Mobility Networks And Safety

Una riflessione centrale nell’ambito del rapporto mobilità e sicurezza è quella relativa al ruolo che le reti per la mobilità rivestono, o possono rivestire, nel garantire la sicurezza del territorio rispetto a fattori di rischio, naturali o antropici. Già da alcuni anni, accrescere la sicurezza delle comunità insediate ai rischi costituisce uno degli obiettivi prioritari delle strategie volte ad orientare in chiave di sostenibilità lo sviluppo urbano e territoriale. Le reti per la mobilità rivestono, in tale contesto, un ruolo centrale: essenziali supporti alla vita quotidiana delle comunità - da cui dipende in molti casi la salute, il comfort e, più in generale, il benessere socioeconomico - esse rappresentano, da un lato ,elementi esposti e spesso ad elevata vulnerabilità rispetto ai diversi fenomeni calamitosi; dall’altro, attrezzature di importanza strategica per la gestione dell’emergenza, indispensabili per garantire l’accesso e l’esodo dalle aree colpite nella fase dell’immediato post evento. Il danneggiamento o la ridotta funzionalità di tali reti può incrementare, anche significativamente, le perdite di vite umane conseguenti ad un evento calamitoso, oltreché indurre danni economici rilevanti anche su orizzonti temporali di medio-lungo periodo. Inoltre, ampliando il campo di attenzione dalle reti come supporti fisici ai flussi di persone e beni che esse supportano, gli impatti di un evento calamitoso su singoli elementi di tali reti possono indurre eventi secondari anche di grande rilevanza quali, ad esempio, rilasci tossici o esplosioni, dovute a danni sulla rete che coinvolgono mezzi per il trasporto di sostanze pericolose o serbatoi localizzati lungo la rete o all’interno dei nodi della rete di trasporto. Tuttavia, nonostante la riconosciuta centralità delle reti per la mobilità, nel garantire la sicurezza del territorio, le analisi di rischio sono state a lungo incentrate prevalentemente sui manufatti edilizi, focalizzando al più l’attenzione sui danni fisici che un dato evento poteva indurre su singoli elementi della rete stessa. È ancora abbastanza recente la consapevolezza che le reti per la mobilità costituiscono un sistema, caratterizzato da rilevanti connessioni e interdipendenze: sia in quanto ciascun elemento della rete è connesso a tutti gli altri, sia in quanto numerose sono le interdipendenze non solo tra le diverse tipologie di infrastrutture a rete ma anche tra infrastrutture a rete e sistemi urbani. Strade e ferrovie, ad esempio, potrebbero non subire danni diretti in conseguenza di un evento calamitoso ma danni o guasti, anche rilevanti, conseguenti al danneggiamento di altre infrastrutture a rete: da quelle elettriche a quelle fognarie. Analogamente, all’interno di un tessuto urbano, le reti viarie e ferroviarie potrebbero subire perdite di funzionalità a causa di ostruzioni provocate dal crollo, parziale o totale, di manufatti edilizi. In ragione di tali considerazioni, il contributo proposto evidenzia i molteplici aspetti della vulnerabilità delle reti per la mobilità e la loro rilevanza nel concorrere a determinare la vulnerabilità di un sistema urbano o territoriale ad eventi calamitosi. Si propone, quindi, un approfondimento del concetto di vulnerabilità delle reti per la mobilità, evidenziandone gli aspetti finora maggiormente esplorati in ambito scientifico. Infine, viene proposta una riflessione su un comune della Regione Campania caratterizzato da rilevanti problemi idrogeologici e dalla presenza di un impianto industriale a rischio di incidente rilevante. Tale riflessione – frutto di un più ampio studio sviluppato dagli autori nell’ambito del PRIN 2006-2008 dal titolo “Sistemi di allarme precoce: aspetti tecnici, urbanistici e di comunicazione” – evidenzia come le tradizionali analisi di rischio, generalmente incentrate su singoli eventi calamitosi, possono talvolta condurre ad investimenti di potenziamento o adeguamento delle reti per la mobilità che, nati per accrescere la sicurezza del territorio, si traducono, di contro, in un complessivo incremento delle condizioni di vulnerabilità.A key point to explore the relationship between mobility and security is the role of mobility networks for ensuring territorial safety with respect to natural and man-made hazards. For many years, increasing the security of settled communities against hazards has represented one of the main target of the strategies meant to address a sustainable urban and territorial development. Mobility networks play a crucial role in that context. They represent a basic support for the community’s everyday life, on which health, comfort and a large part of economic activities depend; moreover, they represent exposed elements often characterized by high vulnerability to different hazards and, in the meanwhile, strategic equipments for the emergency management. The damage or the reduced functionality of those networks can increase the loss of human lives caused by an hazardous event as well as produce relevant economic damages at medium and long term. Besides, by extending the investigation field from the networks meant as physical supports to the flows of goods along them, the impacts of an hazardous event on such elements can provoke relevant secondary events (toxic releases, explosions and so on). Although the relevance of the mobility networks in assuring territorial safety is at present largely recognized, risk analyses have been long focused on buildings’ vulnerability or, even where they have paid attention to the mobility networks, they mainly stressed the physical damages that a given event could produce to the single elements of such networks. It is still recent the awareness that mobility networks represent a system, characterized by relevant interdependences: either because each element of the network is linked to all the others, or because there are several interdependences not only among the different typologies of network infrastructure, but also among network infrastructure and urban systems. Starting from the above assumptions, this paper points out the several aspects of the vulnerability of mobility networks and their relevance in determining the vulnerability of a territorial or urban system to hazardous events. Therefore, it is suggested an in-depth investigation of the concept of vulnerability of the mobility networks, in order to highlight the aspects mostly analyzed until now. Finally, in the last part of the paper, it is presented a case study in the Campania Region targeted to point out how the traditional risk analyses, usually based on single hazardous events, can sometimes led to invest in the improvement and adjustment of mobility networks which, targeted to increase the security of a territory, on the contrary, produce an increase of the territorial vulnerability. The case study is part of a wider study developed by the authors within the National Project 2006-2008 entitled “Early Warning Systems: technical, urban planning and communication aspects”

The one-hour post-load plasma glucose predicts progression to prediabetes in a multiethnic cohort of obese youths

One-hour post-load hyperglycemia has been proposed as an independent predictor of type 2 diabetes in adults. We examined whether 1-hour plasma glucose (1hPG) during an oral glucose tolerance test (OGTT) can predict changes in the glucose tolerance status in a multiethnic cohort of youths with normal glucose tolerance (NGT)

Achieving long-term goals through early personalized management of schizophrenia: expert opinion on the role of a new fast-onset long-acting injectable antipsychotic

Definition of an appropriate and personalized treatment plan focused on long-term outcomes is crucial in the management of schizophrenia. Following review of the literature, a panel of six leading psychiatrists discussed the importance of clear and shared long-term goals when initiating antipsychotic treatment in light of their clinical experience. The importance of establishing shared and progressive treatment objectives was stressed, which should be tailored based on the patient's characteristics, goals, and preferences. Consensus emerged on the key role that therapeutic alliance and patient empowerment play throughout the course of treatment. Reduction in symptoms in the acute phase along with good efficacy and tolerability in the maintenance phase emerged as essential features of a therapy that can favor achievement of long-term outcomes. Long-acting injectable (LAI) antipsychotics enhance adherence to treatment compared to oral formulations and have been shown to be effective in the maintenance phase. Currently available LAIs are characterized by a delayed onset of action and require a loading dose or oral supplementation to achieve therapeutic concentrations. Risperidone ISM® is a novel LAI antipsychotic with fast and sustained release of antipsychotic, reaching therapeutic plasma levels within a few hours after administration without oral supplementation or loading doses. Risperidone ISM® has been shown to rapidly control symptoms in patients with an acute exacerbation of schizophrenia and to be effective and well tolerated as maintenance treatment irrespective of the severity of initial symptoms. It thus represents a valuable and novel therapeutic option in management of schizophrenia

Pedestrian routes and urban requalification: the Montesanto area in Naples

Il contributo illustra una proposta progettuale per la riqualificazione di un’area del centro storico di Napoli attraverso la realizzazione di una rete di percorsi a prevalente fruizione pedonale. L’area di studio, il nucleo di Montesanto, è attualmente sede di rilevanti attrezzature urbane e si caratterizza quale nodo primario del trasporto urbano su ferro, punto di smistamento di rilevanti flussi di utenza sia verso il nucleo della città greco-romana sia verso l’area direzionale e il centro monumentale. La proposta progettuale – che si inquadra in un più ampio Piano per la Mobilità Pedonale Protetta nella città storica di Napoli - è volta a favorire la coesistenza, in condizioni di sicurezza, tra flussi pedonali ad elevata intensità e flussi automobilistici (utenza locale e accessibilità di emergenza), oltre che garantire l’innesco di un processo di riqualificazione che, a partire dagli archi e dai nodi della rete pedonale, investa l’area nel suo complesso. Più specificamente, a partire da una approfondita analisi delle caratteristiche di contesto e delle peculiarità dei singoli assi e nodi della rete viaria, la proposta fornisce indirizzi progettuali per la riorganizzazione delle attività e dei flussi lungo la rete viaria e per la conseguente ridefinizione delle caratteristiche spaziali degli elementi inclusi nella rete a prevalente fruizione pedonale.This paper illustrates a project targeted to the recovery of the area of Montesanto, included in the historical city of Naples, through a route network devoted to a prevailing pedestrian use. At present, relevant urban equipments are located in the investigated area; moreover, this area represents one of the main junction of the urban railway network, the shunting point of relevant flows of users either towards the Greek-Roman part of the historical city or towards the directional area and the monumental core. Furthermore, in the above-said area, interventions addressed to the recovery of the Cumana station and of the square in front of the station have been recently carried out. The project proposal – which is part of a wider Plan for Protected Pedestrian Mobility in the historical city of Naples - aims at fostering the co-existence, under security conditions, between high intense pedestrian flows and car flows (local users and emergency accessibility), apart form assuring the implementation of a requalification process which, starting from the pedestrian network, would affect the overall area. In detail the proposal, grounding on in-depth analyses of the features both of the urban context and of the individual roads and squares to be included in the pedestrian network, provides some guidelines for the reorganization of the heterogeneous activities and flows along the network and for the consequent redefinition of its spatial features

Investigating the Relationship between White Matter Connectivity and Motivational Circuits in Subjects with Deficit Schizophrenia: A Diffusion Tensor Imaging (DTI) Study

Deficit schizophrenia is a subtype of schizophrenia presenting primary and enduring negative symptoms (NS). Although one of the most updated hypotheses indicates a relationship between NS and impaired motivation, only a few studies have investigated abnormalities of motivational circuits in subjects with deficit schizophrenia (DS). Our aim was to investigate structural connectivity within motivational circuits in DS. We analyzed diffusion tensor imaging (DTI) data from 46 subjects with schizophrenia (SCZ) and 35 healthy controls (HCs). SCZ were classified as DS (n = 9) and nondeficit (NDS) (n = 37) using the Schedule for Deficit Syndrome. The connectivity index (CI) and the Fractional Anisotropy (FA) of the connections between selected brain areas involved in motivational circuits were examined. DS, as compared with NDS and HCs, showed increased CI between the right amygdala and dorsal anterior insular cortex and increased FA of the pathway connecting the left nucleus accumbens with the posterior insular cortex. Our results support previous evidence of distinct neurobiological alterations underlying different clinical subtypes of schizophrenia. DS, as compared with NDS and HCs, may present an altered pruning process (consistent with the hyperconnectivity) in cerebral regions involved in updating the stimulus value to guide goal-directed behavior

Cerebral connectivity and psychotic personality traits: A diffusion tensor imaging study

This study aims to investigate the relationship between regional connectivity in the brain white matter and the presence of psychotic personality traits, in healthy subjects with psychotic traits. Thirteen healthy controls were administered the MMPI-2, to assess psychotic traits and, according to MMPI results, a dichotomization into a group of "high-psychotic” and "low-psychotic” was performed. Diffusion tensor imaging (DTI) was used as a non-invasive measure, in order to obtain information about the fractional anisotropy (FA), an intravoxel index of local connectivity and, by means of a voxelwise approach, the between-group differences of the FA values were calculated. The "high-psychotic” group showed higher FA in the left arcuate fasciculus. Subjects with low scores for psychotic traits had significantly higher FA in the corpus callosum, right arcuate fasciculus, and fronto-parietal fibers. In line with previous brain imaging studies of schizophrenia spectrum disorders, our results suggest that psychotic personality traits are related to altered connectivity and brain asymmetr

Insight in cognitive impairment assessed with the Cognitive Assessment Interview in a large sample of patients with schizophrenia

The Cognitive Assessment Interview (CAI) is an interview-based scale measuring cognitive impairment and its impact on functioning in subjects with schizophrenia (SCZ). The present study aimed at assessing, in a large sample of SCZ (n = 601), the agreement between patients and their informants on CAI ratings, to explore patients' insight in their cognitive deficits and its relationships with clinical and functional indices. Agreement between patient- and informant-based ratings was assessed by the Gwet's agreement coefficient. Predictors of insight in cognitive deficits were explored by stepwise multiple regression analyses. Patients reported lower severity of cognitive impairment vs. informants. A substantial to almost perfect agreement was observed between patients' and informants' ratings. Lower insight in cognitive deficits was associated to greater severity of neurocognitive impairment and positive symptoms, lower severity of depressive symptoms, and older age. Worse real-life functioning was associated to lower insight in cognitive deficit, worse neurocognitive performance, and worse functional capacity. Our findings indicate that the CAI is a valid co-primary measure with the interview to patients providing a reliable assessment of their cognitive deficits. In the absence of informants with good knowledge of the subject, the interview to the patient may represent a valid alternative

Mismatch Negativity and P3a Impairment through Different Phases of Schizophrenia and Their Association with Real-Life Functioning

Impairment in functioning since the onset of psychosis and further deterioration over time is a key aspect of subjects with schizophrenia (SCZ). Mismatch negativity (MMN) and P3a, indices of early attention processing that are often impaired in schizophrenia, might represent optimal electrophysiological candidate biomarkers of illness progression and poor outcome. However, contrasting findings are reported about the relationships between MMN-P3a and functioning. The study aimed to investigate in SCZ the influence of illness duration on MMN-P3a and the relationship of MMN-P3a with functioning. Pitch (p) and duration (d) MMN-P3a were investigated in 117 SCZ and 61 healthy controls (HCs). SCZ were divided into four illness duration groups: ≤ 5, 6 to 13, 14 to 18, and 19 to 32 years. p-MMN and d-MMN amplitude was reduced in SCZ compared to HCs, independently from illness duration, psychopathology, and neurocognitive deficits. p-MMN reduction was associated with lower “Work skills”. The p-P3a amplitude was reduced in the SCZ group with longest illness duration compared to HCs. No relationship between P3a and functioning was found. Our results suggested that MMN amplitude reduction might represent a biomarker of poor functioning in SCZ

Family functioning and personal growth in Italian caregivers living with a family member affected by schizophrenia: Results of an add-on study of the Italian network for research on psychoses

To date, the role of family members in caring for relatives affected by schizophrenia has focused largely on the negative aspects of impact of the illness. The present study aimed to: (1) assess family functioning and burden of care in caregivers living in Northern, Central, and Southern Italy who looked after subjects affected by chronic schizophrenia; (2) evaluate the relationship between aspects of family functioning and burden of care, in particular personal growth (PG) of caregivers; and (3) identify variables capable of affecting PG of caregivers. A total of 136 caregivers (mean length of illness of family member more than 20 years) were recruited from 9 Italian research sites and evaluated in terms of "positive" family functioning-problem-solving, communication skills and personal goals Family Functioning Questionnaire (FFQ), burden of care, and PG Family Problems Questionnaire (FPQ). Caregivers reported an overall good family functioning with a relatively low objective and subjective burden of care. The latter was positively correlated with length of illness, with women showing a higher subjective burden than men. Reduced problem-solving skills and ability of each family member to pursue personal goals were both associated with reduced objective and subjective burden which, conversely, were both increased by inadequate support and scarce positive comments from relatives and friends. Approximately 50% of caregivers stated that "they had learned something positive from the situation," highlighting a statistically higher proportion of caregivers in southern Italy than in northern and central Italy. Caregivers' PG was associated with good family functioning, adequate professional support, and positive comments. PG also seemed to be positively influenced by support from relatives and friends (O.R. 14.306). The numerous challenges and positive aspects associated with caregiving should be duly acknowledged by mental health services and integrated into routine clinical assessment and intervention framework