3 resultados para POLE PLACEMENT

em AMS Tesi di Dottorato - Alm@DL - Università di Bologna


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Object of the search is the advertising phenomenon of the "product placement", with reference to that it has been investigated legality’s limits, as well as the relationship with the constitutionally protected liberty of expression. Particularly, it has been analyzed, in first place, the problem of the relationship between the freedom of expression and the liberty of economic initiative, with particular reference to the different circles of guardianship to these prepared: or, larger, the one provided for the first from the 21th article of Costitution, more circumscribed, instead, the one established in the 41th article of Costitution, with reference to the second. This analysis has been made with the purpose to investigate the coordination among such liberties in those forms of communications that, for the proper peculiarities that characterize them, can be qualified, according to the concrete circumstances in which they are spread, so much forms of liberty of expression, how much exercise of an activity of enterprise. Under this last profile, it has been taken attention on the advertising activity and, specially, on the non transparent publicities, or not immediately perceivable as such from their receivers, and, therefore, in contrast with the advertising trasparence’s principle: or, the so-called cases of hidden publicity, what the editorial publicity, both "in narrow sense" both "in general sense", as well as the phenomenon of the product placement (or positioning of product), by now diffused in the commercial routine. Therefore, it has been proceeded to a complete and exhaustive examination of innovations introduced by the recent legislative discipline in subject of “planned placement of marks and products” in the cinema works, appraising, in the specific one, the effects, juridical and no juridical, consequential from the introduction of a first form of regulation of the phenomenon of the product placement and, particularly, from the express provision about the legality of the use to such advertising, if it has realized according to specific requirements or condition. In relationship to such profile, it has been also investigate limits (sub kind of normative gaps) from which the recently introduced discipline in subject would seem characterized. Finally, a further circle of investigation has concerned the possible organization of the phenomenon under a negotiate aspect, as particular contract of advertising, in which the object consists in an promotional activity. Concerning this, the experience of foreign countries (above all the Anglo-Saxon one) has been very important, because of the absence, in our arrangement, of a general normative discipline about advertising contracts. Consequently, I’ve investigated principal characteristics of similar contracts, in first place the atypicalness, because of the lack, in Italy, of a legislative discipline of this contract. Such investigation has also been developed through a comparation between the positioning of product and the other advertising contracts, among which, particularly, the sponsorship, as well as the contracts for the advertising exploitation of the name and other people's image, and, specially, the contract of testimonial and the contract of endorsement.

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Through this research I have tried to demonstrate how the evolution of the newest marketing strategies - that work towards engaging relationships with consumers, thus building an emotional connection between the brand and the user- can be considered as a response to the evolution of young audiences and consumers. More specifically, I have analized product placement as a cultural and social phenomena above all, and not only as an economical one, thus demonstrating all the social and cultural practices that this tool implies. The approach I have chosen to do so, is historical-analytical, particularly focusing on the evolution of the society and of the consumer, especially for what teenagers (both as audiences and as consumers) are concerned.

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Introduction Lower pole kidney stones represent at time a challenge for the urologist. The gold standard treatment for intrarenal stones <2 cm is Extracorporeal Shock Wave Lithotripsy (ESWL) while for those >2 cm is Percutaneous Nephrolithotomy (PCNL). The success rate of ESWL, however, decreases when it is employed for lower pole stones, and this is particularly true in the presence of narrow calices or acute infundibular angles. Studies have proved that ureteroscopy (URS) is an efficacious alternative to ESWL for lower pole stones <2 cm, but this is not reflected by either the European or the American guidelines. The aim of this study is to present the results of a large series of flexible ureteroscopies and PCNLs for lower pole kidney stones from high-volume centers, in order to provide more evidences on the potential indications of the flexible ureteroscopy for the treatment of kidney stones. Materials and Methods A database was created and the participating centres retrospectively entered their data relating to the percutaneous and flexible ureteroscopic management of lower pole kidney stones. Patients included were treated between January 2005 and January 2010. Variables analyzed included case load number, preoperative and postoperative imaging, stone burden, anaesthesia (general vs. spinal), type of lithotripter, access location and size, access dilation type, ureteral access sheath use, visual clarity, operative time, stone-free rate, complication rate, hospital stay, analgesic requirement and follow-up time. Stone-free rate was defined as absence of residual fragments or presence of a single fragment <2 mm in size at follow-up imaging. Primary end-point was to test the efficacy and safety of flexible URS for the treatment of lower pole stones; the same descriptive analysis was conducted for the PCNL approach, as considered the gold standard for the treatment of lower pole kidney stones. In this setting, no statistical analysis was conducted owing to the different selection criteria of the patients. Secondary end-point consisted in matching the results of stone-free rates, operative time and complications rate of flexible URS and PCNL in the subgroup of patients harbouring lower pole kidney stones between 1 and 2 cm in the higher diameter. Results A total 246 patients met the criteria for inclusion. There were 117 PCNLs (group 1) and 129 flexible URS (group 2). Ninety-six percent of cases were diagnosed by CT KUB scan. Mean stone burden was 175±160 and 50±62 mm2 for groups 1 and 2, respectively. General anaesthesia was induced in 100 % and 80% of groups 1 and 2, respectively. Pneumo-ultrasonic energy was used in 84% of cases in the PCNL group, and holmium laser in 95% of the cases in the flexible URS group. The mean operative time was 76.9±44 and 63±37 minutes for groups 1 and 2 respectively. There were 12 major complications (11%) in group 1 (mainly Grade II complications according to Clavidien classification) and no major complications in group 2. Mean hospital stay was 5.7 and 2.6 days for groups 1 and 2, respectively. Ninety-five percent of group 1 and 52% of group 2 required analgesia for a period longer than 24 hours. Intraoperative stone-free rate after a single treatment was 88.9% for group 1 and 79.1% for group 2. Overall, 6% of group 1 and 14.7% of group 2 required a second look procedure. At 3 months, stone-free rates were 90.6% and 92.2% for groups 1 and 2, respectively, as documented by follow-up CT KUB (22%) or combination of intra-venous pyelogram, regular KUB and/or kidney ultrasound (78%). In the subanalysis conducted comparing 82 vs 65 patients who underwent PCNL and flexible URS for lower pole stones between 1 and 2 cm, intreoperative stone-free rates were 88% vs 68% (p= 0.03), respectively; anyway, after an auxiliary procedure which was necessary in 6% of the cases in group 1 and 23% in group 2 (p=0.03), stone-free rates at 3 months were not statistically significant (91.5% vs 89.2%; p=0.6). Conversely, the patients undergoing PCNL maintained a higher risk of complications during the procedure, with 9 cases observed in this group versus 0 in the group of patients treated with URS (p=0.01) Conclusions These data highlight the value of flexible URS as a very effective and safe option for the treatment of kidney stones; thanks to the latest generation of flexible devices, this new technical approach seems to be a valid alternative in particular for the treatment of lower pole kidney stones less than 2 cm. In high-volume centres and in the hands of skilled surgeons, this technique can approach the stone-free rates achievable through PCNL in lower pole stones between 1 and 2 cm, with a very low risk of complications. Furthermore, the results confirm the high success rate and relatively low morbidity of modern PCNL for lower pole stones, with no difference detectable between the prone and supine position.