1,721,051 research outputs found
The personality factor: how top management teams make decisions. A literature review
No full textPast research has increasingly suggested that CEO/TMT personality can
play a relevant role in influencing various external (e.g. firm performance) and internal (e.g. firm organizational structure) management outcomes. These promising results need appropriate systematization and discussion, which we aim at providing through a literature review based on rigorous inclusion/exclusion criteria. Our analysis shows great heterogeneity in regard to both the personality traits and the personality based management outcomes explored by the investigated population of studies. Thus, we specifically use the framework provided by the Five-Factor Model
(FFM) of personality to codify the publications and this framework allows us to identify some possible theoretical trajectories. These trajectories mainly regard the empirical testing of the highlighted associations between CEO emotional stability, extraversion and conscientiousness with bureaucratization, strategic pro-activity and firm performance. Our article is primarily intended for those scholars and practitioners who want to improve their knowledge about psychology-based decision making and behavioural corporate governance through the understanding of how CEO/TMT personality can affect their strategic decisions
Il consenso informato al trattamento psichiatrico-forense. Luci,ombre, presupposti, prospettive [Informed consent in forensic treatment. Lights, shadows, assumptions, perspectives]
No full textThe progressive process leading to deinstitutionalization of socially dangerous insanity acquittees in Italy seems to have come to its conclusion. Forty years after the closure of psychiatric hospitals, the latest custodial models regarding forensic psychiatric patients also gave way to approaches to care and rehabilitation. In our opinion, however, the treatment of the forensic psychiatric deserves specific profiles in relation to treatments, methods, motivations, objectives, setting. In this paper, the authors will address the topic informed consent to forensic psychiatric treatment, its relationship with the security measure and implications for treatment in the judicial context. © Pensa MultiMedia Editore
Little patients, large risks: An overview on patient safety management in pediatrics settings
Full text linkPatient safety is an emerging healthcare discipline with the ultimate goal to reduce errors and harm to patients by implementing quality health services. In 1999, the well-known “To Err is Human: Building a safer health system” reported that between 2% and 4% of people die annually in United States hospitals for medical errors. Since that publication, the focus on healthcare safety has encouraged efforts by legislators, hospital government, and health professionals to promote policies and behaviors heavily to reduce errors and implement a safe provision of healthcare delivery. In 2019, the World Health Organization (WHO) declared September 17th as Patient Safety Day, confirming that as a global priority.
The increasing interest in patient safety has significant repercussions on scientific publications with an ever-increasing production of studies in the growing interdisciplinary field of public health. New concepts and new terms had born, such as “clinical risk,” which refers to the probability that a patient can be the victim of an adverse event due to medical care, although unintentionally.
The WHO proposed to adopt a “universal vocabulary” thus standardizing the terminology and allowing effective scientific research. In clinical risk, the most explored field is adult patient safety, where growing interest is shown primarily to prevent nosocomial infections, falls, and pressure injuries. Instead, a little-explored area concerns the pediatric population.
This article aims to overview the spread of pediatric clinical risk management and organizational culture for healthcare quality improvement, looking at what has been done and enhancing healthcare practices to implement inpatient safety. The authors have reviewed the main concerns on pediatric patient safety and issued the main medico-legal aspects. After summarizing the relevant literature, the authors addressed their point of view by writing an opinion article
Psychopathy, Personality Disorders, and Violence
No full textThe relationship between personality disorders, psychopathy, and aggression/violent crime is a central issue in forensic psychiatry and psychology. It is also relevant in clinical criminology, as it has long been demonstrated that personality factors contribute greatly to recidivism, and they can be decisive when assessing offenders for parole/ probation. In this chapter, we first focus on a historical overview of the main works that led to the development of the concepts of psychopathy and personality, as well as their link to crime and violence. We then focus on the most recent evidence on DSM-5 personality disorders and violence, and their relevance for recurrence prevention
Schizofrenia: il problema del consenso informato al trattamento con clozapina
No full textObjective: The factor-structure of schizophrenic symptoms has long been investigated by many investigators. Schizophrenia dimensions have been proposed as possible specific pharmacological targets. Some authors also advanced the hypothesis that dimensions, or specific dimensional profiles, could help to discriminate the heterogeneous schizophrenic-spectrum symptomatology as well as to identify homogeneous subgroups. Despite the advances in the knowledge of schizophrenia dimensions, only few dimensional models have been proposed, with few of them gaining awareness in clinical practice. Apart from the classical dichotomous positive-negative and a tridimensional positive-negative- disorganization models, further 4-factor and 5-factor models have been proposed. Despite these efforts there is still lack of consensus on the "real" schizophrenia dimensional structure. Moreover the degree to which a symptom could be considered dimension-specific is still debated. Aim of the study was to investigate the proposed dimensional structure of schizophrenia and the specificity of symptoms in a given dimension. Methods: PubMed, Medline, and PsychInfo were searched online and key journals were searched manually for factor-analytic studies investigating the dimensional structure of schizophrenia. Papers were systematically reviewed. Studies conducted on patients who had schizophrenia, schizophreniform or schizoaffective disorder according to the DSM-IV, DSM-III or ICD-9 criteria were included. Multiple analyses in the same study were all included. A further analysis was conducted on factor-analytic studies using the Positive and Negative Syndrome Scale (PANSS) and with a 5-factor solution. Results: Fifty-four factor analytic studies were found, the number of patients included was 13024 (55% outpatients). The studies identified 3 to 6 factors with a median of 5 factors. The mean total explained variance was 59.1 ± 9.5 (95% IC = 56.3-61.9). Ninety-nine studies using PANSS with a 5-factor solution were identified, including 4115 patients (Table II). Data are discussed herein. These findings suggest heterogeneity among factorial solutions in schizophrenia spectrum disorders. The structure and type of items of the rating scales might explain this heterogeneity. A 5-factor solution with "positive", "negative", "disorganization", "excitement/hostility " and "anxiety-depression " seemed to adequately describe schizophrenic symptomatology in a heterogeneous group of patients (Figs. 1-5). However, few items (symptoms) seemed to be dimension-specific in this model. Conclusions: Further studies with broad and valid psychometric instruments are needed to better clarify the dimensional structure of schizophrenia
Informed consent and neuromodulation techniques for psychiatric purposes: an introduction
No full textScopo di questa rassegna è stato delineare le principali problematiche relative al consenso informato al trattamento
con metodiche di neuromodulazione chirurgica, in pazienti affetti da disturbi mentali. È stata effettuata un’analisi della
letteratura concernente l’utilizzo di tecniche neurochirurgiche, in particolare della stimolazione cerebrale profonda e della
stimolazione vagale in Psichiatria, con particolare riferimento a studi che si fossero occupati di decision-making in relazione
al consenso informato. I risultati sono discussi alla luce della dottrina del consenso informato. Nonostante gli importanti
risvolti etici e deontologici, attualmente, non sono stati individuati studi che si siano occupati specificamente delle problematiche
inerenti al consenso informato, ad interventi di neuromodulazione chirurgica, in pazienti con disturbi mentali. Le tecniche
neurochirurgiche sono utilizzate, quasi esclusivamente, in protocolli sperimentali nel trattamento del disturbo depressivo
maggiore, della sindrome di Tourette e del disturbo ossessivo-compulsivo, farmaco-resistenti. Le caratteristiche degli interventi,
i possibili rischi e benefici rendono l’acquisizione del consenso critica in popolazioni a rischio di incapacità. I dati desumibili
dagli studi sperimentali effettuati lasciano emergere, tuttavia, la necessità di approfondire e valutare specificamente
gli aspetti relativi alla capacità di prestare consenso informato al trattamento dei pazienti candidati a interventi di neuromodulazione
chirurgica, garantendo la possibilità di curare soggetti farmaco-resistenti in un contesto di piena autonomia decisionale.
L’attuale carenza di evidenze sperimentali indica l’esigenza di studi e procedure specifici che valutino la capacità di
prestare consenso informato in una popolazione a rischio di incapacita
Il Disturbo Ossessivo Compulsivo (DOC): dalla clinica alle valutazioni medico legali nella valutazione di disabilità.
No full textObsessive-compulsive disorder (OCD) is among the leading causes of disability in adults. Despite growing evidence provided by genetic, clinica! and neuroimaging studies, the pathophysiology of this disorder is
stili a matter of debate. Further complexity comes from the great variability in individuai response to psychiatric treatment as well as pharmacoresistance. Moreover, the variable burden of OCD is associated with the heterogeneous psychopathological symptoms and course characteristic of the disease. In the present study, we will first discuss the clinica! features of OCD, then we will focus on the most reliable assessment procedures that can be used to evaluate patients' disability within a medico-legai context
Validation of a new instrument to guide and support insanity evaluations: the defendant's insanity assessment support scale (DIASS)
Full text link: The insanity defense represents one of the most controversial and debated evaluations performed by forensic psychiatrists and psychologists. Despite the variation among different jurisdictions, in Western countries, the legal standards for insanity often rely on the presence of cognitive and/or volitional impairment of the defendant at the time of the crime. We developed the defendant's insanity assessment support scale (DIASS) based on a wide view of competent decision-making, which reflects core issues relevant to legal insanity in many jurisdictions. To assess the characteristics of the DIASS we asked 40 forensic experts (16% women; years of experience = 20.6 ± 12.9) to evaluate 10 real-life derived forensic cases with the DIASS; cases included defendants' psychiatric symptom severity, evaluated through the 24-itemBrief Psychiatric Rating Scale (BPRS). Exploratory factor analysis by principal axis factoring was conducted, which disclosed a two-factor solution explaining 57.6% of the total variance. The DIASS showed a good internal consistency (Cronbach's alpha = 0.86), and substantial inter-rater reliability (Cohen's kappa = 0.72). The capacities analyzed through the DIASS were mainly affected by mania/excitement and psychotic dimensions in nonresponsible and with substantially diminished responsibility defendants, while by hostility and negative symptoms in responsible defendants. The DIASS proved to be an effective psychometric tool to guide and structure insanity defense evaluations, in order to improve their consistency and reliability
Capacity to consent to treatment in severe eating disorders
No full textEating disorders represent a disabling, deadly and costly condition, whose principal treatment is constituted by weigh restoration and psychotherapy. Partial or total refuse of treatment is very common, leading some authors to question their decision-making capacity (DMC) to consent to treatment. However, very few studies have investigated treatment DMC, leading to contrasting results. Forty-five women were enrolled at the Psychiatric and Eating Disorders Unit of the University Hospital Policlinico Umberto I of Rome. Psychiatric symptoms severity (Brief Psychiatric Rating Scale Expanded, BPRS-E), treatment DMC (MacArthur Competence Assessment Tool for Treatment, MacCAT-T), depressive symptoms (Hamilton Depression Rating Scale, HAM-D), anxiety symptoms (Hamilton Anxiety Rating Scale, HAM-A), symptoms and psychological characteristics of eating disorders (Eating Disorder Inventory, EDI-3) and Metacognitive beliefs (Metacognitions Questionnaire 30, MCQ-30) were assessed. Sixty-seven percent of the total sample showed low treatment DMC; specifically, 70.4% of patients affected by Anorexia Nervosa, 72.7% of patients affected by Bulimia Nervosa, and 42.9% of patients affected by Binge Eating Disorder. Specific psychopathological symptoms enhance or hamper patients’ decisional capacities. Clinicians should be aware of the risk of impaired DMC in this vulnerable group of patients and pay attention at those factors suggesting the need of an in-depth evaluation
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