Departure

We sat Powder white, As wind blew our heads In little wisps Set in motion by The night-moths\u27 wings..

Again

A little light flickered over the edges of your eyes, And you told me it was just the Moon paying you her nightly visit;..

Motivazione e filtri di ammissibilità dell'atto impugnatori

il seminario si inserisce nell'ambito di un percorso didattico interdisciplinare sulla Motivazione della sentenz

Decisioni ed opinioni nel fine vita: confronto tra i diversi professionisti coinvolti nell'assistenza al paziente. Lo studio pilota E.L.D.Y.

Background: For a long time the approach of clinicians towards death has focused only on the pathological process of the organ dysfunction, while the clinical practice has revealed a more holistic and multi-dysfunctional nature of death, as a biological, psychological and social process engaging the individual as a whole. In developed countries, moreover, the causes that lead to death are widely changed: today chronic and degenerative diseases are prevailing with an increase in people dying in intensely medicalized conditions or in morbid terminal conditions, related to the continuous progress in medical technology and to the increased life expectancy. Consequently, what concerns the end of life is still a source of many ethical issues and uncertainties in taking the decisions in clinical practice, especially in the suspension or abstention of a treatment. The multidisciplinary reflection on these issues has led to a large increase in the interest of numerous national and international researchers towards the end of life, pointing out a growing change in the common thought and a difference of approach to these issues by Italian physicians and professionals than their European and/or American colleagues. The literature shows a lack of data linked to the geriatric field, especially in Italy. Aims: The main purposes of the research called ELDY (End of Life Decisions studY) were: 1) to study the frequency and the typology of the decisions taken - by physicians and nurses working in geriatrics - in the clinical practice and in the life terminal phase of patients. 2) to investigate the end of life decisions-making opinionsâ by physicians and other social health workers (employed in the elderly assistance). 3) to compare the achieved results with those of analogous studies done in National and European context. The secondary purposes consisted of: 4) detecting the potential relationships among the different attitudes towards end of life decisions and some cultural and working characteristics of the staff involved in the assistance of the elderly. 5) Formulating and judging the reliability of a more appropriate questionnaire for the Italian context, intended to analyze all the possible decisions and opinions that physician (or other health workers) could take in the final stage of the patientâÂÂs life. Materials and Methods: By means of a complex interdisciplinary work, which took into account the criticisms of previous national and international studies, a new evaluation questionnaire was developed and then sent to about 5000 doctors, nurses, health workers, psychologists and other staff employed in elderly patients assistance units in Veneto and Trentino Alto-Adige. It was also created a special website in which it was possible to fill in or download the material. The questionnaire was divided into three parts: the first part (Q1) was addressed only to physicians and nurses, concerning the last death that they attended; the second one (Q2) was referred to health workers, regarding their convictions and opinions about the end of life decisions; the last part (Q3) was designed to identify some general features of the professional. Results: The number of respondents was 1051 social and health workers: 205 physicians (MD), 508 registered nurses (RN), 173 healthcare workers (HW), 106 psychologists (PSY), and 59 of other personnel working in the involved structures. The questionnaires that met the selection criteria for the statistical analysis were 633 about the end-of-life decisions and 990 about the opinions stated: it is observed that 97% of doctors and nurses state that they have never intervened directly and intentionally to anticipate the end of life. It was found: two cases of euthanasia were reported (MD: 1 and IP: 1); twelve cases reported the termination of life without explicit request of the patient (MD: 2 and RN: 10); two cases of intentional medically assisted death, without, however, specifying who was the acting subject (patient, physician, nurse, other); cases of doctor-assisted suicide did not emerge. The 54.6% of respondents stated that they had started or had not stopped a treatment, taking into account the possibility that this act would have extended the life of the patient; otherwise the 21% claimed to have not withhold or withdrawal a treatment, taking into account the possibility, or with the clear intention, that this act could have anticipated the death of patients already in end-stage. About the opinions towards end-of-life decisions: only a lower number of professionals agrees on the principle of unavailability of life (MD: 31.4%, RN: 21%, HW: 32.4%, PSY: 13.5%), while the majority of respondents supports the âÂÂright to decideâ to anticipate the end of life (MD: 46.1%, RN: 59.1%, HW: 59.3%, PSY: 61%) and takes into account the possibility not to implement or discontinue life-sustaining treatments (MD: 74.5%, RN: 79%, HW: 75.1%, PSY: 88.5%). Substantially concurring opinions among the various professionals have emerged regarding the appointment of a trustee to make decisions to anticipate the end of life if the patient is not in full possession of his faculties (MD: 79.9%, RN: 76.4%, HW: 73.1%, PSY: 88.6 %) and to draft the directives in advance on non-implementation or termination of life-sustaining treatments (MD: 60.5%, RN: 61.3%, HW: 64.9.%, PSY: 72.1%). A large majority of professionals also agrees on the value for the end-of-life decisions for an interdisciplinary approach based on not only medical and nursing figures (MD: 82%, RN: 83.9%, HW: 76.3%, 96.2% PSY). Conclusions: 1) Both physicians and nurses assume decisions with the possibility, or the intention, to hasten the end of life. 2) Many different professionals agreed on, for example: the principle of availability of human life, the importance of appointing a trustee in the case of non-competence, of involving relatives in the decision-making process, in order to satisfy the no-treatment request and to respect the advanced directives, the importance of pain relief, quality of life, respect the dignity and determination in assisting the patient in the terminal phase. Contrasting opinions emerged, however, about the practice of euthanasia. 3) Some interesting data that agree with the previous studies seem to confirm the reliability of the emerged answers of our study and an approach of the Italian physicians to the European colleagues both on the practices and on the opinions regarding the end life decisions. 4) The non-medical health professionals are more likely to the principle of self-determination of the patient, the possibility of allowing the use of drugs in lethal doses and to the delegation of decisions to be made by relatives in the terminal stages of life if not competent. Among the doctors who claimed to be in agreement with the statement that life is an unavailable value and there is no "right to die", no one has implemented a form of medically assisted death, and vice versa, more than half of those who disagreed took over a decision to end life in their last death assisted. 5) Between the Italian and European doctors and among the various professionals involved in the study it seems that a disagreement exists about the communicative approach the end of life. 6) Observing the high percentage of interest, the request for in-depth study of these issues and the number of respondents to the various questionnaire parties, we can consider as reached the target of elaborating a new instrument useful for investigating effectively bioethical issues of end-of-life decisions among the professionals employed in geriatrics. This questionnaire could become useful to monitor the development of stances and practices in physicians and other health workers. Finally, it can be extended beyond the field of geriatrics, to a national as well as international leve

Le misure di prevenzione tra efficientismo ed immediatismo

La prognosi di pericolosità sociale implica un ragionamento, che deve essere immune da vizi, sebbene sia fondato su indizi non qualificati ai sensi dell’art. 192 comma 2 c.p.p. Sicchè la loro rilevanza processuale non è condizionata dalla sussistenza dei connotati giuridici di gravità, precisione e concordanza. L’attribuzione di centralità alla componente ricostruttiva del giudizio di prevenzione non risolve le antinomie interne al meccanismo preventivo, in quanto la descrizione delle situazioni di cui agli artt. 1 e 4 del d.lgs n. 159 del 2011, non ha il medesimo valore della norma penale, esprimendo soltanto in apparenza la previa selezione e connotazione dei parametri fattuali: meri simulacri. Se le cose stanno in questi termini, non può considerarsi una soluzione soddisfacente l’invito ad una lettura tassativizzante, sulla base di precedenti giurisprudenziali, già orientati in tale direzione . La convinzione è, dunque, che l’insindacabilità della discrezionalità giurisdizionale vanifichi anche gli epiloghi interpretativi successivi alla decisione della Corte di Strasburgo, inerenti al recupero di tassatività delle previsioni normative

Violenza di genere-stalking-nuove prassi operative

La vulnerabilità della vittima costituisce una categoria aspecifica che apre un doppio binario all'interno della fase delle indagini preliminari e della fase dibattimentale, con l'effetto dell'affievolimento della presunzione di non colpevolezza dell'indagato/imputato. Da qui non soltanto le aporie sistematiche, ma anche l'inefficacia di un'azione di contrasto alla violenza di genere che necessita, invece, di una reale politica di prevenzione

Glycine Signaling in the Framework of Dopamine-Glutamate Interaction and Postsynaptic Density. Implications for Treatment-Resistant Schizophrenia

Treatment-resistant schizophrenia (TRS) or suboptimal response to antipsychotics affects almost 30% of schizophrenia (SCZ) patients, and it is a relevant clinical issue with significant impact on the functional outcome and on the global burden of disease. Among putative novel treatments, glycine-centered therapeutics (i.e. sarcosine, glycine itself, D-Serine, and bitopertin) have been proposed, based on a strong preclinical rationale with, however, mixed clinical results. Therefore, a better appraisal of glycine interaction with the other major players of SCZ pathophysiology and specifically in the framework of dopamine – glutamate interactions is warranted. New methodological approaches at cutting edge of technology and drug discovery have been applied to study the role of glycine in glutamate signaling, both at presynaptic and post-synaptic level and have been instrumental for unveiling the role of glycine in dopamine-glutamate interaction. Glycine is a non-essential amino acid that plays a critical role in both inhibitory and excitatory neurotransmission. In caudal areas of central nervous system (CNS), such as spinal cord and brainstem, glycine acts as a powerful inhibitory neurotransmitter through binding to its receptor, i.e. the Glycine Receptor (GlyR). However, glycine also works as a co-agonist of the N-Methyl-D-Aspartate receptor (NMDAR) in excitatory glutamatergic neurotransmission. Glycine concentration in the synaptic cleft is finely tuned by glycine transporters, i.e. GlyT1 and GlyT2, that regulate the neurotransmitter's reuptake, with the first considered a highly potential target for psychosis therapy. Reciprocal regulation of dopamine and glycine in forebrain, glycine modulation of glutamate, glycine signaling interaction with postsynaptic density proteins at glutamatergic synapse, and human genetics of glycinergic pathways in SCZ are tackled in order to highlight the exploitation of this neurotransmitters and related molecules in SCZ and TRS

Event Venue Satisfaction and Its Impact On Sponsorship Outcomes

The importance of sponsorship as a marketing communications tool is well recognized in the event literature. Despite the growth in event sponsorship investments and the increasing importance of the role of the venue in event planning, there is still a lack of research on the impact of event venue satisfaction on sponsorship outcomes. Thus, the objective of the present study is to analyze the effect of event venue satisfaction on sponsor image, and, in particular, to verify if attendee satisfaction with the venue has a positive effect on sponsor recall, attitude, and purchase intention. The article presents the results of a survey conducted during the International Rome Film Festival, which takes place annually at the Rome Auditorium. Results suggest that attendee satisfaction with venues affects attitudes toward the sponsors and sponsor-related purchase intention, while sponsor awareness is not affected. The main contribution of the article is the development of a comprehensive model of event sponsorship evaluation, in which traditional sponsorship outcomes are considered in light of attendee satisfaction and quality of services in the sponsor-related exclusive venue zones