The local public library among municipality, region and state: a dispute with no real disputant

Trattare di legislazione bibliotecaria può sembrare un approccio un po' accademico al mondo delle biblioteche, certamente astratto. Non è così: i principi e gli indirizzi che la legislazione individua e pone come linee guida vanno a incidere profondamente sul tessuto connettivo ed organizzativo dell’oggetto in questione, in questo caso le biblioteche pubbliche locali. Esse sono a tutti gli effetti istituzioni chiamate a svolgere un servizio pubblico, e sono condizionate nella loro attività e nel loro funzionamento proprio dalla normativa che di esse si occupa – o si occupa male, o non si occupa affatto.La legislazione regionale vigente in materia di biblioteche colpisce per la sua staticità, ripetitività e obsolescenza. Questo copioso insieme di norme – approvato in gran parte negli anni Ottanta del Novecento e ripreso in alcuni casi nel decennio passato al solo scopo di riallinearlo (senza novità sostanziali) al nuovo Codice dei beni Culturali e del Paesaggio (D. lgs. 42/2004) – è tutt’ora impostato e costruito intorno a principi e finalità in gran parte superati.Per non vedere afflosciarsi e cadere nel nulla l'investimento qualitativo fin qui prodotto ed economicamente sostenuto da gran parte dalle municipalità, sembra a questo punto urgente e necessario procedere a una radicale reimpostazione normativa dei servizi bibliotecari pubblici, anche a fronte dei cambiamenti che nel frattempo sono intervenuti in quella che oggi viene definita “società dell’informazione”.Writing about library law may seem a rather theoretical approach to the library world, but the principles and orientations identified by the law actually affect the connective and organizational tissue of local public libraries, and they do it in a quite substantial way. Public libraries are – to all intents and purposes – institutions intended to provide a public service, and in providing that service they're influenced by the law. Sometimes it is a good law, sometimes it's not, and sometimes there's just no law at all.In Italy, the existing regional library law is amazingly static, repetitive and obsolescent. It is a huge set of laws passed during the 1980s, and sometimes adjusted during the last decade in order to adapt them (with no substantial changes) to the new Code of the Cultural and Landscape Heritage, Legislative Decree no. 42/2004. These laws are still based upon principles and aims well out-of-date, and if we don't want to waste the investment done so far it is now necessary to proceed with a completely new public library law, also in consideration of the changes occurred in what we call “the information society”

Réformer les services

L’histoire des bibliothèques en Italie est particulièrement complexe et difficile à suivre tout comme peut l’être celle de leurs collections, riches et variées. Jamais l’État n’a manifesté la volonté de planifier ni de développer un système national au sein duquel seraient précisés les cadres, les fonctions et les particularités des différents types de bibliothèques. L’auteur réfléchit ici aux effets d’une réforme des services publics et privés

Otimização da aplicação comercial - concept SPA & leisure

The applications dedicated to the spa and leisure are in huge demand due to the latter growth in developed countries. This type of application has been designed to manage activities at hotels, health spas and leisure venues. Usually, appointments are booked quickly and efficiently via a series of flexible grid control screens or through an availability search, where the system automatically finds available times. This project presents a solution to the problem of SPA & Leisure (SPA) application. Nowadays it generates thousands of records daily, which leads to increase data on the database. Currently, the application is facing a performance challenge due to the amount of data involved in the booking process. The objective of the present work is to propose a dedicated notification framework to optimize the SPA application. The main goal of this framework model is to reduce traffic on the network between the client application and database server. This would be achieved by using as much as possible data stored locally, rather than requesting it from the database every time it is needed. The search engine process is speeded up, keeping as many data as possible within the client application. A message broadcast framework will be created to maintain local data synchronized with the database. The main idea is to have a parallel system to keep watching data changes on the database and as soon as data change, a message will be sent to processes to inform that current data held is out-of-date and must be refreshed before use in the client application. In the meantime, the Message Broadcast Framework was implemented. The tests performed and the analysis of their results, are presented in Chapter 5.As aplicações dedicadas ao spa e lazer estão em grande demanda devido ao crescimento destes nos países desenvolvidos. Esse tipo de aplicação foi projetado para gerir atividades em hotéis, spas e locais de lazer. Normalmente, os compromissos são agendados de forma rápida e eficiente por meio de uma série de ecrãs com grelhas flexíveis ou por meio de pesquisa de disponibilidade, na qual o sistema encontra automaticamente os horários disponíveis. Este trabalho apresenta uma solução para o problema da aplicação SPA & Leisure (SPA). Atualmente, a aplicação enfrenta um desafio de desempenho devido à quantidade de dados envolvidos no processo de reserva. O objetivo deste trabalho é propor uma forma de notificação dedicada para otimizar a aplicação SPA. O principal objetivo deste modelo é reduzir o tráfego na rede entre a aplicação cliente e o servidor da base de dados. Isto será obtido usando os dados armazenados localmente, sempre que possível, em vez de solicitá-los à base de dados sempre que for necessário. Uma estrutura de transmissão de mensagens será criada para manter os dados locais sincronizados com a base de dados. O intuito é ter um sistema paralelo a observar continuamente as mudanças de dados na base de dados e assim que forem alterados, uma mensagem será enviada às aplicações para informar que os seus dados estão desatualizados e devem ser atualizados antes de serem utilizados. Entretanto, o sistema de mensagens foi implementado. Os testes efetuados e a análise dos resultados são apresentados no capítulo 5

Prognostic Correlates of Combined Coronary Flow Reserve Assessment on Left Anterior Descending and Right Coronary Artery in Patients with Negative Stress Echocardiography by Wall Motion Criteria.

Aims: To assess the prognostic correlates of Doppler echocardiographically derived coronary flow reserve (CFR) on two coronaries in patients with negative stress echo. Vasodilator stress echocardiography allows dual imaging of regional wall motion and CFR both on left anterior descending (LAD) and right coronary artery (RCA). Methods: The study group comprised 460 patients with known or suspected coronary artery disease and negative stress echo by wall motion criteria. All underwent dipyridamole (up to 0.84 mg/kg over 6 minutes) stress echo with CFR evaluation of either LAD or RCA by Doppler, and were followed up for a median of 32 months. A CFR value of(2.0 was taken as abnormal. Results: CFR was abnormal in 174 patients (38%) (57 in LAD only, 48 in RCA only, and 69 in both LAD and RCA) and normal in 286 patients (62%). During follow-up, there were 77 cardiac events: 5 deaths, 44 acute coronary syndromes (6 STEMI, and 38 NSTEMI) and 28 late (.6 months from stress echo) revascularisations. CFR of (2.0 on LAD was the strongest multivariable predictor of either definite (death, acute coronary syndrome) and major (death, acute coronary syndrome, late revascularisation) events, followed by diabetes mellitus. Antiischaemic therapy at the time of testing and resting wall motion abnormality were also independently associated with major events. Preserved CFR in both LAD and RCA was associated with better (p,0.0001) definite and major event-free survival compared to abnormal CFR in one or both coronary vessels. Conclusion: CFR evaluation of either LAD or RCA allows the identification of distinct prognostic patterns. In particular, preserved CFR in both coronary vessels is highly predictive of a very favourable outcome, while reduced CFR in either coronary vessel, and especially on LAD, is a strong predictor of future cardiac events

Additive Prognostic Value of Coronary Flow Reserve in Patients With Chest Pain Syndrome and Normal or Near-Normal Coronary Arteries

In patients with angiographically normal coronary arteries and chest pain, pharmacologic stress echocardiography can identify a subgroup of patients with a less benign prognosis. Coronary flow reserve (CFR) in the left anterior descending artery (LAD) can currently be combined with wall motion analysis during vasodilator stress echocardiography. The aim of this study was to assess the prognostic value of CFR response in patients with normal coronary arteries and normal wall motion during stress. We selected 394 patients (171 men, 61 11 years of age) who underwent dipyridamole stress echocardiography (0.84 mg/kg over 6 minutes) with 2-dimensional echocardiography and CFR evaluation of the LAD by Doppler. All had angiographically nonsignificant (<50% quantitatively assessed) stenosis in any major vessel, normal left ventricular function (wall motion score index 1), and test negativity for conventional wall motion criteria. Images were independently read by a core laboratory for wall motion and a core laboratory for CFR. Mean CFR was 2.5 0.6 and 87 patients (22%) had an abnormal CFR <2. During a median follow-up of 51 months, 31 events occurred, namely 4 deaths and 27 nonfatal myocardial infarctions (3 ST-elevated myocardial infarctions and 24 non-ST-elevated myocardial infarctions). Kaplan-Meier survival estimates for hard events showed a better outcome for those patients with a normal CFR compared with those with an abnormal CFR (96% vs 55%, p 0.001, at 48 months of follow-up). In conclusion, in patients with angiographically normal or near-normal coronary arteries and preserved at-rest regional and global left ventricular function at baseline and during stress, CFR adds incremental value to the prognostic stratification achieved with clinical and angiographic data

Prognostic value of pharmacologic stress echocardiography in diabetic and nondiabetic chest pain patients with intermediate-to-high threshold positive exercise electrocardiography

Aims: To compare the prognostic value of pharmacologic stress echocardiography in diabetic and nondiabetic patients with chest pain and intermediate-to-high threshold positive exercise electrocardiography. Materials and methods: 935 chest pain patients (131 diabetics) with ST-segment depression &#8805;1 mm on exercise electrocardiography at >75 watt workload underwent dipyridamole (n=786) or dobutamine (n=149) stress echocardiography and were followed-up for the occurence of hard (death, infarction) and major events (death, infarction, late revascularization). Results: During a median follow-up of 26 months, 158 events (51 deaths, 28 myocardial infarctions, and 79 late revascularizations) occurred: 34 in diabetics and 124 in nondiabetics (see Figure). Independent predictors of hard events were age, diabetes, and ischemia at stress echo. 5-year hard event rate was 24 % in patients with and 4 % in those without ischemia (p<0.0001). Independent predictors of major events were age, diabetes, hypercholesterolemia, smoking habit, antianginal therapy at the time of testing, and ischemia at stress echo. 5-year major event rate was 46 % in patients with and 7 % in those without ischemia (p<0.0001). Conclusions: Stress echocardiography is effective in risk stratifying diabetics and nondiabetics with intermediate-to-high threshold ischemic exercise electrocardiography. However, major event rate associated with a non ischemic test is similar in diabetics and nondiabetics during the first year of follow-up, and markedly increased in the former thereafter

Coronary Flow Reserve During Dipyridamole Stress Echocardiography Predicts Mortality

ObjectivesThe goal of this study was to evaluate the ability of coronary flow reserve (CFR) over regional wall motion to predict mortality in patients with known or suspected coronary artery disease (CAD).BackgroundCFR evaluated using pulsed Doppler echocardiography testing on left anterior descending artery is the state-of-the-art method during vasodilatory stress echocardiography.MethodsIn a prospective, multicenter, observational study, we evaluated 4,313 patients (2,532 men; mean age 65 ± 11 years) with known (n = 1,547) or suspected (n = 2,766) CAD who underwent high-dose dipyridamole (0.84 mg/kg over 6 min) stress echocardiography with CFR evaluation of left coronary descending artery (LAD) by Doppler. Overall mortality was the only endpoint analyzed.ResultsStress echocardiography was positive for ischemia in 765 (18%) patients. Mean CFR was 2.35 ± 0.68. At individual patient analysis, 1,419 (33%) individuals had CFR ≤2. During a median follow-up of 19 months (1st quartile 8; 3rd quartile 36), 146 patients died. The 4-year mortality was markedly higher in subjects with CFR ≤2 than in those with CFR >2, both considering the group with ischemia (39% vs. 7%; p < 0.0001) and the group without ischemia at stress echocardiography (12% vs. 3%; p < 0.0001). At multivariable analysis, CFR on LAD ≤2 (hazard ratio [HR]: 3.31; 95% confidence interval [CI]: 2.29 to 4.78; p < 0.0001), ischemia at stress echocardiography (HR: 2.40, 95% CI: 1.65 to 3.48, p < 0.0001), left bundle branch block (HR: 2.26, 95% CI: 1.50 to 3.41; p < 0.0001), age (HR: 1.08, 95% CI: 1.06–1.10; p < 0.0001), resting wall motion score index (HR: 3.52, 95% CI: 2.38 to 5.21; p < 0.0001), male sex (HR: 1.74, 95% CI: 1.12 to 2.52; p = 0.003), and diabetes mellitus (HR: 1.47, 95% CI: 1.03 to 2.08; p = 0.03) were independent predictors of mortality.ConclusionsCFR on LAD is a strong and independent indicator of mortality, conferring additional prognostic value over wall motion analysis in patients with known or suspected CAD. A negative result on stress echocardiography with a normal CFR confers an annual risk of death <1% in both patient groups

A microbiological and morphological study of blocked biliary stents

Biliary stent blockage represents the main limitation of the use of such devices in relieving obstructive jaundice due to a variety of malignant and benign conditions. Microbiological and morphological analysis of the occluding sludge present on the inner surface of 30 biliary stents was performed to evaluate the different components of such material and the effect of the antibiotic treatment on the biofilm formation. A highly organized biofilm, constituted by microbial cells embedded in an amorphous matrix together with crystallized bile salts, was observed Enterococcus spp . represented the most common isolate from both occluded and non-occluded stents. The antibiotic therapy, while selecting for multi-resistant bacteria and fungi, might possibly delay the biofilm formation. Key words: biliary stents, microbial colonization, biofilm