The vulnerable carotid plaque. Identification of endothelial markers predictive of plaque weakness, rupture predisposition and neoangiogenesis

Background. Neoangiogenesis is crucial in plaque progression and instability. Previous data from our group demonstrated that intra-plaque neovessels show both a Nestin+/WT+ and a Nestin+/WT1- phenotype, the latter being correlated with complications and plaque instability. Aims. The aims of the present thesis are: (i) to confirm our previous results on Nestin/WT1 phenotype in a larger series of carotid atheromatous plaques, (ii) to evaluate the relationship between the Nestin+/WT1- neoangiogenesis phenotype and plaque morphology, (iii) to evaluate the relationship between the immunohistochemical and histopathological characteristics and the clinical instability of the plaques. Materials and Methods. Seventy-three patients (53 males, 20 females, mean age 71 years) were consecutively enrolled. Symptoms, brain CT scan, 14 histological variables, including intraplaque hemorrhage and diffuse calcifications, were collected. Immunohistochemistry for CD34, Nestin and WT1 was performed. RT-PCR was performed to evaluate Nestin and WT1 mRNA (including 5 healthy arteries as controls). Results. Diffusely calcified plaques (13 out of 73) were found predominantly in females (P=0.017), with a significantly lower incidence of symptoms (TIA/stroke) and brain focal lesions (P=0.019 and P=0.013 respectively) than not-calcified plaques, but with the same incidence of intraplaque complications (P=0.156). Accordingly, both calcified and not calcified plaques showed similar mean densities of positivity for CD34, Nestin and WT1. The density of Nestin and WT1 correlated with the occurrence of intra-plaque hemorrhage in all cases, while the density of CD34 correlated only in not-calcified plaques. Conclusions. We confirmed that the Nestin+/WT1- phenotype characterizes the neovessels of instable plaques, regardless the real amount of CD34-positive neoangiogenesis. The calcified plaques show the same incidence of histological complications, albeit they do not influence symptomatology and plaque vulnerability. Female patients show a much higher incidence of not-complicated or calcified plaques, receiving de facto a sort of protection compared to male patients.

Social inclusion of vulnerable groups through participatory and emancipatory approaches. Implementing active citizenship and socially innovative actions in the framework of civil & human rights model of disability

The research hypothesis of the thesis is that “an open participation in the co-creation of the services and environments, makes life easier for vulnerable groups”; assuming that the participatory and emancipatory approaches are processes of possible actions and changes aimed at facilitating people’s lives. The adoption of these approaches is put forward as the common denominator of social innovative practices that supporting inclusive processes allow a shift from a medical model to a civil and human rights approach to disability. The theoretical basis of this assumption finds support in many principles of Inclusive Education and the main focus of the hypothesis of research is on participation and emancipation as approaches aimed at facing emerging and existing problems related to inclusion. The framework of reference for the research is represented by the perspectives adopted by several international documents concerning policies and interventions to promote and support the leadership and participation of vulnerable groups. In the first part an in-depth analysis of the main academic publications on the central themes of the thesis has been carried out. After investigating the framework of reference, the analysis focuses on the main tools of participatory and emancipatory approaches, which are able to connect with the concepts of active citizenship and social innovation. In the second part two case studies concerning participatory and emancipatory approaches in the areas of concern are presented and analyzed as example of the improvement of inclusion, through the involvement and participation of persons with disability. The research has been developed using a holistic and interdisciplinary approach, aimed at providing a knowledge-base that fosters a shift from a situation of passivity and care towards a new scenario based on the person’s commitment in the elaboration of his/her own project of life.

Families Stories. Rappresentazioni di famiglie nella letteratura per l'infanzia in Europa e negli Stati Uniti

In questa tesi dottorale viene preso in analisi il tema della famiglia, uno degli elementi fondanti della riflessione pedagogica, crocevia di una molteplicità di nuclei interpretativi con diramazioni e contaminazioni, con mutamenti attraverso le epoche storiche, rappresentati in pagine contenute nei Classici della letteratura per l’infanzia e nei migliori libri di narrativa contemporanea. Si tratta di un tema di grande ampiezza che ha comportato una scelta mirata di Autori che, nei loro romanzi hanno trattato questioni riguardanti la famiglia nelle sue pluralità delle sue tante accezioni, dalla vita familiare agli abbandoni, dalle infanzie senza famiglia alle famiglie altre. Nelle diverse epoche storiche, le loro narrazioni hanno lasciato un segno per l'originalità interpretativa che ancora oggi ci raccontano storie di vie familiale Dai romanzi ottocenteschi alle saghe fantasy degli ultimi cinquant’anni, fino ai picturebook, destinati ai più piccoli, le families stories possono costituire un materiale pedagogico privilegiato, sia offrendo occasioni di scoperta e conoscenza di sé e del mondo, attraverso le quali i lettori bambini, enigmatici frontalieri, varcano soglie verso altrovi misteriosi, sia fornendo spunti agli studiosi per approfondire tematiche multiple e complesse. Le families stories riflettono spesso in maniera critica le divergenze che possono manifestarsi tra le prassi individuate e studiate dalle scienze umane e sociali e le metafore narrative proposte dai numerosi Autori della letteratura per l’infanzia. Proponendo una prospettiva spesso spiazzante, esse interpretano la realtà a fondo, cogliendo i più piccoli ed inosservati particolari che, invece, hanno la capacità di rompere gli schemi socio-educativi dell’epoca storica in cui le storie prendono vita.