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Objective: To assess frequency, types, and mechanisms of comorbidities in people with epilepsy and verify their association with disease features and outcome. Methods: This cohort study was performed in 13 Italian epilepsy centers with nationwide distribution and accurate records. Eligible patients were children and adults diagnosed before December 31, 2005, and followed for a minimum of 10 years. Two pairs of raters independently reviewed patients’ records and classified each comorbidity. In case of disagreement, a third reviewer made the final decision. Comorbidities were classified according to type (organ/system) and underlying mechanism (causal, shared risk factors, chance association). Comorbidity types and mechanisms were described in the entire sample and according to epilepsy prognostic patterns (sustained remission, relapsing-remitting course, no remission). Results: Of 1006 included patients, 266 (26.4%) had at least one comorbidity. The most common were developmental/perinatal (7.5% of cases), psychiatric (6.2%), cardiovascular (5.3%), and endocrine/metabolic (3.8%). Among 408 reported comorbidities, the underlying mechanisms were, in decreasing order, chance association (42.2%), shared risk factors (31.1%), and causal (26.7%). Psychiatric diseases were present in 13.3% of patients with no remission, 5.9% of patients with relapsing-remitting course, and 4.8% of patients with sustained remission (p =.016). The corresponding numbers for endocrine/metabolic diseases were respectively, 9.6%, 3.4%, and 2.9% (p =.013); for respiratory diseases were 3.6%,.3%, and.3% (p =.001), and for urogenital diseases were 3.6%,.7%, and 1.6% (p =.048). The association of endocrine/metabolic, psychiatric, and respiratory comorbidities with epilepsy prognosis was confirmed by multivariable analysis adjusted for the main demographic and clinical variables, with patients with these comorbidities showing a lower probability of achieving remission. Signifi

Urban nightlife is often depicted as a homogeneous category dominated by the entertainment industry and characterised by at risk drinking practices. Taking on a more critical perspective, which recognises the heterogeneity of the physical and social settings as well as how nightgoers exercise their agency to manipulate and shape products and spaces defined by the consumeristic economic order, the paper aims to 1) explore the physical and social settings of two districts of Torino (North Italy) characterised by an intense nightlife, and 2) understand young people’s tactics with regard to alcohol consumption. The study adopted a mixed-methods approach including non-participant observation (40 hours) and face-to-face interviews (No. 22). Results show that youth drinking in an urban nightlife setting is a ‘tactical operation’ that concerns both the choice of what, how and where to consume and how to reduce potential risks. Indeed, young people embrace the possibilities offered by the night districts to achieve their goals (mainly to socialize and have fun) while limiting negative outcomes by adopting self-regulation and harm reduction practices.

Purpose: The purpose of this paper is to investigate motives and modalities of psychedelic substance use in the psychonaut community that is hosted on the Reddit platform (r/psychonaut). Psychonauts are sometimes described as responsible drug users. Elements of responsible use include sharing stories, advice and experiences, reagent testing substances, proper dosing and education on harm reduction and its practical implication. Investigating psychonauts’ substance use can highlight what responsible use means for them and could inform best practices for psychedelic use. Design/methodology/approach: Qualitative content analysis of posts and comments on the r/psychonaut subreddit was completed. In total, 350 posts were investigated. A combination of deductive and inductive methods was used to both structure the research and to allow room for novel information. To investigate participant’s motives, this combination was used to both collect and analyse the data. To examine modalities, concepts and keywords were formed out of the collected data and then analysed. Findings: Motives for use ranged from self-knowledge, self-investigation and self-medication to increasing artistic expression, curiosity and recreation. Concerning modalities, the respondents put a high emphasis on preparation, set and setting, integration, dosage and gathering and sharing information through research, articles and trip reports. These features are identified in the literature as elements of responsible drug use. This investigation can help by unearthing best practices already in use by the community to inform the bourgeoning movement of psychedelic substance use – both in a medical and self-reflexive setting. Originality/value: This paper is framed in the context of paucity of the academic literature on people taking psychedelic substances in Western society in non-rave and non-medical settings, with findings that indicate important change happening in the psychonaut subculture.

Over the last 30 years, substantive progress has been made in terms of polices for and responses to alcohol and other drug-related problems in many EU Member States. Despite being one of the six founding member states of the European Communities, Italy is one of those countries that have not embraced a similar progressive approach, due to what we could call Italian anti-drug alarmism: an enduring social concern towards drugs that have drug users as main target of a punitive approach. The chapter examines the consequences of this long-lasting, anti-drug alarmism for Italian public debate and attitude, by exploring adolescents’ social representations of drugs users and using focus groups as research technic. The participants’ discussions were rather vague, drawing on a socially transmitted yet superficial knowledge, regarding nearly all of the subjects touched upon, with the exception of cannabis. The way they represent users is a litmus test of anti-drug alarmism, since they reproduce the stigmatising and dehumanising image of ‘hard drugs’ users as a uniform category of people, marked by a problem-driven consumption as well as by physical and moral degradation, which makes them a middle way between criminal and sick people. Nonetheless, it is important to stress that social representations are marked by the ability to change over time, so it is therefore possible to give those of the students a different direction, helping adolescents to develop less paternalistic and judgmental positions on drugs and drugs users.

Focus group data from 92 youths from Italy and the U.S.A. indicate that Italians and Americans differ in perceived threshold of acceptability of drinking to excess. Youth from the U.S.A. were more accepting of intoxication than Italian youth, reflecting features of each respective dominant drinking culture. Alcohol gender double standards existed in both countries and were conceptually connected to sexuality. However, the social construction behind such connections differed across the two groups: focusing on harms to the woman in the U.S.A. and the respectability of her social group in Italy.

Aims: To compare the drinking cultures of youth in the USA and in Italy. Method: Sequential explanatory mixed method design. Phase 1: Multigroup latent class analysis was used to identify subgroups of drinkers from samples of 424 (61.3% female) Italian and 323 American college students (57.3% female). Phase 2: Focus group interviews with 41 Italian and 47 American youth were used to collect narratives on features of the two drinking cultures. Results: Four partially invariant subgroups of drinkers were found. Most participants (>75%) in both countries concentrated drinking during weekends. Overall, US drinkers displayed greater probabilities to report risky drinking behaviors and experience negative consequences as compared to comparable subgroups of Italian drinkers. Discrepancies in terms of socialisation processes during childhood (i.e. permissiveness) and underlying cultural assumptions with regard to alcohol consumption (i.e. purposes of alcohol use) may explain differences in how alcohol is used in the two countries. Conclusions: Findings suggest that there are crucial differences in societal schema of beliefs, informal social norms, practices, and values attached to alcoholic beverages across the USA and Italy. These results demonstrate the need for culturally tailored alcohol preventive interventions and clinical practice targeted to young people that capitalise on such differences.

Objective: The new epilepsy definition adopted by the International League Against Epilepsy (ILAE) includes patients with one unprovoked seizure with a probability of further seizures, similar to the general recurrence risk after two unprovoked seizures, occurring in a 10-year period. Long-term follow-up of patients diagnosed after a single seizure is needed to assess the applicability of the new epilepsy definition in clinical practice. Methods: Patients with newly diagnosed epilepsy were recruited retrospectively with a minimum follow-up of 10 years. Patients were stratified in two groups depending on the occurrence of one (new definition, ND) or two or more unprovoked seizures (traditional definition, TD) at the time of epilepsy diagnosis and compared for disease characteristics and factors predicting seizure recurrence. The primary outcome was the occurrence of a new unprovoked seizure during follow-up in the ND group. The secondary outcome was the achievement of an early remission in both groups. Results: Among 1,006 patients with newly diagnosed epilepsy, 152 (15.1%) were diagnosed after a single seizure. Compared to patients diagnosed using the TD, patients diagnosed according to the ND showed a higher proportion of subjects with an abnormal neurologic examination (19.9% vs. 13.7%, p = 0.0504) and with focal seizures (69.3% vs. 60.4%, p = 0.0021). The two samples differed in the presence of at least one of the factors predicting seizure recurrence (focal seizures or abnormal findings in at least one among the following: neurologic examination, electroencephalography [EEG], and neuroimaging) (94.6% vs. 89.1%, p = 0.0376). Long-term recurrence in patients diagnosed with the new definition was 83.6% at 10 years and 89.1% at 15 years. The probability of early remission did not differ between the two groups. Significance: Our results support the applicability of the new epilepsy definition in clinical practice. Individual patient characteristics and a personalized

Item does not contain fulltext, Background and aims: This is the first study to examine the effect of alcohol marketing exposure on adolescents' drinking in a cross-national context. The aim was to examine reciprocal processes between exposure to a wide range of alcohol marketing types and adolescent drinking, controlled for non-alcohol branded media exposure. Design: Prospective observational study (11-12- and 14-17-month intervals), using a three-wave autoregressive cross-lagged model. Setting: School-based sample in 181 state-funded schools in Germany, Italy, Netherlands, Poland. Participants: A total of 9075 eligible respondents participated in the survey (mean age 14 years, 49.5% male. Measurements: Adolescents reported their frequency of past-month drinking and binge drinking. Alcohol marketing exposure was measured by a latent variable with 13 items measuring exposure to online alcohol marketing, televised alcohol advertising, alcohol sport sponsorship, music event/festival sponsorship, ownership alcohol-branded promotional items, reception of free samples and exposure to price offers. Confounders were age, gender, education, country, internet use, exposure to non-alcohol sponsored football championships and television programmes without alcohol commercials. Findings: The analyses showed one-directional long-term effects of alcohol marketing exposure on drinking (exposure T1 on drinking T2: beta = 0.420 (0.058), P < 0.001, 95% confidence interval (CI) = 0.324-0.515; exposure T2 on drinking T3: beta = 0.200 (0.044), P < 0.001, 95% CI = 0.127-0.272; drinking T1 and drinking T2 on exposure: P > 0.05). Similar results were found in the binge drinking model (exposure T1 on binge T2:beta = 0.409 (0.054), P < 0.001, 95% CI = 0.320-0.499; exposure T2 on binge T3: beta = 0.168 (0.050), P = 0.001, 95% CI = 0.086-0.250; binge T1 and binge T2 on exposure: P > 0.05). Conclusions: There appears to be a one-way effect of alcohol marketing exposure on adolescents' alcohol use over time, which cannot be exp

Item does not contain fulltext, Background and aims: This is the first study to examine the effect of alcohol marketing exposure on adolescents' drinking in a cross-national context. The aim was to examine reciprocal processes between exposure to a wide range of alcohol marketing types and adolescent drinking, controlled for non-alcohol branded media exposure. Design: Prospective observational study (11-12- and 14-17-month intervals), using a three-wave autoregressive cross-lagged model. Setting: School-based sample in 181 state-funded schools in Germany, Italy, Netherlands, Poland. Participants: A total of 9075 eligible respondents participated in the survey (mean age 14 years, 49.5% male. Measurements: Adolescents reported their frequency of past-month drinking and binge drinking. Alcohol marketing exposure was measured by a latent variable with 13 items measuring exposure to online alcohol marketing, televised alcohol advertising, alcohol sport sponsorship, music event/festival sponsorship, ownership alcohol-branded promotional items, reception of free samples and exposure to price offers. Confounders were age, gender, education, country, internet use, exposure to non-alcohol sponsored football championships and television programmes without alcohol commercials. Findings: The analyses showed one-directional long-term effects of alcohol marketing exposure on drinking (exposure T1 on drinking T2: beta = 0.420 (0.058), P < 0.001, 95% confidence interval (CI) = 0.324-0.515; exposure T2 on drinking T3: beta = 0.200 (0.044), P < 0.001, 95% CI = 0.127-0.272; drinking T1 and drinking T2 on exposure: P > 0.05). Similar results were found in the binge drinking model (exposure T1 on binge T2:beta = 0.409 (0.054), P < 0.001, 95% CI = 0.320-0.499; exposure T2 on binge T3: beta = 0.168 (0.050), P = 0.001, 95% CI = 0.086-0.250; binge T1 and binge T2 on exposure: P > 0.05). Conclusions: There appears to be a one-way effect of alcohol marketing exposure on adolescents' alcohol use over time, which cannot be exp

Item does not contain fulltext, Background and aims: This is the first study to examine the effect of alcohol marketing exposure on adolescents' drinking in a cross-national context. The aim was to examine reciprocal processes between exposure to a wide range of alcohol marketing types and adolescent drinking, controlled for non-alcohol branded media exposure. Design: Prospective observational study (11-12- and 14-17-month intervals), using a three-wave autoregressive cross-lagged model. Setting: School-based sample in 181 state-funded schools in Germany, Italy, Netherlands, Poland. Participants: A total of 9075 eligible respondents participated in the survey (mean age 14 years, 49.5% male. Measurements: Adolescents reported their frequency of past-month drinking and binge drinking. Alcohol marketing exposure was measured by a latent variable with 13 items measuring exposure to online alcohol marketing, televised alcohol advertising, alcohol sport sponsorship, music event/festival sponsorship, ownership alcohol-branded promotional items, reception of free samples and exposure to price offers. Confounders were age, gender, education, country, internet use, exposure to non-alcohol sponsored football championships and television programmes without alcohol commercials. Findings: The analyses showed one-directional long-term effects of alcohol marketing exposure on drinking (exposure T1 on drinking T2: beta = 0.420 (0.058), P < 0.001, 95% confidence interval (CI) = 0.324-0.515; exposure T2 on drinking T3: beta = 0.200 (0.044), P < 0.001, 95% CI = 0.127-0.272; drinking T1 and drinking T2 on exposure: P > 0.05). Similar results were found in the binge drinking model (exposure T1 on binge T2:beta = 0.409 (0.054), P < 0.001, 95% CI = 0.320-0.499; exposure T2 on binge T3: beta = 0.168 (0.050), P = 0.001, 95% CI = 0.086-0.250; binge T1 and binge T2 on exposure: P > 0.05). Conclusions: There appears to be a one-way effect of alcohol marketing exposure on adolescents' alcohol use over time, which cannot be exp

The use of a standard definition of ‘binge drinking’ can potentially offer the advantage of ‘objectifying’ the concept of excessive drinking. Nevertheless, the term has become somewhat confusing, as it is often used as a synonym of drunkenness, making cross-cultural comparison difficult. The present study investigates the meaning Italian young people attribute to binge drinking, to explain the gap between self-reported rates of drunkenness and episodes of binge drinking found by comparative youth drinking surveys. About 134 face-to-face semi-structured interviews were conducted, targeting adolescents (aged 15–17) and young adults (aged 22–24) who had admitted to drinking excessively. In addition, an online forum was created, using a video clip as a stimulus and asking for web users' comments (132 were analysed). Results show how in the view of Italian bingers, binge drinking does not necessarily entail drunkenness, but only being tipsy. This is what they aim at when they drink, while they have negative attitudes and expectations regarding intoxication and its effects. This boundary establishes the concept of excess and marks the threshold between socially acceptable and unacceptable drinking. In conclusion, the concept of binge drinking cannot be used as a synonym of drunkenness, which young people in Italy judge severely.

Background: In recent years, English-speaking and Northern European alcohol researchers have turned a historical gaze towards their subject, and in particular have explored how a medical view attempted to describe and explain phenomena such as alcohol abuse and addiction. Although there was a heated and prolific debate in Italy in the late 19th and early 20th centuries, there are few historical studies of the first scholars’ thoughts on alcohol-related problems. Aims: The article depicts how the Italian scientific community interpreted and explained alcohol-related concerns following the emergence of the alcohol issue in the late 19th century. Specifically, the stances of the two main groups of scientists who dealt with the issue, the Positive School of Criminology and Legal Socialism, are examined. Method: The article is based on the materials collected by the Italian research group during a comparative study carried out as part of the ALICE RAP project. More than 40 books and five scientific journals were consulted. Results: Medical-related concerns were never predominant in the late 19th-century Italian debate on the alcohol question, but were addressed in the broader discussion of criminality, where positivists’ and legal socialists’ perspectives both focused mainly on social consequences, albeit with differing interpretations of causalities and remedies

This article considers the ways in which Italian scholars conceptualized alcohol and drug addiction between 1860 and 1930. Based on the analysis of more than 40 books and 5 scientific journals (112 issues), it is argued that in the period 1860-1930, scholars were more interested in alcohol than any other substance. Indeed “alcoholism’ was the term used the most to describe alcohol problems, although its meaning changed over time. At the beginning of the period alcoholism was seen as a consequence of drunkenness, later on its definition became more precise, including both physical/pathogenic factors and the addictive power of alcoholic beverages. In contrast, the debate about drugs involved fewer scientists and their description of the topic was divided between poisoning and addiction. There was an evolution in the definition of addiction-related concepts and also a heated exchange of conflicting views among scholars. In the scientific debate experts with various backgrounds such as jurisprudence, forensic science, criminal anthropology, sociology and different medical specialties were all involved. This article highlights the vitality of interest among the Italian scientific community regarding addiction themes in the late nineteenth and early twentieth centuries.

Aims: This study aims to plug the gap about how young people understand their direct and indirect experience with alcohol by investigating the prevalent images of alcohol among 15-year-olds. The study also aims to clarify the position of young Italians towards traditional Italian drinking culture. Methods: Twenty-two focus groups were organized in two Italian towns, Torino and Cosenza. The focus groups (FGs) used the Reception Analytical Group Interview (RAGI) method, wherein respondents are invited to discuss after seeing video clips used as a stimulus. The material thus collected was analysed through an approach that takes both the participants' interpretative processes and their socio-cultural environment into consideration. Findings: Using 'drinking situations' as an analytical tool, it was found that young people's images about drinking are still in line with tradition, as are the importance assigned to social drinking and the stigma attached to intoxication. Young people also appear to be aware of the negative consequences of drinking, even if the risks related to pharmaceutical use seem to be underestimated. Conclusions: Results cast doubt on the supposed convergence of drinking patterns within Europe and provide useful insights for the development of alcohol use and abuse policies and prevention. © 2014 Informa UK Ltd.

Aims: This study aims to investigate the views of adults towards youth drinking, and what they think about alcohol-related parenting styles, as these attitudes are among the factors most affecting adolescents' alcohol use and misuse. Methods: Ten focus groups involving 30 parents and 32 teachers were organized in two towns located in Northern (Torino) and Southern (Cosenza) Italy. The Reception Analytical Group Interview (RAGI) method was used, employing video-clips as stimuli. Findings: Gaps in adult's understanding of youth drinking were found, the most important being the overestimation of young people's appreciation of drunkenness and the underestimation of young people's pharmaceutical use of alcohol. Parents viewed the family as the main influence on youth drinking and alcohol-related problems, but had doubts about what alcohol-specific parental practices are best. Conclusion: General reflection is needed about the public discourse surrounding youth drinking and its influences on the views of adults. In addition, more evidence is needed about the effectiveness of alcohol-specific parenting practices, so that parents can be better informed.

Concepts play a central part in the formulation of problems and proposed solutions to the use of substances. This article reports the initial results from a cross European historical study, carried out to a common methodology, of the language of addiction and policy responses in two key periods, 1860–1930 and the 1950s and 1960s. It concludes that the language of addiction was varied and nonstandard in the first period. The Anglo-American model of inebriety did not apply across Europe but there was a common focus on theories of heredity and national degeneration. After World War II, there was a more homogenous language but still distinct national differences in emphasis and national interests and policy responses to different substances. More research will be needed to deepen understanding of the conditions under which these changes took place and the social and policy appeal of disease theories.

Gli individui acquisiscono aspettative, atteggiamenti e abitudini riguardo all’alcol a partire dall’infanzia, all’interno di un processo di trasmissione della conoscenza prevalentemente informale, fortemente influenzato dalla cultura di appartenenza. Attraverso la socializzazione all’alcol i soggetti si avvicinano e familiarizzano con le bevande alcoliche, formando in questo modo le loro prime rappresentazioni sull’alcol, apprendendo e interiorizzando valori e norme sociali che definiscono cosa, quando, come e dove bere o non bere. Gli agenti impegnati nella socializzazione sono molteplici e comprendono sia attori sociali come il nucleo familiare e il gruppo di pari, sia istituzioni come la scuola, la religione e i media. Nello specifico, la socializzazione avviene attraverso due forme, una indiretta, quando si guardano gli altri, spesso adulti, consumare le proprie bevande, l’altra diretta, quando si fanno le prime esperienze personali di consumo.