Gabriella Martino

Continuous apomorphine infusion and neuropsychiatric disorders: a controlled study in patients with advanced Parkinson's disease.

Abstract.The aim of this study was to asses whether patients with Parkinson’s disease (PD) develop cognitive and psychiatric complications more frequently during prolonged therapy with continuous apomorphine infusion compared with standard oral treatment. Thirty consecutive PD patients with severe motor fluctuations were included in the study. Twelve patients accepted the treatment with subcutaneous continuous apomorphine infusion, while the remaining 18 preferred to continue with oral dopaminergic therapy. The two groups were evaluated with neuropsychological, psychiatric, and motor tests at baseline and after 1 year. The off daily duration and the levodopa dosage were significantly reduced in infused patients. The neuropsychiatric assessment did not change in both groups compared with baseline, except for a significant improvement of mood in the apomorphine group.

Pain in Osteoporosis: From Pathophysiology to Therapeutic Approach

The high worldwide prevalence of osteoporosis means it is considered a serious public health concern, possibly leading to physical disability and an increased mortality rate. Although osteoporosis is known as a silent disease affecting aging populations, its primary symptom remains pain. Acute pain is reported by patients with osteoporosis-related fractures, but chronic pain, mainly back pain, is also a characteristic of severe osteoporosis. Pain is associated not only with fractures but also with bodily changes in patients with osteoporosis that may include sensory, affective, and cognitive aspects. Chronic pain leads to progressive loss of independence and the need for long-term care, especially in the elderly. Pain prevention is linked to the appropriate treatment of osteoporosis, and pain management in patients with osteoporosis requires a multidimensional approach to preserve and improve quality of life. Our aim was to review and discuss the main causes of pain in patients with osteoporosis and suggest possible strategies for its management and prevention.

What happened to the clinical approach to case study in psychological research? A clinical psychological analysis of scientific articles in high impact-factor journals

The paper aims at investigating the incidence of case studies in high impact factor psychological journals and at creating a paradigm model which may conceptualize and explain the different uses and purposes of case study as research method. Overall, 6,393 articles from 16 psychological journals published in the 5-year period 2007-2011 were examined. Results show the low incidence of case studies (n=16) equal to about 0.25% out of the total. In addition, grounded theory allows the detection of two main thematic area: neuroscience and psychosocial risk. In neuroscientific research, case study seems mainly to serve as critical case in testing well-formulated theories. Instead, with regard to psychosocial risk, case study is regarded as useful for psychological intervention in both exceptional events management and best practices-related innovation in atypical fields.

Vitamin D status is associated with anxiety levels in postmenopausal women evaluated for osteoporosis

Vitamin D status has been previously associated with a wide range of acute and chronic diseases. The nervous system express vitamin D receptors and thus vitamin D may be involved in mental health. Poor data exist about the correlation between vitamin D and anxiety levels. Our aim was to investigate the association of vitamin D status with anxiety severity. A group of 177 postmenopausal women (mean age 65.5±8.22 yr.) referring to an outpatients clinic for the prevention of osteoporosis were evaluated. Severity of perceived anxiety symptoms was measured by the Hamilton Anxiety rating scale (HAMA). Depression levels were also evaluated using the Beck Depression Inventory-second edition scale (BDI-II). 25(OH)D serum levels, indicative of vitamin D status, were detected by high-performance liquid chromatography. 25(OH)D levels were significantly related HAMA-score (r=-0.15, p=0.04); particularly a deep association was observed between 25(OH)D levels and somatic symptoms (r=-0.195, p=0.009). HAMA score was associated with BDI-II score (r=0.487, p=<0.001); HAMA psychic symptom score was also related with age and time since menopause (r=0.149, p=0.039 and r=0.222, p=0.003, respectively). At a multiple regression analysis, after correcting for age and depression levels, 25(OH)D was predictive of HAMA score (β =-0,05961, p= 0.02, SE=-2.206), but the strength of association was lost further correcting for time since menopause. In conclusion, in a setting of postmenopausal women, we observed a significant association between anxiety levels and serum 25(OH)D concentrations irrespective of age and depression levels.

Promoting the development of children with disabilities through school inclusion: clinical psychology in supporting teachers in Mozambique

This article presents an intervention study developed within an international cooperation program, and aimed at promoting the school inclusion of children with disabilities in Mozambique. To avoid the risk of exporting models from a local context to another, and in order to favour a sustainable social change, a participatory and ecological framework was adopted. The main aim of the Participatory Action Research (PAR) carried out was to explore teachers’ views and beliefs concerning disability and inclusion, and determine best practices to fully include students with disabilities. The paper illustrates the overall outcomes of a participatory research development process, and the results achieved in each phase. The final purpose is to increase the knowledge on school inclusion of children with disabilities in the Global South. Potentials and challenges of using clinical psychological, ecological and collaborative paradigms to address issues concerning health promotion and development of children with disabilities and local development are also discussed.