Changes to the welfare system in post-modern society

The post modern society has increased the welfare state crisis, and strengthened the relationship between economy and society. The literature considers the welfare as a maker of local development. The social policy is able to produce health, social capital and capability. These aspects are called “social determinant of the development”. The post modernity increased also the different kind of “course of live” and social risks. The welfare state has produced a standardization of the services, but this differentiation breaks this kind of answer to social needs. The needs differentiation requires services more personalized. The welfare mix has increased and differentiated the producers of welfare’s services. This aspect requires new way of regulation able to integrate hierarchy, market and network. This approach requires a revision of governance technologies in order to avoid an increase of bureaucratic proceduresWelfare mix, social determinant, governace

Medicina specialistica e community care

I sistemi sanitari di tutti i paesi occidentali stanno attraversando un periodo di profonda trasformazione. I cambiamenti socio-economici ed epidemiologici hanno contribuito a mostrare i limiti delle attuali politiche sanitarie ed hanno l’urgenza di porre i servizi territoriali al centro. Questo processo richiede una rivisitazione delle forme organizzative territoriali, delle identità e dei ruoli degli operatori del settore. Il libro affronta il dibattito su questo processo di cambiamento con particolare attenzione al ruolo dei medici specialisti che operano nel SSN a livello territoriale

Crisi economica e comportamenti illegali

"Economic and sociological research has long shown that the widespread presence of criminal organizations in the territory is a factor that contrasts economic and social development. This is just one aspect of the complex relationship that exists between local economic dynamics and the illegal behavior of social actors. The relationship between social norms and legal norms, the quality and quantity of social capital, the bonds of trust between the actors and the legitimization of the state, the local power systems, the certainty of the sanctions, are other aspects that certainly contribute to create the conditions that favor illegal responses to the crisis. The book seeks to highlight how legality and illegality present facets and interdependencies that can't simply be traced back to the moral categories of good and evil, but need to be analyzed in a multifactorial perspective.

Comparing hybrid welfare systems: The differentiation of health and social care policies at the Regional Level in Italy

Welfare-state research has traditionally been centered on national states, while regional differences have received less attention. This article analyzes local welfare policies in 20 Italian regions using data in 2005 and 2010. We use factor and cluster analysis and typological classifications on institutional data concerning two areas of intervention, social care and healthcare policies. The results show that the Italian welfare system is a hybrid and is differentiated both across regions and policies. By using a regional perspective, we highlight the need to consider the subnational level as central to the construction of descriptive welfare typology

Deep HST imaging surveys and the formation of spheroidal galaxies

We have extended our previous analysis of morphologically selected elliptical and S0 galaxies in the Hubble Deep Field (HDF) North to include HST data in the HDF South and the HDFS-NICMOS areas. Our final sample amounts to 69 E/S0 galaxies with $K<20.15$ over an area of 11 square arcmins. Although a moderately small number over a modest sky area, this sample benefits of the best imaging and photometric data available on high-redshift galaxies. Multi-waveband photometry allows us to estimate with good accuracy the redshifts for the majority of these galaxies which lack a spectroscopic measure. We confirm our previous findings that massive E/S0s tend to disappear from flux-limited samples at $z>1.4$. This adds to the evidence that the rest-frame colours and SEDs of the numerous objects found at $0.8<z<1.2$ are inconsistent with a very high redshift of formation for the bulk of stars, while they are better consistent with protracted (either continuous or episodic) star-formation down to $z \le 1$. These results based on high-quality imaging on a small field can be complemented with data from colour-selected EROs on much larger sky areas: our claimed demise of E/S0s going from $z=1$ to $z=1.5$ is paralleled by a similarly fast decrease in the areal density of EROs when the colour limit is changed from $(R-K)=5$ to $(R-K)=6$ (corresponding to $z\simeq 1$ and $z\simeq 1.3$ respectively). Altogether, the redshift interval from 1 to 2 seems to correspond to a very active phase for the assembly of massive E/S0 galaxies in the field, and also probably one where a substantial fraction of their stars are formed.Comment: 9 pages, 7 figures -- Version accepted by MNRA

Final results of the second prospective AIEOP protocol for pediatric intracranial ependymoma

BACKGROUND: This prospective study stratified patients by surgical resection (complete = NED vs incomplete = ED) and centrally reviewed histology (World Health Organization [WHO] grade II vs III). METHODS: WHO grade II/NED patients received focal radiotherapy (RT) up to 59.4 Gy with 1.8 Gy/day. Grade III/NED received 4 courses of VEC (vincristine, etoposide, cyclophosphamide) after RT. ED patients received 1-4 VEC courses, second-look surgery, and 59.4 Gy followed by an 8-Gy boost in 2 fractions on still measurable residue. NED children aged 1-3 years with grade II tumors could receive 6 VEC courses alone. RESULTS: From January 2002 to December 2014, one hundred sixty consecutive children entered the protocol (median age, 4.9 y; males, 100). Follow-up was a median of 67 months. An infratentorial origin was identified in 110 cases. After surgery, 110 patients were NED, and 84 had grade III disease. Multiple resections were performed in 46/160 children (28.8%). A boost was given to 24/40 ED patients achieving progression-free survival (PFS) and overall survival (OS) rates of 58.1% and 68.7%, respectively, in this poor prognosis subgroup. For the whole series, 5-year PFS and OS rates were 65.4% and 81.1%, with no toxic deaths. On multivariable analysis, NED status and grade II were favorable for OS, and for PFS grade II remained favorable. CONCLUSIONS: In a multicenter collaboration, this trial accrued the highest number of patients published so far, and results are comparable to the best single-institution series. The RT boost, when feasible, seemed effective in improving prognosis. Even after multiple procedures, complete resection confirmed its prognostic strength, along with tumor grade. Biological parameters emerging in this series will be the object of future correlatives and reports

Pediatric diffuse midline glioma H3K27- altered: A complex clinical and biological landscape behind a neatly defined tumor type

The 2021 World Health Organization Classification of Tumors of the Central Nervous System, Fifth Edition (WHO-CNS5), has strengthened the concept of tumor grade as a combination of histologic features and molecular alterations. The WHO-CNS5 tumor type “Diffuse midline glioma, H3K27-altered,” classified within the family of “Pediatric-type diffuse high-grade gliomas,” incarnates an ideally perfect integrated diagnosis in which location, histology, and genetics clearly define a specific tumor entity. It tries to evenly characterize a group of neoplasms that occur primarily in children and midline structures and that have a dismal prognosis. Such a well-defined pathological categorization has strongly influenced the pediatric oncology community, leading to the uniform treatment of most cases of H3K27-altered diffuse midline gliomas (DMG), based on the simplification that the mutation overrides the histological, radiological, and clinical characteristics of such tumors. Indeed, multiple studies have described pediatric H3K27-altered DMG as incurable tumors. However, in biology and clinical practice, exceptions are frequent and complexity is the rule. First of all, H3K27 mutations have also been found in non-diffuse gliomas. On the other hand, a minority of DMGs are H3K27 wild-type but have a similarly poor prognosis. Furthermore, adult-type tumors may rarely occur in children, and differences in prognosis have emerged between adult and pediatric H3K27-altered DMGs. As well, tumor location can determine differences in the outcome: patients with thalamic and spinal DMG have significantly better survival. Finally, other concomitant molecular alterations in H3K27 gliomas have been shown to influence prognosis. So, when such additional mutations are found, which one should we focus on in order to make the correct clinical decision? Our review of the current literature on pediatric diffuse midline H3K27-altered DMG tries to address such questions. Indeed, H3K27 status has become a fundamental supplement to the histological grading of pediatric gliomas; however, it might not be sufficient alone to exhaustively define the complex biological behavior of DMG in children and might not represent an indication for a unique treatment strategy across all patients, irrespective of age, additional molecular alterations, and tumor location

The evolution of early-type galaxies in clusters from z~ 0.8 to z~ 0: the ellipticity distribution and the morphological mix

We present the ellipticity distribution and its evolution for early-type galaxies in clusters from z~0.8 to z~0, based on the WIde-field Nearby Galaxy-cluster Survey (WINGS)(0.04<z<0.07), and the ESO Distant Cluster Survey (EDisCS)(0.4<z<0.8). We first investigate a mass limited sample and we find that, above a fixed mass limit, the ellipticity distribution of early-types noticeably evolves with redshift. In the local Universe there are proportionally more galaxies with higher ellipticity, hence flatter, than in distant clusters. This evolution is due partly to the change of the mass distribution and mainly to the change of the morphological mix with z (among the early types, the fraction of ellipticals goes from ~70% at high to ~40% at low-z). Analyzing separately the ellipticity distribution of the different morphological types, we find no evolution both for ellipticals and S0s. However, for ellipticals a change with redshift in the median value of the distributions is detected. This is due to a larger population of very round (e<0.05) elliptical galaxies at low-z. To compare our finding to previous studies, we also assemble a magnitude-"delimited" sample that consists of early-type galaxies on the red sequence with -19.3>M_B+1.208z>-21. Analyzing this sample, we do not recover exactly the same results of the mass-limited sample. Hence the selection criteria are crucial to characterize the galaxy properties: the choice of the magnitude-delimited sample implies the loss of many less massive galaxies and so it biases the final results. Moreover, although we are adopting the same selection criteria, our results in the magnitude-delimited sample are also not in agreement with those of Holden et al.(2009). This is due to the fact that our and their low-z samples have a different magnitude distribution because the Holden et al.(2009) sample suffers from incompleteness at faint magnitudes.Comment: 19 figures and 9 tables, MNRAS in pres