Alcune considerazioni sulla natura giuridica della responsabilità da illecito endofamiliare e sulla sua estensibilità all'interno della famiglia di fatto

Recourse to compensatory measures within marital relationships is a recent occurrence in Italian Courts, achieved after a long and complex evolution. This study analyses the current doctrinal debate on the correct legal framework of intrafamily tort liability: it presents an accurate reconstruction of the provisions of the Italian Civil Code (with particular reference to Article 2059 thereof) and some possible adjustments of the current model established by the legal practice. Lastly, the study offers a reflection on the extension of intrafamily tort liability to non-married partners, as the Italian Court of Cassation held in 2013

Brexit and the EU Patent

This paper addresses as EU patent the “European patent with unitary effect”, and concludes that 1) the EU patent applies only to the EU territory; 2) the instruments composing the Patent Package are tied to each other; 3) the UK withdrawal makes the TEU and TFEU and the whole EU secondary law inapplicable to UK; 4) the withdrawal extends to the UPCA; 5) the currently scheduled UPC London section has to be re-located in another EU member state; 6) the UK ratification of the UPCA would infringe a general principle of the Vienna convention on treaties (according to which they have to be performed in good faith); the private law principle on the performance of contracts in good faith, considered as a source of international law under Art. 38 of the International Court of Justice statute; and the principles deriving from those on good faith, which impose protection of co-contracting partie

Are Guidelines Needed for the Diagnosis and Management of Incipient Alzheimer's Disease and Mild Cognitive Impairment?

Current research is aiming to push the boundaries of the point at which a diagnosis of Alzheimer Disease (AD) can be made. Clinical syndromes such as Mild Cognitive Impairment (MCI) and various clinical and biological markers of AD may help to identify people in the early stage of AD, before a full dementia syndrome is present. In the first part of this paper, we discuss whether MCI represents incipient AD, and examine some of the methods currently used in research to identify AD patients in the preclinical phase. In the second part, we discuss whether specific guidelines are needed for the diagnosis and management of MCI and incipient AD, and consider the potential impact of this on clinical practice and public health from the perspective of patients, caregivers, and healthcare providers

Corticobasal syndrome: neuroimaging and neurophysiological advances

Corticobasal degeneration (CBD) is a neurodegenerative condition characterized by 4R-tau protein deposition in several brain regions that clinically manifests itself as a heterogeneous atypical parkinsonism typically expressing in the adulthood. The prototypical clinical phenotype of CBD is corticobasal syndrome (CBS). Important insights into the pathophysiological mechanisms underlying motor and higher cortical symptoms in CBS have been gained by using advanced neuroimaging and neurophysiological techniques. Structural and functional neuroimaging studies often showed asymmetric cortical and subcortical abnormalities, mainly involving perirolandic and parietal regions and basal ganglia structures. Neurophysiological investigations including electroencephalography and somatosensory evoked potentials provided useful information on the origin of myoclonus and on cortical sensory loss. Transcranial magnetic stimulation demonstrated heterogeneous and asymmetric changes in the excitability and plasticity of primary motor cortex and abnormal hemispheric connectivity. Neuroimaging and neurophysiological abnormalities in multiple brain areas reflect the asymmetric neurodegeneration, leading to the asymmetric motor and higher cortical symptoms in CBS. This article is protected by copyright. All rights reserved

Non-Pharmacological Intervention for Memory Decline

Non-pharmacological intervention of memory difficulties in healthy older adults, as well as those with brain damage and neurodegenerative disorders, has gained much attention in recent years. The two main reasons that explain this growing interest in memory rehabilitation are the limited efficacy of current drug therapies and the plasticity of the human central nervous and the discovery that during aging, the connections in the brain are not fixed but retain the capacity to change with learning. Moreover, several studies have reported enhanced cognitive performance in patients with neurological disease, following non-invasive brain stimulation [i.e., repetitive transcranial magnetic stimulation and transcranial direct current stimulation to specific cortical areas]. The present review provides an overview of memory rehabilitation in individuals with mild cognitive impairment and in patients with Alzheimer’s disease with particular regard to cognitive rehabilitation interventions focused on memory and non-invasive brain stimulation. Reviewed data suggest that in patients with memory deficits, memory intervention therapy could lead to performance improvements in memory, nevertheless further studies need to be conducted in order to establish the real value of this approach

I riflessi delle stock options sulle cause determinanti della crisi finanziaria

Le tecniche di remunerazione degli amministratori, volte a mitigare i problemi di agency delle grandi società - attraverso l’allineamento dell’interesse degli amministratori e dei managers a quello delle società – risultano scarsamente regolamentate in tutti i principali ordinamenti che si limitano, in prevalenza, a disciplinare la trasparenza e la competenza del procedimento che approva i compensi. Le esperienze degli ultimi anni segnalano una diffusa e preoccupante divaricazione tra remunerazione ed andamento dell’impresa, che contraddice la stessa logica dell’incentivazione. In particolare, le stock options hanno indotto il management a massimizzare il valore delle azioni nel breve periodo, attraverso l’adozione di strategie e decisioni eccessivamente rischiose, idonee a mantenere elevato il valore dei titoli entro un arco temporale limitato, al fine di beneficiare, per le opzioni esercitabili, dei vantaggi legati alla immediata crescita della quotazione. In taluni casi l’obiettivo è stato perseguito con il ricorso a prassi contabili creative ed aggressive - volte a fornire una rappresentazione ottimistica e di breve periodo dei risultati economici delle società – degenerati talvolta in vere e proprie manipolazioni di mercato ed in frodi contabili, dirette sempre al condizionamento delle quotazioni. Trattasi di fenomeni che, delineando un’eccessiva attenzione dei managers al dato finanziario più che a quello produttivo, determinando un’errata percezione del valore delle società da parte del mercato, hanno contribuito all’inefficiente valutazione dei rischi dalle stesse assunti. Particolarmente nel settore bancario e finanziario, le stock options hanno contribuito a rendere i bilanci più opachi di quanto già non lo fossero - visti i complessi strumenti finanziari che gli intermediari avevano nei loro portafogli – impedendo l’esatta conoscenza della loro esposizione debitoria. E la cattiva stima dei rischi e dei debiti è tra i fattori che hanno scatenato la crisi finanziaria. Individuato il collegamento tra stock options, condotte manageriali e gestione/conoscibilità del rischio, lo studio analizza i correttivi normativi che la più accreditata dottrina americana propone di adottare nella struttura di queste sofisticate tecniche di remunerazione, comuni oramai alle società di tutti gli ordinamenti

Action and Object Naming in Physiological Aging: An rTMS Study

Word-retrieval difficulties commonly occur in healthy aging. Recent studies report an improved ability to name pictures after the administration of high-frequency repetitive transcranial magnetic stimulation (rTMS) in healthy younger adults and in patients with neurological disease. The aim of this study was to assess the effect of high-frequency rTMS applied to the dorsolateral prefrontal cortex (DLPFC) on picture naming in healthy older adults. High-frequency rTMS was applied to the left and right DLPFC during object and action naming in 13 healthy older adults. The naming latency for actions was shortened after stimulation of the left and right DLPFC compared to application of the sham stimulation. Stimulation was not observed to have any effect on correctness of naming. Our data demonstrate the involvement of the left and right DLPFC in a sample of healthy aging subjects during an action-naming task. The bilateral involvement of the DLPFC in these participants is discussed together with data on younger adults and on Alzheimer's patients

"Delirium Day": A nationwide point prevalence study of delirium in older hospitalized patients using an easy standardized diagnostic tool

Background: To date, delirium prevalence in adult acute hospital populations has been estimated generally from pooled findings of single-center studies and/or among specific patient populations. Furthermore, the number of participants in these studies has not exceeded a few hundred. To overcome these limitations, we have determined, in a multicenter study, the prevalence of delirium over a single day among a large population of patients admitted to acute and rehabilitation hospital wards in Italy. Methods: This is a point prevalence study (called "Delirium Day") including 1867 older patients (aged 65 years or more) across 108 acute and 12 rehabilitation wards in Italian hospitals. Delirium was assessed on the same day in all patients using the 4AT, a validated and briefly administered tool which does not require training. We also collected data regarding motoric subtypes of delirium, functional and nutritional status, dementia, comorbidity, medications, feeding tubes, peripheral venous and urinary catheters, and physical restraints. Results: The mean sample age was 82.0 ± 7.5 years (58 % female). Overall, 429 patients (22.9 %) had delirium. Hypoactive was the commonest subtype (132/344 patients, 38.5 %), followed by mixed, hyperactive, and nonmotoric delirium. The prevalence was highest in Neurology (28.5 %) and Geriatrics (24.7 %), lowest in Rehabilitation (14.0 %), and intermediate in Orthopedic (20.6 %) and Internal Medicine wards (21.4 %). In a multivariable logistic regression, age (odds ratio [OR] 1.03, 95 % confidence interval [CI] 1.01-1.05), Activities of Daily Living dependence (OR 1.19, 95 % CI 1.12-1.27), dementia (OR 3.25, 95 % CI 2.41-4.38), malnutrition (OR 2.01, 95 % CI 1.29-3.14), and use of antipsychotics (OR 2.03, 95 % CI 1.45-2.82), feeding tubes (OR 2.51, 95 % CI 1.11-5.66), peripheral venous catheters (OR 1.41, 95 % CI 1.06-1.87), urinary catheters (OR 1.73, 95 % CI 1.30-2.29), and physical restraints (OR 1.84, 95 % CI 1.40-2.40) were associated with delirium. Admission to Neurology wards was also associated with delirium (OR 2.00, 95 % CI 1.29-3.14), while admission to other settings was not. Conclusions: Delirium occurred in more than one out of five patients in acute and rehabilitation hospital wards. Prevalence was highest in Neurology and lowest in Rehabilitation divisions. The "Delirium Day" project might become a useful method to assess delirium across hospital settings and a benchmarking platform for future surveys

Different Apathy Profile in Behavioral Variant of Frontotemporal Dementia and Alzheimer's Disease: A Preliminary Investigation

Apathy is one of the most common behavioral symptoms of dementia; it is one of the salient features of behavioral variant of frontotemporal dementia (bvFTD) but is also very frequent in Alzheimer's disease. This preliminary investigation was aimed at assessing the type of apathy-related symptoms in a population of bvFTD and AD subjects showing comparable apathy severity. Each patient underwent a comprehensive neuropsychological assessment; behavioral changes were investigated by the neuropsychiatric inventory (NPI), using the NPI-apathy subscale to detect apathetic symptoms. At univariate analysis, bvFTD subjects showed lack of initiation (χ2 = 4.602, p = 0.032), reduced emotional output (χ2 = 6.493, p = 0.008), and reduced interest toward friends and family members (χ2 = 4.898, p = 0.027), more frequently than AD subjects. BvFTD displayed higher scores than AD on NPI total score (p = 0.005) and on subscales assessing agitation (p = 0.004), disinhibition (p = 0.007) and sleep disturbances (p = 0.025); conversely, AD subjects were more impaired on memory, constructional abilities, and attention. On multivariate logistic regression, reduced emotional output was highly predictive of bvFTD (OR = 18.266; p = 0.008). Our preliminary findings support the hypothesis that apathy is a complex phenomenon, whose clinical expression is conditioned by the site of anatomical damage. Furthermore, apathy profile may help in differentiating bvFTD from AD