1,721,195 research outputs found
Prevalence and determinants of resistant hypertension in a sample of patients followed in Italian hypertension centers: Results from the MINISAL-SIIA study program
No full textLa comunicazione interculturale in ambito aziendale: una chiave per l'internazionalizzazione
No full textPsychopatological problems in neurological disorders of children and adolescents
No full textIn neurological disorders of children and adolescents, psychiatric syndromes may occur and adaptive problems are commonly to be expected; adolescence problems may enhance difficulties to cope with chronic conditions and related disability. Prevention of these problems is often neglected in spite of good chances and remarkable know-how. Psychopathological risk depends on both medical and non-medical factors, that are examined in detail in this chapter. The former vary according to severity, timing and features of the disease and to eventual brain changes; the importance of mental retardation and of some genetic disorders is stressed. The latter are related to environment, social condition, school integration, familial relations, sex, age and life events. On the other hand some subjects show resilience to unfavourable events and environmental, educational and familial resources may play a protective role. All these aspects intersect with factors predicting either academic failure or success. Appropriate attention to such problems should be paid during clinical interview. Non-medical as well as medical features should be considered. Possible guidelines for general population and individual prevention are discussed. At individual level, a profile of risk and protection factors should be marked out and a balance between them should be struck. More significant factors should be identified; the key role of familial relations and of cognitive level is stressed. If risk should be considered high, protective factors should be exploited and possible correction of negative factors evaluated. Cognitive and behavioural effects of drugs should be carefully considered. Direct involvement of the child in diagnostic and therapeutic procedure may prevent misunderstanding, unfounded anxiety and non-compliance. Psychological support may be helpful. School performance assessment and neuropsychological evaluation should be performed to design, if necessary, rehabilitation treatment or an individual educational plan. Intervention on non-medical factors involves other professional and non-professional operators. The teachers’ role is stressed. The family has an irreplaceable role, as behaviour ruling involves upbringing and depends on parents’ ethic principles
Esperienza e formazione nella Terapia della Neuro e Psicomotricità dell'Età Evolutiva: la nascita di una professione e di una metodologia riabilitativa
No full textChildhood and adolescence Neuropsychiatry started during the XX century. After the 2nd World War, a rehabilitative approach in this field developed in Italy. Physiotherapy, occupational therapy, neuromuscular facilitation, speech therapy, neuropsychological, psychomotor and other techniques melted into an individualized, eclectic method called ‘Terapia della Neuro e Psicomotricità dell’età Evolutiva’ (Neuro-Psychomotor Therapy of Developmental Age, NPMTDA) dedicated to the motor, sensorial, language, cognitive and relational disabilities of children and adolescents. At the beginning, an eclectic approach had been an obliged option owing to lack of therapeutic resources. In spite of manifold know-how required, in NPMTDA the treatment is performed by one therapist whose competence is defined by patient’s age rather than particular techniques or disorders. A global diagnostic and therapeutic approach is adopted even if definite developmental processes are impaired. We could reconstruct the development of NPMTDA at the University ‘La Sapienza’ of Rome, where Giovanni Bollea had created a team of childhood and adolescence Neuropsychiatry. In the 50’s three physiotherapists coming form the U.S.A., expert in physical, occupational and speech therapy, were the first trainers of roman therapists. Their assessment scheme was adapted to the needs of neuropsychiatric disorders and gradually the above mentioned practices flowed into both evaluation and therapeutic method, thanks also to the competence of other NPCA specialists. A rehabilitation school officially dedicated to children started only in 1973, though it had existed informally since the beginning. It progressively increased in academic dignity finally becoming, in 2000, a graduate school. The professional progress of therapists was favoured by medical advances, National Health Service institution (in the 70’s), territorial spreading of rehabilitation centres, academic evolution of NPMTDA teaching
Prevalence and determinants of resistant hypertension in a sample of patients followed in Italian hypertension centers: results from the MINISAL-SIIA study program
No full textThe aim of this study was to detect the prevalence of resistant hypertension (RH), allowing for adherence to appropriate lifestyle measures according to European Society of Hypertension-European Society of Cardiology (ESH-ESC) 2013 guidelines, in a sample of 1284 hypertensive subjects participating at the MINISAL-SIIA study. Hypertensive patients were recruited in 47 Italian centres, recognised by the Italian Society of Hypertension. Anthropometric indexes, blood pressure and 24-h urinary sodium (Na24h) and potassium (K24h) excretion were measured. Data on antihypertensive therapy were available for 1177 (92%) subjects. The population was divided into three groups (North, Central and South), according to their geographical location. Accounting only at the treatment criteria, the prevalence of RH was 8.2% (96/1177). RH prevalence in the southern, central and northern regions was respectively: 1, 3.8 and 3.3% (P<0.001). Participants with RH were older and showed a higher body mass index (BMI) and waist circumference compared with other subjects (P<0.005). RH risk was statistically significant (P<0.01) increased of 1.52-fold (95% confidence interval (CI):1.20-1.92) for one unit increase in s.d. score of age (11 years), and 1.50-fold (95% CI:1.22-1.83) for one unit increase in s.d. score of BMI (4.5 kg m(-)(2)). Including in RH diagnosis also the adherence to appropriate lifestyle measures, such as dietary salt restriction (Na24h <100 mmol) and normal BMI (18-25 kg m(-)(2)), RH prevalence felt respectively to 2.2% (26/1177) and 0.8% (9/1177). In conclusion in this national sample of Italian hypertensive population, among participants following both drug treatment and lifestyle modifications advises, the 'true' RH prevalence appears to be particularly low.Journal of Human Hypertension advance online publication, 3 March 2016; doi:10.1038/jhh.2016.6
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