Search

Previous research on sense of community (SOC) has predominantly assumed that this construct plays a role in predicting well‐being (WB). However, it is only recently that a bidirectional relationship between SOC and WB has been hypothesised and tested. Moreover, no study investigated the longitudinal relationships between psychological WB and SOC among early adolescents. The present research followed a sample of middle school students from six‐grade through nine‐grade to investigate the reciprocal relationships between SOC and WB. Participants were 576 Italian students. In the present article, we utilised latent change score modelling based on longitudinal data collected in three waves across 3 years. Using bivariate dual change score modelling, dynamic reciprocal relationships were observed between SOC and WB. The revealed bidirectional relationship between SOC and WB contribute to the extant literature by illuminating more nuanced interplays between these constructs among early adolescents. [ABSTRACT FROM AUTHOR]

The central aim of the present research was to examine the psychometric properties of adapted versions of the sense of community (SOC) responsibility scale in three Italian samples. We examined the psychometric properties of three modified versions of the sense of community responsibility (SOC‐R) scale. Consistent with the original scale, exploratory and confirmatory factor analyses demonstrated that the scale was unidimensional and exhibited excellent internal consistency. In addition, factor analyses revealed that SOC responsibility and SOC are two separate, albeit related, constructs. The results also provided evidence of the discriminant validity of SOC and SOC‐R on key outcomes. Taken together, these results provide support for the Community Experience Model, which posits that community experiences are a function of resource and responsibility components, as well as for the adaptable nature of the SOC‐R scale to the Italian context. [ABSTRACT FROM AUTHOR]

Community coalitions or intersectoral partnerships have long been advocated for the promotion of population health. In the present study, we assessed the quality of the functioning of health promotion partnerships created within a large community health promotion program implemented by the Emilia‐Romagna region located in the north‐east of Italy (2014–2016). In particular, we aimed to test the effectiveness of partnership working in strengthening participants' empowerment, sense of community and ultimately, the outcomes of a well‐functioning partnership, conceptualized as including perceived effectiveness of health promotion interventions developed by the partnership, trust in their implementation and personal commitment in health promotion in the future. Participants were 238 stakeholders (e.g., health professionals, representatives of local administrations, teachers, representative of community and volunteer organizations, and citizens) formally included in six partnerships lead by six major local health services. Using Bayesian structural equation modeling, we found that a higher perceived quality of collaboration within the partnership enhances the outcomes of a well‐functioning partnership, by strengthening their sense of a health‐promoting community and empowerment. Sense of community responsibility did not predict future commitment in health promotion. The study findings suggest that community members' ownership and feeling of responsibility, as well as empowerment constitute positive partnership processes. [ABSTRACT FROM AUTHOR]

Objective: Quality of life (QOL) and quality of care (QOC) in systemic lupus erythematosus (SLE) remains poor. Satisfaction with care (SC), a QOC surrogate, correlates with health behaviors and outcomes. This study aimed to determine correlates of SC in SLE. Methods: A total of 1262 patients with SLE were recruited from various countries. Demographics, disease activity (modified Systemic Lupus Erythematosus Disease Activity Index for the Safety of Estrogens in Lupus Erythematosus: National Assessment trial [SELENA‐SLEDAI]), and QOL (LupusPRO version 1.7) were collected. SC was collected using LupusPRO version 1.7. Regression analyses were conducted using demographic, disease (duration, disease activity, damage, and medications), geographic (eg, China vs United States), and QOL factors as independent predictors. Results: The mean (SD) age was 41.7 (13.5) years; 93% of patients were women. On the univariate analysis, age, ethnicity, current steroid use, disease activity, and QOL (social support, coping) were associated with SC. On the multivariate analysis, Asian participants had worse SC, whereas African American and Hispanic patients had better SC. Greater disease activity, better coping, and social support remained independent correlates of better SC. Compared with US patients, patients from China and Canada had worse SC on the univariate analysis. In the multivariate models, Asian ethnicity remained independently associated with worse SC, even after we adjusted for geographic background (China). No associations between African American or Hispanic ethnicity and SC were retained when geographic location (Canada) was added to the multivariate model. Canadian patients had worse SC when compared with US patients. Higher disease activity, better social support, and coping remained associated with better SC. Conclusion: Greater social support, coping, and, paradoxically, SLE disease activity are associated with better SC. Social support and coping are modifiable factors that should be addressed by the provider, especially in the Asian population. Therefore, evaluation of a patient's external and internal resources using a biopsychosocial model is recommended. Higher disease activity correlated with better SC, suggesting that the latter may not be a good surrogate for QOC or health outcomes. [ABSTRACT FROM AUTHOR]

Objective: Systemic lupus erythematosus (SLE) predominantly affects women. Clinical phenotype and outcomes in SLE may vary by sex and are further complicated by unique concerns that are dependent upon sex-defined roles. We aimed to describe sex differences in disease-specific quality of life (QoL) assessment scores using the Lupus Patient-Reported Outcome (LupusPRO) tool in a large international study.Methods: Cross-sectional data from 1,803 patients with SLE on demographics, self-identified sex status, LupusPRO, and disease activity were analyzed. The LupusPRO tool has 2 constructs: health-related QoL (HRQoL) and non-HRQoL. Disease activity and damage were evaluated using the Safety of Estrogens in Lupus Erythematosus National Assessment version of the Systemic Lupus Erythematosus Disease Activity Index and the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index, respectively. Nonparametric tests were used to compare QoL and disease activity by sex.Results: A total of 122 men and 1,681 women with SLE participated. The mean age was similar by sex, but the damage scores were greater among men. Men fared worse on the non-HRQoL social support domain than women (P = 0.02). When comparing disease and QoL among men and women ages ≤45 years, men were found to have greater damage and worse social support than women. However, women fared significantly worse on lupus symptoms, cognition, and procreation domains with trends for worse functioning on physical health and pain-vitality domains.Conclusion: In the largest study of a diverse group of SLE patients, utilizing a disease-specific QoL tool, sex differences in QoL were observed on both HRQoL and non-HRQoL constructs. Although men performed worse in the social support domain, women (especially those in the reproductive age group) fared worse in other domains. These observations may assist physicians in appropriately addressing QoL issues in a sex-focused manner. [ABSTRACT FROM AUTHOR]

Abstract: Previous studies have demonstrated the role of students’ school sense of community (i.e., emotional connection and bonds with other students at school and sense of belonging to the school as a community) in predicting well‐being (presence of positive feelings and positive functioning in life). Specifically, these studies have found that individual sense of community in the school is associated with well‐being. However, individual sense of community in the school does not constitute a school‐level characteristic, and the influence of sense of community at the school level on students’ well‐being was not investigated. To address this gap in the literature, we conducted a study investigating the influence of sense of community at the school level on students’ well‐being, using multilevel analysis. Our sample comprised 1,800 students (age ranged from 11 to 20 years) from public lower and upper secondary schools in Italy. Results showed that higher sense of community scores at the school level were associated with higher well‐being scores, while controlling for individual sense of community, gender, and age. These results provide support for a school‐level theory of school sense of community (i.e., moving school sense of community theory from the individual to the school level). [ABSTRACT FROM AUTHOR]

Abstract: Collective action is typically studied in social protest contexts and predicted by different motivations (i.e., ingroup identification and efficacy beliefs, and outgroup‐directed anger). Assuming that voting to some extent reflects a form of collective action, we tested whether these three different motivations predicted voting in Dutch, Israeli, and Italian national election contexts. Based on previous meta‐analyses on voting and collective action, we hypothesized that identification with and efficacy beliefs regarding this party would motivate voting across the different elections (i.e., context‐independent effects). As for anger, we predicted more context‐dependent effects, depending on whether the anger is targeting the previous government or at the political system at large. Results were largely in line with predictions, showing the relatively context‐independent motivational power of party identification and efficacy beliefs, and clearly context‐dependent effects for anger. Specifically, we found little support for a similar motivational power of anger targeting previous government policies, but anger targeting politics in general demotivated Dutch and Israeli participants to vote (interpreted as an expression of political cynicism), while curiously motivating Italian participants to vote (interpreted as a desire for system change from “old” to “new” politics). We discuss these findings in the context of voting in national elections, and recommend further integration of the voting and social protest literatures. [ABSTRACT FROM AUTHOR]

Abstract: Patient engagement is recognized as a crucial component of high‐quality healthcare services. Among rheumatic diseases, systemic lupus erythematosus (SLE) appears particularly challenging for the engagement of patients in their own care. According to the patient health engagement (PHE) model, patient engagement is a dynamic phenomenon that proceeds through four experiential positions (blackout, arousal, adhesion and eudaimonic project). The aim of the present study was to describe the engagement process from the point of view and the experiences of SLE patients. Ten in‐depth interviews and four focus groups were conducted with an international sample of SLE patients from different European countries. Transcripts were analysed through thematic content analysis. Findings showed that a fully engaged patient results from reframing emotional, cognitive and behavioural dimensions. The advances along the process depends on how the patient succeeds in each position. In conclusion, PHE represents an appropriate model by which to understand the engagement process of SLE patients. In order to meet patients’ needs, healthcare providers and patient support groups should consider the specific position of SLE patients, providing adequate and tailored support. [ABSTRACT FROM AUTHOR]

We assume that emotions (anger, shame and hope) mediate the relationship between perceiving a discriminatory context and civic/political engagement. Results of a survey with 1242 participants (mean age 20.7 years; 53% men; 32.8% migrants) showed that such emotions play a different role according to the type of engagement and the population (native Italians versus migrants). Copyright © 2015 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Because individuals' fundamental right to water is often taken for granted, little is known about why individuals participate in water activism. We examine how individuals identify with and intend to participate in the Italian Water Movement to defend the 'public management' of water supply. Building on the collective-action literature, we test an explanatory model in which the perceived violation of the right to water and group and participative-efficacy beliefs increase movement identification, which predicts subsequent activism. Study 1 ( N = 153 activists) largely confirmed our hypotheses: right violation and participative efficacy uniquely influenced movement identification, which in turn predicted activism. Study 2 corroborated these findings by employing a broader sample of 132 Italian citizens, with right violation, participative and group-efficacy beliefs predicting movement identification, which in turn predicted activism. We discuss the theoretical and practical implications of these findings. [ABSTRACT FROM AUTHOR]

The aim of this cross-national study was to assess the relationships among sense of community (SoC) vis-à-vis the residential community (i.e., one's home town), identity formation processes, and feelings of loneliness toward parents and peers. The sample included 431 Italian adolescents (59.4% females) and 221 Belgian (Flemish) adolescents (54.3% females) aged 14-23 years. Results indicate that the more adolescents developed firm and sustained commitments, the more they developed positive feelings toward the residential community. SoC toward the home town is lower among youth in less advanced identity statuses. Parent- and peer-related loneliness differentially predicted Italian and Belgian adolescents' SoC. Results have significant theoretical and methodological implications for the study of SoC, identity, and loneliness. [ABSTRACT FROM AUTHOR]

ABSTRACT In many communities, supplying water and sanitation is a huge task, and the fact that these essential services can be carried out by the private sector is a debated issue. This article presents an exploratory study aimed to identify the range of motives for collective action shared by activists of the Italian Movement for 'Public Water'. In-depth interviews were conducted with 28 activists and were qualitatively analysed. Five main motivational categories emerged: defending the right to water, preserving community ties, opposing to the Government and 'water sellers', preserving the environment and money interests. Each motive is based on a specific representation of the issue of water and privatization process. Findings provide further support for the importance of moral convictions and sense of community in collective action development and suggest a critical reconsideration of the role played by collective efficacy. The results are discussed in the framework of the psychosocial literature on collective action and community psychology perspectives on participatory processes. Copyright © 2012 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Introduction: Corticosteroid treatment is the standard of care in Duchenne muscular dystrophy (DMD), but the optimal age to initiate treatment and dosage pattern remain a matter of discussion. Methods: We performed a long-term study of alternate-day corticosteroids in five 2- to 4-year-old DMD patients. The primary outcome measure was prolongation of the ability to walk. Results: One patient lost ambulation at age 10. Four patients, aged 16 to 18 were fully ambulant, and 3 of them could still climb stairs. Respiratory function was moderately reduced in 2. Left ventricular ejection fraction was > 45%. Short stature and delayed puberty were the most relevant side effects. Although the negative impact of corticosteroid treatment on growth rate remained their major concern, parents and patients stated that they preferred corticosteroid therapy. Conclusions: Long-term corticosteroid treatment is effective in prolonging function but not in recovering lost function, and its early use seems appropriate. Muscle Nerve 45: 796-802, 2012 [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate, among members of a large cooperative company, the role of worker status (partner vs. employee), length of service, and cooperative values in influencing organizational identification (OI) and organizational sense of community (OSC). The study involved the totality of members of the cooperative ( N = 805; 67.7% partners, 32.3% employees), who completed a self-administered questionnaire, measuring perceived cooperative values, OI, OSC, and, among partners, identification as a partner. The results indicate that partners, more than employees, perceived the cooperative as living up to its core values and scored higher on OI and OSC. The impact of worker status on OI and OSC was mediated by perceived cooperative values. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate, among members of a large cooperative company, the role of worker status (partner vs. employee), length of service, and cooperative values in influencing organizational identification (OI) and organizational sense of community (OSC). The study involved the totality of members of the cooperative ( N = 805; 67.7% partners, 32.3% employees), who completed a self-administered questionnaire, measuring perceived cooperative values, OI, OSC, and, among partners, identification as a partner. The results indicate that partners, more than employees, perceived the cooperative as living up to its core values and scored higher on OI and OSC. The impact of worker status on OI and OSC was mediated by perceived cooperative values. [ABSTRACT FROM AUTHOR]

Maltoni G, Zucchini S, Scipione M, Mantovani V, Salardi S, Cicognani A. Onset of type 1 diabetes mellitus in two patients with maturity onset diabetes of the young. The association between maturity onset diabetes of the young (MODY) and type 1 diabetes mellitus (T1DM) has been rarely described. We report two patients affected by MODY who developed T1DM. Case 1: a 4-yr-old girl referred for glycosuria presented hemoglobin A1c (HbA1c) of 6.6%. Islet cell antibodies (ICA) and anti-glutamic acid decarboxylase (GADA) were initially negative. As her father, uncle and grandmother showed mild hyperglycemia, they were screened for MODY 2. A novel mutation in glucokinase gene was found in the family. Few months later, her glycemic control worsened consistently and she required insulin treatment. A high titer of GADA and ICA was then detected. Six years afterwards insulin requirement is 0.8 U/kg and HbA1c 6.7%. Case 2: a 15-yr-old boy treated for growth hormone deficiency was found with a blood glucose level of 106 mg/dL. HbA1c was 7.2%, ICA and GADA were negative. Family history was positive for autoimmune diseases and type 2 diabetes mellitus. The patient was investigated for MODY 2 and MODY 3, and a mutation of hepatocyte nuclear factor-1 alpha gene was found. The same mutation was found in the mother who had never been referred for hyperglycemia. After 1 yr, due to an unjustified worsening of the metabolic control, autoimmunity was again investigated and a mild positivity was found. He then required insulin therapy and after 5 yr current HbA1c was 8.2%. The diagnosis of MODY does not exclude the risk of developing T1DM. Therefore autoimmunity should be investigated when ordinary treatments fail and metabolic control unexpectedly worsens. [ABSTRACT FROM AUTHOR]

Venturia inaequalis (Cooke) Winter with reduced sensitivity to strobilurins has been reported in several countries, including Italy. This study aimed to characterise the sensitivity to strobilurins of three different types of V. inaequalis population: (a) wild types; (b) from commercial orchards satisfactorily managed with strobilurins; (c) from an experimental orchard with control failures by trifloxystrobin and kresoxim-methyl. In vitro sensitivity tests included antigerminative activity on population conidia and mycelial growth inhibition on monoconidial isolates. Cleaved amplified polymorphic sequence (CAPS) analysis was used for the detection of G143A substitution. Wild-type populations showed EC values lower than 0.031 mg L, while those of orchards with good performance by strobilurins presented EC values never higher than 0.063 mg L. Samples with scab control failures showed a strongly reduced population sensitivity. Similar differences were confirmed in monoconidial isolates. The G143A substitution was always detected in low-sensitivity populations, only sometimes in well-controlled populations and generally not in wild types. In vitro sensitivity assays were able to discriminate the three population types with different scab management, while the qualitative PCR analysis (CAPS) was only partially reliable. High sensitivity differences among V. inaequalis populations with good and poor field control by strobilurins were observed. Copyright © 2011 Society of Chemical Industry [ABSTRACT FROM AUTHOR]

This study examined age and gender differences in coping strategies used by adolescents ( N = 342; age = 14-19 years) in dealing with everyday minor stressors. Relationships with coping resources (self-efficacy, social support) and the impact of coping on psychological well-being were assessed. Coping strategies were measured using the Coping Across Situations Questionnaire (CASQ; ). Results showed that adolescents' coping strategies differed according to problem domain. The most frequently used strategies were active and internally focused. Females used a wider range of coping strategies than did males. Significant correlations were found among coping strategies and coping resources. Moreover, the adoption of some strategies significantly affected adolescents' psychological well-being. [ABSTRACT FROM AUTHOR]

The role of conflict in parent–adolescent relationships is a topic of considerable theoretical debate and empirical investigation; however, limited attention has been devoted to the strategies used by family members to deal with disagreements and their outcomes and how they differ from early to late adolescence. This study explored conflict styles and outcomes in a sample of 302 families with adolescent children (total N = 906), of two age groups (13-year-olds and 15-year-olds). One hundred sixty-four adolescents (45.7%) are female. Participants completed the ‘when we disagree’ scales. Results from both adolescents and parents confirmed the intensification of conflict from early to middle adolescence, in terms of conflict style (higher aggression, lower compromise) and outcome (lower intimacy). Age trends differ according to gender; in particular, there is evidence of a more difficult position of older girls, and of the worsening of mother–adolescent relationship from early to middle adolescence. [ABSTRACT FROM AUTHOR]

Sense of Community (SoC) is a key theoretical construct in community psychology. This study validated a SoC scale for adolescents (SoC-A) in Italy. The scale comprises 20 items and five components: satisfaction of needs and opportunities for involvement; support and emotional connection with peers; support and emotional connection in the community; sense of belonging; and opportunities for influence. The sample included 661 Italian high school students (47% male and 53% female) between the ages of 15 and 18 years old. Factor analysis and confirmatory factor analysis confirmed five components corresponding to the original work of Cicognani, Albanesi, and Zani (2006). The boys scored higher on SoC than girls. There were no differences between age groups. Results showed differences in SoC between types of schools (lycee, vocational and technical institutes). These findings provide support for the 20-item SoC-A scale and its underlying multidimensional theory of SoC. © 2010 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

The study investigates the impact of residential context on stressful events and Subjective Well being (Emotional and Psychological) in young people living in a deprived geographical area, and the mediating role of personal (Self-Efficacy) and social (Social Support, Sense of Community) variables. A questionnaire was submitted to 297 subjects (48.5% males): 203 adolescents (14–19 years old) and 94 young adults (20–27 years old), from different socio-economic (SES) levels. Results confirm the significant impact of the residential context on youngsters' perceived residential quality, Stress and Subjective Well being outcomes; such effect partly differs according to participants' gender and age. Adolescents are less satisfied of their living context and enjoy lower well being than young adults. Social resources (Friend and Family Support) significantly buffer the effect of a deprived residential context of youngsters' Well being, whereas personal resources (Self-Efficacy) directly increase Well being levels. Copyright © 2008 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Context Carney complex (CNC) is an autosomal dominant multiple endocrine neoplasia syndrome (OMIM 160980). About 70% of cases are familiar; most have mutations of the PRKAR1A gene on chromosome 17q22–24. There is little phenotype–genotype correlation known to date. Objective To study the genotype–phenotype correlation in a family with newly diagnosed CNC and three generations of subjects bearing the same PRKAR1A mutation. The proband was diagnosed with hepatocellular carcinoma, a tumour that appears to be associated with CNC. Design The study consisted of clinical and genetic analysis of a total of 10 individuals belonging to a large Italian family. Patients The index case was referred for PRKAR1A gene mutation analysis because he met the diagnostic criteria for a clinical diagnosis of CNC. Results The PRKAR1A-inactivating mutation c.502 +1G > A in the intron 5 splice-donor site was detected after bidirectional sequencing of germline DNA. The mutation causes a frameshift in the transcribed sequence and a nonsense mRNA that was shown to be degraded; this leads to PRKAR1A haploinsufficiency in all tissues. All available relatives were screened first by DNA testing and, if the latter was positive, by clinical, biochemical and imaging means. Conclusions A novel PRKAR1A mutation with an apparently low penetrance and variable expression is reported; the same mutation is also associated with a hepatocellular carcinoma. This is the first time a PRKAR1A mutation is reported in individuals who were diagnosed with CNC after retrospective family screening and following the identification of a proband; the finding has implications for genetic counselling on PRKAR1A and/or CNC. [ABSTRACT FROM AUTHOR]

Objective: To evaluate self and parent reports on quality of life (QoL) and psychological adjustment of youths with type 1 diabetes, in comparison to a general paediatric population, and identify relationships between disease duration, metabolic control and psychological parameters. Research design and methods: Participants included 70 youths with type 1 diabetes and their parents. They were compared with 70 non-diabetic subjects. Data were analyzed in the whole group and in subgroups aged 6–10, 11–13 and 14–18 yr. All cases performed pediatric QoL, Child Behaviour Checklist, filled in by parents, and Youth Self-Report, filled in by youths. Data were compared with haemoglobin A1c (HbA1c) values and disease duration. Results: Self-reports showed a psychological adjustment of youths with type 1 diabetes similar to that of controls. Parent reports showed that parents of children with type 1 diabetes were more worried than those of controls (p < 0.01). Adolescents showed a worse QoL and more frequent psychological disturbances. In this group, for youth and parent reports, HbA1c levels correlated positively with psychological problems (p < 0.05) and negatively with QoL (p < 0.05). Only for parent reports, in the whole group and in subgroups aged 6–10 and 11–13 yr, disease duration correlated positively with psychological adjustment (p < 0.05). Conclusions: Before adolescence, youths with type 1 diabetes showed only slight problems in psychological adjustment and QoL, with an association with disease duration reported by parents. In adolescence, both youths and their parents reported more emotional and behavioural problems, independent of disease duration. Better metabolic control and psychological well-being seemed directly related. [ABSTRACT FROM AUTHOR]

The development of a testis requires the proper spatiotemporal expression of the SRY gene and other genes that act in a dosage-sensitive manner. Mutations in the SRY gene account for only 10–15% of patients with 46,XY gonadal disorder of sex development (DSD). To enable the diagnostics of deletions and duplications of genes known to be involved in different forms of DSD, we developed a synthetic probe set for multiplex ligation-dependent probe amplification (MLPA) analysis. Here, we report the results from the analysis of 22 patients with 46,XY gonadal DSD. The analysis with the DSD probe set has led to the identification of two copy number variations, an 800-kb NR0B1 ( DAX1) locus duplication on Xp21 in a patient with isolated partial gonadal dysgenesis and a duplication of the SRD5A2 gene that represents a rare normal variant. The described MLPA kit represents an optimal complement to DNA sequence analysis in patients with DSD, enabling screening for deletions and duplications of several genes simultaneously. Furthermore, the second identification of an NR0B1 locus duplication in a patient with isolated gonadal dysgenesis, without dysmorphic features and/or mental retardation, highlights the importance of evaluating NR0B1 duplication in patients with gonadal dysgenesis. [ABSTRACT FROM AUTHOR]

Impairment because of narcolepsy strongly limits job performance, but there are no standard criteria to assess disability in people with narcolepsy and a scale of disease severity is still lacking. We explored: (1) the interobserver reliability among Italian Medical Commissions making disability and handicap benefit decisions for people with narcolepsy, searching for correlations between the recognized disability degree and patients’ features; (2) the willingness to report patients to the driving licence authority and (3) possible sources of variance in judgement. Fifteen narcoleptic patients were examined by four Medical Commissions in simulated sessions. Raw agreement and interobserver reliability among Commissions were calculated for disability and handicap benefit decisions and for driving licence decisions. Levels of judgement differed on percentage of disability ( P < 0.001), severity of handicap ( P = 0.0007) and the need to inform the driving licence authority ( P = 0.032). Interobserver reliability ranged from Kappa = −0.10 to 0.35 for disability benefit decision and from Kappa = −0.26 to 0.36 for handicap benefit decision. The raw agreement on driving licence decision ranged from 73% to 100% ( Kappa not calculable). Spearman’s correlation between percentages of disability and patients’ features showed correlations with age, daytime naps, sleepiness, cataplexy and quality of life. This first interobserver reliability study on social benefit decisions for narcolepsy shows the difficulty of reaching an agreement in this field, mainly because of variance in interpretation of the assessment criteria. The minimum set of indicators of disease severity correlating with patients’ self assessments encourages a disability classification of narcolepsy. [ABSTRACT FROM AUTHOR]

This study investigates the relationship between sense of community, civic engagement and social well-being in a sample of Italian adolescents. Participants were 14–19 year-old high school students (N = 566) from two demographically distinct cities. Participants completed a questionnaire assessing sense of community, social well-being (Keyes, 1998), involvement in structured group activities (group membership) and civic engagement. Results showed that involvement in formal groups is associated with increased civic involvement and increased sense of community. Sense of community predicts social well-being and explains some of the association between civic engagement and social well-being. Findings suggest that, to increase social well-being, it is important to provide adolescents with more opportunities to experience a sense of belonging to the peers' group and promote prosocial behaviours in the community context. Copyright © 2007 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The aim of this research was to assess which criteria laypeople use to evaluate the importance of treatments the Italian National Health Service (NHS) should or should not guarantee and the relationship with their degree of importance. A convenience sample of 100 individuals (22–65 years old) were asked to evaluate 52 treatments partly included and partly not included in the Essential Assistance Levels. Results showed that laypeople employ a wide range of criteria, only part of which corresponds to those traditionally investigated in the psychosocial literature. Two main dimensions emerge as organizing principles underlying their judgments, referring to NHS function (prevention vs. treatment) and to the opportunity to focus on the specific health needs of particular categories of citizens (selectivity). [ABSTRACT FROM AUTHOR]

Objective To evaluate the influence of sex as well as pubertal stage at diagnosis on the growth outcome of childhood thyrotoxicosis. Design Retrospective, collaborative study. Patients and methods Longitudinal auxological evaluation in 101 patients (M/F 23/78) for 4·7 ± 3·1 years subdivided according to pubertal stage at diagnosis into prepubertal (group I) and pubertal (group II). Results At diagnosis height and bone age (BA) standard deviation score (SDS) were positive both in girls and boys of groups I and II. In boys of group II, height SDS was significantly higher than in girls of the same group ( P = 0·007) and in boys of group I ( P = 0·026). During the follow-up, in group I, height SDS remained positive without significant differences between boys and girls, and in group II, height SDS remained significantly lower in girls than in boys. The age at onset of puberty and the age at menarche were within the normal range. Final height (FH) was within target height (TH) range in all groups The FH SDS and the height gain (FH–TH) were similar in girls and in boys in group I and significantly higher in boys than in girls ( P < 0·05) in group II. The boys of group II showed a mean height gain significantly greater than that found in all the other groups. Conclusions Despite the advancement of BA at presentation, there were no adverse effects on subsequent growth and FH; the growth outcome seems to be better in boys than in girls in group II. [ABSTRACT FROM AUTHOR]

Objective The differential diagnosis of male under-masculinization, including a wide spectrum of phenotypes and a heterogeneous genetic basis, is crucial for the correct management of the patients. To characterize an Italian population of under-masculinized males, we performed the molecular analysis of the SRD5A2 gene (2p23), encoding the 5α-reductase-2 enzyme that converts testosterone (T) to dihydrotestosterone (DHT), and is required for full masculinization of the male foetus. Design and patients Twenty-six Italian patients with 46,XY kariotype and various degrees of ambiguous genitalia were retrospectively selected for this study. Twelve of these patients, 10 of whom were referred for partial androgen insensitivity syndrome (PAIS), were raised as females; 15 were raised as males and all had a severe hypospadias. For most of the patients, the case histories and hormonal findings were incomplete but all could be included in the clinical characteristics of under-masculinization. Measurement For hormonal evaluation, T and DHT were measured by means of radioimmunoassay (RIA) and high-performance liquid chromatography (HPLC)-RIA methods, respectively. Genomic DNA of all patients and relatives was extracted from peripheral blood, the five exons of the SRD5A2 gene were amplified by polymerase chain reaction (PCR) and submitted to automatic sequencing. Results Five known mutations affecting the NADPH binding function and one new mutation affecting the enzyme C-terminus were identified in a total of eight patients (two of whom were sisters). Five families were characterized, and in two patients only one affected allele was observed. The extension of the analysis to the regions flanking exons allowed the identification of a new polymorphism in intron 2, whose frequency was determined. Conclusion This first report of an Italian population underlines the importance of differential diagnoses in patients with under-masculinization. The lack of precise genotype–phenotype correlation in some of the mutations highlights the necessity to improve knowledge about the biochemical aspects of steroid 5α-reductase action and about the interactions of genetic and environmental factors. [ABSTRACT FROM AUTHOR]

Abstract: Aim: The purpose of the present study was to compare relationships between the clinical presentation of type 1 diabetes in children and residual β-cell secretion and long-term metabolic control. Methods: This retrospective study was conducted in 66 diabetic children with age at diagnosis ranging from 0.7 to 14.8 yr. The patients showed contrasting characteristics at diagnosis: either diabetic ketoacidosis (DKA) (group 1, n = 29) or absence of metabolic derangement (group 2, n = 37) associated with marked (group 2A, n = 12) or mild hyperglycemia (group 2B, n = 25). A regular follow-up was available for at least 10 yr (10–32 yr) in all cases and for 20 yr in 23 cases. C-peptide levels were measured from diagnosis and thereafter at intervals for the first years of disease until becoming permanently undetectable. Results: C-peptide levels at diagnosis were undetectable in about 20% of the cases both with and without DKA. C-peptide levels at diagnosis, the duration of measurable C-peptide levels and the maximum value found during follow-up were not significantly different in the three groups and were not correlated with glycated hemoglobin (GHb) calculated throughout the whole period. No differences were found between the groups of patients concerning GHb values and insulin dose at 10, 15 and 20 yr of disease. The patients of group 2A, characterized by an extremely high glycemic level without ketoacidosis, had a significantly higher prevalence of HLA DR3/4 heterozygosity. Conclusions: The severity of clinical presentation at diagnosis does not significantly influence residual β-cell function, and long-term metabolic control. [ABSTRACT FROM AUTHOR]

The purpose of this research was to explore adolescents' feeling of unsafety associated with living in the urban context, their perceptions of the quality of social relations (social support from different persons) and sense of community, and the differences according to the size of the city and adolescent gender. A second aim was to analyse the antecedents of feeling of unsafety. In particular, we considered the influence of sense of community, perception of social support and personal involvement in negative experiences in the urban environment. A questionnaire was submitted to 823 adolescents aged 14 to 19 years (43.3% male and 56.7% female), living in cities of different sizes in north-central Italy. Results show the presence of differences in feeling of unsafety and sense of community according to the size of the urban context and adolescent gender. Personal involvement in negative situations is a strong predictor of feeling of unsafety, whereas sense of community plays a limited role in reducing it. The picture concerning the effect of social support is mixed. Copyright © 2001 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

OBJECTIVES We have genotyped the patients with congenital adrenal hyperplasia due to 21-hydroxylase deficiency identified from March 1980 to December 1997 through a combined program of neonatal screening and case survey in the Emilia–Romagna Region (Italy). We have also analysed retrospectively the possible advantages of genotypical neonatal classification. DESIGN A ‘phase A’ of screening and clinical monitoring (March 1980–September 1983 and March 1991–December 1997) and a ‘phase B’ of clinical monitoring only (October 1983–February 1991) were taken into account. PATIENTS A total of 61 patients (20 salt wasting, nine simple virilizing and 32 nonclassical forms) were genotyped, HLA typed and hormonally tested to understand better the genotype/phenotype relationship and the epidemiology and geographical distribution of associated mutations. The fully genotyped patients were classified into four mutation groups according to the degree of enzymatic activity (‘null’ and ‘A’ to ‘C’). RESULT The most frequent genotype alterations were deletion (24.1% classical, 3.3% nonclassical forms), large gene conversion (9.2% classical, 1.7% nonclassical forms), In2 splice (27.7% classical, 15.0% nonclassical forms), I172N (5.5% classical, 10.0% nonclassical forms), V281L (3.7% classical, 43.3% nonclassical forms), P453S (5.0% nonclassical forms). A significant difference (χ2 = 5.101; P < 0.025) in the distribution of classical genotypes was found in Romagna (south-east; incidence 1 : 7437 newborns) compared to Emilia (north-west; incidence 1 : 25 090 newborns). Two putative new mutations were found in our population. Little discrepancy was found between genotype and phenotype. CONCLUSIONS The high frequency of genotypes ‘null’ or ‘A’ in the ‘phase A’ vs. ‘phase B’ of our study confirms the usefulness of neonatal screening... [ABSTRACT FROM AUTHOR]

This study evaluated, in vitro, the effectiveness of diamond and carbide burs, and bur sequences to remove the plasma-sprayed titanium coating from IMZ fixture surfaces. Fifteen polishing procedures were tested. They included the use of 12, 16, 30 bladed carbide burs or bevered carbide burs and 30, 15, 8 μm mean-particles-size diamond burs. The treated surfaces were evaluated with profilometer and SEM. Worn burs and titanium debris produced by the grinding were observed with SEM. All procedures produce smoother surfaces than baseline plasma-sprayed surfaces for both Ra and Rz(DIN) parameters (P<0.001). A roughening effect of the 8 μm mean-grit diamond bur and 30 bladed burs were noted. The single carbide burs produce polished surfaces affected by waviness. Waviness was minimized by sequence or diamond bur use. The carbide bur blades were variously damaged after their use. In contrast, the grit of diamond burs was observed to be clogged by titanium debris whose amount seemed to be inversely related to the diamond mean particle size. Debris produced by diamond burs was granular whereas that produced by carbide bladed burs showed needle or flake morphology. In conclusion, the most effective titanium plasma sprayed removal were obtained by 30 μm and 15 μm mean-particle-size diamond burs, i.e. 30 μm plus 15 μm diamond burs and carbide 12 plus 16 bladed burs used in sequence. [ABSTRACT FROM AUTHOR]

OBJECTIVE Birth weight influences both postnatal growth and the initial response to GH therapy in GH-deficient subjects, but its relationship to final height is uncertain. Therefore, we examined final height results in a group of subjects treated for GH deficiency who were born small, appropriate or large for gestational age (GA). DESIGN Retrospective study. PATIENTS 108 GH-treated patients (age at diagnosis 11.1 ± 2.0 years) affected by idiopathic and isolated GH deficiency (peak < 8 μg/l after pharmacological and/or nocturnal mean GH concentration ≤ 3.3 μg/l) were examined. Twenty-four had a birth weight < 3rd centile (2300 g ± 268 - small for GA), 77 between the 3rd and 90th centile (3216 g ± 317: appropriate for GA) and 7 above the 90th centile (4193 g ± 143: large for GA). MEASUREMENTS All subjects reached final height (growth velocity < 0.5 cm/year in the last year of treatment) after hGH treatment (range 33–96 months) at a dose of 20 U/m2 /week. The 3 groups of subjects started therapy at a similar height for chronological and bone age. RESULTS Final height in the small for GA group was - 1.71 ± 0.93 standard deviation score (SDS), significantly lower than that of both appropriate (- 1.14 ± 0.83 (P < 0.01)) and large (- 0.70 ± 0.89 (P < 0.01)) for GA groups. Similarly, the small for GA group had a significantly lower height SDS increment from the start of therapy to adult height (0.54 ± 0.84) than both the appropriate (0.99 ± 0.78 (P < 0.05)) and the large (1.49 ± 0.84 (P < 0.01)) for GA groups. The percentage of subjects with final height above target height was significantly different in the 3 groups: 21% for the small, 38% for the appropriate and 71% for the large for GA groups (P < 0.05). In the whole group of patients there was a positive correlation between birth weight and final height (r = 0.38; P < 0.0001). CONCLUSIONS The present study showed that our patients, affected by isolated and idiopathic GH deficiency but with different birth weights, despite starting treatment with a similar height and bone age delay, had different auxological outcomes. It seems, therefore, that final height is strongly influenced by birth weight which penalizes the smaller newborns and assists the larger ones. [ABSTRACT FROM AUTHOR]