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Paola Ferri,1 Monica Silvestri,1 Cecilia Artoni,2 Rosaria Di Lorenzo3 1Department of Diagnostic, Clinical and Public Health Medicine, School of Nursing, 2School of Psychiatry, University of Modena and Reggio, 3Department of Mental Health, Service of Psychiatric Diagnosis and Treatment, Modena, Italy Background: Workplace violence (WPV) against health professionals is a global problem with an increasing incidence. The aims of this study were as follows: 1) to examine the frequency and characteristics of WPV in different settings and professionals of a general hospital and 2) to identify the clinical and organizational factors related to this phenomenon. Methods: The study was cross-sectional. In a 1-month period, we administered the “Violent Incident Form” to 745 professionals (physicians, head nurses, nurses, nursing assistants), who worked in 15 wards of a general hospital in northern Italy. Results: With a response rate of 56%, 45% of professionals reported WPV. The most frequently assaulted were nurses (67%), followed by nursing assistants (18%) and physicians (12%). The first two categories were correlated, in a statistically significant way, with the risk of WPV (P=0.005, P=0.004, multiple logistic regression). The violent incidents more frequently occurred in psychiatry department (86%), emergency department (71%), and in geriatric wards (57%). The assailants more frequently were males whereas assaulted professionals more often were females. Men committed physical violence more frequently than women, in a statistically significant way (P=0.034, chi-squared test). Verbal violence (51%) was often committed by people in a lucid and normal state of consciousness; physical violence (49%) was most often perpetrated by assailants affected by dementia, mental retardation, drug and substance abuse, or other psychiatric disorders. The variables positively related to WPV were “calling for help during the attack” and “physical injuries suffered in violent attack” (P=0.02, P=0.03, multiple logistic regression).Conclusion: This study suggests that violence is a significant phenomenon and that all health workers, especially nurses, are at risk of suffering aggressive assaults. WPV presented specific characteristics related to the health care settings, where the aggression occurred. Prevention programs tailored to the different care needs are necessary to promote professional awareness for violence risk. Keywords: workplace violence, health professionals, nurses, physicians, patient, general hospital, aggression

Ferroelectric random access memory (FeRAM) is an attractive candidate technology for embedded nonvolatile memory, especially in applications where low power and high program speed are important. Market introduction of high-density FeRAM is, however, lagging behind standard complementary metal-oxide semiconductor (CMOS) because of the difficult integration technology. This paper discusses the major integration issues for high-density FeRAM, based on SrBi2Ta2O9 (strontium bismuth tantalate or SBT), in relation to the fabrication of our stacked cell structure. We have worked in the previous years on the development of SBT-FeRAM integration technology, based on a so-called pseudo-three-dimensional (3D) cell, with a capacitor that can be scaled from quasi two-dimensional towards a true three-dimensional capacitor where the sidewalls will importantly contribute to the signal. In the first phase of our integration development, we integrated our FeRAM cell in a 0.35 μm CMOS technology. In a second phase, then, possibility of scaling of our cell is demonstrated in 0.18 μm technology. The excellent electrical and reliability properties of the small integrated ferroelectric capacitors prove the feasibility of the technology, while the verification of the potential 3D effect confirms the basic scaling potential of our concept beyond that of the single-mask capacitor. The paper outlines the different material and technological challenges, and working solutions are demonstrated. While some issues are specific to our own cell, many are applicable to different stacked FeRAM cell concepts, or will become more general concerns when more developments are moving into 3D structures. [ABSTRACT FROM AUTHOR]

Different aspects of the integration of strontium bismuth tantalate (SBT)-based high-density ferroelectric random access memory (FeRAM) is discussed in relation to the fabrication of pseudo-three-dimensional (3D) cell structure. The excellent electrical and reliability properties of the small integrated FeCAP prove the feasibility of the technology, while the verification of the potential electrical 3D effect confirms the basic scaling potential of the concept beyond that of the single-mask capacitor.

Introduction: According to the WHO, detainees attempt suicide ten times more than the general population. Objectives: To investigate the impact of migration traumas on suicide behaviours of migrants in jail and to explore how substance use and other psychiatric features affect this relation. Methods: Prospective cohort study, conducted at "Sant'Anna" jail in Modena (Italy). Socio-demographic, psychiatric features and previous suicide attempts were collected, and traumas assessed with the LiMEs (List of Migration Experiences) checklist. Every participant was followed-up until an episode of suicide behaviour or to September 2019 (end of study). Survival analysis was performed. Cox's Hazard Ratios were used as a measure of association for the comparison between groups. Results: We recruited 113 subject, 96% male, median age 33. Prevalence of mental disorders was 26% and substance abuse 59%. History of self-harm was present in 36% of the sample. Median follow-up time was 80 days. During follow-up, 11 events were observed (8 self-harm and 3 suicide attempts); cumulative survival probability was 85% (Figure 1). Having experienced traumas related to wars was significantly associated with suicide behaviours, HR: 5.168 (Figure 2, Figure 3). Interestingly, no subject without substance abuse presented the outcome. Conclusions: Migrants in custody who experienced traumas in the post-migration periods, attempt suicide 5 timesmore frequently than those without traumas at any time. War traumas seem to be more strongly associated with suicide attempts, also controlling for psychiatric diagnosis, ongoing psychopharmacological therapy and substance abuse. Further research and possible intervention programs should focus on addressing post-migration living-difficulties. [ABSTRACT FROM AUTHOR]

This paper reports on the integration of MOCVD SBT based stacked ferroelectric capacitors in a 0.35 μm CMOS technology for embedded FeRAM, using a ferroelectric capacitor (FeCap) that is scalable to a 3D configuration. The electrical parameters of the CMOS devices with and without FeCap integration are presented. No significant shifts of the CMOS characteristics are noticed after FeCap integration. Also the effects of the CMOS processing on the FeCaps are discussed. There is no degradation of the hysteresis loops of the FeCaps throughout the CMOS back-end-of-line processing, which proves that the integrated encapsulation layer effectively prevents any hydrogen induced damage. Another key element in the successful integration of stacked ferroelectric devices is the conductive oxygen barrier, which protects the plugs from oxidation. A low contact resistance and a high yield are obtained on plug contacts covered by the oxygen barrier. Also damage free etching is a critical issue in FeRAM integration. Excellent results are presented for the etch process to form the contacts to the electrodes. [ABSTRACT FROM AUTHOR]

Background: According to the WHO, detainees attempt suicide ten times more than the general population., Aims: To investigate the impact of migration trauma on Suicidal and Self-Harm Behaviours (SSHB) of migrants in jail and to explore how substance use and other psychiatric features affect this relationship., Methods: Prospective cohort study, conducted at the 'Sant'Anna' jail in Modena (Italy) between February 2017 and September 2019. Socio-demographic, psychiatric features and records of previous SSHB were collected. Experience of migration-related trauma was assessed with the LiMEs (List of Migration Experiences) checklist. Participants were followed-up for the occurrence of further SSHB. Survival analysis was performed and Cox's Hazard Ratios (HR) were used as a measure of association of comparisons., Results: Amongst the 112 subjects (96% male, median age 33), the prevalence of any mental disorder was 26% and of substance abuse 59%. History of SSHB was present in 36% of the sample. Median follow-up time was 80 days. During follow-up, 11 events were observed (of which three were suicide attempts). Cumulative survival probability was 85%. Having experienced trauma related to war and violence was significantly associated with SSHB, HR: 7.05. No SSHB were recorded amongst subjects without substance abuse., Conclusions: Migrants in custody who experienced trauma in the post-migration period, attempt SSHB seven times more frequently than those without traumas at any time. War trauma and post-migration trauma due to exposure to violence seem to be more strongly associated with SSHB, also controlling for psychiatric diagnosis, ongoing psychopharmacological therapy and substance abuse. Further research and possible intervention programs should focus on addressing post-migration living-difficulties.

The current treatment of distal femur fractures includes locking plating and retrograde intramedullary nailing. These fractures are difficult to manage also for experienced surgeons, with results not always satisfactory. Reported nonunion rates now range from 0 to 34%. Factors associated with nonunion include comorbidities, such as obesity and diabetes, as well as the presence of open fractures, medial bone defects and comminuted fractures. This case report summarizes all of these assumptions and it concerns a 58 years old patient who underwent to 6 surgical procedures before to arrive to bone healing.

Background and Aim: Pelvic ring fractures represent a challenge for orthopaedic surgeon. Their management depends on patient's condition, pattern of fracture and associated injuries. Optimal timing for synthesis is not yet clear. The aim of this study was to define if surgical timing influenced clinic and radiographic outcomes following open reduction and internal fixation for Tile B and C fractures., Materials and Methods: 38 patients were included. Patients underwent a clinical examination with the Majeed Score, Iowa Pelvic Score and Orlando Pelvic Score. The radiographic assessment was performed according to Matta Pelvic Score. A statistical analysis of the data compared patients who were operated within 3 weeks (group 1) and those operated later (group 2)., Results: Both clinical and radiological outcomes were influenced by timing of surgery., Conclusion: Pelvic ring fractures interest many polytrauma patients and, therefore, their surgical orthopedic approach is frequently delayed as consequence of the severity of the associated clinical conditions. An early surgery of pelvic rong fractures allows a better quality of reduction and osteosynthesis.

Background and Aim: There is a wide debate about the number, diameter and length of the syndesmotic screw and necessity and timing for its removal. The aim of this study is to determine whether functional and radiological outcomes differ in patients operated for Weber type B and C ankle fractures who had syndesmotic screws removed (group 1) compared to those who did not (group 2). Furthermore, authors want to define if it is really necessary to remove this device and its correct timing., Materials and Methods: 90 patients were eligible for the study. The functional outcomes were analyzed 1 year after surgery using OMAS and AOFAS scores. Radiographic evaluation assessed the tibiofibular distance immediately and 12 months after surgery and fracture's healing., Results: Clinical and x-rays results were similar in both groups at follow-up., Discussion: Fractures with interruption of syndesmosis are lesions that, if not well treated, are complicated by joint stiffness, residual pain and post-traumatic osteoarthritis. Syndesmotic screw removal is not routinely performed, thus accepting the risk of rupture but avoiding a new surgery., Conclusions: Results observed suggest that syndesmotic screw removal is not necessary. If surgeon decide to remove this device correct timing is mandatory in order to obtain satisfactory long-term results.

Background: In Italy, psychiatric compulsory treatments are regulated by Law 180 of 13-5-1978 that establishes three criteria: 1) acute psychiatric conditions requiring urgent treatment, 2) patient's refusal of treatment, 3) inpatient treatment is necessary and cannot be postponed., Aim: To highlight demographic and clinical risk factors for involuntary treatments., Methods: We retrospectively collected all hospitalizations in the Service of Psychiatric Diagnosis and Treatment of a northern Italian town from 1-1-2015 to 31-12-2015. We statistically compared demographic and clinical variables related to voluntarily and involuntarily admitted patients and their hospitalizations., Results: We divided our sample into patients voluntarily hospitalized (PVH=236) and involuntarily (PIH=160) according to their voluntary (VH= 304) and involuntary (IH=197) hospitalizations. PIH were older than PVH and, more frequently, lived alone and were unemployed (p<0.001). "Acute worsening of psychopathology" for IH and "Suicidality" for VH were the prevalent reasons (p<0.001). IH was longer than VH (p<0.001). Among PIH, the most frequent diagnoses were "Schizophrenia and Other Psychosis" (ICD-9-CM) and "Ineffective Impulse Control + Disturbed Personal Identity" (NANDA-I) (p<0.001). During hospitalizations, PIH more often than PVH presented aggressive behavior (p<0.001). At discharge, PIH were more frequently sent to another psychiatric ward or protected facility with long-acting injectable antipsychotics (p<0.001)., Conclusions: Our involuntarily admitted patients were affected by severe psychiatric disorders with social maladjustment and required complex therapeutic and rehabilitative programs to counteract aggressive behaviour, poor therapeutic compliance and prolonged hospitalizations. The assessment of patients' characteristics can help clinicians recognize who are at risk for compulsory treatment and prevent it.

The Authors have executed a retrospective study about the incidence of intrahepatic cholestasis in pregnancy in 85 patients hospitalized in the department of Obstetrics and Gynaecology, University of Parma. Particularly, they have investigated about the incidence of fetal distress, about the intrauterine death, and about poor intrauterine fetal growth.