Biomedical subjects

Giovanni Salvi

Publications and source records attributed to Giovanni Salvi.

8 recordsLinked to original sources

PubMed2006

Satisfaction with community and hospital-based emergency services amongst severely mentally ill service users: a comparison study in South-Verona and South-London.

OBJECTIVE: This study compares the satisfaction with emergency interventions among severely mentally ill (SMI) service users of a community-based and a hospital-based mental health service (South-Verona, Italy and Nunhead, South-London, UK). METHODS: A measurement of the satisfaction with psychiatric emergency services was conducted among all those users in the two catchment areas who, in a 1-year period: (1) had at least two contacts with the service; (2) had a diagnosis of psychosis according to ICD10; (3) had not been living in hospital or sheltered apartment for most of the time. These users completed seven items belonging to the Verona Service Satisfaction Scale (VSSS) regarding their satisfaction with crisis response during and out of office hours and their satisfaction with the different interventions, which may be provided during emergencies, such as consultation for the user, consultation for the relative, day-centre attendance, informal and compulsory admission. RESULTS: Users in South-Verona were generally more satisfied with emergency interventions. The main differences between the two samples were due to contacts outside the hospital setting, whilst satisfaction scores for informal admission were similar. The number of users who did not receive, but would have liked, different types of emergency intervention was smaller in South-Verona than in Nunhead. In South-Verona, users wishes mainly concerned consultation for the relatives during emergencies; in the Nunhead sample, the most requested types of intervention were consultation for the user and the possibility of day-centre attendance during crisis. CONCLUSIONS: The findings suggest that users of a service with a well developed community-oriented approach and with crisis intervention outside the hospital setting are more satisfied of the emergency interventions than users of a mental health service relying mostly on hospital facilities during emergencies.

Adult↗

PubMed2005

Effective interactions between chaotropic agents and proteins.

Chaotropic agents are cosolutes that can disrupt the hydrogen bonding network between water molecules and reduce the stability of the native state of proteins by weakening the hydrophobic effect. In this work, we represent the chaotropic agent as a factor that reduces the amount of order in the structures formed by water molecules, both in the bulk and the hydration shells around hydrophobic amino acids. In this framework we show that low chaotrope concentrations lead to a destabilization of the native state of proteins, and that high concentrations induce complete denaturation. We also find that the reduction of the number of bulk ordered states of water molecules can give origin to an effective interaction between chaotropic molecules and proteins.

Entropy↗

PubMed2005

Listening to patients' needs to improve their subjective quality of life.

BACKGROUND: Subjective quality of life has gained a crucial role as a global measure of outcome in mental health care. This study aimed to investigate the impact of meeting needs for care, as assessed by both patients and mental health professionals, to improve the subjective quality of life in a sample of patients receiving community-based psychiatric care. METHOD: The study was conducted using a 4-year prospective longitudinal design. A cohort of patients from the South-Verona Community-based Mental Health Service (CMHS) was assessed at baseline and follow-up using, among other social and clinical measures, the Camberwell Assessment of Need (both staff and patient versions) and the Lancashire Quality of Life Profile. Predictors of changes of subjective quality of life were explored using block-stratified multiple regression procedures. RESULTS: Improvement in patients' clinical conditions as well as the reduction in patient-rated unmet needs in the social domain predicted an increase in subjective quality of life over 4 years; changes in staff-rated needs did not show any association with changes in subjective quality of life. CONCLUSIONS: Meeting self-perceived social needs, beyond symptoms reduction, seems to be of particular importance for ensuring a better quality of life for people with mental disorders. If the main goal of mental health care is to improve the quality of life of users, a policy of actively addressing patient-rated needs should be implemented.

Community Mental Health Services↗

PubMed2005

Technical and biological complications/failures with single crowns and fixed partial dentures on implants: a 10-year prospective cohort study.

OBJECTIVES: To assess prospectively over 10 years the incidences of technical and/or biological complications and failures occurring in a cohort of consecutive partially edentulous patients with fixed reconstructions on implants of the ITI Dental Implant System. METHODS: Eighty-nine patients were available, 34 (38.2%) were male, 55 (61.8%) were female. At the 10-year examination (range 8-12 years), they were 58.9 years old (range 28-88 years). RESULTS: Single crowns (SC): 48 patients had been restored with 69 SC on 69 implants. Five of the implants with the crowns were lost because of biological failures. Two crowns (2.9%) were remade because of technical failures. Total failure amounted to seven (10%). Implant borne fixed partial dentures (I-I FPD): In 29 patients who had been restored with 33 implant borne suprastructures, the total number of failed I-I FPD was 2 (6.1%). Tooth-implant borne fixed partial dentures (I-T FPD): In 21 patients, 22 mixed tooth-implant borne reconstructions were constructed. The number of failed FPD reached 7 (31.8%). Statistically significantly fewer biological failures occurred with I-I FPD compared with the I-T FPDs (ANOVA, Bonferroni, P=0.022). The I-T FPDs experienced statistically significantly more frequent technical failures compared with the other two groups of suprastructures (P=0.003, 0.031). Consequences of complications: The occurrence of loss of retention as a complication increased the odds ratio (OR) to 17.6 (P<0.001) to end up in a technical failure. Similarly, the event of a porcelain fracture increased the OR for the suprastructure to be a failure at 10 years to 11.0 (P< or =0.004). Treatment of periimplantitis increased the OR to 5.44 (P< or =0.011) to result in a biological failure compared with implants in which this type of treatment was not applied. CONCLUSION: The three groups of suprastructures demonstrated marked differences in their patterns of failures and complications. Complications increased the risk for failure. Support by CRF, University of Berne, Switzerland.

Adult↗

PubMed2005

Routine use of mental health outcome assessments: choosing the measure.

BACKGROUND: There is little consensus about which outcome measures to use in mental healthcare. AIMS: To investigate the relationship between the items in four staff-rated measures recommended for routine use. METHOD: Correlation analysis of total scores and factor analysis using combined data from the Health of the Nation Outcome Scales (HoNOS). The Camberwell Assessment of Need Short Appraisal Schedule (CANSAS), the Threshold Assessment Grid (TAG) and the Global Assessment of Functioning (GAF) were performed. Procrustes analysis on factors and scales, and Ward's cluster analysis to group the items, were applied. RESULTS: The total scores of the measures were moderately correlated. The Procrustes analysis, factor analysis and cluster analysis all agreed on better coverage of the patients' problems by HoNOS and CANSAS. CONCLUSIONS: A global severity factor accounts for 16% of the variance, and is best measured with TAG or GAF. The CANSAS and HoNOS each provide a detailed characterisation of the patient; only CANSAS provides information about met needs.

Adult↗

PubMed2005

Changes and predictors of change in objective and subjective quality of life: multiwave follow-up study in community psychiatric practice.

BACKGROUND: There is little knowledge of the predictors of objective and subjective quality of life. AIMS: To describe changes at 2 and 6 years in objective and subjective quality of life in 261 individuals attending a community mental health service and to identify predictors of change in each life domain. METHOD: Prospective study of demographic, diagnostic and service utilisation characteristics, psychopathology, functioning, disability, self-esteem, affect balance and service satisfaction. RESULTS: Female gender, unmarried status, older age, less education and greater disability predicted a worsening of objective quality of life over time, but explain a small amount of variance. The variance in subjective quality of life was higher (>40%). Greater clinician-rated anxiety and depressive symptoms had a negative effect on satisfaction with health and general well-being. Psychological status, self-esteem and satisfaction with service were the most important predictors in almost all subjective domains; these variables should be important targets for treatment. CONCLUSIONS: This study is the first to provide information to enable clinicians to make prognostic judgements about quality of life and plan effective therapeutic strategies to improve quality of life.

Adult↗

PubMedDate not supplied

[Quality of mental health services: a self audit in the South Verona mental health service].

AIMS: To start a process of Continuous Quality Improvement (CQI) in an Italian Community Mental Health Service by using a quality assurance questionnaire in a self audit exercise. METHODS: The questionnaire was administered to 14 key workers and clinical managers with different roles and seniority. One senior manager's evaluation was used as a benchmark for all the others. Changes were introduced in the service practice according to what emerged from the evaluation. Meetings were scheduled to monitor those changes and renew the CQI process. RESULTS: There was a wide difference in the key workers' answers. Overall, the senior manager's evaluation was on the 60th percentile of the distribution of the other evaluations. Those areas that required prompt intervention were risk management, personnel development, and CQI. The CQI process was followed up for one year: some interventions were carried out to change the practice of the service. CONCLUSIONS: A self audit exercise in Community Mental Health Services was both feasible and useful. The CQI process was easier to start than to carry on over the long term.

Catchment Area, Health↗

PubMedDate not supplied

[Systematic review of the role of service users as researchers in mental health studies].

AIMS: Service user involvement in mental health service development and research is becoming more common in countries like the UK, USA and Canada. This systematic review of the international scientific literature has been carried out to assess the stage of development of mental health service users involvement in research. METHOD: Systematic review of any research project actively involving service users in any part of the research process. RESULTS: Thirty-five studies met the inclusion and exclusion criteria and were included in the systematic review. Nine studies used quantitative techniques, 24 used qualitative techniques and two studies used both quantitative and qualitative techniques. While three studies were user-led, in three other studies the users were simply consulted but did not have any active role in the research. The remaining 29 studies were based on a collaboration between service users and professional researchers. CONCLUSIONS: The involvement of mental health service users in the research process is feasible both in quantitative and qualitative research studies. The involvement of service users in research has a number of benefits; such research requires more accurate planning and more time than the traditional research.

Biomedical Research↗