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Scienze Umane e Medical Humanities nella didattica medica. Il contributo della Storia della Medicina
Full text linkLe scienze storiche si aggiornano continuamente rivedendo a volte anche totalmente i propri cardini interpretativi su cui si posano le loro fondamenta; anche la Storia della Medicina ha decisamente cambiato la propria attività di ricerca nel corso degli anni. Nello studio che ho condotto ho potuto constatare come nell’arco di un secolo gli indirizzi di ricerca storico-medica si siano diversificati, come sia mutato il panorama dei protagonisti, come siano sorti nuovi interessi per la storia delle istituzioni sanitarie, per la storia delle malattie e delle singole discipline specialistiche. Alla ricerca di date significative di questo percorso, credo sia stata davvero importante, come vedremo, la nascita nel 1907 della Società Italiana di Storia delle Scienze Mediche e Naturali. Questa ricerca si è posta gli obiettivi di delineare come, nell’arco del secolo scorso, siano cambiate le identità di quanti affrontavano lo studio della Storia della Medicina, di stendere le biografie dei protagonisti della Storia della Medicina, di ricostruire un secolo di storiografia italiana tramite gli autori ed i trattati, i maestri e le legislazioni, di trattare della nascita e dello sviluppo delle Società e della stampa periodica in Italia inerente la Storia della Medicina, di analizzare le attualità e le problematiche della attività didattico-formativa, di indicare quali prospettive la Storia della Medicina, le Scienze Umane e le Medical Humanities possano avere oggi nella formazione del medico. Da alcuni anni si è aperta una discussione sull’ingresso delle Scienze Umane e delle Medical Humanities nei percorsi formativi delle professioni mediche, in particolare nei piani didattici delle Scuole di Medicina. Con l’avanzare della ricerca medico-scientifica, abbiamo assistito alla spersonalizzazione del rapporto medico-paziente. La necessità di affrontare e gestire questi cambiamenti porta senza dubbio al recupero delle origini umanistiche della medicina anche attraverso corsi nel piano didattico degli studenti dell’area sanitaria. Qui entrano in campo le Scienze Umane e le Medical Humanities su cui negli ultimi anni abbiamo avuto un aumento crescente di studi e pubblicazioni non solo in Italia, segno di un costante aumento di interesse da parte degli studiosi. Per il raggiungimento degli obiettivi sopra esposti mi sono indirizzata verso quanto è stato pubblicato dalla Società Italiana di Storia della Medicina (SISM) attraverso il suo periodico ed attraverso i cinquantuno Congressi Nazionali, ho consultato i maggiori trattati di Storia della Medicina editi dall’inizio del secolo scorso, i documenti emanati dal Regno d’Italia, dal Consiglio Superiore di Sanità, dal Ministero della Salute e da quello dell’Istruzione oltre gli articoli in riviste. Ho consultato le fonti conservate presso biblioteche universitarie e documenti di collezioni private. Per la ricerca ergobiografica mi sono avvalsa di testimonianze di coloro che hanno conosciuto personalmente alcuni dei personaggi oggetti del mio studio oltre che di ricerca archivistica.
I risultati del mio studio hanno sottolineato l’importanza della Storia della Medicina nella storiografia italiana del secolo scorso e nei piani didattici formativi del personale sanitario, in particolar modo per gli studenti di medicina. Inoltre la mia ricerca vuole essere un punto di partenza per analizzare e riflettere sull’attualità, le problematiche e le prospettive dell’insegnamento di Storia della Medicina, anche nelle più vaste denominazioni di Scienze Umane e di Medical humanities, alla luce di una ridefinizione dei Settori Scientifico Disciplinari (SSD)
La giurisdizione in materia extracontrattuale nello spazio giudiziario europeo.
No full textArticles 7 n. 2 of Regulation No 1215/2012 and 5 n. 3 of the Lugano Convention of 2007 regulate jurisdiction in cross-border non-contractual matters.
Given the issues of interpretation concerning the jurisdictional criterion of the “place where the harmful event occurred” (so-called locus commissi delicti), the European Court of Justice: i) developed the ubiquity rule; ii) differently located the place of the event giving rise to the damage and the place where the damage occurred, depending on the type of tort; iii) specified the ubiquity rule with the rule of the initial event giving rise to the damage, the relevance of direct and nonconsequential damages, the mosaic principle and the principle of territoriality and iv) included a third jurisdictional criterion in online defamation and antitrust matters and derogated to the mosaic principle in national trade mark, antitrust and product liability matters.
In light of such a variety of interpretations, this thesis considers to develop a uniform interpretation of the locus commissi delicti in cybertorts in order to confirm the sole principle of ubiquity by attributing jurisdiction to the court of the place of establishment of the wrongdoer and to the court of the place of the center of interest of the victim of the tort. This solution is also confirmed by Article 79, paragraph 2, of Regulation No 2016/679.
Regarding cross-border collective actions, the thesis proposes to include in Article 7 n. 2 of Regulation No 1215/2012 the jurisdictional criterion of the “place where the majority of the harmful event occurred or may occur”, referring to both the place where the majority of the event giving rise to the damage occurred and to the place where the majority of the damage occurred.
This thesis also considers the coordination between Article 7 n. 2 of Regulation No 1215/2012 and Articles 79, paragraph 2, of Regulation No 2016/679, 122, paragraph 2, lett. a) of Regulation No 2017/1001, 79, paragraph 3, lett. a) of Regulation No 6/2002 and 31 of the Agreement on a Unified Patent Court
Evaluation of a new ultrasonic device for surgical dissection in lung lobectomy and lymphadenectomy for lung cancer
Full text linkObjective
To assess and compare surgical electric hook vs Harmonic ACE Plus® impact on short-term postoperative outcomes after video-assisted thoracoscopic (VATS) lung lobectomy and lymphadenectomy for non-small cell lung cancer (NSCLC).
Materials and methods
We prospectively collected data of 120 consecutive patients [60% male; median age: 71 (62-76 IQR:) years] undergoing lung lobectomy and lymphadenectomy by VATS for NSCLC in our Center from October 1st 2016 to July 31th 2019. Patients were divided in two groups based on the device used for tissue dissection: the electric hook (Group A) in 68 cases and the Harmonic ACE Plus® (Group B) in 52. Multivariable analysis by binary logistic regression was performed in order to test the energy device as possible risk factor for pleural effusion volume at 48 hours after surgery and for postoperative chest tube duration.
Results
No intraoperative complications due to energy device were recorded in both groups.
Chylothorax incidence was higher in Group A with no statistically significant difference between the two groups (3% vs 0%; p-value=0.50). Pleural effusion volume during the first 48 postoperative hours was significantly higher in Group B: 253 ml (IQR: 149-405) vs 408 (IQR: 294-508) ml (p-value<0.01). However, chest tube duration was similar in the two groups: 4 (IQR: 3-8) vs 5 (IQR: 4-8) days (p-value=0.39). At multivariable analysis energy device was not independently associated with pleural effusion volume at 48 hours after surgery and with postoperative chest tube duration.
Conclusions
Electric hook or Harmonic ACE Plus® use during VATS lobectomy for NSCLC is safe and leads to similar postoperative short-term outcomes
Regulation mechanisms of human D-amino acid oxidase
No full textThe human peroxisomal FAD-dependent enzyme D-amino acid oxidase (hDAAO, EC 1.4.3.3) plays a key role in important physiological processes by catalyzing the stereospecific degradation of several D-amino acids (D-AAs). A number of studies demonstrated that a dysregulation in processes regulating D-AAs concentration is related to the mechanism(s) predisposing to several pathologies. The important role played by hDAAO in modulating D-AAs levels increased the interest for this flavoenzyme: while structural and biochemical properties have been extensively investigated, several aspects in the modulation of its functionality remain elusive. Furthermore, it has been recently suggested that DAAO could be mistargeted to the nucleus or secreted in the (mouse) intestinal lumen, where it could select the composition of gut microbiota by generating H2O2.
Here, some biochemical properties of the recombinant enzyme were investigated. Moreover, we focused on mistargeting of DAAO by studying a variant lacking the N-terminal signal peptide (thus shedding light on the mechanism of microbiota selection) and two variants at position 120 (a residue belonging to a putative nuclear translocation signal): the cellular targeting of the flavoenzyme seems a way to modulate hDAAO functionality. This modulation allows hDAAO to fulfil different physiological functions, such as the control of the level of D-Ser in the brain and of other D-AAs in different tissues or the selection of microbiota in the gut
Essays on multidimensional poverty measurement and the dependence among well-being dimensions
Full text linkEvaluating the welfare of nations is high on the research agenda of the economists, practitioners and policy-makers. The literature contributions of the last decades triggered a multivariate perception of the well-being, which is suggested to go beyond the GDP, and created a need for more complex approaches to evaluate the welfare as well as poverty. The first essay investigates the approaches to multivariate poverty measurement and focuses on the composite index approach and the steps involved in it. An important aspect of the multivariate perspective in well-being is the dependence among the underlying indicators. There is a growing evidence in the literature that well-being dimensions are interrelated. This dependence among attributes matters for multidimensional poverty measurement, since income is no longer the only indicator to be considered. However, the reviewed approaches to multivariate poverty measurement do not commonly capture this interdependence. The second essay suggests a copula function as a flexible tool to estimate the dependence among welfare variables. Moreover, it proposes to incorporate the evaluated dependence in the composite indicator. The trade-off among attributes, which is established via the weighting of dimensions, is identified as a possible channel to include the interdependence in the composite indicator. The third essay of this dissertation defines bivariate and multivariate copula-based measures of dependence and applies them using the recent data from the EU-SILC. The results suggest that key dimensions of well-being, i.e. income, education and health, are positively interdependent. In addition, the strength of pairwise and multivariate dependence reinforced in the post-crises period in some European countries. Finally, the last essay proposes a new class of the copula-based multidimensional poverty indices by innovating over the weighting approach. The weighting scheme proposed in this dissertation incorporates the estimated copula-based dependence and contains necessary normative controls to be chosen by the practitioner. The findings of the last essay suggest that the overall poverty is driven not only by the individual shortfalls, but also I by the degree of interdependence among well-being indicators. Considering the proposed copula-based weighting scheme and the proposal of the new class of copula-based poverty indices, this dissertation contributes to the multivariate poverty measurement by suggesting the channel to enclose the dependence structure in the composite indicators. The proposed copula-based methodology will advance the multidimensional poverty analysis and the poverty-reducing policy, which can be designed to address the problem of interdependence of individual achievements
Privacy nell’era digitale: la tutela dei dati personali fra legislazione e salvaguardia della libertà e dignità dell’uomo
Full text linkIn the first chapter, starting from some general definitions of privacy and tracing the history of the term since its modern affirmation, we have directed our attention to the inherent aspect of the protection of personal data, coming to outline the concept of privacy as "self-ownership ", an area belonging to the subject and, as such, like any economic asset (although it is an immaterial property) needs to be safeguarded from external interference. From the question of privacy and its protection, the foundations have been laid for a broader reflection, closely related to the values of human dignity and freedom, fundamental and essential components of every democracy.
In the second chapter we focused on the description of the complex social reality in which we live: postmodernity. Our analysis took into consideration three closely related aspects: 1. Technological aspect: it was highlighted how a radical anthropological change occurred in human being following an instrumental dimension that influenced his mindset (brainframe) allowing him to transcend the categories of space and time, virtually extending his being beyond the physicality of the body. 2. Socio-economic aspect: we have shown how the emergence of a new planetary economy has favored the birth of a morphological structure of the society of which the Network embodies the model par excellence. 3. Political aspect: the establishment of forms of power and control that tend to colonize every aspect of life in a subliminal way.
In the third chapter, starting from the concept of the infosphere, the economic, political and social value of the big data (Big data) and the dangers that may derive from their mismanagement by third parts or from their voluntary dissemination have been highlighted, as in the case of social networks.
In the fourth chapter the general legal principles underlying the right to privacy have been reported. Moving from a broader context, which sees the protection of the private life of the person sanctioned for the first time in 1948 with the Universal Declaration of Human Rights, we have restricted the field of investigation to the right to the protection of personal data, analyzing in the specific the most interesting points of the new General Data Protection Regulation (GDPR).
In the fifth and last chapter, we focused on what, hopefully, should be the direction to take to protect the person in the digital age and guarantee them the rights of freedom and dignity; it provides, in addition to solid legislation on data protection (a necessary but not sufficient condition), a cultural-educational policy aimed at making the individual acquire conscious digital citizenship
A cure for the soul: mesmerism, psychical research, and psychoanalysis in the life and work of Emilio Servadio (1904-1995)
No full textEmilio Servadio was an international scholar and psychoanalyst native of Sestri Ponente. He distinguished himself in several fields of studies and literary production, he wrote over one thousand contributions for the Enciclopedia italiana di Scienze, Lettere e Arti (1931) wrote poems and composed music, and also founded with his master, friend and colleague Edoardo Weiss, the Società Psicoanalitica Italiana. Servadio was renowned for the constitution of S.P.I., as well as he pioneered the field of psychoanalytic studies and sexology. In this context we may situate the beginning of Servadio's career and interest in the cure of sexual deviances.
A comparison between Eastern and Western culture and a multidisciplinary perspective towards different branch of humanities have a predominant role in Servadio's work, thought and therapeutic approach to sexual deviances. The life and work of the Genoese psychoanalyst was also deeply influenced by Metapsychic milieus. Evidence that Servadio's conception of therapeutics was strictly connected with these cultural fields and is conceived at the 'intersection' of different forms of knowledge is to be found in the beginning of his career. Servadio wrote several articles on the topic of the “interaction of body and soul”, which were published in the journals of psychoanalytical and metapsychic associations. Servadio was member of different metapsychic groups, which attended to find out which channels (of social, cultural, psychological and parapsychological nature) and means allow to make an interaction between the mind and the individual/collective psychic sphere possible, such as it happens in the “oneiric features” of dreams
La risicoltura italiana oltre la PAC: nuove opportunità e possibili strategie
No full textRice is the staple food of more than half of the world population and its availability is crucial to food security in a context of continuous demographic growth. Rice production also represents a fundamental economic activity: more than 110 countries are involved, generating a global paddy production of 759.6 million tonnes and an estimated international exchange of about 24.5 billion dollars. Likewise, rice production is strictly linked to social and environmental sustainability, as it is based on a complex ecological system, which has crucial influence on climate, biodiversity and landscape challenges.
Despite of its worldwide nature, rice market is highly concentrated. Italy has a key role since rice fields in the Po valley cover half of total EU28 production. Thanks to the agricultural self-sufficiency policy, Italian rice sector grew rapidly after the Second World War, highlighting the competitiveness of national producers and varieties. Nevertheless, in recent decades, the sector is wobbeling under the pressure of internal structural problems, combined with a global economic downturn and a critical evolution of the international commerce. A partial reduction of the number of farms as well as of the extension of cultivations, frequent price fluctuations and the fall of revenues, emphasise the presence of serious weaknesses and threats.
In such a context, the revision of the Common Agricultural Policy (CAP) is considered to be the main responsible of this crisis. Nevertheless, a critical overview underlines that it is only one of multiple interacting factors influencing rice market development, whereas lacks in business strategies and entrepreneurial culture determine a poor performance in this sector, at large. Moreover, CAP not only creates obstacles and limits to farmers’ activity, but also support innovative strategies for the renewal of this sector
Fluids at interfaces: Casimir effect, depletion and thermo-osmosis.
Full text linkThe critical Casimir effect is the long-range interaction between two planar walls in a critical fluid due to the confinement, achieved by the wall interfaces, of the critical density fluctuations. In this Thesis we provide a microscopic description of the critical Casimir force, introducing a novel density functional approximation coupled to the hierarchical reference theory of fluids.
The depletion interaction is an effective attractive force arising between colloidal particles immersed in a solvent: The first prediction of this effect dates back to the seminal work by Asakura and Oosawa and has been obtained assuming that the colloidal particles were perfectly smooth spheres immersed in an ideal gas. In this Thesis we address the study of the interaction potential mediated by an ideal gas between two rough colloidal particles, as a function of the geometry, the dimension and the spatial configuration of the corrugations.
When a thermal gradient is applied to a fluid at contact with a surface a stationary flow develops. This effect, referred to as thermo-osmosis, has been discovered in the late nineteenth century but successful theoretical descriptions have been up to now devised only when the fluid is a rarefied gas. In this thesis we presents a microscopic theory of thermo-osmosis based on a generalisation of linear response theory to inhomogeneous and anisotropic environments and to thermal disturbances
Per una storia della comunicazione globale: dal Centro Mondiale di Andersen al Web.
No full textThe concept of global communication was defined through the comparison between the World Centre of Communication and the World Wide Web. This notion refers to the idea, spread in the nineteenth century, to create a system which ensure connection over long distances. Electrification, the construction of infrastructures and the use of media allowed to connect geographically distant places. This process, which began in the 19th century, ended its long and difficult path between the 80s and 90s of the 20th century with the advent of the World Wide Web. Well before Tim Berners Lee’s innovation, Norwegian sculptor Hendrik Christian Andersen developed an ideal project with similar objectives: The World Centre of Communication. Poorly studied by historiography in the field of technology and communication, this plan represented the hypothesis to create a universal communication system to connect different territories and spread information and knowledge throughout the globe. Unfortunately, this idea remained a utopia; while the Web has developed between the 80s and 90s of the twentieth century, becoming a real universal library of information open and accessible. Over time Lee’s innovation has gone into crisis. The digital giants have taken control of the network: through the algorithms - complex, opaque and invisible -, they have undermined the pedagogical and educational functions of the Web, supporting a commercial orientation