L'impatto della pandemia Covid-19 sulle nuove strutture psichiatrico-forensi in Italia

After the closure of Psychiatric Hospitals (OPs), in 2012 the Italian Government decided to close the High Security Psychiatric Hospitals (OPGs). Law 81/2014 established that each region would provide smaller forensic psychiatry facilities, theREMS (Residence for the Execution of the Security Measures), to accommodate socially dangerous NGRI (Not Guilty by Reason of Insanity) offenders. The main characteristic of a REMS is that it is purely therapeutic and rehabilitative in naturewhile remaining a custodial safety measure. The COVID-19 pandemic undoubtedly tested the organization of these new Italian forensic psychiatry facilities whose practices were not yet fully established, forcing them to ensure patient safety during lockdown amidst the epidemic. The Chapter V Constitutional reform which assigned each region exclusive competence for health policies in its own territory, once the prerogative of the central government, was also put to the test. To assess the impact of the pandemic on the new forensic care system in Italy, we conducted a semi-structured interview with REMS health professionals from various regions with differing levels of contagion: the Poli REMS di Castiglione delle Stiviere; the REMS of Volterra; the REMS of Carovigno and the REMS of Pisticci. The interview assessed how the rehabilitation objectiveshad been met notwithstanding the serious operational limitations consequent to COVID-19 related decisions by the authorities.Dopo la chiusura degli Ospedali Psichiatrici (OP), nel 2012 il Governo Italiano ha deciso di chiudere gli Ospedali Psichiatrici Giudiziari, gli OPG. La legge 81/2014 stabiliva che ogni regione avrebbe dovuto prevedere l’istituzione di strutture psichiatrico-forensi più piccole, le REMS (Residenze per la Esecuzione delle Misure di Sicurezza), per accogliere gli autori di reatonon imputabili, socialmente pericolosi. La caratteristica principale delle REMS è quella di avere una natura prettamente terapeutica e riabilitativa pur rimanendo una misura di sicurezza detentiva. Non c’è dubbio che la pandemia COVID-19 abbia messo alla prova l’organizzazione delle nuove strutture psichiatrico-forensi italiane, con prassi ancora non del tutto consolidate, costringendo le REMS durante il lock-down ad adoperarsi per gestire l’epidemia, garantendo al tempo stesso la sicurezza dei pazienti. In questo contesto è stata messa alla prova anche la riforma del Capitolo V della Costituzione, che assegnava a ciascuna Regione la competenza esclusiva per le politiche sanitarie del proprio territorio, un tempo prerogativa del governo centrale. Alla luce di ciò, per valutare l’impatto della pandemia sul nuovo sistema di assistenza forense in Italia, abbiamo condotto un’intervista strutturata con gli operatori sanitari delle REMS di diverse regioni con diversi livelli di diffusione della malattia: la Poli REMS di Castiglione delle Stiviere; la REMS di Volterra; la REMS di Carovigno e la REMS di Pisticci. L’intervista ha valutato come gli obiettivi riabilitativi fossero stati garantiti nonostante i gravi limiti operativi conseguenti alle decisioni delle autorità determinate dal COVID-19

Sex offenders dichiarati non imputabili per infermità mentale: caratteristiche cliniche e legali

Sexual offenders constitute a diversified group with mixed specifics, motive and criminal acts. Significant evidences in research suggest that these offenders suffer from large proportions of psychiatric disorders, along with psychotic disorders, mood disorders, paraphilic disorders and Substance Use Disorders. It has been recently ascertained considerable percentages of personality disorders among sex offenders as well: borderline/narcisistic/antisocial. This is a cross-sectional study in which we included all the patients admitted in the 8 REMSs in Castiglione delle Stiviere from January 2009 to December 2018 sentenced for sexual offenses. The result of this study is that most of individuals found NGRI for a sexual offense have a psychotic disorder as a primary diagnosis. The majority of our sample was known by the local mental health services, even if the proportion of whom were not known was high.I sex offender rappresentano un gruppo eterogeneo di autori di reato con motivazioni varie. Le evidenze scientifiche suggeriscono che questi autori di reato, in larga parte sono affetti da disturbi mentali. Fra di essi disturbi psicotici, disturbi dell’umore, disturbi parafilici e disturbi da uso di sostanze e, del tutto recentemente, disturbi di personalità, fra cui in particolare, disturbo borderline, narcisitico ed antisociale di personalità. Il presente studio è trasversale: abbiamo incluso tutti i pazienti ammessi nelle 8 REMS di Castiglione delle Stiviere da gennaio 2009 a dicembre 2018 per aver commesso reati sessuali. Lo studio ha dimostrato che la grande maggioranza dei sex offender con vizio totale di mente erano affetti da un disturbo psicotico. Per lo più si trattava di pazienti già noti ai servizi psichiatrici, sebbene fosse alta anche la percentuali di quelli sconosciuti

The DUNDRUM ToolKit, Italian version and its potenzial use in the italian forensic treatment model

The legislative process that led to the closure of the Judicial Psychiatric Hospitals (OPG), replaced by theResidences for the Execution of Security Measures (REMS), constituted a significant step forward towardsthe establishment of a community model of care of offenders with severe socially dangerous mental disordersmore respectful of human rights. Among the main criticalities that had been identified in the previous forensicpsychiatric treatment system, based on OPGs, were considered the overcrowding, the problematic hygienic-sanitary conditions, the inexistence of treatment programs that were adequate to the levels of social danger that changed over time, the non-therapeutic-rehabilitative nature of the internment in OPG, the“anti-therapeutic” presence of the Penitentiary Police personnel, the hypothetically unlimited duration ofthe internment. The new model has certainly remedied these critical issues, but other issues have arisen thatneed to be worked on. The authors report here the first data of a multicenter research project that developedon the national territory during the years 2021 and 2022 aimed at validating the DUNDRUM Toolkit, a toolfor evaluating the effectiveness of forensic treatment and recovery, in validation course also in other Europeancountries, particularly adaptable to the treatment model that has been developing in Italy with the establishment of REMS.Il processo legislativo che ha portato alla chiusura degli Ospedali Psichiatrici Giudiziari (OPG), sostituitidalle Residenze per l’Esecuzione delle Misure di Sicurezza (REMS), ha costituito un significativo passo inavanti verso l’istituzione di un modello comunitario di cura degli autori di reato affetti da gravi disturbi mentali socialmente pericolosi più rispettoso dei diritti umani. Tra le principali criticità che erano state ravvisatenel precedente sistema trattamentale psichiatrico forense, basato sugli OPG, sono state considerate il sovraffollamento, le condizioni igienico-sanitarie problematiche, l’insussistenza di programmi trattamentaliche fossero adeguati ai livelli di pericolosità sociale modificantisi nel tempo, la natura non terapeutico-riabilitativa dell’internamento in OPG, la presenza “anti-terapeutica” del personale di Polizia Penitenziaria, ladurata ipoteticamente senza termine dell’internamento. A queste criticità il nuovo modello ha certamenteposto rimedio, ma sono sorte altre problematicità su cui bisognerà lavorare. Gli autori riportano in questasede i primi dati di un progetto di ricerca multicentrico che si è sviluppato sul territorio nazionale nel corsodegli anni 2020-2022 teso a validare il DUNDRUM Toolkit, strumento di valutazione dell’efficacia del trattamento forense e della recovery, in corso di validazione anche in altri Paesi europei, particolarmente adattabile al modello trattamentale che si è andato sviluppando in Italia con l’istituzione delle REMS

La politica energetica dell'Unione europea : obiettivi e sviluppi dalle origini fino al pacchetto 'Energia pulita per tutti gli europei'

Published online 27 Deccember 2018Special issue: Andrea CIAFFI and Cecilia ODONE (eds), Papers del Programma di 'Formazione in materia europea – 2017', Roma : CINSEDO, Centro INterregionale Studi E Documentazione, 2018L’energia è stata per decenni uno dei settori in cui minore è stato il ruolo giocato dalle politiche europee. Nonostante il processo di integrazione fosse partito proprio dal carbone, la principale fonte di energia dell’Europa nel secondo dopoguerra, una politica energetica europea strutturata e legittimata dai trattati si afferma solamente nel primo decennio del XXI secolo. Con l’entrata in vigore del Trattato di Lisbona (2009), l’energia diventa infatti formalmente materia concorrente tra il livello di governo europeo e quello nazionale e le decisioni prese a Bruxelles definiscono in maniera più stringente la cornice entro cui le politiche nazionali e locali si devono sviluppare. In quanto segue si fornirà una panoramica della politica energetica europea dall’avvio del processo di integrazione negli anni ’50 del secolo scorso fino al recente pacchetto “Energia pulita per tutti gli europei” (Clean Energy Package for all Europeans nella dizione inglese). Per ovvi motivi di spazio, la trattazione non sarà esaustiva, ma si limiterà a indicare gli obiettivi e gli sviluppi più salienti, offrendo al lettore uno strumento utile a orientarsi tra le numerose iniziative legislative e non legislative che l’Unione ha messo in campo negli ultimi anni e che hanno un impatto non trascurabile sulle competenze e gli obblighi dei vari livelli della pubblica amministrazione, centrale e locale.- Introduzione - 1. Una lunga genesi – 2. Gli obiettivi al 2020 e la competenza formale – 3. L’attuazione tra successi e fallimenti e lo sguardo al 2030 - 4. L’Unione dell’energia e il Pacchetto “Energia pulita per tutti gli europei” – Conclusioni – Bibliografia per approfondir

Assistenti Sociali e Maltrattamento Infantile: conoscenze e prassi operative degli operatori nel territorio Veneto

Il maltrattamento infantile determina gravi conseguenze sul benessere dei bambini con un conseguente altissimo costo sociale per tutta la societ\ue0. Attraverso la somministrazione di un questionario ad assistenti sociali dei servizi di tutela (comunali e sociosanitari) e dei servizi sociosanitari altri rispetto alla tutela (p.e. Servizi per le Dipendenze o per la Salute Mentale) si \ue8 voluto indagare la conoscenza del fenomeno del maltrattamento infantile e le prassi operative attualmente utilizzate. I risultati hanno evidenziato sia elementi positivi, quali l\u2019adeguata conoscenza del fenomeno, quanto elementi di criticit\ue0, quali le carenze nella fase di segnalazione da parte degli operatori non direttamente impegnati nella tutela

Psychological Aspects of Combined Homicide-Suicide (Self-Directed Violence).

From a criminological point of view, homicide-suicide represents a “double death” and takes on a meaning that transcends the specificity of the two events individually understood, which, although diametrically opposed on the phenomenal level, actually share the same matrix, from seeking oneself either in aggression or in the desire to eliminate the tension underlying it. With this in mind, the homicidal phenomenon has been subjected to various attempts at classification, on the basis of which it has been found that those who, with murder, deprive themselves of a primary source of gratification can then decide to commit suicide due to this loss. Suicide following the murder, therefore, would be an indicator of the importance of the link between the murderer and his victim. Some authors, moreover, have confirmed that a strong attachment between the two increases the chances of suicide of the first after the death of the second; or that the event matures in a relational context that qualifies for abuse and mistreatment, or for fear of betrayal and the loss of an object that escapes any attempt to possess it; in many cases, the destruction of the object with the crime is followed by the selfannihilation of the murderer

Interaction of gold nanoparticles with proteins and HUVEC cells followed with confocal fluorescence microscopy techniques

The increasing use of metal nanoparticles as new multi-functional platforms for diagnostic and drug delivery requires characterization of their interaction with biological substrates under both static and flow conditions. In this work we will follow the interaction of 20 nm gold nanoparticles (capped with different surfactants) with the BSA protein through experiments of fluorescence correlation spectroscopy and fluorescence lifetime imaging. In particular we will analyze independently the behavior of free gold nanoparticles as well as BSA (tagged with a fluorescent label) inside a microfluidic device as a function of the channel surface coating and the flow speed of the device. Then we will address the characterization of adsorption dynamic of BSA on the gold nanoparticles both in static and in flow conditions. Flow condition will be realized by fabrication of Y shaped microfluidic devices in polydimethylsiloxane (PDMS) and glass and continuous flow will be provided by syringe pumps. At the same time we will present our result on the uptake and toxicity of the same nanoparticles with respect to HUVEC (Human Umbilical Vein Endothelial Cells) cultured in stationary vs flow conditions, realized also via PDMS microfluidic devices.The continuous perfusion provided by a microfluidic system simulates the physiological characteristics of the circulatory system and creates a cellular microenvironment that is typically found in the biological systems.

An optofluidic light detector based on the photoacoustic effect

An optofluidic light detector based on the photoacoustic effect is presented. The device performances are tested at 532 nm using a pulsed solid-state laser as light source and a potassium permanganate (KMnO4) water solution as active medium. As expected, the device shows linear response with respect to applied light irradiance. By changing flow rate the device sensitivity increases non-linearly. This change in sensitivity is mainly attributed to a rise in water temperature as the flow rate increases, leading to a higher thermal expansion coefficient. Changes of water temperature with applied flow rate are confirmed through independent fluorescence intensity experiments with Rhodamine B in water. Comparison of the photoacoustic and fluorescence data points out that the change in temperature inside the microfluidic device is not promoted by the absorbed laser light, but instead is mainly due to viscous friction

Strategy for the improvement of mixing in microdevices

One of the most promising way to exploit microfluidic systems is as microreactors. A microreactor can be considered as a microchamber where chemical reactions take place, aimed at the synthesis of novel materials with controlled experimental conditions. The main goal is to reach the highest efficiency towards the desired output product. Mixing is usually very slow in microchannels, when laminar flow conditions characterized by low Reynolds numbers (below 3000) are applied. Many different strategies can be proposed to enhance mixing. In this work we explore and model the behavior of microreactor prototypes having different geometry and aimed at the improvement of mixing efficiency. These prototypes exploit either the hydrodynamic focusing effect or the presence of microstructuration inside the microchannel. In the first case, the focusing effect is used to reduce the diffusion distance between the molecules flowing in the reactors. In the second approach, we explore the influence of lateral steps fabricated inside the channels on the mixing efficiency. The behavior of fluid features is numerically modeled via Navier-Stokes equations coupled to convection-diffusion equations. Moreover, fluorescence based techniques are used to characterize the mixing efficiency in the experimental devices

Strategy for the improvement of mixing in microdevice

One of the most promising way to exploit microfluidic systems is as microreactors. A microreactor can be considered as a microchamber where chemical reactions take place, aimed at the synthesis of novel materials with controlled experimental conditions. The main goal is to reach the highest efficiency towards the desired output product. Mixing is usually very slow in microchannels, where laminar flow conditions characterized by low Reynolds numbers (below 3000) are applied. Many different strategies can be proposed to enhance mixing. In this work we explore and model the behavior of microreactor prototypes having different geometry and aimed at the improvement of mixing efficiency. These prototypes exploit either the hydrodynamic focusing effect or the presence of microstructuration inside the microchannel. In the first case, the focusing effect is used to reduce the diffusion distance between the molecules flowing in the reactors. In the second approach, we explore the influence of lateral steps fabricated inside the channels on the mixing efficiency. The behavior of fluid features is numerically modeled via Navier-Stokes equations coupled to convection-diffusion equations. Moreover, fluorescence based techniques are used to characterize the mixing efficiency in the experimental devices