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We have recently presented an algorithm to compute metabolic syndrome (MetS) as a continuous variable, called MetS score . It summarizes waist circumference, BMI, blood pressure, blood glucose, HDL-cholesterol and triglycerides into one quantitative phenotype that is both clinically interpretable and useful for evaluating the association with cardiovascular diseases and for investigating the MetS genetic component . We first evaluated its performance assessing the area under the receiver operating characteristics (ROC) curve, which was 0.88, indicating excellent discrimination

Obiettivo. Lo scopo di questo studio era valutare il profilo delle comorbidità psichiatriche in bambini e adolescenti afferenti ai 18 centri di riferimento della Regione Lombardia per sospetto Disturbo da deficit dell'attenzione con iperattività/impulsività (ADHD). Metodi. Sono stati analizzati i dati clinico-anamnestici presenti nel database del Registro Lombardo dell’ADHD di tutti i nuovi pazienti valutati nel periodo Giugno 2011-Novembre 2014. Risultati. 1108 di 1703 pazienti con sospetta ADHD (65%) hanno ricevuto una diagnosi di ADHD: 952 (86%) maschi e 156 (14%) femmine (età mediana: 9aa; range: 5-17aa), di questi 402 (36%) hanno ricevuto esclusivamente una diagnosi di ADHD, mentre 706 (64%) presentavano almeno un altro disturbo psichiatrico (disturbi dell’apprendimento: 35%, disturbo oppositivo/provocatorio: 13%, disturbi del sonno: 13%, disturbi d’ansia: 8%). 254 di 1703 casi sospetti (15%) non hanno ricevuto alcuna diagnosi. La diagnosi di ADHD di tipo combinato (OR: 1,37, 95% IC: 1,07-1,76), un punteggio CGI-S ≥ 5 (OR:1,93, 95% IC: 1,44-2,60) e la prescrizione di trattamento farmacologico (OR: 3,07, 95% IC: 2,05-4,60) erano associate ad una maggiore probabilità di presentare disturbi psichiatrici in comorbidità. Conclusioni. Nei pazienti con ADHD è importante valutare e monitorare sistematicamente l’intero spettro delle possibili comorbilità psicopatologiche associate, anche tenendo conto della loro evoluzione, comparsa e associazione con particolari tappe cronologiche e psicologiche dello sviluppo, Objective. The main aim of this study was to evaluate psychiatric comorbidity of children and adolescent accessing the 18 Reference Centers of the Lombardy Region for a suspected Attention Deficit Hyperactivity Disorder (ADHD). Methods. Data in the ADHD Lombardy Registry database of all new patients evaluated on June 2011-November 2014 period were analyzed. Results. 1108 of 1703 patients with a suspected ADHD (65%) met the DSMIV-TR criteria for ADHD: 952 (86%) males and 156 (14%) females (median age: 9yrs; range: 5-17yrs), of those 402 (36%) received only a diagnosis of ADHD, while 706 (64%) had at least a psychiatric disorder associated (learning disorders: 35%, oppositional defiant disorder: 13%, sleep disorders: 13%, anxiety disorders: 8%). 254 of 1703 (15%) did not receive any diagnosis. A diagnosis of ADHD-C (OR 1:37 CI 1,07 to 1,76), a CGI-S score ≥ 5 (OR 1,93 CI 1,44 to 2,60) and a prescription of drug treatment (OR 3:07 CI 2,05 to 4,60) were associated with an higher risk to present comorbid psychiatric disorders. Conclusions. It is important to fully assess and systematically monitor the entire spectrum of psychopathological disorders in patients with ADHD, also taking into account their evolution, lifespan presentation and association with psychological development.

Objective. The aim of this study was to describe the experiences of parents and clinicians in relation to the transition from child and adolescent neuropsychiatric services (CANPS) to adult services for people with attention deficit hyperactivity disorder (ADHD) in Italy. Methods. Parents of people with ADHD who reached the transition boundary for CANPS were sampled from the A.I.F. A. association (Italian Association of ADHD Families). We thematically analyzed informative and qualitative questionnaires completed by parents and clinicians. Results. Parents’ (n = 24) and clinicians’ (n = 27) experiences differed slightly on challenges and unmet needs, whereas clinicians agreed on the variables required for an optimal transition process. Poor transition and multiple barriers to such care were identified. Specifically, far fewer people received services, especially public health services, after reaching the age of 18, and perceived barriers included problems with user access, limited transition protocols, poor service coordination, and possible lack of ADHD-related knowledge on the part of adult practitioners. Conclusions. Care continuity in mental healthcare remains a need to be prioritized and better defined also for ADHD patients (and their parents). Parents’ and clinicians’ experiences are more likely to be positive if transition management is characterized by a gradual preparation, a period of parallel care, and commonly acknowledged, clear information on available services and how to access them. Identifying the needs and barriers of the people representing the different roles (clinicians, parents, and users) involved in the transition to adult mental health services is of particular importance in designing effective, shared transfer planning procedures.

To review the evidence from randomized controlled trials (RCTs) on the safety and efficacy of guanfacine in pediatric attention deficit hyperactivity disorder (ADHD), a bibliographic search up to May 2014 was performed using the Cochrane Library[U+05F3]s Central Register of Controlled Trials, the Embase, PsycINFO, and Medline databases, and clinical trials registers. The search terms used were: ["guanfacine"] and ["child" or "adolescent" or "pediatrics"] and ["randomized controlled trial"] and ["Attention Deficit Disorder with Hyperactivity" or "Attention Deficit Disorder" or "Attention Hyperactivity Disorder" or "Hyperactivity" or "ADHD"]. A meta-analysis was performed using response, defined as a score≤2 on the Clinical Global Impression Improvement score, as the outcome measure. In all, 7 out of 48 studies were included, for a total of 1752 participants. All studies compared guanfacine versus placebo, with a duration ranging from 6 to 16 weeks. In all, the Clinical Global Impression Improvement score was reported as a secondary measure. Overall, 694/1177 (59.0%) participants in the guanfacine group benefited from the treatment compared to 192/575 (33.3%) in the placebo group (pooled OR 3.2; 95%CI 2.4-4.1). The participants with at least one adverse event were 948 (82.4%) in the guanfacine and 376 (67.9%) in the placebo group (OR 2.6; 95%CI 1.6-4.4). Somnolence (OR 4.9), sedation (OR 2.8), and fatigue (OR 2.2), were the adverse events with the greatest risk of occurrence in the guanfacine versus the placebo group. On the basis of seven randomized, placebo controlled trials guanfacine resulted safe and effective in treating children and adolescents with ADHD

Objective: To investigate the care management and continuity from child to adult mental health service for young adults with ADHD. Method: A questionnaire survey from 18 Regional ADHD Pediatric Centers (RAPC) in Lombardy, Italy, was used to collect data on transition protocols and population served, and to track the pathway of care of ADHD patients once they reached adulthood. Results: Twenty-eight percent of RAPC had transition protocols and 3% of the population annually served were potential referrals to adult service. Of 52 patients who turned 18 years, just over 70% were monitored by the general practitioner, of those 5 with RAPC support. One fifth of patients continued to use mental health services, the majority was still monitored by the RAPC, and only three by services for adult. Conclusion: Managing the process of transition to adult services in mental health care remains a need to be prioritized and better defined for ADHD patients

Background and objectives: Prospective investigations on cardiovascular risk factors in populations provide a unique opportunity to dissect time-dependent quantitative complex traits, such as arterial blood pressure (BP), into their polygenic and environmental components. BP heritability analyses were carried out on 2620 patients belonging to 711 nuclear pedigrees that could be followed up throughout 25 years in the Gubbio Population Study. Methods: Each patient's BP serial measurements were summarized into individual intercepts (expected values at baseline) and slopes (time-related changes), which were predicted through latent curve models. These models considered either age in years or waves (times from the first survey) as time axis and were linked at a family level in the heritability analyses using additive polygenic-common environment-unique error models adjusted for sex, age and clinical variables. Results: The additive genetic effect explained 32-49% of the variance of SBP values at baseline, the wave-dependent analysis with nuclear pedigrees and the sibs-household matrix accounting for higher heritability values. Heritability of DBP baseline value was lower than that of SBP in analyses by age (5-15%), but fell in the same heritability range as SBP on the analysis by waves (36-37%). The BP variation over time (slope) explained by an additive genetic effect ranged from 33 to 43% and from 24 to 25% for SBP and DBP, respectively, in the analysis by age. Shared environment also exerted a significant influence, but explained a smaller portion of the variances (4-17%) for both traits. Conclusion: Longitudinal data from the Gubbio population show strong to moderate genetic influences on SBP and DBP baseline values and changes over time with a smaller, though significant, effect of environment.

We compare a more complete characterization of the low temperature performance of a nominal 1.7um cut-off wavelength 1kx1k InGaAs (lattice-matched to an InP substrate) photodiode array against similar, 2kx2k HgCdTe imagers to assess the suitability of InGaAs FPA technology for scientific imaging applications. The data we present indicate that the low temperature performance of existing InGaAs detector technology is well behaved and comparable to those obtained for state-of-the-art HgCdTe imagers for many space astronomical applications. We also discuss key differences observed between imagers in the two material systems.

We present the results of a study of the performance of InGaAs detectors conducted for the SuperNova Acceleration Probe (SNAP) dark energy mission concept. Low temperature data from a nominal 1.7um cut-off wavelength 1kx1k InGaAs photodiode array, hybridized to a Rockwell H1RG multiplexer suggest that InGaAs detector performance is comparable to those of existing 1.7um cut-off HgCdTe arrays. Advances in 1.7um HgCdTe dark current and noise initiated by the SNAP detector research and development program makes it the baseline detector technology for SNAP. However, the results presented herein suggest that existing InGaAs technology is a suitable alternative for other future astronomy applications.

A user-friendly and automatic illuminator with adjustable wavelength and optical power has been developed to obtain precision quantum efficiency (QE) curves of astronomical CCD as well as optical transmission measurements for cryogenic holographic gratings and other optical components. Integrating commercial components with custom mechanical parts and control software, this equipment is able to illuminate a target with light of controlled intensity and wavelength. This facility is primarily intended for testing of Volume Phase Holographic (VPH) gratings at low temperature as well as obtaining CCD quantum efficiencies. A Labview control application runs on a desktop computer allowing full automation of the spectrophotometer. The apparatus includes a Quartz-Tungsten light source, neutral density filters, a monochromator, visible and near-infrared power meters, as well as collimating and focusing optics. Rotation mechanisms allow the characterization of gratings for all angles of diffractions. For CCD testing, network commands allow the facility to get raw images, compute and record QE curves for further detector characterization.