Le politiche giudiziarie inglesi degli anni 2000: mutamento di paradigma e rafforzamento dell'incisività politica dei giudici

The Ph.D. dissertation analyses the reasons for which political actors (governments, legislatures and political parties) decide consciously to give away a source of power by increasing the political significance of the courts. It focuses on a single case of particular significance: the passage of the Constitutional Reform Act 2005 in the United Kingdom. This Act has deeply changed the governance and the organization of the English judicial system, has provided a much clearer separation of powers and a stronger independence of the judiciary from the executive and the legislative. What’s more, this strengthening of the judicial independence has been decided in a period in which the political role of the English judges was evidently increasing. I argue that the reform can be interpreted as a «paradigm shift» (Hall 1993), that has changed the way in which the judicial power is considered. The most diffused conceptions in the sub-system of the English judicial policies are shifted, and a new paradigm has become dominant. The new paradigm includes: (i) stronger separation of powers, (ii) collective (as well as individual) conception of the independence of the judiciary, (iii) reduction of the political accountability of the judges, (iv) formalization of the guarantees of judicial independence, (v) principle-driven (instead of pragmatic) approach to the reforms, and (vi) transformation of a non-codified constitution in a codified one. Judicialization through political decisions represent an important, but not fully explored, field of research. The literature, in particular, has focused on factors unable to explain the English case: the competitiveness of the party system (Ramseyer 1994), the political uncertainty at the time of constitutional design (Ginsburg 2003), the cultural divisions within the polity (Hirschl 2004), federal institutions and division of powers (Shapiro 2002). All these contributes link the decision to enhance the political relevance of the judges to some kind of diffusion of political power. In the contemporary England, characterized by a relative high concentration of power in the government, the reasons for such a reform should be located elsewhere. I argue that the Constitutional Reform Act 2005 can be interpreted as a result of three different kinds of reasons: (i) the social and demographical transformations of the English judiciary, which have made inefficient most of the precedent mechanism of governance, (ii) the role played by the judges in the policy process and (iii) the cognitive and normative influences originated from the European context, as a consequence of the membership of the United Kingdom to the European Union and the Council of Europe. My thesis is that only a full analysis of all these three aspects can explain the decision to reform the judicial system and the content of the Constitutional Reform Act 2005. Only the cultural influences come from the European legal complex, above all, can explain the paradigm shift previously described.

Charakterisierung atherosklerotischer Plaques am Beispiel der A. carotis mittels Histologie, CT und semiautomatischer Farbcodierung

Auf der Suche nach dem „vulnerablen Plaque“, der ein besonders hohes Risiko für Schlaganfall und Herzinfarkt besitzt, findet momentan ein Paradigmenwechsel statt. Anstelle des klassischen Stenosegrades gewinnt die Darstellung der Plaquemorphologie zunehmend an Bedeutung. Fragestellung: Ziel dieser Arbeit ist es, die Fähigkeiten eines modernen 16-Kanal-CT hinsichtlich der Auflösung des Plaqueinneren bei Atherosklerose der Karotiden zu untersuchen und den Halo-Effekt in vivo zu erforschen. Methoden: Für die Studie wurden von 28 Patienten mit bekannter, symptomatischer Karotisstenose vor der gefäßchirurgischen Intervention CT-Bilder angefertigt, die nachfolgend mit der Histologie der Gefäßpräparate korreliert wurden. Auf diese Weise konnten die mikroskopisch identifizierten Lipidkerne im CT-Bild eingezeichnet und hinsichtlich ihrer Fläche und Dichtewerte evaluiert werden. In einem weiteren Schritt führten 2 Radiologen in Unkenntnis der histologischen Ergebnisse unabhängig voneinander eine Befundung durch und markierten mutmaßliche Lipidkerne. Zudem wurden sowohl in der verblindeten als auch in der histologiekontrollierten Auswertung die Plaquetypen anhand der AHA-Klassifikation bestimmt. Ein dritter Befundungsdurchgang geschah unter Zuhilfenahme einer von uns entwickelten Software, die CT-Bilder farbkodiert um die Detektion der Lipidkerne zu verbessern. Anhand der Farbkodierung wurde zudem ein Indexwert errechnet, der eine objektive Zuordnung zur AHA-Klassifikation ermöglichen sollte. Von 6 Patienten wurde zusätzlich noch eine native CT-Aufnahme angefertigt, die durch MPR exakt an die Kontrastmittelserie angeglichen wurde. Auf diese Weise konnte der Halo-Effekt, der die Plaqueanteile im lumennahen Bereich überstrahlt, quantifiziert und charakterisiert werden. Ergebnisse: Während die Einstufung in die AHA-Klassifikation sowohl durch den Befunder als auch durch den Softwarealgorithmus eine hohe Korrelation mit der Histologie aufweist (Typ IV/Va: 89 %, Typ Vb: 70 %, Typ Vc: 89 %, Typ VI: 55 %), ist die Detektion der Lipidkerne in beiden Fällen nicht ausreichend gut und die Befunderabhängigkeit zu groß (Cohens Kappa: 18 %). Eine Objektivierung der AHA-Klassifikation der Plaques durch Indexberechnung nach Farbkodierung scheint möglich, wenn auch dem Befunder nicht überlegen. Die fibröse Kappe kann nicht abgegrenzt werden, da Überstrahlungseffekte des Kontrastmittels dessen HU-Werte verfälschen. Dieser Halo-Effekt zeigte sich im Median 1,1 mm breit mit einer Standardabweichung von 0,38 mm. Eine Abhängigkeit von der Kontrastmitteldichte im Gefäßlumen konnte dabei nicht nachgewiesen werden. Der Halo-Effekt fiel im Median um -106 HU/mm ab, bei einer Standardabweichung von 33 HU/mm. Schlussfolgerung: Die CT-Technologie zeigt sich, was die Darstellung von einzelnen Plaquekomponenten angeht, den bekannten Fähigkeiten der MRT noch unterlegen, insbesondere in Bezug auf die fibröse Kappe. Ihre Fähigkeiten liegen bisher eher in der Einstufung von Plaques in eine grobe Klassifikation, angelehnt an die der AHA. Die klinische Relevanz dessen jedoch gilt es in Zukunft in größeren Studien weiter zu untersuchen. Auch lässt die Weiterentwicklung der Computertomographie auf eine zukünftig höhere Auflösung der Plaquemorphologie hoffen.

Il Maquis nella letteratura spagnola contemporanea. Storia, memoria e rappresentazione narrativa

La tesi analizza la rappresentazione del maquis nella letteratura spagnola contemporanea, scritti in castigliano e pubblicati dal 1985 ad oggi. La tesi si articola in tre capitoli: il primo presenta a livello teorico la metodologia e gli strumenti utilizzati nello svolgimento dello studio, ed è incentrato innanzitutto sul tentativo di definizione e catalogazione dei romanzi del maquis, con una particolare attenzione alla temperie culturale cui fanno riferimento, presentando le estetiche postmoderna e neomoderna e cercando di situare le opere narrative facenti parte del corpus della ricerca. Nel secondo capitolo è centrale in cambio l’analisi dei rapporti tra Storia e narrazione: oltre a concentrarsi sul dibattito interdisciplinare circa le connessioni tra la Storia e la narrativa, si cerca di dar conto dei riflessi di questa riflessione contemporanea all’interno delle opere facenti parte del corpus. Infine, il terzo capitolo riguarda l’analisi delle metafore animali rintracciabili nei romanzi sul maquis scelti, concentrandosi principalmente su Luna de lobos di Julio Llamazares e La agonía del búho chico di Justo Vila. L’impiego di questa figura retorica, che si ritrova in vari gradi in tutte le opere narrative scelte, risponde tanto ad una ricerca di verosimiglianza quanto alle modalità di rappresentazione della realtà empirica, riportando l’attenzione sui metodi atti alla figurazione e all’accesso alla conoscenza del mondo. La proposta di un cambio di paradigma estetico e narrativo in atto nella letteratura contemporanea spagnola cerca quindi una conferma nel momento dell’analisi, attraverso la quale si cerca di indagare se, e in che misura, il romanzo sul maquis si inserisce nel dibattito letterario odierno, e quanto contribuisce allo sviluppo del medesimo paradigma estetico in via di definizione – quello neomoderno –, cercando una conferma che si basa sulla presenza di quelle tematiche segnalate nel momento della discussione teorica e metodologica come tratti basilari e strutturanti le opere.

Ict security: Defence strategies against targeted attacks

L’avanzare delle tecnologie ICT e l’abbattimento dei costi di produzione hanno portato ad un aumento notevole della criminalità informatica. Tuttavia il cambiamento non è stato solamente quantitativo, infatti si può assistere ad un paradigm-shift degli attacchi informatici da completamente opportunistici, ovvero senza un target specifico, ad attacchi mirati aventi come obiettivo una particolare persona, impresa o nazione. Lo scopo della mia tesi è quello di analizzare modelli e tassonomie sia di attacco che di difesa, per poi valutare una effettiva strategia di difesa contro gli attacchi mirati. Il lavoro è stato svolto in un contesto aziendale come parte di un tirocinio. Come incipit, ho effettuato un attacco mirato contro l’azienda in questione per valutare la validità dei sistemi di difesa. L’attacco ha avuto successo, dimostrando l’inefficacia di moderni sistemi di difesa. Analizzando i motivi del fallimento nel rilevare l’attacco, sono giunto a formulare una strategia di difesa contro attacchi mirati sotto forma di servizio piuttosto che di prodotto. La mia proposta è un framework concettuale, chiamato WASTE (Warning Automatic System for Targeted Events) il cui scopo è fornire warnings ad un team di analisti a partire da eventi non sospetti, ed un business process che ho nominato HAZARD (Hacking Approach for Zealot Attack Response and Detection), che modella il servizio completo di difesa contro i targeted attack. Infine ho applicato il processo all’interno dell’azienda per mitigare minacce ed attacchi informatici.

Predicting and monitoring cancer treatment response with diffusion-weighted MRI

An imaging biomarker that would provide for an early quantitative metric of clinical treatment response in cancer patients would provide for a paradigm shift in cancer care. Currently, nonimage based clinical outcome metrics include morphology, clinical, and laboratory parameters, however, these are obtained relatively late following treatment. Diffusion-weighted MRI (DW-MRI) holds promise for use as a cancer treatment response biomarker as it is sensitive to macromolecular and microstructural changes which can occur at the cellular level earlier than anatomical changes during therapy. Studies have shown that successful treatment of many tumor types can be detected using DW-MRI as an early increase in the apparent diffusion coefficient (ADC) values. Additionally, low pretreatment ADC values of various tumors are often predictive of better outcome. These capabilities, once validated, could provide for an important opportunity to individualize therapy thereby minimizing unnecessary systemic toxicity associated with ineffective therapies with the additional advantage of improving overall patient health care and associated costs. In this report, we provide a brief technical overview of DW-MRI acquisition protocols, quantitative image analysis approaches and review studies which have implemented DW-MRI for the purpose of early prediction of cancer treatment response.

Chapter V: Diabetic foot

Ulcerated diabetic foot is a complex problem. Ischaemia, neuropathy and infection are the three pathological components that lead to diabetic foot complications, and they frequently occur together as an aetiologic triad. Neuropathy and ischaemia are the initiating factors, most often together as neuroischaemia, whereas infection is mostly a consequence. The role of peripheral arterial disease in diabetic foot has long been underestimated as typical ischaemic symptoms are less frequent in diabetics with ischaemia than in non-diabetics. Furthermore, the healing of a neuroischaemic ulcer is hampered by microvascular dysfunction. Therefore, the threshold for revascularising neuroischaemic ulcers should be lower than that for purely ischaemic ulcers. Previous guidelines have largely ignored these specific demands related to ulcerated neuroischaemic diabetic feet. Any diabetic foot ulcer should always be considered to have vascular impairment unless otherwise proven. Early referral, non-invasive vascular testing, imaging and intervention are crucial to improve diabetic foot ulcer healing and to prevent amputation. Timing is essential, as the window of opportunity to heal the ulcer and save the leg is easily missed. This chapter underlines the paucity of data on the best way to diagnose and treat these diabetic patients. Most of the studies dealing with neuroischaemic diabetic feet are not comparable in terms of patient populations, interventions or outcome. Therefore, there is an urgent need for a paradigm shift in diabetic foot care; that is, a new approach and classification of diabetics with vascular impairment in regard to clinical practice and research. A multidisciplinary approach needs to implemented systematically with a vascular surgeon as an integrated member. New strategies must be developed and implemented for diabetic foot patients with vascular impairment, to improve healing, to speed up healing rate and to avoid amputation, irrespective of the intervention technology chosen. Focused studies on the value of predictive tests, new treatment modalities as well as selective and targeted strategies are needed. As specific data on ulcerated neuroischaemic diabetic feet are scarce, recommendations are often of low grade.

New-onset epilepsy: considerations for initial and follow-up MRI to detect brain tumor

Seizures are often the presenting symptoms of a cerebral tumor and may precede its diagnosis by many years. The article under evaluation searched two large English registries for patients admitted for new-onset epilepsy. The risk of subsequently being diagnosed with a malignant brain tumor was found to be 26-fold higher compared with controls, persisted over many years and was accentuated in young patients. Recently, surgical advances have led to a significant decrease in surgical morbidities, making surgery the first treatment option for gliomas, especially low-grade gliomas. This paradigm shift warrants a consequent diagnostic workup (MRI) in patients at risk for low-grade glioma - that is, patients with new-onset epilepsy. The study is discussed in the context of the ongoing debate on neuroimaging after new-onset epilepsy.

Radiolabeled somatostatin receptor antagonists are preferable to agonists for in vivo peptide receptor targeting of tumors

Targeting neuroendocrine tumors expressing somatostatin receptor subtypes (sst) with radiolabeled somatostatin agonists is an established diagnostic and therapeutic approach in oncology. While agonists readily internalize into tumor cells, permitting accumulation of radioactivity, radiolabeled antagonists do not, and they have not been considered for tumor targeting. The macrocyclic chelator 1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid (DOTA) was coupled to two potent somatostatin receptor-selective peptide antagonists [NH(2)-CO-c(DCys-Phe-Tyr-DAgl(8)(Me,2-naphthoyl)-Lys-Thr-Phe-Cys)-OH (sst(3)-ODN-8) and a sst(2)-selective antagonist (sst(2)-ANT)], for labeling with (111/nat)In. (111/nat)In-DOTA-sst(3)-ODN-8 and (111/nat)In-DOTA-[4-NO(2)-Phe-c(DCys-Tyr-DTrp-Lys-Thr-Cys)-DTyr-NH(2)] ((111/nat)In-DOTA-sst(2)-ANT) showed high sst(3)- and sst(2)-binding affinity, respectively. They did not trigger sst(3) or sst(2) internalization but prevented agonist-stimulated internalization. (111)In-DOTA-sst(3)-ODN-8 and (111)In-DOTA-sst(2)-ANT were injected intravenously into mice bearing sst(3)- and sst(2)-expressing tumors, and their biodistribution was monitored. In the sst(3)-expressing tumors, strong accumulation of (111)In-DOTA-sst(3)-ODN-8 was observed, peaking at 1 h with 60% injected radioactivity per gram of tissue and remaining at a high level for >72 h. Excess of sst(3)-ODN-8 blocked uptake. As a control, the potent agonist (111)In-DOTA-[1-Nal(3)]-octreotide, with strong sst(3)-binding and internalization properties showed a much lower and shorter-lasting uptake in sst(3)-expressing tumors. Similarly, (111)In-DOTA-sst(2)-ANT was injected into mice bearing sst(2)-expressing tumors. Tumor uptake was considerably higher than with the highly potent sst(2)-selective agonist (111)In-diethylenetriaminepentaacetic acid-[Tyr(3),Thr(8)]-octreotide ((111)In-DTPA-TATE). Scatchard plots showed that antagonists labeled many more sites than agonists. Somatostatin antagonist radiotracers therefore are preferable over agonists for the in vivo targeting of sst(3)- or sst(2)-expressing tumors. Antagonist radioligands for other peptide receptors need to be evaluated in nuclear oncology as a result of this paradigm shift.

Delayed gadolinium enhanced MRI of cartilage (dGEMRIC): Molekulare MRT-Bildgebung des Hüftgelenkknorpels [Delayed gadolinium enhanced MRI of cartilage (dGEMRIC): molecular MRI of hip joint cartilage]

Factors such as instability and impingement lead to early cartilage damage and osteoarthritis of the hip joint. The surgical outcome of joint-preserving surgery about the hip joint depends on the preoperative quality of joint cartilage.For in vivo evaluation of cartilage quality, different biochemically sensitive magnetic resonance imaging (MRI) procedures have been tested, some of which have the potential of inducing a paradigm shift in the evaluation and treatment of cartilage damage and early osteoarthritis.Instead of reacting to late sequelae in a palliative way, physicians could assess cartilage damage early on, and the treatment intensity could be adequate and based on the disease stage. Furthermore, the efficiency of different therapeutic interventions could be evaluated and monitored.This article reviews the recent application of delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) and discusses its use for assessing cartilage quality in the hip joint. dGEMRIC is more sensitive to early cartilage changes in osteoarthritis than are radiographic measures and might be a helpful tool for assessing cartilage quality.

Concepts for Contemporary Social Work: Globalization, Oppression, Social Exclusion, Human Rights, Etc.

The society wrestles with mass social change congruent with economic globalization and the communications revolution. This change creates new challenges for the social work profession in the areas of social and economic justice. This article analyzes the terminology of the new global era, words that signify a paradigm shift in outlook, most of them a reaction to the new authoritarianism of the age. Globalization, oppression, social exclusion, human rights, harm reduction, and restorative justice are the representative terms chosen.

Volumetric morphometrics

Geometric morphometrics (GMM) methods are very popular in physical anthropology. One disadvantage common to the existingGMM methods is that despite significant advancements in computed tomography (CT) and magnetic resonance imaging (MRI)technology, these methods still depend on landmarks or features that are either digitized directly from subject surface or extractedfrom surface models or outlines derived from a laser surface scan or from a CTor MRI scan. All the rest image contents contained ina CTor MRI scan are ignored by these methods. In this paper, we present a complementary solution called Volumetric Morphometrics(VMM). With VMM, we are aiming for a paradigm shift from landmarks and surfaces used in existing GMM approaches todisplacements and volumes in the new VMM approaches, taking the full advantage of modern CTand MRI technology. Preliminaryvalidation results on ancient human skulls are presented.

Modular training in vascular and endovascular surgery exemplified by the Vascular International Foundation and School

The partial shift from patient to model is a reasonable and necessary paradigm shift in surgery in order to increase patient safety and to adapt to the reduced training time periods in hospitals and increased quality demands. Since 1991 the Vascular International Foundation and School has carried out many training courses with more than 2,500 participants. The modular build training system allows to teach many open vascular and endovascular surgical techniques on lifelike models with a pulsatile circulation. The simulation courses cannot replace training in operating rooms but are suitable for supporting the cognitive and associative stages for achieving motor skills. Scientific evaluation of the courses has continually shown that the training principle established since 1991 can lead to significant learning success. They are extremely useful not only for beginners but also for experienced vascular surgeons. They can help to shorten the learning curve, to learn new techniques or to refine previously used techniques in all stages of professional development. Keywords Advanced training · Advanced training regulations · Training model · Vascular International · Certification

In Memoriam: Herbert E Wright Jr 1917-2015

Herbert E Wright Jr was one of the foremost Quaternary scientists of the last century. He made wide ranging contributions to our understanding of the late-Quaternary of North and South America, Europe, Asia and Africa. This was based largely on reconstructing palaeoenvironments from lake sediments and included the important implications for glacial, vegetational, fire and climatic history, geoarchaeology and conservation. Many of his inter-disciplinary research projects involved fieldwork with his graduate students and co-workers from the University of Minnesota where he created and led the renowned Limnological Research Center. Perhaps his most outstanding contribution was as an instigator of the Co-operative Holocene Mapping Project (COHMAP). This triggered a paradigm shift in Holocene climatic research involving the comparison of climate-model simulations of past climates with palaeoclimatic data.

Zuni elders: Ethnography of American Indian aging

Problem/purpose. The specific aim of this focused ethnography was to provide insight into the experience of aging of the American Indian (AI) elder as demonstrated by one tribe, the Zuni of New Mexico. Discovering how Zuni elders construct the experience of aging and the associated behaviors allowed the researcher to deconstruct aging and then re-present it in a cogent description for this population. Such a description is lacking in the literature and will be useful in planning for culturally relevant eldercare services. ^ Methods. Ethnographic field techniques were used to sample from elders, pueblo members-at-large, activities, events and places. Over 1800 hrs were spent in the field spanning 14 months and five site visits, with the longest at almost 4 weeks. Developing codes for transcribed interviews, field notes, supplementary documents, photographs, videos, and artifacts was carried out during analysis. Categories and ultimately a cognitive map and model were developed which represented aging in Zuni Pueblo in 2000. ^ Findings. Zuni elders are aging in two worlds. Their primary world has been described as a sevenfold universe, a complicated structure with seven planes wherein the middle plane refers to themselves, a synthesis of all the other planes. The increasing influence of the white world has formed a ‘new middle’ out of which everyday aspects of aging are viewed. ^ Implications for nursing/gerontology. Nurses and others in gerontology must recognize that vast differences in worldviews are present between themselves and AI elders regarding health practices, spirituality, eating patterns, family roles, medicine, religion and countless other aspects of life. Their centuries old beliefs and practices drive these differences coupled with a collision with the white world. Making a paradigm shift using an appropriate lens with which to view these differences can only increase our understanding and efficacy in delivering culturally relevant care. ^

Performance tiers: Implementing comparative effectiveness analysis in the health care setting through operations research and spatial methods

This dissertation develops and tests a comparative effectiveness methodology utilizing a novel approach to the application of Data Envelopment Analysis (DEA) in health studies. The concept of performance tiers (PerT) is introduced as terminology to express a relative risk class for individuals within a peer group and the PerT calculation is implemented with operations research (DEA) and spatial algorithms. The analysis results in the discrimination of the individual data observations into a relative risk classification by the DEA-PerT methodology. The performance of two distance measures, kNN (k-nearest neighbor) and Mahalanobis, was subsequently tested to classify new entrants into the appropriate tier. The methods were applied to subject data for the 14 year old cohort in the Project HeartBeat! study.^ The concepts presented herein represent a paradigm shift in the potential for public health applications to identify and respond to individual health status. The resultant classification scheme provides descriptive, and potentially prescriptive, guidance to assess and implement treatments and strategies to improve the delivery and performance of health systems. ^