bluuebunny/crossref_metadata_2025 huggingface dataset:
Health status, resource consumption, and costs of dysthymic patients in Italian primary care
Authors: Barbui Corrado , Garattini Livio , Krulichova Iva , Apolone Giovanni
Published: October 2011

Aims – To describe the health status, resource consumption and costs of patients with dysthymic disorder in the Italian primary care setting. Methods – A total of 79 general practitioners (GPs) participated the study. Diagnosis was based on each GP's clinical assessment. At entry the Mini-International Neuropsychiatric Interview (MINI) was used as a supporting diag- nostic aid. Health status was measured with the SF-36 questionnaire. Resource consumption and costs regarded the six months before enrolment. Results – Out of 598 patients enrolled by GPs according to their clinical assessment, 503 fulfilled the MINI cri- teria and 95 did not. The latter had a better perception of their health than the former. Resource consumption was similar in the two groups; and the total per patient six-month costs did not differ significantly. Conclusions – The study confirms there may be a gap between standardised criteria for defining dysthymia and everyday clinical practice. All dysthymic patients diagnosed by GPs might be considered together from a health policy perspective.

Declaration of Interest: this research was partly supported by a contribution from Sanofi-Synthelabo Italy.
Some thoughts on the care needs of demented patients. Part II
Authors: Spagnoli Alberto , Cocco Ennio
Published: October 2011

Riassunto

Scopo - Data la mancanza di una tradizione e di studi o riflessioni sistematiche sul problema dell'assistenza ai pazienti dementi, ed in considerazione delle numerose esperienze avviate anche in Italia per esplorare modi innovativi di assistenza agli anziani affetti da demenza, abbiamo ritenuto interessante formulare alcune riflessioni sull'argomento. Il vero obiettivo di queste riflessioni è in realtà quello di iniziare, e sollecitare, un discorso sulla valutazione dei servizi psicogeriatrici. Metodo - È stata condotta una ricerca su MEDLINE a partire dal 1980, utilizzando le parole chiave qui riportate. Data la necessità di affrontare (o, se non altro, elencare) un ampio spettro di argomenti, che va dal ruolo giocato dalla distribuzione degli spazi interni nelle istituzioni, agli aspetti relazionali o agli psicofarmaci, abbiamo integrato la ricerca bibliografica attingendo da altre fonti molto diversificate. Risultati e conclusioni - La riflessione sui bisogni assistenziali degli anziani dementi suggerisce prima di tutto la necessità di impiegare il metodo epidemiologico anche per la descrizione e la valutazione dei servizi, e degli «stili assistenziali», dove il termine assistenza e da intendersi nell'accezione più comprensiva di health care. In secondo luogo, emerge l'importanza degli aspetti relazionali, di accoglimento e, per i pazienti istituzionalizzati, della distribuzione degli spazi interni e, ancora, la necessità che argomenti tanto (apparentemente) disparati trovino sintesi ed ospitalità in riviste lette da chi si occupa di assistenza. Infine, è evidente che la preziosa cultura anti-istituzionale prodotta dalla psichiatria sociale richiede, in psicogeriatria, una revisione che individui i punti di adesione e di distanza da strategic fondate sull'affermazione deU'autonomia del paziente (vs la dignità della disabilità), sul suo coinvolgimento in una vita più attiva (vs il «rispetto dell'apatia») e sul suo recupero alia vita sociale (vs nuove forme di equilibrio tra stimolazione e protezione).
Psychiatric services, social co-operatives, voluntary organisations. New relationship for new strategies
Authors: Guerriero Ernesto
Published: October 2011

Objective — Eighteen years after the 1978 reform law no. 180, psychiatric services have to find new roles and goals in the social arena, in order to continue to effectively pursue the improvement of mental health in the commi nity. The aim of the present paper is to show some theoretical and practical elements that could stimulate in the psychii trie services a deep consideration about the relationship between psychiatric services and «private social» bodies, part cularly social co-operatives and voluntary organisations. Method — The elements shown in this study come from an ani lysis: a) of the literature about the crisis factors of the Italian welfare state, particularly in the Public Health Service and i the social assistance; b) of the literature about the development of the «private social» and about the relationship with tl public services; c) of national and regional laws, particularly of Veneto region; d) of the present experiences in Sout Verona Psychiatric Service. Results — The crisis of the traditional welfare state, the emergence in large sectors of gener; population of needs related to social fragmentation and relational impoverishment, the aspiration of a great number (individuals excluded from society to benefit of the right to full citizenship, all this urgently questions the traditional roh and responsibilities, the organisation, operational modalities, and the community orientation of existing health and hi man services. Within this framework, the relationship between psychiatric services (or, broadly speaking, public serviet in general) and «private social» bodies, particularly social co-operatives and voluntary organisations, has become part of a foreseeing, strategic new awareness of mental health workers. Conclusion — A shift from a relationship of mutual exploitation between organisations, to one of co-operation between them, each considering the other as an equal partne may be a critical step forward a new model of welfare. This, in turn, would hopefully meet the needs for health of th population in terms of efficiency, quality, relevance and consideration of the users' resources and social competencies.
The suicidal behaviour in the North province of Varese: an epidemiological analysis
Authors: Bressani Roberto , Cioffi Isidoro , Fraticelli Carlo , Grillo Franco , Pisani Salvatore , Verri Anna Maria , Banfi Fabio , Vender Simone
Published: October 2011

RIASSUNTO

Scopo – Conoscere dati quantitativi e caratteristiche del comportamento suicidario nell'area nord della Provincia di Varese, comprendente il capoluogo ed i comuni limitrofi (Valceresio, valli del luinese e nord-Verbano), al fine di individuare interventi preventivi. Disegno – Studio epidemiologico-descrittivo. Sono state utilizzate le schede di morte ISTAT del Registro di Mortalità dell'ex Azienda USSL di Varese negli anni 1995-97. Sono stati inclusi i soggetti che al momento del suicidio risultavano residenti. Successivamente i casi delle schede ISTAT sono stati ricercati negli archivi dei servizi psichiatrici, per valutare eventuali contatti. Per costoro sono state rilevate informazioni, quali tentativi suicidari, patologia psichiatrica, data del primo contatto. Setting – Distretti di Arcisate, Cittiglio, Luino e Varese, corrispondenti al bacino di utenza delle Unità Operative di Psichiatria 1 e 2 dell'Azienda Ospedaliera Universitaria Macchi di Varese. Principali misure utilizzate – Sono stati calcolati i tassi di suicidio deH'area e tramite standardizzazione diretta sono stati confrontati i tassi dei singoli distretti. Risultati – I suicidi sono stati 78 (24 femmine e 54 maschi), con un tasso dell'8.2 per 100.000. In analogia all'andamento nazionale si osserva una diminuzione generale del fenomeno negli ultimi anni, ma non per i più giovani. Ci sono alcune aree geografiche (distretti di Luino e di Arcisate) da monitorare nel tempo, perche una casistica più ampia potrebbe rivelare un rischio più elevato. La fascia d'età giovane e anziana è più colpita nei maschi, e per i due sessi sono particolarmente a rischio i 55-64enni. I mezzi utilizzati differiscono per fasce d'età. Un'alta percentuale di soggetti sono non coniugati o con scarsa istruzione. Meno di un terzo dei casi era entrato in contatto con i servizi psichiatrici. Conclusioni – I dati consentono un confronto con la casistica nazionale e una riflessione sulle caratteristiche del suicidio nell'area di riferimento, al fine di elaborare strategie preventive orientate da un approccio multidimensionale, la cui efficacia potrà essere validata nel tempo attraverso l'attivazione di un osservatorio provinciale.
Monitoring the impact on the international literature of the scientific production of Italian researchers, in the disciplines ‘psychiatry’ and ‘psychology’: 1985-1989 and 1995-1999
Authors: Tansella Michele , Fava Giovanni A.
Published: October 2011

RIASSUNTO

Scopo — Questo lavoro si propone di evidenziare i settori ed i ricercatori italiani, nell'ambito delle discipline ‘psichiatria’ e ‘psicologia’, con il maggiore impatto sulla letteratura internazionale nel quinquennio 1995-1999 e di confrontare i dati con quelli relativi al quinquennio 1985-1989. Metodo — Utilizzando un database predisposto dall'Institute for Scientific Information (ISI), che includeva tutti i lavori, apparsi nei due quinquenni 1995-1999 e 1985-1989 su riviste di psichiatria e psicologia censite da Current Contents che avevano come autore o coautore almeno un ricercatore italiano operante in Italia, à stata effettuata un'analisi delle citazioni relative agli anni successivi ai due quinquenni, fino al 1999. Risultati — Nel 1995-1999 i ricercatori che avevano raccolto il maggior numero di citazioni appartenevano alle aree della psicologia clinica, della psichiatria e della psicofarmacologia. La neuropsicologia, in posizione dominante nel 1985-1989, ha subito un netto calo. Conclusioni — L'analisi delle citazioni relativa a periodi di tempo relativamente brevi (quinquenni) risulta essere un utile strumento per monitorare l'evoluzione della ricerca scientifica in specifiche discipline ed i trend deH'impatto della produzione dei ricercatori.
Packages of care in the Departments of Mental Health in Lombardy
Authors: Lora Antonio , Bezzi Roberto , Di Vietri Roberta , Gandini Anna , Spinogatti Franco , Zocchetti Carlo
Published: October 2011

RIASSUNTO

Scopo – Il lavoro ha lo scopo di individuare i pacchetti di trattamento erogati dai Dipartimenti di Salute Mentale, ponendoli in relazione sia alia diagnosi dei pazienti che all'intensità nell'utilizzo delle risorse. Disegno – Lo studio è stato condotto a partire dai dati raccolti dal Sistema Informativo Psichiatrico lombardo; il campione è formato da 55518 pazienti residenti in Lombardia e in contatto nel 1999 con i Dipartimenti di Salute Mentale, di cui sono stati rilevati nel corso dell'anno i contatti territoriali, semiresidenziali, residenziali e ospedalieri. Setting – I Dipartimenti di Salute Mentale della Regione Lombardia nel 1999. Principali misure utilizzate – Secondo uno approccio empirico, basato sull'esperienza dei ricercatori, sono stati definiti 15 pacchetti di cura; il pacchetto di cura “solo attivita territoriale” è stato ulteriormente distinto in sei macroattività; a ciascun pacchetto sono stati assegnati i pesi assistenziali. Risultati – Quattro pacchetti di cura (solo Ass. Territoriale, Ass. Ospedaliera e Ass. Territoriale, solo Ass. Ospedaliera, Ass. Semiresidenziale e Ass. Territoriale) da soli caratterizzano il 95% dei pazienti. Tre quarti dei pazienti vengono trattati solo nell'ambito territoriale, senza l'intervento di strutture ospedaliere, residenziali e semiresidenziali. I pazienti più gravosi, vale a dire i pazienti inseriti in un pacchetto con un peso medio maggiore di 5000, rappresentano solo il 4% degli utenti dei servizi. L'attivita residenziale sembra svolgere un ruolo sempre maggiore nella rete dei servizi psichiatrici (36% del peso assistenziale totale), mentre la schizofrenia si conferma la diagnosi di maggiore impatto per i servizi (59% del peso assistenziale totale). Dei pazienti trattati solo neH'ambito territoriale un terzo riceve unicamente interventi ambulatoriali medici e psicologi, mentre i due terzi restanti ricevono trattamenti integrati in cui l'attività clinica ambulatoriale si accompagna a interventi di carattere domiciliare, familiare, riabilitativo e sociale. Conclusioni – Nel modello territoriale di assistenza psichiatrica i pacchetti di cura più complessi e diversificati rappresentano l'eccezione piùttosto che la regola. I pacchetti più complessi e/o con maggior peso assistenziale si rivolgono ai pazienti che per la loro diagnosi sono definiti gravi.
Phenomenology of patients with early- and adult-onset obsessive-compulsive disorder
Authors: Albert Umberto , Picco Chiara , Maina Giuseppe , Forner Federica , Aguglia Eugenio , Bogetto Filippo
Published: October 2011

RIASSUNTO

Scopo– Valutare eventuali differenze nelle caratteristiche sociodemografiche e cliniche (sintomatologia ossessivo–compulsiva, la comorbidità di Asse I e la comorbidità di Asse II) in soggetti adulti con disturbo ossessivo–compulsivo ad esordio precoce (>18 anni) e in eta adulta (≤18 anni).Disegno– Studio clinico controllato.Setting– Servizio per i disturbi depressivi e d'ansia, Dipartimento di Neuroscienze, Università di Torino.Metodo– Sono stati inclusi nello studio 149 pazienti adulti con diagnosi di DOC (DSM–IV) e un punteggio Y–BOCS totale <16.1 soggetti sono stati valutati attraverso un'intervista semi–strutturata diretta ad indagare le caratteristiche socio–demografiche é cliniche. La comorbidita longitudinale di Asse I, secondo i criteri del DSM–IV, è stata valutata attraverso un'intervista clinica strutturata diretta secondo le indicazioni di Othmer & Othmer (1994; 1999): particolare attenzione è stata rivolta alia rilevazione dei disturbi dello spettro ossessivo–compulsivo (Hollanderet al, 1996; 1997). Per l'analisi della comorbidita con i disturbi di personalitá è stata utilizzata la Structured ClinicalInterview for DSM–IV Axis II Disorders(SCID–II).Risultati– 39 pazienti (26.2%) hanno presentato l'esordio del DOC prima dei 18 anni (early–onset) e 110 pazienti (73.8%) hanno presentato l'esordio del DOC dopo i 18 anni (later–onset). Sono state rilevate differenze significative tra i due gruppi di confronto: i soggetti con esordio precoce presentano una predominanza del sesso maschile, un decorso cronico del disturbo e l'associazione con il disturbo schizotipico di personalità.Conclusioni– Suddividendo il campione secondo l'eta di esordio del disturbo abbiamo rilevato alcune differenze significative nell'espressivita del DOC che indicano una possibile eterogeneita del disturbo, meritevole di ulteriori approfondimenti. In particolare, il rilievo nel gruppo ad esordio precoce di un decorso prevalentemente cronico e soprattutto di una specifica associazione con il disturbo schizotipico di personalita appare significativo ai fini dell'impostazione di specifiche strategic terapeutiche.
Quality of life routine outcomes measurement: lessons from experience in the USA and the UK
Authors: Huxley Peter , Evans Sherrill
Published: October 2011

This paper is concerned with issues in the routine measurement of quality of life in a mental health context. It is in three parts. In the first part the first author reviews briefly, lessons from a decade of experience in the use of data produced by routine measurement using the Colorado Client Assessment Record (CCAR) in the Mental Health Centre of Boulder County (MHCBC) in Colorado, USA. In the second part, the specific issues surrounding quality of life assessment as a routine outcome measure are considered. Evidence is presented to counter some of the commonly held beliefs about QoL measurement problems. Finally, general problems that affect QoL and all other routine measures are described and analysed using a framework devised by Peterson (1989).
Determinants of hospitalization from psychiatric E.R. from S. Gerardo hospital in Monza: epidemiological cross-sectional study
Authors: Giampieri Emanuela , Ratti Alessandra , Beretta Alessandra , Mattavelli Cinzia , Ferrarini Elena , Pruneri Carlo , Carta Italo
Published: October 2011

RIASSUNTO

Scopo – Individuare i fattori predittivi di ricovero in pazienti che giungono presso il Pronto Soccorso con problem psichiatrici. Disegno – Studio epidemiologico trasversale condotto presso il Pronto Soccorso dell'Ospedale S. Gerardo di Monza, tra il 1 giugno 1995 ed il 31 maggio 1997. Sono stati inclusi tutti i soggetti di età maggiore di 18 anni per i quali sia stata richiesta una valutazione psichiatrica. E' stato sondato il peso di variabili socio-demografiche, di variabili cliniche e di variabili di servizio sulla decisione di ricovero. Principali misure utilizzate – I dati sono stati raccolti mediante una scheda appositamente costruita, compilata dal medico di guardia al momento della visita. I dati sono stati analizzati tramite analisi univariata e regressione logistica. Risultati – Sono stati raccolti dati inerenti 2076 casi. All'analisi univariata la probabilita di ricovero è risultata più elevata per soggetti tra i 39 ed i 48 anni, celibi o nubili, disoccupati, affetti da schizofrenia, da disturbi deH'umore o da disturbi di personalità. Il ricovero è più probabile in proporzione alia gravità, all'ideazione suicidiaria ed a precedenti ricoveri. Tra i sintomi troviamo che l'ansia protegge dal ricovero laddove allucinazioni, delirio, assenza di critica di malattia, blocco psicomotorio, agitazione psicomotoria, stato confusionale, crisi pantoclastiche, bizzarrie comportamentali, alterazioni dello stato di coscienza e precedenti ricoveri incrementano la probabilità di ospedalizzazione. Il lunedì ed il venerdì sono i giorni a più alta frequenza di ricoveri. La regressione logistica conferma il ruolo predittivo di età, sintomi, aggressività, gravità ed ideazione suicidiaria, e dei giorni della settimana tra le variabili di servizio. Conclusione – Tra i fattori predittivi di ricovero in SPDC le variabili cliniche mantengono un ruolo predominante, rispetto a fattori socio-demografici. Accanto a queste, tuttavia, si nota un peso rilevante deH'organizzazione del servizio con un aumento del tasso di ricoveri proprio nei giorni a cavallo del fine settimana, quando i servizi territoriali chiudono.
Validation of the Italian version of the self report Insight Scale
Authors: Roncone Rita , Tozzini Carola , Mazza Monica , Risio Alessandro De , Giosuè Patricia , Morosini Pierluigi , Casacchia Massimo
Published: October 2011

Aims – To evaluate the psychometric properties of the Italian version of the Insight Scale (IS), self-report questionnaire assessing the awareness of psychiatric illness. The instrument contains two forms, the first A that enquires about the present status, and the second B that concerns past episodes of illness. Method – Factorial structure, internal consistency and concurrent validity (towards three selected items of the 24-item BPRS, Unusual thought content”, Conceptual disorganisation and Uncooperativeness) were studied on 80 chronic subjects affected by schizophrenia. Differences between acute and stabilised patients were investigated. Test-retest reliability was assessed in a sub-sample of 22 stable cases. Results – The Italian IS showed satisfactory concurrent validity and reliability. Acute patients had lower scores than stabilised ones. Factorial analysis brought to the distinction between insight for need for care in the present and in the past, which seems both plausible and clinically-useful. Conclusion æ The use of the IS Italian version may be encouraged as a valid insight self–report instrument. Sensitivity to change and predictive power concerning clinical and social outcome and adherence to treatment should be investigated.

Declaration of Interest: the study was supported by the National Project Mental Health, Mental Health Institute, Rome, Italy.
Sequential analysis of the phasing of the medical interview
Authors: Meeuwesen Ludwien
Published: October 2011

Aims– To study an analytical approach towards sequential analysis of the medical interview. An interview phase constitutes the analytical unit. Generally accepted phases of the medical interview are 1) medical history, 2) physical examination and 3) the conclusion segment. While descriptive and prescriptive studies claim that the sequence of the phasing is standard, it is hypothesised that in natural medical conversation the sequencing of the interview is more complex. For the doctor, the sequencing pattern is a powerful device to structure the interview and to manage the interactions within a limited time span. For the patient, especially the conclusion segment will contain more self-selection than other segments. Key concepts are turn taking, topic shift, topic flow, conversational coherence and responsiveness.Methods– The data consisted of 800 verbatim transcript pages of 85 medical interviews obtained from general practice. Interplay of theoretical notions and data-driven observations produced a reliable analytical method described in the article. The method enables to study processes of (a)symmetry in medical communication and the ways to deal with problems of misunderstanding.Results– Results confirmed 1) the asymmetrical character of the interview, 2) the complexity of the phasing, and 3) the existence of several types of interviews.Conclusions– The method can be applied for a broad range of research questions.

Declaration of Interest: none.
Epidemiology of overweight and obesity among Italian early adolescents: relation with physical activity and sedentary behaviour
Authors: Vieno Alessio , Santinello Massimo , Martin Maria Cristiana
Published: October 2011

Aims – The prevalence of overweight and obesity and the role of possible related factors were analysed among Italian early adolescents. Method – The survey reported here is part of the larger “Health Behaviour in School Aged Children” (HBSC) trans-national study, which is co-ordinated by the European Office of the World Health Organization. The data were gathered through self-administered questionnaires filled out by a representative sample of 4,386 (48.4% males) Italian students (11-, 13- and 15-year old). Results – The overall prevalence is 16.7% for overweight and 2.5% for obesity. Boys are more at risk than girls for the two phenomena. Moreover, age group, mother's education, area of residence, physical activity, and sedentary behaviour show a significant association with both outcomes. Conclusion – Findings of the present study are in agreement with similar studies carried out on early adolescents population, showing that prevalence in overweight and obesity decreases during this phase and is more diffused among boys than girls. The prevalence of both diseases is higher in the South and Islands. Sedentary behaviour and physical activity are substantive factors which preventive interventions could act on.

Declaration of Interest: the HBSC study is partly funded by the University of Padova through a scholarship attributed to Dr. Alessio Vieno (Year 2001 – prot. CPDR013233).
The role of the environmental factors on the development of adaptive skills in intellectual disabilities subjects
Authors: Scuccimarra Goffredo , Velotti Roberto , Canfora Flaviano , Facciuto Agata , Mellucci Simona
Published: October 2011

Aims — The aims of the study was to evaluate if environmental factors can influence the effectiveness of therapeutic intervention of subjects with intellectual disabilities. Methods — 46 adolescents and adults with mental retardation, in semi-residential rehabilitative treatment, have been assessed over a 2-years period. The evolution of adaptive functioning over time has been assessed through the AAMD-ABS. The development of the adaptive skills at follow-up has been correlated with socio-economic and cultural factors. Results — Linear regression showed that age of both parents, mother's health status, lack of one parent, SES, and housing conditions, represent significant covariates to predicting evolution of the adaptive functioning; these factors independently influence effectiveness of the therapy from the kind of treatment. Conclusion — The results demonstrate that effectiveness of the therapy can be conditioned from ability to fulfil the needs of the families, through social and supporting programs.

Declaration of Interest: none.
Schizophrenia, social class and immigrant status: the epidemiological evidence
Authors: Cooper Brian
Published: October 2011

Background — By the mid-1960s, the importance of socio-economic status for schizophrenia had been demonstrated in terms of differences between social-class groups in prevalence and incidence rates, illness course and outcome, and treatment experience. In the causation – selection debate, however, opinion had swung in favour of the selection hypothesis. Aims — To reassess evidence on the social-class distribution of schizophrenia in Britain, and to compare this body of research with population-based studies of schizophrenia risk in socially disadvantaged ethnic minorities. Method — Systematic review of medical and psychological data-bases. Results — Epidemiological research, while confirming the importance of premorbid social decline, has also provided support for the environmental ‘breeder’ hypothesis. High psychosis rates have been confirmed in ethnic minori-ties; in particular among Afro-Caribbean and other Black immigrants whose low social status cannot be accounted for by selective downward social drift or segregation. Conclusions — There are striking parallels, both in the epidemiology of schizophrenia and in social characteristics, between the lower-class indigenous groups highlighted by earlier psychiatric surveys and African-Caribbean populations in Britain's inner cities today. These similarities underline the need for a broader perspective in the search for environmental risk factors.

Declaration of Interest: none.
Linking epidemiology and disability measurement with mental health service policy and planning
Authors: Jenkins Rachel
Published: October 2011

RIASSUNTO

Scopo— Questo articolo discute in quale misura l'epidemiologia e la misurazione della disabilità puó dare un contributo alia salute mentale, alia politica dei servizi e alia pianificazione.Metodo— La rassegna esamina le informazioni necessarie per una politica e una pianificazione locale e internazionale in diversi setting.Risultati— L'epidemiologia e la misurazione della disabilità sono essenziali per sostenere una politica di pianificazione che dia risposta ai bisogni locali, contemporaneamente ad informazioni sugli input e sulle variabili di processo e di esito.Conclusioni— L'epidemiologia e la misurazione della disabilità dovrebbero essere parte integrante della politica sanitaria e della pianificazione atte a sostenere lo sviluppo del servizio, i suoi processi e la misurazione degli esiti, non solo per i servizi specialistici di salute mentale, ma anche per l'attività nella medicina di base, nelle scuole e nei posti di lavoro.
System failure? The problems of reductions in long-stay beds in the UK
Authors: Shepherd Geoff
Published: October 2011

RIASSUNTO

Scopo — Esaminare la letteratura riguardante gli effetti della riduzione del numero di letti per lungodegenti nei Servizi di Salute Mentale della Gran Bretagna. Metodo — Revisione selettiva della letteratura, con particolare riferimento a ricerche condotte dall'autore e dai suoi colleghi presso il Sainsbury Centre for Mental Health.Risultati — Le evidenze suggeriscono che gli effetti della riduzione dei letti dei lungodegenti dovrebbero essere esaminati separatamente, distinguendo i «vecchi» dai «nuovi» lungodegenti. Mentre i «vecchi» lungodegenti, che sono stati più direttamente toccati da questi cambiamenti, hanno avuto generalmente risultati positivi, lo stesso non può dirsi per i «nuovi» lungodegenti. Questi pazienti vengono correntemente accumulati in Unità per pazienti gravi, spesso in reparti di ospedali generali o entrano nel meccanismo della «porta girevole», che è rappresentato dai trattamento dei pazienti acuti a cui segue un inadeguato supporto sociale. Nonostante sia evidente la scarsita di letti per acuti, specialmente nelle aree centrali delle città, molti di questi letti sono attualmente occupati da pazienti che sarebbero curati meglio (e con minore spesa) in strutture territoriali alternative, se esse fossero disponibili. Le evidenze suggeriscono che e possibile migliorare gli esiti per questo gruppo di «nuovi» lungodegenti, se fossero utilizzabili specifici team territoriali che si occupino di reperire alloggi e lavoro e di assicurare adeguato sostegno. Conclusioni — Gli effetti della riduzione dei letti di pazienti lungoassistiti dovrebbero essere considerati in una prospettiva sistemica. Si possono organizzare servizi sociali efficaci, ma, per ottenere una efficace sostituzione di un tipo di servizio con un altro, ci deve essere un sistema ben coordinato, con obiettivi definiti e tecnicamente efficiente. Attualmente tali tipi di servizi sono rari. Comunque è improbabile che mettere a fuoco semplicemente un singolo elemento del sistema (ad esempio, il numero di letti) produca soluzioni efficaci ed efficienti.
Probabilistic models to analyze psychiatric contacts
Authors: Canal Luisa , Micciolo Rocco
Published: October 2011

Objective – To present three probabilistic models (Poisson, negative binomial, Waring) to analyze the distribution of the number of contacts of patients followed using a psychiatric case register. Design – Longitudinal to obtain the distribution of the number of contacts (during 91 days following that of the first contact) observed on patients followed using the South-Verona Psychiatric Case Register during the period 1/1/79-31/12/91. Results – There were a total number of 6913 contacts on 3454 subjects. The chi-square test for the goodness of fit yields a significant result both for the Poisson distribution (3580 with 6 degrees of freedom, p < 0.001) and for the negative binomial distribution (65.47 with 18 degrees of freedom, p < 0.001); on the other hand a non significant result was obtained for the Waring distribution (25.31 with 19 degrees of freedom, p = 0.151). Conclusions – The Poisson distribution gave a very poor fit for the distribution of contacts. The negative binomial distribution could be employed to analyze the pattern of contacts when the right tail of the distribution is not important. The Waring distribution is the best of the three presented. Moreover, the variance of the Waring distribution can be decomposed in three components: a random component, a component which accounts for endogenous factors and another component which accounts for esogenous factors. Therefore the Waring distribution is useful when one wants to make comparisons between psychiatric case registers of the same country or of different countries.
The Verona-Medical Interview Classification System/Patient (VR-MICS/P). The instrument and its reliability
Authors: Piccolo Lidia Del , Benpensanti Maria Grazia , Bonini Piero , Cellerino Paola , Saltini Anna , Zimmermann Christa
Published: October 2011

Objective – To assess the reliability and to describe the categories and the procedure to apply the VRMICS/P (Verona-Medical Interview Classification System/Patient). Setting – The interviews used for the reliability study were audio taped. Five general practitioners (GPs) working in two general practices in South-Verona recorded their consultations. Sample – 50 interviews selected randomly from 120, 10 for each GP. The selection criterion for the participating patients was a GHQ-12 score of 3 and the consultation for a new illness episode. Main outcome measures -The VR-MICS/P classifies patients' verbal behaviours into 21 categories, 15 of them are defined by form (cue or statement) and content. Procedure – Two trained raters classified 50 interviews. Before applying the classification system each interview is divided into units which are numbered to define doctor's and patient's sequence of speech. Results – The reliability of VR-MICS/P was satisfactory (Kappa 0.85). Similarity Index (Dice, 1945) for categories varied between 0.71 and 0.94. Reliability for form and content classification was satisfactory too (Similarity Index between 0.81 and 0.89 and between 0.84 and 0.94, respectively). Conclusions – The VR-MICS/P is a reliable measure for describing patients' verbal behaviours during medical interviews. It can be used together with the VR-MICS/D (Verona-Medical Interview Classification System/Doctor; Saltini et al., 1998) to describe the medical interview, the quality of doctor-patient interview and can be used as a measure of patient centredness.
Detection and management of mental distress and psychiatric disorders in primary care settings
Authors: Pini Stefano , Tansella Michele
Published: October 2011

Objective – Epidemiological and clinical studies indicate that 10–50% of primary care patients suffering from clinically relevant psychiatric distress are not diagnosed by their physician and only a minority of them receive an appropriate treatment. The improvement of physicians' ability to detect mental distress and psychiatric disorder, in their routine clinical activity, represents a crucial point to reduce the social impact of mental illnesses, prevent their worsening and chronicity and, eventually, relieve mental health services of an excessive burden of care and costs. The aim of this article is to examine a number of factors which intervene in the process of detection of mental distress by the physician. Then, we will examine factors related to the management of psychiatric disorders most commonly co-occurring with physical illness in general health care sector. Method – The method used for this review was essentially a recension of the literature concerning detection and treatment of psychiatric disorders in primary care settings, having in view to see the factors connected with these processes. Results – Among factors intervening in the process of identification of mental distress in primary care settings, both the characteristics of the physician and the characteristics of the patient should be taken into account. Primary care physicians and psychiatrists are being asked to work together more frequently in this era of community care. The principal aim of such invoked collaboration is the amelioration of quality of care and reduction of costs for mentally ill patients. An important issue within this collaboration is the referral by primary care physicians to specialist services.
The Italian asylum law: moving towards the deinstitutionalization model
Authors: Dell'Acqua Giuseppe
Published: October 2011

An evaluation is currently underway concerning the changes which have taken place in Italy in the twenty years following the reform law. The qualitative and quantitative changes are being analyzed based on a possible shared definition of the processes of deinstitutionalization. This theme is generally the object of misundestandings and cliches. The need for change in clinical and istitutional psychiatry is the indispensable premise for the development of community psychiatry and the growth of a culture of public psychiatry in general. In this framework, an attempt is being made to define the meaning of change through the growth of the active participation of persona affected with mental disorders and their families in treatment, the participation of ordinary citizens, the spread of services in the community and the quantitative increase of the number of personnel involved in public community services. Emblematic of this change is the increase in the number of psychiatrists working in the public sector, from 700 to 7,000, over this twenty year period. The changes which must take place in psychiatric practice must also be emphasized: the heirarchies, the relationships, the search for non-health resources and enhancing the value of operators as subjects outside of their institutional role. The various forms of resistence which have retarded, and continue to retard, the process of change are also considered: the persistence of clinical cultural models, administrative inertia, the defense of acquired privileges by medical and nursing lobbies, the interests of the private, commercial and religious sectors and political manipulation. In any case, the beginning of a process of change which contains all the potential of a real project for prevention is judged positively.
The closure of psychiatric hospital S. Lazzaro in Reggio Emilia
Authors: Asioli Fabrizio
Published: October 2011

This is not a scientific paper. It is the report of the actions carried out during 1996 and 1997 to close the Psychiatric Hospital S. Lazzaro in Reggio Emilia.
Systematic review of the role of service users as researchers in mental health studies
Authors: Salvi Giovanni , Jones Julia , Ruggeri Mirella
Published: October 2011

Aims– Service user involvement in mental health service development and research is becoming more common in countries like the UK. USA and Canada. This systematic review of the international scientific literature has been carried out to assess the stage of development of mental health service users involvement in research.Method– Systematic review of any research project actively involving service users in any part of the research process.Results– Thirty-five studies met the inclusion and exclusion criteria and were included in the systematic review. Nine studies used quantitative techniques, 24 used qualitative techniques and two studies used both quantitative and qualitative techniques. While three studies were user-led, in three other studies the users were simply consulted but did not have any active role in the research. The remaining 29 studies were based on a collaboration between service users and professional researchers.Conclusions– The involvement of mental health service users in the research process is feasible both in quantitative and qualitative research studies. The involvement of service users in research has a number of benefits; such research requires more accurate planning and more time than the traditional research.

Declaration of Interest: none.
Scanning Photoemission Spectromicroscopic Study of 4-nm Ultrathin SiO3.4 Protrusions Probe-Induced on the Native SiO2 Layer
Authors: Devan Rupesh S. , Gao Shun-Yu , Lin Yu-Rong , Cheng Shun-Rong , Hsu Chia-Er , Chen Chia-Hao , Shiu Hung-Wei , Liou Yung , Ma Yuan-Ron
Published: October 2011

Atomic force microscopy probe-induced large-area ultrathin SiOx (x ≡ O/Si content ratio and x > 2) protrusions only a few nanometers high on a SiO2 layer were characterized by scanning photoemission microscopy (SPEM) and X-ray photoemission spectroscopy (XPS). SPEM images of the large-area ultrathin SiOx protrusions directly showed the surface chemical distribution and chemical state specifications. The peak intensity ratios of the XPS spectra of the large-area ultrathin SiOx protrusions provided the elemental quantification of the Si 2p core levels and Si oxidation states (such as the Si4+, Si3+, Si2+, and Si1+ species). The O/Si content ratio (x) was evidently determined by the height of the large-area ultrathin SiOx protrusions.
A REMARK ON THE BRYLINSKI CONJECTURE FOR ORBIFOLDS
Authors: BAK L. , CZARNECKI A.
Published: October 2011

The paper presents a proof of the Brylinski conjecture for compact Kähler orbifolds. The result is a corollary of the foliated version of the Mathieu theorem on symplectic harmonic representations of de Rham cohomology classes. The proofs are based on the idea of representing an orbifold as the leaf space of a Riemannian foliation and on the correspondence between foliated and holonomy invariant objects for foliated manifolds.
Financial literacy and retirement planning in Sweden
Authors: ALMENBERG JOHAN , SÄVE-SÖDERBERGH JENNY
Published: October 2011

We use data from the Swedish Financial Supervisory 2010 consumer survey to look at levels of financial literacy and retirement planning in the Swedish population. The results indicate that many adults have low financial literacy. In general, financial literacy levels are lower among the young, the old, women and those with low income or low educational attainment. People who report having tried to plan for retirement have higher levels of financial literacy. In particular, an understanding of risk diversification is strongly correlated with planning for retirement. We relate our findings to features of the Swedish pension system.
Financial literacy and retirement planning in New Zealand
Authors: CROSSAN DIANA , FESLIER DAVID , HURNARD ROGER
Published: October 2011

We compare levels of financial literacy between the general adult population of New Zealand, people of Māori ethnicity, and people of Ngāi Tahu, a Māori tribe that is providing financial education to its members. While the level of financial knowledge of Māori people is generally lower than for non-Māori (controlling for demographic and economic factors), there is little difference between the financial knowledge of the people of Ngāi Tahu and other New Zealanders. Moreover, we find that financial literacy is not significantly associated with planning for retirement. This could reflect the dominant role of New Zealand's universal public pension system in providing retirement income security.
15 GHz quadrature voltage controlled oscillator in 130 nm CMOS technology
Authors: Lucchi Paolo , Dermit Davide , Jacquemod Gilles , Begueret Jean Baptiste , Borgarino Mattia
Published: October 2011

This paper reports a 15 GHz quadrature voltage controlled oscillator (QVCO) designed in a 130 nm CMOS technology. The phase noise performance of the QVCO and of a phase locked loop (PLL) where the QVCO was inserted were compared with the literature and with telecom standards and commercial products for broadcast satellite applications.
The Trauma of Torture and the Rehabilitation of Torture Survivors
Authors: Hárdi Lilla , Kroó Adrienn
Published: October 2011

The aim of torture is to cause severe pain and suffering in order to destroy the structure of the personality and the identity of the victim. Torture is applied in over a 100 countries worldwide, and its consequences affect millions of survivors. The rehabilitation of those who have experienced torture is a lengthy and complex process; treatment centers all over the world are constantly developing their methods to assist the mental and physical healing of torture survivors. The present article offers insights into the nature of torture, applied torture techniques, the psychological sequelae of torture, and diagnostic developments. Furthermore, current issues of rehabilitation and reparation are discussed, including the debate on evidence-based practice in treatment. The aim of the authors is to offer a brief but comprehensive review on torture and rehabilitation for professionals of mental health care and other relevant fields.
Are the American Psychological Association’s Detainee Interrogation Policies Ethical and Effective?
Authors: Pope Kenneth S.
Published: October 2011

After 9–11, the United States began interrogating detainees at settings such as Abu Ghraib, Bagram, and Guantanamo. The American Psychological Association (APA) supported psychologists’ involvement in interrogations, adopted formal policies, and made an array of public assurances. This article’s purpose is to highlight key APA decisions, policies, procedures, documents, and public statements in urgent need of rethinking and to suggest questions that may be useful in a serious assessment, such as, “However well intended, were APA’s interrogation policies ethically sound?”; “Were they valid, realistic, and able to achieve their purpose?”; “Were other approaches available that would address interrogation issues more directly, comprehensively, and actively, that were more ethically and scientifically based, and that would have had a greater likelihood of success?”; and “Should APA continue to endorse its post-9–11 detainee interrogation policies?”
Recent Developments in Paleomagnetism and Geomagnetism: Sixth Nordic Paleomagnetic Workshop; Lule, Sweden, 15–22 September 2009
Authors: Elming S.Å. , Pesonen L. J.
Published: October 2011

The Sixth Nordic Paleomagnetic Workshop was held in northern Sweden. The meeting focused on discussion of recent developments in paleomagnetism/geomagnetism, covering topics including thousand‐year‐scale geomagnetic field variations, paleoclimate of the Holocene (∼10,000 years ago to the present), Phanerozoic (∼545 million years ago to the present) plate reconstructions, and Precambrian (more than ∼545 million years ago) supercontinents.

The workshop series began in 1986 in Espoo, Finland, in connection with the European Geotraverse Project. Since then, workshops have occurred every 45 years: the second in Sweden (1990), the third in Norway (1994), the fourth in Denmark (1999), and the fifth in Finland (2005). A total of 23 paleomagnetists and geomagnetists representing 12 countries (Australia, Brazil, Canada, Denmark, Estonia, India, Finland, Norway, Switzerland, Sweden, United Kingdom, and United States) participated in the sixth workshop.
Rock mechanic research
Authors: Anonymous
Published: October 2011

Scientists and engineers at the Research Center of Halliburton Company, Duncan, Oklahoma, are researching rock mechanics to improve recovery of oil and gas in fracturing operations and to apply their results to cementing practices, grouting, well logging, acidizing, and waste disposal. Attention will be focused upon rock in the 10,000 ft.‐depth range where rock may be under stress conditions of 5,000 to 10,000 psi. The company hopes to be able to predict the orientation, direction, and extent of fractures at producing levels. They are using a 120,000‐lb. Riehle universal testing machine in the project.
Modular subsurface buoy
Authors: Anonymous
Published: October 2011

An illustrated data sheet spotlights a fiberglass subsurface buoy, modularized to provide maximum flexibility and performance under operating pressures up to 10,000 psi. The data sheet contains a list of specifications and accessories for the system. For information write for data sheet 44 at the Braincon Corporation, Marion, Massachusetts 02738.
Lunar Science Institute
Authors: Anonymous
Published: October 2011

The Lunar Science Institute in Houston, Texas, was established March 1, 1968, to provide a base for academic scientists participating in the lunar exploration program, working in the Lunar Receiving Laboratory, or using the facilities of the Manned Spacecraft Center devoted to the study of the moon. It will serve as a center for analysis and study of lunar data obtained as a result of NASA unmanned missions. The Institute is expected to be an influential demonstration of university‐government collabroation in the laboratory. The National Academy of Sciences has accepted interim responsibility for its operation until a consortium of universities can be formed to direct it.
Deaths
Authors: Anonymous
Published: October 2011

Frank Adams, died in 1967; member of AGU since 1931; Life Member, 1946.

Rollin S. Baldwin, died December 13, 1967; member of AGU since 1966.
Water laws and concepts
Authors: Thomas Harold E.
Published: October 2011

A publication on water management of the National Academy of Sciences [1966, 38] contains the following statement: In the public allocation process it is unlikely that society will welcome widepread and strict allocation of water. Water is regarded as a birthright of Americans—a common holding in which there are common stakes. Other commodities are not so regarded; water is singled out for special consideration. This statement is an expression of human rights without qualification as to property or economic status. It also implies that people have rights to water suitable and adequate to their needs wherever they may be.
A scrutiny of the abstract
Authors: Landes Kenneth K.
Published: October 2011

The behavior of editors is discussed. What should be covered by an abstract is considered. The importance of the abstract is described. Dictionary definitions of ‘abstract’ are quoted. At the conclusion a revised abstract is presented.