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Characterize and Address Mental health Problems in University Students (CAMPUS Study): preliminary results
- M. Nosè, G. Muriago, F. Tedeschi, G. Turrini, C. Barbui
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- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, p. S546
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Introduction
The transition phase from late adolescence to early adulthood, which corresponds with the period of university life, is a time that offers important opportunities for personal growth. However, this developmental phase also concurs with the peak period of risk for the onset of mental health disorders. For this reason, the literature clearly identifies university students as a vulnerable population group for psychogical distress and mental problems. Digital psychological interventions and e-mental health solutions are emerging as a promising solution for university students, particularly appealing due to their anonymity, portability and ease of access. Hence, the World Health Organisation has developed several psychosocial e-mental health tools including Doing What Matters in Times of Stress (DWM), which has been consistently shown effective in various vulnerable populations. These data provide the framework for the CAMPUS study that is intended for students attending the University of Verona.
ObjectivesThe main objective of this project is to adapt the WHO psychological intervention called “Doing What Matters in Times of Stress” (DWM) to this target population and to evaluate the effectiveness, feasibility, and acceptability of WHO’s DWM as a psychological strategy for effective mental health prevention and promotion, and for reducing psychological symptoms and distress in university students. Secondary objectives of the project include to evaluate the fidelity of DWM, to assess factors associated with its implementation and effectiveness and to co-create the necessary local conditions for implementation and up-scaling of DWM.
MethodsThe CAMPUS study is a prospective non-randomized follow-up study. The target population is composed by university students of University of Verona, Italy. The online assessments, which are collected pre and post intervention, consist of an ad-hoc sociodemographic information page, and four self-administered questionnaires assessing psychological distress, depression and anxiety symptoms, and psychological well-being. In addition, implementation checklists will be administered to assess the acceptability, appropriateness and feasibility of the intervention.
ResultsPreliminary results on a sample of 300 students attending University of Verona show that the adapted DWM intervention promote students’ psychological well-being and reduce the level of psychological distress as well as the risk for the later development of a psychopathology. Moreover we expect that future results would include data on the effectiveness, feasibility, and acceptability of the adapted DWM intervention among university students
ConclusionsThese results provide valuable information for mental health promotion and support programs for university students, as well as insights into factors influencing its implementation and suggestions for future scaling of the intervention.
Disclosure of InterestNone Declared
Psychotherapies for generalized anxiety disorder in adults: systematic review and network meta-analysis of randomized-controlled trials
- D. Papola, C. Miguel Sanz, M. Mazzaglia, P. Franco, F. Tedeschi, S. A. Romero, A. R. Patel, G. Ostuzzi, C. Gastaldon, E. Karyotaki, M. Harrer, M. Purgato, M. Sijbrandij, V. Patel, T. A. Furukawa, P. Cuijpers, C. Barbui
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- Journal:
- European Psychiatry / Volume 67 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 27 August 2024, pp. S50-S51
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Introduction
Generalized anxiety disorder (GAD) is one of the most common mental disorders in adults. Psychotherapies are among the most recommended treatment choices for GAD, but which should be considered as first-line treatment still needs to be clarified.
ObjectivesTo examine the most effective and accepted psychotherapy for GAD both in the short and long-term, via a network meta-analysis.
MethodsWe searched MEDLINE, Embase, PsycINFO, and the Cochrane Register of Controlled Trials – CENTRAL, from database inception to January 1st, 2023, to find randomized controlled trials (RCTs) of psychotherapies for GAD. Eight psychotherapies (behaviour therapy, cognitive-behaviour therapy, cognitive restructuring, psychoeducation, psychodynamic therapy, relaxation therapy, supportive psychotherapy, and third-wave CBTs) were compared with each other and two control conditions (treatment as usual, waiting list). We followed Cochrane standards when extracting data and assessing data quality and used PRISMA guidelines for the reporting. We conducted random-effects model pairwise and network meta-analyses. We assessed risk of bias of individual studies through the second version of the Cochrane’s Risk of Bias tool and used the Confidence in Network Meta-Analysis (CINeMA) to rate certainty of evidence for meta-analytical results. Severity of GAD symptoms and acceptability of the psychotherapies were our outcomes of interest.
ResultsWe analysed data from 66 RCTs. Effect size estimates on data from 5,597 participants suggest third wave cognitive-behavioural therapies (standardized mean differences [SMDs] =-0.78; 95%CI=-1.19 to -0.37; certainty=moderate), cognitive-behavioural therapy (CBT) (SMD=-0.68; 95%CI=-1.05 to -0.32 certainty=moderate), and relaxation therapy (SMD=-0.54; 95%CI=-1.04 to -0.05; certainty=low) reduced generalized anxiety symptoms more than treatment as usual (TAU). Relative risks for all-cause discontinuation signalled no differences compared with TAU for all psychotherapies. When excluding studies at high risk of bias, relaxation therapy lost its superiority over TAU. When considering anxiety severity at three to twelve months after completion of the intervention only CBT remained significantly more efficacious than TAU (SMD=-0.58; 95%CI=-0.93 to -0.23).
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ConclusionsGiven the evidence for both acute and long-term efficacy, CBT may represent the reasonable first-line psychological treatment for GAD. Third-wave CBT and relaxation therapy have short-term efficacy and may also be offered. Results from this investigation should inform patients, clinicians, and guidelines. This project is funded by the European Union’s HORIZON EUROPE research programme under grant agreement No 101061648.
Disclosure of InterestNone Declared
Resilience of people with a history of mental disorder during the COVID-19 pandemic: a 2-years longitudinal prospective study
- I. Pinucci, L. Tarsitani, F. Tedeschi, M. Patanè, R. Serra, D. Papola, C. Palantza, C. Acartürk, R. Bryant, S. Burchert, D. Fuhr, B. J. Hall, E. Mittendorfer-Rutz, N. Morina, C. Panter-Brick, S. Quero, S. Seedat, H. Setyowibowo, J. van der Waerden, M. Pasquini, M. Sijbrandij, C. Barbui
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S77-S78
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Introduction
During the COVID-19 pandemic, people with mental disorders were exposed to a common and prolonged source of stress. Studies focusing on the consequences of the pandemic on individuals with a history of mental disorder are scarce, but they suggest a higher vulnerability as compared to the general population.
ObjectivesWe aimed at identifying predictors of stress resilience maintained over time among these people during the first two years of the pandemic.
MethodsThe presented study is part of a larger 2-year, 5-wave international longitudinal online survey.
The Patient Health Questionnaire, the Generalized Anxiety Disorder scale and the PTSD Checklist DSM-5 were used as latent class indicators for a proxy measure of distress. Specifically, a Latent-Class Analysis was performed to identify a group that showed resilient outcomes across all waves.
We investigated socio-demographic characteristics, economic and housing status, lifestyle and habits, pandemic-related issues, and chronic disease. Adherence to and approval of the restrictions imposed, trust in governments and the scientific community during the pandemic were also assessed. Social support, fear of contamination and personal values were investigated respectively through the Oslo Social Support Scale, the Padua Inventory, and the Portrait Values Questionnaire. The aforementioned characteristics were used to predict sustained resilience through a logistic regression.
ResultsA total of 1711 participants out of the total sample (8011 participants from 13 different countries) reported a diagnosis of mental disorder before the pandemic. Nine hundred forty-three participants completed at least three of the five versions of the survey and were included in the analysis. A latent class of participants with resilience maintained over time (sustained resilience) was identified, with an estimated probability of 24.8%. The demographic and clinical variables associated with a higher chance of sustained resilience were older age, maintaining a job during the pandemic, and having a larger number of people in the household. In contrast, female gender, losing job during the pandemic, having difficulty meeting basic needs, greater fear of contamination, a stronger focus on hedonism, less social support and feeling lonely resulted in a lower likelihood of being sustained resilient.
ConclusionsThis study identified a number of factors that may help predict resilient outcomes maintained over time in people with mental disorders. COVID-19 related predictors of sustained resilience are new findings which might inform resilience-building interventions during pandemics.
Disclosure of InterestNone Declared
Effect of COVID-19 pandemic on utilisation of community-based mental health care in North-East of Italy: A psychiatric case register study
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- E. Prina, F. Tedeschi, D. Salazzari, T. Botte, M. Ballarin, L. Rabbi, G. Imperadore, S. Roccato, S. Nicolaou, M. Ruggeri, F. Gomez, A. Lasalvia, F. Amaddeo
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- Journal:
- Epidemiology and Psychiatric Sciences / Volume 32 / 2023
- Published online by Cambridge University Press:
- 11 April 2023, e17
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Aims
WHO declared that mental health care should be considered one essential health service to be maintained during the coronavirus disease 2019 (COVID-19) pandemic. This study aims to describe the effect of lockdown and restrictions due to the COVID-19 pandemic in Italy on mental health services’ utilisation, by considering psychiatric diagnoses and type of mental health contacts.
MethodsThe study was conducted in the Verona catchment area, located in the Veneto region (northeastern Italy). For each patient, mental health contacts were grouped into: (1) outpatient care, (2) social and supportive interventions, (3) rehabilitation interventions, (4) multi-professional assessments, (5) day care. A ‘difference in differences’ approach was used: difference in the number of contacts between 2019 and 2020 on the weeks of lockdown and intermediate restrictions was compared with the same difference in weeks of no or reduced restrictions, and such difference was interpreted as the effect of restrictions. Both a global regression on all contacts and separate regressions for each type of service were performed and Incidence Rate Ratios (IRRs) were calculated.
ResultsIn 2020, a significant reduction in the number of patients who had mental health contacts was found, both overall and for most of the patients’ characteristics considered (except for people aged 18–24 years for foreign-born population and for those with a diagnosis of schizophrenia. Moreover, in 2020 mental health contacts had a reduction of 57 096 (−33.9%) with respect to 2019; such difference remained significant across the various type of contacts considered, with rehabilitation interventions and day care showing the greatest reduction. Negative Binomial regressions displayed a statistically significant effect of lockdown, but not of intermediate restrictions, in terms of reduction in the number of contacts. The lockdown period was responsible of a 32.7% reduction (IRR 0.673; p-value <0.001) in the overall number of contacts. All type of mental health contacts showed a reduction ascribable to the lockdown, except social and supportive interventions.
ConclusionsDespite the access to community mental health care during the pandemic was overall reduced, the mental health system in the Verona catchment area was able to maintain support for more vulnerable and severely ill patients, by providing continuity of care and day-by-day support through social and supportive interventions.
Long-term effectiveness of Self-Help Plus in refugees and asylum seekers resettled in Western Europe: 12-month outcomes of a randomised controlled trial
- G. Turrini, M. Purgato, F. Tedeschi, C. Acartürk, M. Anttila, T. Au, K. Carswell, R. Churchill, P. Cuijpers, F. Friedrich, C. Gastaldon, T. Klein, M. Kösters, T. Lantta, M. Nosè, G. Ostuzzi, D. Papola, M. Popa, M. Sijbrandij, L. Tarsitani, L. Todini, E. Uygun, M. Välimäki, L. Walker, J. Wancata, R. G. White, E. Zanini, M. van Ommeren, C. Barbui
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- Epidemiology and Psychiatric Sciences / Volume 31 / 2022
- Published online by Cambridge University Press:
- 08 June 2022, e39
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Aims
As refugees and asylum seekers are at high risk of developing mental disorders, we assessed the effectiveness of Self-Help Plus (SH + ), a psychological intervention developed by the World Health Organization, in reducing the risk of developing any mental disorders at 12-month follow-up in refugees and asylum seekers resettled in Western Europe.
MethodsRefugees and asylum seekers with psychological distress (General Health Questionnaire-12 ⩾ 3) but without a mental disorder according to the Mini International Neuropsychiatric Interview (M.I.N.I.) were randomised to either SH + or enhanced treatment as usual (ETAU). The frequency of mental disorders at 12 months was measured with the M.I.N.I., while secondary outcomes included self-identified problems, psychological symptoms and other outcomes.
ResultsOf 459 participants randomly assigned to SH + or ETAU, 246 accepted to be interviewed at 12 months. No difference in the frequency of any mental disorders was found (relative risk [RR] = 0.841; 95% confidence interval [CI] 0.389–1.819; p-value = 0.659). In the per protocol (PP) population, that is in participants attending at least three group-based sessions, SH + almost halved the frequency of mental disorders at 12 months compared to ETAU, however so few participants and events contributed to this analysis that it yielded a non-significant result (RR = 0.528; 95% CI 0.180–1.544; p-value = 0.230). SH + was associated with improvements at 12 months in psychological distress (p-value = 0.004), depressive symptoms (p-value = 0.011) and wellbeing (p-value = 0.001).
ConclusionsThe present study failed to show any long-term preventative effect of SH + in refugees and asylum seekers resettled in Western European countries. Analysis of the PP population and of secondary outcomes provided signals of a potential effect of SH + in the long-term, which would suggest the value of exploring the effects of booster sessions and strategies to increase SH + adherence.
A multi-inverse approach for a holistic understanding of applied animal science systems
- L. M. Vargas-Villamil, L. O. Tedeschi, S. Medina-Peralta, F. Izquierdo-Reyes, J. Navarro-Alberto, R. González-Garduño
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Technological and mathematical advances have provided opportunities to investigate new approaches for the holistic quantification of complex biological systems. One objective of these approaches, including the multi-inverse deterministic approach proposed in this paper, is to deepen the understanding of biological systems through the structural development of a useful, best-fitted inverse mechanistic model. The objective of the present work was to evaluate the capacity of a deterministic approach, that is, the multi-inverse approach (MIA), to yield meaningful quantitative nutritional information. To this end, a case study addressing the effect of diet composition on sheep weight was performed using data from a previous experiment on saccharina (a sugarcane byproduct), and an inverse deterministic model (named Paracoa) was developed. The MIA successfully revealed an increase in the final weight of sheep with an increase in the percentage of corn in the diet. Although the soluble fraction also increased with increasing corn percentage, the effective nonsoluble degradation increased fourfold, indicating that the increased weight gain resulted from the nonsoluble substrate. A profile likelihood analysis showed that the potential best-fitted model had identifiable parameters, and that the parameter relationships were affected by the type of data, number of parameters and model structure. It is necessary to apply the MIA to larger and/or more complex datasets to obtain a clearer understanding of its potential.
2846 – A Multicentre Study on Adult Attention-Deficit/Hyperactivity Disorder in Subjects with Affective Disorders: Role of Personality Traits and Clinical Implications
- M. Di Nicola, L. Sala, L. Romo, V. Catalano, D. Tedeschi, C. Even, C. Dubertret, M. Mazza, G. Martinotti, A. Callea, J.D. Guelfi, F. Rouillon, L. Janiri, P. Gorwood
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- European Psychiatry / Volume 28 / Issue S1 / 2013
- Published online by Cambridge University Press:
- 15 April 2020, 28-E1715
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Background:
A significant comorbidity between attention-deficit/hyperactivity disorder (ADHD) and affective disorders has been consistently reported in adults. Less data regarding the role of personality traits, and the influence of ADHD co-occurrence on clinical characteristics and outcome of mood disorders are currently available.
Methods:The sample consisted of 296 subjects, divided into three homogeneous groups according to demographic characteristics: 106 subjects diagnosed with major depressive disorder, 92 with bipolar disorders and 98 healthy controls. ADHD diagnosis was based on DSM-IV-TR criteria. Childhood and adult ADHD features were measured with the Wender Utah Rating Scale (WURS), the Adult ADHD Self-rating Scale (ASRS) and the Brown Attention Deficit Disorder Scale (ADD). The Hospital Anxiety and Depression Scale (HAD) and the Revised NEO Personality Inventory (NEO-PI-R) were also administered to the clinical groups, in order to investigate depressive/anxious symptoms and personality dimensions.
Results:The prevalence of adult ADHD in subjects with bipolar disorders or major depressive disorder was 22.0% and 8.5% respectively (p < .001), compared to 3.1% in healthy controls. Significant associations between personality traits, depressive/anxious symptoms and ADHD features were found.
Discussion:The present study emphasises the close relationship between affective disorders, especially bipolar disorders, and ADHD in adults. Our findings support the need to assess subjects with mood disorders in the clinical setting for possible co-existing ADHD and to further investigate personality traits to better understand the etiology of affective disorders and ADHD co-occurrence.
Efficacy and acceptability of psychosocial interventions in asylum seekers and refugees: systematic review and meta-analysis
- G. Turrini, M. Purgato, C. Acarturk, M. Anttila, T. Au, F. Ballette, M. Bird, K. Carswell, R. Churchill, P. Cuijpers, J. Hall, L. J. Hansen, M. Kösters, T. Lantta, M. Nosè, G. Ostuzzi, M. Sijbrandij, F. Tedeschi, M. Valimaki, J. Wancata, R. White, M. van Ommeren, C. Barbui
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- Epidemiology and Psychiatric Sciences / Volume 28 / Issue 4 / August 2019
- Published online by Cambridge University Press:
- 11 February 2019, pp. 376-388
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Aims
In the past few years, there has been an unprecedented increase in the number of forcibly displaced migrants worldwide, of which a substantial proportion is refugees and asylum seekers. Refugees and asylum seekers may experience high levels of psychological distress, and show high rates of mental health conditions. It is therefore timely and particularly relevant to assess whether current evidence supports the provision of psychosocial interventions for this population. We conducted a systematic review and meta-analysis of randomised controlled trials (RCTs) assessing the efficacy and acceptability of psychosocial interventions compared with control conditions (treatment as usual/no treatment, waiting list, psychological placebo) aimed at reducing mental health problems in distressed refugees and asylum seekers.
MethodsWe used Cochrane procedures for conducting a systematic review and meta-analysis of RCTs. We searched for published and unpublished RCTs assessing the efficacy and acceptability of psychosocial interventions in adults and children asylum seekers and refugees with psychological distress. Post-traumatic stress disorder (PTSD), depressive and anxiety symptoms at post-intervention were the primary outcomes. Secondary outcomes include: PTSD, depressive and anxiety symptoms at follow-up, functioning, quality of life and dropouts due to any reason.
ResultsWe included 26 studies with 1959 participants. Meta-analysis of RCTs revealed that psychosocial interventions have a clinically significant beneficial effect on PTSD (standardised mean difference [SMD] = −0.71; 95% confidence interval [CI] −1.01 to −0.41; I2 = 83%; 95% CI 78–88; 20 studies, 1370 participants; moderate quality evidence), depression (SMD = −1.02; 95% CI −1.52 to −0.51; I2 = 89%; 95% CI 82–93; 12 studies, 844 participants; moderate quality evidence) and anxiety outcomes (SMD = −1.05; 95% CI −1.55 to −0.56; I2 = 87%; 95% CI 79–92; 11 studies, 815 participants; moderate quality evidence). This beneficial effect was maintained at 1 month or longer follow-up, which is extremely important for populations exposed to ongoing post-migration stressors. For the other secondary outcomes, we identified a non-significant trend in favour of psychosocial interventions. Most evidence supported interventions based on cognitive behavioural therapies with a trauma-focused component. Limitations of this review include the limited number of studies collected, with a relatively low total number of participants, and the limited available data for positive outcomes like functioning and quality of life.
ConclusionsConsidering the epidemiological relevance of psychological distress and mental health conditions in refugees and asylum seekers, and in view of the existing data on the effectiveness of psychosocial interventions, these interventions should be routinely made available as part of the health care of distressed refugees and asylum seekers. Evidence-based guidelines and implementation packages should be developed accordingly.
The balance of adult mental health care: provision of core health versus other types of care in eight European countries
- G. Cetrano, L. Salvador-Carulla, F. Tedeschi, L. Rabbi, M. R. Gutiérrez-Colosía, J. L. Gonzalez-Caballero, A.-L. Park, D. McDaid, R. Sfetcu, J. Kalseth, B. Kalseth, Ø. Hope, M. Brunn, K. Chevreul, C. Straßmayr, G. Hagmair, K. Wahlbeck, F. Amaddeo, for the REFINEMENT group
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- Journal:
- Epidemiology and Psychiatric Sciences / Volume 29 / 2020
- Published online by Cambridge University Press:
- 17 October 2018, e6
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Aims
Although many mental health care systems provide care interventions that are not related to direct health care, little is known about the interfaces between the latter and core health care. ‘Core health care’ refers to services whose explicit aim is direct clinical treatment which is usually provided by health professionals, i.e., physicians, nurses, psychologists. ‘Other care’ is typically provided by other staff and includes accommodation, training, promotion of independence, employment support and social skills. In such a definition, ‘other care’ does not necessarily mean being funded or governed differently. The aims of the study were: (1) using a standard classification system (Description and Evaluation of Services and Directories in Europe for Long Term Care, DESDE-LTC) to identify ‘core health’ and ‘other care’ services provided to adults with mental health problems; and (2) to investigate the balance of care by analysing the types and characteristics of core health and other care services.
MethodsThe study was conducted in eight selected local areas in eight European countries with different mental health systems. All publicly funded mental health services, regardless of the funding agency, for people over 18 years old were identified and coded. The availability, capacity and the workforce of the local mental health services were described using their functional main activity or ‘Main Types of Care’ (MTC) as the standard for international comparison, following the DESDE-LTC system.
ResultsIn these European study areas, 822 MTCs were identified as providing core health care and 448 provided other types of care. Even though one-third of mental health services in the selected study areas provided interventions that were coded as ‘other care’, significant variation was found in the typology and characteristics of these services across the eight study areas.
ConclusionsThe functional distinction between core health and other care overcomes the traditional division between ‘health’ and ‘social’ sectors based on governance and funding. The overall balance between core health and other care services varied significantly across the European sites. Mental health systems cannot be understood or planned without taking into account the availability and capacity of all services specifically available for this target population, including those outside the health sector.
Standard comparison of local mental health care systems in eight European countries
- M. R. Gutiérrez-Colosía, L. Salvador-Carulla, J. A. Salinas-Pérez, C. R. García-Alonso, J. Cid, D. Salazzari, I. Montagni, F. Tedeschi, G. Cetrano, K. Chevreul, J. Kalseth, G. Hagmair, C. Straßmayr, A. L. Park, R. Sfectu, T. Ala-Nikkola, J. L. González-Caballero, L. Rabbi, B. Kalseth, F. Amaddeo, For the REFINEMENT Group
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- Epidemiology and Psychiatric Sciences / Volume 28 / Issue 2 / April 2019
- Published online by Cambridge University Press:
- 18 September 2017, pp. 210-223
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Aims.
There is a need of more quantitative standardised data to compare local Mental Health Systems (MHSs) across international jurisdictions. Problems related to terminological variability and commensurability in the evaluation of services hamper like-with-like comparisons and hinder the development of work in this area. This study was aimed to provide standard assessment and comparison of MHS in selected local areas in Europe, contributing to a better understanding of MHS and related allocation of resources at local level and to lessen the scarcity in standard service comparison in Europe. This study is part of the Seventh Framework programme REFINEMENT (Research on Financing Systems’ Effect on the Quality of Mental Health Care in Europe) project.
Methods.A total of eight study areas from European countries with different systems of care (Austria, England, Finland, France, Italy, Norway, Romania, Spain) were analysed using a standard open-access classification system (Description and Evaluation of Services for Long Term Care in Europe, DESDE-LTC). All publicly funded services universally accessible to adults (≥18 years) with a psychiatric disorder were coded. Care availability, diversity and capacity were compared across these eight local MHS.
Results.The comparison of MHS revealed more community-oriented delivery systems in the areas of England (Hampshire) and Southern European countries (Verona – Italy and Girona – Spain). Community-oriented systems with a higher proportion of hospital care were identified in Austria (Industrieviertel) and Scandinavian countries (Sør-Trøndelag in Norway and Helsinki-Uusimaa in Finland), while Loiret (France) was considered as a predominantly hospital-based system. The MHS in Suceava (Romania) was still in transition to community care.
Conclusions.There is a significant variation in care availability and capacity across MHS of local areas in Europe. This information is relevant for understanding the process of implementation of community-oriented mental health care in local areas. Standard comparison of care provision in local areas is important for context analysis and policy planning.
Differences in the use of involuntary admission across the Veneto Region: which role for individual and contextual variables?
- V. Donisi, F. Tedeschi, D. Salazzari, F. Amaddeo
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- Epidemiology and Psychiatric Sciences / Volume 25 / Issue 1 / February 2016
- Published online by Cambridge University Press:
- 09 December 2014, pp. 49-57
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Aims.
The first aim of this study is to compare involuntary admissions across the Veneto Region in Italy. The second aim is to explore the relation between mental health services provision, characteristics of population, individual factors and involuntary admissions.
Methods.For 21 Mental Health Departments (MHDs) in the Veneto Region (Italy), the average population prevalence rate of involuntary admissions between 2000 and 2007 and the percentage of involuntary admissions were calculated. Chi-square tests for equality of proportions were used to test hypotheses. Variables at the individual, contextual and organisational levels were used in multiple regressions, with the involuntary admission data as dependent variables.
Results.The average prevalence rate of involuntary commitment was 12.75 ranging from 1.96 to 27.59 across MHDs . About 75% of the involuntary admissions referred to psychotic patients, and almost half of patients were aged 25–44. Significant differences among MHDs emerged; higher percentages of involuntary admissions were generally found in densely populated areas. Higher ageing indices and rates of social workers were found as predictors of the prevalence rate. In the multilevel regression, being males and psychotic significantly increased involuntary admissions, while the percentage of singles in population decreased it.
Conclusions.This study contributes to define the specific contribution of each factor predicting the use of involuntary admission, even within areas under the same legislation. It shows how the inclusion of both individual and contextual factors may lead to better predictions and provides precious data for the services improvement.
Comparison of growth curves of two genotypes of dairy goats using nonlinear mixed models
- J. G. L. REGADAS FILHO, L. O. TEDESCHI, M. T. RODRIGUES, L. F. BRITO, T. S. OLIVEIRA
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- The Journal of Agricultural Science / Volume 152 / Issue 5 / October 2014
- Published online by Cambridge University Press:
- 27 November 2013, pp. 829-842
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The objective of the current study was to assess the use of nonlinear mixed model methodology to fit the growth curves (weight v. time) of two dairy goat genotypes (Alpine, +A and Saanen, +S). The nonlinear functions evaluated included Brody, Von Bertalanffy, Richards, Logistic and Gompertz. The growth curve adjustment was performed using two steps. First, random effects u1, u2 and u3 were linked to the asymptotic body weight (β1), constant of integration (β2) and rate constant of growth (β3) parameters, respectively. In addition to a traditional fixed-effects model, four combinations of models were evaluated using random variables: all parameters associated with random effects (u1, u2 and u3), only β1 and β2 (u1 and u2), only β1 and β3 (u1 and u3) and only β1 (u1). Second, the fit of the best adjusted model was refined by using the power variance and modelling the error structure. Residual variance ($\sigma _e^2 $) and the Akaike information criterion were used to evaluate the models. After the best fitting model was chosen, the genotype curve parameters were compared. The residual variance was reduced in all scenarios for which random effects were considered. The Richards (u1 and u3) function had the best fit to the data. This model was reparameterized using two isotropic error structures for unequally spaced data, and the structure known in the literature as SP(MATERN) proved to be a better fit. The growth curve parameters differed between the two genotypes, with the exception of the constant that determines the proportion of the final size at which the inflection point occurs (β4). The nonlinear mixed model methodology is an efficient tool for evaluating growth curve features, and it is advisable to assign biologically significant parameters with random effects. Moreover, evaluating error structure modelling is recommended to account for possible correlated errors that may be present even when using random effects. Different Richard growth curve parameters should be used for the predominantly Alpine and Saanen genotypes because there are differences in their growth patterns.
Evaluating the statistical variation in estimating forage dry matter intake of grazing Brahman bulls using n-alkanes
- A. DE-STEFANI AGUIAR, T. D. A. FORBES, F. M. ROUQUETTE, JR., L. O. TEDESCHI, R. D. RANDEL
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- The Journal of Agricultural Science / Volume 151 / Issue 1 / February 2013
- Published online by Cambridge University Press:
- 12 April 2012, pp. 129-140
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The objectives of the current study were to determine the variation structure within a day and across days when determining dry matter intake (DMI) of Coastal bermudagrass (Cynodon dactylon (L.) Pers.) pasture using dotriacontane (C32) as an external marker, to determine the optimal times for faecal collection for forage DMI estimation and to compare C31 and C33 as internal markers in estimating forage DMI in Brahman bulls. Sixteen Brahman bulls were allocated by weight to four pastures, and stocked at a moderate to low grazing pressure for 63 days from late June to the end of August. Three intake measurement periods (P1, P2, P3) were used; each period consisting of 10 days of twice daily C32 (400 mg/day) administration. Faecal collections were taken during the last 5 days (07.00, 11.00, 15.00 and 19.00 h). The C32 was individually hand fed using Calan gates, with maize gluten as a carrier for the alkane. Gas chromatography was used to determine n-alkanes in the forage and faecal samples. The concentration of C31 was less than C33 in the bermudagrass for all periods (P < 0·001), but the concentration of C31 and C33 in faeces was not significantly different (P > 0·05). The average concentration of C32 in the forage was 5·1, 7·6 and 9·6 mg/kg dry matter (DM), for P1, P2 and P3, respectively, with an average of 7·5 mg/kg DM for all periods. During P1 and P2, the estimation of forage DMI using C33 had a better fit (smaller –2 × log and Akaike's information criterion (AIC)) than using C31 either with or without adjustments for C32. The variation in estimated forage DMI decreased when forage C32 was not included. The variances of forage DMI were similar using C31 across days, but the Pearson correlations between days were low, which suggested that several days of collection were needed to estimate forage DMI accurately. Correlations between collection times within days were medium to high for all periods and varied from 0·65 to 0.97 for C31 and from 0·26 to 0·96 for C33. When all periods were analysed together, estimates of forage DMI either using C31 or C33 had low correlations between days of collection. Adjustment for C32 did not improve the variance and (co)variance matrix. In summary, C33/C32 had the lowest variation in estimating forage DMI, and at least 5 days of faecal collection were needed to decrease the variability of estimating forage DMI. The optimum times for faecal collection were 07.00 and 19.00 h, and it was important to adjust for C32 alkane concentration in estimating forage DMI in Brahman bulls grazing Coastal bermudagrass.
A novel industrial thin film deposition technology for sustainable CdTe photovoltaics
- P. Nozar, G. Mittica, S. Milita, C. Albonetti, F. Corticelli, A. Brillante, I. Bilotti, G. Tedeschi, C. Taliani
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- Journal:
- MRS Online Proceedings Library Archive / Volume 1447 / 2012
- Published online by Cambridge University Press:
- 29 August 2012, mrss12-1447-v02-01
- Print publication:
- 2012
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CdTe and CdS are emerging as the most promising materials for thin film photovoltaics in the quest of the achievement of grid parity. The major challenge for the advancement of grid parity is the achievement of high quality at the same time as low fabrication cost. The present paper reports the results of the new deposition technique, Pulsed Plasma Deposition (PPD), for the growth of the CdTe layers on CdS/ZnO/quartz and quartz substrates. The PPD method allows to deposit at low temperature. The optical band gap of deposited layers is 1.50 eV, in perfect accord with the value reported in the literature for the crystalline cubic phase of the CdTe.
The films are highly crystalline with a predominant cubic phase, a random orientation of the grains of the film and have an extremely low surface roughness of 4.6±0.7 nm r.m.s.. The low roughness, compared to traditional thermal deposition methods (close space sublimation and vapour transport) permits the reduction of the active absorber and n-type semiconductor layers resulting in a dramatic reduction of material usage and the relative deposition issues like safety, deposition rate and ultimately cost
DNA-based discrimination and frequency of phytoplasma infection in the two hawthorn-feeding species, Cacopsylla melanoneura and Cacopsylla affinis, in northwestern Italy
- R. Tedeschi, F. Nardi
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- Journal:
- Bulletin of Entomological Research / Volume 100 / Issue 6 / December 2010
- Published online by Cambridge University Press:
- 23 June 2010, pp. 741-747
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A molecular tool, focused on the mitochondrial Control Region (CR), was developed to discriminate the two hawthorn-feeding psyllid species, Cacopsylla melanoneura (Förster) and C. affinis (Löw), and to estimate their frequencies in mixed populations. The test was carried out in paired and single-tube amplifications and validated analysing 52 male specimens previously determined by morphological analysis. The frequencies of the two species in mixed populations in the Aosta Valley (northwestern Italy) were analysed. The presence and type of 16SrX-group phytoplasmas was detected by nested PCR and RFLP tests in both species. C. melanoneura was the predominant species (86.5%; 80.4–91.2 CI); of these, 0.9% of the samples were positive for ‘Ca. Phytoplasma mali’ and 1.8% for ‘Ca. Phytoplasma pyri’. One of 21 specimens of C. affinis was positive for ‘Ca. Phytoplasma pyri’. The test also allowed us to identify two genetic variants of C. melanoneura, depending on the presence or absence of a 56 bp indel; these were named WI (with indel) and WOI (without indel), respectively. Further analyses were carried out on C. melanoneura specimens collected in apple orchards at six different locations in northern Italy where different levels of transmission efficiency have been described. Our preliminary observations suggest that some differences might exist between the two genetic variants in their ability to transmit phytoplasmas and to colonise different host plants.
Seasonal progression of sex ratio and phytoplasma infection in Scaphoideus titanus Ball (Hemiptera: Cicadellidae)
- F. Lessio, R. Tedeschi, M. Pajoro, A. Alma
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- Journal:
- Bulletin of Entomological Research / Volume 99 / Issue 4 / August 2009
- Published online by Cambridge University Press:
- 09 December 2008, pp. 377-383
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The differences between the seasonal occurrence and likelihood of being infected by FD phytoplasmas, of male and female Scaphoideus titanus Ball, were investigated. Sex ratio (male: female) was calculated by counting males and females sampled by means of yellow sticky traps and sweep-nets and from adults derived from hatched eggs in field-collected grapevine wood. PCR essays were performed to test differences in infection between genders. Overall, the sex ratio on sticky traps was significantly more male biased (1.99:1) if compared to net sweeping (0.62:1) and laboratory rearing (0.60:1). The peak of male presence was recorded in the middle of July in laboratory rearing and sweep net, and in the middle of August on sticky traps; the maximum presence of females was detected at the end of July in laboratory rearing, and at the end of August in sweep net samplings and on sticky traps. The seasonal sex ratio was more male biased at the beginning in laboratory rearing (1.50:1) and sticky traps (9:1), and then decreased in favor of females at the end of the sampling period, both in laboratory rearing (0.17:1) and in sticky traps (0.07:1). This trend was significantly less skewed, although similar, in sweep net samplings that recorded a sex ratio of 1:1 and 0.16:1 at the beginning and at the end of the sampling period, respectively. Concerning phytoplasma detection, an interaction between gender and sampling period was observed, the males showing a peak of infected individuals later in the season (35%). Some possible behavioral explanations of the data obtained are given.