Il carcere e l’esecuzione penale in Italia nell’ultimo decennio

The number of people held in custody in Italy has reached its highest level since the Second World War. In interpreting the data and trends observed over the last decade, however, we should bear in mind that prison is no longer the only place where sentences may be served, but is part of a wider and more complex system of penal control.  Specifically, sentences may nowadays be served in various settings (prison, community, house arrest, on bail), at various times (immediately,for those already serving a prison sentence or alternative measures; later, for those enjoying the stay of execution), or in ways that do not necessarily involve contact with prison (from alternative measures to release). Therefore, in describing and interpreting the trends in imprisonment it is necessary to refer to the other modalities of enforcement as well:  alternative measures and suspension. We considered three factors that affect the number of people subject to criminal enforcement:  the granting of suspend sentences, the duration of the custodial sentences imposed by the courts and the application of alternative measures.  The analysis of the latest data relating to these factors reveals that all of them affect the modalities of criminal enforcement in varying degrees. Specifically,  three concomitant phenomena can be observed: the decline of suspension, the significant increase in custodial sentences and the considerable decrease in the granting of alternative measures.  Although these factors alone cannot entirely explain theincrease in prison population, they are certainly of great relevance. Finally, we should bear in mind that drug addicts and foreigners have long been the majority of prison population.  Although their large number is certainly a direct consequence of the above-mentioned factors, it also stems from other causes. In this  regard special attention is deserved by the application of the latest laws regarding recidivism, drug and immigration.La popolazione detenuta in Italia ha raggiunto livelli di presenza mai toccati dal secondo dopoguerra del secolo scorso. Ma oggi, a differenza di ieri, nell’interpretare dati e tendenze dell’ultimo decennio, occorre tener conto che il carcere non è più il principale luogo della pena ma è parte di un più vasto sistema di controllo della penalità che prevede una complessa articolazione. L’espiazione della pena alla reclusione – in particolare – oggi può avvenire in luoghi diversi (carcere, comunità, abitazione, “a piede libero”), in tempi differenti (immediatamente, per chi è già in carcere o in misura alternativa, in modo differito per coloro che godono della “sospensione dell’esecuzione”), oppure seguendo percorsi diversi che non prevedono necessariamente il contatto con il carcere (dalla libertà alle misure alternative). Nel descrivere e interpretare l’andamento della carcerazione è necessario pertanto fare riferimento anche alle altre aree dell’esecuzione penale, quella delle misure alternative e quella delle “sospensioni”. Ciò premesso sono presi in considerazione tre fattori che influiscono sulla consistenza dei soggetti sottoposti ad esecuzione penale: la concessione o meno della sospensione condizionale della pena, la quantità di pena alla reclusione inflitta in sede giudicante e la concessione delle misure alternative.L’analisi dei dati più recenti riferiti a questi fattori consente di mettere in evidenza che tutti e tre influiscono sia pure in diversa misura sulle modalità di esecuzione della pena. In particolare si assiste a tre fenomeni concomitanti: il deciso declino della “condizionale”, la crescita significativa dell’ammontare delle pene alla reclusione nelle sentenze di condanna e la forte riduzione della concessione delle misure alternative. Pur non essendo certamente esaustivi dei meccanismi causali per cui la popolazione carceraria aumenta (o diminuisce) questi tre fattori sono da tenere assolutamente in primo piano. Occorre infine considerare la massiccia presenza dei due gruppi sociali dei tossicodipendenti e degli stranieri che insieme costituiscono ormai da tempo la maggioranza della popolazione detenuta negli istituti penitenziari. La loro consistenza numerica è sicuramente diretta conseguenza dell’azione dei predetti fattori ma deriva anche da altre cause tra le quali meriterebbero particolare attenzione l’applicazione delle recenti leggi sulla recidiva reiterata, sulla droga e sull’immigrazione

Il malato di mente autore di reato nelle strutture residenziali: una ricerca in una comunità terapeutica

Italian Government has decided that in 2013 italian forensic mental hospitals (Ospedali psichiatrici giudiziari”) shall close: offenders sentenced to a “misura di sicurezza” (detention in psychiatric care) will be restrained in facilities appointed by the National Health System, either public or accredited private ones. Since the 90s, some private psychiatric residential facilities are already treating such patients, on appointment with NHS mental health departments: the main aim of this study is to understand if and how forensic psychiatric patients hosted in one of such institutions differ from non-forensic ones. For this purpose, an analysis of the characteristics of 147 patients of a private facility, including 66 forensic patients and 81 non-forensic patients (hosted between 2005 and 2010), has been performed. Such facility (Pra’ Ellera) founded in Cairo Montenotte (Savona) over twenty year ago, currently hosts about 60 patients (now mainly forensic) and treats them via an integrated approach (both pharmacological and psychodynamic).Our findings show that, in general, forensic patients did not generally differ significantly from non-forensic ones. Their presence in the community isn’t making their problem worse, despite serious problems such as the long-stay and risk of re-internment to forensic mental hospital. In particular, forensic patients share with others the same failure rate (a quarter of them ‘can’t cope’); the average length of stay is only slightly higher than non-forensic patients; moreover, they are minor players of self-destructive acts (self-harm, attempted suicides). Unlike other guests, forensic patients significantly show a decrease in psychosis, which remains, however, the most common diagnosis in the facility. One could then say, considering the trend, that increasingly small differences may be observed in future between the categories.Secondo recenti provvedimenti governativi a partire dal prossimo anno gli ospedali psichiatrici giudiziari chiuderanno i battenti, mentre all’applicazione delle misure di sicurezza per i malati di mente autori di reato saranno destinate strutture ad esclusiva gestione sanitaria. La struttura residenziale psichiatrica costituisce una delle possibili soluzioni a disposizione dei dipartimenti di salute mentale, e ospita già da tempo questo tipo di pazienti. Obiettivo principale di questo studio è comprendere se e quanto, in una struttura esidenziale, i malati di mente autori di reato differiscono dai pazienti non autori di reato. A tale scopo è stata condotta un’analisi delle caratteristiche di 147 pazienti, di cui 66 autori di reato e 81 non-autori di reato, limitatamente ai pazienti ospitati dalla comunità Pra’ Ellera tra il 2005 e il 2010. La comunità è stata fondata oltre vent’anni fa a Cairo Montenotte (Savona), ospita attualmente circa 60 pazienti, in maggioranza autori di reato, seguiti con un approccio integrato (di impostazione farmacologica e psicodinamica). I risultati evidenziano che i pazienti autori di reato in generale non differiscono significativamente dagli altri pazienti, in quanto la loro presenza non aggrava criticità che pure esistono, come la cronicizzazione degli interventi e il rischio del re-internamento. In particolare i pazienti psichiatrici autori di reato condividono il medesimo tasso di insuccesso (uno su quattro non ce la fa); permangono mediamente in comunità per periodi solo leggermente superiori e non sono maggiori protagonisti di eventi critici (autolesioni, tentati suicidi). A differenza degli altri pazienti i malati di mente autori di reato registrano una diminuzione significativa del disturbo psicotico, che rimane comunque la diagnosi più frequente in comunità. Si potrebbe quindi affermare, in prospettiva temporale, che tra le due tipologie di pazienti potranno osservarsi differenze sempre più esigue

Influência da luz na produção do cogumelo hiboukitake em bagaço de uva

A busca de novos substratos para o cultivo de cogumelos e o aproveitamento de resíduos agroindustriais levaram ao desenvolvimento do cultivo de Hiboukitake (Pleurotus sajor-caju) por fermentação em estado sólido em bagaço de uva Isabel proveniente da indústria de sucos e vinhos. Nesse contexto teve-se como objetivo o estabelecimento das condições de cultivo nesse substrato avaliando-se a influência da luz sobre o inoculante e sobre o sistema de cultivo em sacos. Foram avaliadas diferentes condições de iluminação, sendo quatro tratamentos resultantes da combinação das condições de iluminação e escuro entre o inoculante e o saco de cultivo. Os resultados demonstraram uma tendência ao aumento do rendimento biológico para os sacos cultivados em ausência de luz cujo inoculante esteve exposto à iluminação. Os cultivos conduzidos com iluminação frutificaram precocemente com perda no rendimento e sem a total miceliação do substrato. O cultivo do cogumelo Pleurotus sajor-caju é bastante viável no bagaço da uva Isabel e pode ser uma ótima alternativa para o aproveitamento dos resíduos da indústria de sucos e vinhos sendo a luz um fator determinante no rendimento dos cogumelos.Palavras-chave: Pleurotus sajor-caju. Produtividade. Cogumelos Ostra

Presenza dei genitori e vittimizzazione dei giovani in Italia: risultati dell’International Self-report Delinquency Study-3

Il presente studio si inserisce all’interno di un più ampio progetto di ricerca internazionale sulla devianza minorile, International Self-Report Delinquency Study-3 (ISRD-3), e si propone di fornire una maggiore conoscenza del legame esistente tra la presenza/assenza genitoriale, il supporto emotivo parentale percepito dai giovani e la vittimizzazione giovanile. I dati elaborati rientrano tra quelli raccolti attraverso la somministrazione del questionario ISRD-3 ad un campione nazionale di 3.508 studenti italiani delle classi seconde e terze della scuola media inferiore e delle classi prime della scuola media superiore. I risultati mostrano come gli adolescenti con maggiore rischio di vittimizzazione siano coloro che vivono in famiglie mono-genitoriali o con caregivers diversi dai genitori (nonni, zii, altri parenti ecc.). Inoltre, ponendo l’attenzione alla percezione che l’adolescente ha del supporto emotivo parentale, dai risultati appare come più scarsa è tale percezione maggiore è la vitti-mizzazione subìta. La ricerca suggerisce che le strategie di intervento sul fenomeno della vittimizzazione giovanile dovrebbero coinvolgere tutti i membri della famiglia in cui il giovane è inserito e avere come obiettivo principale il miglioramento della qualità delle relazioni

Storia e caratteristiche del progetto multicentrico di ricerca "International Self - Report Delinquency Study": il contributo della Criminologia italiana

The present paper reviews the history, the principal characteristics, the recent evolutions and the objectives of the international multi-centric study on juvenile self-report delinquency and victimization called ISRD, and describes the contribution of Italian criminology to the project. The most important international results of the first two waves of the research (ISRD 1 and ISRD2), and the innovations introduced in the planning of the third wave (ISRD3) are also described: The collection of data has been concluded in Italy, but not in all the 35 countries participating to the study

3D-printed boluses for radiotherapy: influence of geometrical and printing parameters on dosimetric characterization and air gap evaluation

The work investigates the implementation of personalized radiotherapy boluses by means of additive manufacturing technologies. Boluses materials that are currently used need an excessive amount of human intervention which leads to reduced repeatability in terms of dosimetry. Additive manufacturing can solve this problem by eliminating the human factor in the process of fabrication. Planar boluses with fixed geometry and personalized boluses printed starting from a computed tomography scan of a radiotherapy phantom were produced. First, a dosimetric characterization study on planar bolus designs to quantify the effects of print parameters such as infill density and geometry on the radiation beam was made. Secondly, a volumetric quantification of air gap between the bolus and the skin of the patient as well as dosimetric analyses were performed. The optimization process according to the obtained dosimetric and airgap results allowed us to find a combination of parameters to have the 3D-printed bolus performing similarly to that in conventional use. These preliminary results confirm those in the relevant literature, with 3D-printed boluses showing a dosimetric performance similar to conventional boluses with the additional advantage of being perfectly conformed to the patient geometry

Artificial Intelligence in the Advanced Diagnosis of Bladder Cancer-Comprehensive Literature Review and Future Advancement

Artificial intelligence is highly regarded as the most promising future technology that will have a great impact on healthcare across all specialties. Its subsets, machine learning, deep learning, and artificial neural networks, are able to automatically learn from massive amounts of data and can improve the prediction algorithms to enhance their performance. This area is still under development, but the latest evidence shows great potential in the diagnosis, prognosis, and treatment of urological diseases, including bladder cancer, which are currently using old prediction tools and historical nomograms. This review focuses on highly significant and comprehensive literature evidence of artificial intelligence in the management of bladder cancer and investigates the near introduction in clinical practice

Low dose rate brachytherapy (LDR-BT) as monotherapy for early stage prostate cancer in Italy: practice and outcome analysis in a series of 2237 patients from 11 institutions

OBJECTIVE: Low-dose-rate brachytherapy (LDR-BT) in localized prostate cancer is available since 15 years in Italy. We realized the first national multicentre and multidisciplinary data collection to evaluate LDR-BT practice, given as monotherapy, and outcome in terms of biochemical failure. METHODS: Between May 1998 and December 2011, 2237 patients with early-stage prostate cancer from 11 Italian community and academic hospitals were treated with iodine-125 ((125)I) or palladium-103 LDR-BT as monotherapy and followed up for at least 2 years. (125)I seeds were implanted in 97.7% of the patients: the mean dose received by 90% of target volume was 145 Gy; the mean target volume receiving 100% of prescribed dose (V100) was 91.1%. Biochemical failure-free survival (BFFS), disease-specific survival (DSS) and overall survival (OS) were estimated using Kaplan-Meier method. Log-rank test and multivariable Cox regression were used to evaluate the relationship of covariates with outcomes. RESULTS: Median follow-up time was 65 months. 5- and 7-year DSS, OS and BFFS were 99 and 98%, 94 and 89%, and 92 and 88%, respectively. At multivariate analysis, the National Comprehensive Cancer Network score (p < 0.0001) and V100 (p = 0.09) were correlated with BFFS, with V100 effect significantly different between patients at low risk and those at intermediate/high risk (p = 0.04). Short follow-up and lack of toxicity data represent the main limitations for a global evaluation of LDR-BT. CONCLUSION: This first multicentre Italian report confirms LDR-BT as an excellent curative modality for low-/intermediate-risk prostate cancer. ADVANCES IN KNOWLEDGE: Multidisciplinary teams may help to select adequately patients to be treated with brachytherapy, with a direct impact on the implant quality and, possibly, on outcome

Quality assurance for automatically generated contours with additional deep learning

Objective: Deploying an automatic segmentation model in practice should require rigorous quality assurance (QA) and continuous monitoring of the model’s use and performance, particularly in high-stakes scenarios such as healthcare. Currently, however, tools to assist with QA for such models are not available to AI researchers. In this work, we build a deep learning model that estimates the quality of automatically generated contours. Methods: The model was trained to predict the segmentation quality by outputting an estimate of the Dice similarity coefficient given an image contour pair as input. Our dataset contained 60 axial T2-weighted MRI images of prostates with ground truth segmentations along with 80 automatically generated segmentation masks. The model we used was a 3D version of the EfficientDet architecture with a custom regression head. For validation, we used a fivefold cross-validation. To counteract the limitation of the small dataset, we used an extensive data augmentation scheme capable of producing virtually infinite training samples from a single ground truth label mask. In addition, we compared the results against a baseline model that only uses clinical variables for its predictions. Results: Our model achieved a mean absolute error of 0.020 ± 0.026 (2.2% mean percentage error) in estimating the Dice score, with a rank correlation of 0.42. Furthermore, the model managed to correctly identify incorrect segmentations (defined in terms of acceptable/unacceptable) 99.6% of the time. Conclusion: We believe that the trained model can be used alongside automatic segmentation tools to ensure quality and thus allow intervention to prevent undesired segmentation behavior

MAGE-C2/CT10 Protein Expression Is an Independent Predictor of Recurrence in Prostate Cancer

The cancer-testis (CT) family of antigens is expressed in a variety of malignant neoplasms. In most cases, no CT antigen is found in normal tissues, except in testis, making them ideal targets for cancer immunotherapy. A comprehensive analysis of CT antigen expression has not yet been reported in prostate cancer. MAGE-C2/CT-10 is a novel CT antigen. The objective of this study was to analyze extent and prognostic significance of MAGE-C2/CT10 protein expression in prostate cancer. 348 prostate carcinomas from consecutive radical prostatectomies, 29 castration-refractory prostate cancer, 46 metastases, and 45 benign hyperplasias were immunohistochemically analyzed for MAGE-C2/CT10 expression using tissue microarrays. Nuclear MAGE-C2/CT10 expression was identified in only 3.3% primary prostate carcinomas. MAGE-C2/CT10 protein expression was significantly more frequent in metastatic (16.3% positivity) and castration-resistant prostate cancer (17% positivity; p<0.001). Nuclear MAGE-C2/CT10 expression was identified as predictor of biochemical recurrence after radical prostatectomy (p = 0.015), which was independent of preoperative PSA, Gleason score, tumor stage, and surgical margin status in multivariate analysis (p<0.05). MAGE-C2/CT10 expression in prostate cancer correlates with the degree of malignancy and indicates a higher risk for biochemical recurrence after radical prostatectomy. Further, the results suggest MAGE-C2/CT10 as a potential target for adjuvant and palliative immunotherapy in patients with prostate cancer