Carlo Cristini: un ricordo a più voci

Ricordo di Carlo Cristini quale ricercatore nell'ambito della psicologia dell'invecchiament

Standard di Servizio delle Comunità Terapeutiche per l’Infanzia e l’Adolescenza. Adattamento alla cultura italiana degli standard prodotti dal programma di miglioramento di qualità “Community of Communities”

International audienceThe Italian translation and adaptation of The Service Standards for Therapeutic Communities for Children and Young People 2nd Edition. Edited by Community of Communities - John O’Sullivan & Sarah Paget The translation is the result of a joint work of the major Italian Associations involved in therapeutic communities for children and residential services for children and adolescents and a group of researcher at University of Palermo. It was now edited in Italy by A. Feruta, G. Foresti, M. Vigorelli on the handbook “Le comunità terapeutiche” (2012). In particular, the work of adapting the Community of Communities standards to the Italian culture has been developed through a comparison between the TC members of “Mito & Realtà” Association (past Presidents has been Enrico Pedriali and Giovanni Foresti and now leaded by Marta Vigorelli), particularly four TC “Rosa dei Venti”, “Gruppo Calimero”, “Lo Scarabocchio, “I Delfini”“, in the improvement group meetings at the Hospital “Niguarda Ca' Grande” in Milano, and some Sicilian Communities for children, in the supervision meetings conducted, by Raffaele Barone and Simone Bruschetta, within the activities of the “Laboratorio di Grouppoanalisi” Association. Associations Mito&Realtà, Il Nodo Group, TCTC (the new organization of the Association for Therapeutic Communities - London) and “Rosa dei venti” have realized in Italy a workhsop “learning living”, leaded by R.Hinselwood and Luca Mingarelli, that is part and item of the Manual. University of Palermo and Professor Francesca Giannone, with the help of Cinzia Guarnaccia, Isabella Giuliano and Olivia Marchese, have also realized a questionnaire based on the items of the Manual and are improving the assessment practice of TC by this questionnaire. The associations Mito&Realtà, Laboratorio di Gruppoanalisi and AIRSAM (Italian Association of Residence/resources for Mental Health – past President Raffaele Barone and Angelo Malinconico and now leaded by Marco D’Alema), are developing a joint programof peer accreditation of therapeutic communities and housing communities for children and adolescents, leaded by Simone Bruschetta and Francesca Giannone, on the model of the Community of Communities, in which will be used the standard translation and the questionnaire realized at University of Palermo. We have tried to remain as faithful as possible to the Community of Communities clinical sense, organizational and psychodynamic statements, while still trying to locate the huge experience behind the philosophy of the therapeutic community in the socio-political Italian context. In Italy, health work is heavily regulated within public institutions with their own competences that cover specific administrative services, different types of users and particular territorial areas. Especially in the health services to childhood, the institutional and legal powers that law administration attaches to families, public schools, social services of territorial competence and local health authorities, require an articulated taking charge, involving all these institutions, which is often added to the Juvenile Court of Justice, with its almost limitless powers of decree. For this reason, in chapter 5.4. of list (collaborating), we proposed two additional items (5.4.3 and 5.4.4), to 5.4.1 and 5.4.2, to better define the design mode of the clinical taking care by communities in Italian context and culture. These are the only items added to the text. Il Community of Communities (C. of C.) è un programma di miglioramento della qualità e di accreditamento tra pari per le Comunità Terapeutiche (CT), attivo nel Regno Unito, ma aperto anche a partecipazioni internazionali, avviato nel 2002 dal Royal College of Psychiatrist su iniziativa dell'Association of Therapeutic Communities (ATC). Il Community of Communities, in questi dieci anni di attività, ha costruito un network scientifico-professionale fondato su di una sere di programmi di miglioramento di qualità e di accreditamento tra pari e sviluppato dal College Centre for Quality Improvement (CCQI) del Royal College of Psychiatrist, che rappresenta una delle più importanti matrici socio-organizzative delle Best Practices sviluppate a livello internazionale sulle Comunità Terapeutiche. Fino ad oggi, il C. of C. ha prodotto diverse edizioni di Service-Standard per comunità terapeutiche specializzate nella cura in diversi setting istituzionali tra i quali due edizioni di Service-Standard per minori ed adolescenti. La seconda edizione curata da John O'Sullivan & Sarah Paget è quella qui tradotta ed adattata alla cultura italiana, con l’approvazione, nella sua stesura finale, del Community of Communities Project Team e del Community of Communities Children and Young People’s Reference Group.The translation is the result of a joint work of the major Italian Associations involved in therapeutic communities for children and residential services for children and adolescents and a group of researcher at University of Palermo. It was now edited in Italy by A. Feruta, G. Foresti, M. Vigorelli on the handbook “Le comunità terapeutiche” (2012).In particular, the work of adapting the Community of Communities standards to the Italian culture has been developed through a comparison between the TC members of “Mito & Realtà” Association (past Presidents has been Enrico Pedriali and Giovanni Foresti and now leaded by Marta Vigorelli), particularly four TC “Rosa dei Venti”, “Gruppo Calimero”, “Lo Scarabocchio, “I Delfini”“, in the improvement group meetings at the Hospital “Niguarda Ca' Grande” in Milano, and some Sicilian Communities for children, in the supervision meetings conducted, by Raffaele Barone and Simone Bruschetta, within the activities of the “Laboratorio di Grouppoanalisi” Association (past Presidenta has been Girolomo Lo Verso, Giuseppe Ruvolo and Corrado Pontalti and now leaded by Ugo Corino).Associations Mito&Realtà, Il Nodo Group, TCTC (the new organization of the Association for Therapeutic Communities - London) and “Rosa dei venti” have realized in Italy a workhsop “learning living”, leaded by R.Hinselwood and Luca Mingarelli, that is part and item of the Manual.University of Palermo and Professor Francesca Giannone, with the help of Cinzia Guarnaccia, Isabella Giuliano and Olivia Marchese, have also realized a questionnaire based on the items of the Manual and are improving the assessment practice of TC by this questionnaire.The associations Mito&Realtà, Laboratorio di Gruppoanalisi and AIRSAM (Italian Association of Residence/resources for Mental Health – past President Raffaele Barone and Angelo Malinconico and now leaded by Marco D’Alema), are developing a joint programof peer accreditation of therapeutic communities and housing communities for children and adolescents, leaded by Simone Bruschetta and Francesca Giannone, on the model of the Community of Communities, in which will be used the standard translation and the questionnaire realized at University of Palermo.We have tried to remain as faithful as possible to the Community of Communities clinical sense, organizational and psychodynamic statements, while still trying to locate the huge experience behind the philosophy of the therapeutic community in the socio-political Italian context. In Italy, health work is heavily regulated within public institutions with their own competences that cover specific administrative services, different types of users and particular territorial areas. Especially in the health services to childhood, the institutional and legal powers that law administration attaches to families, public schools, social services of territorial competence and local health authorities, require an articulated taking charge, involving all these institutions, which is often added to the Juvenile Court of Justice, with its almost limitless powers of decree. For this reason, in chapter 5.4. of list (collaborating), we proposed two additional items (5.4.3 and 5.4.4), to 5.4.1 and 5.4.2, to better define the design mode of the clinical taking care by communities in Italian context and culture. These are the only items added to the text

The effect of dietary guar on serum cholesterol, intestinal transit and fecal output in man

n six healthy subjects serum cholesterol was unchanged during a 2-wk period of controlled diet (2750 kcal) followed by a 2-wk period of free diet but showed a 16% decrease (p less than 0.05) during a further 2-wk period of controlled diet to which guar (5.7 g bid) was added. Stool weight, frequency and whole gut transit time did not differ in the diet periods with and without guar. Of guar ingested 82-95% was metabolized in the gut. Mouth to cecum transit of a meal measured by the hydrogen breath test in the same subjects was unaffected by the addition of 5.7 g of guar

Adattamento Italiano degli Standard di Servizio delle Comunità Terapeutiche per l’Infanzia e l’Adolescenza

Il Community of Communities (C. of C.) è un programma di miglioramento della qualità e di accreditamento tra pari per le Comunità Terapeutiche (CT), attivo nel Regno Unito, ma aperto anche a partecipazioni internazionali, avviato nel 2002 dal Royal College of Psychiatrist su iniziativa dell’Association of Therapeutic Communities (ATC). Il Community of Communities, in questi dieci anni di attività, ha costruito un network scientifico-professionale fondato su di una sere di programmi di miglioramento di qualità e di accreditamento tra pari e sviluppato dal College Centre for Quality Improvement (CCQI) del Royal College of Psychiatrist, che rappresenta una delle più importanti matrici socio-organizzative delle Best Practices sviluppate a livello internazionale sulle Comunità Terapeutiche. Fino ad oggi, il C. of C. ha prodotto diverse edizioni di Service-Standard per comunità terapeutiche specializzate nella cura in diversi setting istituzionali tra i quali due edizioni di Service-Standard per minori ed adolescenti. La seconda edizione curata da John O’Sullivan & Sarah Paget è quella qui tradotta ed adattata alla cultura italiana, con l’approvazione, nella sua stesura finale, del Community of Communities Project Team e del Community of Communities Children and Young People’s Reference Group

Prolongation of antibiotic prophylaxis after clean and clean-contaminated surgery and surgical site infection

AIM: Several guidelines have recommended that antibiotic prophylaxis (AMP) should be given only at premedication, except in selected cases. Conversely, in clinical practice, AMP is often unnecessarily prolonged after the surgical procedure. In this observational study, we evaluated the risk of surgical site infection (SSI) associated with the prolongation of AMP after clean and clean-contaminated surgery. METHODS: All consecutive patients who underwent a surgical procedure were eligible. AMP was always administered before the surgical incision. Prolongation of AMP for the first 24 hours was allowed only in presence of at least one risk factor for SSI: an ASA score >2 or surgical procedure longer than the specific cutoff (as indicated by the NNIS--the National Nosocomial Infections Surveillance System). SSIs were evaluated during the hospital stay and after hospital discharge. RESULTS: Three hundred fifty-eight patients were enrolled; 19 (5.3%) and 17 (6.5%) patients developed respectively intra-hospital and post hospital discharge SSIs. AMP prolongation for 24 hours in patients with at least one risk factor did not reduce the risk for intra-hospital SSI (OR 1.102; 95% CI: 0.336-3.612; P=0.873), while it increased the risk in patients without risk factors (OR: 8.99; 95% CI: 1.46-55.4; P=0.018). AMP longer than 24 hours raised the risk for intra-hospital and post hospital discharge SSI, regardless of the presence of risk factors (OR: 3.39; 95% CI 1.11-10.35; P=0.032 and OR: 5.39; 95% CI: 1.64-17.75; P=0.006, respectively.) CONCLUSION: Postoperative AMP prolongation should be avoided

Prolongation of antibiotic prophylaxis after clean and clean-contaminated surgery and surgical site infection.

AIM: Several guidelines have recommended that antibiotic prophylaxis (AMP) should be given only at premedication, except in selected cases. Conversely, in clinical practice, AMP is often unnecessarily prolonged after the surgical procedure. In this observational study, we evaluated the risk of surgical site infection (SSI) associated with the prolongation of AMP after clean and clean-contaminated surgery. METHODS: All consecutive patients who underwent a surgical procedure were eligible. AMP was always administered before the surgical incision. Prolongation of AMP for the first 24 hours was allowed only in presence of at least one risk factor for SSI: an ASA score >2 or surgical procedure longer than the specific cutoff (as indicated by the NNIS--the National Nosocomial Infections Surveillance System). SSIs were evaluated during the hospital stay and after hospital discharge. RESULTS: Three hundred fifty-eight patients were enrolled; 19 (5.3%) and 17 (6.5%) patients developed respectively intra-hospital and post hospital discharge SSIs. AMP prolongation for 24 hours in patients with at least one risk factor did not reduce the risk for intra-hospital SSI (OR 1.102; 95% CI: 0.336-3.612; P=0.873), while it increased the risk in patients without risk factors (OR: 8.99; 95% CI: 1.46-55.4; P=0.018). AMP longer than 24 hours raised the risk for intra-hospital and post hospital discharge SSI, regardless of the presence of risk factors (OR: 3.39; 95% CI 1.11-10.35; P=0.032 and OR: 5.39; 95% CI: 1.64-17.75; P=0.006, respectively.) CONCLUSION: Postoperative AMP prolongation should be avoided