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

Il recupero ai fini antisismici del massone

Among the different earth architectural techniques largely diffused in the Italian regions - rammed earth, various types of “adobe”, light earth and cob – the last one is the less known due to its prevalent use in traditional rural buildings and in a few small settlements in Central Italy, partially abandoned in the last years 50/60. Only recently the administrations of the Regions where the majority of this cultural heritage is located developed an interest in cob technique and earth architecture, mainly in Marche and Abruzzo regions. Conservation and ecological interest are the main aim of the local groups which have to face the very “heavy” task to cope with national technical norms, particularly seismic ones which do not include traditional earth based building technologies. A detailed study has been carried out to assess the technological and structural pathologies of a typical rural residence in Treia (Macerata Council, Marche Region) now abandoned in critical conditions due to the lack of maintenance and to the destructive use of concrete and bricks in previous repair interventions. An appropriate technological and cultural sound restoration was proposed along with a structural improvement taking into account the seismic hazard of the area, by means of a wooden grid included into the outside façade of the cob structure. Seismic forecast performance of the proposed syste

Insulin dependent diabetes mellitus epidemiology: HLA genotype in 12 north eastern italian families with two siblings affected by type I diabetes

The purpose of our study was to evaluate the relationship between the histocompatibility antigens and type I diabetes mellitus in families living in the north-eastern part of Italy. In each family two siblings were affected by diabetes. HLA-antigens were determined with the lymphocytotoxicity test, utilizing antisera of the series A-B-C-DR. The phenotypic frequencies were compared with those observed in controls. We showed that diabetes has a strong association with HLA DR 3 and/or DR 4 antigens. In particular we registered high frequency of compound heterozygous DR 3 - DR 4 subjects, and this fact supports the hypothesis of the existence of two different genes for diabetes associated with these HLA antigens. Moreover we observed a particular haplotype segregation with a very high percentage of HLA identity between patients belonging to the same family, confirming the association between HLA and genetic susceptibility to insulin dependent diabetes. These results confirm data in the literature and, completed by other data from other patients' families living in our area, will be useful in providing reliable genetic counselling

Lesions to right prefrontal cortex impair real-world planning through premature commitments.

While it is well accepted that the left prefrontal cortex plays a critical role in planning and problem-solving tasks, very little is known about the role of the right prefrontal cortex. We addressed this issue by testing five neurological patients with focal lesions to right prefrontal cortex on a real-world travel planning task, and compared their performance with the performance of five neurological patients with focal lesions to left prefrontal cortex, five neurological patients with posterior lesions, and five normal controls. Only patients with lesions to right prefrontal cortex generated substandard solutions compared to normal controls. Examination of the underlying cognitive processes and strategies revealed that patients with lesions to right prefrontal cortex approached the task at an excessively precise, concrete level compared to normal controls, and very early locked themselves into substandard solutions relative to the comparison group. In contrast, the behavior of normal controls was characterized by a judicious interplay of concrete and abstract levels/modes of representations. We suggest that damage to the right prefrontal system impairs the encoding and processing of more abstract and vague representations that facilitate lateral transformations, resulting in premature commitment to precise concrete patterns, and hasty albeit substandard conclusions (because the space of possibilities has not been properly explored