To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure email@example.com
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
This research communication explores the value of routinely collected bulk tank milk quality data for estimating dairy cattle welfare at herd level. Selected bulk tank milk quality parameters (somatic cell count, total bacterial count, urea, protein and fat contents) recorded during the years 2014–2016 in 287 Italian dairy farms were compared with the animal welfare data of each farm. The welfare assessment data were extracted from the database of the Italian Reference Centre for Animal Welfare (CReNBA), which includes the outputs of the application of the CReNBA welfare assessment protocol for dairy cows, used at national level for on-farm controls. The statistical analysis was carried out using the correlation coefficient for Kendall's Tau ranks, in order to investigate the presence of a categoric relationship between the selected bulk tank milk quality parameters and the overall animal welfare score or the scores of the single areas A (farm management and staff training), B (housing) and C (animal-based measures). Somatic cell count, total bacterial count, urea and proteins demonstrated only a few statistically significant and very weak correlations with farm animal welfare data, while no significant correlations were obtained for milk fat content. Given the weak correlations found, the selected bulk tank milk parameters seems to be able to provide only limited information about the welfare level of the herd, thus it could be difficult to use them for drawing up a pre-screening model for identifying herds at risk of poor welfare.
To evaluate psychiatric features in liver post transplant HIV recipients.
An observational study was conducted. Different psychiatric rating scales to evaluate cognitive status (MMSE), anxiety and depressive symptoms (HAM-A, HAM-D), social phobia (BSPS), quality of life (SF-36), sexual satisfaction (ISS), coping strategies (Brief Cope) and alcohol-drug abuse (LDQ) were submitted to a population of 11 HIV outpatients that underwent to OLT (19% of the Italian HIV transplant recipients). Scores were statistically related to socio-demographic and clinical data.
All patients were male, aged between 33 and 54 years. In the past 8 patients were drug abusers, three suffered from depression. At the moment of the evaluation 8 patients didn't suffer from any psychiatric disease while the three youngest patients presented a mild depressive status. BASIS-32 scores were related to HAM-D and to a history of drug abuse (p< 0.01). SF-36 was related to age (p< 0.05), HAM-D (p< 0.01), BSPS and BASIS 32 (p< 0.02).
Despite the higher risk for a HIV patient of developing an anxious or mood disorder, our population isn’t affected by psychiatric diseases; this is an encouraging data considering that post transplant period can be very stressful. This result may be due to a personality organization or a coping style strengthened by a long term disease such as HIV. Further studies are needed to investigate psychosocial outcome of OLT in HIV and to improve our knowledge of this controversial issue and guarantee a better take in care of these complex patients.
To construct and test the validity of a new psychometric questionnaire to assess psychological impact of facial lipoatrophy (ABCD-F), that is the most stigmatizing feature of HIV-related lipodystrophy.
Construction: The development went through Focus groups and Content Validity, Item reduction and Exploratory Factor Analysis.
Validation: ABCD-F questionnaire was administered together with ABCD and MOS HIV questionnaires. The Cronbach's Alfa was used to test internal consistency, while convergent validity and divergent validity were analyzed by the correlations with MOS, ABCD items and BMI and CD4 counts respectively.
42 HIV+ people participated to focus groups. In the EFA the 17 Items were aggregated around psychological distress and role functioning domains.
ABCD-F showed high internal consistency (Chronbach's alpha = 0.95). Both convergent and divergent validity were confirmed. ABCD-F scores were highly correlated to Physical Health Summary (B 0.59; 95% [CI] 0.35; 0.84; p< 0.0001), Mental Health Summary (B-1.54; 95% [CI] 1.15; 1.93; p< 0.0001), and weakly correlated to CD4 count (B-0.02; 95% [CI] -0.01; 0.06; p=0.54) and HIV viral load (B-0.004; 95% [CI] -2.69; 2.69; p=1.00).
ABCD-F is a valid and reliable questionnaire to assess psychological impact of facial lipoatrophy (FLA).
ABCD-F may result as a useful tool both in clinical and research settings: it's able to identify people experiencing greater psychological impact due to FLA. It may become an objective instrument to evaluate priority and efficacy of plastic surgery to treat lipodystrophy. In research setting may be used to compare different populations or different treatments of FLA.
Suicide is a serious public health problem. In the international literature there is evidence to support the notion that certain temperaments and personality traits are often associated with suicidal behavior. In this study, 150 psychiatric inpatients were investigated using the TEMPS-A, the MMPI-2 and the Beck Hopelessness Scale (BHS) and evaluated for suicide risk through the critical items of the Mini International Neuropsychiatric Interview (MINI). Statistical analysis, including linear regression analysis and multiple regression analysis, showed that suicide risk contributed to the prediction of hopelessness. Among the temperaments, only the Hyperthymic temperament, as a protective factor, and the Dys/Cyc/Anx temperament contributed significantly to the prediction of hopelessness. Irritable temperament and Social Introversion were protective factors for suicidal risk. Hopelessness and depression were associated with higher suicidal behavior and ideation, but, unexpectedly, depression as measured by the MMPI did not contribute significant to the multiple regression.. The present study indicated that, although suicidal psychiatric patients have MMPI-2’s profiles in the pathologic range, they exhibit several differences from nonsuicidal patients. Patients at risk of suicide have specific temperaments as well as personality and defense mechanism profiles. They are more social introverted, depressed and psychasthenic, and use hysterical and schizoid mechanisms more often. Generalizability of the findings was limited by the small sample size, mix of BPD-I, BPD-II, MDD and psychotic disorder patients.
Ortothopic Liver Transplantation (OLTx) is a therapeutic option for selected patients with severe hepatopatic diseases. Resources are precious and limited, and selection of “ideal” candidates is tough but necessary; the psychiatrist is involved in the assessment of compliance and adherence to the therapeutic process by the patient. Moreover, the inclusion in the waiting list for OLTx activates multiple psychological reactions in the patient, mainly anxiety and depression, and a need to test patients' coping capacity is also crucial.
567 patients from the Liver Transplantation Surgery Unit of Modena General Hospital were assessed by professionally-trained psychiatrists between January 2002 and December 2005. After a standard psychiatric assessment, the Transplant Evaluation Rating Scale (TERS) and Montgomery-Asberg Depression Rating Scale (MADRS) scales were administered to each patient. The TERS scale was specifically developed to test the attitude of the patient to receive a transplant. The MADRS quantifies the presence of anxious and depressive symptoms.
TERS and MADRS scores show a statistically significant inverse correlation one to each other: patients showing high levels of anxious and/or depression symptoms appear to be worse candidates at the TERS evaluation.
Psychiatric assessment of patients waiting for OLTx is relevant, not only for selection of candidates, but also to activate a psychological support and/or a psychopharmacological therapy, to improve patients' coping strategies in facing both a debilitating physical illness and a difficult therapeutic pathway.
Since 2003 the national research program for solid organ transplantation in HIV patients is active at the Liver Transplantation Centre of Modena. HIV patients who enter this protocol are assessed by the CLP Service. The aim of the present study is to evaluate their psychiatric comorbidity.
An observational prospective study was conduced comparing ESLD patients with and without HIV. After the assessment, the psychiatrist compiled the TERS and the MADRS. Baseline (B) evaluation was made before the inclusion in the OLTx waiting list and the Follow-Up (FU) one was made 12 months later.
From January 2003 to December 2006 we assessed 553 patients: 39 (6%) with HIV and 361 (94%) without HIV. The two groups were homogeneous for gender (75% of male patients; p = ns) but not for age (46 ± 5 vs 56 ± 9; p = ns). Psychiatric anamnesis was negative in 176 (49%) patients without HIV and in 6 (15%) patients with HIV, p<0.001.
At baseline psychiatric comorbidity was present in 33 HIV patients (85%) and in 148 non HIV patients (41%), p<0.001.
At the follow-up MADRS highlights an improvement at all the items for HIV patients. In the non-HIV group score variation was: B = 7.10, FU = 8.15; in the HIV group: B = 10.20, FU = 4.09 (p<0.001).
The average score at TERS was higher in patients with HIV (43 ± 9 vs 35 ± 9, p = ns).
At B HIV patients with ESLD show a greater frailty to psychopathology but they quite improved during FU. The contrary happen in non-HIV group.
HIV testing is not yet a routine procedure in most mental health settings although adults with severe mental illness (SMI) are disproportionately affected by HIV/AIDS.
We focused our attention to explore if the appropriate care of patients with SMI may include a routine HIV testing offering and thus contribute to diagnose HIV-infected persons earlier in the course of their infection.
We present three case histories related to primary HIV diagnosis in patients presenting with different psychiatric disorders, admitted to Modena teaching Hospital in the passed two years.
Psychiatric symptoms delayed HIV diagnosis in all of the three reported cases.
The case histories here presented suggest that HIV testing is appropriate in the care of people with SMI, avoiding delay in HIV diagnosis with an obvious clinical benefit for the patient. Further studies are needed to assess the prevalence of HIV in those patients. These will be able to validate psychiatric diseases within a specific HIV indicator diseases list and help identifying a segment of the population in which HIV test must be routinely offered as a public health strategy, to face the burden of undiagnosed HIV infection.
Retrospective evaluation of patients admitted consecutively to the psychiatric units of two general hospitals in Florence, to evaluate the rate and risk factors of neuroleptic-induced dystonia (NDA). One hundred and fifty-nine patients out of 2354 reviewed charts were included. The incidence of NDA was 15.7%. Multivariate analyses revealed that both age and neuroleptization speed (NS)—a new variable—were related to the occurrence of dystonia.
To test the prognostic value of suicidal status in depressed patients for responses to antidepressant treatment.
We evaluated treatment response and covariates in depressed patients diagnosed with DSM-IV major depressive (n=50) or bipolar disorders (n=32) treated initially in a day-hospital for 2 weeks, followed by 4 weeks of outpatient treatment with antidepressants, with or without a mood-stabilizer. Being suicidal was based on an item-3 of the 17-item Hamilton Depression Rating Scale (HDRS17) scored at ≥3 and verified by baseline clinical assessment; morbidity and improvement were based on the total of the remaining 16 nonsuicidal items (HDRS16).
Suicidal (n=31) and nonsuicidal subjects (n=51) were similar in baseline ratings of depressive symptom-severity (HDRS16), but were depressed longer and less likely to be married. Suicidality ratings improved by 36% during 6 weeks of treatment among initially suicidal patients, but other depressive symptoms (HDRS16) improved (13%) only half as much as in nonsuicidal subjects (25%), independent of diagnosis and treatment. Fewer than half as many suicidal subjects showed ≥20% improvement in HDRS16 scores.
Findings, based on diagnostically complex and relatively treatment-resistant subjects, may not generalize.
Being suicidal may limit response to treatment in depressed major affective disorder patients, independent of diagnosis or overall symptomatic severity.
Affective temperament is a phenotype underpinned by a constitutional substrate.
It represents signs related to certain mood stability and attitudes to react to environmental stimuli.
Temperament has been related to predisposition to bipolar disorder.
Bipolar disorder is highly related to Substance Abuse Disorders but it is less clear which affective temperaments are more involved in this relation and if they can influence substance abuse patterns.
The aim of this study was to investigate temperamental traits, according to the Akiskal and Mallya formulation, in patients with bipolar I disorder associated with comorbid substance abuse disorders.
Data from 120 patients with Bipolar Disorders and Comorbid substance abuse disorders, were assessed in inpatient unit.
The brief TEMPS- M self-questionnaire was used to assess the temperamental distribution. The temperamental scores on various outcomes were investigated using Sperman rank (Rho), Principal Component Analysis (PCA), Cluster Ananlysis (CA).
Chyclothymia was positively correlated to Opiate Addiction (ρ 0.18 p< 0.001).
Irritability was positive correlated with Alchol Abuse and Cannabis Abuse (ρ 0.26 and 0.27 p< 0.001).
The PCA and CA did not show statistically significant results although showed a trend to link irritability with alchool abuse.
Our results suggest that bipolar patients with comorbid substance abuse disorders exhibit a prevalent temperament of irritable and cyclothymic related to alcohol and cannabis abuse and opiate dependence respectively. Further studies are needed to explore this relationship.
Takotsubo cardiomyopathy (TC) is an acute cardiologic syndrome, characterized by specific symptoms and ECG, echocardiographic and enzymatic abnormalities, similar to an acute myocardial infarction, with no hemodynamically significant stenosis at coronary-ventriculography.
To assess personality in TC patients in order to find common psychopathological elements.
A series of consecutive patients suffering from TC hospitalized at the Cardiology Unit of “Ingrassia” Hospital in Palermo in 2013–2014, were included in the study. We used Structured Clinical Interview for Axis I and II, according to DSM-IV TR criteria. Further, the Defense Mechanisms Inventory (DMI), used in order to explore defensive strategies: turning against self (TAS), projection (PRO), principalization (PRN), turning against object (TAO), and reversal (REV).
Eight women (mean age + SD: 57 ± 5 years) have been included in the study. A common element of them was a stressful event immediately preceding the onset of TC, in particular bereavement (4), armed robbery (1), infarction of a family member (1), estrangement of a family member (1), and separation from a partner (1). Although the patients did not fulfill any diagnostic criteria for Axis I or Axis II disorders of DSM-IV-TR, they showed scores at the SCID-II close to the limit values for avoidant and dependent personality .DMI showed, unequivocally, the common use of TAS-type defence style.
Although the sample size was too small for complex statistical analyses, nevertheless our initial findings would indicate the presence of a common, defensive style in TC patients, and how this syndrome may be related to stressful life events.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
In parents of autistic children there are high levels of stress. For parents, counseling can help them face the world of autism through the many stressors they experiment.
To evidence a possible effect of the counseling intervention on parental stress.
The sample consisted of 24 parents (mean age = 38.7) of children diagnosed with autism spectrum disorder related to the treatment centre “Una breccia nel muro”. Parents’ group was randomly divided into two subgroups, the first (EG experimental group) consists in 12 parents, which were included in a counseling treatment of six months (one meeting of 2 hours every 15 days), while the other subgroup parents, (CG control group) were not included. We used parenting stress index–short form (PSI-SF) before counseling intervention (T0) and after (T1) with every parent. PSI values stress level in following scales: parental distress (PD), parent-child dysfunctional interaction (PCDI) and difficult child characteristics (DC). Figure 1 shows all the variables in each group at T0 and T1.
Then a 2-tail t-test was separately carried out for each group (Counseling Yes; Counseling No). Counseling Yes: PD (t22 = .70, P = .49); PCDI (t22 = .72, P = .47); DC (t22 = 2.23, P = .03); Tot Stress (t22 = 1.04, P = .3). Counseling No: PD (t22 = .82, P = .42); PCDI (t22 = 1.7, P = .09); DC (t22 = .59, P = .56); Tot Stress (t22 = .72, P = .48)
Our data confirm the positive effects of counseling especially on the difficulties related to children (DC scale).
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Recent studies on autism concern the number of individuals diagnosed with pervasive developmental disorder (PDD) according to DSM-IV-TR who may no longer qualify for diagnoses under the new DSM-5 autism spectrum disorder (ASD). ASD is diagnosed using the impairments in two dimensions:
– the social and communication dimension;
– the restricted and repetitive interests and behaviors (RRIB) dimension whereas PDD is diagnosed using impairments in three dimensions.
All the studies indicate between 50 and 75% of individuals will maintain diagnoses.
The aim of the study is to quantify how many individuals with previous PDD diagnoses under DSM-IV-TR criteria would maintain a diagnosis of ASD under DSM-5 criteria.
Our sample consists of 23 cases (21 males, 2 female) related to the treatment Centre “Una breccia nel muro” of Rome and Salerno. All the cases previous received a PDD diagnose according to DSM-IV TR criteria. The mean age of cases was 7.7 years. All the cases were diagnosed by our team according to DSM-5 criteria, clinicians also used to make diagnoses: the Autism Diagnostic Observation Schedule-2, the Autism Diagnostic Interview-Revised.
Eighty-seven percent of cases with PDD were classified as ASD using DSM-5 criteria. Thirteen percent of cases, that previous received an Asperger diagnose, did not meet the ASD criteria (Fig. 1).
DSM-5 criteria may easily exclude cases with high functioning from ASD because they tend to be atypical for ASD according to this study.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
During the current COVID-19 disease emergency, it is not only an ethical imperative but also a public health responsibility to keep the network of community psychiatry services operational, particularly for the most vulnerable subjects (those with mental illness, disability, and chronic conditions). At the same time, it is necessary to reduce the spread of the COVID-19 disease within the outpatient and inpatient services affiliated with Mental Health Departments. These instructions, first published online on 16 March 2020 in their original Italian version, provide a detailed description of actions, proposed by the Italian Society of Epidemiological Psychiatry, addressed to Italian Mental Health Departments during the current COVID-19 pandemic. The overall goal of the operational instructions is to guarantee, during the current health emergency, the provision of the best health care possible, taking into account both public health necessities and the safety of procedures. These instructions could represent a useful resource to mental health providers, and stakeholders to face the current pandemic for which most of Mental Health Departments worldwide are not prepared to. These instructions could provide guidance and offer practical tools which can enable professionals and decision makers to foresee challenges, like those already experienced in Italy, which in part can be avoided or minimised if timely planned. These strategies can be shared and adopted, with the appropriate adjustments, by Mental Health Departments in other countries.
The quality of a dataset used for evaluating data linking methods, techniques, and tools depends on the availability of a set of mappings, called reference alignment, that is known to be correct. In particular, it is crucial that mappings effectively represent relations between pairs of entities that are indeed similar due to the fact that they denote the same object. Since the reliability of mappings is decisive in order to perform a fair evaluation of automatic linking methods and tools, we call this property of mappings as mapping fairness. In this article, we propose a crowd-based approach, called Crowd Quality (CQ), for assessing the quality of data linking datasets by measuring the fairness of the mappings in the reference alignment. Moreover, we present a real experiment, where we evaluate two state-of-the-art data linking tools before and after the refinement of the reference alignment based on the CQ approach, in order to present the benefits deriving from the crowd assessment of mapping fairness.
In recent years, the discovery of massive quasars at
has provided a striking challenge to our understanding of the origin and growth of supermassive black holes in the early Universe. Mounting observational and theoretical evidence indicates the viability of massive seeds, formed by the collapse of supermassive stars, as a progenitor model for such early, massive accreting black holes. Although considerable progress has been made in our theoretical understanding, many questions remain regarding how (and how often) such objects may form, how they live and die, and how next generation observatories may yield new insight into the origin of these primordial titans. This review focusses on our present understanding of this remarkable formation scenario, based on the discussions held at the Monash Prato Centre from November 20 to 24, 2017, during the workshop ‘Titans of the Early Universe: The Origin of the First Supermassive Black Holes’.
There is a long history of exploitation of the South American river turtle Podocnemis expansa. Conservation efforts for this species started in the 1960s but best practices were not established, and population trends and the number of nesting females protected remained unknown. In 2014 we formed a working group to discuss conservation strategies and to compile population data across the species’ range. We analysed the spatial pattern of its abundance in relation to human and natural factors using multiple regression analyses. We found that > 85 conservation programmes are protecting 147,000 nesting females, primarily in Brazil. The top six sites harbour > 100,000 females and should be prioritized for conservation action. Abundance declines with latitude and we found no evidence of human pressure on current turtle abundance patterns. It is presently not possible to estimate the global population trend because the species is not monitored continuously across the Amazon basin. The number of females is increasing at some localities and decreasing at others. However, the current size of the protected population is well below the historical population size estimated from past levels of human consumption, which demonstrates the need for concerted global conservation action. The data and management recommendations compiled here provide the basis for a regional monitoring programme among South American countries.
The Atacama Large (Sub-)millimeter Array (ALMA) has provided glimpse of the interstellar medium (ISM) properties of galaxies at the Epoch of Reionization (EoR); however, detailed understanding of their internal structure is still lacking. We present properties of molecular cloud complexes (MCCs) in a prototypical galaxy at this epoch studied in cosmological zoom-in simulations (Leung et al. 2019c). Typical MCC mass and size are comparable to nearby spirals and starburst galaxies (Mgas∼106.5Mȯ and R≃45–100 pc). MCCs are highly supersonic, with velocity dispersion of σgas≃20–100 km s−1 and pressure of P/kB ≃107.6Kcm−3, which are comparable to gas-rich starburst galaxies. In addition, we perform stability analysis to understand the origin and dynamical properties of MCCs. We find that MCCs are globally stable in the main disk of Althæa. Densest regions where star formation is expected to take place in clumps and cores on even smaller scales instead have lower virial parameter and Toomre-Q values. Detailed studies of the star-forming gas dynamics at the EoR thus require a spatial resolution of < 40 pc ( ≃ 0.01″), which is within reach of ALMA, to complement studies of stellar populations at EoR using the James Webb Space Telescope (JWST).
Truth commissions are temporary bodies that aim to disclose the truth about past human rights violations. Drawing on Hayner's widely used definition, truth commissions are created to investigate patterns of human rights abuses over a period of time, to engage directly and broadly with the affected population and to issue a final report recommending reparations programmes and institutional reforms to ensure such abuses do not reoccur.
These bodies have been used in more than 30 countries since the fall of the military regime in Argentina in 1983. From an historical perspective, the first generation of truth commissions included those established in the Southern Cone of Latin America. Despite the limitations of the initial commissions, these represented the baseline and were a source of inspiration for later truth commissions. Since then, ‘truth commissions have become a staple of postconflict or post-authoritarian transitions across numerous and diverse contexts’.
Truth commissions have changed considerably since their early establishment and they are no longer regarded as ‘quick-fix’ solutions to overcome complex transitions or as a substitute for criminal justice. These bodies have developed significantly over the past three decades, expanding their mandates and objectives and becomingly increasingly innovative in their processes, thus forming very sophisticated and complex enterprises. Therefore, a large amount of literature has been written on the supposed benefits of truth commissions claiming that they provide victims with an opportunity to tell their story, promote accountability and the rule of law, produce an authoritative account of state crimes, recommend institutional reforms, and promote reconciliation. Since truth commissions in the last two decades have become increasingly popular mechanisms for dealing with the past, the trend in recent research has been towards evaluating the impact and merit of these bodies. One of the most active debates in the research on transitional justice is focused on the problem of how to assess the impact and effectiveness of truth commissions and other transitional justice mechanisms. While there has been some attempt made to identify common guidelines in order to evaluate the effectiveness and efficacy of such bodies, the results of the first empirical studies, both qualitative and quantitative, have so far produced mixed and sometimes contradictory results.