Réadaptation sociale des patients psychiatriques dans la province de Parme, en Italie

Dans cet article, les auteurs soulignent les importants changements qui ont affecté la prestation des soins psychiatriques dispensés dans la province de Parme et, par ricochet, dans l'ensemble de l'Italie. Avant 1960, on notait une tendance centralisatrice caractéristique visant à regrouper les interventions thérapeutiques au sein d'une grande institution psychiatrique, l'Hôpital psychiatrique de Colorno. Par la suite, avec l'entrée en vigueur de la Loi de la réforme des soins psychiatriques, en 1978, toutes les activités ont été relocalisées sur le territoire. Les problèmes de réadaptation rencontrés lors de la mise en place de cet ambitieux projet sont analysés ici, et en particulier, les modèles d'intervention qui furent privilégiés pour le remplacement définitif de l'Hôpital psychiatrique de Colorno.In this article, the authors shed light on important changes that have affected psychiatric caragiving in the province of Parma and, by ricochet, in the whole of Italy. Up to 1960, there was a marked centralizing trend toward concentrating therapeutic interventions within a large psychiatric institution, namely Colorno Psychiatric Hospital. When the psychiatric care reform bill took effect, in 1978, all activities were relocated throughout the territory. As this ambitious project was being implemented, a number of rehabilitation problems were encountered. In addition to analyzing these problems, the authors examine specific intervention models that were used to definitively replace Colorno Psychiatric Hospital

Metal surface oxidation and surface interactions

In this chapter we discuss the main aspects of metal oxides in metallic biomaterials, with a special emphasis on titanium. Basic chemico- physical principles, in terms of titanium oxide layer ability to promote specific interactions in biological environments, are discussed. Further on, the theoretical approaches to describe the surface behaviour at atomistic level are reviewed, together with the hydration studies and protein adsorption at the surface of the titanium dioxide polymorphs. We then critically discuss the role of chemical and electrochemical surface modification technologies, aimed at modifying TiO2 structure, morphology and chemistry to tailor in vivo biological response. A perspective analysis of the correlation between theoretical studies and metal oxide surface modifications is finally offered, discussing their strengths and weaknesses and emphasizing their role as a powerful design tool for a new generation of implantable devices in which metal oxide surfaces can be tuned to yield a specific biological response

Smart Bio-Materials and Drug Delivery

Three main research lines are presently developed at Politecnico di Milano: drug and gene delivery; surface modification/modeling; design of advanced materials; shape memory polymers and biodegradable stents. For gene delivery, non-viral polycationic-branched polyethylenimine (b-PEI) polyplexes are coated with pectin, an anionic polysaccharide, to enhance the polyplex stability and decrease b-PEI cytotoxicity. Perfluorinated materials, specifically perfluoroether, and perfluoro-polyether fluids are proposed as ultrasound contrast agents and smart agents for drug delivery. Non-fouling, self-assembled PEG-based monolayers are developed on titanium surfaces with the aim to drastically reduce cariogenic bacteria adhesion on dental implants. Femtosecond laser microfabrication is used for selectively and spatially tuning the wettability of polymeric biomaterials and the effects of femtosecond laser ablation on surface properties of polymethylmethacrylate were studied. Innovative functionally graded Alumina-Ti coatings for wear resistant articulating surfaces are deposited with PLD and characterized through a combined experimental and computational approach. Protein adsorption on biomaterials surfaces with an unlike wettability and surface-modification induced by pre-adsorbed proteins are studied by atomistic computer simulations. A study is performed on fabrication of porous Shape Memory Polymeric structures and on the evaluation of their potential application in minimally invasive surgical procedures. A model of Magnesium (alloys) degradation, in a finite element framework analysis, and a bottom-up multiscale analysis for modeling the degradation mechanism of PLA matrices is developed, with the aim to provide valuable tools in the design of bioresorbable stents

A multi-element psychosocial intervention for early psychosis (GET UP PIANO TRIAL) conducted in a catchment area of 10 million inhabitants: study protocol for a pragmatic cluster randomized controlled trial

Multi-element interventions for first-episode psychosis (FEP) are promising, but have mostly been conducted in non-epidemiologically representative samples, thereby raising the risk of underestimating the complexities involved in treating FEP in 'real-world' services