Spatial clusters of suicide in the municipality of Sao Paulo 1996-2005: an ecological study

Background: In a classical study, Durkheim mapped suicide rates, wealth, and low family density and realized that they clustered in northern France. Assessing others variables, such as religious society, he constructed a framework for the analysis of the suicide, which still allows international comparisons using the same basic methodology. The present study aims to identify possible significantly clusters of suicide in the city of Sao Paulo, and then, verify their statistical associations with socio-economic and cultural characteristics. Methods: A spatial scan statistical test was performed to analyze the geographical pattern of suicide deaths of residents in the city of Sao Paulo by Administrative District, from 1996 to 2005. Relative risks and high and/or low clusters were calculated accounting for gender and age as co-variates, were analyzed using spatial scan statistics to identify geographical patterns. Logistic regression was used to estimate associations with socioeconomic variables, considering, the spatial cluster of high suicide rates as the response variable. Drawing from Durkheim's original work, current World Health Organization (WHO) reports and recent reviews, the following independent variables were considered: marital status, income, education, religion, and migration. Results: The mean suicide rate was 4.1/100,000 inhabitant-years. Against this baseline, two clusters were identified: the first, of increased risk (RR = 1.66), comprising 18 districts in the central region; the second, of decreased risk (RR = 0.78), including 14 districts in the southern region. The downtown area toward the southwestern region of the city displayed the highest risk for suicide, and though the overall risk may be considered low, the rate climbs up to an intermediate level in this region. One logistic regression analysis contrasted the risk cluster (18 districts) against the other remaining 78 districts, testing the effects of socioeconomic-cultural variables. The following categories of proportion of persons within the clusters were identified as risk factors: singles (OR = 2.36), migrants (OR = 1.50), Catholics (OR = 1.37) and higher income (OR = 1.06). In a second logistic model, likewise conceived, the following categories of proportion of persons were identified as protective factors: married (OR = 0.49) and Evangelical (OR = 0.60). Conclusions: This risk/ protection profile is in accordance with the interpretation that, as a social phenomenon, suicide is related to social isolation. Thus, the classical framework put forward by Durkheim seems to still hold, even though its categorical expression requires re-interpretation.

Using selected scenes from Brazilian films to teach about substance use disorders, within medical education

CONTEXT AND OBJECTIVES: Themes like alcohol and drug abuse, relationship difficulties, psychoses, autism and personality dissociation disorders have been widely used in films. Psychiatry and psychiatric conditions in various cultural settings are increasingly taught using films. Many articles on cinema and psychiatry have been published but none have presented any methodology on how to select material. Here, the authors look at the portrayal of abusive use of alcohol and drugs during the Brazilian cinema revival period (1994 to 2008). DESIGN AND SETTING: Qualitative study at two universities in the state of São Paulo. METHODS: Scenes were selected from films available at rental stores and were analyzed using a specifically designed protocol. We assessed how realistic these scenes were and their applicability for teaching. One author selected 70 scenes from 50 films (graded for realism and teaching applicability > 8). These were then rated by another two judges. Rating differences among the three judges were assessed using nonparametric tests (P < 0.001). Scenes with high scores (> 8) were defined as "quality scenes". RESULTS: Thirty-nine scenes from 27 films were identified as "quality scenes". Alcohol, cannabis, cocaine, hallucinogens and inhalants were included in these. Signs and symptoms of intoxication, abusive/harmful use and dependence were shown. CONCLUSIONS: We have produced rich teaching material for discussing psychopathology relating to alcohol and drug use that can be used both at undergraduate and at postgraduate level. Moreover, it could be seen that certain drug use behavioral patterns are deeply rooted in some Brazilian films and groups.

Dalla Francia all'Italia: impegno politico, inchiesta e transfers culturali alle origini della sociologia del lavoro in Italia

Sociology of work in Italy revived at the end of WWII, after thirty years of forced oblivion. This thesis examines the history of discipline by considering three paths that it followed from its revival up to its institutionalization: the influence of the productivity drive, the role of trade unions and the activity of early young researchers. European Productivity Agency's Italian office Comitato Nazionale per la Produttività propagandised studies on management and on the effects of the industrialization on work and society. Academicians, technicians, psychologists who worked for CNP started rethinking sociology of work, but the managerial use of sociology was unacceptable for both trade unions and young researchers. So “free union” CISL created a School in Florence with an eager attention to social sciences as a medium to become a new model union, while Marxist CGIL, despite its ideological aversion to sociology, finally accepted the social sciences lexicon in order to explain the work changes and to resist against the employers' association offensive. On the other hand, political and social engagement led a first generation of sociologists to study social phenomenon in the recently industrialized Italy by using the sociological analysis. Finally, the thesis investigate the cultural transfers from France, whose industrial sociology (sociologie du travail) was considered as a reference in continental Europe. Nearby the wide importance of French sociologie, financially aided by planning institutions in order to employ it in the industrial reconstruction, other minor experiences such as the social surveys accomplished by worker-priests in the suburbs of industrial cities and the heterodox Marxism of the review “Socialisme ou Barbarie” influenced Italian sociology of work.

La nuit dans les romans des Lumières Du roman libertin au roman gothique

Cette thèse se propose d’analyser les images de la nuit et ses significations dans les romans du XVIII siècle, à partir des années 1730-1740, dans le cadre de trois littératures: la littérature anglaise, française et italienne. Deux conceptions opposées sont mises en comparaison: la première, d’exorcisation de la nuit, est typique de la première partie du siècle; elle est représentée principalement par le genre des romans libertins. La deuxième conception montre une valorisation de la nuit qu’on trouve en particulier dans les romans gothiques, qui se sont développés à partir de la seconde partie du siècle. Le but final de la présente recherche est de trouver une explication au refus de la nuit de la part de certains auteurs et ensuite de repérer les causes du bouleversement de cette vision. Puisque la nuit empêche le sens de la vue, elle a été considérée une forme de négation de l’espace physique; selon le profil psychologique et anthropologique la nuit constituerait alors la cause principale de la perte d’orientation. Selon une interprétation intellectuelle et philosophique, elle serait un symbole d’ignorance et d’irrationalité. La situation change vers la moitié du siècle des Lumières, car la nuit commence à assumer un rôle actif et nécessaire dans le processus d’apprentissage. Au niveau social, les rencontres les plus importantes adviennent pendant la nuit. Dans le revival des cathédrales gothiques et des châteaux médiévaux, on voit que la nuit s’empare désormais de l’espace, qui s’enrichit de lumières et d’ombres.

Intuizione e visualizzazione in matematica con particolare riferimento a Felix Klein

Questo lavoro trae spunto da un rinnovato interesse per l’«intuizione» e il «pensiero visivo» in matematica, e intende offrire un contributo alla discussione contemporanea su tali questioni attraverso lo studio del caso storico di Felix Klein. Dopo una breve ricognizione di alcuni dei saggi più significativi al riguardo, provenienti sia dalla filosofia della matematica, sia dalla pedagogia, dalle neuroscienze e dalle scienze cognitive, l’attenzione si concentra sulla concezione epistemologia di Klein, con particolare riferimento al suo uso del concetto di ‘intuizione’. Dai suoi lavori e dalla sua riflessione critica si ricavano non solo considerazioni illuminanti sulla fecondità di un approccio «visivo», ma argomenti convincenti a sostegno del ruolo cruciale dell’intuizione in matematica.

La costruzione delle relazioni politiche ed economiche tra l'Italia e la Germania occidentale dopo la seconda guerra mondiale (1945-1951)

L’autore ricostruisce ed esamina la storia dei rapporti italo-tedeschi negli anni immediatamente precedenti la riapertura ufficiale delle relazioni diplomatiche tra Italia e Repubblica federale tedesca. Un riavvicinamento economico e politico progressivo, ma che suscitò forti contrasti tra i principali attori della diplomazia italiana. Il saggio si basa su una documentazione conservata presso l’Archivio storico del ministero degli Esteri, l’Archivio centrale dello Stato, l’Archivio storico della Banca d’Italia e l’Archivio Politico del ministero degli Esteri della Repubblica federale. L’autore sostiene che le relazioni economiche italo-tedesche assunsero un ruolo centrale nel processo di elaborazione della politica estera italiana sulla questione tedesca nel corso di questi anni. Prima dell’istituzione della Repubblica federale tedesca, l’Italia divenne un partner economico fondamentale per la Germania occidentale. Tra il 1945 e il 1949 l'Italia fu il primo paese europeo favorevole alla rinascita di un nuovo stato tedesco non sottoposto alla diretta influenza dell’Unione Sovietica. Il presidente del Consiglio De Gasperi e il ministro degli Esteri Sforza per sostenere la nuova Germania attuarono una precisa azione diplomatica di riavvicinamento politico, promuovendo diversi scambi di visite e di incontri con i rappresentanti tedeschi.

Interacting bosons and fermions in three-dimensional optical lattice potentials

This thesis reports on the realization, characterization and analysis of ultracold bosonic and fermionic atoms in three-dimensional optical lattice potentials. Ultracold quantum gases in optical lattices can be regarded as ideal model systems to investigate quantum many-body physics. In this work interacting ensembles of bosonic 87Rb and fermionic 40K atoms are employed to study equilibrium phases and nonequilibrium dynamics. The investigations are enabled by a versatile experimental setup, whose core feature is a blue-detuned optical lattice that is combined with Feshbach resonances and a red-detuned dipole trap to allow for independent control of tunneling, interactions and external confinement. The Fermi-Hubbard model, which plays a central role in the theoretical description of strongly correlated electrons, is experimentally realized by loading interacting fermionic spin mixtures into the optical lattice. Using phase-contrast imaging the in-situ size of the atomic density distribution is measured, which allows to extract the global compressibility of the many-body state as a function of interaction and external confinement. Thereby, metallic and insulating phases are clearly identified. At strongly repulsive interaction, a vanishing compressibility and suppression of doubly occupied lattice sites signal the emergence of a fermionic Mott insulator. In a second series of experiments interaction effects in bosonic lattice quantum gases are analyzed. Typically, interactions between microscopic particles are described as two-body interactions. As such they are also contained in the single-band Bose-Hubbard model. However, our measurements demonstrate the presence of multi-body interactions that effectively emerge via virtual transitions of atoms to higher lattice bands. These findings are enabled by the development of a novel atom optical measurement technique: In quantum phase revival spectroscopy periodic collapse and revival dynamics of the bosonic matter wave field are induced. The frequencies of the dynamics are directly related to the on-site interaction energies of atomic Fock states and can be read out with high precision. The third part of this work deals with mixtures of bosons and fermions in optical lattices, in which the interspecies interactions are accurately controlled by means of a Feshbach resonance. Studies of the equilibrium phases show that the bosonic superfluid to Mott insulator transition is shifted towards lower lattice depths when bosons and fermions interact attractively. This observation is further analyzed by applying quantum phase revival spectroscopy to few-body systems consisting of a single fermion and a coherent bosonic field on individual lattice sites. In addition to the direct measurement of Bose-Fermi interaction energies, Bose-Bose interactions are proven to be modified by the presence of a fermion. This renormalization of bosonic interaction energies can explain the shift of the Mott insulator transition. The experiments of this thesis lay important foundations for future studies of quantum magnetism with fermionic spin mixtures as well as for the realization of complex quantum phases with Bose-Fermi mixtures. They furthermore point towards physics that reaches beyond the single-band Hubbard model.

Gender und Genre in melodramatischen Literaturverfilmungen der Gegenwart - Far From Heaven, The Hours, A Single Man

Die Dissertation Gender und Genre in melodramatischen Literaturverfilmungen der Gegenwart untersucht das Medium Film anhand von Todd Haynes’ Far from Heaven (2002), Stephen Daldrys The Hours (2002) und Tom Fords A Single Man (2009) als Quelle des Wissens über gesellschaftlich-normierte Geschlechterrollen und sozialkonstruierte Genderkonzepte. Die Arbeit versteht sich als eine nachhaltige Schnittstellenforschung zwischen Gender-, Literatur-, Film- und Medienwissenschaften und zeigt die Öffnung der Germanistik für den medial geprägten Kulturwandel, welcher den deutschen bzw. den deutschsprachigen Kulturraum betrifft. Gender und Geschlecht destabilisieren die Gesellschaft und die „heterosexuelle Matrix“ durch das individuelle Suchen, Finden, Konstruieren und Anerkennen einer eigenen, individuellen Genderidentität. Dieser Prozess kann unter Zuhilfenahme des Erzählens von Geschlecht im Film verdeutlicht werden, denn die audiovisuelle Fiktion modelliert Wirklichkeitsvorstellungen und das Wirklichkeitsverständnis der Rezipienten. Wobei offen bleibt, ob die Fiktion die Realität oder die Realität die Fiktion imitiert. Denn es gibt nicht nur eine Wahrheit, sondern mehrere, vielleicht unzählige Bedeutungszuschreibungen. Die drei paradigmatischen Literaturverfilmungen wurden jeweils in Bezug zu ihren Literaturvorlagen von Virginia Woolf, Michael Cunningham und Christopher Isherwood gesetzt. Sie können als Beispiele für ein wissendes, postmodernes Pastiche des Themen-Clusters Diskriminierung/Homophobie/Homosexualität/„Rasse“ gelten. Alle drei Filme verhandeln durch gemeinsame, melodramatische Motive (Spiegel, Telefon, Krieg, Familie) die Darstellbarkeit von Emotionen, Begehren, Sehnsüchten, Einsamkeit und dem Verlust der Liebe. Durch Verbindungslinien zu den Melodramen von Douglas Sirk und mittels den Theorien von u.a. Judith Butler, Stanley Cavell, Carolin Emcke, Thomas Elsaesser, Sigmund Freud, Hermann Kappelhoff und Laura Mulvey wurde das Begriffspaar Genre und Gender her-ausgestellt und im zeitgenössischen Geschlechter-Diskurs verortet. Das im Verlauf der Arbeit erarbeitete Wissen zu Gender, Sexualität, Körper und Geschlecht wurde als ein Gender-Genre-Hybrid verstanden und im Genre des queeren bzw. homosexuellen Melodrams (gay melodrama) neu verortet. Die drei Filme sind als ein Wiederbelebungsversuch bzw. ein Erweiterungsversuch des melodramatischen Genres unter dem Genderaspekt anzusehen. Die Analyse und Dekonstruktion feststehender Begriffe im Kontext der Gender- und Gay Studies und dem Queer Cinema lösen produktive Krisen und damit emanzipierte Verfahren aus. Diese müssen immer wieder neu beschrieben werden, damit sie wahrgenommen und verstanden werden. Daher sind die drei melodramatischen Literaturverfilmungen ein fiktionales Dokumentationsmodell gesellschaftlicher Konflikte, welches anhand individueller Schicksale verdeutlicht wird.

Paradigma Babylon: Rezeption und Visualisierung des Alten Orients im Spielfilm

Die Dissertation erschließt einen bislang unberücksichtigten Teil der Filmgeschichte: die cinematische Adaption altorientalischer Sujets in Gestalt monumentalistischer Bild-Epen. Die Arbeit ist in drei Teile gegliedert: Die erste beleuchtet die Entwicklung des westlichen Orientalismus mit Augenmerk auf den Alten Orient anhand biblischer und antiker Quellen, orientalischer Märchen, Reiseberichte, Malerei, Operngeschichte und, schlaglichtartig, weiterer kulturhistorischer Gebiete. Hinzu kommen die neuen, Fachwelt wie Öffentlichkeit überwältigenden, Erkenntnisse durch die Archäologie im 19. und frühen 20. Jh. Teil II konzentriert sich auf die Analyse von Stummfilmen, die die altorientalische Antike oder alttestamentliche Quellen mit Bezug zum Alten Orient thematisieren. Diese stammen aus Frankreich, Italien, Österreich und den USA. Dabei konnte herausgearbeitet werden, dass bis zum Jahr 1914 die französischen Produktionen dem Selbstverständnis nach eher dem Genre Historienfilm unterstanden, die italienischen wiederum dem Genre des, zunehmend spektakulärer werdenden, Antikfilms. Der von beiden Filmstandorten seinerseits zwar beeinflusste frühe amerikanische Film basiert hingegen vor allem auf dem protestantischen Bibelverständnis der eigenen Landesgeschichte und Religiosität. Ein eigenes Kapitel widmet sich Griffiths Babylon(kon-)version in INTOLERANCE aus dem Jahr 1916, bei dessen Untersuchung nicht nur die archäologischen, sondern auch sämtliche historischen wie literarischen Bezüge erstmals auf ihre Quellen zurückverfolgt wurden und bis dahin vorhandene Widersprüche somit geklärt werden konnten. Griffiths Interpretation der Quellen trug dazu bei, dass Babylon bzw. sein Mythos zum ersten und letzten Mal eine positive Konnotation erfuhr. Ein weiterer Schwerpunkt bis zum Jahr 1928 liegt auf der gender-Thematik, speziell auf der femme fatale in Gestalt von historischen, legendären und fiktiven altorientalischen Frauenfiguren wie der Königin von Saba, Delilah, Judith oder Semiramis. Darüber hinaus spiegeln die Filme der 1920er Jahren auch das Bild vom Neuen Babylon. Bis zum Ende der Stummfilmzeit kann abschließend von einer direkten Traditionslinie zu den Klischees des Orientalismus sowie zum Assyrian revival des 19. Jh. gesprochen werden. Dies ändert sich im dritten Teil der Arbeit, der sich mit der zweiten Blütezeit des Monumentalfilms während der 1950er und 1960er Jahre befasst. Teil III enthält daher sämtliche, heute noch verfügbaren Tonfilme, die den Alten Orient rezipieren. Diese entstammen den Produktionsstätten Hollywood und Cinecittà. Was die US-Filme betrifft, so konnte erneut ein Fokus auf dem amerikanischen Bibelverständnis herausgearbeitet werden, diesmal jedoch speziell auf dem Antagonismus zwischen Babylon und Zion. Denn dieser diente seitens der Regisseure auch der Legitimation der zeitgenössischen Nahostpolitik aus der Geschichte heraus. Darüber hinaus spiegeln die antiken Frauenfiguren die Rolle der Frau in der amerikanischen Gesellschaft während dieser Zeit. Die italienischen Produktionen dieser Jahre hingegen zeigen, so konnte dargelegt werden, dass diese Filme die altorientalische Antike vielmehr dergestalt inszenieren, wie sie bereits seit Jahrhunderten vor allem durch die griechisch-römische Geschichtsschreibung, Literatur und Operntradition Italiens Teil einer, nicht auf Moral basierenden, landestypischen Motivgeschichte gewesen war, derer sich auch der Film lustvoll bedient. Bei allen Produktionen wurden, als spezifische Aspekte, stets alle recherchierbaren Informationen zum Film, seiner Entstehung und seiner Handlung, zu seinen Kulissen und Kostümen, zu sämtlichen Inspirationsquellen sowie zeitgenössische Kritiken berücksichtigt. Die abschließenden Bewertungen innerhalb der einzelnen Filmkapitel fließen in einem Fazit zur jeweiligen Epoche ihrer Entstehung zusammen.

Scott Joplin: Treemonisha

Scott Joplin’s (1867–1917) opera Treemonisha is the only opera in existence about the Reconstruction era African-American experience written by a black man who actually lived through it. This fact alone makes the opera a work of tremendous significance. Further, Joplin’s music is profoundly expressive and as stylistically unique as anything ever created in America. Through his score and libretto, Joplin vividly documented a culture that has left us few other artifacts: The echoes of the “field hollers,” spirituals, fiddle tunes, revival hymns, and ancient African dances of his rural childhood are all heard, along with the dialects of his people rising up from slavery. Yet for all of its obvious significance, Treemonisha has been a deeply misunderstood work. The opera was complex and virtually unprecedented, two reasons why 1910s America could not embrace it. And tragically, Joplin's original 1911 materials for the opera were almost entirely destroyed in the early 1960s. In the early 1970s several attempts were made to reconstruct it, but for the most part these were not concerned with the opera’s cultural origins or historic authenticity. But now, on the centennial of this extraordinary creation, comes this new recording of a completely authentic reconstruction of Treemonisha by Rick Benjamin, based on eighteen years of research.

Interethnic Interaction Dynamics in the Russian Federation

The collapse of the Soviet Union at the beginning of the 1990s also meant the end of the idea of a common soviet identity incarnated in the "soviet man" and the new "historic community of the soviet people". While this idea still lives on in the generations of the 1920s to 1940s, the younger generations tend to prefer identification with family, profession, ethnic group or religion. Ms. Alexakhina set out to investigate different interethnic interaction strategies in the multi-ethnic context of the Russian Federation, with an emphasis on analysing the role of cultural and ethno-demographic characteristics of minority ethnic groups. It aimed to identify those specific patterns of interaction dynamics that have emerged in response to the political and economic transformation at present under way. The basic supposition was that the size and growth of an ethnic population are defined not only by demographic features such as fertility, mortality and net migration, but are also dependent on processes interethnic interaction and ethnic transition. The central hypothesis of the project was that the multi-ethnic and multi-cultural composition of Russia is apparently manifesting itself in the ethnic minority groups in various forms, but particularly in the form of ethnic revival and/or assimilation. The results of these complex phenomena are manifested as changes in ethnic attachments (national re-identification and language behaviour (multi-lingualism, language transition and loss of the mother tongue). The stress of the political and economic crisis has stimulated significant changes in ethnographic, social and cultural characteristics of inter-ethnic dynamics such as the rate of national re-identification, language behaviour, migration activity and the spread of mixed marriages, among both those minorities with a long history of settlement in Russia and those that were annexed during the soviet period. Patterns of language behaviour and the spread of mixed marriages were taken as the main indicators of the directions of interethnic interaction described as assimilation, ethnic revival and cultural pluralism. The first stage of the research involved a statistical analysis of census data from 1959 to 1994 in order to analyse the changing demographic composition of the largest ethnic groups of the Russian Federation. Until 1989 interethnic interaction in soviet society was distinguished by the process of russification but the political and economic transformation has stimulated the process of ethnic revival, leading to an apparent fall in the size of the Russian population due to ethnic re-identification by members of other ethnic groups who had previously identified themselves as Russian. Cross-classification of nationalities by demographic, social and cultural indicators has shown that the most important determinants of the nature of interethnic interaction are cultural factors such as religion and language affiliation. The analysis of the dynamics of language shift through the study of bilingualism and the domains of language usage for different demographic groups revealed a strong correlation between recognition of Russian as a mother tongue among some non-Russian ethnic groups and the declining size of these groups. The main conclusion from this macro-analysis of census data was the hypothesis of the growing importance of social and political factors upon ethnic succession, that ethnic identity is no longer a stable characteristic but has become dynamic in nature. In order to verify this hypothesis Ms. Alexakhina conducted a survey in four regions showing different patterns of interethnic interaction: the Karelian Republic, Buryatiya, the Nenezkii Autonomous Region and Tatarstan. These represented the west, east, north and south of the Russian Federation. Samples for the survey were prepared on the basis of census lists so as to exclude mono-Russian families in favour of mixed and ethnic-minority families. The survey confirmed the significant growth in the importance of ethnic affiliation in the everyday lives of people in the Federation following the de-centralisation of the political and economic spheres. Language was shown to be a key symbol of the consciousness of national distinction, confirmed by the fact that the process of russification has been reversed by the active mastering of the languages of titular nationalities. The results also confirmed that individual ethnic identity has ceased to be a fixed personal characteristic of one's cultural and genetic belonging, and people's social adaptation to the current political, social and economic conditions is also demonstrated in changes in individual ethnic self-identification. In general terms, the dynamic nature of national identity means that ethnic identity is at present acquiring the special features of overall social identity, for which the frequent change of priorities is an inherent feature of a person's life cycle. These are mainly linked with a multi-ethnic environment and high individual social mobility. From her results Ms. Alexakhina concludes that the development of national languages and multi-lingualism, together with the preservation of Russian as a state language, seems to be the most promising path to peaceful coexistence and the development of the national cultures of different ethnic groups within the Russian Federation.

Czech Syllabic-Accentual Metres (1795-1914)

This project was part of a major research project into Czech verse texts from the National Revival to the present and looked at two groups of topics from the theory and history of Czech verse. The first was the rhythm of iambic and trochaic trimeter and trochaic hexameters, with a typological distinction of variants due to individual and generational arising. The rhythmic contours of 63 sets of verses were described statistically and differences in the frequency of stresses on strong and weak positions of the metre were identified. The second part of the project concerned the Czech dactyl. The history of triple metres ranging from poets of the Enlightenment to the present day underground writer Krchovsky were traced in detail. Along with the rhythm and technique of verse, the group analysed the semantics of dactylic metres of different extents (dimeters, trimeters, etc.) and their relationships to literary genres and trends. Their findings differ totally from the assumptions of traditional metrics. A general metrical norm of dactylic verses was defined within the system of rules of correspondence by the method of generative metrics. They established a typology, specified the frequency of divergences from the norm in a range of texts and investigated their role in the style and rhythmic differentiation of poetic works.

Analyzing, Capturing and Taming Software Change

Software systems need to continuously change to remain useful. Change appears in several forms and needs to be accommodated at different levels. We propose ChangeBoxes as a mechanism to encapsulate, manage, analyze and exploit changes to software systems. Our thesis is that only by making change explicit and manipulable can we enable the software developer to manage software change more effectively than is currently possible. Furthermore we argue that we need new insights into assessing the impact of changes and we need to provide new tools and techniques to manage them. We report on the results of some initial prototyping efforts, and we outline a series of research activities that we have started to explore the potential of ChangeBoxes.

Rotational atherectomy followed by drug-eluting stent implantation (Rota-DES): a rational approach for complex calcified coronary lesions

Rotational atherectomy has been regaining interest over the last couple of years after it almost has disappeared from most interventional catheterization laboratories for several years due to failure to prove its original concept of improving long term results of percutaneous coronary interventions (PCI) as was repeatedly shown in studies in the 1990s. Its revival coupled the introduction of drug-eluting stents (DES); these devices have led to treating much more complex lesions and high-risk patients by PCI. However, real-world experience suggested that off-label use of DES is associated with a higher rate of early and late stent thrombosis. Therefore, more attention is now being paid to the initial implantation technique of DES including aggressive lesion preparation to facilitate stent delivery and expansion. The limited studies with rot-ablation and DES showed promising results with no long term safety concerns. In these studies, a subtle observation was made suggesting that rot-ablation prior to DES implantation in such lesions may have an add-on effect on long term outcome compared to DES alone. An ongoing multicenter study is investigating such effect among complex calcified coronary lesions. Even if this additive benefit does not prove true, rot-ablation remains an efficient tool for preparing certain lesions to facilitate effective and safe DES implantation. Therefore, interventional training programs should focus on this difficult technique to bridge the gap of experience which resulted from neglecting it for several years. In this regard, dedicated courses at experienced sites as well as medical simulation may be appropriate.