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In the last decades, psychiatric training has undergone a major transformation due to the contribution of recent scientific developments in psychiatry. Nowadays, the information acquired during the Psychiatric training seems considerably variable in content and quality between different countries. However, data concerning access to information and also about the educational resources available to the trainees in Europe is very limited.
Objectives and aims
The ATIIPT survey aimed to evaluate Psychiatric trainees’ access to published, online, senior's or industry's information in Europe.
A short paper questionnaire constituted of 7 questions (Appendix 1) was created by the members of the EFPT Research Working Group and passed to each delegate of the 32 countries represented at the 19th EFPT Forum in Prague, Czech Republic, on the 2nd of July 2011.
According to the ATIIPT results, access to information among Psychiatric trainees in Europe is heterogeneous. The most available resources are books and websites, and the most preferable resource is journals. Most of the trainees find their resources sufficient, with the main obstacles being related to low availability of journals and books, lack of time and help from seniors.
Better access to information and more evidence in practice is warranted, since the introduction of novel approaches to access to information may create better psychiatrists in the future, encourage medical students to consider psychiatry as a potential career, and help reduce negative attitudes towards mental illness.
The influence of pharmaceutical industry (PI) on clinical practice and research in psychiatry has been considered a serious problem. Strict rules and guidelines were developed to regulate the interactions between doctors and PI. However, there is an ongoing debate whether these were thoroughly implemented in practice and internalized by physicians. The objective of our study was to assess the attitudes and behaviors of trainees in psychiatry and child & adolescent psychiatry toward PI across Europe. Methodologically, a validated questionnaire with additional items was administered to1444 trainees in 20 European countries. The minimum response rate was set at 60%. We found a high variation across countries in number of interactions between trainees and PI representatives; Portugal and Turkey had the highest number of interactions. The majority (59.76%) agreed that interactions with PI representatives have an impact on physicians’ prescribing behavior; whereas only 29.26% and 19.79% agreed interactions with PI representatives and gifts from PI have impact on their own prescribing behavior, respectively. Most of the gifts were considered appropriate by the majority, except tickets to vacation spot and social dinner at a restaurant. Of the sample, 70.76% think they have not been given sufficient training regarding how to interact with PI representatives. Only less than 20% indicated they have guidelines at institutional or national level. In conclusion, there is substantial interaction between trainees and PI across countries. The majority feel inadequately trained regarding professional interaction with PI, and believes they are immune to the influence of PI.
The concept of the “social network” (SN) describes the set of social relationships of an individual. SNs of patients with psychotic disorders have often been investigated in the last few decades, however, diverse theories and different assessment methods were utilised within this field of research.
To assess morphological (size, density, degree) and interactional (direction and intensity) characteristics of SNs of patients with psychotic disorders reported in different studies.
To explore the characteristics of the SNs of psychotic patients and to identify the factors that influence their size and composition.
A systematic literature review was carried out using the databases MEDLINE, PsychInfo and EMBASE. When feasible, the characteristics of SNs were compared across studies.
Out of 739 identified studies, 142 reported quantitative findings on SN characteristics. 27 (19%) of them reported figures on the size of SNs in a way that allowed meaningful comparison across studies. For all other SN characteristics, only descriptive accounts were possible. The overall mean network size was 15.2 (SD 9.4). Being single was negatively correlated with SN size.
The concept of SNs in psychotic disorders has been underpinned by diverse theoretical frameworks and assessed with a variety of tools. Only a small number of studies were methodologically comparable, which makes findings on SN characteristics and associated factors difficult to interpret. There is a need to develop standardised instruments in order to advance the quality of the research in the field.
Gender identity disorder (GID) is defined as a strong and persisting cross-gender identification, associated to the discomfort with the biological sex with which subjects were born. Over the last years, the question whether GID really represents a true psychiatric disorder and if it should be included within the upcoming editions of the major diagnostic psychiatric systems or not is generating growing controversies.
Although GID represents a major challenge for the whole medical community, involves different specialists and posits relevant treatment issues, the scientific literature concerning the psychological and clinical characteristics of GID is still limited and further studies are needed in the field.
The present research is aimed to explore the psychological, personality and clinical profile of subjects with DIG.
To this aim, 100 consecutive adult patients with a standardized DSM-IV-TR diagnosis of GID, were recruited from those attending the dedicated day-care facilities of the Department of Psychiatry of the University of Bari. All included subjects underwent a psychopathological evaluation including general psychopathology (SCL-90), personality traits (MMPI-2), anxiety and depression (Zung scales for anxiety and depression, respectively) self-rated assessment.
Preliminary analyses confirmed that GID subjects did not show pathological personality traits and did not reach standardized cut-off scores for anxiety, depression, or any other general psychopathological item.
These results are in line with recent findings on the topic and support the notion that transexualism, although possibly causing negative feelings and psychological distress, might be not considered a psychiatric disorder.
Interactions between the pharmaceutical industry (PI) and psychiatrists have been under scrutiny recently, though there is little empirical evidence on the nature of the relationship and its intensity at psychiatry trainee level. We therefore studied the level of PI interactions and the underlying beliefs and attitudes in a large sample of European psychiatric trainees.
One thousand four hundred and forty-four psychiatric trainees in 20 European countries were assessed cross-sectionally, with a 62-item questionnaire.
The total number of PI interactions in the preceding two months varied between countries, with least interactions in The Netherlands (M (Mean) = 0.92, SD = 1.44, range = 0–12) and most in Portugal (M = 19.06, SD = 17.44, range = 0–100). Trainees were more likely to believe that PI interactions have no impact on their own prescribing behaviour than that of other physicians (M = 3.30, SD = 1.26 vs. M = 2.39, SD = 1.06 on a 5-point Likert scale: 1 “completely disagree” to 5 “completely agree”). Assigning an educational role to the pharmaceutical industry was associated with more interactions and higher gift value (IRR (incidence rate ratio) = 1.21, 95%CI = 1.12–1.30 and OR = 1.18, 95%CI = 1.02–1.37).
There are frequent interactions between European psychiatric trainees and the PI, with significant variation between countries. We identified several factors affecting this interaction, including attribution of an educational role to the PI. Creating alternative educational opportunities and specific training dedicated to PI interactions may therefore help to reduce the impact of the PI on psychiatric training.
The scales for the assessment of depressive symptoms, translated and validated in Italian, lacks in the recognition of the psychopathological nuances of the disorder. The Bipolar Depression Rating Scale (BDRS) is a tool specifically built to reflect the characteristics of bipolar depression.
- aged 18–65 years
- diagnosis of BD (DSM-IV-TR) (125 patients) or
- diagnosis of MDD (DSM-IV-TR) (30 patients)
- manifestation of depressive symptoms
- no further psychiatric comorbidity on axis I and axis II (including abuse/addiction)
The analysis of the BDRS scores, according to the Kolmogorov-Smimov method shows a normal distribution; the α Cronbach's coefficient shows that the the scale, in its Italian version, has considerable validity and reliability (r = 0.82). The factor analysis was verified using the Varimax rotational method: after several tests, we found 2 subscales, one linked to mixed/depressive symptoms and a second related to (hypo)manic symptoms.
The BDRS is a valid scale for the measurement of depression in patients with Bipolar Disorder, with a notable internal consistency (Cronbach α 0.82), a significant consistency between items/total (Cronbach α from 0.80 to 0.82) and positive correlation with other scales (MADRS r 0.67, p < 0.001; HAM-D r 0.81, p < 0.001; YMRS r 0.46 p < 0.0001), including the Young Mania Rating Scale (better than the original validation sample Berk et al., 2007).
There is a shortage of psychiatrists worldwide. Within Europe, psychiatric trainees can move between countries, which increases the problem in some countries and alleviates it in others. However, little is known about the reasons psychiatric trainees move to another country.
Survey of psychiatric trainees in 33 European countries, exploring how frequently psychiatric trainees have migrated or want to migrate, their reasons to stay and leave the country, and the countries where they come from and where they move to. A 61-item self-report questionnaire was developed, covering questions about their demographics, experiences of short-term mobility (from 3 months up to 1 year), experiences of long-term migration (of more than 1 year) and their attitudes towards migration.
A total of 2281 psychiatric trainees in Europe participated in the survey, of which 72.0% have ‘ever’ considered to move to a different country in their future, 53.5% were considering it ‘now’, at the time of the survey, and 13.3% had already moved country. For these immigrant trainees, academic was the main reason they gave to move from their country of origin. For all trainees, the overall main reason for which they would leave was financial (34.4%), especially in those with lower (<500€) incomes (58.1%), whereas in those with higher (>2500€) incomes, personal reasons were paramount (44.5%).
A high number of psychiatric trainees considered moving to another country, and their motivation largely reflects the substantial salary differences. These findings suggest tackling financial conditions and academic opportunities.
The increased use of the MATRICS Consensus Cognitive Battery (MCCB) to investigate cognitive dysfunctions in schizophrenia fostered interest in its sensitivity in the context of family studies. As various measures of the same cognitive domains may have different power to distinguish between unaffected relatives of patients and controls, the relative sensitivity of MCCB tests for relative–control differences has to be established. We compared MCCB scores of 852 outpatients with schizophrenia (SCZ) with those of 342 unaffected relatives (REL) and a normative Italian sample of 774 healthy subjects (HCS). We examined familial aggregation of cognitive impairment by investigating within-family prediction of MCCB scores based on probands’ scores.
Multivariate analysis of variance was used to analyze group differences in adjusted MCCB scores. Weighted least-squares analysis was used to investigate whether probands’ MCCB scores predicted REL neurocognitive performance.
SCZ were significantly impaired on all MCCB domains. REL had intermediate scores between SCZ and HCS, showing a similar pattern of impairment, except for social cognition. Proband's scores significantly predicted REL MCCB scores on all domains except for visual learning.
In a large sample of stable patients with schizophrenia, living in the community, and in their unaffected relatives, MCCB demonstrated sensitivity to cognitive deficits in both groups. Our findings of significant within-family prediction of MCCB scores might reflect disease-related genetic or environmental factors.
The chemical composition of soil from the Glasgow (UK) urban area was used to identify the controls on the availability of potentially harmful elements (PHEs) in soil to humans. Total and bioaccessible concentrations of arsenic (As), chromium (Cr) and lead (Pb) in 27 soil samples, collected from different land uses, were coupled to information on their solid-phase partitioning derived from sequential extraction data. The total element concentrations in the soils were in the range <0.1–135mgkg–1 for As; 65–3680mgkg–1 for Cr and 126–2160mgkg–1 for Pb, with bioaccessible concentrations averaging 27, 5 and 27% of the total values, respectively. Land use does not appear to be a predictor of contamination; however, the history of the contamination is critically important. The Chemometric Identification of Substrates and Element Distribution (CISED) sequential chemical extraction and associated self-modelling mixture resolution analysis identified three sample groupings and 16 geochemically distinct phases (substrates). These were related to iron (n=3), aluminium–silicon (Al–Si; n=2), calcium (n=3), phosphorus (n=1), magnesium (Mg; n=3), manganese (n=1) and easily extractable (n=3), which was predominantly made up of sodium and sulphur. As, Cr and Pb were respectively found in 9, 10 and 12 of the identified phases, with bioaccessible As predominantly associated with easily extractable phases, bioaccessible Cr with the Mg-dominated phases and bioaccessible Pb with both the Mg-dominated and Al–Si phases. Using a combination of the Unified Barge Method to measure the bioaccessibility of PHEs and CISED to identify the geochemical sources has allowed a much better understanding of the complexity of PHE mobility in the Glasgow urban environment. This approach can be applied to other urban environments and cases of soil contamination, and made part of land-use planning.
A sensitivity study is presented here on a compact hybrid postacceleration scheme coupling laser-generated protons to a high frequency Linac based on the use of a SCDTL (Side Coupled Drift Tube Linac) structure. The study analyzes the main laser-generated beam characteristics and the most important parameters linked to the accelerating structure. We show that the required tolerances regarding alignment and field uniformity, although challenging, are within the reach of actual technology. Regarding the laser-generated proton beam parameters (spot size and divergence), we show that they have only a little influence on the final emittance that is mainly determined by the capturing and accelerating structure. However, these parameters can sensitively affect the final transmission of the proton beam current.
Multiple XMM–Newton observations of the mini-BAL QSOs PG 1351+640 and PG 1126–041 revealed dramatic and complex spectral variability on different timescales, providing clues about the physical mechanism responsible for outflows in quasars.
The ESA observatory INTEGRAL (International Gamma-Ray Astrophysics Laboratory) is dedicated to fine imaging and spectroscopy in the energy range 15 keV to 10 Mev with concurrent X-ray (3-35 keV) and optical monitoring. It was launched on October 17, 2002 and has been succesfully operating ever since. Its two main instruments the spectrometer SPI – optimized for high resolution spectroscopy – and the imager IBIS – optimized for for high resolution imaging – are complemented by the X-ray monitor JEM-X and the optical monitor OMC. All the high energy instruments use coded mask techniques, allowing imaging in the gamma-ray range and combining wide fields of view with high spatial resolution. The presentation gives an overview of the unique properties of INTEGRAL.
Foodborne transmission is estimated to account for 95% of non-typhoidal Salmonella infections reported in the United States; however, outbreaks of salmonellosis are rarely traced to food handlers. In August 2000, an increase in Salmonella serotype Thompson infection was noted in Southern California; most of the cases reported eating at a restaurant chain (Chain A) before illness onset. A case-control study implicated the consumption of burgers at Chain A restaurants. The earliest onset of illness was in a burger bun packer at Bakery B who had not eaten at Chain A but had worked while ill. Bakery B supplied burger buns to some Chain A restaurants in Southern California and Arizona. This outbreak is notable for implicating a food handler as the source of food contamination and for involving bread, a very unusual outbreak vehicle for Salmonella. Inadequate food-handler training as well as delayed reporting to the health department contributed to this outbreak.
Layer-by-layer films incorporating single-wall carbon nanotubes (SWNTs) with anionic or cationic coatings have been prepared. The process of self-assembly was monitored using the quartz microbalance technique, while the morphology of the resulting thin layers was studied with atomic force microscopy. A variety of different architectures have been built up. The dc conductivities of the thin films, in-plane and out-of-plane, were measured at room temperature and contrasted with reference architectures. The results show clearly that the incorporation of SWNTs into the multilayers resulted in electrically conductive thin films.
SPARC and SPARX are two different initiatives toward an Italian
Free Electron Laser (FEL) source
operating in the Self Amplified Spontaneous
Emission (SASE) mode, in which several national
research institutions are involved. SPARC is a high gain FEL project
devoted to provide a source of visible and VUV radiation while
exploiting the SASE mechanism. An advanced Photo-Injector system,
emittance compensating RF-gun plus a 150 MeV Linac, will inject a high
quality e-beam into the undulator to generate high brilliance FEL
radiation in the visible region at the fundamental wavelength,
(∼500 nm). The production of flat top drive laser beams, high peak
current bunches, and emittance compensation scheme will be investigated
together with the generation of higher harmonic radiation in the VUV
region. SPARX is the direct evolution of such a high gain SASE FEL
toward the 13.5 and 1.5 nm operating wavelengths, at 2.5 GeV. To get
the required value for the bunch peak current, Ipeak ≈
2.5 kA, the “hybrid” scheme, RF-compression stage plus
magnetic chicane, is analyzed and compared with the more standard
double stage of magnetic compression. The two options are reviewed
considering the tolerance to the drive laser pulse phase jitter.
A systematic study of 30 Radio Loud AGNs available in the BeppoSAX archive has been carried out. The sample consists of 9 Broad Line radio Galaxies, 5 Steep Spectrum Radio Quasars and 16 Flat Spectrum Radio Quasars. These objects represent, according to Unified Models, objects with decreasing viewing angles. Our analysis shows considerable differences between FSRQs and BLRGs'SSRQS. As expected in the AGN Unified Model: i) the X-Ray spectrum of FSRQs is a simple power law with a hard spectral slope (the only exception being 3C273), ii) Broad Line and Steep Radio Spectrum AGNs show a steeper X-Ray continuum and Seyfert like features. We also find that the Fe line is weaker than in radio quiet objects. However no strong evidence emerges that a jet contamination may be the main responsible for the EW shrinking in BLRGs and SSRQs. Recent XMM-Newton observations of Pictor A, 3C445 and PKS 2152-69 confirm the nuclear BeppoSAX results and better constrain the Fe line parameters.To search for other articles by the author(s) go to: http://adsabs.harvard.edu/abstract_service.html
Intensive research is currently underway to exploit the intriguing optical and electronic behaviour of nano-sized particles. The basis of the unique properties of these particles is the smallness of their size; dimensions on the nanometre scale can result in interesting quantum mechanical phenomena, such as Coulomb blockade. There are currently a number of ways by which the nanoparticles can be deposited onto solid substrates. Here, we report on the use of the layer-by-layer electrostatic method, which has shown much promise in the context of deposition of thin films of certain organic materials. In this technique, layers of oppositely charged materials are generated by dipping an appropriate substrate into solutions of polyelectrolytes. For example, the polybases poly(ethyleneimine) (PEI), when adsorbed on a substrate, produce a positively charged surface. We have deposited carboxylic acid (-COOH) derivatised gold nanoparticles onto a PEI-coated silicon substrate and an amine funtionalised silicon substrate. The distribution of the gold nanoparticles was compared using atomic force microscopy.