Viral community acquired pneumonia at the emergency department: Report from the pre COVID-19 age.

The role of viruses in community acquired pneumonia (CAP) has been largely underestimated in the pre-coronavirus disease 2019 age. However, during flu seasonal early identification of viral infection in CAP is crucial to guide treatment and in-hospital management. Though recommended, the routine use of nasopharyngeal swab (NPS) to detect viral infection has been poorly scaled-up, especially in the emergency department (ED). This study sought to assess the prevalence and associated clinical outcomes of viral infections in patients with CAP during peak flu season. In this retrospective, observational study adults presenting at the ED of our hospital (Rome, Italy) with CAP from January 15th to February 22th, 2019 were enrolled. Each patient was tested on admission with Influenza rapid test and real time multiplex assay. Seventy five consecutive patients were enrolled. 30.7% (n = 23) tested positive for viral infection. Of these, 52.1% (n = 12) were H1N1/FluA. 10 patients had multiple virus co-infections. CAP with viral infection did not differ for any demographic, clinic and laboratory features by the exception of CCI and CURB-65. All intra-ED deaths and mechanical ventilations were recorded among CAP with viral infection. Testing only patients with CURB-65 score ≥2, 10 out of 12 cases of H1N1/FluA would have been detected saving up to 40% tests. Viral infection occurred in one-third of CAP during flu seasonal peak 2019. Since not otherwise distinguishable, NPS is so far the only reliable mean to identify CAP with viral infection. Testing only patients with moderate/severe CAP significantly minimize the number of tests.

TEMPS-A[P] temperament profile related to professional choice. Differences between applicants to become a cadet officer in the Italian Air Force or Navy.

BACKGROUND: Temperament appears to be a factor involved in professional attitudes. The most impressive findings are those on the importance of cyclothymia in art and of hyperthymia in leadership. AIM: In this study we raise the issue of whether the relationship between hyperthymic temperament and the choice of a military career, previously reported among Italian Air Force applicants, can be extended to another military service such as the Italian Navy. METHODS: We compared temperaments between those who had applied to become a cadet officer in the Italian Air Force or in the Italian Navy, with special reference to gender differences and the ability of the two types of applicants to pass the psychiatric examination for admission that we had recently assessed in the Italian Air Force. RESULTS: Hyperthymic traits were well represented in both these armed services. Navy applicants differed from air-force applicants in obtaining higher depressive, cyclothymic and irritable scores. Navy applicants who passed the psychiatric entrance examination (PEE) showed the same incidence of hyperthymic temperament as their Air Force counterparts, but higher depressive, cyclothymic and irritable scores. Considering gender, among Air Force applicants depressive traits were better represented in males; conversely, among Navy applicants they were better represented in females. If we consider gender together with PEE results, the highest hyperthymic scores were more frequently found among males who passed and females who failed to pass the PEE. On the other hand, a greater number of cyclothymic traits were found in females who passed and males who failed to pass the PEE. CONCLUSIONS: It was confirmed that hyperthymic temperament represents the temperamental profile of those who aim to become a cadet officer in the Italian armed forces. This study further supports the idea that hyperthymic traits bring distinct advantages in a professional field, such as a military career, which is closely related to leadership.

Discriminant and convergent validity of TEMPS-A[P]. Correlation with Occupational Personality Questionnaire (OPQ32) during a stressful situation.

BACKGROUND: The Temperament Evaluation of the Memphis, Pisa, Paris and San Diego Questionnaire (TEMPS) has, in its self and rater-wise evaluation form, been designed to evaluate temperamental characteristics in clinical and non-clinical populations. METHODS: In this study we aim to extend the field of correlations of TEMPS to include the Occupational Personality Questionnaire, ipsative version (OPQ32i). These correlations, if present, could provide a partial contribute to the validation process of TEMPS, currently in progress in various countries. OPQ32 is a self-report personality questionnaire designed to give information on an individual's preferred behavior, as assessed in terms of a number of work-related characteristics. In 921 applicants, who were competing to become cadets in the Italian Navy, we assessed, during the entrance examination, the correlations between TEMPS-A[P] and OPQ32i. RESULTS: Depressive temperament implies a low level of ability to relate to others; hyperthymic temperament implies high levels of feelings and emotions, and the capability to relate to people; cyclothymic temperament appears to be distinguished by creativity and a low level of relationships with others; irritable temperament partly overlaps with cyclothymic temperament, the main difference being the higher level of energy and the lower level of empathy of irritable subjects. CONCLUSIONS: The four affective temperaments, in our sample, proved to significantly differ in the work capacity features measured by OPQ32 factors. These observed correlations between the two tests partially contributes to the ongoing validation process of TEMPS-A[P]. From a personality standpoint this study further supports the hypothesis that temperaments belong to the realm of normality rather than that of pathology, in line with their putative adaptive role.

Temperamental traits and results of psychoaptitude tests in applicants to become a cadet officer in the Italian Navy.

BACKGROUND: Consistently with the involvement of affective temperaments in professional choices, our research team is aiming to outline the temperamental profile of subjects who are applying to enter a military career in the Italian Armed Forces. In this study we aim to verify the importance of temperamental traits not only in choosing the military career as a profession, but also in passing or failing the entrance examinations. METHODS: We compared the affective temperaments (evaluated by TEMPS-A[P]) of those applying to become a cadet officer in the Italian Navy, divided into various subgroups depending on whether they passed or failed the entrance examination at various levels (high school final test, medical (physical and psychiatric), mathematical examination and aptitude test). We also tested for correlations between grades received and temperamental scores. RESULTS: Higher scores for those with a hyperthymic and lower scores for those with a depressive, cyclothymic or irritable temperament characterized applicants taking medical exams and aptitude tests. Higher scores on the high school final test correlated with lower hyperthymic, cyclothymic and irritable temperament scores. No correlations were found between temperamental traits and mathematical examinations. Multivariate analysis stressed the negative impact of a cyclothymic temperament and the poor discriminant power of temperaments regarding medical and mathematical examinations, and aptitude tests. Conversely, temperaments showed good discriminant power as far as psychiatric examinations are concerned. CONCLUSIONS: Hyperthymic temperamental traits appear to be important not only in choosing a profession, but also in passing entrance examinations. Even so, affective temperaments (strong hyperthymic and weak cyclothymic, depressive and irritable traits) are the only successfully predictors of the outcome of psychiatric examinations and, to a lesser extent, medical examinations and aptitude tests. Achieving high school graduation and passing mathematical exams are independent of temperamental traits.