Hyperkinetic movement disorders represent a heterogeneous group of disorders in which involuntary... more Hyperkinetic movement disorders represent a heterogeneous group of disorders in which involuntary movements are the prevalent clinical symptoms. The five main categories of hyperkinetic disorders are tremor, dystonia, tics,myoclonus and drug-induced dyskinesia.The severity of hyperkinetic disorders is assessed by all clinicians when they examine a patient; quantifying the severity also provides a means of studying the natural history of a given disorder and the possible effect of new therapeutic interventions. This means that good rating instruments are required in both everyday practice and experimental settings. Unfortunately, the clinical evaluation of these disorders is complicated by the inherent nature and variability over time of involuntary movements. A number of scales have been proposed over the years to study the various hyperkinetic disorders. The aim of this review is to systematically identify all the clinical scales that have been proposed and to classify them according to the criteria developed by the Movement Disorder Society (MDS) task force for rating scales in Parkinson's disease.On the basis of this methodology, a scale may be defined as 'Recommended', 'Suggested' or 'Listed' in decreasing order of value.We found that, although numerous scales aimed at assessing hyperkinetic disorders have been published, their variability in terms of clinimetric properties, availability and effort required to administer them is high. In this evaluation, we identified scales defined as 'Recommended' for the assessment of all forms of hyperkinetic disorders. The situation highlighted by our analysis varies considerably, with several 'Recommended' scales being available for some conditions such as tics or dystonia, but only one being available for myoclonus. This gap needs to be filled by the scientific community through both the development of new clinical tools and there finement of existing ones.
we performed a three-stages door-to-door survey to estimate incidence and prevalence of epilepsy ... more we performed a three-stages door-to-door survey to estimate incidence and prevalence of epilepsy associated with convulsive seizures (EACS) in a rural area of Bolivia. the study was carried out in the Cordillera Province, southern-eastern Bolivia. One hundred fourteen rural communities with a total population of 18,907 inhabitants were included in the survey. In order to identify subjects with EACS, trained fieldworkers administered a validated single screening question to the householders (stage I). A second face-to-face questionnaire was administered to each positive subject (stage II) that, in case of positive answer, underwent a complete neurological examination to confirm the diagnosis (stage III). We estimated age and sex specific life-time and active EACS prevalence at the prevalence day (30th June 2010). Incidence risk was evaluated for the 10-year period between January 2000 and December 2010. on prevalence day we identified 136 subjects with EACS, 124 of whom had active epilepsy. The life-time prevalence of EACS was 7.2/1,000 (7.6/1,000 age-adjusted to the world standard population) while the prevalence of active EACS was 6.6/1,000 (6.7/1,000 age-adjusted to the world standard population). Both life-time and active prevalence showed a peak (10.3/1,000) in the 15-24 years age group and, overall, were higher among women. During the incidence study period, 105 patients living in the study area had the onset of EACS. The crude incidence risk was 55.4/100,000 (49.5/100,000 age-adjusted to the world standard population). Incidence was slightly but not significantly higher among women (58.9/100,000 versus 51.9/100,000). the present study demonstrated a considerable burden of EACS in the Bolivian Chaco, showing prevalence and incidence estimates close to those reported for low and middle- income countries and underlying the need of treatment programs.
In Parkinson&... more In Parkinson's disease (PD), different topographically defined cortical-subcortical oscillatory networks have been implicated in motor program dysfunction. Few studies have focused on clinical correlates of cortical activity asymmetry using quantitative electroencephalography. We retrospectively selected N = 34 l-dopa naïve PD subjects who had undergone standardized electroencephalography. We selected N = 18 subjects group-matched by age, sex and hand dominance with normal electroencephalography and no parkinsonism and/or cognitive decline as controls. A Welch's periodogram was applied to electroencephalographic signal epochs recorded from homologous pairs of electrodes over each hemisphere. An index of lateralization was then obtained as the absolute value of the electroencephalographic asymmetry index, computed by subtracting left from right-sided log power spectral density for each homologous site and frequency band. A standardized l-dopa acute challenge test was performed on all PD subjects to compute short-duration response magnitude. In mid/lateral frontal regions higher index of lateralization for the beta band (p = 0.015) and lower index of lateralization for the theta band (p = 0.036) were found in PD subjects as compared to controls. Both parameters correlated with Hoehn-Yahr staging (beta: r = 0.428, p = 0.012; theta: r = -0.464, p = 0.006). In occipital region lower index of lateralization for the alpha band was found in PD correlating with l-dopa short-duration response magnitude (r = 0.456; p = 0.007). Lateralization of frontal cortex beta electroencephalographic activity is associated with clinical disability. Occipital cortex alpha activity may relate to l-dopa responsiveness in untreated PD subjects.
Cognitive impairment (CIm) is a frequent finding in multiple sclerosis (MS) affecting up to 65 % ... more Cognitive impairment (CIm) is a frequent finding in multiple sclerosis (MS) affecting up to 65 % of patients. The aim of this study was to evaluate the prevalence and incidence of CIm in a population-based cohort of MS patients identified in the city of Catania from 1995 to 2004. One-hundred and twenty-five patients experiencing the onset of MS during 1995-2004 were enrolled. Cognitive performance was assessed through the Brief Repeatable Battery (BRB) of neuropsychological tests and the Stroop word-color task (ST). CIm was defined as the failure on at least three tests involving at least two different domains. Patients without CIm at baseline were followed up after over 3 years. The most impaired tests were the Symbol Digit Modalities Test (36 %) and the Paced Auditory Serial Addition Test 3 (35 %). At baseline the prevalence of CIm was 44 % (95 % CI 35.2-53.1). An almost sixfold increased risk of developing CIm was found among MS patients aged 40 and above at the time of the NPS examination (OR 5.84; 95 % CI 2.57-13.2; p value <0.0001) and a threefold increased risk for patients with an EDSS score >3 (OR 3.51; 95 % CI 1.30-9.46, p value 0.01). At the follow-up out of the 70 MS patients without CIm at baseline evaluation, 26 (37.1 %) developed CIm. The total person-years at risk was 269 person-years giving an incidence rate of CIm of 96.6/1,000 person-year (95 % CI 57.3-128.7). The overall prevalence of CIm in MS is 44 % and the incidence after 4 years is 37.1 %. CIm affects more frequently patients older than 40 years and with a higher EDSS score.
Purpose:´seau Action-Recherche sur l'Epilepsie) program, a model of managing and treating people ... more Purpose:´seau Action-Recherche sur l'Epilepsie) program, a model of managing and treating people with epilepsy (PWE) at a primary health-care level in rural areas of Mali, we assessed treatment efficacy and compliance of patients who underwent the first year follow-up.
Background: Trace elements have been hypothesised to be involved in the pathogenesis of Multiple ... more Background: Trace elements have been hypothesised to be involved in the pathogenesis of Multiple Sclerosis and volcanic degassing is the major natural sources of trace elements. Both incidence of Multiple Sclerosis in Catania and volcanic activity of Mount Etna have been significantly increased during the last 30 years. Due to prevailing trade winds direction, volcanic gases from Etna summit craters are mostly blown towards the eastern and southern sectors of the volcano.
Background: Cysticercosis is caused by the invasion of human or pig tissues by the metacestode la... more Background: Cysticercosis is caused by the invasion of human or pig tissues by the metacestode larval stage of Taenia solium. In Europe, the disease was endemic in the past but the autochthonous natural life cycle of the parasite is currently completed very rarely. Recently, imported cases have increased in parallel to the increased number of migrations and international travels. The lack of specific surveillance systems for cysticercosis leads to underestimation of the epidemiological and clinical impacts.
Objective: Human toxocariasis is a zoonotic infection caused by the larval stages of Toxocara can... more Objective: Human toxocariasis is a zoonotic infection caused by the larval stages of Toxocara canis (T. canis) and less frequently Toxocara cati (T. cati). A relationship between toxocariasis and epilepsy has been hypothesized. We conducted a systematic review and a meta-analysis of available data to evaluate the strength of association between epilepsy and Toxocara spp. seropositivity and to propose some guidelines for future surveys.
The difference in epilepsy burden existing among populations in tropical regions has been attribu... more The difference in epilepsy burden existing among populations in tropical regions has been attributed to many factors, including the distribution of infectious diseases with neurologic sequels. To define the burden of epilepsy in Latin American Countries (LAC) and to investigate the strength of association with neurocysticercosis (NCC), considered one of the leading causes of epilepsy, we performed a systematic review and meta-analysis of the literature.
Essential tremor (ET) is one of the most common movement disorders of adults, characterized by po... more Essential tremor (ET) is one of the most common movement disorders of adults, characterized by postural and kinetic tremor. It often causes embarrassment and more rarely serious disability, requiring treatment. To assess the current state of knowledge on ET therapy and produce recommendations based on the analysis of evidence the authors reviewed the literature regarding pharmacologic and surgical therapies, providing a quality assessment of the studies and the strength of recommendations for each treatment. A committee of experts selected clinical-based questions to guide the search. A systematic literature review was performed to identify all the studies conducted on patients with ET published until September 2010. Articles were classified according to GRADE evidence profile, a system for grading the quality of evidence and the strength of recommendation based on the quality of the studies. The quality of evidence was often rated as ''low'' or ''very low'' for the studies analyzed. Propranolol, long-acting propranolol, primidone, and topiramate are recommended as first-line therapy, with restrictions for their side effects. Arotinolol, sotalol, ICI 118.551 and LI 32.468 (experimental drugs), zonisamide, gabapentin, alprazolam, clozapine, and olanzapine are recommended as a second-line treatment. Botulinum toxin type A and thalamic deep-brain stimulation are recommended for refractory ET. The results highlight the need of well-designed direct comparison trials aimed at evaluating relative effectiveness and safety of the drugs currently used in clinical practice. Furthermore, additional controlled clinical trials are required to define other possible treatment strategies for ameliorating the management of ET. J Neurol (2013) 260:714-740 715 1 strong recommendation, 2 weak recommendation A, B, C, D indicate the quality of evidences (respectively high, moderate, low, very low) J Neurol (2013) 260:714-740 717 RCT randomized controlled trial, DBS deep-brain stimulation ??? Good degree of symptom control ::: Severe side-effects/high discontinuation rate :: Moderate side-effects/low discontinuation rate $ No side-effects J Neurol (2013) 260:714-740 725
A population-based case-control study in the city of Catania, Sicily, was carried out to determin... more A population-based case-control study in the city of Catania, Sicily, was carried out to determine restless legs syndrome (RLS) prevalence and its association with multiple sclerosis (MS). Patients were randomly selected from a cohort of MS patients resident in the study area and a group of age and sex matched controls was enrolled from the general population. RLS was diagnosed according to the International Restless Legs Syndrome Study Group criteria. In total, 152 MS patients and 431 controls were included in the study. A significantly higher prevalence of RLS amongst MS patients (14.5%) compared with controls (6.0%) was detected, corresponding to an almost threefold increased risk (odds ratio 2.7, 95% confidence interval 1.4-5.0) of developing RLS. Spinal cord lesions in MS patients were associated with a higher risk of RLS (odds ratio 3.7, 95% confidence interval 1.1-13.5). RLS was strongly associated with MS, with a significantly higher risk in patients presenting spinal cord lesions.
Epilepsy is associated with a significant burden of social stigma that appears to be influenced b... more Epilepsy is associated with a significant burden of social stigma that appears to be influenced by psychosocial and cultural factors. Stigma has a negative effect on the management of people with epilepsy (PWE), representing one of the major factors that contribute to the burden of epilepsy. To assess stigma perception among the Guarani population, one hundred thirty-two people living in Guaraní communities in Bolivia were invited to complete the Stigma Scale of Epilepsy questionnaire. The main determinants of stigma identified were: the fear linked to loss of control, the feelings of sadness and pity toward PWE, the difficulties faced by PWE in the professional and relationship fields, the level of education and type of seizure. Our study pointed out that, in this population, PWE face difficulties in everyday life because of epilepsy-associated stigma and the results attest to the importance of promoting community-based educational programs aimed at reducing the stigmatization process.
The overlap between obsessive compulsive personality disorder (OCPD) and obsessive compulsive dis... more The overlap between obsessive compulsive personality disorder (OCPD) and obsessive compulsive disorder (OCD) has received increasing recognition and continues to be a source of much debate. With the advent of new research methodologies, researchers have attempted to distinguish whether OCPD and OCD are two distinct phenomena that can co-occur or whether they are similar, overlapping constructs. MEDLINE was used to systematically review the OCPD and OCD literature published between 1991 and 2004. Using the more stringent DSM-IV criteria, results from OCD clinical samples suggest that the majority of individuals with OCD (75%) do not have OCPD. Similarly, results from personality disorder samples suggest that the majority of individuals with OCPD (80%) do not have OCD. While there is evidence that OCD and OCPD are linked, the literature does not support either one as a necessary or sufficient component of the other.
The purpose of this publication is to explore complementary methods to existing forms of interact... more The purpose of this publication is to explore complementary methods to existing forms of interaction between citizens and policy-makers at EU level which foster co-decision processes using the Internet and Web 2.0 technologies. Through crowdsourcing it is possible to go beyond national borders and engage a wider audience real-time online. This publication describes the use of crowdsourcing for policy-making in Iceland, Finland and Paris as non-exclusive examples, which show the added value of co-legislating with citizens in terms of process (wisdom of the crowd) and outcomes (increased legitimacy in the adopted policy).
At European level, based on the models identified and on the lessons’ learnt in the field of eParticipation projects, a design to test crowdsourcing on EU policies is outlined. This design takes into consideration the policy cycle and proposes the creation of an avenue for citizens to co-legislate together with policy-makers (EU officials and Members of the European Parliament) alongside the ordinary legislative procedure. The crowdsourcing exercise should take place independently from the EC consultation process, which is designed and best suited for consulting organised interest groups. It should be multilingual and accessible to everyone, benefiting from the commitment of policy-makers at all stages of the process and ensuring the transparency and accountability of the actors involved. In order to launch crowdsourcing legislation at EU level, policy-makers and civil society organisations need to work together to foster eParticipation policies.
ECAS believes that only by including citizens in the policy-making process can we bridge the gap between Europe and its citizens. Co-legislating with citizens using crowdsourcing legislation is possible, it’s a reality and it’s our future. In line with its mid-term strategy ECAS is committed to facilitate, in cooperation with partners, a pilot to crowdsource legislation at EU level.
Hyperkinetic movement disorders represent a heterogeneous group of disorders in which involuntary... more Hyperkinetic movement disorders represent a heterogeneous group of disorders in which involuntary movements are the prevalent clinical symptoms. The five main categories of hyperkinetic disorders are tremor, dystonia, tics,myoclonus and drug-induced dyskinesia.The severity of hyperkinetic disorders is assessed by all clinicians when they examine a patient; quantifying the severity also provides a means of studying the natural history of a given disorder and the possible effect of new therapeutic interventions. This means that good rating instruments are required in both everyday practice and experimental settings. Unfortunately, the clinical evaluation of these disorders is complicated by the inherent nature and variability over time of involuntary movements. A number of scales have been proposed over the years to study the various hyperkinetic disorders. The aim of this review is to systematically identify all the clinical scales that have been proposed and to classify them according to the criteria developed by the Movement Disorder Society (MDS) task force for rating scales in Parkinson's disease.On the basis of this methodology, a scale may be defined as 'Recommended', 'Suggested' or 'Listed' in decreasing order of value.We found that, although numerous scales aimed at assessing hyperkinetic disorders have been published, their variability in terms of clinimetric properties, availability and effort required to administer them is high. In this evaluation, we identified scales defined as 'Recommended' for the assessment of all forms of hyperkinetic disorders. The situation highlighted by our analysis varies considerably, with several 'Recommended' scales being available for some conditions such as tics or dystonia, but only one being available for myoclonus. This gap needs to be filled by the scientific community through both the development of new clinical tools and there finement of existing ones.
we performed a three-stages door-to-door survey to estimate incidence and prevalence of epilepsy ... more we performed a three-stages door-to-door survey to estimate incidence and prevalence of epilepsy associated with convulsive seizures (EACS) in a rural area of Bolivia. the study was carried out in the Cordillera Province, southern-eastern Bolivia. One hundred fourteen rural communities with a total population of 18,907 inhabitants were included in the survey. In order to identify subjects with EACS, trained fieldworkers administered a validated single screening question to the householders (stage I). A second face-to-face questionnaire was administered to each positive subject (stage II) that, in case of positive answer, underwent a complete neurological examination to confirm the diagnosis (stage III). We estimated age and sex specific life-time and active EACS prevalence at the prevalence day (30th June 2010). Incidence risk was evaluated for the 10-year period between January 2000 and December 2010. on prevalence day we identified 136 subjects with EACS, 124 of whom had active epilepsy. The life-time prevalence of EACS was 7.2/1,000 (7.6/1,000 age-adjusted to the world standard population) while the prevalence of active EACS was 6.6/1,000 (6.7/1,000 age-adjusted to the world standard population). Both life-time and active prevalence showed a peak (10.3/1,000) in the 15-24 years age group and, overall, were higher among women. During the incidence study period, 105 patients living in the study area had the onset of EACS. The crude incidence risk was 55.4/100,000 (49.5/100,000 age-adjusted to the world standard population). Incidence was slightly but not significantly higher among women (58.9/100,000 versus 51.9/100,000). the present study demonstrated a considerable burden of EACS in the Bolivian Chaco, showing prevalence and incidence estimates close to those reported for low and middle- income countries and underlying the need of treatment programs.
In Parkinson&... more In Parkinson's disease (PD), different topographically defined cortical-subcortical oscillatory networks have been implicated in motor program dysfunction. Few studies have focused on clinical correlates of cortical activity asymmetry using quantitative electroencephalography. We retrospectively selected N = 34 l-dopa naïve PD subjects who had undergone standardized electroencephalography. We selected N = 18 subjects group-matched by age, sex and hand dominance with normal electroencephalography and no parkinsonism and/or cognitive decline as controls. A Welch's periodogram was applied to electroencephalographic signal epochs recorded from homologous pairs of electrodes over each hemisphere. An index of lateralization was then obtained as the absolute value of the electroencephalographic asymmetry index, computed by subtracting left from right-sided log power spectral density for each homologous site and frequency band. A standardized l-dopa acute challenge test was performed on all PD subjects to compute short-duration response magnitude. In mid/lateral frontal regions higher index of lateralization for the beta band (p = 0.015) and lower index of lateralization for the theta band (p = 0.036) were found in PD subjects as compared to controls. Both parameters correlated with Hoehn-Yahr staging (beta: r = 0.428, p = 0.012; theta: r = -0.464, p = 0.006). In occipital region lower index of lateralization for the alpha band was found in PD correlating with l-dopa short-duration response magnitude (r = 0.456; p = 0.007). Lateralization of frontal cortex beta electroencephalographic activity is associated with clinical disability. Occipital cortex alpha activity may relate to l-dopa responsiveness in untreated PD subjects.
Cognitive impairment (CIm) is a frequent finding in multiple sclerosis (MS) affecting up to 65 % ... more Cognitive impairment (CIm) is a frequent finding in multiple sclerosis (MS) affecting up to 65 % of patients. The aim of this study was to evaluate the prevalence and incidence of CIm in a population-based cohort of MS patients identified in the city of Catania from 1995 to 2004. One-hundred and twenty-five patients experiencing the onset of MS during 1995-2004 were enrolled. Cognitive performance was assessed through the Brief Repeatable Battery (BRB) of neuropsychological tests and the Stroop word-color task (ST). CIm was defined as the failure on at least three tests involving at least two different domains. Patients without CIm at baseline were followed up after over 3 years. The most impaired tests were the Symbol Digit Modalities Test (36 %) and the Paced Auditory Serial Addition Test 3 (35 %). At baseline the prevalence of CIm was 44 % (95 % CI 35.2-53.1). An almost sixfold increased risk of developing CIm was found among MS patients aged 40 and above at the time of the NPS examination (OR 5.84; 95 % CI 2.57-13.2; p value <0.0001) and a threefold increased risk for patients with an EDSS score >3 (OR 3.51; 95 % CI 1.30-9.46, p value 0.01). At the follow-up out of the 70 MS patients without CIm at baseline evaluation, 26 (37.1 %) developed CIm. The total person-years at risk was 269 person-years giving an incidence rate of CIm of 96.6/1,000 person-year (95 % CI 57.3-128.7). The overall prevalence of CIm in MS is 44 % and the incidence after 4 years is 37.1 %. CIm affects more frequently patients older than 40 years and with a higher EDSS score.
Purpose:´seau Action-Recherche sur l'Epilepsie) program, a model of managing and treating people ... more Purpose:´seau Action-Recherche sur l'Epilepsie) program, a model of managing and treating people with epilepsy (PWE) at a primary health-care level in rural areas of Mali, we assessed treatment efficacy and compliance of patients who underwent the first year follow-up.
Background: Trace elements have been hypothesised to be involved in the pathogenesis of Multiple ... more Background: Trace elements have been hypothesised to be involved in the pathogenesis of Multiple Sclerosis and volcanic degassing is the major natural sources of trace elements. Both incidence of Multiple Sclerosis in Catania and volcanic activity of Mount Etna have been significantly increased during the last 30 years. Due to prevailing trade winds direction, volcanic gases from Etna summit craters are mostly blown towards the eastern and southern sectors of the volcano.
Background: Cysticercosis is caused by the invasion of human or pig tissues by the metacestode la... more Background: Cysticercosis is caused by the invasion of human or pig tissues by the metacestode larval stage of Taenia solium. In Europe, the disease was endemic in the past but the autochthonous natural life cycle of the parasite is currently completed very rarely. Recently, imported cases have increased in parallel to the increased number of migrations and international travels. The lack of specific surveillance systems for cysticercosis leads to underestimation of the epidemiological and clinical impacts.
Objective: Human toxocariasis is a zoonotic infection caused by the larval stages of Toxocara can... more Objective: Human toxocariasis is a zoonotic infection caused by the larval stages of Toxocara canis (T. canis) and less frequently Toxocara cati (T. cati). A relationship between toxocariasis and epilepsy has been hypothesized. We conducted a systematic review and a meta-analysis of available data to evaluate the strength of association between epilepsy and Toxocara spp. seropositivity and to propose some guidelines for future surveys.
The difference in epilepsy burden existing among populations in tropical regions has been attribu... more The difference in epilepsy burden existing among populations in tropical regions has been attributed to many factors, including the distribution of infectious diseases with neurologic sequels. To define the burden of epilepsy in Latin American Countries (LAC) and to investigate the strength of association with neurocysticercosis (NCC), considered one of the leading causes of epilepsy, we performed a systematic review and meta-analysis of the literature.
Essential tremor (ET) is one of the most common movement disorders of adults, characterized by po... more Essential tremor (ET) is one of the most common movement disorders of adults, characterized by postural and kinetic tremor. It often causes embarrassment and more rarely serious disability, requiring treatment. To assess the current state of knowledge on ET therapy and produce recommendations based on the analysis of evidence the authors reviewed the literature regarding pharmacologic and surgical therapies, providing a quality assessment of the studies and the strength of recommendations for each treatment. A committee of experts selected clinical-based questions to guide the search. A systematic literature review was performed to identify all the studies conducted on patients with ET published until September 2010. Articles were classified according to GRADE evidence profile, a system for grading the quality of evidence and the strength of recommendation based on the quality of the studies. The quality of evidence was often rated as ''low'' or ''very low'' for the studies analyzed. Propranolol, long-acting propranolol, primidone, and topiramate are recommended as first-line therapy, with restrictions for their side effects. Arotinolol, sotalol, ICI 118.551 and LI 32.468 (experimental drugs), zonisamide, gabapentin, alprazolam, clozapine, and olanzapine are recommended as a second-line treatment. Botulinum toxin type A and thalamic deep-brain stimulation are recommended for refractory ET. The results highlight the need of well-designed direct comparison trials aimed at evaluating relative effectiveness and safety of the drugs currently used in clinical practice. Furthermore, additional controlled clinical trials are required to define other possible treatment strategies for ameliorating the management of ET. J Neurol (2013) 260:714-740 715 1 strong recommendation, 2 weak recommendation A, B, C, D indicate the quality of evidences (respectively high, moderate, low, very low) J Neurol (2013) 260:714-740 717 RCT randomized controlled trial, DBS deep-brain stimulation ??? Good degree of symptom control ::: Severe side-effects/high discontinuation rate :: Moderate side-effects/low discontinuation rate $ No side-effects J Neurol (2013) 260:714-740 725
A population-based case-control study in the city of Catania, Sicily, was carried out to determin... more A population-based case-control study in the city of Catania, Sicily, was carried out to determine restless legs syndrome (RLS) prevalence and its association with multiple sclerosis (MS). Patients were randomly selected from a cohort of MS patients resident in the study area and a group of age and sex matched controls was enrolled from the general population. RLS was diagnosed according to the International Restless Legs Syndrome Study Group criteria. In total, 152 MS patients and 431 controls were included in the study. A significantly higher prevalence of RLS amongst MS patients (14.5%) compared with controls (6.0%) was detected, corresponding to an almost threefold increased risk (odds ratio 2.7, 95% confidence interval 1.4-5.0) of developing RLS. Spinal cord lesions in MS patients were associated with a higher risk of RLS (odds ratio 3.7, 95% confidence interval 1.1-13.5). RLS was strongly associated with MS, with a significantly higher risk in patients presenting spinal cord lesions.
Epilepsy is associated with a significant burden of social stigma that appears to be influenced b... more Epilepsy is associated with a significant burden of social stigma that appears to be influenced by psychosocial and cultural factors. Stigma has a negative effect on the management of people with epilepsy (PWE), representing one of the major factors that contribute to the burden of epilepsy. To assess stigma perception among the Guarani population, one hundred thirty-two people living in Guaraní communities in Bolivia were invited to complete the Stigma Scale of Epilepsy questionnaire. The main determinants of stigma identified were: the fear linked to loss of control, the feelings of sadness and pity toward PWE, the difficulties faced by PWE in the professional and relationship fields, the level of education and type of seizure. Our study pointed out that, in this population, PWE face difficulties in everyday life because of epilepsy-associated stigma and the results attest to the importance of promoting community-based educational programs aimed at reducing the stigmatization process.
The overlap between obsessive compulsive personality disorder (OCPD) and obsessive compulsive dis... more The overlap between obsessive compulsive personality disorder (OCPD) and obsessive compulsive disorder (OCD) has received increasing recognition and continues to be a source of much debate. With the advent of new research methodologies, researchers have attempted to distinguish whether OCPD and OCD are two distinct phenomena that can co-occur or whether they are similar, overlapping constructs. MEDLINE was used to systematically review the OCPD and OCD literature published between 1991 and 2004. Using the more stringent DSM-IV criteria, results from OCD clinical samples suggest that the majority of individuals with OCD (75%) do not have OCPD. Similarly, results from personality disorder samples suggest that the majority of individuals with OCPD (80%) do not have OCD. While there is evidence that OCD and OCPD are linked, the literature does not support either one as a necessary or sufficient component of the other.
The purpose of this publication is to explore complementary methods to existing forms of interact... more The purpose of this publication is to explore complementary methods to existing forms of interaction between citizens and policy-makers at EU level which foster co-decision processes using the Internet and Web 2.0 technologies. Through crowdsourcing it is possible to go beyond national borders and engage a wider audience real-time online. This publication describes the use of crowdsourcing for policy-making in Iceland, Finland and Paris as non-exclusive examples, which show the added value of co-legislating with citizens in terms of process (wisdom of the crowd) and outcomes (increased legitimacy in the adopted policy).
At European level, based on the models identified and on the lessons’ learnt in the field of eParticipation projects, a design to test crowdsourcing on EU policies is outlined. This design takes into consideration the policy cycle and proposes the creation of an avenue for citizens to co-legislate together with policy-makers (EU officials and Members of the European Parliament) alongside the ordinary legislative procedure. The crowdsourcing exercise should take place independently from the EC consultation process, which is designed and best suited for consulting organised interest groups. It should be multilingual and accessible to everyone, benefiting from the commitment of policy-makers at all stages of the process and ensuring the transparency and accountability of the actors involved. In order to launch crowdsourcing legislation at EU level, policy-makers and civil society organisations need to work together to foster eParticipation policies.
ECAS believes that only by including citizens in the policy-making process can we bridge the gap between Europe and its citizens. Co-legislating with citizens using crowdsourcing legislation is possible, it’s a reality and it’s our future. In line with its mid-term strategy ECAS is committed to facilitate, in cooperation with partners, a pilot to crowdsource legislation at EU level.
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Papers by Elisa Bruno
At European level, based on the models identified and on the lessons’ learnt in the field of eParticipation projects, a design to test crowdsourcing on EU policies is outlined. This design takes into consideration the policy cycle and proposes the creation of an avenue for citizens to co-legislate together with policy-makers (EU officials and Members of the European Parliament) alongside the ordinary legislative procedure. The crowdsourcing exercise should take place independently from the EC consultation process, which is designed and best suited for consulting organised interest groups. It should be multilingual and accessible to everyone, benefiting from the commitment of policy-makers at all stages of the process and ensuring the transparency and accountability of the actors involved. In order to launch crowdsourcing legislation at EU level, policy-makers and civil society organisations need to work together to foster eParticipation policies.
ECAS believes that only by including citizens in the policy-making process can we bridge the gap between Europe and its citizens. Co-legislating with citizens using crowdsourcing legislation is possible, it’s a reality and it’s our future. In line with its mid-term strategy ECAS is committed to facilitate, in cooperation with partners, a pilot to crowdsource legislation at EU level.
At European level, based on the models identified and on the lessons’ learnt in the field of eParticipation projects, a design to test crowdsourcing on EU policies is outlined. This design takes into consideration the policy cycle and proposes the creation of an avenue for citizens to co-legislate together with policy-makers (EU officials and Members of the European Parliament) alongside the ordinary legislative procedure. The crowdsourcing exercise should take place independently from the EC consultation process, which is designed and best suited for consulting organised interest groups. It should be multilingual and accessible to everyone, benefiting from the commitment of policy-makers at all stages of the process and ensuring the transparency and accountability of the actors involved. In order to launch crowdsourcing legislation at EU level, policy-makers and civil society organisations need to work together to foster eParticipation policies.
ECAS believes that only by including citizens in the policy-making process can we bridge the gap between Europe and its citizens. Co-legislating with citizens using crowdsourcing legislation is possible, it’s a reality and it’s our future. In line with its mid-term strategy ECAS is committed to facilitate, in cooperation with partners, a pilot to crowdsource legislation at EU level.