A focus on the rights to self-determination and quality of life in people with mental disabilities. Editorial

Abstrac

New mode of care. Value and limit of the person-centered care planning for people with mental disability

Riassunto L'enorme aumento delle persone con disabilità mentali e intellettuali in tutto il mondo e la capacità di difesa raggiunta da questi pazienti, culminata nella Convenzione sui diritti delle persone con disabilità (CRPD), hanno comportato cambiamenti nel modo in cui i relativi affari servizi Pubblici. In particolare, negli ultimi decenni, molti paesi hanno esaminato come fornire una persona con disabilità un funzionamento sociale accettabile, migliorare il benessere, secondo i principi di equità, solidarietà e partecipazione. È nato un nuovo modello politico e socio-sanitario, chiamato "welfare community", gli utenti sono protagonistidel loro progetto sanitario e le risorse messe in atto assumono un carattere di investimento sulla comunità e il suo sviluppo economico. La personalizzazione dei servizi sociali e sanitari è anche garantita in molti paesi come una "nuova modalità di cura", necessaria in forme diverse a seconda dell'aspetto finanziario e dei destinatari. Il presente articolo è una rassegna narrativa che esamina e sintetizza la ricerca internazionale e il materiale non di ricerca per esaminare le diverse strategie di implementazione della personalizzazione in diversi paesi,con particolare attenzione all'Italia, nel tentativo di fornire chiarezza concettuale su questo argomento in termini di opportunità e insidie

Prenatal chlorpyrifos exposure alters motor behavior and ultrasonic vocalization in cd-1 mouse pups

<p>Abstract</p> <p>Background</p> <p>Chlorpyrifos (CPF) is a non-persistent organophosphate (OP) largely used as pesticide. Studies from animal models indicate that CPF is a developmental neurotoxicant able to target immature central nervous system at dose levels well below the threshold of systemic toxicity. So far, few data are available on the potential short- and long-term adverse effects in children deriving from low-level exposures during prenatal life and infancy.</p> <p>Methods</p> <p>Late gestational exposure [gestational day (GD) 14–17] to CPF at the dose of 6 mg/kg was evaluated in CD-1 mice during early development, by assessment of somatic and sensorimotor maturation [reflex-battery on postnatal days (PNDs) 3, 6, 9, 12 and 15] and ultrasound emission after isolation from the mother and siblings (PNDs 4, 7 and 10). Pups' motor skills were assessed in a spontaneous activity test on PND 12. Maternal behavior of lactating dams in the home cage and in response to presentation of a pup previously removed from the nest was scored on PND 4, to verify potential alterations in maternal care directly induced by CPF administration.</p> <p>Results</p> <p>As for the effects on the offspring, results indicated that on PND 10, CPF significantly decreased number and duration of ultrasonic calls while increasing latency to emit the first call after isolation. Prenatal CPF also reduced motor behavior on PND 12, while a tendency to hyporeflexia was observed in CPF pups by means of reflex-battery scoring. Dams administered during gestation with CPF showed baseline levels of maternal care comparable to those of controls, but higher levels of both pup-directed (licking) and explorative (wall rearing) responses.</p> <p>Conclusion</p> <p>Overall our results are consistent with previous epidemiological data on OP neurobehavioral toxicity, and also indicate ultrasonic vocalization as an early marker of CPF exposure during development in rodent studies, with potential translational value to human infants.</p

Nationwide Survey of Healthcare Services for Autism Spectrum Disorders (ASD) in Italy

n/

Selective reduction in the expression of type-1 metabotropic glutamate receptors in the hippocampus of adult rats born by caesarean section.

AbstractPerinatal hypoxia causes long‐term neurobiological consequences, including alterations in mechanisms of activity‐dependent synaptic plasticity and cognitive dysfunction. Changes in neurotransmitter receptors have been associated with these alterations, but little is known on how early hypoxia influences the expression and function of metabotropic glutamate (mGlu) receptors in adult life. This is an important issue because mGlu receptors are implicated in mechanisms of synaptic plasticity. Here, we examined the expression of mGlu1, mGlu5, and mGlu2/3 receptor subtypes in the hippocampus, nucleus accumbens, prefrontal cortex, and dorsal striatum in 6‐month old Wistar rats (a) born by vaginal delivery; (b) born by caesarean section; and (c) born by caesarean section followed by 20 min of asphyxia. Unexpectedly, we found a large reduction of mGlu1α protein levels in the hippocampus of rats born by caesarean section regardless of the presence of asphyxia. No changes in mGlu1α receptor protein levels were found in the other brain regions. Levels of mGlu5 and mGlu2/3 receptors and levels of GluA2/3 and GluN1 subunits of AMPA and NMDA receptors did not differ among the three groups of rats in any brain region. These results are consistent with previous findings showing that changes in mGlu1 receptors occur within the epigenetic programming caused by early‐life events

Are touch screen technologies more effective than traditional educational methods in children with autism spectrum disorders? A pilot study

Applied Computer technologies can address the needs of individuals with autism spectrum disorders (ASD). Data on the efficacy of assistive technology in ASD is limited, and its effectiveness in supporting and facilitating skill acquisition in this specific population must be still demonstrated. 63 Italian ASD subjects underwent learning activities administered by cardboards or a touch screen support. The support preference was evaluated in a choice trial, and quantitative analysis was performed on items regarding communication and challenging behaviours. Touch devices are attractive especially for males without intellectual disability and a lower communication and cooperation behaviours with the use of touch screen compared with paper support was shown depending on activities. Overall, our data do not confirm the hypothesis that touch screen presentation improves activity completion and behavioural performance for each individual with ASD. Data discourage an indiscriminate use of these devices and suggest analysing with more attention the core ingredients that should shape digital devices when used for people on ASD.

Multifactorial Origin of Neurodevelopmental Disorders: Approaches to Understanding Complex Etiologies

A significant body of evidence supports the multifactorial etiology of neurodevelopmental disorders (NDDs) affecting children. The present review focuses on early exposure to environmental chemicals as a risk factor for neurodevelopment, and presents the major lines of evidence derived from epidemiological studies, underlying key uncertainties and research needs in this field. We introduce the exposome concept that, encompassing the totality of human environmental exposures to multiple risk factors, aims at explaining individual vulnerability and resilience to early chemical exposure. In this framework, we synthetically review the role of variable gene backgrounds, the involvement of epigenetic mechanisms as well as the function played by potential effect modifiers such as socioeconomic status. We describe laboratory rodent studies where the neurodevelopmental effects of environmental chemicals are assessed in the presence of either a “vulnerable” gene background or adverse pregnancy conditions (i.e., maternal stress). Finally, we discuss the need for more descriptive and “lifelike” experimental models of NDDs, to identify candidate biomarkers and pinpoint susceptible groups or life stages to be translated to large prospective studies within the exposome framework