diabetes who were at least 65 years of age when they visited our hospital. Sarcopenia was evaluated based on the AWGS definition. The cutoff values for the appendicular skeletal mass index (multi-frequency bioelectrical impedance method), grip strength, and walking speed were, respectively, 7.0 kg/m 2 for men and 5.7 kg/m 2 for women, 26 kg for men and 18 kg for women, and ≤0.8 m/s for both men and women. Those with grip strength of less than or equal to the cutoff value were considered to have dynapenia. Fear of falling was assessed by a self-administered questionnaire survey with the Fall Efficacy Scale (FES) Japanese version. A multiple regression analysis was conducted using the FES score as a dependent variable and dynapenia or sarcopenia and moderators as explanatory variables. A total of 202 patients (male, n=127; female, n=75) were analyzed in this study. The FES scores of the patients with and without sarcopenia did not differ to a statistically significant extent in either male or female patients. The multiple regression analysis revealed a statistically significant association between dynapenia and the FES score in men (P=0.028). In elderly outpatients with diabetes, no association was found between sarcopenia and the fear of falling in either men or women. In contrast, a statistically significant association was found between dynapenia and fear of falling in men. This suggests the importance paying attention to the fear of falling when examining elderly male diabetes patients with dynapenia.

Italian research on Antarctic atmosphere: 1st workshop. Ricerche italiane sull'atmosfera antartica: 1o workshop

Energy Technology Data Exchange (ETDEWEB)

Colacino, M. (ed.); Giovannelli, G. (ed.); Stefanutti, L. (ed.)

1989-01-01

The papers and reports, presented at this 1st workshop on 'Italian research on antarctic atmosphere', deal with several main topics: meteorology and climatology, aerosol and tropospheric clouds, planetary boundary layer, chemical-physic stratospheric property, aeronomy. They define the stage of development of Italian research in this area after 3 years of activity in Antarctica.

[Subjective and objective indicators of job stress and burnout in a residential home for the elderly].

Science.gov (United States)

Fiabane, Elena; Dordoni, Paola; Argentero, Piergiorgio

2016-01-01

Elderly care workers have a higher risk than other professionals of developing burnout. Despite literature has highlighted the methodological advantage resulting from an integration of subjective and objective measures of stressors, only few studies have investigated job stress and burnout in the Italian elderly care context using this kind of assessment. The aims of this study were: (a) to investigate the level of stress and burnout and their organizational sources in a sample of eldercare workers by means of subjective and objective tools, and b) to compare the stress and burnout levels between health care staff and nursing aides employed in a residential home for the, elderly. The sample of the study included the totality of the elderly workers employed in a residential home for the elderly (N=49; response rate: 100%). The Maslach Burnout Inventory-GS and the Areas of Worklife Scale were used for the subjective assessment of burnout and organizational riskfactors. A check list of objective indicators was used for the objective assessment of job stress. Results from the self-report questionnaires showed high levels of exhaustion and a perception of high workload and unfairness for, the total sample. Objective parameters ofjob stress risk were biomechanical overload, dealing with suffering people and the risk of work-related violence. Nursing aides had greater risk of burnout and reported a greater number of objective sources of stress, compared to health care workers. This exploratory study supports the use of both subjective and objective method for the assessment of job stress risk as the most comprehensive approach for the implementation of preventive and corrective interventions.

Geriatric forensics - Part 2 "Prevalence of elder abuse and their potential forensic markers among medical and dental patients".

Science.gov (United States)

Mattoo, Khurshid A; Garg, Rishabh; Kumar, Shalabh

2015-01-01

This study is a continuation of the earlier studies and has been extended to investigate the potential forensic markers of elder abuse. To determine the prevalence of elder abuse in various outpatient departments (OPDs). To study the associated parameters related to the abuser and the abused. To determine the existence of potential forensic markers of elder abuse. The subjects were randomly selected from the medical and the dental OPDs of the university. Eight hundred and thirty two elderly subjects in the age range 40-60 years were interviewed using a questionnaire to determine the existence of elder abuse. The subjects were investigated and examined for weight, nutrition and hydration, vital signs, habits, existing visual and auditory capabilities, medications, disclosure of wills/deeds, signs of depression, and documented cleanliness. The mini-mental state examination, the Geriatric Depression Scale, the Clock drawing test, and the Brief Psychiatric Rating Scale were used to determine the potential forensic markers. Mean values in percentage were determined by dividing the number of determined subjects by the total number of subjects for that parameter. About 37% in medical and 41% in dental OPDs were found to have suffered from abuse, mostly in the age group 60-70 years. Females received more abuse and a combination of son and daughter-in-law constituted most abusers. Various potential markers of elder abuse and neglect investigated among the elder abuse victims included depression (89%), signs of improper feeding (83%), changes in personal hygiene (69%), need for medical/dental treatment (78%), medication misuse (67%), changes in wills/deeds (26%), decubiti (10%), bruises (17%), skin tears (27%), and confusion (23%). Elder abuse exists in one or more forms in both medical and dental OPDs among both males and females in all age groups.

Calcium Channel Blockers in Secondary Cardiovascular Prevention and Risk of Acute Events: Real-World Evidence from Nested Case-Control Studies on Italian Hypertensive Elderly.

Science.gov (United States)

Bettiol, Alessandra; Lucenteforte, Ersilia; Vannacci, Alfredo; Lombardi, Niccolò; Onder, Graziano; Agabiti, Nera; Vitale, Cristiana; Trifirò, Gianluca; Corrao, Giovanni; Roberto, Giuseppe; Mugelli, Alessandro; Chinellato, Alessandro

2017-12-01

Antihypertensive treatment with calcium channel blockers (CCBs) is consolidated in clinical practice; however, different studies observed increased risks of acute events for short-acting CCBs. This study aimed to provide real-world evidence on risks of acute cardiovascular (CV) events, hospitalizations and mortality among users of different CCB classes in secondary CV prevention. Three case-control studies were nested in a cohort of Italian elderly hypertensive CV-compromised CCBs users. Cases were subjects with CV events (n = 25,204), all-cause hospitalizations (n = 19,237), or all-cause mortality (n = 17,996) during the follow-up. Up to four controls were matched for each case. Current or past exposition to CCBs at index date was defined based on molecule, formulation and daily doses of the last CCB delivery. The odds ratio (OR) and 95% confidence intervals (CI) were estimated using conditional logistic regression models. Compared to past users, current CCB users had significant reductions in risks of CV events [OR 0.88 (95% CI: 0.84-0.91)], hospitalization [0.90 (0.88-0.93)] and mortality [0.48 (0.47-0.49)]. Current users of long-acting dihydropyridines (DHPs) had the lowest risk [OR 0.87 (0.84-0.90), 0.86 (0.83-0.90), 0.55 (0.54-0.56) for acute CV events, hospitalizations and mortality], whereas current users of short-acting CCBs had an increased risk of acute CV events [OR 1.77 (1.13-2.78) for short-acting DHPs; 1.19 (1.07-1.31) for short-acting non-DHPs] and hospitalizations [OR 1.84 (0.96-3.51) and 1.23 (1.08-1.42)]. The already-existing warning on short-acting CCBs should be potentiated, addressing clinicians towards the choice of long-acting formulations.

’The Italian Color’: Race, Crime Iconography and Dubbing Conventions in the Italian-language Versions of Scarface (1932

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Carla Mereu Keating

2016-02-01

Full Text Available In the early 1930s the crime film Scarface: The Shame of a Nation (1932, USA, dir. Howard Hawks stirred censorship controversies in the United States because of its gritty portrayal of criminality and violence. Debates over crime, race and immigration proliferated in the North-American press and finally led to Italian-American pressure groups to call out for the film’s boycott because it ‘offended the Italian nation and people’ and vilified immigrant communities. Archival historical research in AVT has revealed how film versions have frequently been cut and dialogues ideologically manipulated to suit political agendas, commercial interests and dominant sexual and religious moralities. Indeed the translation of films has often served too many masters, suffering direct or indirect censorship intervention whenever a film defied existing societal taboos. My contribution aims to offer a diachronic perspective on the reception of Scarface lo sfregiato in Italy. It will look at the film’s Italian-language translation and re-translations for cinema, television and DVD, prepared by different hands and re-voiced by different actors during a span of fifty years (1940-90s. From the textual and contextual analysis of the film’s different Italian editions, it will be possible to trace significant ideological shifts in the reception of Italian-American crime iconography and in the language used to communicate it.

The effect of loneliness on malnutrition in elderly population.

Science.gov (United States)

Ramic, Enisa; Pranjic, Nurka; Batic-Mujanovic, Olivera; Karic, Enisa; Alibasic, Esad; Alic, Alma

2011-01-01

The clinical and epidemiological data show that proper nutrition plays an important role in maintaining health and combating the danger of developing some chronic diseases in the elderly population. Nutrition is an important factor in many physiological and pathological changes that accompany the aging process. More than 50% of elderly patients are suffering from malnutrition which is information that concerns. Due to various factors, older people are potentially vulnerable groups at risk of malnutrition. Loneliness, isolation from society and neglect of parents by children is a big problem to many people in old age. To determine differences in nutritional status of elderly people living alone compared to those who live in family surroundings. The study was conducted in the municipality of Tuzla in 2009-2010, in outpatient family medicine Simin Han. The survey covered a total of 200 elderly subjects (age >65 years). Subject group consisted of 45% of people living alone, and 55% control group consisted of elderly patients who live in traditional family surroundings. Questionnaires used in this study are General geriatric assessment questionnaire and Mini nutritional status. The average age (+/- SD) was 75.4 +/- 6.2 years in subject group, while the same in the control group was 74.9 +/- 5.6 years. In subject group significantly more patients are on the verge of poverty. There are significant differences in the classification of financial status, according to the groups (p = 0.043). Members of subject groups have significantly lower BMI categories (p = 0.03) compared with the control group. In our study, people who live alone are at increased risk of malnutrition (p = 0030), have reduced the number of daily meals, significantly lower daily intake of protein, fruits and vegetables in the diet in relation to persons living in a family environment. Significantly more patients with loss of appetite live alone. According to the existence of self-reported food problems

Production in Italian industry: Electric power demand indicators

International Nuclear Information System (INIS)

Ajello, V.

1993-01-01

The effects of the recession in Italy were first evidenced during the period spanning 1990-1992 with a sharp drop in the international competitiveness of Italian products. This phase was then followed by a significant drop in internal demand, the devaluation of the Italian Lira and subsequent market uncertainty. This paper presents graphs of national and regional electric power production and consumption figures which reflect the downturn in the viability of the Italian economy, especially in the industrial sector

Italianization Accomplished. Forms and Structures of Albanian Television’s Dependency on Italian Media and Culture

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Paolo Carelli

2014-06-01

Full Text Available After the fall of the Berlin Wall and the end of communist regimes in 1989, national media systems of the Eastern European countries belonging to the Soviet bloc began a process of transformation along the way of liberalization and commercialization. In Albania, this process occurred in different phases, but with a common trend, that is the Italian television as a structural, economic and cultural model to inspire. In this article, I try to outline the deep influences and legacies between Italian and Albanian television systems (dating back to the last years of the regime showing how, despite a progressive sliding towards americanization, they remain a typical landmark of Albanian media. From the formats of the first programmes after the regime to the recent appearances of Italian Tv presenters (in particular, from Berlusconi's channels on Albanian private channels, we can observe a subtle but rooted and continuous dependency from the country on the other side of the Adriatic Sea.  

IBD in the elderly population: results from a population-based study in Western Hungary, 1977-2008.

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Lakatos, Peter Laszlo; David, Gyula; Pandur, Tunde; Erdelyi, Zsuzsanna; Mester, Gabor; Balogh, Mihaly; Szipocs, Istvan; Molnar, Csaba; Komaromi, Erzsebet; Kiss, Lajos S; Lakatos, Laszlo

2011-02-01

Limited data are available on the incidence and disease course of IBD in the elderly population. Our aim was to analyze the incidence and disease course of IBD according to the age at diagnosis in the population-based Veszprem province database, which included incident patients diagnosed between January 1, 1977 and December 31, 2008. Data of 1420 incident patients were analyzed (UC: 914, age at diagnosis: 38.9 SD 15.9 years; CD: 506, age at diagnosis: 31.5 SD 13.8 years). Both hospital and outpatient records were collected and comprehensively reviewed. 106 (11.6%) of UC patients and 21 (4.2%) of CD patients were diagnosed with >60 years of age. In UC, the incidence increased from 1.09 to 10.8/10(5) in the elderly, while CD increased to 3.04/10(5) in 2002-2007. In CD, colonic location (elderly: 61.9% vs. pediatric: 24.3%, p=0.001, and adults: 36.8%, p=0.02) and stenosing disease (elderly: 42.9% vs. pediatric: 14.9%, p=0.005, and adults: 19.5%, p=0.01) were more frequent in the elderly. A change in disease behavior was absent in the elderly, while in pediatric and adult CD population it was 20.3% (p=0.037), 19.8% (p=0.036) after 5 years. In UC, extensive disease was more frequent in pediatric patients compared to the elderly (p=0.003, OR: 2.73, 95%CI: 1.38-5.41). In addition, pediatric (57.3%, p<0.001, OR: 6.58; 95%CI: 3.22-12.9) and adult (39.8%, p<0.001, OR: 3.24; 95%CI: 1.91-5.49) patients required more often systemic steroids during follow-up compared to the elderly (17%). Proximal extension at 10 years was 11.6%, but time to extension was not different according to the age at onset. Elderly patients represent an increasing proportion of the IBD population. Stenosing and colon-only disease were characteristic for elderly CD patients, while the disease course in UC was milder. Copyright © 2010 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.

Physicochemical and microbiological characteristics of Italian salami ...

African Journals Online (AJOL)

The purpose of this study was to evaluate and compare the inclusion of different levels of pequi (Caryocar Brasiliense, Cambess) pulp in the processing of Italian salami made of lamb for the evaluation of their physicochemical and microbiological characteristics. Six formulations of Italian salamis were processed: no pequi ...

Migrations, families, generations: Language transmission among several Italian communities in England

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Margherita Di Salvo

2015-06-01

Full Text Available This paper researches the ethnic language shift in two Italian communities in the UK, those in Bedford and Cambridge. It focuses mainly on Italians of first and second generation. The present study questions whether the loss of the ethnic language (Italian or an Italian dialect, can be very costly to the migrants and their families and what happens in family in which adults do not understand children and children do not understand adults and how, in these dynamics, Italian identity remains.

Spelling acquisition in English and Italian: A cross-linguistic study

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Chiara Valeria eMarinelli

2015-12-01

Full Text Available We examined the spelling acquisition in children up to late primary school of a consistent orthography (Italian and an inconsistent orthography (English. The effects of frequency, lexicality, length and regularity in modulating spelling performance of the two groups were examined. English and Italian children were matched for both chronological age and number of years of schooling. Two-hundred and seven Italian children and 79 English children took part in the study. We found greater accuracy in spelling in Italian than English children: Italian children were very accurate after only two years of schooling, while in English children the spelling performance was still poor after five years of schooling. Cross-linguistic differences in spelling accuracy proved to be more persistent than the corresponding ones in reading accuracy. Orthographic consistency produced not only quantitative, but also qualitative differences, with larger frequency and regularity effects in English than in Italian children.

Spelling Acquisition in English and Italian: A Cross-Linguistic Study.

Science.gov (United States)

Marinelli, Chiara V; Romani, Cristina; Burani, Cristina; Zoccolotti, Pierluigi

2015-01-01

We examined the spelling acquisition in children up to late primary school of a consistent orthography (Italian) and an inconsistent orthography (English). The effects of frequency, lexicality, length, and regularity in modulating spelling performance of the two groups were examined. English and Italian children were matched for both chronological age and number of years of schooling. Two-hundred and seven Italian children and 79 English children took part in the study. We found greater accuracy in spelling in Italian than English children: Italian children were very accurate after only 2 years of schooling, while in English children the spelling performance was still poor after 5 years of schooling. Cross-linguistic differences in spelling accuracy proved to be more persistent than the corresponding ones in reading accuracy. Orthographic consistency produced not only quantitative, but also qualitative differences, with larger frequency and regularity effects in English than in Italian children.

Factors affecting medication adherence in elderly people

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Jin HK

2016-10-01

Full Text Available Hyekyung Jin,1 Yeonhee Kim,2 Sandy Jeong Rhie1,3 1College of Pharmacy, 2Center for Excellence in Teaching & Learning, 3Division of Life and Pharmaceutical Sciences, Ewha Womans University, Seoul, Republic of Korea Background: Little is known about the functional health literacy (FHL associated with medication adherence in elderly patients. The aim of this study was to examine the FHL among older adults and identify influencing factors that can predict medication adherence. Methods: This was a cross-sectional survey. Participants (n=160 aged 65 years and older were selected from outpatient clinics of 3 tertiary care hospitals, 6 community pharmacies, and 2 senior centers between November 1 and 30, 2014. The participants’ FHL was measured using the Korean Functional Health Literacy Test, which consists of 15 items including 8 numeracy and 7 reading comprehension items. Medication adherence was measured by the Adherence to Refills and Medication Scale. Descriptive statistics, chi-square or Fisher’s exact test, and multiple regression analyses were used to analyze the data. Results: The mean score of the total FHL was 7.72±3.51 (range 0–15. The percentage of the total number of correct answers for the reading comprehension subtest and numeracy subtest were 48.1% and 54.4%, respectively. Among 160 participants, 52.5% showed low adherence to medication. The factors affecting medication adherence included the patient’s degree of satisfaction with the service (β=-0.215, P=0.022, sufficient explanation of medication counseling (β=-0.335, P=0.000, education level (β=-0.153, P=0.045, health-related problems (β=-0.239, P=0.004, and dosing frequency (β=0.189, P=0.018. Conclusion: In this study, we found medication adherence of elderly patients was associated with education level, health-related problems, dosing frequency, satisfaction with patient counseling, and explanation of medication, but no association was found with FHL. Pharmacists

Rationale and design of the DARWIN-T2D (DApagliflozin Real World evIdeNce in Type 2 Diabetes): A multicenter retrospective nationwide Italian study and crowdsourcing opportunity.

Science.gov (United States)

Fadini, G P; Zatti, G; Consoli, A; Bonora, E; Sesti, G; Avogaro, A

2017-12-01

Randomized controlled trials (RCTs) in the field of diabetes have limitations inherent to the fact that design, setting, and patient characteristics may be poorly transferrable to clinical practice. Thus, evidence from studies using routinely accumulated clinical data are increasingly valued. We herein describe rationale and design of the DARWIN-T2D (DApagliflozin Real World evIdeNce in Type 2 Diabetes), a multicenter retrospective nationwide study conducted at 50 specialist outpatient clinics in Italy and promoted by the Italian Diabetes Society. The primary objective of the study is to describe the baseline clinical characteristics (particularly HbA1c) of patients initiated on dapagliflozin from marketing authorization approval to the end of 2016. Secondary and exploratory objectives will evaluate the changes in glycaemic and extraglycaemic efficacy parameters after initiation of dapagliflozin or after initiation of comparator glucose lowering medications (DPP-4 inhibitors, gliclazide extended release, and long-acting GLP-1 receptor agonists). An automated software will extract relevant data from the same electronic chart system at all centres, thereby minimizing data treatment and human intervention. The study is expected to collect an enormous dataset of information on dapagliflozin- and comparator-using patients. After study completion, the Italian Diabetes Society will launch an open crowdsourcing call on the DARWIN-T2D database, challenging diabetes researchers to apply their ideas and approaches to address new unmet needs and knowledge gaps in diabetes. We believe this will move DARWIN-T2D to the next generation of real world studies. Copyright © 2017 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

Italian R and D in field of environmental biotechnologies

International Nuclear Information System (INIS)

Robertiello, A.; Levi, G.

1995-01-01

The analysis carried out on the Italian R and D allows to draw the following conclusions: 1) There are about 1,000 'inside workers' totalling an outlay of 2,700 billion Italian Liras per year. 2) In the five years from 1987 to 1992, state financing to R and D on environmental biotechnologies was around 80 billion Italian Liras, averaging 16 billion Italian Liras a year. 3) Although these are rough estimates, it can be seen that, given the gap between resources made available and actual expense, there must be other incentive mechanism justifying the commitment of Italian R and D and the quality of the work so far carried out in this specific field. 4) These mechanisms could possibly be of two kinds; the realization that a large part of the market is dissatisfied; the pervasiveness of biotechnologies, especially in the field of environmental conservation

[Vitreoretinal outpatient surgery: clinical and financial considerations].

Science.gov (United States)

Creuzot-Garcher, C; Aubé, H; Candé, F; Dupont, G; Guillaubey, A; Malvitte, L; Arnavielle, S; Bron, A

2008-11-01

Vitreoretinal surgery has benefited from great advances opening the opportunity for outpatient management. We report on the 6-month experience of outpatient surgery for vitreoretinal diseases. From November 2007 to April 2008, 270 patients benefited from a vitreoretinal surgery, with 173 retinal detachments, 63 epiretinal membranes, and 34 other procedures. Only 8.5% (n=23) of the patients had to stay at the hospital one or two nights. The main reasons were the distance from the hospital and surgery on a single-eye patient. The questionnaire given after the surgery showed that almost all the patients were satisfied with the outpatient setting. In contrast, the financial results showed a loss of income of around 400,000 euros due to the low level of payment of outpatient surgery in France by the national health insurance system. Vitreoretinal surgery can be achieved in outpatient surgery with an improvement in the information given to the patients and the overall organization of the hospitalization. However, the current income provided with vitreoretinal outpatient surgery is highly disadvantageous in France, preventing this method from being generalized.

Psychiatric disorders in outpatients with borderline intellectual functioning: comparison with both outpatients from regular mental health care and outpatients with mild intellectual disabilities.

Science.gov (United States)

Wieland, Jannelien; Kapitein-de Haan, Sara; Zitman, Frans G

2014-04-01

In the Netherlands, patients with borderline intellectual functioning are eligible for specialized mental health care. This offers the unique possibility to examine the mix of psychiatric disorders in patients who, in other countries, are treated in regular outpatient mental health care clinics. Our study sought to examine the rates of all main Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, Axis I psychiatric diagnoses in outpatients with borderline intellectual functioning of 2 specialized regional psychiatric outpatient departments and to compare these with rates of the same disorders in outpatients from regular mental health care (RMHC) and outpatients with mild intellectual disabilities (IDs). Our study was a cross-sectional, anonymized medical chart review. All participants were patients from the Dutch regional mental health care provider Rivierduinen. Diagnoses of patients with borderline intellectual functioning (borderline intellectual functioning group; n = 235) were compared with diagnoses of patients from RMHC (RMHC group; n = 1026) and patients with mild ID (mild ID group; n = 152). Compared with the RMHC group, psychotic and major depressive disorders were less common in the borderline intellectual functioning group, while posttraumatic stress disorder and V codes were more common. Compared with the mild ID group, psychotic disorders were significantly less common. Mental health problems in people with borderline intellectual functioning may not be well addressed in general psychiatry, or by standard psychiatry for patients with ID. Specific attention to this group in clinical practice and research may be warranted lest they fall between 2 stools.

Outpatient invasive radiologic procedures - Diagnostic and therapeutic

International Nuclear Information System (INIS)

Dublin, A.

1987-01-01

This book is a ''how-to'' book for radiologists who are planning to, or considering whether to establish outpatient practice in response to DRGs. It provides practical, expert advice on both the administrative and clinical sides of outpatient radiology. It focuses on the essentials of clinical practice in the outpatient setting - and how it differs from inpatient practice

The occurrence of antimicrobial resistance and class 1 integrons among commensal Escherichia coli isolates from infants and elderly persons

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Kõljalg Siiri

2009-12-01

Full Text Available Abstract Background The aim of our study was to compare the presence of the intI1 gene and its associations with the antibiotic resistance of commensal Escherichia coli strains in children with/without previous antibiotic treatments and elderly hospitalized/healthy individuals. Methods One-hundred-and-fifteen intestinal E. coli strains were analyzed: 30 strains from 10 antibiotic-naive infants; 27 from 9 antibiotic-treated outpatient infants; 30 from 9 healthy elderly volunteers; and 28 from 9 hospitalized elderly patients. The MIC values of ampicillin, cefuroxime, cefotaxime, gentamicin, ciprofloxacin, and sulfamethoxazole were measured by E-test and IntI1 was detected by PCR. Results Out of the 115 strains, 56 (49% carried class 1 integron genes. Comparing persons without medical interventions, we found in antibiotic-naive children a significantly higher frequency of integron-bearing strains and MIC values than in healthy elderly persons (53% versus 17%; p Conclusion The prevalence of integrons in commensal E. coli strains in persons without previous medical intervention depended on age. The resistance of integron-carrying and non-carrying strains is more dependent on influencing factors (hospitalization and antibiotic administration in particular groups than merely the presence or absence of integrons.

Limited referral to nephrologists from a tertiary geriatric outpatient clinic despite a high prevalence of chronic kidney disease and anaemia

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Boudville Neil

2012-08-01

Full Text Available Abstract Background Chronic kidney disease (CKD is increasing in prevalence world-wide with the largest growth being in the elderly. The aim of this study was to examine the prevalence of CKD in a geriatric outpatient clinic within a tertiary hospital and its association with anaemia and mortality with a focus on the referral patterns towards nephrologists. Methods Retrospective study utilising administrative databases. The cohort was defined as all patients that attended the geriatric outpatient clinics of a single tertiary hospital within the first 3 months of 2006. Patients were followed for 18 months for mortality and referral to a nephrologist. Results The mean Glomerular filtration rate (eGFR of the 439 patients was 67.4 ± 29.1 mL/min/1.73 m2 (44% 2. 11.8% had a haemoglobin 2 (p = 0.0092. Kidney function and anaemia were significantly associated with mortality on multivariate analysis (p = 0.019 and p = 0.0074. After 18 months, 8.8% of patients with CKD were referred to a nephrologist. Conclusion Despite a high prevalence of CKD in patients attending a geriatric outpatient clinic and its association with anaemia and mortality, few of these patients were referred to a nephrologist. An examination of the reasons behind this bias is required.

Diet quality of Italian yogurt consumers: an application of the probability of adequate nutrient intake score (PANDiet).

Science.gov (United States)

Mistura, Lorenza; D'Addezio, Laura; Sette, Stefania; Piccinelli, Raffaela; Turrini, Aida

2016-01-01

The diet quality in yogurt consumers and non-consumers was evaluated by applying the probability of adequate nutrient intake (PANDiet) index to a sample of adults and elderly from the Italian food consumption survey INRAN SCAI 2005-06. Overall, yogurt consumers had a significantly higher mean intake of energy, calcium and percentage of energy from total sugars whereas the mean percentage of energy from total fat, saturated fatty acid and total carbohydrate were significantly (p yogurt consumers than in non-consumers, (60.58 ± 0.33 vs. 58.58 ± 0.19, p yogurt consumers. The items of calcium, potassium and riboflavin showed the major percentage variation between consumers and non-consumers. Yogurt consumers were more likely to have adequate intakes of vitamins and minerals, and a higher quality score of the diet.

Catholic Modernity and the Italian Constitution

DEFF Research Database (Denmark)

Thomassen, Bjørn; Forlenza, Rosario

2016-01-01

and give direction to the very idea of political modernity, bridging a positive encounter between Catholicism, democracy, and freedom. The specific argument is embedded within a larger aim to recognize attempts within Catholic philosophy and political thought to articulate a trajectory that moved away from......This article analyzes the Catholic contribution to the Italian republican and democratic Constitution of 1948. The focus is on the specific way in which the Italian citizen became symbolically coded as a ‘person’ and not as an ‘individual’, inspired by Catholic social philosophy. The Catholic...... project for the new Constitution had a considerable impact on modern Italian culture and politics and on the building of a modern mass democracy and welfare state. During the crucial historical juncture that followed the collapse of Fascism, Catholic politicians and intellectuals sought to interpret...

Quality of Drinking Water Treated at Point of Use in Residential Healthcare Facilities for the Elderly.

Science.gov (United States)

Sacchetti, Rossella; De Luca, Giovanna; Guberti, Emilia; Zanetti, Franca

2015-09-09

Municipal tap water is increasingly treated at the point of use (POU) to improve the acceptability and palatability of its taste. The aim of this study was to assess the bacteriologic and nutritional characteristics of tap water treated at the point of use in residential healthcare facilities for the elderly. Two types of POU devices were used: microfiltered water dispensers (MWDs) and reverse-osmosis water dispensers (ROWDs). All samples of water entering the devices and leaving them were tested for the bacteriological parameters set by Italian regulations for drinking water and for opportunistic pathogens associated with various infections in healthcare settings; in addition, the degree of mineralization of the water was assessed. The results revealed widespread bacterial contamination in the POU treatment devices, particularly from potentially pathogenic species. As expected, the use of ROWDs led to a decrease in the saline content of the water. In conclusion, the use of POU treatment in healthcare facilities for the elderly can be considered advisable only if the devices are constantly and carefully maintained.

Quality of Drinking Water Treated at Point of Use in Residential Healthcare Facilities for the Elderly

Directory of Open Access Journals (Sweden)

Rossella Sacchetti

2015-09-01

Full Text Available Municipal tap water is increasingly treated at the point of use (POU to improve the acceptability and palatability of its taste. The aim of this study was to assess the bacteriologic and nutritional characteristics of tap water treated at the point of use in residential healthcare facilities for the elderly. Two types of POU devices were used: microfiltered water dispensers (MWDs and reverse-osmosis water dispensers (ROWDs. All samples of water entering the devices and leaving them were tested for the bacteriological parameters set by Italian regulations for drinking water and for opportunistic pathogens associated with various infections in healthcare settings; in addition, the degree of mineralization of the water was assessed. The results revealed widespread bacterial contamination in the POU treatment devices, particularly from potentially pathogenic species. As expected, the use of ROWDs led to a decrease in the saline content of the water. In conclusion, the use of POU treatment in healthcare facilities for the elderly can be considered advisable only if the devices are constantly and carefully maintained.

Italian Studies, Italian Theory and the politics of trans-lation

NARCIS (Netherlands)

Minca, C.

2016-01-01

Italian Theory has emerged as the result of the search for new conceptual frameworks in the face of a series of international political events concerning not only the proliferation of states of exception but also of new forms of politicization of life related to biomedical science and the

Electricity : Italian style

International Nuclear Information System (INIS)

Murray, L.

2007-01-01

Italy's electricity system was described. Italy relies on outside sources for between 10 and 15 per cent of its electricity supply. Most Italians use gas, wood stoves and fossil fuels, and are conservative about lighting. Electricity costs more in Italy than in any other European country. Italy made the decision to decommission its nuclear power stations after Chernobyl. In 2005, Italy's largest utility group signed a memorandum of understanding ensuring that they would contract energy from France's nuclear reactors. Italy is now financing and managing projects in Russia and eastern Europe, and has strengthened its ties in Spain and the Netherlands. Although Italy is intent on producing its own power, the perceptions of health hazards from electricity towers cause citizens to strongly protest new installations. It was concluded that rising energy prices may force Italians to reconsider the use of alternative energy sources. 3 figs

The short hyperacusis questionnaire: A tool for the identification and measurement of hyperacusis in the Italian tinnitus population

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Federica Tortorella

2017-10-01

Full Text Available The aim of this study was to explore the collapsibility of the Italian version of Khalfa’s hyperacusis questionnaire (HQ. We identified the more statistically significant items of the HQ and created the short hyperacusis questionnaire (SHQ. We recruited 117 consecutive outpatients with a primary complaint of tinnitus at least from 3 months. All patients filled in the complete Italian version of the HQ and underwent an audiological examination including uncomfortable loudness levels (ULLs. A logistic model was carried out getting odds ratios (ORs estimates of hyperacusis according to the items responses. To create the SHQ, we selected six items that were the only ones to present a statistically significant ORs value different from 1. The internal consistency of the SHQ was assessed by means of Cronbach α index. A ROC analysis was performed and an optimal cut-off point was found using the Youden index. Our analysis showed a Cronbach α of 0.67. The area under the ROC curve (AUC, expression of the overall performance of the SHQ versus the ULLs test, was statistically significant (P<0.05. We found a cut-off of 0.24 as indicative of hyperacusis (sensitivity (Se = 78.79%, specificity (Sp = 42.50%. SHQ could be useful only in the initial screening of individuals with hyperacusis. We suggest further studies for the validation of a new questionnaire on hyperacusis.

Transcranial Magnetic Stimulation to Address Mild Cognitive Impairment in the Elderly: A Randomized Controlled Study

Science.gov (United States)

Drumond Marra, Hellen Livia; Myczkowski, Martin Luiz; Maia Memória, Cláudia; Arnaut, Débora; Leite Ribeiro, Philip; Sardinha Mansur, Carlos Gustavo; Lancelote Alberto, Rodrigo; Boura Bellini, Bianca; Alves Fernandes da Silva, Adriano; Ciampi de Andrade, Daniel; Teixeira, Manoel Jacobsen; Forlenza, Orestes Vicente; Marcolin, Marco Antonio

2015-01-01

Transcranial magnetic stimulation (TMS) is a noninvasive brain stimulation technique with potential to improve memory. Mild cognitive impairment (MCI), which still lacks a specific therapy, is a clinical syndrome associated with increased risk of dementia. This study aims to assess the effects of high-frequency repetitive TMS (HF rTMS) on everyday memory of the elderly with MCI. We conducted a double-blinded randomized sham-controlled trial using rTMS over the left dorsolateral prefrontal cortex (DLPFC). Thirty-four elderly outpatients meeting Petersen's MCI criteria were randomly assigned to receive 10 sessions of either active TMS or sham, 10 Hz rTMS at 110% of motor threshold, 2,000 pulses per session. Neuropsychological assessment at baseline, after the last session (10th) and at one-month follow-up, was applied. ANOVA on the primary efficacy measure, the Rivermead Behavioural Memory Test, revealed a significant group-by-time interaction (p = 0.05), favoring the active group. The improvement was kept after one month. Other neuropsychological tests were heterogeneous. rTMS at 10 Hz enhanced everyday memory in elderly with MCI after 10 sessions. These findings suggest that rTMS might be effective as a therapy for MCI and probably a tool to delay deterioration. PMID:26160997

Wind power: Italian auto-production legislation (ISES convention)

International Nuclear Information System (INIS)

Mari, G.

1991-01-01

With reference to what was discussed at the Bologna (Italy) June 1991 ISES (International Solar Energy Society) convention on wind energy, this paper summarizes the Italian legislative framework relative to on-site power generation and outlines the National Energy Plan objectives regarding the promotion of the use, by industry, of renewable energy sources. Brief notes are also provided on wind energy promotional activities being carried out by ENEL (the Italian National Energy Board), ENEA (Italian Agency for New Technologies, Energy and the Environment), and EWEA (the European Wind Energy Association)

75 FR 64611 - Italian American Heritage and Culture Month, 2010

Science.gov (United States)

2010-10-19

.... As we honor the long history and vast contributions of Italian Americans, let us recommit to... society and steer the course of our history. During Italian American Heritage and Culture Month, we... Culture Month. I call upon all Americans to learn more about the history of Italian Americans, and to...

L'insegnamento dell'economia industriale nelle università italiane

OpenAIRE

Alzona Gianluigi; Frigero Piercarlo; Ninni Augusto

2003-01-01

The study analyses the importance and characteristics of Industrial Economics/Organisation and related courses (e.g. Firm Economics, Innovation Economics, Applied Economics) in Italian Universities. Attention is concentrated on first level (3-year) degree courses, set up by Italian Faculties according to the New Organisation of Studies. The research points out that the IE-IO teaching cluster plays a major role in Italian Universities, counting on about 170 courses and 160 professors. Most of ...

Italian Studies in Southern Africa/Studi d'Italianistica nell'Africa ...

African Journals Online (AJOL)

The journal aims at providing a forum for academic discussion on all aspects of Italian culture. It features articles on Italian language and literature and, since it is one of the primary aims of the journal to foster multi- and inter-disciplinary study and communication, contributions are invited from all writers interested in Italian ...

Discriminative and predictive properties of disease-specific and generic health status indexes in elderly COPD patients

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Forastiere Francesco

2008-08-01

Full Text Available Abstract Background The association between bronchial obstruction severity and mortality in Chronic Obstructive Pulmonary Disease (COPD is well established, but it is unknown whether disease-specific health status measures and multidimensional assessment (MDA have comparable prognostic value. Methods We analyzed data coming from the Salute Respiratoria nell'Anziano (Respiratory Health in the Elderly – SaRA study, enrolling elderly people attending outpatient clinics for respiratory and non-respiratory problems. From this population we selected 449 patients with bronchial obstruction (77.3% men, mean age 73.1. We classified patients' health status using tertiles of the Saint George Respiratory Questionnaire (SGRQ and a MDA including functional (the 6' walking test, WT, cognitive (Mini-Mental State Examination, MMSE and affective status (Geriatric Depression Scale, GDS. The agreement of the classification methods was calculated using the kappa statistic, and survival associated with group membership was evaluated using survival analysis. Results Pulmonary function, expressed by the FEV1, worsened with increasing SGRQ or MDA scores. Cognitive function was not associated with the SGRQ, while physical performance and mood status were impaired only in the highest tertile of SGRQ. A poor agreement was found between the two classification systems tested (k = 0.194. Compared to people in the first tertile of SGRQ score, those in the second tertile had a sex-adjusted HR of 1.22 (0.75 – 1.98 and those in the third tertile of 2.90 (1.92 – 4.40. The corresponding figures of the MDA were 1.49 (95% CI 1.02 – 2.18 and 2.01 (95% CI: 1.31 – 3.08. After adjustment for severity of obstruction, only a SGRQ in the upper tertile was associated with mortality (HR: 1.86; 95% CI: 1.14 – 3.02. Conclusion In elderly outpatients with mild-moderate COPD, a disease-specific health status index seems to be a better predictor of death compared to a MDA.

77 FR 5317 - Medicaid Program; Covered Outpatient Drugs

Science.gov (United States)

2012-02-02

... for Medicare & Medicaid Services 42 CFR Part 447 Medicaid Program; Covered Outpatient Drugs; Proposed... Part 447 [CMS-2345-P] RIN 0938-AQ41 Medicaid Program; Covered Outpatient Drugs AGENCY: Centers for... requirements pertaining to Medicaid reimbursement for covered outpatient drugs to implement provisions of the...

Assessments of functional status, comorbidities, polypharmacy, nutritional status and sarcopenia in Turkish community-dwelling male elderly.

Science.gov (United States)

Bahat, Gulistan; Tufan, Fatih; Bahat, Zumrut; Aydin, Yucel; Tufan, Asli; Akpinar, Timur Selcuk; Erten, Nilgun; Karan, Mehmet Akif

2013-06-01

Functionality, comorbidities, polypharmacy, nutritional status and sarcopenia affect the prognosis of elderly excessively. These parameters are influenced by the population, living settings and age. We aimed to study these parameters in Turkish community-dwelling male elderly. We studied 274 male elderly ≥60 years of age admitted to our Geriatrics outpatient clinics. Mean age was 74.4 ± 7.1 years; 47.4% of the subjects were ≥75 years, 24.1% were ≥80 years. Mean activities-of-daily-living (ADL) and instrumental ADL (IADL) scores were 9.4 and 11.1, respectively. Patients with at least one-dependence at ADL-IADL were 22.6%-47.2%, and more than half-dependence at ADL-IADL were 2.8%-17.9%, respectively. Mean number of comorbidities were 2.6. Most common diagnosis was hypertension with 65%; mean number of drugs were 4.5; 55.3% were using ≥4 chronic drugs. Prevalences of malnutrition were 3.7%-6.9%, malnutrition risk were 23.5%-26.7% by the mini nutritional assessment test-long form and short form, respectively. Calf circumference was measured elderly may have greater prevalences of functional dependence, sarcopenia but lower rates of malnutrition and similar rates of polypharmacy compared with the western developing countries and developed countries. This study emphasized the geographical differences in and/or between the individual countries highlighting the need for studies both country- and world-wide.

Representation of the serial killer on the Italian Internet.

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Villano, P; Bastianoni, P; Melotti, G

2001-10-01

The representation of serial killers was examined from the analysis of 317 Web pages in the Italian language to study how the psychological profiles of serial killers are described on the Italian Internet. The correspondence analysis of the content of these Web pages shows that in Italy the serial killer is associated with words such as "monster" and "horror," which suggest and imply psychological perversion and aberrant acts. These traits are peculiar for the Italian scenario.

Predictors of low bone mineral density in the elderly: the role of dietary intake, nutritional status and sarcopenia.

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Coin, A; Perissinotto, E; Enzi, G; Zamboni, M; Inelmen, E M; Frigo, A C; Manzato, E; Busetto, L; Buja, A; Sergi, G

2008-06-01

The aims of this study were to investigate the relationship between sarcopenia, dietary intake, nutritional indices and hip bone mineral density (BMD) in the elderly, and to estimate the risk of low BMD due to specific independent predictor thresholds. Body mass index (BMI), serum albumin, energy and protein intake were studied in 352 elderly outpatients (216 women aged 73.5+/-5.3 years and 136 men aged 73.9+/-5.6 years). BMD at different hip sites and appendicular skeletal muscle mass (ASMM) were assessed by dual-energy X-ray absorptiometry. The prevalence of osteoporosis was 13% in men and 45% in women, while the prevalence of sarcopenia (50%) and hypoalbuminemia (5%) were similar in both genders. BMI, albumin and ASMM were significantly associated with BMD in both genders: so was protein intake, but only in men. By multiple regression analysis, the variables that retained their independent explanatory role on total hip BMD, were BMI and protein intake in men, and BMI and albumin in women. By logistic regression analysis, men risked having a low BMD with a BMI elderly, particularly in women. Age-related sarcopenia does not seem to be involved in bone mass loss.

Vaginal hysterectomy, an outpatient procedure.

Science.gov (United States)

Engh, Marie Ellström; Hauso, Wenche

2012-11-01

To report our experience of treating women undergoing vaginal hysterectomy in an outpatient setting and to identify risk factors for hospital admission and women dissatisfied with care. Prospective observational report. department of obstetrics and gynecology, university hospital in Norway. 150 women who underwent vaginal hysterectomy at the outpatient clinic from February 2009 to April 2010. Perioperative data were collected prospectively and case notes were searched for complications. On the first postoperative day all women were contacted by telephone by a nurse. A visual analogue scale (VAS) was used to monitor pain and nausea during the stay at the outpatient clinic and the day after surgery. VAS was also used to specify the women's degree of satisfaction with care the day after surgery. The number of women who could be discharged from the outpatient unit and had a satisfaction score of ≥7 the day after surgery. Of the 150 women, 84% could be discharged after a mean observation period of 276 min (SD ± 80 min). The mean satisfaction score was 9.0, SD ± 1.4, and 92.6% of the women reported ≥7 points in the satisfaction score. No women with serious complications were sent home. Using a multivariable logistic regression model only pain at discharge was found as significant (p= 0.009) for admittance to hospital. Vaginal hysterectomy is a feasible outpatient procedure and the majority of women were satisfied with the care they received. © 2012 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2012 Nordic Federation of Societies of Obstetrics and Gynecology.

Outpatient treatment for acute uncomplicated diverticulitis

NARCIS (Netherlands)

Ünlü, Çagdas; Gunadi, Patrick M.; Gerhards, Michael F.; Boermeester, Marja A.; Vrouenraets, Bart C.

2013-01-01

Traditionally, treatment of acute diverticulitis has mostly been based on inpatient care. The question arises whether these patients can be treated on an outpatient basis as the admissions for diverticular disease have been shown to be increasing every year. We studied whether outpatient treatment

Italian validation of the Amsterdam Preoperative Anxiety and Information Scale.

Science.gov (United States)

Buonanno, Pasquale; Laiola, Anna; Palumbo, Chiara; Spinelli, Gianmario; Terminiello, Virginia; Servillo, Giuseppe

2017-07-01

Preoperative anxiety is usually experienced by patients awaiting surgical procedures and it can negatively impact patient's outcome. The Amsterdam Preoperative Anxiety and Information Scale (APAIS) is a questionnaire created to identify anxious patients and their need for information: it has been translated and validated in many languages because of its reliability and ease of completion. To date, no Italian version of the APAIS has been produced; our aim was to translate and validate the APAIS in Italian. We produced an Italian version of the APAIS and we administered it to 110 patients undergoing elective surgery; we explored its structure by factor analysis and its reliability by Cronbach's alpha. We analyzed its external validity by confronting it to the Spielberg's State-Trait Anxiety Inventory (STAI). Sensitivity, specificity, and positive and negative predictive values of the Italian version of the APAIS were determined. The Italian version of the APAIS confirmed the original structure of the questionnaire and its internal consistency; it well correlated with the STAI-Y1, the subscale of the STAI which explore the anxiety "state." An APAIS score of 14 was found as best cutoff to distinguish anxious and non-anxious patients. The Italian translation of the APAIS showed psychometric properties similar to the original version. Its reliability and its efficiency make it a powerful tool even in Italian population to detect anxiety and need for information.

Elder Abuse and Help-Seeking Behavior in Elderly Chinese.

Science.gov (United States)

Yan, Elsie

2015-09-01

Elder abuse is a prevalent phenomenon resulting in physical, emotional, and social costs to individuals, families, and society. Timely and effective intervention is crucial because victims are often involved in relationships where re-victimization is common. Most elder abuse victims, however, are reluctant to seek help from outside their families. The aim of the present study is to explore factors associated with help-seeking behaviors among mistreated elders in Hong Kong. In-depth interviews were conducted with 40 elder abuse survivors. Although almost all of the participants could provide some examples of elder abuse, most denied that their own experience was abusive. Personal and professional social networks were important determinants of help seeking. Social isolation, cultural barriers, self-blame, and lack of knowledge were major barriers to help seeking. © The Author(s) 2014.

LA LINGUA ITALIANA E LE SCUOLE ITALIANE NEL TERRITORIO ISTRIANO

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Chiara De Battisti

2011-02-01

Full Text Available L’articolo ricostruisce brevemente, dal punto di vista storico, le vicende della comunità italiana in Istria per contestualizzarne i mutamenti di carattere linguistico e socioculturale che essa ha vissuto, in particolare dal secondo dopoguerra ad oggi. Sulla base di studi e indagini  recenti, vengono prese in esame le lingue e i dialetti parlati dalla comunità italiana, la realtà multilingue e multiculturale dell’Istria attuale,  le istituzioni italiane presenti nel territorio istriano e la loro attività finalizzata alla permanenza della lingua e cultura italiana nella regione. In particolare si ricostruisce la storia della scuola di lingua italiana, le sue origini, il suo declino dopo la cessione dell’Istria alla Yugolaslavia e durante i difficili e drammatici anni dell’esodo di molti italiano dalla regione, la sua rinascita ed evoluzione dal 1980 ad oggi. Delle scuole di lingua italiana, che attualmente operano sia nel territorio istriano che fa parte della Slovenia sia in quello che fa parte della Croazia, si analizza la loro distribuzione nella regione, la loro organizzazione, il ruolo della lingua italiana come materia, come lingua di scolarizzazione e come lingua straniera, i problemi, ancora aperti, della formazione degli insegnanti e dei libri di testo, e si valuta la loro possibilità di evoluzione e di sviluppo.     Italian language and Italian schools in the territory if Istria   This article briefly discusses, from the historical point of view, the Italian community in Istria to contextualize the linguistic and socio cultural changes that have taken place in the region, especially after WWII. Based on recent surveys and studies, languages and dialects spoken in the Italian community, the multilungual and multicultural reality of Istria are examined, as well as the Italian institutions in the Istrian territory and their efforts to conserve Italian language and culture in the area.  In particular, the history of

Italian Validation of Homophobia Scale (HS)

OpenAIRE

Ciocca, Giacomo; Capuano, Nicolina; Tuziak, Bogdan; Mollaioli, Daniele; Limoncin, Erika; Valsecchi, Diana; Carosa, Eleonora; Gravina, Giovanni L.; Gianfrilli, Daniele; Lenzi, Andrea; Jannini, Emmanuele A.

2015-01-01

Introduction: The Homophobia Scale (HS) is a valid tool to assess homophobia. This test is self‐reporting, composed of 25 items, which assesses a total score and three factors linked to homophobia: behavior/negative affect, affect/behavioral aggression, and negative cognition. Aim: The aim of this study was to validate the HS in the Italian context. Methods: An Italian translation of the HS was carried out by two bilingual people, after which an English native translated the test back i...

Validação da escala de depressão geriátrica em um ambulatório geral Validation of geriatric depression scale in a general outpatient clinic

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Emylucy Martins Paiva Paradela

2005-12-01

Full Text Available OBJETIVO: A Escala de Depressão Geriátrica, utilizada para o rastreamento de sintomas depressivos em idosos, ainda não teve suas características de medida avaliadas em ambulatórios gerais no Brasil. O objetivo foi estudar a validade da Escala, com 15 itens (EDG-15, na identificação de episódio de Depressão Maior ou Distimia em idosos atendidos em ambulatório geral. MÉTODOS: A Escala foi aplicada em 302 indivíduos com 65 anos ou mais, que em seguida foram examinados, de maneira independente, por um geriatra que não tinha conhecimento dos resultados da Escala. Os diagnósticos de Depressão Maior ou Distimia foram feitos utilizando-se os critérios do Diagnostic and Statistical Manual of Mental Disorders-IV. A sensibilidade e a especificidade nos vários pontos de corte foram expressas pela curva Receiver Operating Characteristic. RESULTADOS: O ponto de corte de melhor equilíbrio foi 5/6, obteve sensibilidade de 81% e especificidade de 71%; e o valor da área sob a curva Receiver Operating Characteristic foi de 0,85 (IC 95%: 0,79-0,91. CONCLUSÕES: A Escala de Depressão Geriátrica pode ser utilizada para o rastreamento de sintomas depressivos na população geriátrica ambulatorial brasileira. O ponto de corte 5/6, sugerido inicialmente por outros autores, mostrou-se adequado.OBJECTIVE: The Geriatric Depression Scale for screening depressive symptoms in the elderly has not been assessed in elderly outpatients who seek primary health care in Brazil. The objective was to determine the validity of the Short Scale for Major Depressive Episode or Dysthymia (GDS-15 in elderly outpatients. METHODS: The scale was applied in 302 subjects with 65 years and older and then examined by an independent geriatrician, blinded to the results. Major depression and dysthymia were diagnosed using the Diagnostic and Statistical Manual of Mental Disorders-IV criteria. Sensitivity and specificity were calculated at several cutoff values and a Receiver

Sarcopenia in Elderly Diabetic Patients: Role of Dipeptidyl Peptidase 4 Inhibitors.

Science.gov (United States)

Rizzo, Maria Rosaria; Barbieri, Michelangela; Fava, Ilaria; Desiderio, Manuela; Coppola, Carla; Marfella, Raffaele; Paolisso, Giuseppe

2016-10-01

Our study aimed to investigate the effect of dipeptidyl peptidase 4 inhibitors (DPP4-I) on sarcopenic parameters in elderly type 2 diabetic patients. All elderly diabetic patients were invited to present themselves at our outpatient Geriatric Centre to undergo to evaluation of glycemic, inflammatory, and sarcopenic parameters and to perform a meal test for glucagon-like peptide-1 analogue (GLP-1) activity evaluation. According to European Working Group on Sarcopenia in Older People (EWGSOP) criteria, sarcopenic parameters were assessed by bioelectrical impedance analysis (BIA) and Kern dynamometer and 4-m gait speed tests. All patients received standardized meals for the assessment of postprandial levels of GLP-1 activity. Data of 80 elderly diabetic patients treated with oral glucose-lowering drugs (DPP4-I or Sulfonylureas Group) for at least 24 months before enrollment were analyzed. The DPP4-I Group showed appropriate glycemic control, lower levels of inflammatory parameters, a significant and greater increase, during interprandial periods, of GLP-1 activity, and better sarcopenic parameters (fat-free mass, skeletal muscle mass, and related indices, muscle strength, and gait speed) compared with the Sulfonylureas Group. Univariate analysis showed that sarcopenic parameters correlated with glycemic control and with GLP-1 area under the curve values. Multivariate analysis confirms these relationships. The results are consistent with the hypothesis that DPP4-I use might have a positive effect on the loss of muscle mass and its function. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

PHRASEOLOGY IN PARČIĆ'S CROATIAN – ITALIAN DICTIONARY

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Helena Pavletić

2005-01-01

Full Text Available The paper analyzes and classifies the types of phraseological groups in Parčić's Croatian – Italian Dictionary comparing them with Italian equivalents and the contemporary Croatian phraseology.

The Italian version of the 16-item prodromal questionnaire (iPQ-16): Field-test and psychometric features.

Science.gov (United States)

Lorenzo, Pelizza; Silvia, Azzali; Federica, Paterlini; Sara, Garlassi; Ilaria, Scazza; Pupo, Simona; Andrea, Raballo

2018-03-20

Among current early screeners for psychosis-risk states, the Prodromal Questionnaire-16 items (PQ-16) is often used. We aimed to assess validity and reliability of the Italian version of the PQ-16 in a young adult help-seeking population. We included 154 individuals aged 18-35years seeking help at the Reggio Emilia outpatient mental health services in a large semirural catchment area (550.000 inhabitants). Participants completed the Italian version of the PQ-16 (iPQ-16) and were subsequently evaluated with the Comprehensive Assessment of At-Risk Mental States (CAARMS). We examined diagnostic accuracy (i.e. specificity, sensitivity, negative and positive likelihood ratios, and negative and positive predictive values) and content, convergent, and concurrent validity between PQ-16 and CAARMS using Cronbach's alpha, Spearman's rho, and Cohen's kappa, respectively. We also tested the validity of the adopted PQ-16 cut-offs through Receiver Operating Characteristic (ROC) curves plotted against CAARMS diagnoses and the 1-year predictive validity of the PQ-16. The iPQ-16 showed high internal consistency and acceptable diagnostic accuracy and concurrent validity. ROC analyses pointed to a cut-off score of ≥5 as best cut-off. After 12months of follow-up, 8.7% of participants with a PQ-16 symptom total score of ≥5 who were below the CAARMS psychosis threshold at the baseline, developed a psychotic disorder. Psychometric properties of the iPQ-16 were satisfactory. Copyright © 2018. Published by Elsevier B.V.

Italian Entrepreneurship: Conjectures and Evidence from a Historical Perspective

OpenAIRE

Pier Angelo Toninelli; Michelangelo Vasta

2009-01-01

This paper is the first product of an ongoing research on the determinants and the role of entrepreneurship in Italian economic development. Its primary aim is the creation of a data-set of Italian entrepreneurs for the period encompassed between the Unification of the Kingdom (1861) and the end of the XXth century. The main source of the research is a collection of 390 entrepreneurial biographies, prepared for an ongoing Dictionary of Italian Entrepreneurs. The first part of the paper presen...

Attitudes toward Suicide: Italian and United States Physicians.

Science.gov (United States)

Domino, George; Perrone, Luisa

1993-01-01

Administered Suicide Opinion Questionnaire to 100 Italian and 100 U.S. physicians, comparable in age, gender, and medical field. Found significant difference on seven of eight scales, with Italian physicians showing greater agreement on mental illness, right to die, religion, impulsivity, normality, aggression, and moral evil scales. Found gender…

Analysis Regarding the Growing Presence of Italian Firms in Romania

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Stefano Valdemarin

2015-12-01

Full Text Available At the end of 2014, the number of firms with an Italian presence in Romania was 39,556, representing 19.33% out of total registered firms and this number is still growing. This article focuses on answering the following question: what kind of Italian firms are investing in Romania and why? Starting from the empirical observation that the number of Italian firms in Romania grew by 6.82% last year, we have used a PESTEL analysis to find the key points characterizing the country, paying attention also to the concept of country brand. From the point of view of Italian firms, we have also analyzed the shifting paradigm of internationalization from a Vertical Foreign Direct Investment model to a Horizontal Foreign Direct Investment model. This paper can be useful for managers and entrepreneurs who are oriented towards investing in Romania following the path of Italian firms.

The Elder Problem

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John W. Elder

2017-03-01

Full Text Available This paper presents an autobiographical and biographical historical account of the genesis, evolution and resolution of the Elder Problem. It begins with John W. Elder and his autobiographical story leading to his groundbreaking work on natural convection at Cambridge in the 1960’s. His seminal work published in the Journal of Fluid Mechanics in 1967 became the basis for the modern benchmark of variable density flow simulators that we know today as “The Elder Problem”. There have been well known and major challenges with the Elder Problem model benchmark—notably the multiple solutions that were ultimately uncovered using different numerical models. Most recently, it has been shown that the multiple solutions are indeed physically realistic bifurcation solutions to the Elder Problem and not numerically spurious artefacts. The quandary of the Elder Problem has now been solved—a major scientific breakthrough for fluid mechanics and for numerical modelling. This paper—records, reflections, reminiscences, stories and anecdotes—is an historical autobiographical and biographical memoir. It is the personal story of the Elder Problem told by some of the key scientists who established and solved the Elder Problem. 2017 marks the 50 year anniversary of the classical work by John W. Elder published in Journal of Fluid Mechanics in 1967. This set the stage for this scientific story over some five decades. This paper is a celebration and commemoration of the life and times of John W. Elder, the problem named in his honour, and some of the key scientists who worked on, and ultimately solved, it.

Italian energy policy

International Nuclear Information System (INIS)

1988-01-01

This document discusses problems associated with Italian energy policy; economic and industrial development as it relates to that policy is covered. Specific areas covered are: (1) the basis of Italy's new energy policy; (2) energy demand; (3) five objectives; (4) the electrical power system; (5) proposed action; and (6) energy resources

Sensitivity and Specificity Analysis: Use of Emoticon for Screening of Depression in Elderly in Singapore.

Science.gov (United States)

Tan, Laurence; Toh, Hui Jin; Sim, Lai Kiow; Low, James Alvin

2018-03-01

The current screening tools for depression can be tedious to administer, especially in the elderly population with hearing impairment and/or limited proficiency in English language. To look at the feasibility of using emoticon as a screening and assessment tool for depression in the elderly. Cross-sectional study. A total of 77 elderly patients completed the study from June 2014 to August 2015 in a general geriatric outpatient clinic of an acute care hospital in Singapore. Patients rated their mood using an emoticon scale, which ranges from 1 ( most happy face) to 7 ( most sad face). Depression was assessed using the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) criteria as the gold standard. Sensitivity and specificity for depression were calculated for the cutoff scores from 1 to 7 on the emoticon scale. The sensitivity percentages were low across all cutoff scores. The specificity was more than 90% for the cutoff score of 5 and above on the emoticon scale. However, all the patients who had depression diagnosed using the DSM-IV criteria did not have emoticon scores of 5 and above. The emoticon scale was easy to use, but its effectiveness in the screening of depression in the elderly needs to be explored further. The inability to use the emoticon scale as a tool may be the lack of measurements in the other domains of the DSM-IV criteria (sleep, energy, appetite, etc.), rather than failure of the emoticon scale to assess mood.

Elder Abuse and Neglect in Israel: A Comparison between the General Elderly Population and Elderly New Immigrants

Science.gov (United States)

Iecovich, Esther

2005-01-01

The present study investigated differences between the general elderly population and elderly new immigrants from former Soviet Union countries in regard to the incidence of elder abuse and neglect, victims' characteristics, and perpetrators' characteristics. In addition, the study sought to examine predictors of various types of abuse and…

Italian Validation of Homophobia Scale (HS

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Giacomo Ciocca, PsyD, PhD

2015-09-01

Conclusions: The Italian validation of the HS revealed the use of this self‐report test to have good psychometric properties. This study offers a new tool to assess homophobia. In this regard, the HS can be introduced into the clinical praxis and into programs for the prevention of homophobic behavior. Ciocca G, Capuano N, Tuziak B, Mollaioli D, Limoncin E, Valsecchi D, Carosa E, Gravina GL, Gianfrilli D, Lenzi A, and Jannini EA. Italian validation of Homophobia Scale (HS. Sex Med 2015;3:213–218.

Depersonalization: An exploratory factor analysis of the Italian version of the Cambridge Depersonalization Scale.

Science.gov (United States)

Fagioli, F; Telesforo, L; Dell'Erba, A; Consolazione, M; Migliorini, V; Patanè, M; Boldrini, T; Graziani, R; Nicoletti, F; Fiori-Nastro, P

2015-07-01

"Depersonalization" (DP) is a common symptom in the general population and psychiatric patients (Michal et al., 2011 [1]). DP is characterized by an alteration in the experience of the self, so that one feels detached from his or her own mental processes or body (or from the world), feeling as being an outside observer of his or her own self, and loosing the experience of unity and identity (American Psychiatric Association, 2013 [2]). We performed an exploratory factor analysis of the Cambridge Depersonalization Scale Italian version (CDS-IV). We enrolled 149 inpatients and outpatients of psychiatric services located in two Italian regions, Lazio and Campania. Patients were aged between 15 and 65 and diagnosed with schizophrenic, depressive or anxiety disorders. Four factors accounted for 97.4% of the variance. Factor 1 (10, 24, 26, 1, 13, 23, 9, 2, 5, and 11), called "Detachment from the Self", captures experiences of detachment from actions and thoughts. Factor 2 (19, 20, 27, 3, 12, 23, 22, and 11), called "Anomalous bodily experiences", refers to unusual bodily experiences. Factor 3 (7, 28, 25, 6, 9, and 2), named "Numbing", describes the dampening of affects. Factor 4 (14, 17, and 16), named "Temporal blunting", refers to the subjective experience of time. We did not find any specific factor that refers to derealization; this suggests that the constructs of depersonalization/derealization (DP/DR) were strongly related to each other. Our results show that the constructs of DP/DR subsume several psychopathological dimensions; moreover, the above mentioned factors were broadly consistent with prior literature. Copyright © 2015. Published by Elsevier Inc.

Strategic Management Accounting in Universities: The Italian Experience

Science.gov (United States)

Agasisti, Tommaso; Arnaboldi, Michela; Azzone, Giovanni

2008-01-01

This paper presents an investigation of management accounting in four major Italian universities, which have been struggling to build their strategy in a context of significant change. Following many OECD countries the Italian government has been changing its higher education system by giving more autonomy to universities. These changes pose a…

exiles/nomads: journeys through language and gender in italian ...

African Journals Online (AJOL)

User

how Italian women's (and men's) pulp fiction is written through gender specific ... by Santacroce's heroines to travel beyond the Italian boundaries, is not limited to the ..... The character's perception of his physical environment as silent and.

Structured outpatient treatment of alcohol vs. drug dependencies.

Science.gov (United States)

Washton, A M

1990-01-01

This chapter describes the rationale, indications, design, and use of a structured outpatient treatment approach as an effective alternative to residential treatment for alcohol and drug dependencies. An increasing demand for outpatient treatment services is being created by a combination of clinical and economic factors, including the influx of employed drug abusers who do not need or desire residential care and mounting financial pressures to contain health care costs. To be effective as a primary treatment modality, outpatient programs must be highly structured and intensive and able to deal with the full spectrum of alcohol and drug addictions. Perpetuating the historical separation between alcoholism and drug abuse treatment programs is unnecessary and counterproductive, although certain modifications in treatment approaches are needed to accommodate the distinctive characteristics of particular classes of drugs and the people who use them. The "outpatient rehab," a treatment model that approximates the intensity of inpatient treatment on an outpatient basis, may help to maximize the clinical efficacy and cost-effectiveness of outpatient treatment as a viable alternative to residential care. Initial treatment results with this model are encouraging.

Hospital Outpatient Prospective Payment System (OPPS) Lim...

Data.gov (United States)

U.S. Department of Health & Human Services — Hospital Outpatient Prospective Payment System (OPPS) Limited Data Set This file contains select claim level data and is derived from 2010 hospital outpatient PPS...

Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems (OAS CAHPS) survey for hospital outpatient departments - Facility

Data.gov (United States)

U.S. Department of Health & Human Services — A list of hospital outpatient department ratings for the Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems (OAS CAHPS)...

Outpatient Vascular Intervention: A Two-Year Experience

International Nuclear Information System (INIS)

Macdonald, Sumaira; Thomas, Steven M.; Cleveland, Trevor J.; Gaines, Peter A.

2002-01-01

Purpose: To retrospectively analyze the outcome of a range of interventional vascular procedures performed on outpatients. Methods: Suitability for outpatient procedures was assessed according to agreed protocols. An episode was defined as any procedure/s through a single access site at one attendance. Retrospective case-note review was performed. Results: There were 693 outpatient episodes between April 1998 and May 2000 (290 interventional, and 403 diagnostic procedures),comprising 25% (693/2769) of the total workload. Follow-up is available in 214; 38 of these were transfers from outlying hospitals and were excluded from analysis. One hundred and seventy-six were true outpatients. There were 98 iliac and 46 femoropopliteal interventions,2 aortic stents, 1 renal and 5 upper-limb angioplasties (PTAs), 5 embolizations, 8 Hickman lines, 1 line stripping, 3 atherectomies, 1 dialysis-graft PTA and 6 bypass-graft PTAs. Sixty-eight closure devices were used. Twelve patients were converted to inpatients (6.8%,12/176). The readmission rate was 3.4% (6/176). The reattendance rate was 1.1% (2/176), both subsequently attending for outpatient duplex ultrasound examination to exclude pseudoaneurysm. The major complication rate was 3.4% and the delayed major complication rate was 1.7%. Conclusion: Outpatient vascular intervention is safe with appropriate protocols and with careful patient selection. Local vascular services benefit from the release of inpatient beds

Patterns of psychotropic medication use in inpatient and outpatient psychiatric settings in Saudi Arabia

Directory of Open Access Journals (Sweden)

Alosaimi FD

2016-04-01

(27.9%, and antianxiety (6.2%. However, compared to outpatients, the current use of medications for inpatients was more frequent (93.8% vs 89.9%, P=0.019 with inpatients more likely to be treated with multiple medications (2.1 vs 1.8 medications. A similar trend was observed in the case of antipsychotics, high potency first-generation antipsychotics, second-generation antipsychotics, mood stabilizers, and antianxiety medicines where inpatients were more frequently treated with these medications for all psychiatric diagnoses when compared with outpatients. On the contrary, in the case of antidepressant treatment, an opposite trend was observed with more number of treated outpatients in comparison to inpatients. Among elderly patients, 75.9% received antipsychotics, mainly second-generation formulations (67.2%, whereas only 41% received antidepressants and 13.8% received mood stabilizers.Conclusion: Based upon the present study data, it is concluded that among all the psychotropic medications, antipsychotics were heavily used and the frequency was found to be significantly high in the case of inpatients compared with outpatients. Such a practice may lead to multiple negative consequences among the Saudi psychiatric patient population. Further, extensive use of sodium valproate in the case of bipolar disorder, and also among females either in childbearing age or during pregnancy is also the cause of concern and warrants logical use. Overall, this study may help in assessing the burden of psychiatric illness within specific patient demographics and might be effectively used to strategically plan health resources allocation, generate new treatment hypothesis, or be used as a source of evidence that could further integrate other observational studies.Keywords: psychotropic, inpatient, outpatient, antipsychotics, antidepressants, mood stabilizers, Saudi Arabia

Aspiration Curettage and its Outpatient Usage

African Journals Online (AJOL)

Aspiration Curettage and its Outpatient Usage. D. A. G. BARFORD, M, NOTELOVITZ. SUMMARY ... its use on a number of outpatients without anaesthesia is discussed. S. Afr. Med. l., 48, 22 (1974). In order to ... plastic aspiration chamber and suction is applied centrally at the base of the chamber, a cylindrical filter within the.

’The Italian Color’: Race, Crime Iconography and Dubbing Conventions in the Italian-language Versions of Scarface (1932)

OpenAIRE

Mereu Keating, Carla

2016-01-01

In the early 1930s the crime film Scarface: The Shame of a Nation (1932, USA, dir. Howard Hawks) stirred censorship controversies in the United States because of its gritty portrayal of criminality and violence. Debates over crime, race and immigration proliferated in the North-American press and finally led to Italian-American pressure groups to call out for the film’s boycott because it ‘offended the Italian nation and people’ and vilified immigrant communities. Archival historical ...

A review of the Italian fast reactor programme

International Nuclear Information System (INIS)

Pierantoni, F.; Tavoni, R.

1984-01-01

This review sums up the Italian situation in the field of the fast reactors on the eve of the fifth five year plan (1985-1989), in which the country undertakes to implement an important activity of research and development in the context of a greater European collaboration. Italian participation in the development of European nuclear power stations together with the completion of the PEC plant which will be used to develop a fuel element with the necessary economic and safety characteristics, remain the two principal goals of the Italian fast reactor programme. In 1983 the sum assigned by ENEA for fast reactors was about 220 billion lire of which 145 billion was for the PEC reactor

The ECO computerized cognitive battery: collection of normative data using elderly New Zealanders.

Science.gov (United States)

Merrick, Paul I; Secker, David I; Fright, Renee; Melding, Pamela

2004-03-01

Computerized testing in the elderly has multiple advantages, including increased time-efficiency, a wider range of stimulus options and response forms, and increased psychometric reliability. The French-language ECO (Examen Cognitif par Ordinateur, Ritchie et al., 1993) computerized cognitive battery is investigated in this study. The purpose of the study was to yield normative data for an English-language version of the ECO, test the effects of age and education on test scores, to observe individual subtest sensitivity to cognitive impairment, and to examine participants' receptivity to this form of testing. A sample of 129 community-dwelling elderly with normal cognitive functioning and 56 cognitively impaired older adults living in both independent and supported accommodation were tested using the ECO at either their own residence or an outpatient facility. Standardized scores for three different age bands are given for both impaired and non-impaired groups. Age and education effects varied between subtests. A discriminant analysis of subtest-sensitivity to group prediction is reported using a stepwise regression model. The English version of the ECO appears to be a sensitive and practical cognitive battery that is highly acceptable to older people.

Healthy migrants but unhealthy offspring? A retrospective cohort study among Italians in Switzerland.

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Tarnutzer, Silvan; Bopp, Matthias

2012-12-22

In many countries, migrants from Italy form a substantial, well-defined group with distinct lifestyle and dietary habits. There is, however, hardly any information about all-cause mortality patterns among Italian migrants and their offspring. In this paper, we compare Italian migrants, their offspring and Swiss nationals. We compared age-specific and age-standardized mortality rates and hazard ratios (adjusted for education, marital status, language region and period) for Swiss and Italian nationals registered in the Swiss National Cohort (SNC), living in the German- or French-speaking part of Switzerland and falling into the age range 40-89 during the observation period 1990-2008. Overall, 3,175,288 native Swiss (48% male) and 224,372 individuals with an Italian migration background (57% male) accumulated 698,779 deaths and 44,836,189 person-years. Individuals with Italian background were categorized by nationality, country of birth and language. First-generation Italians had lower mortality risks than native Swiss (reference group), but second-generation Italians demonstrated higher mortality risks. Among first-generation Italians, predominantly Italian-speaking men and women had hazard ratios (HRs) of 0.89 (95% CI: 0.88-0.91) and 0.90 (0.87-0.92), respectively, while men and women having adopted the regional language had HRs of 0.93 (0.88-0.98) and 0.96 (0.88-1.04), respectively. Among second-generation Italians, the respective HRs were 1.16 (1.03-1.31), 1.06 (0.89-1.26), 1.10 (1.05-1.16) and 0.97 (0.89-1.05). The mortality advantage of first-generation Italians decreased with age. The mortality risks of first- and second-generation Italians vary substantially. The healthy migrant effect and health disadvantage among second-generation Italians show characteristic age/sex patterns. Future investigation of health behavior and cause-specific mortality is needed to better understand different mortality risks. Such insights will facilitate adequate prevention and

Healthy migrants but unhealthy offspring? A retrospective cohort study among Italians in Switzerland

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Tarnutzer Silvan

2012-12-01

Full Text Available Abstract Background In many countries, migrants from Italy form a substantial, well-defined group with distinct lifestyle and dietary habits. There is, however, hardly any information about all-cause mortality patterns among Italian migrants and their offspring. In this paper, we compare Italian migrants, their offspring and Swiss nationals. Methods We compared age-specific and age-standardized mortality rates and hazard ratios (adjusted for education, marital status, language region and period for Swiss and Italian nationals registered in the Swiss National Cohort (SNC, living in the German- or French-speaking part of Switzerland and falling into the age range 40–89 during the observation period 1990–2008. Overall, 3,175,288 native Swiss (48% male and 224,372 individuals with an Italian migration background (57% male accumulated 698,779 deaths and 44,836,189 person-years. Individuals with Italian background were categorized by nationality, country of birth and language. Results First-generation Italians had lower mortality risks than native Swiss (reference group, but second-generation Italians demonstrated higher mortality risks. Among first-generation Italians, predominantly Italian-speaking men and women had hazard ratios (HRs of 0.89 (95% CI: 0.88-0.91 and 0.90 (0.87-0.92, respectively, while men and women having adopted the regional language had HRs of 0.93 (0.88-0.98 and 0.96 (0.88-1.04, respectively. Among second-generation Italians, the respective HRs were 1.16 (1.03-1.31, 1.06 (0.89-1.26, 1.10 (1.05-1.16 and 0.97 (0.89-1.05. The mortality advantage of first-generation Italians decreased with age. Conclusions The mortality risks of first- and second-generation Italians vary substantially. The healthy migrant effect and health disadvantage among second-generation Italians show characteristic age/sex patterns. Future investigation of health behavior and cause-specific mortality is needed to better understand different mortality risks

Notulae to the Italian alien vascular flora: 4

OpenAIRE

Galasso,Gabriele; Domina,Gianniantonio; Bonari,Gianmaria; Buono,Sergio; Chianese,Giuseppina; Cortesi,Gloria; Cortesi,Gloria; Iamonico,Duilio; Olivieri,Nicola; Peruzzi,Lorenzo; Pierini,Brunello; Roma-Marzio,Francesco; Scoppola,Anna; Soldano,Adriano; Stinca,Adriano

2017-01-01

In this contribution, new data concerning the Italian distribution of alien vascular flora are presented. It includes new records and exclusions for Italy or for Italian administrative regions of taxa in the genera Cedrus, Cenchrus, Citrus, Cyrtomium, Diospyros, Elaeagnus, Erigeron, Iris, Oenothera, Pavonia, Phytolacca, Styphnolobium, and Verbena. Furthermore, a new combination in the genus Amaranthus is proposed.

Eliciting change in at-risk elders (ECARE): evaluation of an elder abuse intervention program.

Science.gov (United States)

Mariam, Lydia Morris; McClure, Regina; Robinson, J B; Yang, Janet A

2015-01-01

The current study evaluated the effectiveness of a community-based elder abuse intervention program that assists suspected victims of elder abuse and self-neglect through a partnership with local law enforcement. This program, Eliciting Change in At-Risk Elders, involves building alliances with the elder and family members, connecting the elder to supportive services that reduce risk of further abuse, and utilizing motivational interviewing-type skills to help elders overcome ambivalence regarding making difficult life changes. Risk factors of elder abuse decreased over the course of the intervention and nearly three-quarters of participants made progress on their treatment goal, advancing at least one of Prochaska and DiClemente's (1983) stages of change (precontemplation, contemplation, preparation, action, and maintenance). Forty-three percent of elders moved into the stages of action and maintenance regarding their goal. The usefulness of eliciting change via longer-term relationships with vulnerable elders in entrenched elder abuse situations is discussed.

Alzheimer’s Disease Diagnosis: Discrepancy between Clinical, Neuroimaging, and Cerebrospinal Fluid Biomarkers Criteria in an Italian Cohort of Geriatric Outpatients: A Retrospective Cross-sectional Study

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Giulia A. M. Dolci

2017-11-01

Full Text Available BackgroundThe role of cerebrospinal fluid (CSF biomarkers, and neuroimaging in the diagnostic process of Alzheimer’s disease (AD is not clear, in particular in the older patients.ObjectiveThe aim of this study was to compare the clinical diagnosis of AD with CSF biomarkers and with cerebrovascular damage at neuroimaging in a cohort of geriatric patients.MethodsRetrospective analysis of medical records of ≥65-year-old patients with cognitive impairment referred to an Italian geriatric outpatient clinic, for whom the CSF concentration of amyloid-β (Aβ, total Tau (Tau, and phosphorylated Tau (p-Tau was available. Clinical diagnosis (no dementia, possible and probable AD was based on the following two sets of criteria: (1 the Diagnostic Statistical Manual of Mental Disorders (DSM-IV plus the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer’s Disease and Related Disorders Association (NINCDS-ADRDA and (2 the National Institute on Aging-Alzheimer’s Association (NIA-AA. The Fazekas visual scale was applied when a magnetic resonance imaging scan was available.ResultsWe included 94 patients, mean age 77.7 years, mean Mini Mental State Examination score 23.9. The concordance (kappa coefficient between the two sets of clinical criteria was 70%. The mean CSF concentration (pg/ml (±SD of biomarkers was as follows: Aβ 687 (±318, Tau 492 (±515, and p-Tau 63 (±56. There was a trend for lower Aβ and higher Tau levels from the no dementia to the probable AD group. The percentage of abnormal liquor according to the local cutoffs was still 15 and 21% in patients without AD based on the DSM-IV plus NINCDS-ADRDA or the NIA-AA criteria, respectively. The exclusion of patient in whom normotensive hydrocephalus was suspected did not change these findings. A total of 80% of patients had the neuroimaging report describing chronic cerebrovascular damage, while the Fazekas scale was positive in 45% of patients

Residential construction cost: An Italian survey.

Science.gov (United States)

Canesi, Rubina; Marella, Giuliano

2017-04-01

This paper reports data describing development projects for new buildings according to construction costs in North-East Italy. A survey was carried out on local companies undertaking new residential development projects in two Italian regions (Veneto and Lombardy). The aim of this survey was to record new real estate construction projects, collecting both technical and socio-economic cost features. It is extremely difficult to collect such data for the Italian real estate construction sector, due to its lack of transparency, so that the novelty for the Italian scenario is the dataset itself. Another interest perspective of this survey is that socio-economic characteristics were also recorded; they are often studied in urban economics, but are usually related to property purchase prices and values, not to construction costs. The data come from an analysis of Canesi and Marella regarding the relationship between the trend of construction costs and the socio-economic conditions of the reference setting, such as the mean years of schooling of the workforce, housing market trends, and average per capita income.

Residential construction cost: An Italian survey

Directory of Open Access Journals (Sweden)

Rubina Canesi

2017-04-01

Full Text Available This paper reports data describing development projects for new buildings according to construction costs in North-East Italy. A survey was carried out on local companies undertaking new residential development projects in two Italian regions (Veneto and Lombardy. The aim of this survey was to record new real estate construction projects, collecting both technical and socio-economic cost features. It is extremely difficult to collect such data for the Italian real estate construction sector, due to its lack of transparency, so that the novelty for the Italian scenario is the dataset itself. Another interest perspective of this survey is that socio-economic characteristics were also recorded; they are often studied in urban economics, but are usually related to property purchase prices and values, not to construction costs. The data come from an analysis of Canesi and Marella regarding the relationship between the trend of construction costs and the socio-economic conditions of the reference setting, such as the mean years of schooling of the workforce, housing market trends, and average per capita income.

Impulse control disorders in elderly patients.

Science.gov (United States)

Tamam, Lut; Bican, Mehtap; Keskin, Necla

2014-05-01

There is no epidemiological study on the prevalence of impulse control disorders (ICDs) in the elderly population. The studies on ICDs in elderly patients are limited and some of them are case reports about pathological gambling and kleptomania. The comorbidity of other psychiatric disorders makes diagnosis difficult and has negative effects on both treatment and the prognosis of ICDs. The aim of this study was to determine the prevalence of ICDs among elderly patients and to evaluate the related sociodemographic and clinical features. A total of 76 patients aged 60 and over who have been referred to our outpatient clinics in a one-year period were included in the study. A demographic data form was completed. The Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) was used to determine axis I psychiatric disorders. The prevalence of ICDs was investigated by using the modified version of the Minnesota Impulse Disorders Interview (MIDI). Impulsivity was measured with the Barratt Impulsiveness Scale Version 11 (BIS-11). The Mini-Mental State Examination (MMSE) test was performed to evaluate the cognitive status of patients and to exclude the diagnosis of dementia. In addition, all patients completed Symptom Check List-90 (SCL-90). The prevalence rate of at least one comorbid ICD in our sample was 17%. When patients with a diagnosis of ICDs not otherwise specified (ICD-NOS) were included, the prevalence rate increased to 22.4%. The most common ICD was intermittent explosive disorder (15.8%), followed by pathological gambling (9.2%). The majority of the sample was men (54%), married (80%), had a high school education (51%), and mid-level socioeconomic status (79%). The only statistically significant difference between the sociodemographic characteristics of patients with or without ICDs was gender. The lifetime prevalence of ICDs was 34.1% in men and 8.6% in women. The prevalence of childhood conduct disorder

The complexities of elder abuse.

Science.gov (United States)

Roberto, Karen A

2016-01-01

Elder abuse is a growing societal concern, affecting at least 1 in 10 older Americans. Researchers and practitioners alike consistently assert that a dramatic discrepancy exists between the prevalence rates of elder abuse and the number of elder abuse cases reported. As a field of study, recognition and understanding of elder abuse is still emerging. Comparing findings of a small, but growing, body of literature on perceived and substantiated cases of elder abuse is challenging because there is no uniform term or agreed-upon definition used among state governments, researchers, health care and service providers, and advocates. This article summarizes current understanding of elder abuse, including what constitutes elder abuse, risk factors for elder abuse, perpetrators of elder abuse, and outcomes of elder abuse. Issues associated with the detection of elder abuse and intervention strategies for victims of abuse are addressed. In the final section, potential roles and contributions of psychologists for advancing elder abuse research, professional practice, and policy development are highlighted. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Italian decommissioning in the post-referendum era

International Nuclear Information System (INIS)

Ferrazzano, Vincenzo; Scarabotti, Serena

2012-01-01

The accident at the TEPCO Fukushima Daiichi nuclear power plant materially reverberated, with its emotional impact, on the preparation of a new nuclear policy in Italy. Italians, wishing to decide directly on the electric power source for their country, applied for a referendum procedure aimed at abrogating the newly enacted legal framework which would have paved the way for an Italian nuclear renaissance. The referendum on the repeal of nuclear power passed on 12-13 June 2011. In addition to the recent termination of the nuclear programme in Italy, effective by law for five years as a result of this referendum, this aborted renaissance of nuclear energy in Italy requires leaders to make many important decisions including how to set up decommissioning programmes and activities and how to establish a national repository for nuclear waste as envisaged by general European policy on the management of such waste. Leaders must also reach consensus regarding the future of the Italian nuclear safety authority. The purpose of this paper is to explore how the Italian Parliament has reacted to this recent referendum on the future of nuclear energy in Italy by strengthening its focus on the safe management of nuclear waste as part of the decommissioning process. More significantly, this paper will analyse the newly enacted Law No. 27 of 24 March 2012 concerning urgent measures for infrastructure development to enhance the competitiveness of the country. This law derives from a political measure taken by Prime Minister Mario Monti in the context of an economic stimulus programme aimed at improving market competition. Article 24 of this so-called 'Liberalisation Decree' focuses on the need for accelerating the deactivation and decommissioning process of Italian nuclear power plants and research reactors. In light of the newly enacted legal provisions, this paper sets forth a general comment on the legal provisions included in Article 24 of Law No. 27/2012 by indicating their

The efficacy of agomelatine in elderly patients with recurrent major depressive disorder: a placebo-controlled study.

Science.gov (United States)

Heun, Reinhard; Ahokas, Antti; Boyer, Patrice; Giménez-Montesinos, Natalia; Pontes-Soares, Fernando; Olivier, Valérie

2013-06-01

The present placebo-controlled study evaluated the efficacy, tolerability, and safety of 8-week treatment with agomelatine (25-50 mg/d by mouth) in elderly patients with major depressive disorder (MDD). Elderly outpatients aged ≥ 65 years with a primary diagnosis of moderate to severe episode of recurrent MDD (DSM-IV-TR) were recruited in 27 clinical centers in Argentina, Finland, Mexico, Portugal, and Romania from November 2009 to October 2011. The primary outcome measure was the 17-item Hamilton Depression Rating Scale (HDRS17) total score. A total of 222 elderly patients entered the study (151 in the agomelatine group, 71 in the placebo group), including 69 patients aged 75 years and older. Agomelatine improved depressive symptoms in the elderly population, as evaluated by the HDRS17 total score, in terms of last postbaseline value (agomelatine-placebo difference: mean estimate [standard error] = 2.67 [1.06] points; P = .013) and response to treatment (agomelatine, 59.5%; placebo, 38.6%; P = .004). The agomelatine-placebo difference according to the Clinical Global Impressions-Severity of Illness scale (CGI-S) score was 0.48 (0.19). The agomelatine-placebo difference (estimate [standard error]) for remission on the HDRS17 was 6.9% (4.7%) and did not achieve statistical significance (P = .179, post hoc analysis). Clinically relevant effects of agomelatine were confirmed on all end points in the subset of severely depressed patients (HDRS17 total score ≥ 25 and CGI-S score ≥ 5 at baseline). Agomelatine was well tolerated by patients, with only minimal distinctions from placebo. The present study provides the first evidence that an 8-week treatment with agomelatine 25-50 mg/d efficiently relieves depressive symptoms and is well tolerated in elderly depressed patients older than 65 years. Controlled-Trials.com identifier: ISRCTN57507360. © Copyright 2011 Physicians Postgraduate Press, Inc.

Glycemic index and glycemic load of commercial Italian foods.

Science.gov (United States)

Scazzina, F; Dall'Asta, M; Casiraghi, M C; Sieri, S; Del Rio, D; Pellegrini, N; Brighenti, F

2016-05-01

The glycemic index (GI) and glycemic load (GL) are useful parameters in the nutritional classification of carbohydrate foods. Diets characterized by a low GI and/or a low GL have been repeatedly and independently associated with decreased risk of diabetes and other chronic diseases. The aim of this study is to report the GI and GL value of carbohydrate-rich foods available on the Italian market and mostly consumed in Italy. GI values were determined according to FAO/WHO (1997) and ISO (2010). Overall, the 141 commercial foods that were analyzed represent food categories that are the source of >80% carbohydrate intake in Italy. The food items chosen were based mainly on the market share of the brand within each food category and grouped into 13 food categories: 1) beverages: fermented milk drink, juice, smoothie, soft drink; 2) biscuits; 3) breads; 4) bread substitutes; 5) breakfast cereals; 6) cakes and snacks; 7) candy and confectionery; 8) cereals; 9) desserts and ice-creams; 10) marmalade and jam; 11) pasta; 12) pizza; 13) sugar and sweetener. This database of commercial Italian foods partly overcomes the lack of information on GI and GL of local foods, contributing to a better understanding of the association between GI/GL and health and providing a more informed choice to Italian consumers and health practitioners. Copyright © 2016 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

Billing for outpatient transplant pharmacy services.

Science.gov (United States)

Maldonado, Angela Q; Seiger, Todd C; Urann, Christina L; McCleary, Jo Ann; Goroski, Angela L; Ojogho, Okechukwu N

2012-01-15

The economic impact of out-patient pharmacy services in a transplant program was evaluated. Full-time kidney transplant pharmacy services were implemented at Providence Sacred Heart Medical Center (PSHMC) in the fall of 2008, with two pharmacists combining hours to provide one full-time-equivalent position. At PSHMC, posttransplantation patients are seen three times per week. The number of patient visits with pharmacists for 2010 was compared with the total number of patient visits. The face-to-face time spent with the patient was translated to a level of billing that was associated with a set reimbursement schedule. For each patient encounter in which a pharmacist was involved, the incremental difference between the nursing and pharmacy levels of billing was examined, as were the levels most often billed by pharmacists. The difference in billing levels between pharmacists and nurses for the same patient encounter was also evaluated. Overall, pharmacist visits accounted for 208 (22%) of the 994 out-patient kidney transplant visits in 2010, with pharmacists billing at a higher level of acuity compared with nursing for the same patient encounter 48% of the time. This translated to an approximate increase of $100 per patient visit. For the one-year study period, pharmacists utilizing facility- fee billing increased out-patient reimbursement by approximately $10,000. By utilizing outpatient facility-fee billing for pharmacy services, the transplant program at PSHMC increased reimbursement in the outpatient setting.

Dealing with the vulnerability of the Italian banking system

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Elisabetta Montanaro

2017-12-01

Full Text Available The major vulnerabilities of the Italian banking system are the overhang of NPLs and low profitability. Differently from the attention given to excesses of NPLs, the profitability problem is normally considered to be a matter to be left to bank management and not an area of explicit direct regulatory action. Although focusing on capital requirements, regulators and supervisors seldom pose the question of where capital comes from. Using a large sample of 410 Italian domestic banking groups and individual banks, we propose an NPL stress test and a viability test that show: that the system’s vulnerability is a widespread phenomenon; that a further recapitalisation of around ten billion euro is necessary; and that, more importantly, limiting interventions to the overhang problem does not put the majority of Italian banks into a viability path due to the inefficiencies coming from their current business models. The analysis of the Italian case strengthens the critique of current regulation and supervision because, not focusing on bank profitability, they do not avoid threats on solvency coming from the accumulation of NPLs. We thus argue that the structural changes necessary to put the Italian banking system into a viable path require new regulatory and supervisory approaches.

Social media marketing in Italian luxury fashion

OpenAIRE

Ananda, Artha Sejati; Hernández García, Ángel; Lamberti, Lucio

2015-01-01

Industries nowadays have been comfortable with the incorporation of social media to their marketing strategy. Italy has been known as a major center of the European fashion industry, a sector that is also following the social media marketing trends. This paper provides empirical findings on Italian luxury fashion brands? social media marketing activities. We present and analyze two case studies of Italian luxury fashion brands: Gucci and The Bridge (Il Ponte Pelletteria). Gucci is one of worl...

Psychiatric morbidity in elderly patients attending OPD of tertiary care centre in western region of Nepal

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Prakash Thapa

2014-01-01

Full Text Available Context: Aging of population is currently a global phenomenon. At least one in 5 people over the age of 65 years will suffer from a mental disorder by 2030. Study of psychiatric morbidities in this age group is essential to prepare for upcoming challenges. Aims: To find out the prevalence of different psychiatric morbidities in elderly population and to find out if there are any age and gender specific differences. Settings and Design: Retrospective review; Psychiatric outpatient department of Manipal Teaching Hospital, Pokhara, Nepal. Materials and Methods: Data for patients ≥ 65 years of age attending the psychiatric outpatient department of Manipal Teaching Hospital, Pokhara, Nepal, from 1 st January 2012 to 15 th January 2013 were collected retrospectively in a predesigned proforma. Statistical Analysis Used: Risk of having different psychiatric disorders was estimated using odds ratio. Results: The mean age of 120 patients included in this study was 69.67 (SD = 5.94 years. Depressive disorder (26.7% was the most common diagnosis. There was no statistically significant difference in psychiatric disorders in >75 years compared with ≤75 years except for dementia [odd ratio (OR (≤75 years/>75 years=0.055, 95% confidence interval (CI=0.016; 0.194]. Alcohol dependence syndrome [OR (male/female=7.826, 95% CI = 1.699;36.705] and dementia [OR (male/female=3.394, 95% CI = 1.015;11.350] was more common in males. Conclusions: Depressive disorder was the most common psychiatric morbidity among the elderly patients. The odds suffering from dementia increased with increasing age. The odds of having alcohol related problems and dementia were more in males compared with females.

42 CFR 410.141 - Outpatient diabetes self-management training.

Science.gov (United States)

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Outpatient diabetes self-management training. 410...-Management Training and Diabetes Outcome Measurements § 410.141 Outpatient diabetes self-management training... Part B covers outpatient diabetes self-management training for a beneficiary who has been diagnosed...

European energy policy and Italian national rights

International Nuclear Information System (INIS)

Gentile, G.G.

1991-01-01

In light of energy market upheavals expected as a result of the up-coming European free trade market, impacts on existing Italian energy legislation, currently hinging on the monopolistic activities of ENEL, (Italian National Electricity Board) are examined. The various aspects dealt with include: legal implications of the integration, under monopolistic and deregulated national energy market scenarios, of new legislation, on the production and distribution of renewable energy sources, with existing energy legislation; the combined effects of strong competition in a new international energy market and energy supply vulnerability due strong dependence on OPEC supplied petroleum; Italian regional economic unbalance due to the possible introduction, in a deregulated European electric power market, of a common carrier system of electric power distribution, that due to Italy's particular geography is expected to be controlled by a firm locatednear the northern border; power pooling legislation and rate structure transparency in a deregulated energy market

Italian electricity supply contracts optimization: ECO computer code

International Nuclear Information System (INIS)

Napoli, G.; Savelli, D.

1993-01-01

The ECO (Electrical Contract Optimization) code written in the Microsoft WINDOWS 3.1 language can be handled with a 286 PC and a minimum of RAM. It consists of four modules, one for the calculation of ENEL (Italian National Electricity Board) tariffs, one for contractual time-of-use tariffs optimization, a table of tariff coefficients, and a module for monthly power consumption calculations based on annual load diagrams. The optimization code was developed by ENEA (Italian Agency for New Technology, Energy and the Environment) to help Italian industrial firms comply with new and complex national electricity supply contractual regulations and tariffs. In addition to helping industrial firms determine optimum contractual arrangements, the code also assists them in optimizing their choice of equipment and production cycles

A replication of the relationship between elderly suicides rates and elderly dependency ratios: cross-national study

Science.gov (United States)

Shah, Ajit

2010-01-01

Abstract: Background: A positive correlation between elderly dependency ratios and elderly suicide rates has been observed using one-year cross-sectional data on elderly suicide rates. Methods: A cross-national study designed to replicate this positive correlation between elderly dependency ratios and elderly suicide rates was undertaken by: (i) using one-year average of five years data on suicide rates; and (ii) using more recent data on both elderly suicide rates and elderly dependency ratios. Data on elderly suicide rates, and the total number of elderly and young people was ascertained from the World Health Organization website. Results: The main findings were of significant positive correlations between elderly dependency ratios and suicide rates in both sexes in both the elderly age-bands (65-74 years and 75+ years). Conclusions: The replication of the positive correlations between elderly dependency ratios and elderly suicide rates by using one-year average of five years data on suicide rates suggests that this relationship is robust and accurate. PMID:21483194

Collective Training & Thinking in JAMD : The Italian JPOWX Experience

NARCIS (Netherlands)

Jacobs, L.R.M.A.; Schavemaker-Piva, O.; Meijer, Y.G.S.; Nuvoloni, P.; Cioli, C.; Manca, R.; Argiolas, G.

2009-01-01

Mission Training through Distributed Simulation (MTDS) has established itself as a powerful tool for collective training in the military domain. This potential has been recognized by the Italian Joint Forces Command and has led to the Italian participation in the 10th edition of Exercise Joint

User-driven innovation of an outpatient department

DEFF Research Database (Denmark)

Broberg, Ole; Edwards, Kasper

2012-01-01

This paper presents experiences from a user-driven innovation process of an outpatient department in a hospital. The mixing of methods from user-driven innovation and participatory design contributed to develop an innovative concept of the spatial and organizational design of an outpatient...

Effects of eradication and restoration treatments on Italian thistle (Carduus pycnocephalus)

Science.gov (United States)

McGinnis, Thomas; Keeley, Jon

2011-01-01

Low elevation grasslands in California long have been dominated by Mediterranean grasses, but many areas still have large native forb populations. Alien forbs invade these grasslands, displacing both native and other alien species. Italian thistle is a noxious alien herb that has recently invaded these grasslands, including ungrazed blue oak (Quercus douglassii) and interior live oak (Quercus wislizenii) stands in Sequoia National Park. Here, Italian thistle tends to dominate under oaks and has the potential to substantially alter the foothill ecosystem by displacing native plants and acting as a ladder fuel that can carry fires into the oak canopy. We tested the effects of selectively reducing Italian thistle populations alone and in combination with restoration of native species. Two thistle eradication techniques (clipping and the application of clopyralid herbicide) and two restoration techniques (addition of native forb seeds or planting native grass plugs) were used. After two consecutive years of treatment we found: a) clipping was not effective at reducing Italian thistle populations (clipping reduced Italian thistle density in some areas, but not vegetative cover), b) herbicide reduced both Italian thistle density and vegetative cover for the first two growing seasons after application, but cover rebounded in the third growing season, c) native forb cover and species richness were not significantly affected by clipping or spot-treating with herbicide, d) the grass and forb addition treatments by themselves were not effective at reducing Italian thistle during the course of this study and e) sowing annual forb seeds after clipping resulted in greater forb cover and moderately reduced Italian thistle vegetative cover in the short term.

Utilisation of outpatient services at Red Cross War Memorial ...

African Journals Online (AJOL)

The demand for outpatient services continues to grow at Red Cross War Memorial Children's Hospital (RCCH). To determine current utilisation patterns, we conducted a 2-week survey in the outpatient department (OPD). In addition, we reviewed the RCCH Annual Reports for the period 1961 - 1988. Annual outpatient ...

Thyroid swellings in the art of the Italian Renaissance.

Science.gov (United States)

Sterpetti, Antonio V; De Toma, Giorgio; De Cesare, Alessandro

2015-09-01

Thyroid swellings in the art of the Italian Renaissance are sporadically reported in the medical literature. Six hundred paintings and sculptures from the Italian Renaissance, randomly selected, were analyzed to determine the prevalence of personages with thyroid swellings and its meaning. The prevalence of personages with thyroid swellings in the art of Italian Renaissance is much higher than previously thought. This phenomenon was probably secondary to iodine deficiency. The presence of personages with thyroid swelling was related to specific meanings the artists wanted to show in their works. Even if the function and the role of the thyroid were discovered only after thyroidectomy was started to be performed, at the beginning of the 19th century, artists of the Italian Renaissance had the intuition that thyroid swellings were related to specific psychological conditions. Artistic intuition and sensibility often comes before scientific demonstration, and it should be a guide for science development. Copyright © 2015 Elsevier Inc. All rights reserved.

Uncovering the Italian Muscle Jew: from Zionist Gymnastics to Fascist Boxing

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Simon Levis Sullam

2017-10-01

Full Text Available In this article I examine the presence and influence among Italian Jews of Max Nordau’s image of the “muscle Jew” and more broadly of a virile imaginary, intertwined with Zionist and Italian nationalist ideas. I first document the relevance of an early phase of Italian muscular Judaism at the beginning of the twentieth century, at the time of the rise of Zionism in Italy. I then study the development, in the 1920s and 1930s, of a virile imagery among the two trends of Italian revisionist Zionism and of what we may call Italian Jewish Fascism. I end by asking whether there were not inherent contradictions, or at least relevant tensions, in the ideal of the muscle Jew, between radical nationalism and Jewish forms of virility, as developed after the First world war and in connection with the rise and stabilization of Fascism.

Contemporary Seicento: On the Dark Background of the Italian Historical Novel

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Davide Messina

2015-11-01

Full Text Available While the historical novel is a product of European Romanticism, the first Italian historical novel expresses the critical awareness of its origin against the dark background of the Seicento. For the historical and political imagination of the Italian Romanticism, the Seicento represents the Middle Age of modernity, namely the obscurity of the contemporary. From the dark background of the Seicento the Italian historical novel draws stories that reflect on the obscurity of its own time. In particular, my essay examines a selection of contemporary texts that show the continued and critical presence of the Seicento in the Italian historical novel.

Validation of the French version of the alcohol, smoking and substance involvement screening test (ASSIST in the elderly

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Khan Riaz

2012-06-01

Full Text Available Abstract Background Substance use disorders seem to be an under considered health problem amongst the elderly. The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST, was developed by the World Health Organization to detect substance use disorders. The present study evaluates the psychometric properties of the French version of ASSIST in a sample of elderly people attending geriatric outpatient facilities (primary care or psychiatric facilities. Methods One hundred persons older than 65 years were recruited from clients attending a geriatric policlinic day care centre and from geriatric psychiatric facilities. Measures included ASSIST, Addiction Severity Index (ASI, Mini-International Neuropsychiatric Interview (MINI-Plus, Alcohol Use Disorders Identification Test (AUDIT, Revised Fagerstrom Tolerance Questionnaire-Smoking (RTQ and MiniMental State(MMS. Results Concurrent validity was established with significant correlations between ASSIST scores, scores from ASI, AUDIT, RTQ, and significantly higher ASSIST scores for patients with a MINI-Plus diagnosis of abuse or dependence. The ASSIST questionnaire was found to have high internal consistency for the total substance involvement along with specific substance involvement as assessed by Cronbach’s α, ranging from 0.66, to 0.89 . Conclusions The findings demonstrate that ASSIST is a valid screening test for identifying substance use disorders in elderly.

Centenarians' offspring as a model of healthy aging: a reappraisal of the data on Italian subjects and a comprehensive overview.

Science.gov (United States)

Bucci, Laura; Ostan, Rita; Cevenini, Elisa; Pini, Elisa; Scurti, Maria; Vitale, Giovanni; Mari, Daniela; Caruso, Calogero; Sansoni, Paolo; Fanelli, Flaminia; Pasquali, Renato; Gueresi, Paola; Franceschi, Claudio; Monti, Daniela

2016-03-01

Within the scenario of an increasing life expectancy worldwide it is mandatory to identify determinants of healthy aging. Centenarian offspring (CO) is one of the most informative model to identify trajectories of healthy aging and their determinants (genetic and environmental), being representative of elderly in their 70th whose lifestyle can be still modified to attain a better health. This study is the first comprehensive investigation of the health status of 267 CO (mean age: 70.2 years) and adopts the innovative approach of comparing CO with 107 age-matched offspring of non-long-lived parents (hereafter indicated as NCO controls), recruited according to strict inclusion demographic criteria of Italian population. We adopted a multidimensional approach which integrates functional and cognitive assessment together with epidemiological and clinical data, including pro- and anti-inflammatory cytokines and adipokines, lipid profile, and insulin resistance. CO have a lower prevalence of stroke, cerebral thrombosis-hemorrhage, hypertension, hypercholesterolemia, and other minor diseases, lower BMI and waist circumference, a better functional and cognitive status and lower plasma level of FT4 compared to NCO controls. We conclude that a multidimensional approach is a reliable strategy to identify the health status of elderly at an age when interventions to modify their health trajectory are feasible.

[The new payment system in psychiatry - do elderly people belong to the losers? An analysis on the basis of the VIPP1 data base].

Science.gov (United States)

Godemann, F; Löhr, M; Wiegand, H F; Wolff-Menzler, C; Nitschke, R; Seemüller, F

2014-11-01

The development of the lump-sum reimbursement System in psychiatry and psychosomatics (PEPP) (Klimke et al., 2014) is being negatively considered - also in gerontopsychiatry.Thus it is reasonable to make a timely analysis of the effects of PEPP on health-care structures. For this two analyses have been carried out. On the one hand the day mix index of elderly patients (> 64 years) was compared with that of younger ones (> 17 years, 0.1) but also in outpatient (difference > 0.07) setting. The exact daily classifications according to PsychPV, however, were markedly poorer for the elderly patients. Thus, on the basis of routine data of VIPP projects, a clear change can be seen in favour of the elderly patient under PEPP conditions as compared to financing according to PsychPV. However, concern remains that the ageing population and modernisation of therapy are not being sufficiently taken into account. The new reimbursement system merely regulates the distribution of available resources; if these resources are too low nothing will change by the PEPP-System. © Georg Thieme Verlag KG Stuttgart · New York.

Bayesian Analysis of Demand Elasticity in the Italian Electricity Market

OpenAIRE

D'Errico, Maria; Bollino, Carlo

2015-01-01

The liberalization of the Italian electricity market is a decade old. Within these last ten years, the supply side has been extensively analyzed, but not the demand side. The aim of this paper is to provide a new method for estimation of the demand elasticity, based on Bayesian methods applied to the Italian electricity market. We used individual demand bids data in the day-ahead market in the Italian Power Exchange (IPEX), for 2011, in order to construct an aggregate demand function at the h...

Renewable resource power production: Italian decree CIP No. 34

International Nuclear Information System (INIS)

Di Macco, C.

1991-01-01

As part of an overall energy conservation campaign, a concrete step, in the form of a more favourable electricity rate structure for auto-producers, is being taken by the Italian Government to encourage medium sized industries to adopt cogeneration systems to meet their heat and power requirements. Within this context, this paper gives a look at the incentives for renewable energy source use which are incorporated in the CIP (Italian Inter-ministerial Commission on Prices) Provision No. 34/90, regulating industrial plant cogeneration systems, and which governs ENEL's (Italian National Electricity Board) rate structure in the case of independent on-site producers ceding power to the national utility's grid

L’insegnamento della lingua e letteratura italiane a Cuba.

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Mayerìn Bello Valdés

2009-12-01

Full Text Available Normal 0 14 MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Tabella normale"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman";} Nel suo articolo l’autrice ricostruisce la storia dell’insegnamento delle lingua e della letteratura italiane a Cuba dal Novecento ai giorni nostri, e fornisce una ricca documentazione sui corsi di italiano, sugli studi e  sulle opere più importanti pubblicate a Cuba sulla nostra letteratura e sulle manifestazioni realizzate per la diffusione della cultura italiana nel paese. In particolare riferisce dell’importante ruolo svolto dalla rivista “Cuadernos de italianística cubana” – e dalle istituzioni accademiche e culturali che ad essa fanno riferimento – nel campo della ricerca linguistica, della glottodidattica, dello studio della cultura italiana nelle sue diverse manifestazioni, tra cui la musica e l’opera lirica, e nella diffusione dell’italiano attraverso specifici programmi televisivi.  Normal 0 14 MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Tabella normale"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman";} In her article the author reconstructs the history of Italian language and literature teaching in Cuba from the Nineteen Hundreds up to the present and provides a wealth of documentation on the Italian courses, studies and the most important works published in Cuba on our literature, as well as on events organized to spread Italian culture throughout the country.  In particular

Elderly Suicide

Science.gov (United States)

Elderly Suicide Fact Sheet Based on 2012 Data (2014) Overview • The elderly (ages 65 and older) made up 13. ... population; they accounted for 16.37% of all suicides in the US. • The rate of suicides for ...

The elderly patients' dignity

DEFF Research Database (Denmark)

Høy, Bente; Hall, E.O.C.; Wagner, L.

2007-01-01

the principles of nursing practice, protecting, enhancing and promoting the elderly patient's health potential. It is suggested that these themes of dignity provide a frame of reference in elder care; they shape the understanding of when health issues become a concern for health-promoting care for the elderly...... patient and what goals should be defined. Key words: Dignity, elderly patient, phenomenological hermeneutical method....

Impact of Blunted Perception of Dyspnea on Medical Care Use and Expenditure, and Mortality in Elderly People

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Satoru eEbihara

2012-07-01

Full Text Available Dyspnea is an alarming symptom responsible for millions of patient visits each year. Poor perception of dyspnea might be reasonably attributed to an inappropriately low level of fear and inadequate earlier medical treatment for both patients and physicians, resulting in subsequent intensive care. This study was conducted to evaluate medical care use and cost, and mortality according to the perception of dyspnea in community-dwelling elderly people. We analyzed baseline data from a community-based Comprehensive Geriatric Assessment (CGA in 2002. The perception of dyspnea in 479 Japanese community-dwelling elderly people with normal lung function was measured in August 2002. The sensation of dyspnea during breathing with a linear inspiratory resistance of 10, 20 and 30 cmH2O/L/s was rated using the Borg scale. According to the perception of dyspnea, we divided the elderly into tertiles and compared all hospitalizations, out-patient visits, costs and death through computerized linkage with National Health Insurance (NHI beneficiaries claims history files between August 2002 and March 2008. In-patient hospitalization days and medical care costs significantly increased with the blunted perception of dyspnea, resulting in an increase in total medical-costs with blunted perception of dyspnea. With low perception group as reference, the hazard ratios of all cause mortality were 0.65 (95%CI 0.23-1.89 for intermediate perception group and 0.31(0.10-0.97 for high perception group, indicating the mortality rate also significantly increased with the blunted perception of dyspnea after multivariates adjustment (p=0.04. The blunted perception of dyspnea is related to hospitalization, large medical costs and all-cause mortality in community-dwelling elderly people. These findings provide a rational for preventing serious illness with careful monitoring of objective conditions in the elderly.

Sophistication and Performance of Italian Agri‐food Exports

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Anna Carbone

2012-06-01

Full Text Available Nonprice competition is increasingly important in world food markets. Recently, the expression ‘export sophistication’ has been introduced in the economic literature to refer to a wide set of attributes that increase product value. An index has been proposed to measure sophistication in an indirect way through the per capita GDP of exporting countries (Lall et al., 2006; Haussmann et al., 2007.The paper applies the sophistication measure to the Italian food export sector, moving from an analysis of trends and performance of Italian food exports. An original way to disentangle different components in the temporal variation of the sophistication index is also proposed.Results show that the sophistication index offers original insights on recent trends in world food exports and with respect to Italian core food exports.

Accountability, Italian style: how to reply to government pressure?

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Mauro M

2015-09-01

Full Text Available Marianna Mauro, Giovanna TalaricoDepartment of Clinical and Experimental Medicine, Magna Græcia University of Catanzaro, Catanzaro, ItalyAbstract: The current paper addresses the complex issue of accountability by focusing on Italian public hospitals and teaching hospitals; it aims to analyze Italian health care organizations' strategies for responding to the pressure generated by regulations. In particular, in the last few years, Italian hospitals and teaching hospitals have been obliged to implement or improve their accountability instruments in response to a new regulation (known as the Brunetta reform, Legislative Decree number 150/2009. The Legislative Decree aims to measure and assess the results of each public administration unit in terms of efficiency of the human resources, satisfaction level of the final users, and transparency of its action. Despite the initial consensus on the necessity to make the decision process in health care visible and transparent, health care organizations find it difficult to demonstrate accountability. The present paper summarizes the evidence on the degree of compliance to the reform requirements and will allow an in-depth understanding of Italian health organizations' attitudes toward accountability. This study will help policymakers understand the degree of acceptance and application of the new reforms and assess whether the law/regulations may be effective drivers for disseminating a culture of transparency and accountability.Keywords: transparency, Italian health care, law/regulations, compliance

The new Italian IVF legislation.

Science.gov (United States)

Benagiano, Giuseppe; Gianaroli, Luca

2004-08-01

Last February, the Italian Parliament gave final approval to a new Law regulating assisted reproduction technology. The new legislation fell short of the expectations of infertile couples and of all specialists in the field. There are three problems with the new Italian law; they involve social issues, human rights and the application of technology. The present paper focuses on the fact that the new rules infringe upon basic human rights and the proper application of IVF technology, because they mandate procedures that are against the best interest of the woman seeking pregnancy. The main point of controversy is the combination of a mandatory limit of three embryos for transfer, and an obligation to reimplant all produced embryos; cryopreservation of excess embryos is prohibited. Obviously, this decreases the chances of most women to achieve pregnancy, while at the same time it increases the number and complexity of procedures they need to undergo and may expose some to an unacceptable increase in the risk of multiple pregnancy. The new law is inspired by the desire to protect every newly produced embryo; this is a commendable aim, although it is in total opposition to a law passed over 25 years ago that liberalized voluntary termination of first trimester pregnancies. This means that today Italy has a law that protects every early, pre-implantation embryo, and another that allows the 'suppression' of every post-implantation one. From a technical point of view, given the low level of human fecundity, the only way to prevent the 'loss' of even one preimplantation embryo is to simply ban IVF altogether, an option that Italian legislators obviously did not have the courage to opt for. The tragedy is that Italian infertile couples are now confronted with new rules that not only severely limit the ability of physicians to correctly apply IVF technology, but are so confused that, depending on the interpretation, anyone may try to nullify the main ideological premise upon

Unpublished texts - Poesie | Cro | Italian Studies in Southern Africa ...

African Journals Online (AJOL)

Tra i suoi ultimi titoli The Noble Savage. Allegory of Freedom, Pirandello and the Baroque, The American Foundations of the Hispanic Utopia. I suoi testi poetici sono apparsi su VIA (Voices in Italian Americana), Gradiva e Canadian Journal of ItalianStudies. Ha pubblicato diversi articoli di critica teatrale e cinematografica su ...

Changes in spinal range of motion after a flexibility training program in elderly women

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Battaglia G

2014-04-01

Full Text Available Giuseppe Battaglia,1,2 Marianna Bellafiore,1,2 Giovanni Caramazza,2 Antonio Paoli,3 Antonino Bianco,1,2 Antonio Palma1,2 1Department of Law, Society, and Sport Sciences, University of Palermo, Palermo, Italy; 2Sicilian Regional Sports School of Italian National Olympic Committee (CONI, Sicily, Italy; 3Department of Biomedical Sciences, University of Padova, Padova, Italy Background: Aging-related reduced spinal mobility can interfere with the execution of important functional skills and activities in elderly women. Although several studies have shown positive outcomes in response to spinal flexibility training programs, little is known about the management of sets and repetitions in training protocols. The purpose of this study was to investigate the effects of an 8-week specific and standardized flexibility training program on the range of spinal motion in elderly women. Methods: Participants were recruited in a senior center of Palermo and randomly assigned in two groups: trained group (TG and control group (CG, which included 19 and 18 women, respectively. TG was trained for 8 weeks at two sessions/week. In particular, every session included three phases: warm up (~10 minutes, central period (~50 minutes, and cool down (~10 minutes. CG did not perform any physical activity during the experimental period. Spinal ranges of motion (ROM were measured from neutral standing position to maximum bending position and from neutral standing position to maximum extension position before and after the experimental period, using a SpinalMouse® device (Idiag, Volkerswill, Switzerland. Results: After the training period, TG showed an increase in spinal inclination by 16.4% (P<0.05, in sacral/hip ROM by 29.2% (P<0.05, and in thoracic ROM by 22.5% (P>0.05 compared with CG from maximum extension position to maximum bending position. We did not observe any significant difference in TG's lumbar ROM compared with CG after the training period (P>0.05. Conclusion

A healthy lesson, Italian-style?

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Walter Ricciardi

2009-12-01

Full Text Available According to the conclusions of the World Health Organisation’s 2000 report Italy had the second best health system in the world [1] with Italians having one of the highest rates of life expectancy... However, since 2001 the 19 Italian Regions and 2 Autonomous Provinces have exercised their autonomy very differently, with Northern regions being more successful in establishing effective structures of health care delivery, management and monitoring, as compared to regions in the South. This regional variation in health care reflects (and exacerbates differences of contextual, political, economic and cultural, factors as well as differences between regional health systems. A recent survey [2] showed that in 14 of the 21 Regions and Autonomous Provinces, the system is performing fairly well and is well perceived by citizens.

A replication of the relationship between elderly suicides rates and elderly dependency ratios: a cross-national study.

Science.gov (United States)

Shah, Ajit

2010-01-01

A positive correlation between elderly dependency ratios and elderly suicide rates has been observed using one-year cross-sectional data on elderly suicide rates. A cross-national study designed to replicate this positive correlation between elderly dependency ratios and elderly suicide rates was undertaken by: (i) using one-year average of five years data on suicide rates; and (ii) using more recent data on both elderly suicide rates and elderly dependency ratios. Data on elderly suicide rates, and the total number of elderly and young people was ascertained from the World Health Organization website. The main findings were of significant positive correlations between elderly dependency ratios and suicide rates in both sexes in both the elderly age-bands (65-74 years and 75+ years). The replication of the positive correlations between elderly dependency ratios and elderly suicide rates by using one-year average of five years data on suicide rates suggests that this relationship is robust and accurate. ‎

Margin alert: time to revisit your outpatient strategy.

Science.gov (United States)

Abramson, Steven M; Tyler, David

2006-04-01

An increasingly competitive market for outpatient services has made it necessary for acute care hospitals to reevaluate their outpatient, and inpatient, strategies. Many acute care hospitals are in a strong market position to command premium payment for their inpatient services. Under current market conditions, hospitals are in danger of pricing themselves out of the outpatient market. Hospitals can benefit from the increased focus of consumers and payers on quality and the rise of pay for performance by investing in service excellence.

Quality of life of lung cancer patients receiving outpatient chemotherapy

OpenAIRE

MATSUDA, AYAKO; KOBAYASHI, MIKA; SAKAKIBARA, YUMI; TAMAOKA, MEIYO; FURUIYE, MASASHI; INASE, NAOHIKO; MATSUSHIMA, EISUKE

2011-01-01

An increasing number of cancer patients receive outpatient chemotherapy as an alternative to inpatient chemotherapy. The aim of this study was to investigate whether quality of life (QOL) during outpatient chemotherapy was better than QOL prior to hospital discharge, and to explore possible related factors prior to hospital discharge that affected the QOL of lung cancer patients who received outpatient chemotherapy. Lung cancer inpatients who were scheduled for outpatient chemotherapy were as...

Cost-effectiveness assessment in outpatient sinonasal surgery.

Science.gov (United States)

Mortuaire, G; Theis, D; Fackeure, R; Chevalier, D; Gengler, I

2018-02-01

To assess the cost-effectiveness of outpatient sinonasal surgery in terms of clinical efficacy and control of expenses. A retrospective study was conducted from January 2014 to January 2016. Patients scheduled for outpatient sinonasal surgery were systematically included. Clinical data were extracted from surgical and anesthesiology computer files. The cost accounting methods applied in our institution were used to evaluate logistic and technical costs. The standardized hospital fees rating system based on hospital stay and severity in diagnosis-related groups (Groupes homogènes de séjours: GHS) was used to estimate institutional revenue. Over 2years, 927 outpatient surgical procedures were performed. The crossover rate to conventional hospital admission was 2.9%. In a day-1 telephone interview, 85% of patients were very satisfied with the procedure. All outpatient cases showed significantly lower costs than estimated for conventional management with overnight admission, while hospital revenue did not differ between the two. This study confirmed the efficacy of outpatient surgery in this indication. Lower costs could allow savings for the health system by readjusting the rating for the procedure. More precise assessment of cost-effectiveness will require more fine-grained studies based on micro costing at hospital level and assessment of impact on conventional surgical activity and post-discharge community care. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Modern Italian libraries – between tradition and modernity

Directory of Open Access Journals (Sweden)

Kinga Adamiak

2011-01-01

Full Text Available For centuries, lands currently belonging to the Republic of Italy boasted the greatest and the most illustrious libraries in Europe. From the Middle Ages to Renaissance, they developed extensively and were dominant in the Old World. The present article, however, concentrates on modern Italian libraries and provides an extensive review of their functioning today. The following issues are covered in the discussion: types of libraries and their cooperation, legal circumstances, the activity of national libraries, library associations and their initiatives and projects aimed at utilization of state-of-the-art IT infrastructures in librarianship. The article also emphasizes strong and weak points of Italian librarianship and ponders on the following: What is the role of Italian libraries today when they are evidently past their prime times? Can the libraries in question meet the requirements of modern times?

Age and homocystein were risk factor for peripheral arterial disease in elderly with type 2 diabetes mellitus.

Science.gov (United States)

Kuswardhani, R A Tuty; Suastika, Ketut

2010-04-01

to find out the magnitude of risk of some traditional and non-traditional risk factors for PAD event in the elderly with Type 2 diabetes mellitus (T2DM) patients. a case-control study involved 40 subjects of each arms (case and control group) at Geriatric Outpatient Clinic Sanglah Hospital, Denpasar, Bali, Indonesia was conducted. the study showed that compared to patients without PAD, patients with PAD had higher age (70.7 vs. 65.0 years; phomocystein levels (13.4 vs. 11.5 mmol/L, p=0.023); while other variables revealed no any significantly difference between two groups. Although no any significant difference, subjects with PAD tend to do exercise less prevalent, consumed anti-hyperlipidemic and anti-thrombotic more frequent compared to subjects without PAD. High age (70-80 years) has risk 7.4 time than those lower age (60-69 years), and high homocystein level (> or =11 mmol/L) has risk 2.5 time than those with lower level to develop PAD. By multivariate analysis (logistic regression), only age has a role in PAD event, while homocystein tend to be risk factor for PAD event. some traditional risk factors and non-traditional risk factors unproved as risk factors for PAD event in the elderly with type 2 diabetes. Older age and homocystein level were risk factors for PAD event in the elderly with type 2 diabetes subjects.

Occupational Gender Stereotypes and Problem-Solving in Italian Adolescents

Science.gov (United States)

Ginevra, Maria Cristina; Nota, Laura

2017-01-01

The first purpose of the study was to establish how Italian adolescents perceive jobs in the newly emerging economy sectors as well as more traditional jobs from gender-stereotyped and gender-segregated perspectives. The second purpose was to verify the role of problem-solving and gender in gender-role stereotyping. A total of 217 Italian high…

Outpatient Imaging Efficiency - National

Data.gov (United States)

U.S. Department of Health & Human Services — Use of medical imaging - national data. These measures give you information about hospitals' use of medical imaging tests for outpatients. Examples of medical...

Case fatality of acute coronary events is improving even among elderly patients; the FINAMI study 1995-2012.

Science.gov (United States)

Koukkunen, Heli; Havulinna, Aki S; Lehto, Seppo; Ketonen, Matti; Mustonen, Juha; Airaksinen, Juhani K; Ukkola, Olavi; Kesäniemi, Y Antero; Salomaa, Veikko

2018-02-01

syndromes still present a remarkable burden to the healthcare system in Finland as well as in many other developed countries. Especially considering the modern trend of reducing hospital resources and shifting patient care to outpatient clinics, the epidemiology of MI in elderly patients remains an important issue for the future planning of the healthcare system.

The Italian contribution to the CSES satellite

Science.gov (United States)

Conti, Livio

2016-04-01

We present the Italian contribution to the CSES (China Seismo-Electromagnetic Satellite) mission. The CSES satellite aims at investigating electromagnetic field, plasma and particles in the near-Earth environment in order to study in particular seismic precursors, particles fluxes (from Van Allen belts, cosmic rays, solar wind, etc.), anthropogenic electromagnetic pollution and more in general the atmosphere-ionosphere-magnetosphere coupling mechanisms that can affect the climate changes. The launch of CSES - the first of a series of several satellite missions - is scheduled by the end of 2016. The CSES satellite has been financed by the CNSA (China National Space Agency) and developed by CEA (China Earthquake Administration) together with several Chinese research institutes and private companies such as the DFH (that has developed the CAST2000 satellite platform). Italy participates to the CSES satellite mission with the LIMADOU project funded by ASI (Italian Space Agency) in collaboration with the Universities of Roma Tor Vergata, Uninettuno, Trento, Bologna and Perugia, as well as the INFN (Italian National Institute of Nuclear Physics), INGV (Italian National Institute of Geophysics and Volcanology) and INAF-IAPS (Italian National Institute of Astrophysics and Planetology). Many analyses have shown that satellite observations of electromagnetic fields, plasma parameters and particle fluxes in low Earth orbit may be useful in order to study the existence of electromagnetic emissions associated with the occurrence of earthquakes of medium and high magnitude. Although the earthquakes forecasting is not possible today, it is certainly a major challenge - and perhaps even a duty - for science in the near future. The claims that the reported anomalies (of electromagnetic, plasma and particle parameters) are seismic precursors are still intensely debated and analyses for confirming claimed correlations are still lacking. In fact, ionospheric currents, plasma

Recent evolution of italian households’ equity portfolio choices: an empirical investigation

Directory of Open Access Journals (Sweden)

Attilio Gardini

2013-05-01

Full Text Available We study Italian households’ portfolio choices, with a special focus on equity investments, by analysing jointly time series and cross-sectional portfolio data. We investigate the temporal evolution of the actual composition of Italian households’ investments in order to explain their portfolio choices and to detect possible determinants of the observed disequilibria phenomena. Moreover, we model the stock market participation choice by using probit regression techniques and we test for parameter stability over time. Instability of participation parameters and a peculiar evolution of Italian households’ portfolios pointed out by our concurrent analysis of cross-sectional and time series data seem to confirm the distance of Italian households’ financial decisions from the rational choice predicted by the Markowitz model. In particular, we find that the housing market bubbles interact strongly with the stock market and financial institutions seem to be unable to advise investors suggesting optimal portfolio choices. The deep reason behind these facts may be the bounded education of investors, in particular the low financial literacy of Italian households.

Outpatient Imaging Efficiency - State

Data.gov (United States)

U.S. Department of Health & Human Services — Use of medical imaging - state data. These measures give you information about hospitals' use of medical imaging tests for outpatients. Examples of medical imaging...

Complementary and alternative medicine use among elderly patients living with chronic diseases in a teaching hospital in Ethiopia.

Science.gov (United States)

Ayele, Asnakew Achaw; Tegegn, Henok Getachew; Haile, Kaleab Taye; Belachew, Sewunet Admasu; Mersha, Amanual Getnet; Erku, Daniel Asfaw

2017-12-01

The use of complementary and alternative medicine (CAM) among patients with chronic diseases has grown rapidly worldwide. Yet, little has been known about CAM use by elderly patients with chronic diseases in Ethiopia. This study aimed at assessing the prevalence and reasons for CAM utilization among elderly patients living with chronic diseases in Ethiopia. An institution-based quantitative cross-sectional survey was conducted among elderly patients with chronic disease attending outpatient ambulatory clinics of University of Gondar referral and teaching hospital (UoGRTH). An interviewer-administered and semi-structured questionnaire were utilized to collect the data. Of the total respondents, 240 (74%) reported the use of CAM, with herbal medicine and spiritual healing being the most commonly utilized CAM modalities (50.4% and 40.8% respectively). Dissatisfaction with conventional therapy (40.8%) and belief in the effectiveness of CAM (30.8%) are the most commonly cited reasons for the use of CAM therapies. Rural residency, higher educational status, higher average monthly income and presence of co-morbidity were positively associated with the use of CAM. This survey revealed a higher rate of CAM use among elderly patients with chronic diseases, along with a very low rate of disclosing their use to their health care providers. Special attention should be given for these patient population due to the potentially harmful interaction of different herbal remedies with the prescribed medications, thereby predisposing the patient to untoward adverse effects and compromised overall health outcome. Copyright © 2017 Elsevier Ltd. All rights reserved.

Scenario e ruoli sociali delle Associazioni teatrali non professionistiche italiane

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Cinzia Toscano

2016-07-01

Full Text Available This paper investigates the present scenario of the non-professional theater associations in Italy so as to understand their current form of organization. The study focuses on the changes that have characterized in time the non-professional associations (due also to the improvement of the legislation regulating the no profit sector and the social role in contemporary local communities. The survey was conducted within the two most relevant Italian associations of non-professional theater: the Italian Federation of non-professional Theatre (Federazione Italiana Teatro Amatori and the Italian Union of Free Theatre (Unione Italiana Libero Teatro.

Depression as a Clinical Determinant of Dependence and Low Quality of Life in Elderly Patients with Cardiovascular Disease

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Giselle Helena de Paula Rodrigues

2015-06-01

Full Text Available Background: The aging process promotes a progressive increase in chronic-degenerative diseases. The effect of these diseases on the functional capacity has been well recognized. Another health parameter concerns “quality of life related to health”. Among the elderly population, cardiovascular diseases stand out due to the epidemiological and clinical impact. Usually, these diseases have been associated with others. This set of problems may compromise both independence and quality of life in elderly patients who seek cardiologic treatment. These health parameters have not been well contemplated by cardiologists. Objective: Evaluating, among the elderly population with cardiovascular disease, which are the most relevant clinical determinants regarding dependence and quality of life. Methods: This group was randomly and consecutively selected and four questionnaires were applied: HAQ, SF-36, PRIME-MD e Mini Mental State. Results: The study included 1,020 elderly patients, 63.3% women. The group had been between 60 and 97 years-old (mean: 75.56 ± 6.62 years-old. 61.4% were independent or mild dependence. The quality of life total score was high (HAQ: 88.66 ± 2.68. 87.8% of patients had a SF-36 total score > 66. In the multivariate analysis, the association between diagnoses and high degrees of dependence was significant only for previous stroke (p = 0.014, obesity (p < 0.001, lack of physical activity (p = 0.016, osteoarthritis (p < 0.001, cognitive impairment (p < 0.001, and major depression (p < 0.001. Analyzing the quality of life, major depression and physical illness for depression was significantly associated with all domains of the SF-36. Conclusion: Among an elderly outpatient cardiology population, dependence and quality of life clinical determinants are not cardiovascular comorbidities, especially the depression.

Sarcopenia and sarcopenic obesity in comparison: prevalence, metabolic profile, and key differences. A cross-sectional study in Italian hospitalized elderly.

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Perna, Simone; Peroni, Gabriella; Faliva, Milena Anna; Bartolo, Arianna; Naso, Maurizio; Miccono, Alessandra; Rondanelli, Mariangela

2017-12-01

The aim of this study is to identify the prevalence, assess the metabolic profile, and key differences (versus healthy) in a cohort of subjects with sarcopenia (S) and in sarcopenic obesity (SO) hospitalized elderly. A standardized comprehensive geriatric assessment was performed. We enrolled 639 elderly subjects (196 men, 443 women) with a mean age of 80.90 ± 7.77 years. Analysis of variance and a multinomial logistic regression analysis adjusting for covariates were used to assess the differences between groups. The prevalence of (S) was 12.42% in women and 23.47% in men. (SO) was 8.13% in women and 22.45% in men. Data showed that either groups had a functional impairment (Barthel index 15 mm/h), CPR (>0.50 mg/dl) homocysteine (>12 micromol/l), and hemoglobin (145 mcg/dl) was detected in either cohort (due to inflammation). (SO) had glycemia (>110 mg/dl). Key differences in (S) cohort (versus healthy) were a reduction in functional impairment (p Sarcopenia is closely linked to an increase in the risk of hip-femur fractures, inflammation, edema, and malnutrition. The (SO) subjects seem to benefit from the "obesity paradox."

The Female Sexual Function Index (FSFI): linguistic validation of the Italian version.

Science.gov (United States)

Filocamo, Maria Teresa; Serati, Maurizio; Li Marzi, Vincenzo; Costantini, Elisabetta; Milanesi, Martina; Pietropaolo, Amelia; Polledro, Patrizio; Gentile, Barbara; Maruccia, Serena; Fornia, Samanta; Lauri, Irene; Alei, Rosanna; Arcangeli, Paola; Sighinolfi, Maria Chiara; Manassero, Francesca; Andretta, Elena; Palazzetti, Anna; Bertelli, Elena; Del Popolo, Giulio; Villari, Donata

2014-02-01

Although several new measurements for female sexual dysfunction (FSD) have recently been developed, the Female Sexual Function Index (FSFI) remains the gold standard for screening and one of the most widely used questionnaires. The Italian translation of the FSFI has been used in several studies conducted in Italy, but a linguistic validation of the Italian version does not exist. The aim of this study was to perform a linguistic validation of the Italian version of the FSFI. A multicenter cross-sectional study conducted in 14 urological and gynecological clinics, uniformly distributed over Italian territory. We performed all steps necessary to determine the reliability and the test-retest reliability of the Italian version of the FSFI. The study population was a convenience sample of 409 Italian women. The reliability of the questionnaire was calculated using Cronbach's alpha, which was considered weak, moderate, or high if its value was found less than 0.6, between 0.6 and 0.8, or equal to or greater than 0.8, respectively. The test-retest reliability was assessed for all women in the sample by calculating Pearson's concordance correlation coefficient for each domain and for the total score, both at baseline and after 15 days (r range between -1.00 to +1.00, where +1.00 indicates the strongest positive association). Cronbach's alpha coefficients for total and domain score were sufficiently high, ranging from 0.92 to 0.97 for the total sample. The test-retest procedure revealed that the concordance correlation coefficient was very high both for FSFI-I total score (Pearson's P = 0.93) and for each domain (Pearson's P always >0.92). For the first time in the literature, our study has produced a validated and reliable Italian version of the FSFI questionnaire. Consequently, the Italian FSFI can be used as a reliable tool for preliminary screening for female sexual dysfunction for Italian women. © 2013 International Society for Sexual Medicine.

Mid-sized manufacturing companies the new driver of Italian competitiveness

CERN Document Server

Resciniti, Riccardo; Tunisini, Annalisa; Varaldo, Riccardo

2013-01-01

The structure of Italian industry is characterized by a predominance of small sized companies and the presence of very few large companies. For a long time a conviction was shared among scholars and practitioners that the strength and safety of Italian industry were based on its industrial districts, that is, the system of interdependent and co-localized small companies which derive their competitive force from an effective and efficient division of labour. This book stresses the idea that a new, vital and promising phenomenon for the competitiveness of Italian industry is focused on mid-sized companies, and the systems of interconnected firms that form a constituent part of their business model. These companies, which originate largely from districts and other local production systems, are a strong entrepreneurial force complementing the districts that have characterized Italy and made Italian industry famous worldwide. A quantitative and qualitative analysis of these firms is provided in this book. Business...

The Journal “Geopolitica” and Formation of the Italian Geopolitical School

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Maximilian Al’bertovich Shepelev

2017-12-01

Full Text Available The article reveals the origins, methodological features and the process of institutionalization of Italian geopolitical school, place and role of the journal “Geopolitica” in this process. The article analyzes the characteristics of Italian geopolitical perception of the world and its geostrategic priorities, formulated by the representatives of the Italian geopolitical schools in the period of its formation in 20-40-ies of the XX century (the Mediterranean - Mare nostrum, Euroafrica. The source of the formation of the Italian geopolitical school was the intellectual influence of irredentism un the age of the Risorgimento. The process of its formation was correlated with the formation of the modern national school of geographical science, in which was dominated the perception of geography as “utilitarian science” and developed the direction of “dynamic political geography”. Its specifical features was the “antideterminism” and “geographic humanism”, the recognition that the environment does not have absolute power over society, but political will is a determining factor in anthropogeographical area. The institutionalization of Italian political school promoted the creation of several research centres in the 20-30-ies and publishing from January 1939 to December 1942 magazine “Geopolitica”. The draft edition of this magazine received support from the minister of national education Giuseppe Bottai, it was headed by Professor Giorgio Roletto and his disciple, Ernesto Massi. Italian geopolitics maintained close ties with their German colleagues, but they were theoretically justified differences between “Latin” and “German” geopolitical worldviews. Unlike the German geopolitics, the concept of “living space” was used primarily in the economic sense, but it was not used in a racial-demographic sense. Italian geopolitics acted against the world order enshrined in the Treaty of Versailles, because it was protected

Respect of standard air quality in major italian towns

International Nuclear Information System (INIS)

Valerio, F.

1995-01-01

In 1983 air quality standards, related to SO 2 , NO 2 , CO, airborne particulate, lead, O 3 were introduced in italian legislation. Now, SO 2 and lead concentrations are rapidly decreasing everywhere thanks to drastic reductions of sulphur and lead in fuels. The situation is still critic in many urban areas as far as NO 2 and CO are concerned. The increasing number of automobiles circulating in italian urban areas (+43% from 1980 to 1988) is probably reducing the positive effects expected from more efficient and less polluting engines. Electric public transport, aiming at low interference with private traffic, and a different urban organization, aiming at reducing compulsory mobility, could be the proper choices to offer italians both higher standards of urban life and air quality

Yugoslav-Italian Economic relations (1918‒1929: Main aspects

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Latinović Goran

2015-01-01

Full Text Available The article looks at some aspects of Yugoslav-Italian economic relations from the end of the First World War to the beginning of the Great Depression. Those relations were not always driven by pure economic interests, but they also had political and strategic aims. Although Yugoslav-Italian political and diplomatic relations were well served in both Serbian/Yugoslav and Italian historiography, little has been written about economic relations between the two countries. Therefore, the article is mainly based on the documents from the Central State Archives (Archivio centrale dello Stato and Historical-Diplomatic Archives of Ministry of Foreign Affairs (Archivio storico-diplomatico del Ministero degli Affari Esteri in Rome, as well as from the Archives of Yugoslavia (Arhiv Jugoslavije in Belgrade.

Follow-up of ischemic cardiopathy, an essential moment in the communication between in-patient and out-patient setting: problems and opportunities

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Italo Paolini

2008-12-01

Full Text Available It is known that the transition from the inpatient to the outpatient setting is a critical time. Evidence suggests that contact between patients and providers (i.e., physicians, nurse practitioners, and physician assistants during this interval may be crucial for appropriate treatment modifications and recognition of errors in treatment. Ambulatory follow-up provides opportunities for clinical assessment, patient education, and medication review, which may in turn improve outcomes. However, little is known about the appropriate timing and type of follow-up that is necessary following hospitalization for AMI. In Italian System of Heath contact between general pratictioner and specialists, after dicharge, is critical moment for management of chronic pharmacological and non pharmacological therapy. If professional approaches are not integrated can reduce patients compliance and effectiveness of therapies themselves. Good management of chronic cardiovascular disease requires attention to stenghtening the continuity of information and management of patients.

Thoughts on the Italian National University Council (CUN

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Borghetti M

2009-01-01

Full Text Available The Italian National University Council (CUN is an elected body that represents the Italian academic system and formulates proposal and gives advice to the Minister of University. The opinion is expressed that the professors who are appointed to CUN should go on sabbatical leave from their universities over the period they are part of CUN, as an important condition for carrying out better their institutional job and preventing any potential conflict of interest.

Clinically relevant potential drug-drug interactions among outpatients: A nationwide database study.

Science.gov (United States)

Jazbar, Janja; Locatelli, Igor; Horvat, Nejc; Kos, Mitja

2018-06-01

Adverse drug events due to drug-drug interactions (DDIs) represent a considerable public health burden, also in Slovenia. A better understanding of the most frequently occurring potential DDIs may enable safer pharmacotherapy and minimize drug-related problems. The aim of this study was to evaluate the prevalence and predictors of potential DDIs among outpatients in Slovenia. An analysis of potential DDIs was performed using health claims data on prescription drugs from a nationwide database. The Lexi-Interact Module was used as the reference source of interactions. The influence of patient-specific predictors on the risk of potential clinically relevant DDIs was evaluated using logistic regression model. The study population included 1,179,803 outpatients who received 15,811,979 prescriptions. The total number of potential DDI cases identified was 3,974,994, of which 15.6% were potentially clinically relevant. Altogether, 9.3% (N = 191,213) of the total population in Slovenia is exposed to clinically relevant potential DDIs, and the proportion is higher among women and the elderly. After adjustment for cofactors, higher number of medications and older age are associated with higher odds of clinically relevant potential DDIs. The burden of DDIs is highest with drug combinations that increase risk of bleeding, enhance CNS depression or anticholinergic effects or cause cardiovascular complications. The current study revealed that 1 in 10 individuals in the total Slovenian population is exposed to clinically relevant potential DDIs yearly. Taking into account the literature based conservative estimate that approximately 1% of potential DDIs result in negative health outcomes, roughly 1800 individuals in Slovenia experience an adverse health outcome each year as a result of clinically relevant potential interactions alone. Copyright © 2017 Elsevier Inc. All rights reserved.

The Italian decommissioning industry

International Nuclear Information System (INIS)

Adinolfi, R.

2005-01-01

Full text: Italy's step out from nuclear activities in 1987 deeply affected an industry that, in the previous years, had managed to grow up in quality and technology levels to meet the nuclear standards. Only a few companies were able to partially retain their skills through activities abroad. The decommissioning program represents a new challenge for the Italian industry at large and will require a consistent effort to properly qualify the potential suppliers. On the other side, a program with such implications in terms of investments and so depending from social aspects cannot be effectively implemented without a significant involvement of the local industry. Essential conditions for the success are a reliable program, as well as a careful supply management scheme, which must facilitate aggregation of skills spread among different subjects. 'Human Resources: Maintaining a Nuclear Culture in Italy' Bruno Panella Politecnico di Torino, Giuseppe Forasassi, Universita di Pisa, Inter-University Consortium for the Nuclear Technological Research (CIRTEN). After a brief history of the nuclear engineering education in Italy within the international and national nuclear energy scenario, the present situation, with reference to the Italian universities, is shown. In order to maintain a nuclear culture in Italy the solution, exploited with different peculiarities in each University, is to carry out high quality research activities in reciprocal collaboration (mostly within the CIRTEN inter university Consortium) as well as with the Industry and research Organisations and to collaborate actively in establishing a stable network and a synergy of teaching activities in Europe in the field of Nuclear Engineering Education. The aim is to maintain at a high level and as updated as possible the Italian educational offer in nuclear engineering and also to attract the best students for the enrolment. (author)

A Pilot Study Evaluating the Contribution of SLC19A1 (RFC-1 80G>A Polymorphism to Alzheimer’s Disease in Italian Caucasians

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Fabio Coppedè

2014-01-01

Full Text Available Alzheimer’s disease (AD is the most common neurodegenerative disorder and the primary form of dementia in the elderly. Polymorphisms of genes involved in folate metabolism have been frequently suggested as risk factors for sporadic AD. A common c.80G>A polymorphism (rs1051266 in the gene coding for the reduced folate carrier (SLC19A1 gene, commonly known as RFC-1 gene was investigated as AD risk factor in Asian populations, yielding conflicting results. We screened a Caucasian population of Italian origin composed of 192 sporadic AD patients and 186 healthy matched controls, for the presence of the RFC-1 c.80G>A polymorphism, and searched for correlation with circulating levels of folate, homocysteine, and vitamin B12. No difference in the distribution of allele and genotype frequencies was observed between AD patients and controls. No correlation was observed among the genotypes generated by the RFC-1 c.80G>A polymorphism and circulating levels of folate, homocysteine, and vitamin B12 either in the whole cohort of subjects or after stratification into clinical subtypes. Present results do not support a role for the RFC-1 c.80G>A polymorphism as independent risk factor for sporadic AD in Italian Caucasians.

Italians and Foreign Immigration

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Corrado Bonifazi

2006-01-01

Full Text Available Opinion surveys on attitudes towards immigration are becoming more and more important, owing to the increasing role of political debate on migration issues in Western European countries. CNR has conducted four surveys on this topic, collecting data on the evolution of Italians attitudes towards migration issues. In fact, the ? rst survey was conducted in the second half of the eighties, when foreign immigration was in its early stages. The last survey took place in 2002, when immigration was already well established in Italy. The article focuses on three main issues: the global impact of immigration on Italian society, the immigrants role in the labour market, and immigration policy. In general, the results of the last survey con? rm a trend that appeared already in 1997, of more balanced and realistic opinion that were less of a response to circumstances perceived as special emergencies. Highly educated people, teachers and students continue to be the most open and receptive groups, whereas the less favourably inclined and more worried continue to be old people, those with less education, the unemployed, housewives, and retirees.

Cost Efficiency and Returns to Scope in Italian Investment Firms

OpenAIRE

Marcello Basili; Fulvio Fontini

2005-01-01

This paper estimates cost efficiency and returns to scope of Italian investment firms during the period 1998-2002, following the stochastic frontier function approach. Results indicate a large inefficiency for Italian investment firms (with a high standard deviation across sample) and the absence of significant returns to scope

Prevalence and determinants for malnutrition in geriatric outpatients

NARCIS (Netherlands)

van Bokhorst-de van der Schueren, M.A.E.; Lonterman-Monasch, S.; de Vries, O.J.; Danner, S.A.; Kramer, M.H.H.; Muller, M.

2013-01-01

Background & aims: Few data is available on the nutritional status of geriatric outpatients. The aim of this study is to describe the nutritional status and its clinical correlates of independently living geriatric older individuals visiting a geriatric outpatient department. Methods: From 2005 to

Valoración geriátrica global del anciano por los servicios de urgencias extrahospitalarias: Caso clínico Comprehensive geriatric assessment of elderly for outpatient emergency services: Case report

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Javier Fernández Eito

2012-12-01

Full Text Available El progresivo envejecimiento de la población española conlleva un aumento de la atención sanitaria, por los servicios de urgencias extrahospitalarias (SUE, a este grupo de edad. El objetivo de este trabajo es evidenciar la importancia de realizar una valoración global del anciano en el contexto domiciliario y comunitario, que contemple tanto los aspectos físicos como los psicosociales y ambientales de la persona en situación de urgencia. Para ello, se desarrolla un caso clínico, que se apoya en la evidencia científica, para determinar la actuación más adecuada que mejore las intervenciones de los servicios de urgencias extrahospitalarias. El análisis del caso se estructura en tres apartados: la valoración de enfermería, el registro de los datos y la transmisión de la información a otros equipos de salud. Como conclusión, se identifica la necesidad de valorar y registrar datos sobre el estado físico y fisiológico del anciano al mismo tiempo que se recoge información sobre su contexto familiar, comunitario o ambiental, para proporcionar unos cuidados integrales y de calidad. Asimismo, se recomienda el desarrollo de herramientas de valoración geriátrica específicas para utilizar en situaciones de urgencias extrahospitalarias.The progressive aging of the Spanish population leads to increased health care for Outpatient Emergency Services (EUS, in this age group. The aim of this paper is to highlight the importance of an overall assessment of the elderly in the household and community context, which involves both the physical and psychosocial in the emergency environmental. To do this, we develop a clinical case, which is based on scientific evidence, to determine the most appropriate action to improve interventions in emergency services. The case analysis is divided into three sections: nursing assessment, data recording and transmission of information to other health teams. In conclusion, it identifies the need to assess and

Intake of vitamin A and carotenoids from the Italian population--results of an Italian total diet study.

Science.gov (United States)

Lucarini, Massimo; Lanzi, Sabina; D'Evoli, Laura; Aguzzi, Altero; Lombardi-Boccia, Ginevra

2006-05-01

The present study focused on vitamin A and carotenoids (alpha-and beta-carotene, lutein and zeaxanthin, beta-cryptoxanthin, lycopene) daily intake from the Italian total diet. The input of some food groups (cereals, vegetables, fruits, milk and dairy, meat and meat products, fish) most responsible for major and minor contributions to the daily intake of these molecules was evaluated. Furthermore the contribution to the dietary intake of beta-carotene and lutein of the most consumed vegetables in the market basket of the Italian total diet (beets, brassica vegetables, carrots, chicory, courgette (zucchini), green beans, lettuce, peas, pepper, spinach, tomatoes) was also investigated. Vitamin A daily intake was 855 mg/person/day. The vegetables food group made the greatest contribution (37%), followed by the meat and meat products food group (23%). The Italian total diet provided 14.3 mg/person/day of carotenoids; lycopene was the highest (7.4 mg/day), followed by lutein + zeaxanthin (4 mg/day), beta-carotene (2.6 mg/day), alpha-carotene (0.15 mg/day), and beta-cryptoxanthin (0.17 mg/day). Carrots and tomatoes were the main sources of beta-carotene in the diet, otherwise the daily consumption of leafy vegetables (spinach, beets, lettuce) made the main contribution to lutein + zeaxanthin daily intake.

Design of short Italian sentences to assess near vision performance.

Science.gov (United States)

Calossi, Antonio; Boccardo, Laura; Fossetti, Alessandro; Radner, Wolfgang

2014-01-01

To develop and validate 28 short Italian sentences for the construction of the Italian version of the Radner Reading Chart to simultaneously measure near visual acuity and reading speed. 41 sentences were constructed in Italian language, following the procedure defined by Radner, to obtain "sentence optotypes" with comparable structure and with the same lexical and grammatical difficulty. Sentences were statistically selected and used in 211 normal, non-presbyopic, native Italian-speaking persons. The most equally matched sentences in terms of reading speed and number of reading errors were selected. To assess the validity of the reading speed results obtained with the 28 selected short sentences, we compared the reading speed and reading errors with the average obtained by reading two long 4th-grade paragraphs (97 and 90 words) under the same conditions. The overall mean reading speed of the tested persons was 189±26wpm. The 28 sentences more similar in terms of reading times were selected, achieving a coefficient of variation (the relative SD) of 2.2%. The reliability analyses yielded an overall Cronbach's alpha coefficient of 0.98. The correlation between the short sentences and the long paragraph was high (r=0.85, P<0.0001). The 28 short single Italian sentences optotypes were highly comparable in syntactical structure, number, position, and length of words, lexical difficulty, and reading length. The resulting Italian Radner Reading Chart is precise (high consistency) and practical (short sentences) and therefore useful for research and clinical practice to simultaneously measure near reading acuity and reading speed. Copyright © 2013 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.

The Italian Code of Medical Deontology: characterizing features of its 2014 edition.

Science.gov (United States)

Conti, Andrea Alberto

2015-09-14

The latest edition of the Italian Code of Medical Deontology has been released by the Italian Federation of the Registers of Physicians and Dentists in May 2014 (1). The previous edition of the Italian Code dated back to 2006 (2), and it has been integrated and updated by a multi-professional and inter-disciplinary panel involving, besides physicians, representatives of scientific societies and trade unions, jurisconsults and experts in bioethics....

Students with a foreign background in Italian Initial Vocational Education and Training (IVET and the access to Italian as Second Language

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Luisa Daniele

2017-11-01

Full Text Available This paper is based on the results of a 2014–2015 quantitative survey on a sample of 1,840 foreign students and 1,835 Italian students, of which, 41% of the Italians and 35% of those of foreign origins interviewed were female. The overall age was between 14 and 24, and these students attended courses in the Initial Vocational Education and Training (IVET system in six Italian Regions: Emilia-Romagna, Lazio, Lombardy, Sicily, Tuscany, and Veneto. Language is the central issue in the survey, both in relation to the construction of multicultural and transcultural identity, and as a bridge to combine localisms with the global dynamics of migration, in its "dialect" edition. Some conclusive reflections on the enhancement of multilingualism in the Initial Vocational Education and Training (IVET system are proposed for the development of national strategies in order to strengthen intercultural teaching and curricula.

Observational study of outpatients with schizophrenia in the Middle ...

African Journals Online (AJOL)

Observational study of outpatients with schizophrenia in the Middle East and Africa — 3- and 6-month efficacy and safety results. The Intercontinental Schizophrenia Outpatient Health Outcomes Study.

[Trauma in the elderly].

Science.gov (United States)

de Souza, José Antonio Gomes; Iglesias, Antonio Carlos R G

2002-01-01

The populational growth of the elderly, associated to a healthier and more active life, make this group of people more exposed to accidents. In some countries, trauma in the elderly is responsible for a high mortality rate, disproportionately higher than in the adults. This fact consumes a great portion of health care resources and implies in a high social cost. The distinct physiologic characteristics of the elderly and the frequent presence of associated diseases make that these patients behave differently and in a more complex way than patients of other ages. These particularities make that health care to the elderly victims of trauma have to be different. The present revision is about aspects of epidemiology, prevention, physiology, health care and rehabilitation of the elderly victims of trauma.

e-Consultation Improves Efficacy in Thoracic Surgery Outpatient Clinics.

Science.gov (United States)

Novoa, Nuria M; Gómez, Maria Teresa; Rodríguez, María; Jiménez López, Marcelo F; Aranda, Jose L; Bollo de Miguel, Elena; Diez, Florentino; Hernández Hernández, Jesús; Varela, Gonzalo

2016-11-01

The aim of this study is analysing the impact of the systematic versus occasional videoconferencing discussion of patients with two respiratory referral units along 6 years of time over the efficiency of the in-person outpatient clinics of a thoracic surgery service. Retrospective and comparative study of the evaluated patients through videoconferencing and in-person first visits during two equivalents periods of time: Group A (occasional discussion of cases) between 2008-2010 and Group B (weekly regular discussion) 2011-2013. Data were obtained from two prospective and electronic data bases. The number of cases discussed using e-consultation, in-person outpatient clinics evaluation and finally operated on under general anaesthesia in each period of time are presented. For efficiency criteria, the index: number of operated on cases/number of first visit outpatient clinic patients is created. Non-parametric Wilcoxon test is used for comparison. The mean number of patients evaluated at the outpatient clinics/year on group A was 563 versus 464 on group B. The median number of cases discussed using videoconferencing/year was 42 for group A versus 136 for group B. The mean number of operated cases/first visit at the outpatient clinics was 0.7 versus 0.87 in group B (P=.04). The systematic regular discussion of cases using videoconferencing has a positive impact on the efficacy of the outpatient clinics of a Thoracic Surgery Service measured in terms of operated cases/first outpatient clinics visit. Copyright © 2016 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.

Titulus Scuola: the new file classification schema for Italian schools

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Gianni Penzo Doria

2017-05-01

Full Text Available This article presents the new file classification schema national for Italian schools, produced by the Italian Directorate General of Archives of the Ministry for Cultural Heritage, within the project Titulus Scuola. This classification schema represents the starting point for a standard documental system, aimed at the digital administration.

[The decoration of Italian Renaissance drug jars after engravings].

Science.gov (United States)

Drey, R E

1994-01-01

Although Italian drug jar painters generally devised original compositions for the ornamentation of their products, on occasion they derived their subjects from printed sources. Printed sources used by drug jar artists of the Renaissance include wood-engraved Italian tarot cards and wood-engraved illustrations by Hans Sebald Beham and Bernard Salomon in miniature bibles published in the sixteenth century in Frankfurt and in Lyons respectively.

Feasibility and safety of outpatient breast cancer surgery

DEFF Research Database (Denmark)

Duriaud, Helle Molter; Kroman, Niels; Kehlet, Henrik

2018-01-01

INTRODUCTION: Improvement in perioperative care programmes has facilitated post-operative recovery and use of short-term or outpatient procedures. The aim of this study was to assess the feasibility and safety of an outpatient breast cancer programme in patients referred to a large breast cancer...

38 CFR 17.163 - Posthospital outpatient dental treatment.

Science.gov (United States)

2010-07-01

... dental treatment. 17.163 Section 17.163 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Dental Services § 17.163 Posthospital outpatient dental treatment. The Chief, Dental Service may authorize outpatient dental care which is reasonably necessary to complete treatment of a...

Elders Health Empowerment Scale: Spanish adaptation and psychometric analysis.

Science.gov (United States)

Serrani Azcurra, Daniel Jorge Luis

2014-01-01

Empowerment refers to patient skills that allow them to become primary decision-makers in control of daily self-management of health problems. As important the concept as it is, particularly for elders with chronic diseases, few available instruments have been validated for use with Spanish speaking people. Translate and adapt the Health Empowerment Scale (HES) for a Spanish-speaking older adults sample and perform its psychometric validation. The HES was adapted based on the Diabetes Empowerment Scale-Short Form. Where "diabetes" was mentioned in the original tool, it was replaced with "health" terms to cover all kinds of conditions that could affect health empowerment. Statistical and Psychometric Analyses were conducted on 648 urban-dwelling seniors. The HES had an acceptable internal consistency with a Cronbach's α of 0.89. The convergent validity was supported by significant Pearson's Coefficient correlations between the HES total and item scores and the General Self Efficacy Scale (r= 0.77), Swedish Rheumatic Disease Empowerment Scale (r= 0.69) and Making Decisions Empowerment Scale (r= 0.70). Construct validity was evaluated using item analysis, half-split test and corrected item to total correlation coefficients; with good internal consistency (α> 0.8). The content validity was supported by Scale and Item Content Validity Index of 0.98 and 1.0, respectively. HES had acceptable face validity and reliability coefficients; which added to its ease administration and users' unbiased comprehension, could set it as a suitable tool in evaluating elder's outpatient empowerment-based medical education programs.

Intensive Outpatient Cognitive Behaviour Therapy for Eating Disorder

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Riccardo Dalle Grave

2008-12-01

Full Text Available The aim of this paper is to describe a novel model of intensive outpatient cognitive-behaviour therapy (CBT indicated for eating disorder patients who are having difficulty modifying their eating habits in response to conventional outpatient CBT. Intensive outpatient CBT is a manual based treatment derived by the CBT-Enhanced (CBT-E for eating disorders. The treatment has four features that distinguish it from the conventional outpatient CBT-E: (1 it is designed to be suitable for both adult and adolescent patients, (2 it is delivered by a multidisciplinary non-eclectic team trained in CBT, (3 there is assistance with eating, (4 there is a family therapy module for patients under the age of 18 years. Preliminary outcome of intensive outpatient CBT-E are encouraging. The treatment has been applied to 20 consecutive underweight eating disorder patients (age 18.2 ± 6.5 years; BMI 14.6 ± 1.5 kg/m2. Thirteen patients (65% concluded the treatment, five (25% were admitted at an eating disorder inpatient unit, and two (10% prematurely interrupted the treatment. Completers obtained significant weight regain and improvement of eating disorder and general psychopathology. Most of the improvements were maintained at six-month follow-up.

The Role of the Senses in the Early Modern Italian Garden

DEFF Research Database (Denmark)

Knudsen, Karin Esmann

According to the Italian humanists gardens can be regarded as a third nature (John Dixon Hunt: Greater Perfections 2000, Claudia Lazzaro: The Italian Renaissance Garden 1990). Different from the first nature, wilderness, and the second nature, the cultural landscape (Cicero) gardens are a special...... combination of nature and culture, more sophisticated, more deliberate, more complex in the mixture of culture and nature. In the Italian renaissance garden this third nature reached an artificial and aesthetic level as a pleasure garden which made use of all the senses, and in doing so it played an important...... role in constructing new conceptions of the connection between man and nature. This presentation will examine how the gardens around Italian Renaissance villas in Tuscany and in the surroundings of Rome, with their use of geometrical lay-out, water, sounds, views, plants and buildings not only...

Team performance in the Italian NHS: the role of reflexivity.

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Urbini, Flavio; Callea, Antonino; Chirumbolo, Antonio; Talamo, Alessandra; Ingusci, Emanuela; Ciavolino, Enrico

2018-04-09

Purpose The purpose of this paper is twofold: first, to investigate the goodness of the input-process-output (IPO) model in order to evaluate work team performance within the Italian National Health Care System (NHS); and second, to test the mediating role of reflexivity as an overarching process factor between input and output. Design/methodology/approach The Italian version of the Aston Team Performance Inventory was administered to 351 employees working in teams in the Italian NHS. Mediation analyses with latent variables were performed via structural equation modeling (SEM); the significance of total, direct, and indirect effect was tested via bootstrapping. Findings Underpinned by the IPO framework, the results of SEM supported mediational hypotheses. First, the application of the IPO model in the Italian NHS showed adequate fit indices, showing that the process mediates the relationship between input and output factors. Second, reflexivity mediated the relationship between input and output, influencing some aspects of team performance. Practical implications The results provide useful information for HRM policies improving process dimensions of the IPO model via the mediating role of reflexivity as a key role in team performance. Originality/value This study is one of a limited number of studies that applied the IPO model in the Italian NHS. Moreover, no study has yet examined the role of reflexivity as a mediator between input and output factors in the IPO model.

Factors predicting meat and meat products consumption among middle-aged and elderly people: evidence from a consumer survey in Switzerland.

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Schmid, Alexandra; Gille, Doreen; Piccinali, Patrizia; Bütikofer, Ueli; Chollet, Magali; Altintzoglou, Themistoklis; Honkanen, Pirjo; Walther, Barbara; Stoffers, Helena

2017-01-01

Background : An adequate diet contributes to health and wellbeing in older age. This is nowadays more important than ever since in industrialised countries the elderly population is growing continually. However, information regarding the consumption behaviour of older persons in Switzerland is limited. Objective : The objective of this investigation was to explore how middle-aged and elderly Swiss view animal products in relation to diet and health, and what factors predict consumption frequency. Design : A representative consumer survey among 632 people over the age of 50 years, living in the German-, French- and Italian-speaking regions of Switzerland was conducted. Results : This paper presents the results related to meat and meat products consumption. Most participants consumed meat and meat products regularly. The majority of participants with low meat intake indicated that eating small amounts would be enough. Respondents judged fresh meat (except pork) to be healthier than meat products, and poultry to be the healthiest meat. Overall meat consumption frequency was predicted by language region, gender, household size, and BMI. Furthermore, participants' opinion about healthiness, taste and safety of meat but not their adherence to the Swiss food pyramid was found to be correlated to the consumption frequency of individual types of meat. Conclusion : Several factors have an impact on consumption frequency of meat and meat products in the middle-aged and elderly Swiss population and the importance varies according to the individual types of meat and meat products. The results show that the traditional food pyramid is not one of these factors for which reason new tools must be explored to support elderly people in regard to a healthy dietary behaviour.

Authentic Italian food as Mamma used to make it

DEFF Research Database (Denmark)

d'Ambrosio, Luigi; Madsen, Jan Halberg

2014-01-01

Research description and purpose: The purpose of this investigation is to explore how Italian restaurants define authentic Italian culinary experiences and how these experiences are designed and rendered to the restaurants’ guests. Design/Methodology: The purpose of this research is exploratory...... are unique to this case and cannot be expected replicated, nor generalized. Originality/value: This article investigates how the authentic Italian culinary experience is defined and designed by restaurant owners or managers in the specific context of the city of Aalborg, Denmark. The originality...... of this research resides in the contribution to a better understanding of how authentic experiences are defined and designed at the supply side in the restaurant industry. Moreover, this article takes on a critical perspective on Gilmore and Pine’s genres of authenticity. Keywords: Genres of authenticity, culinary...

Transitional care management in the outpatient setting.

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Baldonado, Analiza; Hawk, Ofelia; Ormiston, Thomas; Nelson, Danielle

2017-01-01

Patients who are high risk high cost (HRHC), those with severe or multiple medical issues, and the chronically ill elderly are major drivers of rising health care costs.1 The HRHC patients with complex health conditions and functional limitations may likely go to emergency rooms and hospitals, need more supportive services, and use long-term care facilities.2 As a result, these patient populations are vulnerable to fragmented care and "falling through the cracks".2 A large county health and hospital system in California, USA introduced evidence-based interventions in accordance with the Triple AIM3 focused on patient-centered health care, prevention, health maintenance, and safe transitions across the care continuum. The pilot program embedded a Transitional Care Manager (TCM) within an outpatient Family Medicine clinic to proactively assist HRHC patients with outreach assistance, problem-solving and facilitating smooth transitions of care. This initiative is supported by a collaborative team that included physicians, nurses, specialists, health educator, and pharmacist. The initial 50 patients showed a decrease in Emergency Department (ED) encounters (pre-vs post intervention: 33 vs 17) and hospital admissions (pre-vs post intervention: 32 vs 11), improved patient outcomes, and cost saving. As an example, one patient had 1 ED visit and 5 hospital admission with total charges of $217,355.75 in the 6 months' pre-intervention with no recurrence of ED or hospital admissions in the 6 months of TCM enrollment. The preliminary findings showed improvement of patient-centered outcomes, quality of care, and resource utilization however more data is required.

Italian Literature in Russia. Some Recent Important Contributions

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Claudia Lasorsa Siedina

2013-02-01

Full Text Available The paper presents an updated review of translations of contemporary Italian literature published in two issues of the popular Russian literary magazine “Inostrannaja literatura”. The first issue (2008, 10, entitled Italian Literature in Search of a Form, published translations by poets, prose writers, especially authors of stories, specimens of classic authors of the twentieth century: futurists, expressionists, surrealists, and writers of critical essays. Translation of some precious octaves of Ariosto’s poem Orlando furioso were also included. The second ‘special’ issue (2011, 8, entitled Italy: Seasons, is devoted to contemporary women writers of fiction. Particularly valuable is the Literature heritage section, which contains translations of Vivaldi’s sonnets by M. Amelin and of G.G. Belli’s Roman sonnets by E. Solonovič, both representatives of the excellence of the Russian school of translation. The two issues include a complete index of Italian authors translated into Russian between 1994 and 2011.

Practicing Reflexivity in the Study of Italian Migrants in London

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Seganti, Francesca Romana

2010-01-01

This article discusses the centrality of reflexivity in qualitative research through examples from my study on the role new media play in the lives of Italians in London. My hypothesis was that Italians were "in transit" in London and they were using new media to build "temporary" communities. I conducted in-depth interviews…

Social inclusion affects elderly suicide mortality.

Science.gov (United States)

Yur'yev, Andriy; Leppik, Lauri; Tooding, Liina-Mai; Sisask, Merike; Värnik, Peeter; Wu, Jing; Värnik, Airi

2010-12-01

National attitudes towards the elderly and their association with elderly suicide mortality in 26 European countries were assessed, and Eastern and Western European countries compared. For each country, mean age-adjusted, gender-specific elderly suicide rates in the last five years for which data had been available were obtained from the WHO European Mortality Database. Questions about citizens' attitudes towards the elderly were taken from the European Social Survey. Correlations between attitudes and suicide rates were analyzed using Pearson's test. Differences between mean scores for Western and Eastern European attitudes were calculated, and data on labor-market exit ages were obtained from the EUROSTAT database. Perception of the elderly as having higher status, recognition of their economic contribution and higher moral standards, and friendly feelings towards and admiration of them are inversely correlated with suicide mortality. Suicide rates are lower in countries where the elderly live with their families more often. Elderly suicide mortality and labor-market exit age are inversely correlated. In Eastern European countries, elderly people's status and economic contribution are seen as less important. Western Europeans regard the elderly with more admiration, consider them more friendly and more often have elderly relatives in the family. The data also show gender differences. Society's attitudes influence elderly suicide mortality; attitudes towards the elderly are more favorable among Western European citizens; and extended labor-market inclusion of the elderly is a suicide-protective factor.

From sick elderly to super-grandparents. A typology of elderly representations in Romanian video advertising

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Simona-Nicoleta Vulpe

2017-12-01

Full Text Available The aim of this paper was to study the elderly representations in Romanian video advertising in order to identify a typology corresponding to these representations. The research method that I used was the content analysis with a dominant qualitative approach, but also including quantification elements. The commercials that I selected for my analysis promoted health products, banking and insurances and fast moving consumers’ goods (FMCG. The identified typology is composed of five types of elderly representations: Super-Grandparents, Seclusive Elderly, Sick Elderly, Funny Elderly, and High-Tech Elderly. The representation types and their stereotypical content varied depending on the type of product/service that was promoted and on the public addressed by commercials.

Comparison of safety and outcomes of shock wave lithotripsy between elderly and non-elderly patients

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Chen YZ

2017-04-01

Full Text Available Yi-Zhong Chen,1 Wun-Rong Lin,1,2 Chih-Chiao Lee,1,2 Fang-Ju Sun,1,3 Yung-Chiong Chow,1,2 Wei-Kung Tsai,1,2 Pai-Kai Chiang,1,2 Ting-Po Lin,1,2 Marcelo Chen,1–3 Allen W Chiu1,4 1Department of Urology, MacKay Memorial Hospital, 2School of Medicine, MacKay Medical College, 3Department of Cosmetic Applications and Management, MacKay Junior College of Medicine, Nursing and Management, 4School of Medicine, National Yang-Ming University, Taipei, Taiwan Background: This study compared the clinical outcomes of extracorporeal shock wave lithotripsy between elderly (aged ≥65 years and non-elderly (aged <65 years patients.Methods: A retrospective review of medical records was performed on 483 (non-elderly: 245, elderly: 238 patients with upper urinary tract stones who underwent shock wave lithotripsy between 2007 and 2015. The demographic data, stone parameters, stone-free rate, retreatment rate, and complication rate were analyzed in both elderly and non-elderly patient groups.Results: There was no significant difference between non-elderly and elderly patients in terms of stone-free rate (46.5% vs 41.1%, P>0.05 regardless of stone site or stone size and overall retreatment rate (41.6% vs 37.0%, P>0.05. Elderly patients had a higher complication rate than non-elderly patients (15.5% vs 23.5%, P=0.026. The most common complication was flank pain. Receiver operating characteristic curves predicted that elderly patients (cutoff value: 65 years of age had a higher risk of complications and that patients with smaller stones (cutoff value: 0.8 cm had a higher stone-free rate.Conclusion: This study showed that elderly patients with upper urinary tract stones undergoing shock wave lithotripsy had comparable efficacy for stone-free rates and retreatment rates, but higher complication rates. Keywords: elderly, shock wave lithotripsy, upper urinary tract stone, safety, outcome

Quality of Elderly\\'s Life in Shiraz, Jahandidegan Club

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Mohammad Rafi' Bazrafshan

2008-04-01

Full Text Available Objectives: Aging is a personal and social experience. while experiences may cause happiness for some individuals, it may cause sadness or tedious in the others. Making decision and planning aimed to improve elderly quality of life among older people, require identification of their problems . Methods & Materials: This study was a cross–sectional study conduced in Jahandidegan Club Foundation for elderly in 2007. Participants were 232 elderly women aged 60–79 years old recruited through a random zed sampling. Data collection was conducted through LEIPAD questionnaire including two domains (essential domain and simplify domain. Data were analyzed using T-test, ANOVA and linear regression in SPSS. Results: The results indicated that there was a significant difference between QOL mean scores (in each of the two domains and total scoreand marital status (P<0.05, as singles had better scores in total than divorced and the other groups, Widowed and divorced elderly women had lower QOL scores than married. QOL scores (in each two domain and total score were strongly correlated with educational level however, only in essential domain a significant difference was observed (P=0.047. QOL mean score decreased with increasing age (P<0.05. There was a significant difference between QOL scores (in essential domain and total score with age of the elderly women, there was also a significant difference between QOL scores (in each two domain and total score with income (P<0.05, QOL mean increased with increasing income. There was a significant difference between QOL mean (in each two domain and total score with existence chronic disease (P<0.05. Conclusion: Results of this study demonstrated some factors such as disease, level of education, marital status, age, income and job may affect quality of elderly's life, Therefore these factors need to be considered in planning and solving older people's problems.

Does self-reported sleep quality predict poor cognitive performance among elderly living in elderly homes?

Science.gov (United States)

Amer, Motassem S; Hamza, Sarah A; El Akkad, Rania M; Abdel Galeel, Yamen I I

2013-01-01

Sleep complaints are common among elderly, especially institutionalized elderly, as they experience poorer sleep quality and higher use of sedative hypnotics, when compared to community-dwelling elderly. Recent findings suggest that there may be a relationship between poor quality of sleep and cognitive deficits. This study aimed at studying the relation between sleep quality and cognitive performance in older adults living in elderly homes. 100 elderly living in an elderly home in El Mansoura, Egypt, were recruited in this study, 50 cases with subjective poor quality of sleep and 50 controls with subjective good quality of sleep as assessed by Pittsburgh sleep quality index (PSQI). Each participant went through comprehensive geriatric assessment (CGA), including geriatric depression scale (GDS), assessment of cognitive function by mini mental state examination (MMSE). 52% of poor sleepers showed impaired MMSE, while only 24% of good sleepers had impaired MMSE. Both orientation and (attention and calculation) were more affected (P = 0.027 and 0.035, respectively). Linear correlation coefficient between PSQI and different variables revealed significant negative correlation with total MMSE score, attention and calculation. Poor quality of sleep is related to cognitive impairment among elderly living in elderly homes and this problem should be taken in consideration among this group of elders.

[Diagnostics and Eradication Therapy for MRSA Carriers in the Outpatient Sector: an Analysis of the Reimbursement Situation in the Light of Current Reimbursement Changes].

Science.gov (United States)

Schwendler, M; Hübner, C S; Fleßa, S

2017-10-01

Infection with methicillin-resistant Staphylococcus aureus (MRSA) occurs in both the inpatient and outpatient sector. The reimbursement for diagnostic services and eradication therapy in the outpatient sector was regulated for the first time on 01.04.2012 and after a 2-year test period, has been adopted into the standard range of care services. The aim of this retrospective study was to give an overview of the current situation in services and reimbursement in Germany and describe MRSA patients and their treatment in the outpatient sector. Secondary data, namely reimbursement data of the National Association of Statutory Health Insurance Physicians (KBV) und the Physicians' Association (KV) Mecklenburg-West Pomerania for the period 01/04/2012-31/03/2014 were analyzed. Results show that on the federal level, MRSA services amounting to € 3,235,870.18 have been reimbursed and that diagnostic costs exceed treatment costs. In Germany, 5,627 doctors invoiced services related to MRSA; 51,56% of these were general practitioners and 21,25% specialists in internal medicine working in general practice. In the KV Mecklenburg-Western Pomerania, patients were elderly (average age 69,13), cost for services were on average 27,76 €, and 76,85% of the patients were treated within one quarter. On the whole, there were regional differences in the identification and eradication of MRSA in the outpatient setting. In order to provide an extended base for a more efficient resource allocation in the health care sector, in addition to analysis of MRSA eradication from the medical point of view, attention needs to be paid to patient flow between the out- and inpatient sectors, as well as economic aspects. © Georg Thieme Verlag KG Stuttgart · New York.

Outpatient waiting time in Jos University Teaching Hospital ...

African Journals Online (AJOL)

Problem Long waiting time for services has been identified as a reason people avoid presenting to for care in African countries. Design Examination of causes for long outpatient waiting time and the effect of measures to reduce waiting time. Setting Outpatient department of the Jos University Teaching Hospital.

[The Italian version of Nordic Musculoskeletal Standardized Questionnaire].

Science.gov (United States)

Ghersi, R; Martinelli, S; Richeldi, A; Clerici, P; Grazioli, P; Gobba, F M

2007-01-01

We translated into Italian the Nordic musculoskelethal questionnaire, as completed by Canadian IRSST with Authors' agreement in 2001, according to OMS recommendations. This translation involved the following items: aches and troubles of neck, dorsal region, low back, shoulders, elbows, hands and wrists, hips and thighs, ankles and feet in the last 12 months. The questionnaire was then submitted to reliability and stability tests. The Italian version of the questionnaire, already used in different languages, proved to be suitable and reliable also for self administration.

Mercury levels in defined Italian population groups

International Nuclear Information System (INIS)

Ingrao, G.; Belloni, P.

1991-01-01

Our group conducts its research activity in the Department AMB-BIO (Biological and Sanitary Effect of Toxic Agents) of ENEA (National Committee for Research and Development of Nuclear and Alternative Energy) at the research centre of Casaccia. The food chain is the main pathway leading to humans for most of the trace elements. The research, therefore, has been directed mainly towards the study of the variability of the trace element content in the Italian diet. This programme aims at assessing the adequacy of the essential trace elements ingestion, and to verify that the ingestion of toxic trace elements is below the recommended values. Part of this research was conducted in the frame of the IAEA CRP on ''Human daily Intakes of Nutritionally Important Trace Elements as Measured by Nuclear and Other Techniques''. Studies carried out by the National Institute of Nutrition and FAO have shown that there are some population groups having a fish consumption significantly higher than the average value for the Italian population. These groups are usually found in coastal towns were fishing is one of the main occupation and generally includes fishermen, fish dealers, restaurant workers and their families. A pilot study was conducted in one of these towns, Bagnara Calabra in the South of Italy, where the average fish consumption is 27.1 kg per year, which is more than twice the national average. The results have shown that the mercury concentration in the diet is significantly higher than in other Italian locations, the mercury levels in blood and hair sample in these subjects are also significantly higher than the values reported for subjects of the general Italian population. 6 refs

Effect of estimated glomerular filtration rate on plasma concentrations of B-type natriuretic peptides measured with multiple immunoassays in elderly individuals

DEFF Research Database (Denmark)

Schou, M.; Alehagen, U.; Goetze, J.P.

2009-01-01

linear regression models. RESULTS: In univariate analyses the effect of a 10% decrease in eGFR on proBNP concentrations was a 15% (95% confidence interval 11% to 18%), 9% (5% to 13%) and 21% (14% to 28%) increase. In multivariate models the effect was a 7% (3% to 11%), 4% (2% to 6%) and 13% (4% to 20....... SETTING: 474 elderly outpatients with suspected heart failure (prevalence 13%) from the primary care. MAIN OUTCOME MEASURES: The effects of eGFR on proBNP, measured with three different immunoassays (Roche Diagnostics, Oslo and Copenhagen), and BNP (Shionogi) concentrations were evaluated by multiple...

Economic assessment of the general thoracic surgery outpatient service.

Science.gov (United States)

Jones, David R; Vaughters, Ann B R; Smith, Philip W; Daniel, Thomas M; Shen, K Robert; Heinzmann, Janet L

2006-09-01

One aspect of the definition of institutional value for any program is based on the return on investment (ROI) for that program. Program requests for future resource allocations depend, in part, on that information. The purpose of this project was to determine the ROI for initial outpatient visits only for our General Thoracic Surgery (GTS) program. The number of GTS outpatient visits, studies, and requested consultations ordered by GTS surgeons only was determined after review of the hospital database and office records for the calendar year 2003. Only charges associated with the initial outpatient visits (no inpatient or physician charges) were included. Charges were based on hospital finance department data. The ROI for GTS outpatient services was calculated using total hospital costs and hospital collections. There were 689 initial outpatient GTS visits. The majority were for lung cancer (48%), benign lung diseases (21%), and esophageal diseases (14%). Total outpatient charges were 1.25M dollars and by disease process were lung cancer (644,000 dollars), benign lung disease (90,000 dollars), esophageal disease (159,000 dollars), and other (357,000 dollars). The most significant hospital charges were the following: radiology (850,000 dollars), laboratory studies (82,000 dollars), gastrointestinal medicine studies (59,000 dollars), and cardiology (42,000 dollars). Total operational costs for the GTS clinic were 415,000 dollars and hospital collections were 513,000 dollars, yielding an ROI of 98,000 dollars or an operating margin of 19%. An operating margin of 19% for GTS outpatient services is better than most Fortune 500 companies. Acquisition of this type of information by GTS surgeons may be helpful for future program development and institutional resource allocation.

Emotion socialization practices in Italian and Hong Kong-Chinese mothers.

Science.gov (United States)

Fiorilli, Caterina; De Stasio, Simona; Di Chicchio, Carlo; Chan, Siu Mui

2015-01-01

Parents' emotion socialization practices are their ways of handling their children's emotional experiences in light of cultural expectations surrounding emotions. Such practices are thought to significantly affect children's social adjustment. We compared the parenting practices of Italian and Hong Kong Chinese samples in an ethnological validation study of the maternal responses to children's emotion scale (MRCES). Participants were 71 Italian mothers (M = 39.45) and 71 Hong Kong-Chinese mothers (M = 37.75) with children aged 6-9 years. The results confirmed the two-factor structure identified by the scale's authors, namely coaching/emotion-encouraging and emotion dismissing approaches, respectively. Each of the two factors displayed satisfactory internal consistency. The Chinese mothers obtained higher scores than the Italian mothers on both subscales. Our findings suggested that parents' emotion socialization practices for coping with children's emotions received different degrees of emphasis and were underpinned by different meaning in the Hong Kong and Italian cultural groups. These cultural differences are discussed in relation to their effect on children's socio-emotional development.

Analysis of association between a microsatellite at intron 1 of the insulin-like growth factor 1 (IGF1 gene and fat deposition, meat production and quality traits in Italian Large White and Italian Duroc pigs

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Luca Fontanesi

2013-10-01

Full Text Available A few studies have shown that a microsatellite at intron 1 of the insulin-like growth factor 1 (IGF1 gene is associated with several production traits in a few pig populations. In the current work we evaluated associations between this microsatellite and production traits in Italian Large White and Italian Duroc pigs. Association studies were carried out on a total of 1120 animals using two experimental designs: i a selective genotyping approach based on extreme and divergent Italian Large White pigs for back fat thickness (BFT estimated breeding value (EBV or on extreme and divergent Italian Duroc pigs for visible intermuscular fat (VIF EBV; and ii analysis of unselected pigs (random groups coming from populations of the two breeds. Allele distributions between Italian Large White and Italian Duroc pigs were different (P<0.05 with longer alleles being more frequent in Italian Large White. Results of the association analyses from two different random groups showed that this marker affects average daily gain EBV, lean cut EBV and BFT EBV in Italian Large White and BFT EBV in Italian Duroc (P<0.05. Association analysis carried out with random residuals confirmed, to some extent (P=0.096, the effects on BFT in the same animals. However, this result was not confirmed in the two extreme and divergent Italian Large White groups used in the selective genotyping experiment. These inconsistent results may indicate that the effect of the IGF1 microsatellite is doubtful in the investigated finishing pigs.

Theories and measures of elder abuse.

Science.gov (United States)

Abolfathi Momtaz, Yadollah; Hamid, Tengku Aizan; Ibrahim, Rahimah

2013-09-01

Elder abuse is a pervasive phenomenon around the world with devastating effects on the victims. Although it is not a new phenomenon, interest in examining elder abuse is relatively new. This paper aims to provide an overview of the aetiological theories and measures of elder abuse. The paper briefly reviews theories to explain causes of elder abuse and then discusses the most commonly used measures of elder abuse. Based on the reviewed theories, it can be concluded that elder abuse is a multifactorial problem that may affect elderly people from different backgrounds and involve a wide variety of potential perpetrators, including caregivers, adult children, and partners. The review of existing measurement instruments notes that many different screening and assessment instruments have been developed to identify elders who are at risk for or are victims of abuse. However, there is a real need for more measurements of elder abuse, as the current instruments are limited in scope. © 2013 The Authors. Psychogeriatrics © 2013 Japanese Psychogeriatric Society.

Allergen immunotherapy: clinical and practical education of Italian trainees in allergy and clinical immunology schools.

Science.gov (United States)

Ridolo, E; Incorvaia, C; Senna, G E; Montagni, M; Olivieri, E; Canonica, G W

2013-10-01

We performed a survey, based on a questionnaire including 20 items, submitted anonymously to Italian trainees in Allergology and Clinical Immunology, in order to obtain information about their specific allergen immunotherapy (AIT) practices. The questionnaire was sent to 40 trainees, who had attended the last two years of the training course. Thirty-four subjects (mean age: 27 years, 65% females) adequately completed the survey. The answers to the questionnaire showed that only 60% of the training programs included lectures on AIT. Among the trainees using AIT, only 40% declared being able to prescribe it independently, while 60% were guided by a tutor. Of the trainees who were able to prescribe AIT autonomously, 60% were familiar with both routes of administration, i.e. subcutaneous (SCIT) and sublingual immunotherapy (SLIT), while 25% of these used only SLIT. In 80% of the training institutions involved, the trainees could attend a dedicated AIT outpatient ward for SCIT administration; only 40% administered AIT personally, and in half of these cases, they were guided by a tutor. Only 70% of trainees had experience in the follow-up of patients still under treatment and of patients who had completed treatment. Analysis of the answers obtained for questions on venom immunotherapy (VIT) showed that, in 90% of cases, the trainees attended a dedicated outpatients ward where VIT is administered, but with a role limited to observation/cooperation. Only 30% were involved in the follow-up of patients who were under treatment or who had completed VIT. Only 20% of the trainees felt confident enough about VIT to prescribe this treatment independently, 80% knew there were several administration protocols, and the majority prescribed products from three different manufacturers. These findings suggest that there is significant room for improving the instructions provided regarding allergology and clinical immunology to trainees in Italy with respect to AIT.

Italian Society of Physics

International Nuclear Information System (INIS)

Anon.

1987-01-01

The abstracts of most of the papers read at the 53 National Congress of the Italian Society of Physics are presented. The Congress developed in ten sessions: high energy and elementary particle physics, physics of nuclei, condensed matter, quantum electronics, cosmic physics, geophysics, general physics, electronics and applied physics, health physics and hystory of physics. An author index is also included

The cost of assisted outpatient treatment: can it save states money?

Science.gov (United States)

Swanson, Jeffrey W; Van Dorn, Richard A; Swartz, Marvin S; Robbins, Pamela Clark; Steadman, Henry J; McGuire, Thomas G; Monahan, John

2013-12-01

The authors assessed a state's net costs for assisted outpatient treatment, a controversial court-ordered program of community-based mental health services designed to improve outcomes for persons with serious mental illness and a history of repeated hospitalizations attributable to nonadherence with outpatient treatment. A comprehensive cost analysis was conducted using 36 months of observational data for 634 assisted outpatient treatment participants and 255 voluntary recipients of intensive community-based treatment in New York City and in five counties elsewhere in New York State. Administrative, budgetary, and service claims data were used to calculate and summarize costs for program administration, legal and court services, mental health and other medical treatment, and criminal justice involvement. Adjusted effects of assisted outpatient treatment and voluntary intensive services on total service costs were examined using multivariate time-series regression analysis. In the New York City sample, net costs declined 43% in the first year after assisted outpatient treatment began and an additional 13% in the second year. In the five-county sample, costs declined 49% in the first year and an additional 27% in the second year. Psychotropic drug costs increased during the first year after initiation of assisted outpatient treatment, by 40% and 44% in the city and five-county samples, respectively. Regression analyses revealed significant declines in costs associated with both assisted outpatient treatment and voluntary participation in intensive services, although the cost declines associated with assisted outpatient treatment were about twice as large as those seen for voluntary services. Assisted outpatient treatment requires a substantial investment of state resources but can reduce overall service costs for persons with serious mental illness. For those who do not qualify for assisted outpatient treatment, voluntary participation in intensive community

[Research on antiemetics: an Italian model of success].

Science.gov (United States)

Roila, F

1998-01-01

At the beginning of the 80's the Italian Group for Clinical Research (G.O.I.R.C.) identified chemotherapy-induced nausea and vomiting as one of the most distressing adverse events, and decided to plan and execute clinical trials on antiemetics in order to reduce this negative impact on patients. Therefore, some consecutive double-blind randomized trials were conducted on cisplatin-treated patients. The first was a dose-finding study on four different high-doses of domperidone, followed by a study comparing two different high-doses of metoclopramide, and a study comparing the addition of a corticosteroid to high-dose metoclopramide with respect to metoclopramide alone. Finally, a study demonstrating that a combination of a higher dose of metoclopramide (3 mg/kg x 2) plus dexamethasone and diphenhydramine was significantly superior with respect to a lower dose of metoclopramide (1 mg/kg x 4) combined with methylprednisolone was carried out. With the introduction of the 5-HT3 receptor antagonists the interest for antiemetic therapy increased and other Italian gynecological and medical oncology centres became involved in the antiemetic research. The Italian Group for Antiemetic Research was formed in 90's and its first study demonstrated the superiority of a combination of a 5-HT3 receptor antagonist plus dexamethasone with respect to the standard three drug combination of high doses of metoclopramide in the prevention of cisplatin-induced acute emesis. In the following years, the Group contributed to the identification of the best antiemetic prophylaxis for acute emesis induced by moderately emetogenic chemotherapy, and for delayed emesis induced by cisplatin. Also a drug utilization review on antiemetics in clinical practice has recently been carried out. Today, the interest of the Group is concentrated in studying the optimal antiemetic prophylaxis for delayed emesis induced by moderately emetogenic chemotherapy. The rules always followed by the Italian Group for

Italian network for human biomonitoring of metals: preliminary results from two regions

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Beatrice Bocca

2010-01-01

Full Text Available The Italian program for human biomonitoring (HBM of chemical elements, PROgram for Biomonitoring of the Exposure (PROBE, started in 2008 with the aim to provide the knowledge about risk assessment of the Italian population following the environmental exposure to metals. The project is implemented through a HBM campaign for the production of data on 19 metals in the blood and serum of subjects living in different Italian Regions. The metals studied are: antimony, beryllium, cadmium, chromium, cobalt, iridium, lead, manganese, mercury, molybdenum, nickel, palladium, platinum, rhodium, thallium, tin, tungsten, uranium and vanadium. The first phase of the project has included the development and validation of laboratory protocols for the collection of fluids and quantification of metals. The second phase provides the HBM data expressed as the reference values (RVs for the Italian population, i.e., as the level of metals in the general population not occupationally exposed. In this paper, the experimental protocols used for the maintenance of high standards of analysis and the RVs for metals in serum of inhabitants of two Italian Regions (Calabria and Umbria are described.

Management of Nonceliac Gluten Sensitivity by Gastroenterology Specialists: Data from an Italian Survey

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Federica Branchi

2015-01-01

Full Text Available Background and Aim. Nonceliac gluten sensitivity is syndrome characterized by symptoms disappearing after a gluten-free diet. Its existence is still argument of discussion among specialists. Our aim was to evaluate the knowledge about nonceliac gluten sensitivity among gastroenterology specialists. Methods. During October 2013 a questionnaire was sent through a medical newsletter to Italian gastroenterologists. Twelve questions investigated their knowledge on nonceliac gluten sensitivity, including their diagnostic and therapeutic approach. Results. A total of 212 gastroenterologists filled in the questionnaire. The 98.6% were aware of the existence of a syndrome called “nonceliac gluten sensitivity” and 77% believe in its existence. However, only 56% gave a correct definition of the term. The majority of specialists diagnosed gluten sensitive patients and the number of diagnoses was not statistically different from that of celiac disease. Moreover, a gluten-free diet was prescribed by 64% of the specialists and among them the 73% noted an increase of gluten sensitive patients attending their outpatient services. Conclusions. Our study indicated that most of the specialists recognize nonceliac gluten sensitivity and prescribe gluten-free diet, although 44% of the specialists are not able to give its correct definition; underlining the necessity of medical education on this topic is needed.

An Unusual Partnership: Brazilian-Italian Forms of Cooperation in the Nuclear Field (1951-1986)

International Nuclear Information System (INIS)

Patti, Carlo

2017-01-01

This chapter discusses the Brazilian-Italian cooperation in the nuclear field between the early 1950s and 1986. Since the late 1930s, Italian or Italian-Brazilian scientists promoted the development of studies in nuclear physics. Immediately after World War II, the Brazilian-Italian collaboration continued. Between the 1950s and the 1970s, Brazilian nuclear scientists studied in Italian institutions. Relying on primary sources from Brazilian archives and oral history interviews with protagonists of the Brazilian nuclear program, this chapter explore the relations between Italy and Brazil from 1951, the year of the establishment of the Brazilian nuclear program, until the 1980s. This study focuses on the bidirectional transfer of knowledge on sensitive technologies, and on the formal and informal cooperation between the two countries.

Breath tests sustainability in hospital settings: cost analysis and reimbursement in the Italian National Health System.

Science.gov (United States)

Volpe, M; Scaldaferri, F; Ojetti, V; Poscia, A

2013-01-01

The high demand of Breath Tests (BT) in many gastroenterological conditions in time of limited resources for health care systems, generates increased interest in cost analysis from the point of view of the delivery of services to better understand how use the money to generate value. This study aims to measure the cost of C13 Urea and other most utilized breath tests in order to describe key aspects of costs and reimbursements looking at the economic sustainability for the hospital. A hospital based cost-analysis of the main breath tests commonly delivery in an ambulatory setting is performed. Mean salary for professional nurses and gastroenterologists, drugs/preparation used and disposable materials, purchase and depreciation of the instrument and the testing time was used to estimate the cost, while reimbursements are based on the 2013 Italian National Health System ambulatory pricelist. Variables that could influence the model are considered in the sensitivity analyses. The mean cost for C13--Urea, Lactulose and Lactose BT are, respectively, Euros 30,59; 45,20 and 30,29. National reimbursement often doesn't cover the cost of the analysis, especially considering the scenario with lower number of exam. On the contrary, in high performance scenario all the reimbursement could cover the cost, except for the C13 Urea BT that is high influenced by the drugs cost. However, consideration about the difference between Italian Regional Health System ambulatory pricelist are done. Our analysis shows that while national reimbursement rates cover the costs of H2 breath testing, they do not cover sufficiently C13 BT, particularly urea breath test. The real economic strength of these non invasive tests should be considered in the overall organization of inpatient and outpatient clinic, accounting for complete diagnostic pathway for each gastrointestinal disease.

Africanized honey bees (Apis mellifera L. are more efficient at removing worker brood artificially infested with the parasitic mite Varroa jacobsoni Oudemans than are Italian bees or Italian/Africanized hybrids

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Guerra Jr. José Carlos Vieira

2000-01-01

Full Text Available Africanized honey bees are more tolerant of infestations with the mite Varroa jacobsoni than are honey bees of European origin. The capacity of these bees to detect and react to brood infested with this mite could be one of the factors determining this tolerance. We tested colonies of Africanized bees headed by queens from swarms collected in Ribeirão Preto, São Paulo State. The Italian colonies had queens imported directly from the USA, or from the Brazilian Island of Fernando de Noronha, where varroa-infested Italian colonies have been maintained, untreated, since 1984. Recently sealed worker brood cells were artificially infested by opening the cell capping, inserting live adult female mites and resealing the cells. Control cells were treated in the same way, but without introducing mites. The ability of the Africanized honey bees to recognize and remove this artificially infested brood was compared with that of first generation Italian/Africanized hybrid bees, and with the two groups of "pure" Italian bees, in three separate experiments. Africanized colonies removed a mean of 51% of the infested brood, while Italian/Africanized hybrid colonies removed 25%. Africanized colonies also removed a significantly greater proportion of infested brood than did Italian colonies, headed by queens from the USA (59 vs. 31%, respectively. Similarly, when Africanized colonies were compared with colonies of Italian bees from Fernando de Noronha, the former were found to be significantly more efficient at removing infested brood (61 vs. 35%, respectively, even though the population of Italian bees on this island has been exposed to and survived varroa infestations (without treatment for more than 12 years. Only the Africanized honey bees removed a significant proportion of varroa-infested brood, when the data was corrected for brood removal from control cells.

Emotional Geographies of the Uncanny: Reinterpreting Italian Transnational Spaces

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Maurizio Marinelli

2013-08-01

Full Text Available The 'Emotional Geographies of the Uncanny' section of Cultural Studies Review aims to read transnational spaces constructed and inhabited by Italian migrants and settlers to Australasia as emotional spaces of uncanny perceptions, memories, narratives and identities. Drawing inspiration from the Freudian suggestions about the uncanny (das unheimliche, and later interpretations by Heiddeger, Derrida, Kristeva, Bhabha, Žižek, and Ahmed, we refer to the uncanny as the emotional reaction to something that is, at the same time, familiar and unfamiliar, homely and unhomely. The uncanny then becomes an aesthetic frame through which experiences of migration and colonialism can be read and interpreted. How have Italians experienced the strange un/familiarity of the places to which they have migrated or that they have colonised in Australasia? And, in the process of familiarising the unfamiliar, how have they perceived the strange familiarity of the newly emerged 'Italian' spaces that they have first constructed and then inhabited, outside the boundaries of the Italian Nation, and often within the space of other essentialist Nations? Furthermore, how have they related to the places they have left in Italy: the places to which they have progressively become strangers yet have continued to constitute a central element of their subjectivity?

The Italian Dementia National Plan

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Teresa Di Fiandra

2015-12-01

Full Text Available The Italian Dementia National Plan was formulated in October 2014 by the Italian Ministry of Health in close cooperation with the regions, the National Institute of Health and the three major national associations of patients and carers. The main purpose of this strategy was to provide directive indications for promoting and improving interventions in the dementia field, not limiting to specialist and therapeutic actions, but particularly focusing on the support of patients and families throughout the pathways of care. Four main objectives are indicated: 1 promote health- and social-care interventions and policies; 2 create/strengthen the integrated network of services for dementia based on an integrated approach; 3 implement strategies for promoting appropriateness and quality of care; and 4 improve the quality of life of persons with dementia and their families by supporting empowerment and stigma reduction. These objectives and the pertaining actions are described in the present paper.

The Italian Tau/charm project

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Biagini Maria Enrica

2014-06-01

Full Text Available A τ/charm Factory, an e + e- collider with very high luminosity at the 2–4.6 GeV center of mass energy, to be built on the Rome University at Tor Vergata campus, was studied by the Consortium Nicola Cabibbo Laboratory and the INFN Frascati Laboratories. This project is the natural evolution of the flagship Italian project SuperB Factory, funded by the Italian Government in 2010 with a budget that turned out to be insufficient to cover the total costs of the project. The study of rare events at the τ/charm energy was already planned as a Phase-II of SuperB [1]. This design keeps all the unique features of SuperB, including the polarization of the electron beam, with the possibility to take data in a larger energy range, with reduced accelerator dimensions and construction and operation costs. A Report on the accelerator design has been published in September 2013 [2].

Teaching Standard Italian to Dialect Speakers: A Pedagogical Perspective of Linguistic Systems in Contact

Science.gov (United States)

Danesi, Marcel

1974-01-01

The teaching of standard Italian to speakers of Italian dialects both in Italy and in North America is discussed, specifically through a specialized pedagogical program within the framework of a sociolinguistic and psycholinguistic perspective, and based on a structural analysis of linguistic systems in contact. Italian programs in Toronto are…

Elder physical abuse.

Science.gov (United States)

Young, Lisa M

2014-11-01

Physical abuse of the elderly is a significant public health concern. The true prevalence of all types is unknown, and under-reporting is known to be significant. The geriatric population is projected to increase dramatically over the next 10 years, and the number of abused individuals is projected to increase also. It is critical that health care providers feel competent in addressing physical elder abuse. This article presents cases illustrating the variety of presenting symptoms that may be attributed to physical elder abuse. Copyright © 2014 Elsevier Inc. All rights reserved.

Gut Microbiome and Putative Resistome of Inca and Italian Nobility Mummies.

Science.gov (United States)

Santiago-Rodriguez, Tasha M; Fornaciari, Gino; Luciani, Stefania; Toranzos, Gary A; Marota, Isolina; Giuffra, Valentina; Cano, Raul J

2017-11-07

Little is still known about the microbiome resulting from the process of mummification of the human gut. In the present study, the gut microbiota, genes associated with metabolism, and putative resistome of Inca and Italian nobility mummies were characterized by using high-throughput sequencing. The Italian nobility mummies exhibited a higher bacterial diversity as compared to the Inca mummies when using 16S ribosomal (rRNA) gene amplicon sequencing, but both groups showed bacterial and fungal taxa when using shotgun metagenomic sequencing that may resemble both the thanatomicrobiome and extant human gut microbiomes. Identification of sequences associated with plants, animals, and carbohydrate-active enzymes (CAZymes) may provide further insights into the dietary habits of Inca and Italian nobility mummies. Putative antibiotic-resistance genes in the Inca and Italian nobility mummies support a human gut resistome prior to the antibiotic therapy era. The higher proportion of putative antibiotic-resistance genes in the Inca compared to Italian nobility mummies may support the hypotheses that a greater exposure to the environment may result in a greater acquisition of antibiotic-resistance genes. The present study adds knowledge of the microbiome resulting from the process of mummification of the human gut, insights of ancient dietary habits, and the preserved putative human gut resistome prior the antibiotic therapy era.

Italian high technology shows its wares at CERN

CERN Multimedia

Maximilien Brice

2005-01-01

Italian industry held an exhibition at CERN on 14-17 November with 26 firms displaying innovative technological developments. In particular it featured categories such as mechanics, high-vacuum technologies, electronics for detectors, and electric and civil engineering. The exhibition was inaugurated in the presence of Guido Possa, vice-minister for education, universities and research. The event was organized by Sandro Centro, INFN researcher and Industrial Liaison Officer at CERN, along with Federico Ferrini, scientific officer for International Organizations of Geneva and the Italian Chamber of Commerce in Switzerland

The Transition to Work for Italian University Graduates

DEFF Research Database (Denmark)

Pozzoli, Dario

This study investigates the hazard of first job for Italian graduates. The analysis is in particular focused on the transition from university to work, taking into account the graduates' characteristics and the effects relating to degree subject. It is used a large data set from a survey on job...... opportunities for the 1998 Italian graduates. The paper employs a non parametric discrete-time single risk models to study employment hazard. Alternative mixing distributions have also been used to account for unobserved heterogeneity. The results obtained indicate that there is evidence of positive duration...

Single-Agent Panitumumab in Frail Elderly Patients With Advanced RAS and BRAF Wild-Type Colorectal Cancer: Challenging Drug Label to Light Up New Hope

Science.gov (United States)

Cremolini, Chiara; Aprile, Giuseppe; Lonardi, Sara; Orlandi, Armando; Mennitto, Alessia; Berenato, Rosa; Antoniotti, Carlotta; Casagrande, Mariaelena; Marsico, Valentina; Marmorino, Federica; Cardellino, Giovanni Gerardo; Bergamo, Francesca; Tomasello, Gianluca; Formica, Vincenzo; Longarini, Raffaella; Giommoni, Elisa; Caporale, Marta; Di Bartolomeo, Maria; Loupakis, Fotios; de Braud, Filippo

2015-01-01

Background. No prospective trials have specifically addressed the efficacy and safety of panitumumab in elderly patients with metastatic colorectal cancer (CRC). We aimed at assessing the efficacy and safety of single agent panitumumab in “frail” elderly patients diagnosed with metastatic RAS and BRAF wild-type CRC. Materials and Methods. Forty elderly patients (aged ≥75 years) with metastatic RAS-BRAF wild-type CRC received off-label prescriptions of single-agent panitumumab at seven Italian institutions. Treatment was administered as first line in patients with absolute contraindication to any chemotherapy or as second-line treatment after failure of a fluoropyrimidine-based treatment, in the presence of contraindication to irinotecan. The outcome measures included objective response rate (ORR), as well as progression-free survival (PFS), disease control rate (DCR), overall survival (OS), and safety. Results. The median PFS and OS were 6.4 months (95% confidence interval [CI]: 4.9–8 months) and 14.3 months (95% CI: 10.9–17.7 months), respectively. ORR was 32.5%, and DCR was 72.5%. Dose reductions related to adverse events (AEs) were reported in 9 (23%) patients, but no permanent treatment discontinuation caused by was reported. The most frequent grade 3 AE was skin rash, with an incidence of 20%. Conclusion. Panitumumab is effective and well-tolerated in frail elderly patients with RAS-BRAF wild-type metastatic CRC and deemed unfit for chemotherapy. A randomized study is needed to confirm these data. Implications for Practice: Treatment of elderly patients with metastatic colorectal cancer represents a difficult challenge in clinical practice. A significant proportion of frail elderly patients do not receive treatment, reflecting ongoing uncertainty of clinical benefit and toxicity of chemotherapy. Unfit condition in this cohort of patients further limits antineoplastic prescription and consequently patient survival. RAS and BRAF wild-type status could

42 CFR 414.63 - Payment for outpatient diabetes self-management training.

Science.gov (United States)

2010-10-01

... 42 Public Health 3 2010-10-01 2010-10-01 false Payment for outpatient diabetes self-management... SERVICES Physicians and Other Practitioners § 414.63 Payment for outpatient diabetes self-management..., payment for outpatient diabetes self-management training is made under the physician fee schedule in...

Brachial artery approach for outpatient arteriography

International Nuclear Information System (INIS)

You, Jai Kyung; Park, Sung Il; Lee, Do Yun; Won, Jae Hwan

1999-01-01

To evaluate the diagnostic usefulness of brachial approach arteriography for outpatients, with particular regard to safety and image quality. The angiographic findings and follow-up medical records of 131 brachial approach arteriographies in 121 outpatients were retrospectively analysed. 5 F pigtail catheters were used in 125 cases and 5-F OCU-A catheters were used in three cases of renal arteriography, and three of upper extremity arteriography without catheter. Except for three cases of brachial artery puncture failure, all procedures were performed successfully. One hundred and fifteen of 119 lower extremity arteriographies were visualized down to the level of the tibioperoneal artery. The non-visualized cases were three in which there was multiple obstruction at the distal common iliac artery and one with insufficient contrast amount due to renal failure In four cases there were complications : two involved arterial thrombosis, one was an intramuscular hematoma, and one an A-V fistula. For outpatients, brachial approach arteriography can replace the femoral approach. Its image quality is excellent, there are time-cost benefits, and the rate of complications is relatively low

Service quality of hospital outpatient departments: patients' perspective.

Science.gov (United States)

Zarei, Ehsan

2015-01-01

Assessment of patient perceptions of health service quality as an important element in quality assessments has attracted much attention in recent years. The purpose of this paper is to assess the service quality of hospital outpatient departments affiliated to Shahid Beheshti University of Medical Sciences from the patients' perspective. This cross-sectional study was conducted in 2014 in Tehran, Iran. The study samples included 500 patients who were selected by multi-stage random sampling from four hospitals. The data collection instrument was a questionnaire consisting of 50 items, and the validity and reliability of the questionnaire were confirmed. For data analysis, exploratory and confirmatory factor analysis, Friedman test, and descriptive statistics were used through LISREL 8.54 and SPSS 18 applications. Eight significant factors were extracted for outpatient service quality, which explained about 67 per cent of the total variance. Physician consultation, information provided to the patient, and the physical environment of the clinic were the three determining factors of the quality of outpatient services. The highest and lowest perceptions were related to physician consultation and perceived waiting time dimension, respectively. The mean score of patients' perception of outpatient service quality was 3.89 (±0.60). About 59.5 per cent of patients assessed the quality of outpatient services as good, 38.2 per cent as moderate, and 2.3 per cent as poor. Practical implications - The instrument developed for this study is valid and reliable, and it can help hospital managers to identify the areas needing improvement and correction. According to the findings of this study, the majority of patients had a positive experience with outpatient departments of teaching hospitals, and the services provided in these centres were of adequate quality, based on patient assessments.

Patient satisfaction in Malaysia's busiest outpatient medical care.

Science.gov (United States)

Ganasegeran, Kurubaran; Perianayagam, Wilson; Manaf, Rizal Abdul; Jadoo, Saad Ahmed Ali; Al-Dubai, Sami Abdo Radman

2015-01-01

This study aimed to explore factors associated with patient satisfaction of outpatient medical care in Malaysia. A cross-sectional exit survey was conducted among 340 outpatients aged between 13 and 80 years after successful clinical consultations and treatment acquirements using convenience sampling at the outpatient medical care of Tengku Ampuan Rahimah Hospital (HTAR), Malaysia, being the country's busiest medical outpatient facility. A survey that consisted of sociodemography, socioeconomic, and health characteristics and the validated Short-Form Patient Satisfaction Questionnaire (PSQ-18) scale were used. Patient satisfaction was the highest in terms of service factors or tangible priorities, particularly "technical quality" and "accessibility and convenience," but satisfaction was low in terms of service orientation of doctors, particularly the "time spent with doctor," "interpersonal manners," and "communication" during consultations. Gender, income level, and purpose of visit to the clinic were important correlates of patient satisfaction. Effort to improve service orientation among doctors through periodical professional development programs at hospital and national level is essential to boost the country's health service satisfaction.

Gesture and Identity in the Teaching and Learning of Italian

Science.gov (United States)

Peltier, Ilaria Nardotto; McCafferty, Steven G.

2010-01-01

This study investigated the use of mimetic gestures of identity by foreign language teachers of Italian and their students in college classes as a form of meaning-making. All four of the teachers were found to use a variety of Italian gestures as a regular aspect of their teaching and presentation of self. Students and teachers also were found to…

Outpatient-shopping behavior and survival rates in newly diagnosed cancer patients.

Science.gov (United States)

Chiou, Shang-Jyh; Wang, Shiow-Ing; Liu, Chien-Hsiang; Yaung, Chih-Liang

2012-09-01

To evaluate the appropriateness of the definition of outpatient-shopping behavior in Taiwanese patients. Linked study of 3 databases (Taiwan Cancer Registry, National Health Insurance [NHI] claim database, and death registry database). Outpatient shopping behavior was defined as making at least 4 or 5 physician visits to confirm a cancer diagnosis. We analyzed patient-related factors and the 5-year overall survival rate of the outpatient-shopping group compared with a nonshopping group. Using the household registration database and NHI database, we determined the proportion of outpatient shopping, characteristics of patients who did and did not shop for outpatient therapy, time between diagnosis and start of regular treatment, and medical service utilization in the shopping versus the nonshopping group. Patients with higher incomes were significantly more likely to shop for outpatient care. Patients with higher comorbidity scores were 1.4 times more likely to shop for outpatient care than patients with lower scores. Patients diagnosed with more advanced cancer were more likely to shop than those who were not. Patients might be more trusting of cancer diagnoses given at higher-level hospitals. The nonshopping groups had a longer duration of survival over 5 years. Health authorities should consider charging additional fees after a specific outpatient- shopping threshold is reached to reduce this behavior. The government may need to reassess the function of the medical sources network by shrinking it from the original 4 levels to 2 levels, or by enhancing the referral function among different hospital levels.

Improving Customer Service in Elderly Care

OpenAIRE

Nielsen, Chris

2015-01-01

The elderly care sector is increasingly facing more competition and demanding customers. This leads to a growing pressure on elderly care home providers to find new and improved solutions that will enhance their level of customer service. The will ensure that the elderly service provider is remaining competitive in the elderly care service marketplace. The purpose of this thesis is to identify areas for improvements and propose implementable solutions for enhancing the elderly care custom...

An Italian multicentre validation study of the coma recovery scale-revised.

Science.gov (United States)

Estraneo, A; Moretta, P; De Tanti, A; Gatta, G; Giacino, J T; Trojano, L

2015-10-01

Rate of misdiagnosis of disorders of consciousness (DoC) can be reduced by employing validated clinical diagnostic tools, such as the Coma Recovery Scale-Revised (CRS-R). An Italian version of the CRS-R has been recently developed, but its applicability across different clinical settings, and its concurrent validity and diagnostic sensitivity have not been estimated yet. To perform a multicentre validation study of the Italian version of the Coma Recovery Scale-Revised (CRS-R). Analysis of inter-rater reliability, concurrent validity and diagnostic sensitivity of the scale. One Intensive Care Unit, 8 Post-acute rehabilitation centres and 2 Long-term facilities Twenty-seven professionals (physicians, N.=11; psychologists, N.=5; physiotherapists, N.=3; speech therapists, N.=6; nurses, N.=2) from 11 Italian Centres. CRS-R and Disability Rating Scale (DRS) applied to 122 patients with clinical diagnosis of Vegetative State (VS) or Minimally Conscious State (MCS). CRS-R has good-to-excellent inter-rater reliability for all subscales, particularly for the communication subscale. The Italian version of the CRS-R showed a high sensitivity and specificity in detecting MCS with reference to clinical consensus diagnosis. The CRS-R showed good concurrent validity with the Disability Rating Scale, which had very low specificity with reference to clinical consensus diagnosis. The Italian version of the CRS-R is a valid scale for use from the sub-acute to chronic stages of DoC. It can be administered reliably by all members of the rehabilitation team with different specialties, levels of experience and settings. The present study promote use of the Italian version of the CRS-R to improve diagnosis of DoC patients, and plan tailored rehabilitation treatment.

The sustainability of the Italian public finances: an overview

OpenAIRE

Salustri, Andrea

2013-01-01

The Italian international reputation in mainly related to the high level of its public debt. During the Great Recession, this fact, associated to the stagnation of productivity, raised serious doubts on its economic and financial sustainability. The doubts are legitimated also by the fact that Italy is a net borrower of capitals from abroad, as its Net International Investment Position (NIIP) is negative. The statistical analysis of the Italian public finances suggests how the deep causes of ...

22nd Italian Workshop on Neural Nets

CERN Document Server

Bassis, Simone; Esposito, Anna; Morabito, Francesco

2013-01-01

This volume collects a selection of contributions which has been presented at the 22nd Italian Workshop on Neural Networks, the yearly meeting of the Italian Society for Neural Networks (SIREN). The conference was held in Italy, Vietri sul Mare (Salerno), during May 17-19, 2012. The annual meeting of SIREN is sponsored by International Neural Network Society (INNS), European Neural Network Society (ENNS) and IEEE Computational Intelligence Society (CIS). The book – as well as the workshop-  is organized in three main components, two special sessions and a group of regular sessions featuring different aspects and point of views of artificial neural networks and natural intelligence, also including applications of present compelling interest.

Stop and Fricative Devoicing in European Portuguese, Italian and German.

Science.gov (United States)

Pape, Daniel; Jesus, Luis M T

2015-06-01

This paper describes a cross-linguistic production study of devoicing for European Portuguese (EP), Italian, and German. We recorded all stops and fricatives in four vowel contexts and two word positions. We computed the devoicing of the time-varying patterns throughout the stop and fricative duration. Our results show that regarding devoicing behaviour, EP is more similar to German than Italian. While Italian shows almost no devoicing of all phonologically voiced consonants, both EP and German show strong and consistent devoicing through the entire consonant. Differences in consonant position showed no effect for EP and Italian, but were significantly different for German. The height of the vowel context had an effect for German and EP. For EP, we showed that a more posterior place of articulation and low vowel context lead to significantly more devoicing. However, in contrast to German, we could not find an influence of consonant position on devoicing. The high devoicing for all phonologically voiced stops and fricatives and the vowel context influence are a surprising new result. With respect to voicing maintenance, EP is more like German than other Romance languages.

TV Goes Social: Italian Broadcasting Strategies and the Challenges of Convergence

Directory of Open Access Journals (Sweden)

Luca Barra

2014-12-01

Full Text Available In recent years, the Italian television scenario has become fully convergent, and social TV is an activity – and a hip buzzword – indicating both a rich set of possibilities for the audience to engage with TV shows, and an important asset developed by television industry to provide such engagement, with promotional and economic goals. Mainly adopting the perspective of the production cultures of Italian broadcasters, the essay will explore the “Italian way to social television”, highlighting the strategies adopted by networks and production companies to encourage online television discourse and to exploit it as a content, a marketing device or a source of supplementary income.

[Anemia in the elderly].

Science.gov (United States)

Maerevoet, M; Sattar, L; Bron, D; Gulbis, B; Pepersack, T

2014-09-01

Anaemia is a problem that affects almost 10% over 65 years and 20% over 85 years. There is no physiological anaemia in the elderly. Any anaemia expresses the existence of a pathological process, regardless of its severity. Anaemia in the elderly is always associated with a poor prognosis that is in terms of mortality, morbidity and risk of fragility. The diagnostic approach to anemia in the elderly is the same as in younger individual. There are many causes of anaemia; anaemia balance is a complex diagnostic process. Most anaemias are due to a deficiency, chronic inflammation or comorbidity. However, in the elderly, the etiology of anaemia is often multifactorial. In a number of cases remain unexplained anaemia. In a number of cases, anemia remain unexplained. Treatment of anaemia is the treatment of the cause, but specific therapeutic aspects to the elderly should be considered, as among other martial substitution or use of erythropoietin (EPO).

Gender discrimination in the elderly and its impact on the elderly health.

Science.gov (United States)

Keskinoglu, Pembe; Ucuncu, Tugba; Yildirim, Idris; Gurbuz, Turgut; Ur, Ismail; Ergor, Gul

2007-01-01

The aim of this study was to determine gender discrimination and risk factors in the elderly population and to assess the impact of that discrimination on elderly health. One hundred and sixty-eight elderly individuals who were selected from the records by simple randomized sampling were enrolled in the study. Data were obtained by face-to-face interviews at the residence of the elderly individuals. Chi(2)-Analysis, t-test, Mann-Whitney U-test, and logistic regression were used for data analysis. 81.1% of the elderly were married and 40.5% were middle or high school graduates, and 93.9% of the subjects had at least one living child. It was determined that 51.7% of the females, and 21.3% of the males were exposed to negative gender discrimination. This discrimination was higher among women in all sub-groups. In fact, older women and elderly individuals with only primary school education or less were significantly more exposed to gender discrimination (p=0.008 and p=0.043, respectively). It was found that only economical variables were related to poor health status, without gender discrimination. Despite the fact that the freedom has been obtained in some areas such as participation in household decision-making and dressing, the patriarchal family structure and sexual inequality continue in older age.

The Italian contributions to the history of salicylates

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Giampiero Pasero

2011-09-01

Full Text Available It is well-known that the modern history of salicylates began in 1899 when the compound acetylsalicylic acid was registered and introduced commercially as “aspirin” by the Bayer Company of Germany. As a matter of fact, however, remedies made from willow bark had been used to treat fever and rheumatic complaints at least since 1763, when Edward Stone described their efficacy against malarian fever. A number of Italian scientists made significant contributions during the long period of research leading up to the synthesis of acetylsalicylic acid and its widespread use in rheumatic diseases. In this paper we will review the contributions of some of these researchers, beginning with Bartolomeo Rigatelli, who in 1824 used a willow bark extract as a therapeutic agent, denominating it “salino amarissimo antifebbrile” (very bitter antipyretic salt. In the same year, Francesco Fontana described this natural compound, giving it the name “salicina” (salicin. Two other Italian chemists added considerably to current knowledge of the salicylates: Raffaele Piria in 1838, while working as a research fellow in Paris, extracted the chemical compound salicylic acid, and Cesare Bertagnini in 1855 published a detailed description of the classic adverse event associated with salicylate overdoses – tinnitus – which he studied by deliberately ingesting excessive doses himself. Bertagnini and above all Piria also played conspicuous roles in the history of Italy during the period of the Italian Risorgimento, participating as volunteers in the crucial battle of Curtatone and Montanara during the first Italian War of Independence.

Viral hepatitis in the elderly.

Science.gov (United States)

Carrion, Andres F; Martin, Paul

2012-05-01

As life expectancy continues to rise, elderly adults represent a rapidly growing proportion of the population. The likelihood of complications of acute and chronic liver disease and overall mortality are higher in elderly populations. Several physiological changes associated with aging, greater prevalence of co-morbid conditions, and cumulative exposure to hepatotropic viruses and environmental hepatotoxins may contribute to worse outcomes of viral hepatitis in the elderly. Although pharmacotherapy for hepatitis B and C continues to evolve, the efficacy, tolerability, and side effects of these agents have not been studied extensively in elderly adults. Immunization against hepatitis A and B in naïve elderly adults is an important public health intervention that needs to be revised and broadened.

Ramsey prices in the Italian electricity market

International Nuclear Information System (INIS)

Bigerna, Simona; Bollino, Carlo Andrea

2016-01-01

In this paper, we derive optimal zonal prices in the Italian day-ahead electricity market using estimation of a complete system of hourly demand in 2010–2011. In Italy, the hourly equilibrium price for all buyers is computed as a uniform average of supply zonal prices, resulting from market splitting due to line congestion. We model ex-ante individual bids expressed by heterogeneous consumers, which are distinguished by geographical zones. Using empirical estimations, we compute demand elasticity values and new zonal prices, according to a Ramsey optimal scheme. This is a new approach in the wholesale electricity market literature, as previous studies have discussed the relative merit of zonal prices, considering only the issue of line congestion. Our results show that the optimal pricing scheme can improve welfare in the day-ahead Italian electricity market, with respect to both the existing uniform price scheme and the proposal to charge the existing supply zonal prices to the demand side. - Highlights: • We model and estimate the demand of heterogeneous buyers in the electricity market. • Transmission line congestion creates welfare distortions in the market. • We derive optimal Ramsey prices in the Italian day-ahead electricity market. • We compare optimal prices with historical ones showing how to improve welfare.

Undergraduate courses in nuclear engineering in Italian universities: Cultural and practical aspects

International Nuclear Information System (INIS)

Guerrini, B.; Lombardi, C.; Naviglio, A.; Oliveri, E.; Panella, B.; Sobrero, E.

1992-01-01

The contents of the undergraduate courses given in Italian nuclear engineering faculties are analyzed, showing the validity of this professional profile also with reference to non-nuclear applications including relevant safety issues and the management of complex projects. The role of Italian universities is stressed, in the defense of knowledge and capability in the nuclear sector, also with reference to the years of the nuclear 'moratoria' decided at the political level after public consultation. The prospects of Italian nuclear engineers are examined, with reference to the European labour market

Gut Microbiome and Putative Resistome of Inca and Italian Nobility Mummies

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Tasha M. Santiago-Rodriguez

2017-11-01

Full Text Available Little is still known about the microbiome resulting from the process of mummification of the human gut. In the present study, the gut microbiota, genes associated with metabolism, and putative resistome of Inca and Italian nobility mummies were characterized by using high-throughput sequencing. The Italian nobility mummies exhibited a higher bacterial diversity as compared to the Inca mummies when using 16S ribosomal (rRNA gene amplicon sequencing, but both groups showed bacterial and fungal taxa when using shotgun metagenomic sequencing that may resemble both the thanatomicrobiome and extant human gut microbiomes. Identification of sequences associated with plants, animals, and carbohydrate-active enzymes (CAZymes may provide further insights into the dietary habits of Inca and Italian nobility mummies. Putative antibiotic-resistance genes in the Inca and Italian nobility mummies support a human gut resistome prior to the antibiotic therapy era. The higher proportion of putative antibiotic-resistance genes in the Inca compared to Italian nobility mummies may support the hypotheses that a greater exposure to the environment may result in a greater acquisition of antibiotic-resistance genes. The present study adds knowledge of the microbiome resulting from the process of mummification of the human gut, insights of ancient dietary habits, and the preserved putative human gut resistome prior the antibiotic therapy era.

Italian Society for Rheumatology recommendations for the management of hand osteoarthritis

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M. Manara

2013-10-01

Full Text Available Hand osteoarthritis (OA is a common and potentially disabling disease, with different features from hip and knee OA so that a specific therapeutic approach is required. Evidence based recommendations for the management of hand OA were developed by the European League Against Rheumatism (EULAR in 2006. The Italian Society for Rheumatology (SIR aimed to update, adapt to national contest and disseminate the EULAR recommendations for the management of hand OA. The multidisciplinary group of experts included specialists involved in the management of patients with hand OA. In order to maintain consistency with EULAR recommendations, a similar methodology was utilized by the Italian group. The original propositions were reformulated in terms of a search query and for every recommendation a systematic search was conducted updating EULAR recommendations’ review. The propositions were translated in Italian and reformulated basing on collected evidences and expert opinion. The strength of recommendation was measured for each proposition with the EULAR ordinal and visual analogue scales. The original 11 propositions of EULAR recommendations were translated and adapted to Italian context. Further evidences were collected about non-pharmacological therapies, local treatments, intra-articular injection with SYSADOA and corticosteroids, and surgery. The SIR has developed updated recommendations for the management of hand OA adapted to the Italian healthcare system. Their implementation in clinical practice is expected to improve the management of patients with hand OA.

Off-Label Prescribing of Second-Generation Antipsychotics to Elderly Veterans with Posttraumatic Stress Disorder and Dementia.

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Semla, Todd P; Lee, Austin; Gurrera, Ronald; Bajor, Laura; Li, Mingfei; Miller, Donald R; Smith, Eric G; Wang, Chao; Wan, Yun; Kazis, Lewis E; Bauer, Mark S

2017-08-01

To determine whether elderly veterans with posttraumatic stress disorder (PTSD) and dementia are more likely to be prescribed second-generation antipsychotics (SGAs) than those with PTSD alone. National serial cross-sectional study. Veterans Health Affairs inpatient and outpatient settings. Veterans aged 65 and older with PTSD (excluding schizophrenia or bipolar disorder) with or without concomitant dementia who received care from the Veterans Health Administration between 2003 and 2010 were identified using International Classification of Diseases, Ninth Revision, codes (N = 93,068; 11.1% with dementia). Trends in SGA prescribing and odds of being prescribed an SGA were determined using a multivariable logistic regression model adjusted for clinical, sociodemographic, and geographic covariates. Between 2004 and 2009, SGA prescribing declined annually from 7.0% to 5.1% of elderly veterans with PTSD without dementia and 13.2% to 8.9% in those with dementia; findings over time consistently indicated that veterans with PTSD and dementia had at least twice the odds of being prescribed an SGA as those without PTSD (odds ratios 2.03 (95% confidence interval (CI) = 1.82-2.26) to 2.33 (95% CI = 2.10-2.58). Although the prescribing of SGAs to elderly veterans with PTSD has decreased, prescribing an SGA to those with dementia remained consistently higher than for those with PTSD alone and is problematic given the high prevalence of medical comorbidities in this aging population coupled with the lack of compelling evidence for effectiveness of SGAs in individuals with dementia. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

Temporal trends in outpatient management of incident pulmonary embolism and associated mortality.

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Klil-Drori, Adi J; Coulombe, Janie; Suissa, Samy; Hirsch, Andrew; Tagalakis, Vicky

2018-01-01

In clinical trial settings, outpatient management of pulmonary embolism (PE) is feasible and safe, but less is known on its use in routine care. We determined trends in outpatient management of PE and associated mortality in a large non-select patient population. All residents of Quebec, Canada with a first-ever work-up for suspected PE in the emergency department (ED) over 10years were included. Patients could transition to outpatient management and from unconfirmed to confirmed PE in a time-varying fashion. Comparing the years 2005-9 with 2000-4, we assessed the odds ratio (OR) for outpatient management, and relative risk (RR) for all-cause mortality, readmissions for PE, and major bleeding in 30days. We adjusted the RR for a mortality risk score. Of 15,217 patients included, 7583 were outpatients (7.5% confirmed PE) and 7634 were inpatients (60.6% confirmed PE). In all, 10.9% of patients with confirmed PE were outpatients, but outpatient management of confirmed PE was more likely in the latter study period (OR 1.73, 95%CI 1.44-2.09). Among outpatients with confirmed PE, mortality (RR 0.84, 95%CI 0.15-4.61) and readmission (RR 1.25, 95%CI 0.45-3.48) rates were stable, and only 3 major bleeding events were noted. Inpatients with confirmed PE had stable mortality rates (RR 0.95, 95%CI 0.72-1.24). Outpatient PE management increased over 10years while remaining fairly uncommon. Nevertheless, stable mortality and readmission rates indicate this practice is safe in routine care, and add to the growing evidence in support of outpatient PE management. Copyright © 2017 Elsevier Ltd. All rights reserved.

The elderly and general anesthesia

DEFF Research Database (Denmark)

Steinmetz, J; Rasmussen, L S

2010-01-01

Due to the aging population, the number of elderly patients taking advantage of healthcare services is increasing. A general physical decline of all organ systems and a high frequency of chronic disease accompanying aging.Comorbidity and polypharmacy are therefore common in the elderly. Hence, th......, the administration of general anesthesia to the elderly can be a very challenging task. This paper aims to highlight some of the important issues presented to the elderly undergoing surgery and to suggest some strategies for management....

NSAIDs utilization for musculoskeletal indications in elderly patients with cerebro/cardiovascular disease.

Science.gov (United States)

Roberto, Giuseppe; Bartolini, Claudia; Rea, Federico; Onder, Graziano; Vitale, Cristiana; Trifirò, Gianluca; Kirchmayer, Ursula; Chinellato, Alessandro; Lucenteforte, Ersilia; Corrao, Giovanni; Mugelli, Alessandro; Lapi, Francesco; Gini, Rosa

2018-05-01

To describe NSAID utilization for musculoskeletal conditions in a large cohort of Italian elderly with cerebro/cardiovascular disease, a population in which NSAIDs should be generally avoided due to the prothrombotic potential. Administrative data from five Italian geographic areas were analyzed. Patients aged ≥ 65 with a cerebro/cardiovascular event recorded between 2008 and 2011 (cohort entry) were selected. Prescription NSAIDs reimbursed for musculoskeletal conditions and dispensed during 1 year follow-up were retrieved to describe (i) prevalence of use, (ii) average amount of defined daily doses of NSAIDs claimed by users per day of follow-up, and (iii) distribution of the received daily dose (RDD) among patients with ≥ 2 dispensings. Among new users, i.e., patients without NSAID dispensings during 2 years before cohort entry, the first dispensed NSAID molecule was observed. Overall, 511,989 patients were selected. Across the five geographic areas, prevalence of use ranged from 48 to 21% and average consumption ranged between 30 and 67 DDD/1000 users/day. Around 10% of patients in the overall cohort had a RDD > 1. Nimesulide (9.6%) and diclofenac (7.5%) had the highest prevalence of use. The most consumed NSAIDs were nimesulide and coxibs with 10.6 and 7.5 DDD/1000 users/day, respectively. Among new users recruited in 2011, 30% had diclofenac or a coxibs as the first prescription. NSAID use was common in the study cohort, particularly in central-southern areas. In contrast with current recommendations, coxibs and diclofenac were among the most prescribed active principles, even in new users. Interventions to promote appropriateness of use are warranted.

Education and Italian Regional Development

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Di Liberto, Adriana

2008-01-01

In this paper, we study the connection between growth and human capital in a convergence regression for the panel of Italian regions. We include measures of average primary, secondary and tertiary education. We find that increased education seems to contribute to growth only in the South. Decomposing total schooling into its three constituent…

Lymphogranuloma venereum: the Italian experience

NARCIS (Netherlands)

Cusini, M.; Boneschi, V.; Arancio, L.; Ramoni, S.; Venegoni, L.; Gaiani, F.; de Vries, H.J.C.

2009-01-01

An epidemic of lymphogranuloma venereum (LGV) has been described in men who have sex with men (MSM) in the western world, particularly in western Europe. The first Italian case was reported by the authors in 2006, and up to March 2008 there have been 13 symptomatic cases, all in MSM. Ten cases had

Determinants of completion of advance directives: a cross-sectional comparison of 649 outpatients from private practices versus 2158 outpatients from a university clinic.

Science.gov (United States)

Pfirstinger, Jochen; Bleyer, Bernhard; Blum, Christian; Rechenmacher, Michael; Wiese, Christoph H; Gruber, Hans

2017-12-21

To compare outpatients from private practices and outpatients from a university clinic regarding the determinants of completion of advance directives (AD) in order to generalise results of studies from one setting to the other. Five determinants of completion of AD were studied: familiarity with AD, source of information about AD, prior experiences with own life-threatening diseases or family members in need of care and motives in favour and against completion of AD. Observational cross-sectional study. Private practices and a university clinic in Germany in 2012. 649 outpatients from private practices and 2158 outpatients from 10 departments of a university clinic. Completion of AD, familiarity with AD, sources of information about AD (consultation), prior experiences (with own life-threatening disease and family members in need of care), motives in favour of or against completion of AD, sociodemographic data. Determinants of completion of AD did not differ between outpatients from private practices versus university clinic outpatients. Prior experience with severe disease led to a significantly higher rate of completion of AD (33%/36% with vs 24%/24% without prior experience). Participants with completion of AD had more often received legal than medical consultation before completion, but participants without completion of AD are rather aiming for medical consultation. The motives in favour of or against completion of AD indicated inconsistent patterns. Determinants of completion of AD are comparable in outpatients from private practices and outpatients from a university clinic. Generalisations from university clinic samples towards a broader context thus seem to be legitimate. Only one-third of patients with prior experience with own life-threatening diseases or family members in need of care had completed an AD as expression of their autonomous volition. The participants' motives for or against completion of AD indicate that ADs are considered a kind of

HPV prevalence and HPV-related dysplasia in elderly women.

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Ruth S Hermansson

Full Text Available In Sweden, where screening ends at the age of 60, about 30% of the cervical cancer cases occur in women older than 60. The aim of the present study was to investigate the prevalence of HPV and cervical dysplasia in women of 60 years and above.From September 2013 until June 2015, 1051 women aged 60-89 years (mean 68 years were sampled for an HPV test when attending an outpatient gynecology clinic. Women with positive results had a second HPV test and liquid based cytology (LBC, after 3.5 months on average. Those with a positive second HPV test were examined by colposcopy, and biopsy and a sample for LBC was obtained.The prevalence of HPV was 4.1%, (95%CI 3.0-5.5, n = 43 at the first test, and at the second test 2.6% remained positive (95%CI 1.7-3.8, n = 27. The majority of women positive in both HPV tests, had dysplasia in histology, 81.5% (22/27 (4 CIN 2-0.4%, 18 CIN 1-1.7%. HPV-related dysplasia was found in 2.1%, (95%CI 1.3-3.2, n = 22 of the 1051 women. Four of the 22 women with positive HPV tests also had abnormal cytology, one ASCUS and three CIN 1. No cancer or glandular dysplasia was detected.A significant proportion of elderly women were found to have a persistent cervical HPV infection. Among them there was a high prevalence of CIN diagnosed by histology. The HPV test showed high sensitivity and specificity in detecting CIN in elderly women, while cytology showed extremely low sensitivity.

Pregnancy and internet: sociodemographic and geographic differences in e-health practice. Results from an Italian multicenter study.

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Scaioli, G; Bert, F; Galis, V; Brusaferro, S; De Vito, E; La Torre, G; Manzoli, L; Messina, G; Torregrossa, M V; Ricciardi, W; Gualano, M R; Siliquini, R

2015-09-01

Since the new millennium, the number of e-health users has significantly increased. Among these, a particular category of people who are interested by this phenomenon is the one of pregnant women. The aim of the present study is to assess the sociodemographic and geographic differences existing in a sample of Italian pregnant women who search for information on the web. Multicenter cross-sectional survey. The present study has been conducted from November 2011 to September 2012, in seven Italian cities, located in the North, in the Centre and in the South of Italy. Data were collected through an anonymous questionnaire, administered in waiting rooms of outpatient departments by trained medical doctors. Data were analysed through multivariate logistic regression models. Overall, 1347 responders were interviewed. Eighty-six percent of them declared to surf the internet to retrieve pregnancy-related information. The most searched topics were fetal development (51.3%), healthy lifestyle during pregnancy (48.7%), physiology of pregnancy (39.8%), generic and specific tips/advices during pregnancy (37.2%) and lactation (36.8%). Statistically significant differences (P < 0.05) according to geographic origin, age and educational level were found with regard to the most frequently searched information on the Web, the reasons that pushed pregnant women to practice e-health, and the possibility to change lifestyles after e-health. Our findings suggest that the phenomenon of pregnancy e-health is widespread and show social and geographic differences, in particular about city of residence, age and educational level. It might encourage healthcare professionals to be more available and exhaustive during routine visits and to be more careful about web content on this topic, also addressing the different needs into different geographic contexts. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

42 CFR 410.59 - Outpatient occupational therapy services: Conditions.

Science.gov (United States)

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Outpatient occupational therapy services... Other Health Services § 410.59 Outpatient occupational therapy services: Conditions. (a) Basic rule... occupational therapy services only if they are furnished by an individual meeting the qualifications in part...

42 CFR 410.60 - Outpatient physical therapy services: Conditions.

Science.gov (United States)

2010-10-01

... services furnished under § 410.62; (iii) Outpatient physical therapy and speech-language pathology services... physical therapy and speech-language pathology services furnished by a nurse practitioner, clinical nurse... 42 Public Health 2 2010-10-01 2010-10-01 false Outpatient physical therapy services: Conditions...

Israeli Perspectives on Elder Abuse

Science.gov (United States)

Rabi, Keren

2006-01-01

Despite the prevailing agreement among researchers that the increasing rate of elder abuse in Israel is relatively understudied, not sufficiently identified, and not appropriately addressed, literature on elderly abuse in the Israeli society remains limited. The common discourse on aging, eldercare, and elder abuse and neglect, mainly revolves…

Continuity of care of outpatients with schizophrenia in Pretoria ...

African Journals Online (AJOL)

Objective. To study the needs of outpatients suffering from schizophrenia and their primary caregivers. Methods. A qualitative descriptive design was selected to study the needs of a non-probability purposive sample of 50 outpatients with schizophrenia and their primary caregivers. Data were collected on their ...

Thoracoscopic Surgery for Pneumothorax Following Outpatient Drainage Therapy.

Science.gov (United States)

Sano, Atsushi; Yotsumoto, Takuma

2017-10-20

We investigated the outcomes of surgery for pneumothorax following outpatient drainage therapy. We reviewed the records of 34 patients who underwent operations following outpatient drainage therapy with the Thoracic Vent at our hospital between December 2012 and September 2016. Indications for outpatient drainage therapy were pneumothorax without circulatory or respiratory failure and pleural effusion. Indications for surgical treatment were persistent air leakage and patient preference for surgery to prevent or reduce the incidence of recurrent pneumothorax. Intraoperatively, 9 of 34 cases showed loose adhesions around the Thoracic Vent, all of which were dissected bluntly. The preoperative drainage duration ranged from 5 to 13 days in patients with adhesions and from 3 to 19 days in those without adhesions, indicating no significant difference. The duration of preoperative drainage did not affect the incidence of adhesions. The operative duration ranged from 30 to 96 minutes in patients with adhesions and from 31 to 139 minutes in those without adhesions, also indicating no significant difference. Outpatient drainage therapy with the Thoracic Vent was useful for spontaneous pneumothorax patients who underwent surgery, and drainage for less than 3 weeks did not affect intraoperative or postoperative outcomes.

Transportation and retention in outpatient drug abuse treatment programs.

Science.gov (United States)

Friedmann, P D; Lemon, S C; Stein, M D

2001-09-01

To determine whether certain types of transportation assistance improve outpatient treatment retention beyond thresholds shown to have therapeutic benefits, we analyzed data from 1,144 clients in 22 outpatient methadone maintenance (OMM) programs and 2,031 clients in 22 outpatient drug-free (ODF) programs in the Drug Abuse Treatment Outcomes Study (DATOS), a national, 12-month, longitudinal study of drug abuse treatment programs. Directors' surveys provided information about provision of car, van, or contracted transportation services or individual vouchers/payment for public transportation. Chart-abstracted treatment retention was dichotomized at 365 days for OMM and 90 days for ODF. Separate multivariate hierarchical linear models revealed that provision of car, van, or contracted transportation services improved treatment retention beyond these thresholds for both OMM and ODF, but individual vouchers or payment for public transportation did not. Future research should validate whether car, van, or contracted transportation services improve retention and other treatment outcomes in outpatient drug abuse treatment.

[Italian Cystic Fibrosis Registry. Report 2011-2014].

Science.gov (United States)

Giordani, Barbara; Amato, Annalisa; Majo, Fabio; Ferrari, Gianluca; Quattrucci, Serena; Minicucci, Laura; Padoan, Rita; Floridia, Giovanna; Puppo Fornaro, Gianna; Taruscio, Domenica; Salvatore, Marco

2018-01-01

The Italian Cystic Fibrosis Registry (ICFR) is based on a new agreement about the data flow towards the Registry signed on October, 4th 2016 by the Centre for Rare Diseases of the Italian National Institute of Health (NIH), the clinicians of the Italian National Referral and Support Centres for Cystic Fibrosis, the Paediatric Hospital "Bambino Gesù" (Rome), the Italian Cystic Fibrosis Society, and the Italian League for Cystic Fibrosis. The aim of the present Report is to improve the knowledge on cystic fibrosis (CF) through the epidemiological description of Italian patients. The members of the Scientific and Technical Committee have to write a report on data collected by ICFR, in order to contribute to achieve the aims of ICFR itself, i.e., to improve the care of CF patients. In particular, the Report should contribute to the following objectives: - to analyze the medium and long-term clinical and epidemiological trends of the disease; - to identify the main healthcare needs at regional and national level in order to contribute to the healthcare programmes and to the distribution of resources; - to compare Italian data with the international ones. Analyses and results described in the present Report are referred to patients in charge to the Italian National Referral and Support Centres for Cystic Fibrosis in the period 2011-2014. Data were sent by Centres by means of a specific software (Camilla, Ibis Informatica) and has undergone a double quality control (QC): the first by NIH and the second at a European level (before the inclusion of the Italian data within the European Cystic Fibrosis Registry). These QCs assure the completeness and accuracy of data as well as their consistency with European core data. A total of 29 different CF centres (referral, support, and Paediatric Hospital "Bambino Gesù") sent their data to ICFR; data referred to the period 2011-2014. Data regarding Sardinia Region (Southern Italy) are missing; data from Molise (Southern Italy) CF

Managing outpatient consultations: from referral to discharge.

Science.gov (United States)

Mitchell, Rachael; Jacob, Hannah; Morrissey, Benita; Macaulay, Chloe; Gomez, Kumudini; Fertleman, Caroline

2017-08-01

Although a great deal of paediatric consultations are not urgent, doctors in training spend so much time providing service for acute conditions that they spend little time focusing on outpatient work before they become a consultant. Engaging clinicians in the managerial aspects of providing clinical care is a key to improving outcomes, and this article addresses these aspects of the outpatient consultation from referral to discharge. We aim to provide doctors in training with a tool to use during their training and their first few years as a consultant, to think about how outpatient work is organised and how it can be improved to maximise patient experience. The non-urgent consultation varies across the world; this article is aimed to be relevant to an international audience. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Calculation of CO2 emissions from the italian energy system

International Nuclear Information System (INIS)

Contaldi, M.; La Motta, S.

2001-01-01

The calculation of CO2 emissions from the Italian energy system is the object of this work. The inventory method used is the Reference Approach from the Intergovernmental Panel for Climate Change (IPCC, 1996 revised Guidelines for National Greenhouse Gas Inventories) and the energy consumption data are taken from the Italian Energy Balance edited by the Ministry of Industry. The years analysed are those from 1990 to 2000 [it

Cost-of-illness in psoriasis: comparing inpatient and outpatient therapy.

Directory of Open Access Journals (Sweden)

Sabine I B Steinke

Full Text Available Treatment modalities of chronic plaque psoriasis have dramatically changed over the past ten years with a still continuing shift from inpatient to outpatient treatment. This development is mainly caused by outpatient availability of highly efficient and relatively well-tolerated systemic treatments, in particular BioLogicals. In addition, inpatient treatment is time- and cost-intense, conflicting with the actual burst of health expenses and with patient preferences. Nevertheless, inpatient treatment with dithranol and UV light still is a major mainstay of psoriasis treatment in Germany. The current study aims at comparing the total costs of inpatient treatment and outpatient follow-up to mere outpatient therapy with different modalities (topical treatment, phototherapy, classic systemic therapy or BioLogicals over a period of 12 months. To this end, a retrospective cost-of-illness study was conducted on 120 patients treated at the University Medical Centre Mannheim between 2005 and 2006. Inpatient therapy caused significantly higher direct medical, indirect and total annual costs than outpatient treatment (13,042 € versus 2,984 €. Its strong influence on cost levels was confirmed by regression analysis, with total costs rising by 104.3% in case of inpatient treatment. Patients receiving BioLogicals produced the overall highest costs, whereas outpatient treatment with classic systemic antipsoriatic medications was less cost-intense than other alternatives.

High-Dose Radioiodine Outpatient Treatment: An Initial Experience in Thailand

International Nuclear Information System (INIS)

Nantajit, Danupon; Saengsuda, Sureerat; NaNakorn, Pattama; Saengsuda, Yuthana

2015-01-01

The aim of this study was to determine whether high-dose radioactive iodine (Na 131 I) outpatient treatment of patients with thyroid carcinoma is a pragmatically safe approach, particularly for the safety of caregivers. A total of 79 patients completed the radiation-safety questionnaires prior to receiving high-dose radioactive iodine treatment. The questionnaire studied the subjects’ willingness to be treated as outpatients, along with the radiation safety status of their caregivers and family members. In patients, who were selected to be treated as outpatients, both internal and external radiation exposures of their primary caregivers were measured, using thyroid uptake system and electronic dosimeter, respectively. Overall, 62 out of 79 patients were willing to be treated as outpatients; however, only 44 cases were eligible for the treatment. The primary reason was that the patients did not use exclusive, separated bathrooms. The caregivers of 10 subjects, treated as outpatients, received an average radiation dose of 138.1 microsievert (mSv), which was almost entirely from external exposure; the internal radiation exposures were mostly at negligible values. Therefore, radiation exposure to caregivers was significantly below the public exposure limit (1 mSv) and the recommended limit for caregivers (5 mSv). A safe 131 I outpatient treatment in patients with thyroid carcinoma could be achieved by selective screening and providing instructions for patients and their caregivers

Running Joke: Criticism of Italian American Culture through Comedy in The Sopranos

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Fred Gardaphe

2016-06-01

Full Text Available Often read as tragic realism, The Sopranos has rarely been seen in the light of the comedy created in every episode.   While a number of television critics and commentators have compared the series to the tragedies of Shakespeare (Bushby, Macintyre, Varble, none have focused on the comic elements, which, as I will show, are descendants of Italian Commedia dell Arte and Shakespearean comedies.  The best way of seeing this is to focus on the character Paulie Walnuts, whom I see as an Italian American version of the zanni of the Commedia or the fool/clown of Shakespeare.  In this article, I present David Chase’s serial narrative as a comedy that serves not only to create laughter but also to criticize U.S. and especially Italian American culture through the character Paulie Walnuts.  Before I launch into this reading I want to present a few words on just how we might read the seriality of Chase’s narrative.  Through Paulie Walnuts, the writers of the show are able insert a running joke throughout the entire series that enables them to poke fun at traditional notions of Italian immigrant culture, and at the same time, show that those notions also serve as viable criticisms of U.S. capitalist culture.  Paulie, who is certainly more reactionary than revolutionary, reflects the many Italian Americans who assimilated quickly into American culture, in spite of holding on to traditions and superstitions of Italian folk culture.

Genetic variability of Italian Heavy Draught Horse

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Fabio Maretto

2010-01-01

Full Text Available This study aimed to analyze the genetic variability of the Italian Heavy Draught Horse (IHDH breed using a panel of 23 microsatellite markers. We also compared the population structure of the IHDH to other two unrelated breeds (Italian Haflinger, IH and Quarter Horse, QH. The IHDH showed a genetic variability comparable with other European heavy draught horse breeds and with the IH and QH breeds analyzed. Clustering analyses using a posterior Bayesian approach clearly differentiated the three breeds; it also showed a fragmentation of the IHDH in three subpopulations that need to be further investigated. These findings are an indicator of the present situation of the IHDH and will contribute to the conservation and implementation of the selection programme for this breed.

Outpatient diagnostic of bladder tumours in flexible cystoscopes

DEFF Research Database (Denmark)

Hermann, Gregers G; Mogensen, Karin; Toft, Birgitte Grønkær

2012-01-01

The aim of this study was to evaluate photodynamic diagnosis (PDD) in flexible cystoscopes and the diagnostic quality of biopsies for diagnosis of non-muscle-invasive bladder cancer in the outpatients department (OPD).......The aim of this study was to evaluate photodynamic diagnosis (PDD) in flexible cystoscopes and the diagnostic quality of biopsies for diagnosis of non-muscle-invasive bladder cancer in the outpatients department (OPD)....

Move to outpatient settings may boost medical hotels.

Science.gov (United States)

Burns, J

1992-06-08

The shift of surgeries to outpatient settings could be healthy for medical hotels, those amenity-equipped facilities originally developed to ease patients out of costly acute-care beds. Because fewer hospitals have a pressing need to use such alternative lodging, some medical hotels are hoping to hitch their fortunes to the outpatient trade, keeping patients overnight after surgeries that don't require hospital admission.

Unexplained somatic symptoms during major depression: prevalence and clinical impact in a national sample of Italian psychiatric outpatients.

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Perugi, Giulio; Canonico, Pier Luigi; Carbonato, Paolo; Mencacci, Claudio; Muscettola, Giovanni; Pani, Luca; Torta, Riccardo; Vampini, Claudio; Fornaro, Michele; Parazzini, Fabio; Dumitriu, Arina

2011-01-01

The aim of this study was to explore the prevalence and impact of unexplained somatic symptoms during major depression. A total of 560 consecutive outpatients with a major depressive episode according to the DSM-IV (text revision) were evaluated in 30 psychiatric facilities throughout Italy. 'Unexplained' somatic symptoms were evaluated using the 30-item Somatic Symptoms Checklist (SSCL-30). Somatic symptoms were considered explained if they were best accounted for as coming from a concomitant physical illness or side effects. Patients evaluated their own mood symptomatology using the Zung questionnaires for depression and anxiety and the Hypomania Checklist-32. According to the SSCL-30, only 90 subjects (16.1%) had no unexplained somatic symptoms, while 231 (41.3%) had 1-5 unexplained symptoms and 239 (42.7%) had more than 5. Asthenia was the most commonly observed unexplained somatic symptom (53% of patients). Unexplained somatic symptoms were more common in females and among those suffering from major depression and depression not otherwise specified rather than in patients with recurrent major depression and bipolar disorders. No relationship between unexplained somatic symptoms and hypomanic features was observed. The presence of a large number of unexplained somatic symptoms is associated with more severe depression and higher rates of misdiagnosis and inappropriate treatment. Copyright © 2011 S. Karger AG, Basel.

ENEL and application of Italian November 14, 1990 Decree CIP 34/3

International Nuclear Information System (INIS)

Vazio, A.

1991-01-01

As part of an overall energy conservation campaign, a concrete step, in the form of a more favourable electricity rate structure for auto-producers, is being taken by the Italian Government to encourage medium sized industries to adopt cogeneration systems to meet their heat and power requirements. Within this context, this paper gives an idea of how ENEL, the Italian National Electricity Board, administers contracts involving the ceding of on-site generated power to the national utility's grid. Reference is made to the specific provisions incorporated in the CIP (Italian Inter-ministerial Commission on Prices) Provision No. 34, dated November 14, 1990

Animal-assisted therapy at an outpatient pain management clinic.

Science.gov (United States)

Marcus, Dawn A; Bernstein, Cheryl D; Constantin, Janet M; Kunkel, Frank A; Breuer, Paula; Hanlon, Raymond B

2012-01-01

The objective of this study was to evaluate the effects of brief therapy dog visits to an outpatient pain management facility compared with time spent in a waiting room. The design of this study is open-label. Setting.  This study was conducted in a university tertiary care adult chronic pain outpatient clinic. The subjects of this study include outpatients, adults accompanying outpatients to their appointments, and clinic staff. Intervention.  Participants were able to spend clinic waiting time with a certified therapy dog instead of waiting in the outpatient waiting area. When the therapy dog was not available, individuals remained in the waiting area. Self-reported pain, fatigue, and emotional distress were recorded using 11-point numeric rating scales before and after the therapy dog visit or waiting room time. Two hundred ninety-five therapy dog visits (235 with patients, 34 family/friends, and 26 staff) and 96 waiting room surveys (83 from patients, 6 family/friends, and 7 staff) were completed over a 2-month study period. Significant improvements were reported for pain, mood, and other measures of distress among patients after the therapy dog visit but not the waiting room control, with clinically meaningful pain relief (decrease ≥2 points) in 23% after the therapy dog visit and 4% in the waiting room control. Significant improvements were likewise seen after therapy dog visits for family/friends and staff. Therapy dog visits in an outpatient setting can provide significant reduction in pain and emotional distress for chronic pain patients. Therapy dog visits can also significantly improve emotional distress and feelings of well-being in family and friends accompanying patients to appointments and clinic staff. Wiley Periodicals, Inc.

Epilepsy in the Elderly

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Lu-An Chen

2012-06-01

Full Text Available Elderly people are the largest and continuously fastest growing population among patients with epilepsy. Elderly patients with epilepsy are very different from other age groups in many respects and clinicians shouldn’t treat them in the same way as younger adults. Accurate diagnosis of epilepsy in the elderly is much more difficult and atypical manifestations and misdiagnoses are certainly not the exception. Syncope is probably the most important differential diagnosis. High clinical suspicion and proper investigation are the best tools for prompt diagnosis. Etiologies of late-onset epilepsy are mainly symptomatic and cerebrovascular diseases are the most common causes in this age group, followed by degenerative diseases such as Alzheimer’s disease. It is appropriate to consider starting antiepileptic drug (AED treatment at the first-ever seizure in elderly patients who have remote symptomatic causes such as stroke and dementia. According to the high recurrence rate of seizure and the good response to AEDs in elderly patients, the proper choice from various AEDs for seizure control is very important. Decision-making for AED choice depends on many different factors, including pharmacological properties, efficacy, tolerability from side effects, drug interactions, and medical comorbidities. The newer AEDs with lesser adverse effects and fewer drug interactions appear to be reasonable treatment options for elderly patients. However, more evidence from clinical trials in this specific age group is warranted.

Low FT3: a possible marker of frailty in the elderly

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Bertoli A

2017-02-01

Full Text Available Aldo Bertoli,1 Alessia Valentini,1 Maria Assunta Cianfarani,1 Elena Gasbarra,2 Umberto Tarantino,2 Massimo Federici1 1Department of Systems Medicine, University of Rome “Tor Vergata”, Rome, Italy; 2Department of Orthopaedics and Traumatology, University of Rome “Tor Vergata”, Rome, Italy Introduction: Frailty is associated with a functional decline of multiple physiological systems, of which they may be a cause or consequence. The objective of the study was to evaluate the prevalence of thyroid hormone modifications in elderly frail subjects and its relationship with frailty.Study population and methods: An observational study was carried out at the University Hospital “Tor Vergata” in Rome among ambulatory and hospitalized patients. The study population consisted of 112 elderly subjects: 62 were hospitalized following hip fracture and 50 control subjects were outpatients. Participating patients received a multidimensional geriatric evaluation. The Survey of Health, Ageing and Retirement in Europe Frailty Instrument (SHARE-FI was used to assess the degree of frailty. Thyroid stimulating hormone (TSH, free triiodothyronine (FT3, and free thyroxine (FT4 were measured to evaluate thyroid status.Results: FT3, but not FT4, was significantly correlated with Frailty score, both in patients with hip fracture and in patients from the control group. In the entire study population, FT3 under normal limits is effective in discriminating frail/prefrail subjects from nonfrail subjects.Discussion: The reduction in serum concentrations of FT3 is a clear manifestation of stress associated with fractures. Numerous preexisting factors, such as the fracture patients’ nutritional status, sarcopenia, disability and comorbidities, which characterize the condition of frailty and influence its pathogenesis, are strongly correlated with FT3 values, suggesting the existence of latent nonthyroidal illness syndrome (NTIS.Conclusion: We conclude that measuring

Prevalence and Risk of Polypharmacy Among Elderly Cancer Patients Receiving Chemotherapy in Ambulatory Oncology Setting.

Science.gov (United States)

Goh, Ivy; Lai, Olive; Chew, Lita

2018-03-26

This was a single center, retrospective cross-sectional study looking into the incidence and types of drug-related problems (DRPs) detected among elderly cancer patients receiving at least three long-term medications concurrent with IV chemotherapy, and the types of intervention taken to address these DRPs. This paper serves to elucidate the prevalence and risk of polypharmacy in our geriatric oncology population in an ambulatory care setting, to raise awareness on this growing issue and to encourage more resource allocation to address this healthcare phenomenon. DRP was detected in 77.6% of elderly cancer patients receiving at least three long-term medications concurrent with IV chemotherapy, with an average incidence of three DRPs per patient. Approximately half of DRPs were related to long-term medications. Forty percent of DRPs required interventions at the prescriber level. The use of five or more medications was shown to almost double the risk of DRP occurrence (OR 1.862, P = 0.039). Out of the eight predefined categories of DRPs, underprescribing was the most common (26.7%), followed by adverse drug reaction (25.0%) and drug non-adherence (16.2%). Polypharmacy leading to DRPs is a common occurrence in elderly cancer patients receiving outpatient IV chemotherapy. There should be systematic measures in place to identify patients who are at greater risk of inappropriate polypharmacy and DRPs, and hence more frequent drug therapy optimization and monitoring. The identification of DRPs is an important step to circumvent serious drug-related harm. Future healthcare interventions directed at reducing DRPs should aim to assess the clinical and economic impact of such interventions.

["They are enjoying their first holiday ever"--working with the elderly, from the post-war years up to the early 1970s].

Science.gov (United States)

Matron, Kristina

2014-01-01

While, in the post-war years and into the 1950s, the building of old people's and care homes and the allocation of home places in those homes was seen as the main task of municipal care institutions for the elderly in Frankfurt am Main, in the decade that followed their main task shifted towards increasing the possibilities of providing care in people's own homes, delaying the move into old people's homes and breaking through the loneliness that elderly people were presumed to experience. Supported by the state, community housing was provided with flats for elderly people and with carers to look after their needs. The "warm rooms" of the post-war period changed into clubs, where members met and received guidance. In the late 1960s the clubs were extended into day-care centres, offering a range of consultation services, organized day trips and recreational holidays for the elderly. It was hoped that "meals-on-wheels" in combination with age-appropriate living conditions would delay the move into a home. But these plans were not adequately developed in the 1960s and often it was not clear who would pay the bills. The same was true of outpatient medical care which had traditionally been the task of community nurses, but was now increasingly carried out by local authority carers, who also provided household assistance. This kind of care could only ever be given for a limited period of time and, while it was able to delay the move into an old people's home, it could not replace it.

Conscientious Objection to Animal Experimentation in Italian Universities.

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Baldelli, Ilaria; Massaro, Alma; Penco, Susanna; Bassi, Anna Maria; Patuzzo, Sara; Ciliberti, Rosagemma

2017-03-13

In Italy, Law 413/1993 states that public and private Italian Institutions, including academic faculties, are obliged to fully inform workers and students about their right to conscientious objection to scientific or educational activities involving animals, hereafter written as "animal CO". However, little monitoring on the faculties' compliance with this law has been performed either by the government or other institutional bodies. Based on this premise, the authors have critically reviewed the existing data and compared them with those emerging from their own investigation to discuss limitations and inconsistencies. The results of this investigation revealed that less than half of Italian academic faculties comply with their duty to inform on animal CO. Non-compliance may substantially affect the right of students to make ethical choices in the field of animal ethics and undermines the fundamental right to express their own freedom of thought. The Italian Ministry of Education, Universities and Research, ethics committees and animal welfare bodies should cooperate to make faculties respect this law. Further research is needed to better understand the reasons for the current trend, as well as to promote the enforcement of Law 413/1993 with particular regard to information on animal CO.

Italian translation and cross-cultural comparison with the Childhood Attachment and Relational Trauma Screen (CARTS).

Science.gov (United States)

Simonelli, A; Sacchi, C; Cantoni, L; Brown, M; Frewen, P

2017-01-01

Background : The Childhood Attachment and Relational Trauma Screen (CARTS) is a computer-administered survey designed to assess retrospectively the socio-ecological context in which instances of child abuse may have occurred. To date, studies supporting the validity of the CARTS have only been undertaken in English-speaking North American populations. Validation projects in other countries and cross-cultural comparisons are therefore warranted. Objective : Develop and preliminarily evaluate the psychometric properties of an Italian version of the CARTS on college students and compare such observations to data acquired from Canadian students. Method : Seventy-nine undergraduate students from the University of Padua (Italy) completed an Italian translation of the CARTS as well as measures of childhood experiences, mental health and attachment, responses to which were compared to those obtained in 288 Canadian students who completed the CARTS in English. Results : Internal consistency and convergent validity with the Childhood Trauma Questionnaire and Parental Bonding Instrument were found to be acceptable for the Italian translation. Within the Italian sample, correlation analyses suggested that CARTS Mother ratings referring to attachment and abuse were associated with romantic attachment, whereas CARTS Father ratings were significantly correlated to PTSD symptoms and other symptoms of psychopathology-distress. Significant differences between Italian and Canadian students across the relationship types for the CARTS abuse and attachment scales were found, indicating that Italian students rated their mothers and fathers as simultaneously less abusive, but also less as a source of secure attachment. Conclusions : The results of this preliminary study seem to suggest convergent validity of the Italian CARTS and the association between childhood attachment-related experiences and romantic attachment. Cultural variations were identified between Canadian and Italian

Poverty among Elderly in India

Science.gov (United States)

Srivastava, Akanksha; Mohanty, Sanjay K.

2012-01-01

Using consumption expenditure data of the National Sample Survey 2004-2005, this paper estimates the size of elderly poor and tests the hypotheses that elderly households are not economically better-off compared to non-elderly households in India. Poverty estimates are derived under three scenarios--by applying the official cut-off point of the…

Immigration policy and birth weight: Positive externalities in Italian law.

Science.gov (United States)

Salmasi, Luca; Pieroni, Luca

2015-09-01

A decade ago, the political party of the Italian center-right voted a law restricting immigration. The law became effective in early 2005, when the Italian parliament approved the decree for its application, but one of its articles, granting amnesty for illegal immigrant workers, became immediately effective in July 2002. As a result, 650,000 immigrants were granted the status of foreign nationals in Italy. In this paper, we examine whether the increase in the prevalence of "regular immigrants" has led to an improvement in health outcomes of babies born to migrant women, measured in terms of birth weight. Two hitherto unexploited birth sample surveys published by Italian Institute of Statistics were used for this study. Our estimates show that regularized immigration reduced the probability of low birth weight. Copyright © 2015 Elsevier B.V. All rights reserved.

Phenomenology of ELDER dark matter

Science.gov (United States)

Kuflik, Eric; Perelstein, Maxim; Lorier, Nicolas Rey-Le; Tsai, Yu-Dai

2017-08-01

We explore the phenomenology of Elastically Decoupling Relic (ELDER) dark matter. ELDER is a thermal relic whose present density is determined primarily by the cross-section of its elastic scattering off Standard Model (SM) particles. Assuming that this scattering is mediated by a kinetically mixed dark photon, we argue that the ELDER scenario makes robust predictions for electron-recoil direct-detection experiments, as well as for dark photon searches. These predictions are independent of the details of interactions within the dark sector. Together with the closely related Strongly-Interacting Massive Particle (SIMP) scenario, the ELDER predictions provide a physically motivated, well-defined target region, which will be almost entirely accessible to the next generation of searches for sub-GeV dark matter and dark photons. We provide useful analytic approximations for various quantities of interest in the ELDER scenario, and discuss two simple renormalizable toy models which incorporate the required strong number-changing interactions among the ELDERs, as well as explicitly implement the coupling to electrons via the dark photon portal.

Evidence-Based Practices in Outpatient Treatment for Eating Disorders

Science.gov (United States)

Schaffner, Angela D.; Buchanan, Linda Paulk

2010-01-01

This study examined the current issues relevant to implementing evidence-based practices in the context of outpatient treatment for eating disorders. The study also examined the effectiveness of an outpatient treatment program for eating disorders among a group of 196 patients presenting with anorexia nervosa, bulimia nervosa, or eating disorder…

Understanding elder abuse in family practice

Science.gov (United States)

Yaffe, Mark J.; Tazkarji, Bachir

2012-01-01

Abstract Objective To discuss what constitutes elder abuse, why family physicians should be aware of it, what signs and symptoms might suggest mistreatment of older adults, how the Elder Abuse Suspicion Index might help in identification of abuse, and what options exist for responding to suspicions of abuse. Sources of information MEDLINE, PsycINFO, and Social Work Abstracts were searched for publications in English or French, from 1970 to 2011, using the terms elder abuse, elder neglect, elder mistreatment, seniors, older adults, violence, identification, detection tools, and signs and symptoms. Relevant publications were reviewed. Main message Elder abuse is an important cause of morbidity and mortality in older adults. While family physicians are well placed to identify mistreatment of seniors, their actual rates of reporting abuse are lower than those in other professions. This might be improved by an understanding of the range of acts that constitute elder abuse and what signs and symptoms seen in the office might suggest abuse. Detection might be enhanced by use of a short validated tool, such as the Elder Abuse Suspicion Index. Conclusion Family physicians can play a larger role in identifying possible elder abuse. Once suspicion of abuse is raised, most communities have social service or law enforcement providers available to do additional assessments and interventions. PMID:23242889

The performance of the Mini-Cog in a sample of low educational level elderly.

Science.gov (United States)

Ribeiro Filho, Sergio Telles; Lourenço, Roberto Alves

2009-01-01

To study the criterion validity of the Mini-Cog in low educational level elderly. Design: Cross-sectional and validation design. Setting: Policlínica Piquet Carneiro, an outpatient unit of Rio de Janeiro State University Hospital, in Brazil. Participants: A convenient sample consisting of 306 individuals, 65 yrs or older, selected from April 8 th to July 15 th , 2002. All participants underwent comprehensive geriatric evaluations which included the Mini-Mental State Examination (MMSE) and the cognitive part of the Cambridge Examination for Mental Disorders of the Elderly - Revised (CAMCOG-R). They were classified as demented or non-demented (DSM-IV). A post-hoc analysis was performed on the data from the 3 word recall test of the MMSE, and the Clock Drawing Test from the CAMCOG-R, and respective scores were added and interpreted in accordance with the Mini-Cog protocol. 293 individuals completed all the study steps; 211 had 4 or less years of schooling and were included in the data analysis. 32% had dementia. Mini-Cog sensitivity and specificity was consistently low independently of the different cut-off points considered. The best performance was found at the cut-off point of 2/3 which yielded sensitivity and specificity of 60% and 65%, respectively. The Mini-Cog is not a good cognitive screening tool for individuals with less than five years of formal education.

Daily Family Routines of Italian and Ecuadorian Immigrant Mothers in Everyday Life

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Nadia Rania

2015-10-01

Full Text Available This study compares Italian mothers’ and Ecuadorian immigrant mothers’ daily family routines. Thirty mothers took part in this investigation: 15 Italians (M = 37.5 years, with ages ranging from 30 to 42 years and 15 Ecuadorians (M = 36.1 years, with ages ranging from 18 to 46 years and having lived in Italy for an average of 15 years, with children ranging in age from 4 to 8 years. The objective is to highlight the differences and similarities between the daily routines and family relations that characterize the lives of each of the two groups of participants. The instruments employed in service of these aims were in-depth interviews and diaries. The results showed similarities regarding the routines of Italian and Ecuadorian families. However, a relevant difference emerged regarding their perceptions of social support. Specifically, Italians receive more social support from their parents than do Ecuadorians, who are supported more by other relatives or by friends.

Italian consensus on Eular 2003 recommendations for the treatment of knee osteoarthritis

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P. Patrignani

2011-09-01

Full Text Available The recommendations for the management of osteoarthritis (OA of the knee firstly proposed by the EULAR in 2000, have been updated in 2003. One of the most important objectives of the expert charged to provide these recommendations was their dissemination. Thus, the information generated may be used by each individual country to produce their own set of management guidelines and algorithms for treatment in primary care. The Italian Society of Rheumatology (SIR and the Italian League against Rheumatism (LIMAR have organised a Consensus on the EULAR recommendations 2003 with the aim to analyse their acceptability and the applicability according to our own experience and local situations in the Italy. The results of this Consensus have demonstrated that a large majority of the EULAR recommendations are endorsed by the Italian experts. Furthermore, the final document of the Italian Consensus clearly indicated the need that the specialists involved in the management of knee OA strongly encourage the dissemination of the EULAR 2003 recommendations also in Italy.

[Articles on elderly in Serbian medical journals].

Science.gov (United States)

Despotović, Nebojsa; Milosević, Dragoslav P; Erceg, Predrag; Davidović, Mladen

2009-01-01

Population aging is a feature of all countries in the world. According to statistics, the Republic of Serbia is one of the countries with the majority of the elderly. Taking this into account, are articles on the elderly well represented in domestic medical journals? The aim of the paper was to determine whether there was a sufficient number of articles on the elderly in domestic medical journals. The articles on the elderly were searched using search engines in domestic and foreign medical journals for the last 5 years compared with the number of articles on children in the same publications for the same period. In the Serbian Citation Index, 11 articles on the topic of the elderly, and 487 on children were registered. In Srpski arhivza celokupno lekarstvo, there was registered only one article on the topic of the elderly, and 30 on children. In Vojnosanitetskipregled, 2 articles on the elderly and 13 on children were registered (p articles on the elderly and 759 articles on children; in the JAMA, there were 63 articles on the elderly and 303 articles on children; and in The Lancet, in the last five years, 46 articles on the elderly and 148 articles on children were published. The themes of the elderly were rarely represented in Serbian medical journals.This has reduced the interest of physicians in medical problems of this growing population of patients and further sent them away from making standards in the diagnosis and treatment of the elderly.

Emotion socialization practices in Italian and Hong Kong-Chinese mothers

OpenAIRE

Fiorilli, Caterina; De Stasio, Simona; Di Chicchio, Carlo; Chan, Siu Mui

2015-01-01

Background Parents? emotion socialization practices are their ways of handling their children?s emotional experiences in light of cultural expectations surrounding emotions. Such practices are thought to significantly affect children?s social adjustment. We compared the parenting practices of Italian and Hong Kong Chinese samples in an ethnological validation study of the maternal responses to children?s emotion scale (MRCES). Participants were 71 Italian mothers (M?=?39.45) and 71 Hong Kong-...

The Italian productivity slowdown in a Real Business Cycle perspective

OpenAIRE

Francesca Marino

2013-01-01

This paper investigates the structural relation between the italian weak macroeco- nomic performances and the productivity decline experienced over the last Öfteen years, estimating a Dynamic Stochastic General Equilibrium (DSGE) model. Modifying Ire- land and SchuhiÌ s (2008) two-sector RBC model in order to account for cointegration between consumption and investment, we interpret the unsatisfactory italian economic dynamics in light of a permanent negative shock to the component of produ...

42 CFR 440.20 - Outpatient hospital services and rural health clinic services.

Science.gov (United States)

2010-10-01

... Definitions § 440.20 Outpatient hospital services and rural health clinic services. (a) Outpatient hospital... services that are not generally furnished by most hospitals in the State. (b) Rural health clinic services... 42 Public Health 4 2010-10-01 2010-10-01 false Outpatient hospital services and rural health...

Treatment in a specialised out-patient mood disorder clinic v. standard out-patient treatment in the early course of bipolar disorder

DEFF Research Database (Denmark)

Kessing, Lars Vedel; Hansen, Hanne Vibe; Hvenegaard, Anne

2013-01-01

BACKGROUND: Little is known about whether treatment in a specialised out-patient mood disorder clinic improves long-term prognosis for patients discharged from initial psychiatric hospital admissions for bipolar disorder. AIMS: To assess the effect of treatment in a specialised out-patient mood...... disorder clinic v. standard decentralised psychiatric treatment among patients discharged from one of their first three psychiatric hospital admissions for bipolar disorder. METHOD: Patients discharged from their first, second or third hospital admission with a single manic episode or bipolar disorder were...... randomised to treatment in a specialised out-patient mood disorder clinic or standard care (ClinicalTrials.gov: NCT00253071). The primary outcome measure was readmission to hospital, which was obtained from the Danish Psychiatric Central Register. RESULTS: A total of 158 patients with mania/bipolar disorder...

Rib and sternum fractures in the elderly and extreme elderly following motor vehicle crashes.

Science.gov (United States)

Bansal, Vishal; Conroy, Carol; Chang, David; Tominaga, Gail T; Coimbra, Raul

2011-05-01

As the population ages, the need to protect the elderly during motor vehicle crashes becomes increasingly critical. This study focuses on causation of elderly rib and sternum fractures in seriously injured elderly occupants involved in motor vehicle crashes. We used data from the Crash Injury Research and Engineering Network (CIREN) database (1997-2009). Study case criteria included occupant (≥ 65 years old) drivers (sitting in the left outboard position of the first row) or passengers (sitting in the first row right outboard position) who were in frontal or side impacts. To avoid selection bias, only occupants with a Maximum Abbreviated Injury Scale (MAIS) 3 (serious) or greater severity injury were included in this study. Odds ratios were used as a descriptive measure of the strength of association between variables and Chi square tests were used to determine if there was a statistically significant relationship between categorical variables. Of the 211 elderly (65-79 years old) occupants with thoracic injury, 92.0% had rib fractures and 19.6% had sternum fractures. For the 76 extreme elderly (80 years or older) with thoracic injury, 90.4% had rib fractures and 27.7% had sternum fractures. Except for greater mortality and more rib fractures caused by safety belts, there were no differences between the extreme elderly and the elderly occupants. Current safety systems may need to be redesigned to prevent rib and sternum fractures in occupants 80 years and older. Copyright © 2010 Elsevier Ltd. All rights reserved.

Impact of Air Pollutants on Outpatient Visits for Acute Respiratory Outcomes

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Ran Li

2017-01-01

Full Text Available The air pollution in China is a severe problem. The aim of our study was to investigate the impact of air pollutants on acute respiratory outcomes in outpatients. Outpatient data from 2 December 2013 to 1 December 2014 were collected, as well as air pollutant data including ozone (O3, nitrogen dioxide (NO2, carbon monoxide (CO, sulfur dioxide (SO2, and particulate matter (PM2.5 and PM10. We screened six categories of acute respiratory outcomes and analyzed their associations with different air pollutant exposures, including upper respiratory tract infection (URTI, acute bronchitis (AB, community-acquired pneumonia (CAP, acute exacerbation of chronic obstructive pulmonary disease (AECOPD, acute exacerbation of asthma (AE-asthma, and acute exacerbation of bronchiectasis (AEBX. A case-crossover design with a bidirectional control sampling approach was used for statistical analysis. A total of 57,144 patients were enrolled for analysis. PM2.5, PM10, NO2, SO2, and CO exposures were positively associated with outpatient visits for URTI, AB, CAP, and AEBX. PM10, SO2, and CO exposures were positively associated with outpatient visits for AECOPD. Exposure to O3 was positively associated with outpatient visits for AE-asthma, but negatively associated with outpatient visits for URTI, CAP, and AEBX. In conclusion, air pollutants had acute effects on outpatient visits for acute respiratory outcomes, with specific outcomes associated with specific pollutants.

Is Morphological Awareness a Relevant Predictor of Reading Fluency and Comprehension? New Evidence From Italian Monolingual and Arabic-Italian Bilingual Children

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Mirta Vernice

2018-03-01

Full Text Available In this study, we examined the contribution of morphological awareness to reading competence in a group of Italian L1 and Arabic-Italian early L2 children, i.e., exposed to Italian before 3 years of age. Children from first to fifth grade (age range: 6–11 years old were tested on a range of morphological awareness and lexical tasks. Reading ability was tested through standardized tests of reading fluency and comprehension. Results showed that L1 children outperformed L2 on every measure of morphological awareness, as well as on reading tests. Regression analyses revealed that morphological awareness contributed to a different extent to reading ability across groups. Accuracy in the morphological awareness tasks was a significant predictor of word (and non-word reading fluency in L1 and L2 first and second graders, while only in L1 third to fifth graders, response times and accuracy to a morphological awareness task explained a unique amount of variance in reading comprehension. Our results highlight the critical role of morphological processing in reading efficiency and suggest that a training inspired by morphological awareness may improve reading skills also in bilingual students.

The Effects of Functional Training, Bicycle Exercise, and Exergaming on Walking Capacity of Elderly Patients With Parkinson Disease: A Pilot Randomized Controlled Single-blinded Trial.

Science.gov (United States)

Ferraz, Daniel Dominguez; Trippo, Karen Valadares; Duarte, Gabriel Pereira; Neto, Mansueto Gomes; Bernardes Santos, Kionna Oliveira; Filho, Jamary Oliveira

2018-05-01

To compare the effects of functional training, bicycle exercise, and exergaming on walking capacity of elderly with Parkinson disease (PD). A pilot randomized, controlled, single-blinded trial. A state reference health care center for elderly, a public reference outpatient clinic for the elderly. Elderly individuals (≥60 years of age; N=62) with idiopathic PD (stage 2 to 3 of modified Hoehn and Yahr staging scale) according to the London Brain Bank. The participants were randomly assigned to three groups. Group 1 (G1) participated in functional training (n=22); group 2 (G2) performed bicycle exercise (n=20), and group 3 (G3) trained with Kinect Adventures (Microsoft, Redmond, WA) exergames (n=20). The primary outcome measure was the 6-minute walk test (6MWT); secondary outcome measures were the 10-m walk test (10MWT), sitting-rising test (SRT), body mass index, Parkinson Disease Questionnaire-39, World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0), and 15-item Geriatric Depression Scale. All groups showed significant improvements in 6MWT (G1 P=.008; G2 P=.001; G3 P=.005), SRT (G1 Ptraining had similar outcomes compared with functional training and bicycle exercise. The three physical exercise modalities presented significant improvements on walking capacity, ability to stand up and sit, and functionality of the participants. Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Frailty and the relationship between blood pressure and mortality in elderly patients with type 2 diabetes (Zwolle Outpatient Diabetes project Integrating Available Care-34)

NARCIS (Netherlands)

van Hateren, Kornelis J. J.; Hendriks, Steven H.; Groenier, Klaas H.; Bakker, Stephan J. L.; Bilo, Henk J. G.; Kleefstra, Nanne; Landman, Gijs W. D.

Objective: We aimed to investigate whether adjustment for frailty influences the relationship of blood pressure with mortality in elderly patients with type 2 diabetes mellitus (T2DM). Methods: Patients aged 60 years and older (n = 858) were selected from a prospective observational cohort study of

Elder Abuse and Neglect

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Muge Gulen

2013-06-01

Full Text Available Abuse and neglect are preventable societal problems that influence elderly individuals physically, spiritually and socially. Elder abuse is neglected for many years and is a growing problem all over the world. The aim of this article is to review the evaluation of elderly individuals who are exposed to abuse and neglect with systematic detailed history and physical examination and to describe individual, familial, and social measures that should be taken to prevent these abuses. [Archives Medical Review Journal 2013; 22(3.000: 393-407

Personality of outpatients with malignant tumors: a cross-sectional study

Directory of Open Access Journals (Sweden)

Wang Zhuo

2012-09-01

Full Text Available Abstract Background There have been scarce large-scale studies investigating the personality of patients with malignant tumors. The purpose of this study is to determine the characteristic personality in malignant tumors outpatients. Methods Three thousand and three among 5013 consecutive outpatients who consented to answer the Japanese Maudsley Personality Inventory questionnaires were divided into two groups. 603 outpatients diagnosed with malignant tumors (M group and the other 2400 outpatients (non-M group were enrolled in this study. We determined three scores such as introversion/extroversion (E-score, neuroticism (N-score, and lie detection (L-score. All data were used to compare the two groups. Results Average E-score was slightly higher, and average N-score was slightly lower in M group than that in non-M group, and no significant differences between the two groups. However, the average L-score in M group was significant higher than that in non-M group (p  Conclusion Outpatients with malignant tumors showed a significantly higher L-score on MPI when compared with patients with non-malignant tumors. These results stress the importance of taking the mentality of patients with cancer into consideration when conducting treatment and care.

Outcome of Pediatric Gastroenterology Outpatients With Fever and Central Line.

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Alexander, Thomas; Blatt, Julie; Skinner, Asheley Cockrell; Jhaveri, Ravi; Jobson, Meghan; Freeman, Katherine

2016-11-01

Although management algorithms for fever and central venous catheters (CVCs) have been implemented for pediatric oncology (PO) patients, management of pediatric outpatients with noncancer diagnoses and CVCs lacks clear protocols. The aim of the study was to assess outcomes for pediatric outpatients with gastrointestinal disorders presenting with fever and CVC. Using a microbiology database and emergency department records, we created a database of pediatric gastroenterology (PGI) and PO outpatients with fever and a CVC who presented to our emergency department or clinics from January 2010 through December 2012. We excluded patients who had severe neutropenia (absolute neutrophil count, gastroenterology outpatients with fever and a CVC have a high prevalence of bloodstream infection. Algorithms for management need to be subspecialty specific. Pediatric gastroenterology patients presenting to emergency departments or clinics with fever and CVC require admission for monitoring and management.

Elder abuse telephone screen reliability and validity.

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Buri, Hilary M; Daly, Jeanette M; Jogerst, Gerald J

2009-01-01

(a) To identify reliable and valid questions that identify elder abuse, (b) to assess the reliability and validity of extant self-reported elder abuse screens in a high-risk elderly population, and (c) to describe difficulties of completing and interpreting screens in a high-need elderly population. All elders referred to research-trained social workers in a community service agency were asked to participate. Of the 70 elders asked, 49 participated, 44 completed the first questionnaire, and 32 completed the duplicate second questionnaire. A research assistant administered the telephone questionnaires. Twenty-nine (42%) persons were judged abused, 12 (17%) had abuse reported, and 4 (6%) had abuse substantiated. The elder abuse screen instruments were not found to be predictive of assessed abuse or as predictors of reported abuse; the measures tended toward being inversely predictive. Two questions regarding harm and taking of belongings were significantly different for the assessed abused group. In this small group of high-need community-dwelling elders, the screens were not effective in discriminating between abused and nonabused groups. Better instruments are needed to assess for elder abuse.

Attivita del Centro di Linguistica Applicata nel campo della lingua e della cultura italiana all'estero (Activities of the Italian Center for Applied Linguistics concerning Italian Language and Culture Abroad).

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Boriosi Katerinov, Maria Clotilde

1979-01-01

Outlines the activities of a recently created section of the Italian Center for Applied Linguistics (CILA), dealing with "Teaching Italian Abroad." Describes these activities as encompassing four areas: research, teaching methodology, consultation, teachers' training and bibliographical information. Lists statistical surveys, research papers, and…

Great landslide events in Italian artificial reservoirs

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A. Panizzo

2005-01-01

Full Text Available The empirical formulations to forecast landslide generated water waves, recently defined in the framework of a research program funded by the Italian National Dam Office RID (Registro Italiano Dighe, are here used to study three real cases of subaerial landslides which fell down italian artificial reservoirs. It is well known that impulse water waves generated by landslides constitute a very dangerous menace for human communities living in the shoreline of the artificial basin or downstream the dam. In 1963, the menace became tragedy, when a 270 millions m3 landslide fell down the Vajont reservoir (Italy, generated an impulse wave which destroyed the city of Longarone, and killed 2000 people. The paper is aimed at presenting the very satisfactorily reproduction of the events at hand by using forecasting formulations.  

Great landslide events in Italian artificial reservoirs

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Panizzo, A.; de Girolamo, P.; di Risio, M.; Maistri, A.; Petaccia, A.

2005-09-01

The empirical formulations to forecast landslide generated water waves, recently defined in the framework of a research program funded by the Italian National Dam Office RID (Registro Italiano Dighe), are here used to study three real cases of subaerial landslides which fell down italian artificial reservoirs. It is well known that impulse water waves generated by landslides constitute a very dangerous menace for human communities living in the shoreline of the artificial basin or downstream the dam. In 1963, the menace became tragedy, when a 270 millions m3 landslide fell down the Vajont reservoir (Italy), generated an impulse wave which destroyed the city of Longarone, and killed 2000 people. The paper is aimed at presenting the very satisfactorily reproduction of the events at hand by using forecasting formulations.

Italian students win a trip to CERN

CERN Multimedia

2006-01-01

The six winners of the Progetto Lauree Scientifiche came to CERN to discover the LHC experiments. Six Italian high-school students visited CERN last week as part of a biennial project sponsored by the Italian Research ministry, the University of Ferrara and INFN. A total of 160 enthusiastic students took part in the project, which aims to introduce and foster interest in higher levels of science and technology. The Progetto Lauree Scientifiche prize was awarded to these students for their excellent grades in an examination covering various areas of physics, including laser, solid and particle physics. The winners spent six days at CERN touring the Laboratory and seeing first-hand the various aspects of research in one of the leading European centres, as well as the excitement of the particle physics adventure.

Energy and competition in italian industry

International Nuclear Information System (INIS)

Zanetti, G.

2000-01-01

The analysis of competition of the Italian production is based on the analysis of the prices. The most important period is between the first petroliferol crisis and these days. The production is concentrated on sector of old tradition and executed from an enterprise of small dimension [it

Benzodiazepine poisoning in elderly.

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Vukcević, Natasa Perković; Ercegović, Gordana Vuković; Segrt, Zoran; Djordjević, Snezana; Stosić, Jasmina Jović

2016-03-01

Benzodiazepines are among the most frequently ingested drugs in self-poisonings. Elderly may be at greater risk compared with younger individuals due to impaired metabolism and increased sensitivity to benzodiazepines. The aim of this study was to assess toxicity of benzodiazepines in elderly attempted suicide. A retrospective study of consecutive presentations to hospital after self-poisoning with benzodiazepines was done. Collected data consisted of patient's characteristics (age, gender), benzodiazepine ingested with its blood concentrations at admission, clinical findings including vital signs and Glasgow coma score, routine blood chemistry, complications of poisoning, details of management, length of hospital stay and outcome. According the age, patients are classified as young (15-40-year old), middle aged (41-65-year old) and elderly (older than 65). During a 2-year observational period 387 patients were admitted because of pure benzodiazepine poisoning. The most frequently ingested drug was bromazepam, the second was diazepam. The incidence of coma was significantly higher, and the length of hospital stay significantly longer in elderly. Respiratory failure and aspiration pneumonia occurred more frequently in old age. Also, flumazenil was more frequently required in the group of elderly patients. Massive benzodiazepines overdose in elderly may be associated with a significant morbidity, including deep coma with aspiration pneumonia, respiratory failure, and even death. Flumazenil is indicated more often to reduce CNS depression and prevent complications of prolonged unconsciousness, but supportive treatment and proper airway management of comatose patients is the mainstay of the treatment of acute benzodiazepine poisoning.

Adherence to anti-Parkinson drug therapy in the "REASON" sample of Italian patients with Parkinson's disease: the linguistic validation of the Italian version of the "Morisky Medical Adherence Scale-8 items".

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Fabbrini, G; Abbruzzese, G; Barone, P; Antonini, A; Tinazzi, M; Castegnaro, G; Rizzoli, S; Morisky, D E; Lessi, P; Ceravolo, R

2013-11-01

Information about patients' adherence to therapy represents a primary issue in Parkinson's disease (PD) management. To perform the linguistic validation of the Italian version of the self-rated 8-Item Morisky Medical Adherence Scale (MMAS-8) and to describe in a sample of Italian patients affected by PD the adherence to anti-Parkinson drug therapy and the association between adherence and some socio-demographic and clinical features. MMAS-8 was translated into Italian language by two independent Italian mother-tongue translators. The consensus version was then back-translated by an English mother-tongue translator. This translation process was followed by a consensus meeting between the authors of translation and investigators and then by two comprehension tests. The translated version of the MMAS-8 scale was then administered at the baseline visit of the "REASON" study (Italian Study on the Therapy Management in Parkinson's disease: Motor, Non-Motor, Adherence and Quality Of Life Factors) in a large sample of PD patients. The final version of the MMAS-8 was easily understood. Mean ± SD MMAS-8 score was 6.1 ± 1.2. There were no differences in adherence to therapy in relationship to disease severity, gender, educational level or decision to change therapy. The Italian version of MMAS-8, the key tool of the REASON study to assess the adherence to therapy, has shown to be understandable to patients with PD. Patients enrolled in the REASON study showed medium therapy adherence.

Outpatient antibiotic prescriptions from 1992 to 2001 in The Netherlands

NARCIS (Netherlands)

Kuyvenhoven, MM; van Balen, FAM; Verheij, TJM

2003-01-01

Objectives: Although Dutch outpatient antibiotic prescription rates are low compared with other European countries, continuing to scrutinize trends in outpatient antibiotic use is important in order to identify possible increases in antibiotic use or inappropriate increases in the use of particular

Paraoxonase polymorphisms PON1 192 and 55 and longevity in Italian centenarians and Irish nonagenarians. A pooled analysis.

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Rea, Irene M; McKeown, Pascal P; McMaster, Dorothy; Young, Ian S; Patterson, Chris; Savage, Maurice J; Belton, Christine; Marchegiani, Francesca; Olivieri, Fabiola; Bonafe, Massimiliano; Franceschi, Claudio

2004-04-01

PON1, an arylesterase, associated with high density lipoprotein (HDL), protects low density lipoprotein (LDL) against oxidative modification. Common polymorphisms PON1 55 (L/M) and 192 (Q/R) in the PON1 gene associate with atherosclerosis and heart disease. Because long-lived people seem protected from premature vascular death, we conducted a pooled statistical analysis to assess any association between these polymorphisms and longevity in a large combined group of Italian centenarians and octo/nonagenarians from Northern Ireland (NI). Separated DNA was available from 1479 subjects from Italy and Northern Ireland (NI). In Italy 308 centenarians (males 67, females 241, mean age 100.8, SD2.1 years) and 579 young controls (males 347, females 232, mean age 40.7, SD 12.7 years) were included in the study. In NI, 296 octo/nonagenarians (males 92, females 204, mean age 89.8, SD 5.7 years) and 296 young sex-matched subjects (mean age 13.0, SD 1.4 years) had available DNA. PON1 55 (L/M) and 192 (Q/R) polymorphisms were studied using a PCR-RFLP approach. There was a significant difference in PON1 192 genotypes in Italian centenarians compared to younger controls (X(2)= 6.8, df = 2 p= 0.03) and a similar but non significant trend between octo/nonagenarian and young subjects in NI (X(2) = 4.0, df=2, p=0.14). Using logistic regression analysis on the combined Italian and Irish datasets, there was a small survival advantage for centenarian and octo/nonagenarian subjects who were heterozygous for PON1 192 R allele, (OR 1.3, CI 1-1.6; p=0.04 with a stepwise increase for RR homozygous subjects (OR 1.7, CI 1.1-2.6; p = 0.02) compared to QQ subjects. Comparing R and Q alleles there was a survival advantage for octo/nonagenarian/centenarian subjects who carried the R allele (OR 1.3, CI 1.1-1.5; p = 0.007) but there was no sex-specific effect p =0.77) LL, LM and MM genotypes of PON 55 polymorphisms showed similar frequencies in Italy (39.9, 47.0, 13.1%) and Ireland (39.5, 48.6, 11

Images of Italian Mathematics in France from Risorgimento to Fascism

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Jouve, Guillaume; Mazliak, Laurent; Tazzioli, Rossana

2016-01-01

The contributions in this proceedings volume offer a new perspective on the mathematical ties between France and Italy, and reveal how mathematical developments in these two countries affected one another. The focus is above all on the Peninsula’s influence on French mathematicians, counterbalancing the historically predominant perception that French mathematics was a model for Italian mathematicians. In the process, the book details a subtle network of relations between the two countries, where mathematical exchanges fit into the changing and evolving framework of Italian political and academic structures. It reconsiders the issue of nationalities in all of its complexity, an aspect often neglected in research on the history of mathematics. The works in this volume are selected contributions from a conference held in Lille and Lens (France) in November 2013 on Images of Italian Mathematics in France from Risorgimento to Fascism. The authors include respected historians of mathematics, philosophers of scien...

Pneumonia and hospitalizations in the elderly

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Francesco Cacciatore

2017-05-01

Full Text Available Pneumonia in the elderly is a common and severe problem. In this review we analyze the state of the art for pneumonia in the elderly. Several aspects are discussed: i how common is the disease; signs and symptoms in the elderly; ii the elderly must always be hospitalized and which is the best place - Intensive Care Unit or medical ward?; iii the role of comorbidities; iv etiology and pathogenesis; medical treatment - when and how to start; v antibiotic resistance; vi antibiotics in hospital acquired and ventilator related pneumonia; vii assisted non-invasive ventilation; viii the treatment in the terminally ill elderly patient.

Italian bioclimatic architecture

Energy Technology Data Exchange (ETDEWEB)

D' Errico, E

1987-04-01

This paper deals with the results of solar space heating research developed within the Finalized Energy Project of the National Research Council of Italy. Energy and cost/benefit parameters were compared for a certain number of Italian buildings incorporating solar architecture. The technical and economic analysis was performed on 31 buildings, of which 24 are residential, and 7 are schools, with different solar devices (direct gain, Trombe walls, sunspaces, hybrid systems). The buildings were constructed between 1976 and 1982. The results emphasize that simple technologies with lower costs and good design usually have a higher performance/cost ratio.

Neoliberty & co. The Architectural Review against 1950s Italian historicism

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Manuel López Segura

2013-10-01

Full Text Available AbstractBuilding upon the Neoliberty polemics (second half of the 1950s, this article offers a revision of the debate on the historicity of architecture that opposed distinguished Italian and British intellectual circles. While the Italian contribution has been extensively analyzed, the existing literature has not dwelt on the reasons why the British refused any operative recovery of history; a gap this article intends to fi ll. From a methodological point of view, given the media nature of the debate, our analysis has been mainly textual, and has focused on the two journals that channelled the exchanges: the Milanese Casabella and the London based Architectural Review. The article is equally of interest as it explores an early episode which already announced two of the paths the architecture of the following decades would follow: postmodern historicism and high-tech.The reasons for the misunderstanding were of diverse nature. First, the different urban cultures present in one country and the other would explain the diverging esteem for the paradoxically Cosmopolitan provincialism of Milan and Turin, admirer of XIXth century bourgeois urbanity. Moreover, Reyner Banham from the English magazine was determined to promote contemporary architecture that would follow the postulates of his beloved Futurism: rejection of tradition and technological assimilation. However, a calm reading of his writings reveals that his antihistoricist stance was not as extreme as is usually believed.The role played by J. M. Richards, editor of Architectural Review, is more problematic. Though he shared many concerns with his Italian counterparts, he did not appease the virulence of the campaign his journal headed. Finally, Nikolaus Pevsner's historiographical project differed from the one the Italians fostered, regarding interpretative keys and methods. The Italian research followed the steps of Benedetto Croce, a position hardly attuned to the Anglo-German historian

Elder Abuse - Multiple Languages

Science.gov (United States)

... Are Here: Home → Multiple Languages → All Health Topics → Elder Abuse URL of this page: https://medlineplus.gov/languages/ ... V W XYZ List of All Topics All Elder Abuse - Multiple Languages To use the sharing features on ...

Tocopherol in Elder Self-Neglect

Science.gov (United States)

Aung, K.; Burnett, J.; Dyer, C.; Smith, S. M.

2009-01-01

Although elder self-neglect is the most common form of elder mistreatment, its pathophysiology is not well understood. Alpha-tocopherol is a lipid soluble antioxidant required for the preservation of cell membranes. Since the association between tocopherol and cognitive impairment in older adults has been described, we explored the possibility of its role in elder self-neglect. OBJECTIVE: (1) To determine whether serum tocopherol levels are associated with elder self-neglect, and (2) to assess the association of serum tocopherol levels and cognitive function in elder self-neglect. METHODS: Serum tocopherol levels were measured in a cohort of 67 self-neglecting elders and 67 matched controls, recruited for the Consortium for Research in Elder Self-neglect of Texas. Pearson s correlation tests were performed to assess bivariate associations between serum tocopherol levels and cognitive function. RESULTS: Mean serum alpha-tocopherol levels were 10.8 +/- 4.7 ug/mL in self-neglect group and 13.0 +/- 4.9 ug/mL in control group (p = 0.006, unpaired student s t-test). None of the participants from either group had alpha-tocopherol level lower than the reference range. Mean serum gamma-tocopherol levels were 2.0 +/- 1.0 ug/mL in self-neglect group and 2.0 +/- 1.1 in control group (p=0.83). Proportion of the elders with gamma-tocopherol level lower than the reference range were 4.5% (3/66) in self-neglect group and 10.4% (7/67) in control group (p=0.32, Fisher s Exact Test). Among the self-neglecting elders, no association was found between serum alpha-tocopherol levels and the Mini-Mental State Examination (MMSE) or the Wolf-Klein Clock Drawing Test (CDT) scores (r =-0.42, p=0.75 for MMSE; r=0.08, p=0.54 for CDT). No association was found between serum gamma-tocopherol levels and the MMSE or the CDT (r=-0.12, p=0.35 for MMSE; r=0.05, p=0.68 for CDT). CONCLUSION: In our sample, neither alpha-tocopherol nor gamma-tocopherol appears to have a role in pathophysiology of elder

Elder Financial Exploitation: Implications for Future Policy and Research in Elder Mistreatment

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Price, Thomas

2011-07-01

Full Text Available Recent advances in the understanding of elder mistreatment have demonstrated that financial exploitation tends to be one of the most common forms of mistreatment affecting older populations. Agencies such as the World Bank and World Health Organization show significant concern regarding financial exploitation and its connection to physical and emotional injury to victims. The World Bank uses the term “financial violence” as a means of generally describing the harm caused to an individual as a result of financial exploitation or abuse. The proportion of financial exploitation in relation to other forms of elder mistreatment is defined in our research. We discuss the potential impact of elder financial exploitation on victims as well as explore the implications for future research and policy development focused on financial aspects of elder mistreatment and call for further study in the concept of financial exploitation as a violent act. [West J Emerg Med. 2011;12(3:354-356.

Validation of an Italian version of the Fibromyalgia Impact Questionnaire (FIQ-I).

Science.gov (United States)

Sarzi-Puttini, P; Atzeni, F; Fiorini, T; Panni, B; Randisi, G; Turiel, M; Carrabba, M

2003-01-01

To validate a translated Italian version of the Fibromyalgia Impact Questionnaire (FIQ). The Italian version of the FIQ was administered to 50 patients affected by fibromyalgia (FM) (48 patients filled out the questionnaire again 10 days later) together with the Italian version of the Stanford Health Assessment Questionnaire (HAQ), the Medical Outcomes Survey Short Form-36 (SF-36), and a tender point count (TPC) obtained by summing the score (0-3) of each tender point tested by thumb palpation. All patients were asked about the severity of pain today (10 cm visual analog scale) and the duration of symptoms. Test-retest reliability was assessed using Spearman correlations. Internal consistency was evaluated with Cronbach's alpha of reliability. Construct validity of the FIQ was evaluated by correlations between the HAQ and subscales of the SF-36 as well as the TPC. The mean duration of symptoms was 6.5 years and the mean age of the participants was 57.4 years. Test-retest reliability was between 0.74 and 0.95 for physical functioning as well as for the total FIQ and other components. Internal consistency was 0.90 for the overall FIQ. Significant correlations were obtained between the FIQ items, the HAQ and the SF-36. The Italian FIQ is a reliable and valid instrument for detecting and measuring functional disability and health status in Italian patients with FM.

[A cross-sectional survey on personality disorder in mental disorder outpatients in Shanghai].

Science.gov (United States)

Zhang, Tian-Hong; Xiao, Ze-Ping; Wang, Lan-Lan; Dai, Yun-Fei; Zhang, Hai-Yin; Qiu, Jian-Yin; Tao, Ming-Yi; Wang, Zhen; Wang, Xiao; Yu, Jun-Han; Wu, Yan-Ru; Jiang, Wen-Hui

2010-08-01

To study the prevalence and risk factors for personality disorder (PD) outpatients attending in for psychiatric and psychological counseling in Shanghai. 3075 subjects were sampled by systematic sampling method from outpatients in psycho-counseling clinics and psychiatric clinics in Shanghai Mental Health Center. Based on DSM-IV criteria, personality disorders were assessed by both questionnaires (personality diagnostic questionnaire, PDQ-4+) and interviews (structured clinical interview for DSM-IV Axis II, SCID-II). Logistic regression analysis was performed to determine the significant independent contributor to PD. 71.3% of the outpatients were found having pathological personality by using questionnaire of self rating PD scale. 982 outpatients (31.9%) met criteria for at least one personality disorder by using structured clinical interview. Younger age (OR = 1.8, 95%CI: 1.5 - 2.1), single or divorced (OR = 1.6, 95%CI: 1.4 - 1.9), psychological counseling outpatients (OR = 1.2, 95%CI: 1.1 - 1.3), mood and outpatients with neurosis disorders (OR = 1.7, 95%CI: 1.4 - 2.0) were more frequently assigned as personality disorders. Data from logistic regression analysis showed that patients of tender age, not nurtured and raised by their parents, with introvert characters were related risk factors of PD. High prevalence rate of PD was found in this sample of Chinese outpatients, especially in those psychological counseling outpatients with mood or neurosis disorders. More attention should be paid to the recognition and intervention of PD in outpatients with mental disorders.

Mitochondrial D-loop sequence variation among Italian horse breeds

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Zanotti Marta

2004-11-01

Full Text Available Abstract The genetic variability of the mitochondrial D-loop DNA sequence in seven horse breeds bred in Italy (Giara, Haflinger, Italian trotter, Lipizzan, Maremmano, Thoroughbred and Sarcidano was analysed. Five unrelated horses were chosen in each breed and twenty-two haplotypes were identified. The sequences obtained were aligned and compared with a reference sequence and with 27 mtDNA D-loop sequences selected in the GenBank database, representing Spanish, Portuguese, North African, wild horses and an Equus asinus sequence as the outgroup. Kimura two-parameter distances were calculated and a cluster analysis using the Neighbour-joining method was performed to obtain phylogenetic trees among breeds bred in Italy and among Italian and foreign breeds. The cluster analysis indicates that all the breeds but Giara are divided in the two trees, and no clear relationships were revealed between Italian populations and the other breeds. These results could be interpreted as showing the mixed origin of breeds bred in Italy and probably indicate the presence of many ancient maternal lineages with high diversity in mtDNA sequences.

Patient migration among the Italian regions in 2003

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Gabriele Messina

2008-03-01

Full Text Available

Background: In the Italian National Health Service hospital planning was influenced by two aspects: the patients’ freedom to choose their health care provider and the equal distribution of centers spread throughout Italy. While every Italian Region should be able to meet the health needs of its own inhabitants, consistent migration among regions exists. Retrospective studies of cross boundaries patient flows can be useful for health planning purposes, providing precious information about citizens’ preferences, and helping health managers to think about inequality and adjust the offer of care. The aim of this study is to describe cross boundary flows which occurred across all the Italian Regions in 2003.

Methods: The hospital discharges for 2003 were obtained from the General Directorate for Health Planning of the Italian Ministry of Health. We analyzed regional cross boundary flows using the Gandy Nomogram. This tool, which assesses patient mobility, can be used to describe regions’ ability to satisfy their internal health demand and their own capability in attracting foreign patients.

Results: All of the regions, for the most part, were able to satisfy internal health care demands, and are placed in the upper right corner of the Gandy Nomogram. Umbria, Emilia Romagna, P. A. di Bolzano, Tuscany, Lombardy, Friuli V. Giulia, Lazio, Abruzzo were the regions that appeared to perform best. The Lombardy region attracts the most patients.

Conclusions: This study briefly provides an evaluation of hospital supply of services giving indications about patients’ perception of the quality and organization of services. A deeper analysis of patient migration may be undertaken by looking at specific diseases. This kind of research could be useful for planning and maximising supplies when making decisions about healthcare.

The new Inventory of Italian Glaciers: Present knowledge, applied methods and preliminary results

Science.gov (United States)

Smiraglia, Claudio; Diolaiuti, Guglielmina; D'Agata, Carlo; Maragno, Davide; Baroni, Carlo; Mortara, Gianni; Perotti, Luigi; Bondesan, Aldino; Salvatore, Cristina; Vagliasindi, Marco; Vuillermoz, Elisa

2013-04-01

A new Glacier Inventory is an indispensable requirement in Italy due to the importance of evaluating the present glacier coverage and the recent changes driven by climate. Furthermore Alpine glaciers represent a not negligible water and touristic resource then to manage and promote them is needed to know their distribution, size and features. The first Italian Glacier Inventory dates back to 1959-1962. It was compiled by the Italian Glaciological Committee (CGI) in cooperation with the National Research Council (CNR); this first inventory was mainly based on field data coupled with photographs (acquired on the field) and high resolution maps. The Italian glaciation resulted to be spread into 754 ice bodies which altogether were covering 525 km2. Moreover in the Eighties a new inventory was compiled to insert Italian data into the World Glacier Inventory (WGI); aerial photos taken at the end of the Seventies (and in some cases affected by a high and not negligible snow coverage) were used as the main source of data. No other national inventory were compiled after that period. Nevertheless during the last decade the largest part of the Italian Alpine regions have produced regional and local glacier inventories which in several cases are also available and queried through web sites and web GIS application. The actual need is now to obtain a complete, homogeneous and contemporary picture of the Italian Glaciation which encompasses the already available regional and local data and all the new updated information coming from new sources of data (e.g.: orthophotos, satellite imagines, etc..). The challenge was accepted by the University of Milan, the EvK2CNR Committee and the Italian Glaciological Committee who, with the sponsorship of Levissima Spa, are presently working to compile the new updated Italian Glacier Inventory. The first project step is to produce a unique homogeneous glacier database including glacier boundary and surface area and the main fundamental

[The demographic and occupational characteristics of Italian migrants to Argentina, 1880-1930].

Science.gov (United States)

Cacopardo, M C; Moreno, J L

1984-09-01

"This essay studies...the demographic and socio-professional characteristics of the Italian emigrants in Argentina during the period 1880-1930. Besides a reconstruction of the demographic variables (age, sex, mortality, and fertility) in the historical series, the essay also depicts the professional profile of the Italians in Argentina...." (summary in ENG, FRE) excerpt

76 FR 49458 - TRICARE; Hospital Outpatient Radiology Discretionary Appeal Adjustments

Science.gov (United States)

2011-08-10

... DEPARTMENT OF DEFENSE Office of the Secretary TRICARE; Hospital Outpatient Radiology Discretionary...: This notice is to advise hospitals of an opportunity for net adjusted payments for radiology services... hospital outpatient services, DoD has determined that, for radiology services specified in the regulation...

Cost associated with stroke: outpatient rehabilitative services and medication.

Science.gov (United States)

Godwin, Kyler M; Wasserman, Joan; Ostwald, Sharon K

2011-10-01

This study aimed to capture direct costs of outpatient rehabilitative stroke care and medications for a 1-year period after discharge from inpatient rehabilitation. Outpatient rehabilitative services and medication costs for 1 year, during the time period of 2001 to 2005, were calculated for 54 first-time stroke survivors. Costs for services were based on Medicare reimbursement rates. Medicaid reimbursement rates and average wholesale price were used to estimate medication costs. Of the 54 stroke survivors, 40 (74.1%) were categorized as independent, 12 (22.2%) had modified dependence, and 2 (3.7%) were dependent at the time of discharge from inpatient rehabilitation. Average cost for outpatient stroke rehabilitation services and medications the first year post inpatient rehabilitation discharge was $17,081. The corresponding average yearly cost of medication was $5,392, while the average cost of yearly rehabilitation service utilization was $11,689. Cost attributed to medication remained relatively constant throughout the groups. Outpatient rehabilitation service utilization constituted a large portion of cost within each group: 69.7% (dependent), 72.5% (modified dependence), and 66.7% (independent). Stroke survivors continue to incur significant costs associated with their stroke for the first 12 months following discharge from an inpatient rehabilitation setting. Changing public policies affect the cost and availability of care. This study provides a snapshot of outpatient medication and therapy costs prior to the enactment of major changes in federal legislation and serves as a baseline for future studies.

Linguistic, geographic and genetic isolation: a collaborative study of Italian populations.

Science.gov (United States)

Capocasa, Marco; Anagnostou, Paolo; Bachis, Valeria; Battaggia, Cinzia; Bertoncini, Stefania; Biondi, Gianfranco; Boattini, Alessio; Boschi, Ilaria; Brisighelli, Francesca; Caló, Carla Maria; Carta, Marilisa; Coia, Valentina; Corrias, Laura; Crivellaro, Federica; De Fanti, Sara; Dominici, Valentina; Ferri, Gianmarco; Francalacci, Paolo; Franceschi, Zelda Alice; Luiselli, Donata; Morelli, Laura; Paoli, Giorgio; Rickards, Olga; Robledo, Renato; Sanna, Daria; Sanna, Emanuele; Sarno, Stefania; Sineo, Luca; Taglioli, Luca; Tagarelli, Giuseppe; Tofanelli, Sergio; Vona, Giuseppe; Pettener, Davide; Destro Bisol, Giovanni

2014-01-01

The animal and plant biodiversity of the Italian territory is known to be one of the richest in the Mediterranean basin and Europe as a whole, but does the genetic diversity of extant human populations show a comparable pattern? According to a number of studies, the genetic structure of Italian populations retains the signatures of complex peopling processes which took place from the Paleolithic to modern era. Although the observed patterns highlight a remarkable degree of genetic heterogeneity, they do not, however, take into account an important source of variation. In fact, Italy is home to numerous ethnolinguistic minorities which have yet to be studied systematically. Due to their difference in geographical origin and demographic history, such groups not only signal the cultural and social diversity of our country, but they are also potential contributors to its bio-anthropological heterogeneity. To fill this gap, research groups from four Italian Universities (Bologna, Cagliari, Pisa and Roma Sapienza) started a collaborative study in 2007, which was funded by the Italian Ministry of Education, University and Research and received partial support by the Istituto Italiano di Antropologia. In this paper, we present an account of the results obtained in the course of this initiative. Four case-studies relative to linguistic minorities from the Eastern Alps, Sardinia, Apennines and Southern Italy are first described and discussed, focusing on their micro-evolutionary and anthropological implications. Thereafter, we present the results of a systematic analysis of the relations between linguistic, geographic and genetic isolation. Integrating the data obtained in the course of the long-term study with literature and unpublished results on Italian populations, we show that a combination of linguistic and geographic factors is probably responsible for the presence of the most robust signatures of genetic isolation. Finally, we evaluate the magnitude of the diversity

Italian Validation of Homophobia Scale (HS).

Science.gov (United States)

Ciocca, Giacomo; Capuano, Nicolina; Tuziak, Bogdan; Mollaioli, Daniele; Limoncin, Erika; Valsecchi, Diana; Carosa, Eleonora; Gravina, Giovanni L; Gianfrilli, Daniele; Lenzi, Andrea; Jannini, Emmanuele A

2015-09-01

The Homophobia Scale (HS) is a valid tool to assess homophobia. This test is self-reporting, composed of 25 items, which assesses a total score and three factors linked to homophobia: behavior/negative affect, affect/behavioral aggression, and negative cognition. The aim of this study was to validate the HS in the Italian context. An Italian translation of the HS was carried out by two bilingual people, after which an English native translated the test back into the English language. A psychologist and sexologist checked the translated items from a clinical point of view. We recruited 100 subjects aged18-65 for the Italian validation of the HS. The Pearson coefficient and Cronbach's α coefficient were performed to test the test-retest reliability and internal consistency. A sociodemographic questionnaire including the main information as age, geographic distribution, partnership status, education, religious orientation, and sex orientation was administrated together with the translated version of HS. The analysis of the internal consistency showed an overall Cronbach's α coefficient of 0.92. In the four domains, the Cronbach's α coefficient was 0.90 in behavior/negative affect, 0.94 in affect/behavioral aggression, and 0.92 in negative cognition, whereas in the total score was 0.86. The test-retest reliability showed the following results: the HS total score was r = 0.93 (P cognition was r = 0.75 (P validation of the HS revealed the use of this self-report test to have good psychometric properties. This study offers a new tool to assess homophobia. In this regard, the HS can be introduced into the clinical praxis and into programs for the prevention of homophobic behavior.