The aim of the Italian Multicentre Neuropsychological HIV Study is to assess the prevalence and natural history of cognitive deficit in intravenous drug users (i.v.DUs) during the asymptomatic phase of HIV infection. The study is currently being conducted in four centres (Napoli, Benevento, Verona and Pavia) whose catchment areas are characterized by different levels of prevalence of HIV infection. Cognitive evaluation is being performed by means of a standardized neuropsychological test battery. A total of 251 subjects (167 males and 84 females) have been recruited in the cross-sectional phase of the study, including 75 asymptomatic HIV-seropositive i.v.DUs (HIV+/i.v.DUs), 97 HIV-seronegative i.v.DUs (HIV-/i.v.DUs) and 79 non-i.v.DU seronegative controls matched to i.v.DUs with regard to sex, age and educational level. The prevalence of global cognitive impairment (performance at least 1.5 standard deviations worse than the average of the control group, on at least two out of five tests) was significantly higher in HIV+/i.v.DUs than in either HIV-/i.v.DUs (22.7% vs. 8.2%; P < 0.01) or healthy controls (22.7% vs. 2.5%; P < 0.001). The difference between HIV-/i.v.DUs and healthy controls was not statistically significant (8.2% vs. 2.5%; P = 0.19). The results of this study lend further support to the 'cerebral reserve' model. The cerebral reserve could indeed be reduced in i.v.DUs as a consequence of chronic exposure to the substance of abuse, so that these subjects become more vulnerable to direct and indirect neurotoxic effects of HIV.
Gambling has seen a significant increase in Italy in the last 10 years and has rapidly become a public health issue, and for these reasons the first National Helpline for Problem Gambling (GR-Helpline) has been established. The aims of this study are to describe the GR-Helpline users' characteristics and to compare the prevalence rates of the users with those of moderate-risk/problematic gamblers obtained from the national survey (IPSAD 2010-2011). Statistical analysis was performed on data obtained from the counselling sessions (phone/e-mail/chat) carried out on 5,805 users (57.5% gamblers; 42.5% families/friends). This confirms that the problems related to gambling concern not only the gamblers but also their families and friends. Significant differences were found between gamblers and families/friends involving gender (74% of gamblers were male; 76.9% of families/friends were female), as well as age-classes and geographical area. Female gamblers had a higher mean age (47.3 versus 40.2 years) and preferred nonstrategy-based games. Prevalence rates of GR-Helpline users and of moderate risk/problematic gamblers were correlated (Rho = 0.58; p = 0.0113). The results highlight the fact that remote access to counselling can be an effective means of promoting treatment for problem gamblers who do not otherwise appeal directly for services.
The present study aimed to describe the cognitive status of a group of HIV-positive asymptomatic intravenous drug users (IVDU) and changes which occurred over a 12-month follow-up period. Forty-two HIV positive IVDU were selected and matched for age, sex, educational level and pattern of drug abuse with 39 seronegative IVDU controls. Baseline and follow-up evaluation included neuropsychological tests exploring attention, language, memory, logic and visuomotor abilities, biological markers and clinical parameters. About one-third of both seropositive and seronegative subjects showed at baseline slight cognitive deficits, ' which did not change during the follow-up period.
The present study aimed to describe the cognitive status of a group of HIV-positive asymptomatic intravenous drug users (IVDU) and changes which occurred over a 12-month follow-up period. Forty-two HIV positive IVDU were selected and matched for age, sex, educational level and pattern of drug abuse with 39 seronegative IVDU controls. Baseline and follow-up evaluation included neuropsychological tests exploring attention, language, memory, logic and visuomotor abilities, biological markers and clinical parameters. About one-third of both seropositive and seronegative subjects showed at baseline slight cognitive deficits, which did not change during the follow-up period.
In letteratura (Gainsbury et al., 2014;Pulford et al., 2009) è ampiamente riconosciuto che i giocatori problematici non sempre riconoscono la situazione critica in cui versano, ma sono spesso le persone loro vicine (famigliari, colleghi/datori di lavoro, amici, ecc.) che li inducono a cercare aiuto per risolvere i problemi psicologici e/o legali connessi all'eccesso di gioco. Inoltre, vergogna e timore dello stigma si rivelano spesso ostacoli insormontabili (Suurvali et al., 2009;Hodgins et al., 2012) che impediscono di intraprendere un trattamento formale. Ciò spiega la nascita di nuove tipologie di aiuto professionale (Carlbring et al., 2008) attraverso l'utilizzo del telefono e delle tecnologie informatiche (es. helpline professionali, counselling online, siti web dedicati). Diverse evidenze (Cunningham et al., 2008) mostrano come molti giocatori problematici preferiscano questo tipo di approccio al momento di chiedere aiuto o intraprendere una terapia (Wood & Griffiths, 2007). Tali interventi, meno costosi rispetto alle modalità tradizionali, consentono maggiore copertura geografica e accessibilità a coloro che ricercano privacy, anonimato e flessibilità nella gestione del proprio tempo (Griffiths & Cooper, 2003;Monaghan & Blaszczynski, 2009;Rodda et al., 2013;Titov et al., 2015, Wood & Griffiths, 2007. Tutte queste considerazioni hanno spinto all'introduzione, anche in Italia, di servizi di consulenza e supporto ai giocatori, sia via telefono che online. Nell'ottobre 2009 è nata Giocaresponsabile (d'ora in avanti, GR), la prima helpline nazionale dedicata al gioco problematico e patologico. Ideato dalla Federazione Italiana degli Operatori dei Dipartimenti e dei Servizi delle Dipendenze (FeDerSerD) con il sostegno di alcuni dei concessionari del settore giochi in Italia (Gtech Group/Lottomatica, Sisal, e, successivamente, Codere, Admiral Gaming Network e Cirsa), il servizio è attivo 13 ore al giorno dal lunedì al sabato (9-22) per quanto concerne i contatti telefonici e via chat in tempo reale -le email inviate al sito giocaresponsabile.it vengono evase nell'arco di 24 ore. Il servizio è gestito da psicoterapeuti, che offrono assistenza sia ai giocatori in difficoltà che ai famigliari e altri significativi indirettamente coinvolti. Oltre alla promozione sul web, i materiali relativi al servizio sono stati distribuiti anche negli studi dei medici di famiglia, SAGGI, STUDI E RICERCHE Evidenze preliminari dalla piattaforma terapeutica online Giocaresponsabile. Condizioni socio-economiche e comportamenti di giocoFabio Lucchini*, Maurizio Fea § , Felice Nava°S ummary It is well known that problem gamblers do not always recognize the critical situation they face. Moreover, shame and fear of stigma often represent insurmountable barriers which prevent many problem gamblers from seeking help. In the attempt to lower these barriers, new types of professional help have emerged which are based on the use of telephone and information technology (eg. professional helplines, online counseling, websites). This study aimed...
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