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Silver Spring, MD, United States

Salvatore G.,Center for Metacognitive Interpersonal Therapy | Salvatore G.,Humanitas, Inc. | Ottavi P.,Center for Metacognitive Interpersonal Therapy | Popolo R.,Center for Metacognitive Interpersonal Therapy | Dimaggio G.,Center for Metacognitive Interpersonal Therapy
Journal of Contemporary Psychotherapy | Year: 2016

Auditory verbal hallucinations (AVHs) are perceptive-like experiences happening without appropriate stimuli, occurring in two thirds of schizophrenia patients, where they often cause emotional suffering and dangerous behaviors, and interfere with social relationships. Patients with schizophrenia involving AVHs can also be drug-resistant or they may discontinue medications. The most well-known psychotherapeutic intervention for voice-hearing is cognitive behavioral therapy (CBT), which focuses on reducing distress by modifying hearers’ beliefs about their voices. We hypothesize that it is possible to reinforce the clinical approach to AVHs by taking into consideration (a) that patients generally hear voices in particular interpersonal contexts where they experience negative emotions; (b) the relationship between AVHs and metacognition, namely the ability to make sense of mental states. On this basis, AVHs can be seen not just as a cause of emotional distress as CBT postulates, but the outcome of difficulties in meta-cognitively making sense of interpersonal exchanges. In this paper, we describe the treatment of a young man at the onset of schizophrenia with pervasive negative AVHs. The patient was treated with metacognitive interpersonal therapy (MIT), aimed to promote the patient’s metacognition. With this aim, in the first part of the treatment, each time AVHs emerged, the patient’s level of arousal was high and his metacognitive ability very low, the therapist treated AVHs helping the patient to understand and cope with the emotional suffering connected with AVHs. At a more advanced stage of therapy, the therapist helped the patient reach the point of understanding the social triggers which, together with the patient’s self-schemas, ignited his auditory hallucinations; this created the conditions for a significant reduction of the pervasiveness of AVHs. © 2016 Springer Science+Business Media New York Source

Padua R.,Fondazione Don C. Gnocchi | Padua L.,Fondazione Don C. Gnocchi | Galluzzo M.,San Camillo Hospital | Ceccarelli E.,Anzio Hospital | And 2 more authors.
Musculoskeletal Surgery | Year: 2011

Four-part proximal humeral fractures are frequently treated with shoulder replacement. Outcome of this procedure has not been standardized, and there are controversy data on range of motion (ROM) and active function of the shoulder. The aim of this study is to compare shoulder prosthesis position (SPP) in terms of version of humeral head and height of stem with clinical subjective and objective outcome. Fifty patients were treated with shoulder hemiarthroplasty for four-part proximal humeral fracture or fracture-dislocation of the humeral head. Radiological examination and CT-scan were performed preoperatively and at follow-up. Clinical outcome evaluation included active and passive ROM, and subjective perspective collected through SF-36, OSQ, ASES, and DASH. No significant correlation between stem height and clinical outcome were found. The prosthesis version correlates with all subjective questionnaires. The ROM was not correlated with stem height and prosthesis version. SPP involves clinical outcome, with great relevance of implant version. © 2011 Springer-Verlag. Source

Bellelli G.,University of Milan Bicocca | Bernardini B.,Humanitas, Inc. | Pievani M.,LENITEM Laboratory of Epidemiology | Frisoni G.B.,LENITEM Laboratory of Epidemiology | And 2 more authors.
Rejuvenation Research | Year: 2012

Adverse clinical events (ACEs) are common in post-acute hospital care. We aimed at developing and validating a method, able to be administered in hospital wards, for identifying elderly patients at increased risk of ACEs after transferral to post-acute care (PAC) facilities. This was a prospective observational study, including 502 patients admitted to 19 PAC facilities in northern Italy from July 1st to August 14th, 2009. A standardized form was used to collect data. Variables showing stable association with ACEs in testing group were used to derive the score. The relative risk (RR) of developing ACEs according to the score was measured in the validation group. Age ≥87 years, delirium, pressure sore, indwelling bladder catheter, malnutrition, and acute infection on admission were identified as stable ACE predictors. A score of 1 was assigned to each predictor. Subjects were classified as having low (score=0), medium-low (score=1), medium-high (score=2-3), or high (score≥4) risk of ACEs. The RR of developing ≥1 ACE increased progressively from low (RR=1) to medium-low (RR=1.5, 95% confidence interval [CI] 1.1-1.9), medium-high (RR=1.6, 95% CI 1.3-2.1), and high (RR=1.8, 95% CI 1.4-2.3) risk score. The RR of being not discharged to home increased monotonically from 1.0 in low-risk to 2.7 in high-risk groups. In conclusion, this study proposes a method, able to be administered in hospital wards, for identifying patients at increased risk of ACEs after transferral to PAC. The score might also be used to identify people who will not return to home after PAC discharge. © Copyright 2012, Mary Ann Liebert, Inc. Source

Agency: Department of Agriculture | Branch: | Program: SBIR | Phase: Phase I | Award Amount: 90.00K | Year: 2010

The poor nutrition habits of Americans are as well documented as the myriad attempts to reverse this course by health practitioners and researchers. The breadth of nutrition knowledge is increasing along with our waistlines. USDA researchers collected data from MEDLINE, a database of medical journal articles. They found that the annual number of journal articles that link fats and cholesterol to heart disease grew from 13 in 1965 to 82 in 1996. By 1997, there were 1,543 studies that linked fat and cholesterol to heart disease (Variyam & Golan, 2002). Since the mid 1970s, the government has released a multitude of nutrition education programs including Dietary Goals for the United States (1977), Hassle-Free Guide to a Better Diet (1977), Dietary Guidelines for Americans (1980 and every five years thereafter), The National Cancer Institutes's 5-a-Day for Better Health (1991), and the USDA/DHHS Food Guide Pyramid/ MyPyramid (1992, 2005). Additionally, health messages have been communicated through Nutrition Facts Labels (Nutrition Labeling and Education Act of 1994), product health claims, and popular media (Variyam & Golan, 2002). While there is an abundance of information and easy access to information resources, there appears to be little success in stemming the tide against an overweight America. This study is designed to look at new ways to communicate nutritional information to clients and to help those clients set better nutritional goals. Motivational Interviewing (MI) began as a technique to help individuals with substance abuse addiction. The idea is to have the counselor engage the client in a nonjudgmental way in order to set realistic goals and to build an activity path towards meeting those goals. The success in the substance abuse field was significant. The technique has now made its way to nutritionists and health educators. However training opportunities in Motivational Interviewing techniques for this audience are scattered and offered mainly in a face-to-face format, making it difficult for the busy professional to participate. An online interactive source might increase the use of motivational interviewing in the nutrition field. This study aims to explore the common body of knowledge shared by health educators interested in nutrition; recognize how motivational interviewing can be used as a tool to help clients; and determine the feasibility of moving the process of educating nutritionists on MI to a format utilizing interactive technology. Specific technical objectives include: 1) Identifying and documenting the types of information used by nutrition educators in conducting conversations with clients via motivational interview techniques; 2) Identifying and documenting the responses presented by clients to educators utilizing motivational interviewing techniques to learn about dietary habits and to analyze and categorize the meaning of the responses; 3) Determining whether a pattern exists in the formulation of questions posed by nutrition educators, based on clients' response; and 4) Determining whether an interactive tool can be created that emulates both sides of the conversation.


Agency: Department of Health and Human Services | Branch: | Program: SBIR | Phase: Phase I | Award Amount: 120.80K | Year: 2001

DESCRIPTION (provided by applicant): Meeting time consuming data collection and reporting requirements is a disincentive for even the most dedicated health professional to promote patient participation in clinical trials. Trial participants at all levels-from the health provider's facility to the trial organizer and ultimately the trial funder-experience time delays in receiving data about trial results. Sponsors' ability to rapidly analyze trial data is further hampered when data are not reported in usable formats, To address these dilemmas, we will develop a handheld web-based system to help health professionals streamline and standardize their collection and reporting of cancer clinical trials data to institutions and collaborating organizations. This project will develop a prototype system for (1) bundling reporting forms for a selected type of cancer on a handheld device; (2) transmitting the completed forms via a wireless connection from the handheld device to a dedicated web site; and (3) storing the data for uploading to institutions and collaborating organizations in formats that comply with HL7 and NCI standards. PROPOSED COMMERCIAL APPLICATION: Develop a handheld web-based system for use by health professionals to streamline and standardize collection and reporting of cancer clinical trials data to institutions and collaborating organizations.

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