Assessment of the Capacity to Express Informed Consent for Organ Donation in Patients with Schizophrenia

Abstract: In Italy, the “silent‐consent” principle of donor’s willingness regulates organ donation for postmortem transplantation, but civil incompetence excludes it. We investigated decisional capacity for organ donation for transplantation of 30 controls and 30 nonincompetent patients with schizophrenia as related to clinical symptoms, cognition, and functioning. Assessments were carried out through the Competence for Donation Assessment Scale (CDAS), Brief Psychiatric Rating Scale (BPRS), Scale for the Assessment of Positive Symptoms (SAPS), Scale for the Assessment of Negative Symptoms, Life Skills Profile (LSP), Raven’s Colored Progressive Matrices (RCPM), Wisconsin Card Sorting Test, Rey RI, Rey RD, and Visual Search. Patients and controls differed on the CDAS Understanding and Choice Expression areas. Patients showed significant inverse bivariate correlations between CDAS Understanding and scores on total BPRS, LSP self‐care scale, and RCPM cognitive test. Our results show that decisional capacity for participating in research does not predict decisional capacity for postmortem organ donation in patients with schizophrenic or schizoaffective psychosis; hence, before judging consent for donation, patients must be provided with enhanced information to better understand this delicate issue.     

Low blood alcohol levels. Experimental study on attention and body sway control functions

Objective

Attempting to prevent alcohol-related road accidents requires sensitive, reliable and easy-to-use methods and instruments for ascertaining drivers’ state of intoxication. This paper examines the scientific validity of a method for assessing psychomotor performance combining measurement of neurosensory functions with the effect of low blood alcohol levels: body sway control and attention functions.

Methods

A double-blind, placebo-controlled study, with cross-over and random distribution on the effects of low blood alcohol levels. Psychomotor performance and body sway control were studied in 16 healthy volunteers after they had drunk a small dose of ethyl alcohol (0.5 g/kg) or placebo. Neurosensory and psychomotor functions were assessed by a Divided Attention Test (DAT), composed of the association between one test exploring short-term memory (Memory Test) and one exploring attention (Response Competition Test). Alterations in body sway were recorded by stabilometry. Tests were administered at 30, 60, 120 and 180 min after intake of alcohol. After a wash-out period of at least one week, subjects repeated the test after taking a second dose of alcohol or placebo. Blood alcohol concentrations were monitored by analysis of concentrations in expired air.

Results

A BAC under 50 mg/dL did not reveal statistically significant impaired memory capacities or motor coordination. Instead, statistically significant oscillations of body sway were measured (p-values = 0.0001), especially when stabilometry was associated with deviant stimuli like those of the DAT (p-values = 0.0001).

Conclusions

This study showed: (1) impaired performance, at the limits of statistical significance, on a complex psychometric test like the DAT; (2) some cognitive, attentive and visual perceptive functions are not compromised or at least not in a statistically significant manner; (3) a considerable alteration in the capacity for control of body sway after intake of alcohol becomes further and massively impaired when deviant stimuli are given; (4) this impairment appeared early and was more marked 1 and 2 h after intake of alcohol.     

Methadone extraction from minimal amounts of biological fluids

A new solid phase extraction method was studied to extract methadone from small amounts of biological samples, by using little disposable columns prepacked with reverse phase sorbents. Two different commercial kinds of reversed phase columns prepacked with octadecylsilane (ODS) were tested; the results were compared to those obtained by a direct liquid/liquid extraction method. Gas chromatograms of extracts obtained by means of ODS reversed phase columns showed a good signal/noise ratio resulting in higher sensitivity (20 ng/ml as detection limit), in comparison with the liquid/liquid extraction method.     

Development of a heptaplex PCR system to analyse X-chromosome STR loci from five Italian population samples. A collaborative study

Many X-chromosome short tandem repeats (X-STRs) have been validated for forensic use even if further studies are needed on allele frequencies and mutation rates to evaluate the extent of polymorphism in different populations and to establish reference databases useful for forensic applications and for anthropological studies. A single multiplex reaction of seven X-STRs, which includes the DXS6789, HUMARA, DXS10011, DXS7423, HPRTB, DXS6807, DXS101 loci, is presented and their allele frequency distribution in a large population sample including 556 subjects (268 females and 288 males) analysed by five forensic laboratories of Central and Northern Italy is shown. Our results demonstrate the feasibility of a single amplification/detection reaction involving seven markers of the X chromosome, which can be fruitfully used in complex kinship analysis.     

Suicide by pencil

We report an unusual suicide, committed with a common pencil. A 72-year-old male inflicted himself a penetrating thoracic wound while being hospitalized for a hip prosthesis operation. Although the patient was immediately operated, the cardiac injury appeared to be fatal. Cases of suicidal penetrating wounds of the anterior chest wall are rare and they are mostly inflicted by knives, glass fragments, or other sharp instruments. The potential danger of a pencil should be taken into consideration, especially in psychiatric hospitals and imprisonment facilities. We examined the legislation in Italy and Finland concerning the regulation of privacy in special care institutions.     

The Role of Legitimizing Ideologies as Predictors of Ambivalent Sexism in Young People: Evidence from Italy and the USA

The studies presented here focus on the relationship between legitimizing ideologies and ambivalent sexism. 544 Italian students (Study 1) and 297 US students (Study 2) completed several scales: social dominance orientation (SDO), system justification (SJ), political orientation, religiosity, and the Glick and Fiske (J Pers Soc Psychol 70(3):491–512, 1996) Ambivalent Sexism Inventory. Zero-order correlations revealed all facets of ideological attitudes to be positively related to each other and correlated with ambivalent sexism. In particular, the SDO was related to both ideology components of SJ and political orientation and to ambivalent sexism (hostile and benevolent). Moderated regressions revealed that SDO has a positive impact on hostile sexism for men only, while SJ has a positive impact on hostile sexism for women only. While the first result was stable across the two studies, the last moderated effect has been detected only in Study 1. We discuss the results with respect to different facets of social ideologies and cultural differences between the two countries.     

Italy's changing defence policy

After the fall of Mubarak, the Muslim Brotherhood (MB) decided to act as a stabilising force, to abandon the street and to lend democratic legitimacy to the political process designed by the army. The outcome of this strategy was that the MB was first ‘burned’ politically and then harshly repressed after having exhausted its stabilising role. The main mistakes the Brothers made were, first, to turn their back on several opportunities to spearhead the revolt by leading popular forces and, second, to keep their strategy for change gradualist and conservative, seeking compromises with parts of the former regime even though the turmoil and expectations in the country required a much bolder strategy.     

Commodities and economic growth

The process of social integration of the people associated with immigrant organisations, and the social (and potentially religious) change that comes with it, present the organisations with the difficult challenge of justifying their legitimacy to various societal actors. This is certainly true of Muslim organisations in Western immigration societies. In Germany, this process is quite clearly reflected within the community of established organisations, which play a part in creating intergenerational change. This is not to say, however, that they will be the only relevant – or even the predominant – actors involved in establishing Islam in Germany in the future, despite their roots in their countries of origin, nor that they will automatically become redundant over time.     

Defending democracy: Reactions to political extremism in inter-war Europe

Abstract. While the strategies of political actors and institutions have been largely analyzed with reference to cases of democratic breakdown, democratic survival has often been viewed as a consequence of socio–economic and cultural 'preconditions'. The analysis of successful reactions to strong extremist challenges in three cases of democratic survival (Czechoslovakia, Finland and Belgium in the inter–war period) against the background of two cases of breakdown in the same historical context (Italy and the Weimar Republic) is a useful complement to this view. The analysis of the selected cases shows how a stable coalition of democratic forces can effectively protect the democratic system from dangerous extremist attacks by pursuing both repressive and inclusive strategies.