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Background: The assessment of the quality of care pathways delivered to people with severe mental disorders in a community-based system remains uncommon, especially using healthcare utilization databases. The aim of the study was to evaluate the quality of care provided to people with bipolar disorders taken-in-care by mental health services of four Italian areas (Lombardy, Emilia-Romagna, Lazio, province of Palermo). Methods: Thirty-six quality indicators were implemented to assess quality of mental health care for patients with bipolar disorders, according to three dimensions (accessibility and appropriateness, continuity, and safety). Data were retrieved from healthcare utilization (HCU) databases, which contain data on mental health treatments, hospital admissions, outpatient interventions, laboratory tests and drug prescriptions. Results: 29,242 prevalent and 752 incident cases taken-in-care by regional mental health services with a diagnosis of bipolar disorder in 2015 were identified. Age-standardized treated prevalence rate was 16.2 (per 10,000 adult residents) and treated incidence rate 1.3. In the year of evaluation, 97% of prevalent cases had ≥ 1 outpatient/day-care contacts and 88% had ≥ 1 psychiatric visits. The median of outpatient/day-care contacts was 9.3 interventions per-year. Psychoeducation was provided to 3.5% of patients and psychotherapy to 11.5%, with low intensity. 63% prevalent cases were treated with antipsychotics, 71.5% with mood stabilizers, 46.6% with antidepressants. Appropriate laboratory tests were conducted in less than one-third of prevalent patients with a prescription of antipsychotics; three quarters of those with a prescription of lithium. Lower proportions were observed for incident patients. In prevalent patients, the Standardized Mortality Ratio was 1.35 (95% CI: 1.26–1.44): 1.18 (1.07–1.29) in females, 1.60 (1.45–1.77) in males. Heterogeneity across areas was considerable in both cohorts. Conclusions: We found a meaningful treatment gap in bipolar disorders in Italian mental health services, suggesting that the fact they are entirely community-based does not assure sufficient coverage by itself. Continuity of contacts was sufficient, but intensity of care was low, suggesting the risk of suboptimal treatment and low effectiveness. Care pathways were monitored and evaluated using administrative healthcare databases, adding evidence that such data may contribute to assess the quality of clinical pathways in mental health.

The use of alternative oak wood products (AOP), such as chips, cubes and staves, among other, from different geographical origins is a common practice for wine aging, where the micro-oxygenation (MOX, adding small doses of oxygen constantly over time) is essential to obtain a final wine more stable in time and with similar characteristics of barrel-aged wine. The aim of this work was to identify if spectroscopic techniques allow to discriminate wines aged with alternative oak products (chips and staves) from different oak woods (American, French and Spanish) and a floating micro-oxygenation (20 µg·L−1) after 10 years of bottling and compared to those aged in barrels. The spectral information and analysis were performed in a FTIR-ATR, with 128 scans per spectrum at a spectral resolution of 8 cm-1 in the wavenumber range from 4,000 to 450 cm-1. Principal component analyses of spectral information were performed using the Unscrambler® X. The results indicate that with this technique it is possible to clearly separate the wines aged by the three systems (chips, staves and barrels) in the case of American oak. In the case of French oak, wines aged in chips were clearly differentiated from wines aged in staves with those aged in barrels between the two. It is also possible to clearly separate aged wines with different Spanish oak systems. The application of FTIR-ATR appears to be a powerful technique for discriminating the quality of wines aged by different AOPs and wood barrels from different geographical origins., VITIS - Journal of Grapevine Research, Vol. 58 No. 5 (2019): Vitis (Special Issue)

Trabajo presentado en el 10th In Vino Analytica Scientia Symposium, celebrado en Salamanca (España), del 17 al 20 de julio de 2017

Aim. The scientific literature focused on factors involved in the onset of borderline personality disorder (BPD) has given a central role to the families of these patients. The role of the family in understanding the disorder has gradually changed thanks to research that investigated the interaction of several factors in the development of this psychopathology. Recently, scientific literature on DBP has allowed to consider parents as no longer "responsible" for the development of the disorder, but as directly involved in interpersonal problems of patients and therefore a potential "ally" in the management of crisis. The aim of this study is to describe and quantify the family burden of BPD patients and browse specific interventions for the family of these patients. Methods. PubMed and PsycINFO have been used for review with the following keywords: "borderline personality disorder", "family", "psychopathology", "burden", "psychoeducation", "caregiver", "caretaker". Results. Studies on family burden of BPD patients are still few. Research shows that the family burden of BPD patients is comparable with that of families of patients with schizophrenia. Clinical trials of interventions for caregivers of patients with BPD show that specific strategies can reduce the family burden and improve their self-efficacy. Discussion. Scientific literature highlights the relevance of problems of families with a BPD member and the importance of involving them in the treatment of these patients.

The presentation describes part of the findings of a national study on drug use among university students

Objectives To summarize participation and coverage rates in population mammographic screening programmes for breast cancer in Europe. Methods We used the European Network for Information on Cancer (EUNICE), a web-based data warehouse (EUNICE Breast Cancer Screening Monitoring, EBCSM) for breast cancer screening, to obtain information on programme characteristics, coverage and participation from its initial application in 10 national and 16 regional programmes in 18 European countries. Results The total population targeted by the screening programme services covered in the report comprised 26.9 million women predominantly aged 50-69. Most of the collected data relates to 2005, 2006 and/or 2007. The average participation rate across all programmes was 53.4% (range 19.4-88.9% of personally invited); or 66.4% excluding Poland, a large programme that initiated personal invitations in 2007. Thirteen of the 26 programmes achieved the European Union benchmark of acceptable participation (>70%), nine achieved the desirable level (>75%). Despite considerable invitation coverage across all programmes (79.3%, range 50.9-115.2%) only 48.2% (range 28.4-92.1%) of the target population were actually screened. The overall invitation and examination coverage excluding Poland was 70.9% and 50.3%, respectively. Conclusions The results demonstrate the feasibility of European-wide screening monitoring using the EBCSM data warehouse, although further efforts to refine the system and to harmonize standards and data collection practices will be required, to fully integrate all European countries. The more than threefold difference in the examination coverage should be taken into account in the evaluation of service screening programmes.

Objective To estimate the cumulative risk of a false-positive screening result in European mammographic screening programmes, and examine the rates and procedures of further assessment. Methods A literature review was conducted to identify studies of the cumulative risk of a false-positive result in European screening programmes (390,000 women). We then examined aggregate data, cross-sectional information about further assessment procedures among women with positive results in 20 mammographic screening programmes from 17 countries (1.7 million initial screens, 5.9 million subsequent screens), collected by the European Network for Information on Cancer project (EUNICE). Results The estimated cumulative risk of a false-positive screening result in women aged 50-69 undergoing 10 biennial screening tests varied from 8% to 21% in the three studies examined (pooled estimate 19.7%). The cumulative risk of an invasive procedure with benign outcome ranged from 1.8% to 6.3% (pooled estimate 2.9%). The risk of undergoing surgical intervention with benign outcome was 0.9% (one study only). From the EUNICE project, the proportions of all screening examinations in the programmes resulting in needle biopsy were 2.2% and 1.1% for initial and subsequent screens, respectively, though the rates differed between countries; the corresponding rates of surgical interventions among women without breast cancer were 0.19% and 0.07%. Conclusion The specific investigative procedures following a recall should be considered when examining the cumulative risk of a false-positive screening result. Most women with a positive screening test undergo a non-invasive assessment procedure. Only a small proportion of recalled women undergo needle biopsy, and even fewer undergo surgical intervention.

Producción Científica, Different oak species or origins have been studied to find an alternative to traditional ones and Quercus humboldtii from Colombia is a candidate. Some studies analyse the composition of this oak, but no work has been found to study its use for wine treatment. The aim was to evaluate volatile composition of toasted Q. humboldtii oak chips and the wines treated with these chips. To evaluate its oenological potential Q. alba and Q. petraea have been included in this trial. The wines were subjected to a sensory analysis. Results indicated that oak chips and wines macerated for 90 days with toasted Colombian chips exhibited higher 5-methylfurfural, guaiacol, trans-isoeugenol and syringol concentrations than others, while the furfural and cis-β-methyl-γ-octalactone content was lower. Sensory analysis showed that the wines treated with Colombian oak presented more notes of smoked and less of coconut. Therefore, this oak could probably be considered suitable for ageing., Ministerio de Ciencia e Innovación (Proyect AGL2014-54602P), Junta de Castilla y León (programa de apoyo a proyectos de investigación - Ref. VA028U16), Fondecyt de Iniciación. Grant Number: 11150462

Producción Científica, The most frequent renewal of barrels of different origins and species is a current trend, but this demand does not match the current availability of wood. An alternative could be the use of Quercus humboldtii wood. However, there is little information about its composition. Because of this, the aim was to study low‐molecular‐weight phenols (LMWP), ellagitannins and volatile compounds in untoasted and toasted Q. humboldtii oak, and compare these with the species traditionally used in cooperage: Q. petraea (French and Romanian) and Q. alba (American). The LMWPs in Q. humboldtii were comparable to those in Q. petraea and Q. alba. Ellagitannin composition in Q. humboldtii was similar to that in Q. alba. The toasting process improved volatile composition, mainly in Q. humboldtii, presenting the highest concentration of several volatile compounds. The results indicate that Q. humboldtii could be considered suitable for aging wine, although it is necessary to continue the study of this wood species to confirm its potential use in oenology., 2019-09-09, Ministerio de Economía, Industria y Competitividad (Project AGL2014- 54602P), Junta de Castilla y León (programa de apoyo a proyectos de investigación - Ref. VA028U16), Fondecyt de Iniciación. Grant Number: 11150462, IBERPHENOL. Grant Number: POCTEP ‐ Programa Operativo Cooperación Transfron

[EN] The use of new oak barrels and the demand for oak wood in oenology is increasing. Thus, it is necessary to search for new wood sources to supply the current demand in cooperage. The aim of this work was to study the composition of ellagitannins and low molecular weight phenolic compounds (LMWP) by HPLC-DAD of green wood Quercus humboldtii Bonpl. (Colombian), compared to the species typically used in cooperage: Quercus sessiliflora Salisb. (French and Romanian) and Quercus alba L. (USA). In Colombian oak wood, the same LMWP and ellagitannins as in the traditional species were identified. The most abundant LMWP was ellagic acid, and its concentration was lower in Q. humboldtii and Q. alba than in Q. sessiliflora, so these two presented a lower content of phenolic acids. As regards phenolic aldehydes, Colombian oak wood only showed significant differences in the content of coniferyl and sinapic aldehydes in relation to French oak. Finally, the total ellagitannin content of Q. humboldtii was lower than that of European oaks and similar to that of American oak (Q. alba). None of the ellagitannins studied presented significant differences compared to Q. alba. Therefore, Q. humboldtii wood was more similar in terms of phenolic composition to Q. alba than to Q. sessiliflora., [PT] O uso de novos barris de carvalho e a procura de madeira de carvalho em enologia estão aumentando. Assim, torna-se necessária a investigação de novas fontes de madeira para satisfazer a atual procura pela tanoaria. O objetivo deste trabalho foi estudar a composição de taninos elágicos e compostos fenólicos de massa molecular baixa (LMWP) por HPLC-DAD de madeiras verdes de Quercus humboldtii Bonpl. (colombiano), em comparação com espécies tipicamente usadas em tanoaria: Quercus sessiliflora Salisb. (francês e romeno) e Quercus alba L. (EUA). Na madeira de carvalho da Colômbia, foram identificados os mesmos LMWP e taninos elágicos do que nas espécies tradicionais. O LMWP mais abundante foi o ácido elágico, e sua concentração foi menor em Q. humboldtii e Q. alba do que em Q. sessiliflora, portanto estas duas madeiras apresentaram menor teor de ácidos fenólicos. Em relação aos aldeídos fenólicos, a madeira de carvalho colombiano mostrou diferenças significativas no teor de aldeídos coniferílico e sinápico em relação ao carvalho francês. Finalmente, o conteúdo total de taninos elágicos de Q. humboldtii foi inferior ao dos carvalhos europeus e semelhante ao do carvalho americano (Q. alba). Nenhum dos taninos elágicos estudados apresentou diferenças significativas relativamente a Q. alba. Assim, a composição fenólica da madeira de Q. humboldtii assemelha-se mais à da madeira de Q. alba do que à de Q. sessiliflora., This work was funded by Grant Nº 11150462 from Fondecyt, Chile. Thanks to the collaboration of Tonelería Nacional LTDA, Santiago de Chile. This paper has received funding from FEDER, Interreg España-Portugal Programme, under the framework of the project Iberphenol. We wish to thank the financial support given by CONICYT through BCH/Doctorado - 72170532.

Il volume descrive i nuovi scenari del consumo di sostanze psicoattive attraverso i risultati di una ricerca che coinvolto più di 10.000 soggetti - in prevalenza studenti universitari - sul rapporto tra droghe legali e illegali e sugli spostamenti compiuti per raggiungere i luoghi del divertimento. Lo studio presentato nel capitolo si proponeva di indagare, a partire dal punto di vista degli stessi studenti universitari, le motivazioni attribuite al proprio e all'altrui consumo di alcolici e sostanze psicoattive nonché la percezione del rischio connessa al loro uso.

Ensuring adequate quality of care to patients with severe mental disorders remains a challenge. The implementation of clinical indicators aimed at assessing the quality of health care pathways delivered is crucial for the improvement of mental health services (MHS). This study aims to evaluate the quality of care delivered to patients who are taken-into-care with depressive disorders by MHS. Thirty-four clinical indicators concerning accessibility, appropriateness, continuity, and safety were estimated using health care utilization databases from four Italian regions (Lombardy, Emilia-Romagna, Lazio, Sicily). A total of 78,924 prevalent patients treated for depressive disorders in 2015 were identified, of whom 15,234 were newly engaged by MHS. During the year of follow-up, access to psychotherapeutic interventions was low, while the intensity was adequate; 5.1% of prevalent patients received at least one hospitalization in a psychiatric ward (GHPW), and 3.3% in the cohort of newly engaged in services. Five-out-of-10 patients had contact with community services within 14 days after GHPW discharge, but less than half of patients were persistent to antidepressant drug therapy. Furthermore, prevalent patients showed an excess of mortality compared to the general population (SMR = 1.35; IC 95%: 1.26–1.44). In conclusion, the quality of health care is not delivered in accordance with evidence-based mental health standards. Evaluation of health interventions are fundamental strategies for improving the quality and equity of health care.

Large-scale longitudinal studies show that specific borderline personality disorder (BPD) symptoms are more likely to remit over time, suggesting that clinical features of BPD may vary between younger patients and older ones. The objective of the present report is to provide a direct comparison between younger (age 18-25 years; n = 44) and older (age 40-59 years; n = 49) BPD patients on the nine DSM-4 BPD criteria (self-harm, emotional dysregulation, impulsiveness, and work and social functioning). Younger and older patients reported similar levels of impulsiveness, emotional dysregulation, and work and social functional impairment. Younger adults were more likely to show anger and self-damaging behaviors compared with older patients, which in turn were more likely to endorse chronic emptiness. In conclusion, older patients with BPD are still impaired in impulsiveness, emotional regulation, and social functioning; treatments for older BPD population should be long term and focused on emotion dysregulation and impulsive behaviors.

Evidence from previous research demonstrated a gap in mortality between patients with mental disorders and the general population. However, a more exhaustive assessment is required to address this public health issue. The aim of this study was to provide comprehensive analysis of mortality examining all causes of death and all psychiatric diagnoses. We conducted a 10-year retrospective cohort study, including all in and out patients registered in the Mental Health Registry of Emilia-Romagna, Italy. Standardized mortality ratios (SMRs) were calculated. The cohort consisted of 137,351 patients 11,236 of whom died during the study period and the overall SMR was 1.99. 85.9 % of excess mortality was attributable to a broad range of natural causes. Diseases of circulatory and respiratory systems as well as neoplasms were the principal contributors to the mortality gap. All psychiatric conditions led to a higher risk of death. The greatest excess was due to neoplasms in depressed and neurotic patients and to cardiovascular diseases in patients with schizophrenia and personality disorders. Our results highlight the need for close collaboration between mental and primary health care services with the aim of reducing excess mortality as a result of medical diseases among all patients suffering from psychiatric condition.

Il capitolo riporta i risultati di una ricerca sul consumo di sostanze psicoattive nei giovani in relazione alle abitudini nel tempo libero