bluuebunny/crossref_metadata_2025 huggingface dataset:
Patterns of clinical course in persons with mental disorders: which impact on social disability and quality of life? A longitudinal study
Authors: Lasalvia Antonio , Bonetto Chiara , Santi Katia De , Ruggeri Mirella
Published: October 2011

Aims — To investigate in persons with mental disorders 1) the patterns of clinical course and their frequencies, 2) the impact of clinical course on two social dimensions of outcome, such as disability and quality of life. Methods — Study conducted with a longitudinal design in the “real world” of community mental health services. Clinical course was retrospectively assessed by using an instrument developed by our group, taking into account previous literature in this area; disability and quality of life were measured, respectively, with the WHO—Disability Assessment Schedule and the Lancashire Quality of Life Profile. Results — In patients with non affective psychosis, continuous and episodic course showed the same tendency to occur, whereas in subjects with affective disorders (either psychotic or neurotic) episodic course was more frequent. Continuous course was associated with higher levels of disability and lower quality of life in psychotic patients, while a poorer quality of life in some areas was associated with episodic course in patients with non psychotic disorders. Conclusions — The impact of clinical course on social disability and quality of life is different depending upon the specific diagnostic category. This suggests that specific and individualised interventions should be provided in order to prevent the negative impact of clinical course on life conditions of persons with mental disorders.

Declaration of Interest

the study has been supported by a Grant from MURST 60% to Prof. Mirella Ruggeri and Fondi 1% per la Ricerca Sanitaria Finalizzata 2001 Ministry of Health, to Professor M. Tansella.
Morale of mental health professionals in Community Mental Health Services of a Northern Italian Province
Authors: Galeazzi Gian Maria , Delmonte Sara , Fakhoury Walid , Priebe Stefan
Published: October 2011

Aims — To explore morale of psychiatrists and psychiatric nurses working in Community Mental Health Centres (CMHC) in an Italian Province, and identify influential factors. Methods — Thirty psychiatrists and 30 nurses working in CMHCs in Modena completed questionnaires on burnout, team identity and job satisfaction. They also answered open questions about different aspects of their work. Answers were subjected to content analysis. Regression analyses were used to identify factors that predicted morale across groups. Results — Psychiatrists had higher scores on emotional exhaustion and depersonalisation. There were no significant differences between the two groups in job satisfaction and job or role perception. Professionals reported positive relationships with patients as the most enjoyable aspects of their job, whilst team conflicts and high workloads were seen as most difficult to cope with. Multivariate analyses showed that being a psychiatrist and perceiving team conflicts as a main cause of pressure in the job predicted higher burnout. Conclusions — Simple open questions coupled with quantitative measures appear a promising tool to investigate morale of mental health professionals and identify factors determining morale. Research, training and service development should focus on relationship aspects both with patients and within teams to reduce burnout in CMHCs.

Declaration of Interest

G.M.G. was employed by Modena local mental health service, but did not work in CMHCs. No other conflict of interest.
Costs of psychiatric services: a study performed in a public mental center in Lombardy Region, Italy
Authors: Fattore Giovanni , Percudani Mauro , Pugnoli Carla , Contini Agostino
Published: October 2011

Objective — The implementation of a simple methodology to estimate full costs of services provided by a public mental health centre. Setting. CPS (NHS Mental Centre) Ussl 35, Magenta, Lombardy Region. Method — To estimate full costs of 16 types of service we followed a two step procedure. The first step was to estimate all costs attributable to the CPS. In the second one, we allocated this estimate to each type of service provided. We attributed to the CPS the following cost items: personnel, utilities (telephone, electricity, water, heating and cleaning), land & building, transports (for services provided outside the clinic) and a share of general cost of the USSL to which the CPS belongs. Full cost of each service was then calculated on the base of the yearly number of services provided and the time spent by each health professional. Results — In 1995, the CPS provided 14, 562 services. Total costs amounted to L 1,356 million, and more than three quarters of this amount was attributable to the personnel working at the CPS. Unit costs ranged from L 5,300 (drug administration) to L 442,400 (family therapy involving two professionals for 90 minutes) The unit cost of psychiatric visits, psychologist consultations and nurse domiciliary visits were L 105,300, L 106,600 and L 78,000, respectively. Conclusions — This approach requires accessible data and is relatively simple to manage. Some refinements are required, especially to improve the methodology for the determination and the allocation of overheads. However, we are convinced that this cost accounting procedure provides acceptable estimates of the services provided by the CPS. These estimates suggest that charges to be used to fund NHS providers may be too low, especially if fee-for-service will be the main funding source.
Predicting length of stay in Italian Psychiatric Forensic Hospitals: a survival analysis
Authors: Fioritti Angelo , Ferriani Elisa , Rucci Paola , Melega Vittorio , Venco Cristina , Scaramelli Anna Rosa , Santarini Fabio
Published: October 2011

RIASSUNTO

L'internamento in Ospedale Psichiatrico Giudiziario (OPG) costituisce un allontanamento dai circuiti assistenziali psichiatrici del Servizio Sanitario Nazionale e la sua durata può influire negativamente sulle possibilità di reinserimento nel territorio di provenienza. Metodo – I fattori predittivi della durata di degenza in OPG sono stati indagati mediante una analisi di sopravvivenza condotta su una coorte di 118 pazienti degenti nei tre OPG del Centro-Nord al 30.06.97, provenienti da tre Regioni (Emilia Romagna, Toscana, Friuli Venezia Giulia), prendendo in esame le dimissioni effettuate nei 18 mesi successivi. Risultati – Da analisi di sopravvivenza condotte sui singoli fattori sono emersi, come predittori di durata di internamento, il reato commesso (omicidio: tempo mediano di permanenza 706.6 settimane, rispetto alle 307.1 e 194.7 dei reati minori e delle lesioni; log-rank =31.8, p<0.001), la durata preventivata della misura di sicurezza (RR=0.98, CI 95% 0.97-0.99, p<0.001); la diagnosi di schizofrenia (621.9 settimane rispetto alle 389.9 settimane o meno delle altre diagnosi; log-rank = 5.83, p<0.01); i disturbi del pensiero alia BPRS (RR=0.89, CI 98% 0.81-0.98, p<0.01); OPG di internamento (314.6 settimane a Montelupo Fiorentino rispetto alle 706.6 di Reggio Emilia e alle 621.9 di Castiglione delle Stiviere; log-rank = 9.64, df=2, p<0.001). In un modello di regressione di Cox a più covariate solo il tipo di reato, la durata della misura di sicurezza e la diagnosi sono risultati significativi. Conclusioni – I fattori inerenti il sistema giudiziario sono determinanti nel predire la durata della degenza. La diagnosi di schizofrenia sembra aver un ruolo indipendente nel predire una degenza più lunga
Progress in the psychotherapy of mood disorders: studies from the Western Psychiatric Institute and Clinic
Authors: Frank Ellen , Novick Danielle
Published: October 2011

RIASSUNTO

— Durante gli ultimi tre decenni abbiamo assistito a significativi miglioramenti sia nei trattamenti psicosociali, sia in quelli farmacologici dei disturbi affettivi.Insieme ai progressi che i nuovi trattamenti farmacologici hanno prodotto, il trattamento psicosociale per la cura specifica del singolo disturbo ha ulteriormente migliorato la prognosi ed il decorso del disturbo bipolare e unipolare.Metodi— Rassegna delle nostre ricerche sul disturbo unipolare e bipolare e sul loro trattamento, in particolare la psicoterapia interpersonale (IPT) e le sue modificazioni.Risultati— Si fornisce la dimostrazione empirica che l'IPT à un trattamento per i disturbi affettivi efficace per la fase acuta e per il mantenimento. La nostra ricerca cumulativa e l'esperienza clinica suggeriscono che le relazioni interpersonali ed i ritmi circadiani e sociali influenzano i disturbi affettivi e che la psicoterapia pud aiutare a normalizzare i problemi in questi settori per i pazienti con disturbi affettivi.Conclusioni— Nonostante l'entusiasmo generato dai recenti progressi nella ricerca sui disturbi mentali e sul loro trattamento, dobbiamo ancora soddisfare l'impegno che l'enorme sviluppo delle conoscenze sulle farmacoterapie mirate e sulle psicoterapie sembrerebbero offrire. Per fare ulteriori progressi, dobbiamo continuare ad applicare rigore scientifico e riflessione per capire l'adattabilita delle attuali nomenclature, l'impatto delle malattie psichiche e mediche in comorbidità sulla manifestazione e sul trattamento dei disturbi affettivi e la praticabilita di un'ampia utilizzazione dei nuovi trattamenti.
Comparing needs assessed by staff and by service users: paternalism or partnership in mental health?
Authors: Thornicroft Graham , Slade Mike
Published: October 2011

This paper examines two questions. Do staff and service users agree when rating the needs of those with severe mental illness? If not, what is the meaning of these differences? To put these questions in context, we shall define needs, examine one particular way in which needs can be measured in a standardised way, using the Camberwell Assessment of Need, and shall discuss three somewhat similar studies which have compared user and staff rated needs.
Early intervention in schizophrenia: a critique
Authors: Warner Richard
Published: October 2011

Objective – Two forms of early intervention in psychosis are currently being proposed — intervention before the onset of illness with at-risk individuals and intervention after the onset of psychosis. Method – The risks and potential benefits associated with these two approaches were examined using published data and Bayes probability theorem. Results -Claims for benefits from early intervention in established psychosis go back more than two hundred years to the nineteenth-century advocates for asylum construction. Theoretical support for early intervention in psychosis rests on data suggesting that a longer duration of untreated psychosis (DUP) is associated with poor outcome. The association of DUP with outcome, however, appears to be inseparable from the confounding influence of the good outcome expected in recent-onset psychosis. Although some researchers advocate treating people with premorbid features of psychosis or other high-risk indicators, adequate screening measures and effective interventions are not yet available. The most promising current screening measure, if applied to the general population, would be accurate only two percent of the time. The accuracy of these measures can be improved by screening only those patients who are referred to a clinic, but this strategy will result in many cases in the population-at-large being overlooked. Discussion – The risks and potential benefits associated with the two early intervention approaches are very different. The provision of optimal treatment early in psychosis could produce benefits, but people with brief, good-prognosis psychotic episodes are likely to receive unnecessary treatment. Screening the general population or patients referred to a clinic will have little public health impact on the incidence of schizophrenia. There is likely to be considerable negative impact on those who are inaccurately labeled as being at imminent risk of psychosis and are treated accordingly.
A patient-centred approach to defining and assessing interviewing competency
Authors: Heaven Cathy , Maguire Peter , Green Claire
Published: October 2011

The inclusion of communication skills as a core competency in health care curricula, has led to the need to define adequacy in this area. Developments in the field of interview analysis have meant that robust and objective ways of assessing interview behaviours are now available; however, these systems in themselves do not provide a model for assessing competency. As adequacy in interviewing is contextually driven, this paper discusses the potential of using patient centeredness to address the issue. It suggests two ways in which patient centeredness may be operationally defined, permitting data available from current rating systems, and from a new system shortly to be available, to be used to assess interviewing competency.

Declaration of Interest: the authors would like to acknowledge Cancer Research UK for funding this work.
Interferon-alpha-induced psychiatric side effects in patients with chronic viral hepatitis: a prospective, observational, controlled study
Authors: Orrù M. Germana , Baita Antonella , Sitzia Rossella , Costa Alessandra , Muntoni Elisabetta , Landau Sabine , Chessa Luchino , Farci M. Giulia , Carpiniello Bernardo , Pariante Carmine M.
Published: October 2011

Aims— Patients with chronic viral hepatitis suffer from a high prevalence of psychiatric problems. Furthermore, the treatment for chronic viral hepatitis, with interferon (IFN) alpha, induces the occurrence of further psychopathological symptoms. The autors examined whether patients with a pre-existing psychiatric diagnosis had more severe IFN alpha-induced psychiatric adverse effects, and whether they were more likely to interrupt the IFN alpha therapy, compared with control patients with no pre-existing psychiatric diagnosis. They also examined the psychopharmacological management of the interferon-alpha-induced psychiatric side effects.Methods— The authors studied prospectively 60 patients with chronic hepatitis B or C in Cagliari, Italy. Patients underwent psychiatric assessment before starting interferon alpha and monthly throughout the therapy.Results— After adjusting for the baseline psychopathology, there was no statistically significant difference in interferon-alpha-induced psychiatric adverse effects between patients with a pre-existing psychiatric diagnosis and controls. There was also no evidence that psychiatric cases were more likely than controls to interrupt the IFN alpha therapy because of psychiatric side effects. Moreover, there was no difference in the psychiatric adverse effects severe enough to require psychopharmacological treatment. Finally, psychopharmaco-logical management successfully treated psychiatric symptoms induced by the IFN alpha.Conclusions— Patients with a pre-existing psychiatric diagnosis do not have a specific vulnerability to interferon-alpha-induced psychiatric adverse effects.

Declaration of Interest: none of the authors have conflict of interests in writing this paper; CM. Pariante is funded by the UK Medical Research Council and by the NARSAD and the Guy's and St Thomas Charity
Relazione del Presidente della Società Italiana di Epidemiologia Psichiatrica (SIEP) all'assemblea dei soci (Pavia, 10 ottobre 1991)
Authors: Torre Eugenio
Published: October 2011

A norma dell'articolo 6 dello Statute è mio compito relazionare all'Assemblea dei soci l'attività svolta dalla SIEP nel triennio 1989-1991. Assolverò tale compito con una breve sintesi delle iniziative realizzate e qualche considerazione sulle linee programmatiche seguite dal Consiglio Direttivo uscente.
Mortalità di una coorte di pazienti ricoverati in un Servizio Psichiatrico di Diagnosi e Cura (SPDC)
Authors: Politi Pierluigi , Montomoli Cristina , Fratti Cesare
Published: October 2011

Riassunto

Scopo e Setting - Nel lavoro vengono presentati i risultati di uno studio di mortalità relativo ai pazienti ricoverati presso il Servizio Psichiatrico di Diagnosi è Cura di Pavia nel periodo 1.1.1986-31.12.1991. Principali misure utilizzate - La mortalita della coorte è stata stimata utilizzando il rapporto standardizzato di mortalità. Il numero di morti osservato per sesso, età e causa specifica è stato confrontato con il numero di morti attese utilizzando come popolazione di riferimento quella dello stesso bacino di utenza del Servizio (USSL di Pavia), specifica per sesso ed eta. Risultati - La mortalità della coorte in studio e risultata circa tre volte quella della popolazione generale. L'eccesso di mortalita si verifica sia per quanto riguarda le cause di morte naturale, sia per quelle di morte violenta. In particolare, si verifica un eccesso di mortalità in entrambi i sessi per quanto riguarda le cause legate alle malattie del sistema circolatorio, ai disturbi psichici e ai traumatismi ed avvelenamenti.
Multiple perspectives on the evaluation of outcome in Eastern Europe
Authors: Tomov Toma
Published: October 2011

RIASSUNTO

Scopo - Lo scopo di questo articolo è quello di analizzare la capacità dei sistemi di salute mentale dell'Europa Orientale di attuare reali riforme nel campo della salute mentale.Metodi - Partendo dalle ipotesi della scuola delle relazioni di gruppo, è stata messa in evidenza la tendenza delle organizzazioni ad abbandonare i principali compiti che esse dichiarano di avere, sotto influenze di tipo ideologico, politico e altre influenze legate al contesto. Lo stato della salute mentale dell'Europa orientale è discusso in questa prospettiva.Risultati - È stato accertato che i cambiamenti ed i progressi sono impediti dai ruoli che proibiscono la curiosita e che mettono in discussione le pratiche routinarie.Conclusioni - L'emergere in Europa orientale di una rete di operatori orientati verso la riforma è ritenuto un segno positivo. Un ulteriore importante obiettivo e la sostituzione delle strutture defunte di salute mentale (servizi, ricerca e training) con muove strutture. La sfida al sistema ereditato e inevitabile. Il ruolo di progetti di collaborazione con i paesi occidentali è di estrema importanza.
Family burden in schizophrenia: effects of socio-environmental and clinical variables and family intervention
Authors: Magliano Lorenza , Fiorillo Andrea , Malangone Claudio , Aletti Adriano , Belotti Giosue , Bevilacqua Paola , Femine Anna Luisa Delle , Fontana Gianmichele , Maucioni Francesca , Travi Michele , Zanus Paola , Rossi Andrea , Maj Mario
Published: October 2011

RIASSUNTO

Scopo- Descrizione del carico, degli atteggiamenti e degli interventi ricevuti da un campione di familiari di pazienti con schizofrenia reclutati in otto DSM stratificati per area geografica e per densità di popolazione.Disegno- Studio trasversale di familiari-chiave di pazienti con diagnosi DSM-IV di schizofrenia in fase di compenso clinico. Valutazione delle: a) relazioni tra carico e caratteristiche cliniche del paziente, socio-demografiche del nucleo familiare, atteggiamenti del familiare nei confronti del paziente, sostegno professionale e sociale ricevuto dalla famiglia; b) differenze nei carico, negli atteggiamenti e nell'aiuto professionale in relazione all'area geografica e alia densità di popolazione.Setting- 8 DSM stratificati per area geografica (Nord, Centro, Sud) e densità di popolazione (urbana vs. rurale).Principali misure- a) dello stato clinico e del funzionamento sociale del paziente: BPRS e ADC; b) del carico, degli atteggiamenti e del sostegno ricevuto: QPF.Risultati- Sono stati raccolti dati relativi a 144 pazienti con schizofrenia e altrettanti familiari. Il carico è risultato correlato positivamente con i livelli di disabilita e di sintomi BPRS positivi e di mania/ostilita, e con il numero di ore trascorse dal familiare a contatto quotidiano col paziente, e negativamente con il livello di aiuto professionale ricevuto dalla famiglia. Il carico è risultato maggiore tra i familiari reclutati nei due centri meridionaii. Gli interventi offerti ai familiari dei pazienti sono piu frequenti e differenziati al Nord e al Centro rispetto al Sud. Solo una minima parte dei familiari ha ricevuto interventi psicoeducativi.Conclusioni- 1 risultati di questo studio sottolineano la necessita di assicurare un'assistenza psichiatrica integrata per i pazienti con schizofrenia che comprenda sia programmi riabilitativi per gli utenti sia interventi informativi e psicoeducativi per le loro famiglie.
Subthreshold affective disorders: a useful concept in psychiatric epidemiology?
Authors: Schotte Kerstin , Cooper Brian
Published: October 2011

RIASSUNTO

Scopo - Negli ultimi anni si è sviluppata una consistente letteratura sui concetti di disturbi affettivi sotto-soglia, sub-sindromici, minori, brevi e ricorrenti e sulle loro applicazioni nelle ricerche sulla popolazione generate. Lo scopo di questa breve revisione della letteratura è quello di esaminare le definizioni è lo stato corrente di queste categorie, proposte in riferimento soprattutto alia depressione e di valutare il loro potenziale contributo alia psichiatria epidemiologica. Metodo - È stata effettuata una ricerca Medline sui suddetti quattro termini per il periodo 1965-1999. Sono state esaminate anche le referenze bibliografiche rilevanti contenute in tutte le pubblicazioni identificate. Risultati - In larga misura questi concetti sono stati sviluppati come risposta ai limiti nel sistema di classificazione DSM e, in minor misura, in quello ICD. I gruppi sono stati identificati per aver meno sintomi rispondenti ai criteri o una minor durata dei sintomi rispetto alle categorie diagnostiche «ufficiali». L'uso di queste definizioni ha dato luogo a stime di prevalenza che variano in modo più esteso. Conclusioni - Sono indispensabili metodi perfezionati per la classificazione di tutte quelle persone nella popolazione generale, che hanno bisogno di trattamento medico e di aiuto per disturbi psicologici, ma che non soddisfano i criteri operativi indicati dalle linee guida ufficiali. Ciò, comunque, non può essere attuato semplicemente abbassando le soglie operative in questi sistemi. Sono necessarie ulteriori ricerche sulle caratteristiche cliniche e psicosociali dei disturbi psichiatrici comuni. In molte società un setting favorevole è quello della medicina di base, dove sono già in corso iniziative per una classificazione pragmatica e globale dei problemi di salute della popolazione.
Instrument development in the Italy-USA Collaborative Spectrum Project
Authors: Rucci Paola , Maser Jack D.
Published: October 2011

RIASSUNTO

Scopo– Il Progetto Collaborativo dello Spettro mira a definire condizioni sottosoglia e atipiche non sufficientemente caratterizzate nel DSM-IV e nell'ICD-10, per le quali non sono disponibili adeguati strumenti di valutazione. Scopo di questo articolo è la descrizione delle procedure di sviluppo e validazione degli strumenti per misurare lo spettro di cinque disturbi psichici.Disegno– Sono stati effettuati 4 studi trasversali, di cui 3 multicentrici condotti in Italia, ed uno condotto esclusivamente a Pisa. Un ulteriore studio trasversale di validazione dello spettro del panico-agorafobia è stato condotto a Pittsburgh.Setting– Pazienti ambulatoriali afferenti alle cliniche universitarie, studenti universitari e, in uno degli studi italiani, anche un campione di frequentatori abttuali delle palestre.Principal misure utilizzate– Cinque interviste strutturate per valutare lo spettro del panico-agorafobia (SCI-PAS), dell'umore (SCI-MOODS), della fobia sociale (SCI-SHY), lo spettro ossessivo-compulsìxvo (SCI-OBS) e quello dei disturbi della condotta alimentare (SCI-ABS), unitamente ad una intervista diagnostica e ad una serie di strumenti auto ed eterovalutativi di contenuto analogo ai domini delle interviste.Risultati– Tutti i domini delle interviste hanno mostrato una elevata stabilità temporale (coefficiente di correlazione intraclasse >0.61) ed una soddisfacente consistenza interna. I punteggi medi dei domini sono risultati significativamente più elevati nei casi rispetto ai controlli e, nella quasi totalità dei confronti, nei pazienti con il disturbo di interesse rispetto ad altri disturbi. I confronti con strumenti analoghi per contenuto hanno messo in luce una buona validità concorrente per i domini dello spettro del panico-agorafobia, della fobia sociale e del disturbo ossessivo-compulsivo. Differenze sono emerse tra i domini dello spettro della condotta alimentare ed altri strumenti autovalutativi, verosimilmente legate anche alla forma di somministrazione. E' stata definita e testata clinicamente una soglia per lo spettro del panico-agorafobia nel campione americano.Conclusioni– Le proprietà psicometriche degli strumenti sono molto soddisfacenti e sono in corso studi di validazione clinica. Le condizioni atipiche e sottosoglia richedono attenzione negli studi clinici ed epidemiologici.
Depression and social change. From transcultural psychiatry to a constructivist model
Authors: Carta Mauro Giovanni , Coppo Piero , Reda Mario Antonio , Hardoy Maria Carolina , Carpiniello Bernardo
Published: October 2011

RIASSUNTO

Sulla base di precedenti studi del nostro gruppo i cui risultati verranno sintetizzati, il lavoro avanza alcune ipotesi sull'evoluzione della sintomatologia depressiva e sul possibile incremento del rischio depressivo legato alle modificazioni sociali. Vengono esaminati i disturbi dell'umore in emigrati senegalesi ed i fattori protettivi quali uno stretto supporto sociale che sembrano determinare un basso rischio in queste popolazioni. Verrà analizzata l'ipotesi che l'“occidentalizzazione”, intesa come la perdita a livello individuale dello stile di vita tradizionale, delle abitudini lavorative, dei valori culturalmente determinati, della lingua, a favore delle attitudini influenzate dalla cultura occidentale, possa rappresentare un fattore di rischio per i disturbi depressivi, almeno nelle espressioni cliniche comuni nei contesti occidentali. Precedenti ricerche del nostro gruppo, sembrano infatti indicare la presenza di quadri depressivi in popolazioni scarsamente occidentalizzate quali i nomadi Peul o i contadini Dogon del Sub-Sahara, ma, in questo contesto, tuttavia, i sintomi depressivi, peraltro rari, appaiono secondari a disturbi somatici gravi, tranne che in individui scolarizzati. Le ricerche rilevano due distinte e contrapposte modalità di espressione clinica che vengono definite rispettivamente “occidentale” o della “colpa” e “tradizionale” o della “dislocazione dal gruppo”. Ulteriori indagini condotte in aree in rapida trasformazione sembrano indicare che i fattori ambientali possano influenzare l'evoluzione dei sintomi depressivi dall'una all'altra forma e modificare la soglia di scatenamento di schemi emotivo comportamentali depressivi. E' supposto che le perturbazioni dell'assetto sociale rendano adattive attitudini alia “iperesponsabilizzazione compulsiva”, una serie di convinzioni profonde che possono essere considerate allo stesso tempo come un prodotto dell'“occidentalizzazione” e come fattore di rischio depressivo. Gli individui dotati di tali caratteristiche di base, attraverso opportunità di vita offerte dal cambiamento sociale maturerebbero sistemi complessi e innovativi di interpretazione della realtà, di attribuzione della causalità e del controllo degli eventi, di vivere le emozioni. A partire da tale modello viene proposta una ridiscussione del concetto di soglia e una chiave di lettura della trasformazione della fenomenologia depressiva, se si ipotizza che i nuovi sistemi organizzativi della conoscenza, pur capaci di rispondere alle esigenze emergenti, espongano ad una maggiore vulnerability depressiva.
Asking for admission: data from eight General Hospital Psychiatric Wards in Lombardy, Italy
Authors: Politi Pierluigi , Tagliavini Giovanni , Colleoni Valerio , Donati Dario , Florian Anna , Griffi Pier Giovanna , Mita Pierluigi , Panetta Barbara , Regazzetti Mariagrazia
Published: October 2011

Objective — To describe requests of admissions to eight General Hospital Psychiatric Wards (SPDC) in Lombardy, Italy, during November 1995. Design — Descriptive prospective multicenter study. Setting — SPDCs of Busto Arsizio (VA), Calcinate (BG), Desio (MI), Magenta (MI), Merate (LC), Milano San Paolo I, Pavia, Treviglio (BG). The global catchment area sums up to 11% of the whole regional area, and to 18% of the population. Main outcome measures — We used a previously developed flowchart with two major key points: who decided to go to the hospital? Did a doctor confirm this initiative? Main sociodemographic characteristics, ICD10 diagnosis and previous psychiatric admissions were collected for each admission. Results — Admissions were 315, patients 246. In 9.5% of cases patients asked for admission without any medical advice. In one third of cases the ward psychiatrist was the first doctor to visit the patient. Compulsive admissions (TSO) were 45 (14.3%), although patient's initiative lacked in 55.6% of cases. A referral from Outpatient Departments (CPS) was present in 28.2%. First-ever admitted were 63 (25.6%): 20.7% sent by CPS, 16% by GPs, 11% by other non psychiatric wards. Conclusions — Although Goldberg & Huxley's model described General Hospital Psychiatric Wards as the last level of intervention, our data show that Italian SPDCs work as «front line» services: less than one admission out of two were referred by a psychiatrist. Problems raised by «self-referred» patients are conspicuous and an evaluation of the filtering function of CPSs seems necessary. In this regard, a comparison with different modalities of Department organization could be useful.
TOPOLOGY OF THE REPRESENTATION VARIETIES WITH BOREL MOLD FOR UNSTABLE CASES
Authors: NAKAMOTO KAZUNORI , TORII TAKESHI
Published: October 2011

In this paper we show that, in the stable case, when m≥2n−1, the cohomology ring H*(Repn(m)B) of the representation variety with Borel mold Repn(m)B and $H^{\ast }(F_{n}(\mathbb {C}^m)) \otimes H^{\ast }(\mathrm {Flag}(\mathbb { C}^n)) \otimes \Lambda (s_{1}, \ldots , s_{n-1})$ are isomorphic as algebras. Here the degree of si is 2m−3 when 1≤i<n. In the unstable cases, when m≤2n−2, we also calculate the cohomology group H*(Repn(m)B) when n=3,4 . In the most exotic case, when m=2 , Rep n (2)B is homotopy equivalent to Fn (ℂ2)×PGL n (ℂ) , where Fn (ℂ2) is the configuration space of n distinct points in ℂ2. We regard Rep n (2)B as a scheme over ℤ, and show that the Picard group Pic (Rep n (2)B) of Rep n (2)B is isomorphic to ℤ/nℤ. We give an explicit generator of the Picard group.
Screening for Torture
Authors: Rasmussen Andrew , Crager Mia , Keatley Eva , Keller Allen S. , Rosenfeld Barry
Published: October 2011

Torture has been defined most precisely in legal contexts. Practitioners who work with torture survivors and researchers who study torture have frequently cited legal definitions, particularly those in the United States’ Torture Victims Relief Act, the United Nations Convention against Torture, or the World Medical Association’s Declaration of Tokyo. Few practitioners have operationalized these definitions and applied them in their practice. We describe how a New York City torture treatment clinic used a coding checklist that operationalizes the definitions, and present results. We found that in practice these definitions were nested; that using guidelines for applying the definitions in practice altered the number of cases meeting criteria for these definitions; and that the severity of psychological symptoms did not differ between those who were tortured and those who were not under any definition. We propose theoretical and practical implications of these findings.
Small Explosion From New Vent at Kilauea's Summit
Authors: Wilson David , Elias Tamar , Orr Timm , Patrick Matt , Sutton Jeff , Swanson Don
Published: October 2011

At 0258 Hawaii‐Aleutian Standard Time (HST) on 19 March 2008, a small explosion scattered altered and fresh lithic debris across a 40‐hectare area at the summit of Kilauea volcano. This explosion, the first recorded there since 1924, issued from a vent about 35 meters wide along the east wall of Halema'uma'u Crater. Ballistic fragments—the largest measuring nearly 1 meter across—were propelled upward more than 70 meters onto the Halema'uma'u crater rim. Coarse ash and centimeter‐size lithic debris covered part of Crater Rim Drive, and fine ash was deposited farther than 30 kilometers to the southwest.
Automated Sensor Network to Advance Ocean Science
Authors: Schofield Oscar , Glenn Scott , Orcutt John , Arrott Matthew , Meisinger Michael , Gangopadhyay Avijit , Brown Wendell , Signell Rich , Moline Mark , Chao Yi , Chien Steve , Thompson David , Balasuriya Arjuna , Lermusiaux Pierre , Oliver Matthew
Published: October 2011

Oceanography is evolving from a shipbased expeditionary science to a distributed, observatory‐based approach in which scientists continuously interact with instruments in the field. These new capabilities will facilitate the collection of long‐term time series while also providing an interactive capability to conduct experiments using data streaming in real time.

The U.S. National Science Foundation has funded the Ocean Observatories Initiative (OOI), which over the next 5 years will deploy infrastructure to expand scientists' ability to remotely study the ocean. The OOI is deploying infrastructure that spans global, regional, and coastal scales. A global component will address planetary‐scale problems using a new network of moored buoys linked to shore via satellite telecommunications. A regional cabled observatory will “wire” a single region in the northeastern Pacific Ocean with a high‐speed optical and power grid. The coastal component will expand existing coastal observing assets to study the importance of high‐frequency forcing on the coastal environment.
Standardization of gravimeter calibrations in the geological survey
Authors: Barnes David F. , Oliver Howard W. , Robbins Stephen L.
Published: October 2011

The calibration of gravimeters has long been primarily the concern of geodesists involved in measuring large gravity differences, but recent developments suggest that the precision and stability of gravimeter calibrations may have greater geologic importance in the future. First, the use of high‐speed computers and an increasing variety of supplemental data now make possible the geologic interpretation of gravity anomalies so small that they would not have been noticed in surveys made ten years ago. The kind of gravity interpretation that identifies small reefs and local accumulations of petroleum [McCulloh, 1967] often requires local increases in station density and the assurance that the calibration of meters used in all parts of a survey are compatible. Second, temporal changes of gravity have already been measured in connection with earthquakes [Barnes, 1966], volcanic eruptions [Iida et al, 1952], and the movement of ice caps [Behrendt, 1967]; they are now being considered for several other types of geologic processes.
Progress on a gravity map of Alaska
Authors: Barnes David F.
Published: October 2011

The U.S. Geological Survey began gravity surveys in Alaska ten years ago with local surveys in the Copper River and Tanana Basins. Shortly before the 1963 AGU gravity symposium [Barnes, 1965], the emphasis shifted from local surveys to the preparation of a reconnaissance gravity map of the whole state with a 10‐mgal contour interval on a scale of 1:2,500,000, which would be similar to the gravity map of the United States [Woollard and Joesting, 1964]. Data have now been obtained in approximately three‐fourths of the state, but there are large variations in both station density and geologic usefulness of the coverage. The amount of coverage is primarily influenced by the distribution of water bodies because more than three‐fourths of the stations have been obtained by riverboats, small skiffs, and floatplanes.
Gravity anomalies over the Aleutian Trench
Authors: Malahoff Alexander , Erickson Barrett H.
Published: October 2011

In 1964 the USC&GS Surveyor crossed the Aleutian trench 48 times between 165° and 180°W longitude. The data provide a basis for a free‐air gravity map, a Bouguer gravity map (density 2.87 gm/cm3), and three possible crustal models that fit the results and available seismic data. The area covered lies west of an earlier gravity survey described by Peter, et al. [1965] of the Aleutian trench between 155°W and 165° longitude and 53° and 55°N latitude. As on the earlier gravity survey, which was also carried out by the U.S. Coast and Geodetic Survey, the observations were made along north‐south lines spaced 20 km apart and extending about 200 km south of the island arc.
Trends in urban air quality
Authors: Ludwig John H. , Morgan George B. , McMullen Thomas B.
Published: October 2011

An evaluation of trends in air quality is a means to assess the net result of numerous interrelated factors that affect the quality of our air resource. Factors such as population growth, industrial activity, energy consumption, rural‐urban distribution of our population, the shape and size of our metropolitan areas, various social and economic changes, and the effectiveness of our efforts to control pollution at its source all play an important role in determining the resulting air quality. It must be noted that the trends in ambient levels of pollutants at any one place is a complex function of some or all of these factors and not merely the direct assessment of the degree of control applied to the various sources of pollution.

We assess trends presumably because we would like to anticipate what is happening to us now, and we inject into this picture projections of potential pollution increases related to our nation's goals in population growth and standard of living, in order to anticipate some of the future consequences of trends in human activity. This also allows us to assess the need to control pollution and to undertake now the research and development required to bring such control about. It is to be noted that the subject of this article is by no means merely of scientific curiosity; rather, it is the basic building block on which our nation's need and program, to restore and protect our environment, is founded.
Apollo 11: Implications for the early history of the solar system
Authors: O'Keefe John A.
Published: October 2011

In this paper, I shall attempt to show that the Apollo 11 data support the idea that the moon was formed by the breakup of the earth, and that they suggest that after the breakup, the moon went through a heating episode that boiled away most of its mass. I will go on to discuss the possibility that the planets of the solar system might have been formed in a similar way, that is by breakdown of Jupiter‐sized objects rather than by buildup from smaller ones.

From the cosmological standpoint, the most interesting results from the Apollo 11 samples were the chemical measurements. To appreciate these, it is necessary to have some idea as to what the chemical measurements should have shown. In other words, if the moon had formed from the primeval materials of the system, what would a chemical analysis have been like? The answer to this question is called the cosmic abundance scheme. In this scheme, hydrogen forms 90% of the material, helium 10%, and the other elements, including the nonvolatile elements, constitute less than 1%. The element abundances have a fixed ratio to one another; that is, there is a definite answer to the question: What was the initial ratio of silicon to iron? A systematic listing of these ratios was first done by Henry Norris Russell in the 1930's. The most recent and useful table is by Cameron [1968].
Composition of the stratospheric “sulfate” layer
Authors: Cadle Richard D.
Published: October 2011

Spectacular sunsets are seen over much of the world following violent volcanic eruptions, and the brilliant displays may occur for many years (Figure 1). Especially noteworthy were those following the eruption of Krakatoa in the East Indies in 1883 and of Gunung Agung in Bali in 1963. The optical effects result from the scattering of sunlight by fine volcanic particles. Other recent eruptions that have been shown to inject particles—volcanic gases such as hydrogen sulfide and sulphur dioxide which by chemical reactions form particles—and entrained air into the stratosphere include Awu in 1966 and Fernandia in 1968. Of course there are small, but not zero, concentrations of particles in the stratosphere even following prolonged periods of little volcanic activity. These particles come from many sources, as discussed later in this article.
The Earth's rotation
Authors: Rochester M. G.
Published: October 2011

The most ancient and fundamental concern of astronomy is the orientation and motion of a terrestrial observer relative to the stars. Its geophysical aspects date from the time of Newton and Halley, and its mathematical foundations were laid by Euler 200 years ago. Despite this honorable antiquity, the subject is far from moribund and today presents a rich and fascinating array of challenges to observation, experiment, data analysis, and theory. The many‐faceted problems of the three‐dimensional rotation of the earth about its center of mass now attract astronomers and paleontologists, solid earth geophysicists and electrical engineers, general relativists and oceanographers, and applied mathematicians and scholars of classical texts.
Geodetic and dynamical properties of planets
Authors: Anderson J. D.
Published: October 2011

The study of planetary dynamics and geodesy is a difficult subject. This is so, not simply because of the complexity of the interactions between several scientific disciplines, including geophysics, geology, geochemistry, seismology, celestial mechanics, radar astronomy, and meteoritics, but perhaps more fundamentally, because of a lack of data.

Although it is true that the space age has brought about important new observational techniques, which are responsible in large part for the rapid developments in planetary science over the past decade, and although we should expect to see significant progress in the field over the next few years, it is still a sad fact that data will be severely limited for an indefinite period of time in the future. The basic problem is that we can observe and study, at present, only one planetary system in the universe. This system, our solar system, contains only four major planets, five terrestrial planets, where we are inclined to include the moon but exclude Pluto, and a fairly hmited collection of debris, presumably left over from some inadequately understood formation process. Thus it is impossible to base the study of planets on a significant statistical sample.
Earthquake‐related experimental studies in the USSR
Authors: Dieterich J. H. , Brace W. F.
Published: October 2011

We recently spent three and a half weeks in the Soviet Union as part of the Soviet/American Working Group on earthquake prediction. We visited the seismological field station at Garm as well as several institutes in Moscow, Tashkent, and Dushanbe. We examined and discussed at some length some of the ongoing experimental research pertaining to earthquake mechanics and prediction. In the following note we mention the laboratories and individuals currently engaged in experimental work, for the benefit of our American colleagues who may wish to communicate with their Soviet counterparts.
The gravity and shape of the Moon
Authors: Kaula William M.
Published: October 2011

This review discusses the current knowledge of the gravity and geometry of the moon, and their implications as to lunar structure. Measurements pertaining to the gravity field are, first and foremost, Doppler tracking of spacecraft that have orbited the moon, but also the laser ranging from the earth to the moon and the gravity meters and accelerometers landed with the Apollo spacecraft. Measurements pertaining to the geometry include (1) those related to the shape: the metric photography and laser altimeters on Apollo 15, 16, and 17; the electromagnetic sounder on Apollo 17; the landmark tracking from earlier Apollo orbiters; and occupations, plus (2) measurements related to the orientation: the laser ranging and interferometry from the earth. The review does not cover determinations of topography from photography taken for geologic or landing reconnaissance purposes. The discussion of tectonic implications is limited to inferences of a quantitative nature. The emphasis is on work since 1970; see Kaula [1969, 1971] for reviews of earlier work.
Toward an ice‐free Arctic ocean
Authors: Aagaard Knut , Coachman L.K.
Published: October 2011

The strong salinity stratification of the Arctic Ocean prevents substantial ice‐free conditions in winter by suppressing convection and reducing upward heat flux from the Atlantic Water. These conditions would be significantly altered in the sensitive southern Eurasian basin if suggested diversions of western Siberian rivers were accomplished.
The great negative Bouguer gravity anomaly over Africa
Authors: Girdler Ronald W.
Published: October 2011

This article draws attention to a most remarkable feature on a recently published Bouguer gravity anomaly map of Africa. The map is published by the U.S. Defense Mapping Agency in a technical paper that may not be widely seen, although it was presented at the Spring Annual Meeting of the AGU in 1973. The authors are R.L. Slettene, L.E. Wilcox, R.S. Blouse, and J.R. Sanders [Slettene et al., 1973].

The map is on a Mercator projection at a scale of 1:20,000,000. The compilation procedure was completely automated, and only terrestrial data were used. A total of 3073 mean anomaly predictions 1°×1° were incorporated. About 40% of these were computed by various conventional and statistical methods; the remaining 60% were made by geophysical correlation methods. The computer‐generated contours are at 10 mgal intervals for anomalies smaller than −100 mgal and at 20 mgal intervals for anomalies larger than −100 mgal.
Symposium on meteorological observations from space
Authors: Anonymous
Published: October 2011

A Symposium on Meteorological Observations From Space will be held in conjunction with 19th Plenary Meeting of the Committee on Space Research (Cospar) in Philadelphia, Pennsylvania, and will be cosponsored by Cospar (ICSU), the International Association of Meteorology and Atmospheric Physics (IUGG/ICSU), the World Meteorological Organization, the Joint Organizing Committee for the Garp (Global Atmospheric Research Program) (ICSU/World Meteorological Organization), and the American Meteorological Society. The symposium will be concerned with the performance of space observing systems, the application of their data to meeting the requirements of the First Garp Global Experiment, now scheduled for 1978–1979, and some observations for the Garp Climate Dynamics Subprogram. Two complementary meetings, the IAMAP Ozone Commission Meeting and the IAMAP Radiation Symposium, will be held in August 1976.
Quake hazard map prepared
Authors: Anonymous
Published: October 2011

A new report and map for the conterminous states appraising the potential ground shaking produced by earthquakes have been prepared by the US. Geological Survey. The map represents a first attempt to show on a national basis the levels of earthquake shaking hazards that can be expected.

Levels of ground shaking for different regions of the United States are shown on the map by contour lines which express in percentages of the force of gravity the maximum amount of horizontal acceleration (shaking) likely to occur at least once in a 50‐year period. For example, a contour at 60% of gravity means that scientists are 90% certain that the region in the vicinity of the contour will not experience ground shaking more than 60% of the force of gravity.