La rappresentazione del rapporto tra utenti e sistema sanitario: I modelli culturali dei medici di medicina generale - The representation of the relationship between users and healthcare system: Cultural models of general practitioners

The present research study explores the emotional and symbolic representation of the Italian healthcare system and specifically of general medical services reported by a group of Italian general practitioners. General medicine is recently affected by a structural change which could be sustained also by a cultural revolution, however this revolution seems to be oriented to expected values without a clear methodology which promotes and accompanies this cultural change. The present study deals with the lack of practices due to these unrealized expected values and assumes that for intervening it is necessary knowing the existing culture before thinking to change it. Interviews to 36 general practitioners were analyzed by Emotional Text Analysis (AET). Results highlight a factorial space characterized by five clusters. According to respondents’ perspective, healthcare problems refer to two large issues characterized by powerlessness of general practitioners to intervene. On the one hand, there is health emergency, dealt with by first aid and emergency medicine. On the other hand, there is chronicity, especially affecting the elderly, which is dealt with by other workers (nurses, private family assistants, social workers) who care patients at home and replace physicians. The general practitioners’ work is difficult because of many different reasons; but the central theme is the lack of absolute power – based on morality and consciousness – which leads to the perception of catastrophic consequences for medical profession and the physician-patient relationship. Often, general practitioners are in their offices and are not able to go to patients’ home, therefore they cannot create care relationships based on trust and dependence which allow useful and trustworthy interventions. In sum, the core theme emerging from data refers to the general practitioners’ perceived lack of personal and trust-based relationships with patients

A model for Hopfions on the space-time S^3 x R

We construct static and time dependent exact soliton solutions for a theory of scalar fields taking values on a wide class of two dimensional target spaces, and defined on the four dimensional space-time S^3 x R. The construction is based on an ansatz built out of special coordinates on S^3. The requirement for finite energy introduces boundary conditions that determine an infinite discrete spectrum of frequencies for the oscillating solutions. For the case where the target space is the sphere S^2, we obtain static soliton solutions with non-trivial Hopf topological charges. In addition, such hopfions can oscillate in time, preserving their topological Hopf charge, with any of the frequencies belonging to that infinite discrete spectrum.Comment: Enlarged version with the time-dependent solutions explicitly given. One reference and two eps figures added. 14 pages, late

La relazione che organizza il contesto sanitario: domanda dell’utenza e risposta dei servizi sanitari, nel territorio e nell’ospedale - The relationship which organizes the healthcare context: users’ demand and response of healthcare services, in the territory and the hospital

Our intent is to present citizens’ demand of health care services in Italy through a research structured in three studies. We used the Emotional Text Analysis (ETA) to lead the three s tudies: the first study regarded the citizens’expectations of the healthcare services, the second study regarded the point of view of the hospital personnel (medical doctors and nurses), the third regarded the point of view of the General Practitioners onthe health care services. These three studies are briefly presented. Data and outcome of an Assumed Similarity Test applied to all experimental subjects of the three studies in order to make a comparison among them, are also presented. The findings of the Emotional Text Analysis show that citizens, potential users of health services, center their requests on their individual subjectivity, and seek answers both to their suffering and to the feeling of alienation that characterizes the being sick feeling that makes them go to a medical doctor. For their part, general practitioners and hospital doctors immediately transform this subjective feeling in an objective medical diagnosis. Here a first gap emerges between patient’s demand and medical response, leavingthe possibility of an alliance on the diagnosis in order to jointly fight the disease. It has long been in place though a change that has expelled the patient also from sharing the diagnostic process, increasingly taken from self-centered dynamics within the healthcare system. This widens the gap between the request of the citizens and the response of the health services, that contributes to that conflictual growth to which defensive medicine gives a dysfunctional answer. The Assumed Similarity Test contributes to the interpretation of the health care dynamic identified in the Emotional Text Analysis; particularly in regard to the unfolding conflict, given by the hypothesis emerging from the data analysis, that a feeling of closeness for the hospital personnel goes along with an emotional stance of overpowering the othe

Effects of intertrochanteric varus osteotomy on norberg angle and percent coverage of the femoral head in displastic dogs

This study was conducted to assess the effects of femoral varus osteotomy on joint congruency in dogs affected by early stage hip dysplasia. Preoperative planning to move the femoral head within the acetabulum was carried out. Varisation of the femoral inclination angle (fIA) was achieved by Intertrochanteric Osteotomy (ITO). Norberg angle (NA), percent coverage (PC) of the femoral head by the acetabulum and fIA was measured from preoperative, immediate postoperative and first and second recheck radiographs of seven dogs that underwent an ITO (joint n = 9). There was significant (p < 0.05) improvement of both NA and PC in all patients as indicated by a change in the mean \ub1 standard deviation of 78.9\ub0 \ub1 7.5 and 36.9% \ub1 5.2 to 92.2\ub0 \ub1 6.7 and 50.6% \ub1 8.3, respectively. No significant difference (p < 0.05) was observed between the values of the planned femoral inclination angle (pfIA) of the femur and the effective femoral inclination angle (efIA) obtained after surgery (115.9\ub0 \ub1 2.5 and 111.3\ub0 \ub1 6.4, respectively). These findings could encourage the use of ITO in veterinary practice and indicate that intertrochanteric varus osteotomy should be re-considered for the treatment of early stage hip dysplasia in dogs with radiological signs of joint incongruenc

Tuning Monte Carlo Generators: The Perugia Tunes

We present 9 new tunes of the pT-ordered shower and underlying-event model in PYTHIA 6.4. These "Perugia" tunes update and supersede the older "S0" family. The data sets used to constrain the models include hadronic Z0 decays at LEP, Tevatron minimum-bias data at 630, 1800, and 1960 GeV, Tevatron Drell-Yan data at 1800 and 1960 GeV, and SPS min-bias data at 200, 546, and 900 GeV. In addition to the central parameter set, called "Perugia 0", we introduce a set of 8 related "Perugia Variations" that attempt to systematically explore soft, hard, parton density, and colour structure variations in the theoretical parameters. Based on these variations, a best-guess prediction of the charged track multiplicity in inelastic, nondiffractive minimum-bias events at the LHC is made. Note that these tunes can only be used with PYTHIA 6, not with PYTHIA 8. Note: this report was updated in March 2011 with a new set of variations, collectively labeled "Perugia 2011", that are optimized for matching applications and which also take into account some lessons from the early LHC data. In order not to break the original text, these are described separately in Appendix B. Note 2: a subsequent "Perugia 2012" update is described in Appendix C.Comment: 46 page

Events with Isolated Charged Leptons and Large Missing Transverse Momentum at HERA

Striking events with isolated charged leptons, large missing transverse momentum and large transverse momentum of the hadronic final state were observed at the electron proton collider HERA in a data sample corresponding to a luminosity of about 130 pb-1. The H1 collaboration observed 11 events with isolated electrons or muons and with transverse momentum above 25 GeV. Only 3.4+-0.6 events were expected from Standard Model (SM) processes. Six of these events have a transverse momentum of greater than 40 GeV, while 1.3+-0.3 events were expected. The ZEUS collaboration observed good agreement with the SM. However, ZEUS found two events with a similar event topology, but tau leptons instead of electrons or muons in the final state. Only 0.2+-0.05 events were expected from SM processes. For various hypotheses the compatibility of the experimental results was investigated with respect to the SM and with respect to possible explanations beyond the SM. Prospects for the high-luminosity HERA-II data taking period are given

Like grandparents, like parents: Empirical evidence and psychoanalytic thinking on the transmission of parenting styles

The authors discuss the issue of intergenerational transmission of parenting from an empirical and psychoanalytic perspective. After presenting a framework to explain their conception of parenting, they describe intergenerational transmission of parenting as a key to interpreting and eventually changing parenting behaviors. Then they present (1) the empirical approach aimed at determining if there is actually a stability across generations that contributes to harsh parenting and eventually maltreatment and (2) the psyphoanalytic thinking that seeks to explain the continuity in terms of representations and clinical phenomena. The authors also discuss the relationship between the attachment and the caregiving systems and hypothesize a common base for the two systems in childhood experience. Finally, they propose the psychoanalytic perspective as a fruitful theoretical framework to integrate the evidence for the neurophysiological mediators and moderators of intergenerational transmission. Psychoanalytically informed research can provide clinically relevant insights and hypotheses to be tested