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Objectives: This study aims to explore the long-term efficacy of a psychoeducational family intervention (PFI) in bipolar I disorder at one and five years post-intervention in terms of improvement of: (1) patients’ symptoms and global functioning and (2) relatives’ objective and subjective burden and coping strategies. Methods: This is a multicentre, real-world, controlled, outpatient trial. Recruited patients and key-relatives were consecutively allocated to the experimental intervention or treatment as usual. Patients were assessed at baseline, and after one and five years. Results: One hundred and thirty-seventh number families have been recruited; 70 have been allocated to the experimental intervention, and 67 have been allocated to the control group. We observed an increasing positive effect of the PFI on patients’ clinical status, global functioning and objective and subjective burden after one year. We also found a reduction in the levels of relatives’ objective and subjective burden and a significant improvement in the levels of perceived professional support and of coping strategies. The efficacy of PFI on patients’ clinical status was maintained at five years from the end of the intervention, in terms of relapses, hospitalizations and suicide attempts. Conclusions: The study showed that the provision of PFI in real-world settings is associated with a significant improvement of patients’ and relatives’ mental health and psychosocial functioning in the long term. We found that the clinical efficacy of the intervention, in terms of reduction of patients’ relapses, hospitalization and suicide attempts, persists after 5 years. It is advisable that PFI is provided to patients with BD I in routine practice.

Background: Psychoeducational family intervention (PFI) has been proven to be effective in improving the levels of family burden and patients’ personal functioning in schizophrenia and bipolar disorders (BDs). Less is known about the impact of PFI on relatives’ coping strategies in BD. Methods: A multicenter, controlled, outpatient trial funded by the Italian Ministry of Health and coordinated by the Department of Psychiatry of the University of Campania “Luigi Vanvitelli” has been conducted in patients with bipolar I disorder (BD-I) and their key relatives consecutively recruited in 11 randomly selected Italian community mental health centers. We aim to test the hypothesis that PFI improves problem-oriented coping strategies in relatives of BD-I patients compared to the Treatment As Usual (TAU) group. Results: The final sample was constituted of 123 patients and 139 relatives. At baseline assessment (T0), the vast majority of relatives already adopted problem-oriented coping strategies more frequently than the emotion-focused ones. At the end of the intervention, relatives receiving PFI reported a higher endorsement of adaptive coping strategies, such as “maintenance of social interests” (odds ratio [OR]=0.309, CI=0.04–0.57; p=0.023), “positive communication with the patient” (OR=0.295, CI=0.13–0.46; p=0.001), and “searching for information” (OR=0.443, CI=0.12–0.76; p=0.007), compared to TAU relatives, after controlling for several confounders. As regards the emotion-focused coping strategies, relatives receiving the experimental intervention less frequently reported to adopt “resignation” (OR=-0.380, CI=-0.68 to -0.08; p=0.014) and “coercion” (OR=-0.268, CI=-0.46 to -0.08; p=0.006) strategies, compared to TAU relatives. Conclusion: PFI is effective in improving the adaptive coping strategies of relatives of BD-I patients, but further studies are needed for evaluating the long-term benefits of this intervention.

Aims: This article aims to (1) explore the levels of perceived insecurity in a sample of patients with mood or anxiety disorders and (2) assess whether living in 'big cities' can influence the levels of patients' perceived insecurity and social contacts compared to living in a non-urbanized context. Methods: A total of 24 Italian mental health centers (MHCs) have been invited to participate. Twenty patients consecutively accessing the MHC have been recruited. All patients have been assessed using validated assessment tools. Results: The sample consisted of 426 patients, mostly female, with a mean age of 45 years. Globally, 52.2% of patients had a diagnosis of mood disorders, and 37.8% had anxiety disorders. Half of the sample declared that the main feeling toward life is uncertainty; higher levels of pessimistic views toward life have been detected in patients living in urban areas. A positive association between negative attitudes toward life and higher levels of depressive and anxiety symptoms, poor social functioning and higher levels of perceived psychological distress has been found. Conclusion: Our findings confirm the presence of a common sense of perceived uncertainty among our sample. Such attitude toward life can have a detrimental impact on patients' psychological and physical well-being, contributing to high levels of distress.

Background Despite several guidelines recommend the use of psychoeducational family interventions (PFIs) as add-on in the treatment of patients with bipolar I disorder, their implementation on a large scale remains limited. The aim of the present study is to identify obstacles for the feasibility of PFIs in routine care. Methods This was a multicentre, real-world, controlled, outpatient trial, carried out in 11 randomly recruited Italian mental health centres. Two mental health professionals from each center attended a modular training course on PFI and provided the intervention. Difficulties and benefits experienced by mental health professionals in implementing the intervention were assessed through the Family Intervention Schedule (FIS-R), which was administered six times. Results Sixteen out of the 22 recruited professionals completed the training and administered the PFI to 70 patients with bipolar I disorder and their relatives. The retention rate of families receiving the intervention was 93%. Mental health professionals reported high levels of organizational difficulties, several benefits in their daily clinical work and low levels of intervention-related difficulties. The most important organizational obstacles were related to the need to integrate the intervention with other work responsibilities and to the lack of time to carry out the intervention. These difficulties did not decrease over time. Intervention-related difficulties were rated as less problematic since the first time assessment and tended to improve over time. Limitations Low number of recruited professionals; use of a not previously validated assessment instrument. Conclusions PFIs are feasible in routine care for the treatment of patients with bipolar I disorder and their relatives, and main obstacles are related to the organization/structure of mental health centres, and not to the characteristics of the intervention itself.

The thermal plasma etching (TPE) at atmospheric pressure on silica rods was studied. The plasma to rod heat transfer was simulated using a commercial computational fluid dynamics (CFD) code Fluent©. An enthalpy probe has been employed to monitor the plasma conditions before the thermal plasma etching process. The heat transfer between the fluid and the silica walls accounts for the energy loss due to surface radiation and vaporization.

Background This study assessed the efficacy of the Falloon model of psychoeducational family intervention (PFI), originally developed for schizophrenia management and adapted to bipolar I disorder. The efficacy of the intervention was evaluated in terms of improvement of patients' social functioning and reduction of family burden.Methods This was a multicentre, real-world, controlled, outpatient trial carried out in 11 randomly recruited Italian mental health centres. Enroled patients and key-relatives were consecutively allocated either to receive PFI and Treatment As Usual (TAU) or to a waiting list receiving TAU alone. The efficacy of the intervention was evaluated in terms of improvement in patients' social functioning (primary outcome) and reduction of family burden (secondary outcome).Results Of the 137 recruited families, 70 were allocated to the experimental group and 67 to the control group. At the end of the intervention, significant improvements in patients' social functioning and in relatives' burden were found in the treated group compared to TAU. This effect of the intervention remained also after controlling for several confounding patient's socio-demographic and clinical factors. The experimental intervention had an impact also on other outcome measures, such as patients' clinical status and personal burden.Limitations Lack of an active control group.Conclusions The results of this study clearly show that the psychoeducational family intervention according to the Falloon model is effective in improving the social outcome of patients with bipolar I disorder.

Background: Depression is a frequently observed and disabling condition in primary care, mainly treated by Primary Care Physicians with antidepressant drugs. Psychological interventions are recommended as first-line treatment by the most authoritative international guidelines but few evidences are available on their efficacy and effectiveness for mild depression.Methods/Design: This multi-center randomized controlled trial was conducted in 9 Italian centres with the aim to compare the efficacy of Inter-Personal Counseling, a brief structured psychological intervention, to that of Selective Serotonin Reuptake Inhibitors. Patients with depressive symptoms referred by Primary Care Physicians to psychiatric consultation-liaison services were eligible for the study if they met the DSM-IV criteria for major depression, had a score ≥13 on the 21-item Hamilton Depression Rating Scale, and were at their first or second depressive episode. The primary outcome was remission of depressive symptoms at 2-months, defined as a HDRS score ≤ 7. Secondary outcome measures were improvement in global functioning and recurrence of depressive symptoms at 12-months. Patients who did not respond to Inter-Personal Counseling or Selective Serotonin Reuptake Inhibitors at 2-months received augmentation with the other treatment.Discussion: This trial addresses some of the shortcomings of existing trials targeting major depression in primary care by evaluating the comparative efficacy of a brief psychological intervention that could be easily disseminated, by including a sample of patients with mild/moderate depression and by using different outcome measures. © 2010 Menchetti et al; licensee BioMed Central Ltd.

Method for the working of woven and non-woven fabrics, yarns, natural, polymeric, and inorganic fibres and films, alcantara and glass, comprising at least one treatment stage with cold plasma, realised using a source of plasma that originates particles that are substantially neutral, wherein said plasma is produced at a pressure approximately the same as the atmospheric pressure.

We present an experimental analysis of an air/methane high voltage discharge at atmospheric pressure which operates in an intermittent spark regime. The aim is to study the feasibility of hydrogen reforming through plasma processing. The structure of the spark and the electrical characteristics of the discharge have been studied as a function of the air/methane mixture composition, the gas flowrate, the average current and the external circuitry resistance. Discharge spectra in visible and near ultraviolet range show the production of several radicals and excited species which provide a clue on the relevant chemical kinetics in the plasma state. Detailed mass analysis of the composition of the exhaust gas flow, shows significant production of hydrogen and high conversion efficiency of methane. The dependence on the discharge operating parameters has been investigated in order to clarify the optimal setup design for an efficient plasma reformer.

A characterization of the device pumping behaviour of our vacuum reactor for plasma treatment of materials at low pressure is presented. The analysis of the pumpdown curves measured both in the viscous and in the molecular regimes was made to study the outgassing flowrates of several leather materials. Estimates of the relevant flowrates in different pressure ranges and measurements of the flow composition have been obtained. Such data can be interpreted in the framework of simplified desorption models and could be used in order to design the pumping system needed for vacuum treatment of such materials. We have also measured other related quantities such as the moisture uptake and the weight loss.

Some selective plasma treatments are described, aiming at modifying specific surface properties of textile polymeric materials, such as their hydrorepellence and dyeability. The prevailing plasma–polymer interactions were identified by correlating the physico-chemical modification of treated polymer surfaces to the characteristics of the plasma sources.

This paper presents the experimental pressure dependence, in the range 1.01 x 10(5)-1.6 x 10(5) Pa, of the I - V characteristic of a N-2 positive corona discharge. The pressure raise is related to the gas flow increase into the chamber where the corona is ignited. Experimental measurements confirm Townsend's I - V characteristic. For a fixed potential difference between the electrodes, corona currents decrease as the gas flow increases (pressure increase): this has been ascribed to a lower ionization rate close to the stressed electrode and a lower charge mobility in the drift region. Both these processes result in a lower current generated by the discharge