Development discourse in Romania: from Socialism to EU Membership

With their accession to the European Union, twelve new countries - Romania among them - (re)entered the international community of international donors. In the history of development aid this can be seen as a unique event: it is for the first time in history that such a large number of countries become international donors, with such short notice and in such a particular context that sees some scholars announcing the ‘death’ of development. But in spite of what might be claimed regarding the ‘end’ of the development era, development discourse seems to be rather vigorous and in good health: it is able to extert an undeniable force of attraction over the twelve countries that, in a matter of years, have already convinced themselves of its validity and adhered to its main tenets. This thesis collects evidence for improving our understanding of this process that sees the co-optation of twelve new countries to the dominant theory and practice of development cooperation. The evidence collected seems to show that one of the tools employed by the promoters of this co-optation process is that of constructing the ‘new’ Member States as ‘new’, inexpert donors that need to learn from the ‘old’ ones. By taking a case-study approach, this thesis gathers data that suggests that conceiving of the ‘twelve’ as ‘new’ donors is both historically inaccurate and value-ladden. On one hand, Romania’s case-study illustrates how in the (socialist) past at least one in the group of the twelve was particularly conversant in the discourse of international development. On the other hand, the process of co-optation, while being presented as a knowledgeproducing process, can also be seen as an ignorance-producing procedure: Romania, along with its fellow new Member States, takes the opportunity of ‘building its capacity’ and ‘raising its awareness’ of development cooperation along the line drawn by the European Union, but at the same time it seems to un-learn and ‘lower’ its awareness of development experience in the (socialist) past. This is one possible reading of this thesis. At a different level, this thesis can also be seen as an attempt to account of almost five decades of international development discourse in one specific country – Romania – in three different socio-political contexts: the socialist years (up to the year 1989), the ‘transition years’ (from 1989 to the pre-accession years) and the membership to the European Union. In this second reading, the thesis seeks to illustrate how – contrary to widespread beliefs – before 1989 Romania’s international development discourse was particularly vivid: in the most varied national and international settings President Ceausescu unfolded an extensive discursive activity on issues pertaining to international development; generous media coverage of affairs concerning the developing countries and their fight for development was the rule rather than the exception; the political leadership wanted the Romanians not only to be familiarized with (or ‘aware of’ to use current terminology) matters of underdevelopment, but also to prove a sense of solidarity with these countries, as well as a sense of pride for the relations of ‘mutual help’ that were being built with them; finally, international development was object of academic attention and the Romanian scholars were able not only to reflect on major developments, but could also formulate critical positions towards the practices of development aid. Very little remains of all this during the transition years, while in the present those who are engaged in matters pertaining to international development do so with a view of building Romania as an EU-compliant donor.

Development of Clinical Decision Support Systems based on Mathematical Models of Physiological Systems

In the last years of research, I focused my studies on different physiological problems. Together with my supervisors, I developed/improved different mathematical models in order to create valid tools useful for a better understanding of important clinical issues. The aim of all this work is to develop tools for learning and understanding cardiac and cerebrovascular physiology as well as pathology, generating research questions and developing clinical decision support systems useful for intensive care unit patients. I. ICP-model Designed for Medical Education We developed a comprehensive cerebral blood flow and intracranial pressure model to simulate and study the complex interactions in cerebrovascular dynamics caused by multiple simultaneous alterations, including normal and abnormal functional states of auto-regulation of the brain. Individual published equations (derived from prior animal and human studies) were implemented into a comprehensive simulation program. Included in the normal physiological modelling was: intracranial pressure, cerebral blood flow, blood pressure, and carbon dioxide (CO2) partial pressure. We also added external and pathological perturbations, such as head up position and intracranial haemorrhage. The model performed clinically realistically given inputs of published traumatized patients, and cases encountered by clinicians. The pulsatile nature of the output graphics was easy for clinicians to interpret. The manoeuvres simulated include changes of basic physiological inputs (e.g. blood pressure, central venous pressure, CO2 tension, head up position, and respiratory effects on vascular pressures) as well as pathological inputs (e.g. acute intracranial bleeding, and obstruction of cerebrospinal outflow). Based on the results, we believe the model would be useful to teach complex relationships of brain haemodynamics and study clinical research questions such as the optimal head-up position, the effects of intracranial haemorrhage on cerebral haemodynamics, as well as the best CO2 concentration to reach the optimal compromise between intracranial pressure and perfusion. We believe this model would be useful for both beginners and advanced learners. It could be used by practicing clinicians to model individual patients (entering the effects of needed clinical manipulations, and then running the model to test for optimal combinations of therapeutic manoeuvres). II. A Heterogeneous Cerebrovascular Mathematical Model Cerebrovascular pathologies are extremely complex, due to the multitude of factors acting simultaneously on cerebral haemodynamics. In this work, the mathematical model of cerebral haemodynamics and intracranial pressure dynamics, described in the point I, is extended to account for heterogeneity in cerebral blood flow. The model includes the Circle of Willis, six regional districts independently regulated by autoregulation and CO2 reactivity, distal cortical anastomoses, venous circulation, the cerebrospinal fluid circulation, and the intracranial pressure-volume relationship. Results agree with data in the literature and highlight the existence of a monotonic relationship between transient hyperemic response and the autoregulation gain. During unilateral internal carotid artery stenosis, local blood flow regulation is progressively lost in the ipsilateral territory with the presence of a steal phenomenon, while the anterior communicating artery plays the major role to redistribute the available blood flow. Conversely, distal collateral circulation plays a major role during unilateral occlusion of the middle cerebral artery. In conclusion, the model is able to reproduce several different pathological conditions characterized by heterogeneity in cerebrovascular haemodynamics and can not only explain generalized results in terms of physiological mechanisms involved, but also, by individualizing parameters, may represent a valuable tool to help with difficult clinical decisions. III. Effect of Cushing Response on Systemic Arterial Pressure. During cerebral hypoxic conditions, the sympathetic system causes an increase in arterial pressure (Cushing response), creating a link between the cerebral and the systemic circulation. This work investigates the complex relationships among cerebrovascular dynamics, intracranial pressure, Cushing response, and short-term systemic regulation, during plateau waves, by means of an original mathematical model. The model incorporates the pulsating heart, the pulmonary circulation and the systemic circulation, with an accurate description of the cerebral circulation and the intracranial pressure dynamics (same model as in the first paragraph). Various regulatory mechanisms are included: cerebral autoregulation, local blood flow control by oxygen (O2) and/or CO2 changes, sympathetic and vagal regulation of cardiovascular parameters by several reflex mechanisms (chemoreceptors, lung-stretch receptors, baroreceptors). The Cushing response has been described assuming a dramatic increase in sympathetic activity to vessels during a fall in brain O2 delivery. With this assumption, the model is able to simulate the cardiovascular effects experimentally observed when intracranial pressure is artificially elevated and maintained at constant level (arterial pressure increase and bradicardia). According to the model, these effects arise from the interaction between the Cushing response and the baroreflex response (secondary to arterial pressure increase). Then, patients with severe head injury have been simulated by reducing intracranial compliance and cerebrospinal fluid reabsorption. With these changes, oscillations with plateau waves developed. In these conditions, model results indicate that the Cushing response may have both positive effects, reducing the duration of the plateau phase via an increase in cerebral perfusion pressure, and negative effects, increasing the intracranial pressure plateau level, with a risk of greater compression of the cerebral vessels. This model may be of value to assist clinicians in finding the balance between clinical benefits of the Cushing response and its shortcomings. IV. Comprehensive Cardiopulmonary Simulation Model for the Analysis of Hypercapnic Respiratory Failure We developed a new comprehensive cardiopulmonary model that takes into account the mutual interactions between the cardiovascular and the respiratory systems along with their short-term regulatory mechanisms. The model includes the heart, systemic and pulmonary circulations, lung mechanics, gas exchange and transport equations, and cardio-ventilatory control. Results show good agreement with published patient data in case of normoxic and hyperoxic hypercapnia simulations. In particular, simulations predict a moderate increase in mean systemic arterial pressure and heart rate, with almost no change in cardiac output, paralleled by a relevant increase in minute ventilation, tidal volume and respiratory rate. The model can represent a valid tool for clinical practice and medical research, providing an alternative way to experience-based clinical decisions. In conclusion, models are not only capable of summarizing current knowledge, but also identifying missing knowledge. In the former case they can serve as training aids for teaching the operation of complex systems, especially if the model can be used to demonstrate the outcome of experiments. In the latter case they generate experiments to be performed to gather the missing data.

Equine and human mutual welfare: a whole subject? Critical aspects and possible strategies in equine-assisted activities and therapies

General aim of the study is equine welfare, particularly concerning different husbandry methodic and inter-specific relational factors. Specific aim is the evaluation of possible mutual (to humans and to equines) benefits and the analysis of critical factors/strength points, of human-horse relationship within Therapeutic Riding context (TR). The peculiarities of human-horse relationship (compared to the bond with “Pet”) are analyzed, concerning their socio-anthropological, psychological, psycho-dynamic distinctive characteristics. 8 European representative therapeutic riding centers (TRC) were therefore selected (on the basis of their different animals’ husbandry criteria, and of the different rehabilitative methodologies adopted). TRC were investigated through 2 different questionnaires, specifically settled to access objective/subjective animal welfare parameters; the quality of human-horse relationship; technicians’ emotional experienced. 3 Centers were further selected, and behavioral (145 hours of behavioral recording) and physiological parameters (heart rate and heart rate variability) were evaluated, aimed to access equine welfare and horses’ adaptive responses/coping (towards general environment and towards TR job). Moreover a specific “handling-task” was ideated and experimented, aimed to measure the quality of TR technicians-horses relationship. We did therefore evaluate both the individual horses’ responses and the possible differences among Centers. Data collected highlight the lack of univocal standardized methodic, concerning the general animals’ management and the specific methodologies (aimed to improve animal welfare and to empower TR efficacy). Some positive and some critical aspects were detected concerning TR personnel-horse relationship. Another experimental approach did evaluate the efficacy (concerning the mutual benefits’ empowerment) of an “ethologically-fitted” TR intervention, aimed to educate children to and through the relationship with horses. Our data evidenced that the improvement of human horse relationship, through structured educational programs for TR personnel might have important consequences both to human and equine welfare.

Semantic Service Architectures for Smart Environments

Many industries and academic institutions share the vision that an appropriate use of information originated from the environment may add value to services in multiple domains and may help humans in dealing with the growing information overload which often seems to jeopardize our life. It is also clear that information sharing and mutual understanding between software agents may impact complex processes where many actors (humans and machines) are involved, leading to relevant socioeconomic benefits. Starting from these two input, architectural and technological solutions to enable “environment-related cooperative digital services” are here explored. The proposed analysis starts from the consideration that our environment is physical space and here diversity is a major value. On the other side diversity is detrimental to common technological solutions, and it is an obstacle to mutual understanding. An appropriate environment abstraction and a shared information model are needed to provide the required levels of interoperability in our heterogeneous habitat. This thesis reviews several approaches to support environment related applications and intends to demonstrate that smart-space-based, ontology-driven, information-sharing platforms may become a flexible and powerful solution to support interoperable services in virtually any domain and even in cross-domain scenarios. It also shows that semantic technologies can be fruitfully applied not only to represent application domain knowledge. For example semantic modeling of Human-Computer Interaction may support interaction interoperability and transformation of interaction primitives into actions, and the thesis shows how smart-space-based platforms driven by an interaction ontology may enable natural ad flexible ways of accessing resources and services, e.g, with gestures. An ontology for computational flow execution has also been built to represent abstract computation, with the goal of exploring new ways of scheduling computation flows with smart-space-based semantic platforms.