When Agencies and Families Come Together: Dealing with Conflict in Building Partnerships

In età tardoromana e bizantina l'insediamento di Vaste era articolato in una serie di villaggi sparsi nel territorio, intorno all'odierno abitato, le cui tracce sono venute in luce grazie alle ricognizioni dio superficie condotte dall'équipe dell'Università del Salento. In questo sistema insediativo un ruolo di particolare importanza era ricoperto da un edificio di culto, messo in luce nell'area di Fondo Giuliano, nelle vicinanze della cripta dei SS. Stefani. La chiesa presenta diverse fasi costruttive. La prima, il cui impianto è collocabile alla fine del IV sec. d.C., ha pianta cruciforme, con piccola abside, e muro di recinzione. La copertura doveva essere a capriate lignee che sostenevano un tetto di tegole. Nell’edificio è stato riconosciuto un martyrium, ossia un monumento dedicato al culto delle reliquie. Dopo la sua distruzione, forse collegabile agli eventi della guerra greco-gotica (535-553), nella seconda metà del VI secolo fu innalzata una seconda chiesa, la maggiore per dimensioni e certamente la più importante: presenta un impianto a tre navate separate da file di pilastri, con grande abside centrale, e tetto a doppio spiovente. La struttura si inserisce bene nel quadro dell’architettura cristiana di Terra d’Otranto. In epoca altomedievale (VIII-IX sec. d.C.), infine, la struttura subisce una significativa trasformazione: viene riutilizzata l’abside, ma sono escluse le navate laterali con l’innalzamento di muri perimetrali tra i pilastri, cambia completamente l’articolazione dello spazio interno, con la creazione di quattro piccole campate per ciascun lato. In relazione con la fase di vita della prima chiesa, nell’area circostante si estende una grande necropoli rupestre. Di questa è stato indagato il nucleo principale, situato alle spalle dell’edificio e comprendente circa 130 tombe. Le tombe sono scavate nel banco calcareo, all'interno di una cavità artificiale ricavata nel costone roccioso in maniera da formare una necropoli rupestre, assai simile alle catacombe. Le fosse erano coperte con lastroni piani o a doppio spiovente con "acroteri" ai quattro angoli, spesso provvisti di “coppelle”, che servivano durante lo svolgimento del rito del refrigerium, l’offerta di cibi e bevande ai defunti. Le tombe risultano prevalentemente utilizzate per numerose deposizioni, probabilmente in riferimento a gruppi famigliari; alcune fosse di piccole dimensioni ospitano esclusivamente bambini. I corredi sono costituiti da oggetti di ceramica e vetro come brocche, coppe e lucerne, monili (bracciali, collane, orecchini, fibbie) ed oggetto di uso personale (pettini e spilloni). Al rituale di offerta dell’obolo per Caronte fa ancora riferimento la presenza di monete, talora collocate nella bocca del defunto

Cortisol and inflammatory processes in ovarian cancer patients following primary treatment: Relationships with depression, fatigue, and disability

a b s t r a c t Elevations in the pro-inflammatory cytokine interleukin-6 (IL-6) and alterations in the anti-inflammatory hormone cortisol have been reported in a variety of cancers. IL-6 has prognostic significance in ovarian cancer and cortisol has been associated with fatigue, disability, and vegetative depression in ovarian cancer patients prior to surgery. Ovarian cancer patients undergoing primary treatment completed psychological self-report measures and collected salivary cortisol and plasma IL-6 prior to surgery, at 6 months, and at 1 year. Patients included in this study had completed chemotherapy and had no evidence of disease recurrence. At 6 months, patients showed significant reductions in nocturnal cortisol secretion, plasma IL-6, and a more normalized diurnal cortisol rhythm, changes that were maintained at 1 year. The reductions in IL-6 and nocturnal cortisol were associated with declines in self-reported fatigue, vegetative depression, and disability. These findings suggest that primary treatment for ovarian cancer reduces the inflammatory response. Moreover, patients who have not developed recurrent disease by 1 year appear to maintain more normalized levels of cortisol and IL-6. Improvement in fatigue and vegetative depression is associated with the normalization of IL-6 and cortisol, a pattern which may be relevant for improvements in overall quality of life for ovarian cancer patients

Depression in Cancer: the many biobehavioural pathways driving tumor progression

Major Depressive Disorder (MDD) is common among cancer patients, with prevalence rates up to four-times higher than the general population. Depression confers worse outcomes, including non-adherence to treatment and increased mortality in the oncology setting. Advances in the understanding of neurobiological underpinnings of depression have revealed shared biobehavioral mechanisms may contribute to cancer progression. Moreover, psychosocial stressors in cancer promote: (1) inflammation and oxidative/nitrosative stress; (2) a decreased immunosurveillance; and (3) a dysfunctional activation of the autonomic nervous system and of the hypothalamic-pituitary-adrenal axis. Consequently, the prompt recognition of depression among patients with cancer who may benefit of treatment strategies targeting depressive symptoms, cognitive dysfunction, fatigue and sleep disturbances, is a public health priority. Moreover, behavioral strategies aiming at reducing psychological distress and depressive symptoms, including addressing unhealthy diet and life-style choices, as well as physical inactivity and sleep dysfunction, may represent important strategies not only to treat depression, but also to improve wider cancer-related outcomes. Herein, we provide a comprehensive review of the intertwined biobehavioural pathways linking depression to cancer progression. In addition, the clinical implications of these findings are critically reviewed

Tumour brain: pre‐treatment cognitive and affective disorders caused by peripheral cancers

People that develop extracranial cancers often display co-morbid neurological disorders, such as anxiety, depression and cognitive impairment, even before commencement of chemotherapy. This suggests bidirectional crosstalk between non-CNS tumours and the brain, which can regulate peripheral tumour growth. However, the reciprocal neurological effects of tumour progression on brain homeostasis are not well understood. Here, we review brain regions involved in regulating peripheral tumour development and how they, in turn, are adversely affected by advancing tumour burden. Tumour-induced activation of the immune system, blood–brain barrier breakdown and chronic neuroinflammation can lead to circadian rhythm dysfunction, sleep disturbances, aberrant glucocorticoid production, decreased hippocampal neurogenesis and dysregulation of neural network activity, resulting in depression and memory impairments. Given that cancer-related cognitive impairment diminishes patient quality of life, reduces adherence to chemotherapy and worsens cancer prognosis, it is essential that more research is focused at understanding how peripheral tumours affect brain homeostasis