Perspectives on Reoffenders: The Views of Detainees, the General Public and Those Working with Offenders

The literature has offered significant data on reoffending: for example, the relationship with drug taking, addiction, mental illness and security. However, research directly involving the voices of detainees and those intervening in the prevention of reoffending appears to be less developed. The present research aims to observe how reoffending is approached by the various players involved: the detainees (whether reoffenders or not), educators and ordinary people. In particular we endeavour to determine how reoffending is perceived, interpreted and managed. The ultimate aim is to assist those involved in the improvement of social reintegration. Interviews revealed substantial differences in how reoffending is interpreted and perceived, and this influences both the management of the risk of reoffending and the process of rehabilitation into society. Furthermore, the results showed some improvements, such as in the teamwork by all players involved, in education for the detainees, and in the implementation of social reintegration projects as alternatives to imprisonment

Self-writing as a tool for change: The effectiveness of a psychotherapy using diary

There is an abundance of literature investigating the relationship between self-writing and well-being in cases of trauma or life-changing events, but no such research has assessed the value of keeping a daily diary in promoting small changes, describing an individual's identity in its slow, but realistic evolution. This study examined how the use of diary as a narration tool contributed to improving a patient's awareness of his personal emotions and feelings during a course of psychotherapy. It investigated the changes occurring in the prevailing writing style of a 200-page diary written by a patient suffering from hypochondria over a period of two and a half years. Sentences relating to the need for change, to the self, to suffering and to the function attributed to the self-writing activity were analyzed on the basis of specific criteria deriving from dialogical self theory, which conceptualizes ways to adopt new identity positions during the course of change. Respondent validation identified a good correspondence between the findings of the textual analysis and the writer's own point of view. Results showed an improvement in awareness of moods and feelings. Identity positions became more integrated and writing more enjoyable. These findings demonstrate the potential of innovative use of diary writing as a longitudinal tool for consolidating strategies for change and as an additional means for assessing psychotherapy efficacy. Writing a diary proved effective both in supporting the patient's personal reflections and changes and in making it easier for him to share his thoughts with the therapist

Discursive chains: How prison becomes real and chains identity movements for a sex offender

Detainees enact a "self" that is faced with the prejudices and stereotypes of the crime for which that detainee was convicted. Of all inmates, sex offenders face the greatest risk of receiving social condemnation alongside their prison sentence. This empirical study worked with 32 male sex offenders over 18 years old that were housed in the "protected" unit of the Due Palazzi. The following analysis explores how these men are required to manage their "self," hetero-narrations, perception of everyday interactions in the protected unit, and conceptions about the rehabilitation path. Moreover, the detainees' view on the prison's strategic opportunities for promoting effective change in their condition and identity are also examined. Discourse analysis applied to an open answer questionnaire showed that, rather than facing the stigma assigned to them, the detainees tend to minimize the importance of storytelling and construct alternative biographies to share with other inmates. Managing narratives allows the sex offenders to distance themselves from the perceived threats of living with other detainees; however, it also prevents the re-signification of their offenses. As such, the rules of "secrecy" must be considered by both qualitative researchers who conduct studies in prisons and prison administrators who plan the housing and treatment of sex offenders

Tackling Prejudice and Discrimination Towards Families with Same-Sex Parents: An Exploratory Study in Italy

Though studies have shown that the sexual orientation of parents does not influence their parenting skills or the well-being of their children, prejudice against same-sex families is still very widespread. Research has not sufficiently explored the ways in which parents tackle this prejudice. Using qualitative methodologies, in particular textual analyses, this study has analysed the discourse used by same-sex families to handle the prejudices that they face. The results highlighted that conflicts, which may even be ideological in nature, are sometimes created between traditional families and “atypical” families. These often result in estrangement and isolation from their own family and the communities to which they belong, in turn damaging the growth of the children involved. Furthermore, means for moving beyond conflict, sharing experiences and effectively tackling prejudices are also discussed

The European Scleroderma Trials and Research group (EUSTAR) task force for the development of revised activity criteria for systemic sclerosis: derivation and validation of a preliminarily revised EUSTAR activity index

Background Validity of European Scleroderma Study Group (EScSG) activity indexes currently used to assess disease activity in systemic sclerosis (SSc) has been criticised. Methods Three investigators assigned an activity score on a 0–10 scale for 97 clinical charts. The median score served as gold standard. Two other investigators labelled the disease as inactive/moderately active or active/very active. Univariate–multivariate linear regression analyses were used to define variables predicting the ‘gold standard’, their weight and derive an activity index. The cut-off point of the index best separating active/very active from inactive/moderately active disease was identified by a receiver-operating curve analysis. The index was validated on a second set of 60 charts assessed by three different investigators on a 0–10 scale and defined as inactive/moderately active or active/very active by other two investigators. One hundred and twenty-three were investigated for changes over time in the index and their relationships with those in the summed Medsger severity score (MSS). Results A weighted 10-point activity index was identified and validated: Δ-skin=1.5 (Δ=patient assessed worsening during the previous month), modified Rodnan skin score (mRss) \u3e18=1.5, digital ulcers=1.5, tendon friction rubs=2.25, C-reactive protein \u3e1 mg/dL=2.25 and diffusing capacity of the lung for CO (DLCO) % predicted \u3c70%=1.0. A cut-off ≥2.5 was found to identify patients with active disease. Changes in the index paralleled those of MSS (p=0.0001). Conclusions A preliminarily revised SSc activity index has been developed and validated, providing a valuable tool for clinical practice and observational studies

Pneumococcal vaccination in adults: rationale, state of the art and perspectives

Streptococcus pneumoniae (SP) is a leading cause of morbid- ity and mortality worldwide. Despite the availability, since the early 1980s, of a 23-valent pneumococcal polysaccharide vaccine (PPV23), its recommendation and increased use in the last decades, and the indirect benefits against invasive pneumococcal diseases following the pediatric immunization strategies with the 7-valent pneumococcal conjugate vaccine (PCV7), pneumoccal diseases, particularly Community Acquired Pneumonia (CAP), still remain a substantial burden among older adults in Western countries. The recent availability on the market of a second generation of pneumococcal conjugate vaccines, with an enlarged spectrum ofprotection against some serotypes not included in the PCV7 (i.e., the 13-valent pneumococcal conjugate vaccine ? PCV13), opens new interesting perspectives for improving the control of this sig- nificant health-care issue among the entire population. The most interesting and up-dated epidemiological data regard- ing the impact of SP in adults and the elderly in Western countries, together with the available evidence concerning the efficacy and effectiveness of the PPV23 in the same population, are reported and discussed below. The full article is free available on www.jpmh.or

Young People’s Narratives of Hearing Voices: Systemic Influences and Conceptual Challenges

Despite the prevalence of voice hearing in childhood and adolescence, little qualitative research has been undertaken with young people directly to advance phenomenological and etiological insights into their experiences and interpretations. Consequently, the researchers sought demographic, contextual and qualitative data from 74 young people from eleven countries, aged 13-18 years (28%=M; 61%=F; 21%=TGNB), who self-identified as hearing voices. A Foucauldian-informed Narrative Analysis yielded four analytic chapters, offering novel perspectives into individual, relational, systemic and cultural interpretative narratives surrounding multisensory and multi-self voice hearing. Overall, young people reported heterogenous experiences of voice hearing and associated sensory experiences and most participants reported voice hearing beginning between ages eight and eleven. Further, the emotions felt by the child, as well as reactions displayed by people around the child in relation to the voices, influenced voice-related distress and the nature of the voices in a triadic relationship. A continuum of multisensory features of voice content, nature and relational significance is tentatively proposed to capture the breadth and depth of voice hearing for adolescents to offer a possible framework for future study and intervention design. Specifically, participants described voice-related distress could be exacerbated by observed anxiety or internalized stigma about voice hearing, social isolation, and attribution to illness. These findings suggest we may need to reconsider how the experience of hearing voices in childhood influences their relationships and how relationships influence the voice hearing experience. Further, young people seem to have a broad understanding of what the term ‘hearing voices’ means, which could inform how researchers and practitioners work with this group of young people. Finally, participants described benefitting from multisensory coping strategies, such as imagery and meditation, which could offer important considerations for tailoring therapeutic interventions for adolescent voice-hearers

Low-dose oral imatinib in the treatment of systemic sclerosis interstitial lung disease unresponsive to cyclophosphamide: a phase II pilot study

Introduction: Pulmonary involvement represents a major cause of death of systemic sclerosis (SSc) patients. Recent data suggest that tyrosine kinase inhibitors, such as imatinib, may be a therapeutic option for SSc patients. However, preliminary published clinical trials were inconclusive about imatinib efficacy and showed side effects. The purpose of this study was to verify efficacy and tolerability of low-dose imatinib on interstitial lung disease in a cohort of SSc patients unresponsive to cyclophosphamide therapy.Methods: Thirty consecutive SSc patients with active pulmonary involvement, unresponsive to cyclophosphamide, were treated with imatinib 200 mg/day for 6 months followed by a 6-month follow-up. A "good response" was defined as an increase of forced vital capacity (FVC) by more of 15% and/or increase of diffusing capacity of carbon monoxide (DLCO) > 15% and PaO2 > 90% of initial value and high-resolution computed tomography (HRCT)-scan pattern unchanged or improved.Results: Twenty-six patients completed the study. Three patients died and one patient was lost to follow-up. Four patients (15.32%) had a good response, 7 worsened and 15 had a stabilized lung disease. Overall, 19 (73.07%) patients had an improved or stabilized lung disease. After a 6-month follow-up, 12 (54.5%) of the 22 patients showed an improved or stabilized lung disease.Conclusions: Lung function was stabilized in a large proportion of patients unresponsive to cyclophosphamide therapy and a beneficial outcome emerged from the analysis of HRCT lung scans. There was no significant improvement of skin involvement, and the low dose was well tolerated. These data provide useful suggestions to design future randomized clinical trials for SSc therapeutics