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Background and aim: PAC-SYM is widely adopted to asses constipation severity. However, it has been validated in a small sample, few items have been included based on expert opinion and not on empirical grounds, and its factor structure has never been replicated. We aimed at evaluating the psychometric properties of PAC-SYM in patients with chronic constipation. Methods: We enrolled 2,203 outpatients with chronic constipation in two waves. We used wave I sample to test the psychometric properties of the PAC-SYM and wave II sample to cross-validate its factor structure, to assess criterion validity, responsiveness to clinical change, and its minimal clinically important difference. Results: Only a minority of patients reported any rectal tearing (38 %). Deletion of such item leads to a 11-item version (M:PAC-SYM). The remaining items in the rectal domain were moderately correlated with the stool domain. Exploratory factor analysis and confirmatory factor analysis revealed a bifactor structure with two subscales (stool and abdominal symptoms) and a general severity factor. The M:PAC-SYM demonstrated excellent reliability, moderate correlation with SF-12 and treatment satisfaction (r = 0.28–0.45), discrimination across Rome III criteria for functional constipation and abdominal pain, and responsiveness to clinical change (β = −0.49; ω 2 = 0.25). M:PAC-SYM minimal clinically important difference was 0.24. Conclusion: Our analysis shows that the rectal domain may not represent a relevant cluster of symptoms for patients with chronic constipation. We developed a modified version of the PAC-SYM which might better represent symptom severity of most patients seeking care in gastroenterology referral centers

La comprensione del processo clinico e terapeutico nei gruppi, l’elaborazione concettuale sui costrutti della relazione terapeutica, l’indagine sulla sovrapposizione concettuale (e statistica) dei costrutti Clima di gruppo, Coesione ed Alleanza sono alla base della proposta del Group Questionnaire - GQ (Burlingame, McClendon, Alonso, 2011), self-report di 30 item, che fornisce informazioni sulla qualità delle relazioni in gruppo. Il Group Questionnaire - GQ si differenzia dagli strumenti precedentemente usati perché fondato su una teoria unificata della relazione gruppale (Johnson et al, 2005, 2008; Bormann and Strauss, 2007; Bakali et al, 2008), che individua un modello a tre fattori: Legame positivo, Capacità di lavoro positiva e Relazione negativa. Inoltre fornisce informazioni specifiche su quanto le relazioni in gruppo (membro-membro, membro-leader e membro-gruppo) siano relativamente forti o deboli. Saranno presentati i risultati preliminari dell’adattamento italiano del GQ, somministrato a 100 soggetti che hanno partecipato ai gruppi di elaborazione sull’identità professionale, organizzati all’interno del training formativo per gli studenti delle Lauree Magistrali in Psicologia Clinica (5 gruppi, durata 8 incontri). Sono state considerate due rilevazioni (3 e 6 incontro). Insieme al GQ sono stati somministrati CALPAS_G (Alleanza) e GMLCS_G (Coesione). Verrà valutata la validità convergente e la coerenza interna del GQ.

GCT account for about 3% of all solidi Neoplasms in children. Because of the confusion as to their classification, diagnostic apporoach and treatment, a multi-istitutional study was carried and a National Protocol for Diagnosis and treatment of CGT (TCG-91), approved by AIEOP, straded in January 1991.

Authors analyze the preliminary results of the first multicentric cooperative study on Germ Celkl Tumors in childhood (TCG 91). The Authors discuss the role of primary surgical procedure on the treatment of benign forms and of resectable malignant tumors.

Numerical prediction of composite damage behaviour at the microscopic level is still a challenging engineering issue for the analysis and design of modern materials. In this work, we document the application of a recently developed numerical technique based on the coupling between the virtual element method (VEM) and the boundary element method (BEM) within the framework of continuum damage mechanics (CDM) to model the in-plane damage evolution characteristics of composite materials. BEM is a widely adopted and efficient numerical technique that reduces the problem dimensionality due to its underlying formulation. It substantially simplifies the pre-processing stage and decreases the computational effort without affecting the solution’s accuracy. VEM is a recent generalization to general polygonal mesh elements of the finite element method that ensures noticeable simplification in the data preparation stage of the analysis, notably for computational micro-mechanics problems, whose analysis domain often features complex geometries. The numerical technique has been applied to artificial microstructures, representing the transverse section of composite material with stiffer circular-shaped inclusions embedded in a softer matrix. BEM is used to model the inclusions that are supposed to behave within the linear elastic range, while VEM is used to model the surrounding matrix material, developing nonlinear behaviours. Numerical results are reported and discussed to validate the proposed method.

In this study, a two-dimensional multi-region framework, based on the use of the Virtual Element Method (VEM), is developed for computational materials homogenization and applied to different classes of widely employed heterogeneous materials. The VEM has recently emerged as a powerful generalisation of the Finite Element Method capable of dealing with very general polygonal mesh elements, including non-convex or highly distorted elements. Such features are appealing for the treatment of problems whose analysis domains present complex or statistical morphological features, which would generally require careful and time-consuming mesh/data preparation and regularization. In this work, the lowest-order VEM for two-dimensional elastostatics is employed for the homogenization of polycrystalline materials and unidirectional fibre-reinforced composites. In both cases, artificial micro-morphologies are usually generated resorting to automatic algorithms aimed at approximating/reproducing the statistical microscopic features of real materials. In such a context, the likely presence of morphological irregularities, and subsequent mesh distortions, usually requires caution and the employment of sophisticated mesh regularization procedures. The study demonstrates how the inherent features of the VEM can be conveniently exploited for such classes of problems, as the method allows the relaxation of the requirements on the mesh quality, yet providing accurate numerical results.

International audience; Although psychological abuse is recognized as a particularly insidious form of child abuse, research on the impact of this type of abuse related to intimate partner violence (IPV) is scant. This study examined the contribution of childhood psychological abuse to IPV in female victims and non-victims. Furthermore, it investigated the role of cumulative abuse in predicting IPV. The study included 38 women victims of IPV and 40 non-IPV women. All participants were investigated using the Childhood Experience of Care and Abuse Interview (CECA); the Revised Conflict Tactics Scale (CTS2) and the IPV History Interview were used to assess IPV in the last year and lifetime, respectively. Results indicated that psychological abuse was a stronger predictor of IPV than other maltreatment types. Furthermore, dose–response effects of cumulative abuse on IPV are well evidenced. Future research should continue examining impacts of psychological abuse on IPV so as to further inform clinical practice and intervention planning.

In the framework of Clean Sky 2 Airgreen 2 GRA ITD project, this paper deals with the design process of a morphing winglet for a regional aircraft. By improving A/C aerodynamic efficiency in off-design flight conditions, the morphing winglet is expected to operate during long (cruise) and short (climb and descent) mission phases to reduce aircraft drag and optimize lift distribution, while providing augmented roll and yaw control capability. The mechanical system is designed to face different flight situations by a proper action on the movable parts represented by two independent and asynchronous control surfaces with variable camber and differential settings. A set of suitable electromechanical actuators are integrated within the limited space inside the winglet loft-line, capable of holding prescribed deflections for long time operations. Such a solution mitigates the risks associated with critical failure cases (jamming, loss of WL control) with beneficial impacts on A/C safety. Numerical details on the system architecture and ability to cope with the typical mission loads profiles are given, along with a description of the conceptual analysis and the expected system performance according to a suitable metric.

Backgroud: Numerose ricerche rilevano l’impatto che esperienze sfavorevoli infantili possono avere sulla dipendenza da sostanze. Metodo: 32 tossicodipendenti maschi in trattamento presso comunità e 32 soggetti appartenenti a un gruppo non clinico sono stai intervistati attraverso la Childhood Experience of Care and Abuse. Risultati: La maggior parte dei soggetti del gruppo clinico ha esperito maggiori esperienze (p

Objectives We have previously shown that at least 50% of patients with asymptomatic chronic pancreatic hyperenzymemia (ACPH) may develop morphological pancreatic alterations. Endoscopic ultrasonography (EUS) may detect small lesions, and its sensitivity seems to be higher than other imaging techniques. The aim of this study was to evaluate whether EUS may modify the management of patients having ACPH. Methods In 2 referral centers for pancreatic disease, a retrospective analysis of prospectively enrolled patients with ACPH was conducted. Results Seventy-three patients with ACPH were enrolled for the purpose of this study. Endoscopic ultrasonography was performed as the last examination in 45 subjects who resulted negative at previous imaging studies (abdominal ultrasound, computed tomography, magnetic resonance imaging associated with cholangiopancreatography). Using EUS in 7 subjects, abnormalities were found in the following: 3 branch-duct intraductal papillary mucinous neoplasms, 1 duodenal diverticulum, 1 annular pancreas, 1 findings suggestive of chronic pancreatitis, and 1 undefined cyst (

Il capitolo presenta il piano della ricerca qualitativa svolta in un campione di scuole in cui sono stati indagati i fattori che concorrono a determinare o a influenzare i rendimenti degli alunni.

Il capitolo analizza il profilo dei dirigenti scolastici italiani e propone una tipologia di stili di attività che consente di mettere a fuoco il loro ruolo e le modalità di assunzione delle loro scelte.