Voices of nigerian women survivors of trafficking held in italian centres for identification and expulsion

Department of Equal Opportunities; Presidency of the Council of Ministries; Province of Rome (metropolitan area)

Flixweed vs. Polyethylene Glycol in the Treatment of Childhood Functional Constipation: A Randomized Clinical Trial

Background: Polyethylene glycol (PEG) is often considered as the first-line treatment for functional constipation in children. Descurainia sophia (L.) Webb et Berth (D. sophia) is a safe recommended medicine in Iranian folk and Traditional Persian Medicine for the treatment of constipation. Objectives: To clinically compare D. sophia with PEG 4000 (without electrolyte) in pediatric constipation and to assess its efficacy and side effects. Patients and Methods: 120 patients aged 2 - 12 years with constipation for at least 3 months were included in an 8 weeks lasting randomized controlled trial within two parallel-groups. Children received either PEG, 0.4 g/kg/day, or D. sophia seeds, 2 grams (for children aged 2 - 4 years) and 3 grams (for those aged > 4 years) per day. Results: A total of 109 patients completed the study (56 in D. sophia and 53 in PEG group). At the end of the study, 36 (64.3%) patients in D. sophia group and 29 (54.7%) in PEG group were out of Rome III criteria (P = 0.205). Median weekly stool frequency in 0, 1, 2, 3 weeks of the treatment was found to be 2, 5, 5, 5 in D. sophia and 3, 4, 4, 5 in PEG group (P = 0.139, 0.076, 0.844, 0.294), respectively. The number of patients who suffered flatulence was less (5, 8.9%) in D. sophia group as compared to PEG group (6, 11.3%) at the end of the trial (P = 0.461). D. sophia taste was less tolerated. Conclusions: D. sophia is introduced as a cheap and available medication which can be applied as a safe alternative to conventional PEG in the management of pediatric chronic functional constipation.

Molecular epidemiology of respiratory viruses in a paediatric cohort from Indonesia

Acute lower respiratory tract infections (ALRTIs) are a common cause of morbidity and mortality among children under 5 years of age and are found worldwide, with pneumonia as the most severe manifestation. Although the incidence of severe disease varies both between individuals and countries, there is still no clear understanding of what causes this variation. Studies of community-acquired pneumonia (CAP) have traditionally not focused on viral causes of disease due to a paucity of diagnostic tools. However, with the emergence of molecular techniques, it is now known that viruses outnumber bacteria as the etiological agents of childhood CAP, especially in children under 2 years of age. The main objective of this study was to investigate viruses contributing to disease severity in cases of childhood ALRTI, using a two year cohort study following 2014 infants and children enrolled in Bandung, Indonesia. A total of 352 nasopharyngeal washes collected from 256 paediatric ALRTI patients were used for analysis. A subset of samples was screened using a novel microarray pathogen detection method that identified respiratory syncytial virus (RSV), human metapneumovirus (hMPV) and human rhinovirus (HRV) in the samples. Real-time RT-PCR was used both for confirming and quantifying viruses found in the nasopharyngeal samples. Viral copy numbers were determined and normalised to the numbers of human cells collected with the use of 18S rRNA. Molecular epidemiology was performed for RSV A and hMPV using sequences to the glycoprotein gene and nucleoprotein gene respectively, to determine genotypes circulating in this Indonesian paediatric cohort. This study found that HRV (119/352; 33.8%) was the most common virus detected as the cause of respiratory tract infections in this cohort, followed by the viral pathogens RSV A (73/352; 20.7%), hMPV (30/352; 8.5%) and RSV B (12/352; 3.4%). Co-infections of more than two viruses were detected in 31 episodes (defined as an infection which occurred more than two weeks apart), accounting for 8.8% of the 352 samples tested or 15.4% of the 201 episodes with at least one virus detected. RSV A genotypes circulating in this population were predominantly GA2, GA5 and GA7, while hMPV genotypes circulating were mainly A2a (27/30; 90.0%), B2 (2/30; 6.7%) and A1 (1/30; 3.3%). This study found no evidence of disease severity associated either with a specific virus or viral strain, or with viral load. However, this study did find a significant association with co-infection of RSV A and HRV with severe disease (P = 0.006), suggesting that this may be a novel cause of severe disease.

Between a rock and a hard place : what do public sector leaders learn from the past as they lead into the future

The purpose of this paper is to bring leadership context into sharper focus and to suggest there are strong constraints on public leaders’ discretion to lead in ways consistent with NPM or NPL. Much of the existing public leadership research focuses on the individual leader and tends to give little attention to the influence of context. This lack of focus on leader context adversely affects our ability to build public leadership capacity. We draw on prior research to establish that (1) there are strong contextual constraints on public leaders’ capacity to lead in ways consistent with NPL, (2) public leaders are subject to contradictory messages and for the most part these contradictions are unacknowledged and unresolved, the impact of which is confusion and informal power-politics, (3) the task of leader transition from traditional leadership to new public leadership is very much underestimated and requires a new way to think about leadership development. On the basis of this analysis, we argue that public leaders find themselves between a rock and a hard place.

Development and pilot study of the Primary Care Practice Improvement Tool (PC-PIT) : an innovative approach

Objective To assess the usability and validity of the Primary Care Practice Improvement Tool (PC-PIT), a practice performance improvement tool based on 13 key elements identified by a systematic review. It was co-created with a range of partners and designed specifically for primary health care. Design This pilot study examined the PC-PIT using a formative assessment framework and mixed-methods research design. Setting and participants Six high-functioning general practices in Queensland, Australia, between February and July 2013. A total of 28 staff participated — 10 general practitioners, six practice or community nurses, 12 administrators (four practice managers; one business manager and eight reception or general administrative staff). Main outcome measures Readability, content validity and staff perceptions of the PC-PIT. Results The PC-PIT offers an appropriate and acceptable approach to internal quality improvement in general practice. Quantitative assessment scores and qualitative data from all staff identified two areas in which the PC-PIT required modification: a reduction in the indicative reading age, and simplification of governance-related terms and concepts. Conclusion The PC-PIT provides an innovative approach to address the complexity of organisational improvement in general practice and primary health care. This initial validation will be used to develop a suite of supporting, high-quality and free-to-access resources to enhance the use of the PC-PIT in general practice. Based on these findings, a national trial is now underway.

Doctors' knowledge of the law on withholding and withdrawing life-sustaining medical treatment

Objectives To examine the level of knowledge of doctors about the law on withholding and withdrawing life-sustaining treatment from adults who lack decision-making capacity, and factors associated with a higher level of knowledge. Design, setting and participants Postal survey of all specialists in emergency medicine, geriatric medicine, intensive care, medical oncology, palliative medicine, renal medicine and respiratory medicine on the AMPCo Direct database in New South Wales, Victoria and Queensland. Survey initially posted to participants on 18 July 2012 and closed on 31 January 2013. Main outcome measures Medical specialists’ levels of knowledge about the law, based on their responses to two survey questions. Results Overall response rate was 32%. For the seven statements contained in the two questions about the law, the mean knowledge score was 3.26 out of 7. State and specialty were the strongest predictors of legal knowledge. Conclusions Among doctors who practise in the end-of-life field, there are some significant knowledge gaps about the law on withholding and withdrawing life-sustaining treatment from adults who lack decision-making capacity. Significant consequences for both patients and doctors can flow from a failure to comply with the law. Steps should be taken to improve doctors’ legal knowledge in this area and to harmonise the law across Australia.

Evaluation of legal capacity by doctors and lawyers : the need for collaborative assessment

• Balancing the interests of individual autonomy and protection is an escalating challenge confronting an ageing Australian society. • One way this is manifested is in the current ad hoc and unsatisfactory way that capacity is assessed in the context of wills, enduring powers of attorney and advance health directives. • The absence of nationally accepted assessment guidelines results in terminological and methodological miscommunication and misunderstanding between legal and medical professionals. • Expectations between legal and medical professionals can be clarified to provide satisfactory capacity assessments based upon the development of a sound assessment paradigm

Editorials: A different kind of treatment

Health professionals' duty of care includes combating racism in society as well as in health care settings. The Australian Government's proposed changes to the Racial Discrimination Act 1975 and the repeal of section 18C has transfixed national debates on legally defining racial discrimination.1 Under these changes, racial discrimination would no longer include acts that “offend, insult, humiliate or intimidate” a person based on the person's race, colour or national or ethnic origin and instead be limited to acts that “incite hatred” or “cause fear of physical harm”.2 These proposed changes have been framed in the context of enabling “free speech”, yet, evidence presented in this issue of the Journal shows that they have potential to cause harm. In this issue, Kelaher and colleagues highlight the prevalence of racism as experienced by Indigenous Australians and its deleterious effects on mental health.3 Alarmingly, almost every Aboriginal Victorian participating in this study reported an experience of racism in the preceding 12 months, which included jokes, stereotypes, verbal abuse and exclusionary practices. The experiences of racism reported here neither incited hatred nor caused fear of physical harm, yet resulted in harm such as psychological distress, especially when meted out in our health care system. These findings are a stark reminder that racism is indeed an important health issue, and as health professionals, our duty of care extends to contributing to these broader policy discussions...

Kulttuurisia kohtaamisia : Suomalaiset kuvataiteilijat ja Rooma 1800-luvulla

Dozens of Finnish artists, practically all the professional sculptors and painters, travelled to and stayed in Rome during the 19th century. The study at hand concentrates for the first time on the Finnish artists in Rome in corpore, and analyses their way of life based on a broad variety of previously unknown and unexplored sources from a number of archives in both Scandinavia and Rome. The extensive corpus of source material is scrutinized with microhistorical precision from the point of view of cultural history. The new information thus achieved adds to the previous knowledge of Rome s often overlooked importance as a source of inspiration in Scandinavian culture in general and significantly clarifies our understanding of the development of Finnish artistic life and cultural identity in the 19th century. The study proves that in Finland, like in all of Europe, the stay in Rome was considered to be a necessary part of becoming a true artist. Already the journey was an integral part of the encounter with Rome, corresponding with the civilized ideal of the period. The stay in Rome provided a northern artist with overwhelming opportunities that were incomparable to the unestablished and modest forms of artistic life Finland could offer. Without domestic artistic institutions or traditions, the professional status of Finnish painters and sculptors took shape abroad, firstly through the encounter with Rome and the different networks the Finnish artists belonged to during and after their stay in the eternal city. The Finnish artists were an integral part of the international artistic community in the cultural capital of Europe, which gave a totally new impetus to their work and contributed to their cosmopolitan identification. For these early masters of Finnish art, the Scandinavian communality and universal artistic identity seemed to be more significant than their nationality. In all, the scrutiny of Finnish artists in their wide social, ideological and international framework gives an interesting aspect to the cultural ambiance of the 19th century, in both Rome and Finland. The study highlights many long-forgotten artists who were influential in shaping Finnish art, culture and identity in their time.

Isänmaamme keisari : Eliitin kansallisen identiteetin murros ja suomalaisen isänmaan rakentuminen autonomian ajan alussa

The emperor of our fatherland The changing national identity of the elite and the construction of the Finnish fatherland at the beginning of the autonomy This study addresses the question of changing national identity of the elite at the beginning of the autonomy (1808 1814) in Finland. Russia had conquered Finland from Sweden, but Finland was not incorporated into the Russian Empire. Instead, it was governed as separately administered area, and Finland retained its own (laws of the realm of Sweden) laws. The inclusion in the Russian Empire compelled the elite of Finland to deliberate their national identity; they had to determine whether they remained Swedes or became Finns or Russians. The elite chose to become Finns, which may seem obvious from the nowadays perspective, but it cannot be taken for granted that the Swedish speaking and noble elite converted their local Finnish identity into a new national identity. The basis of this study is constructive in a sense that identity is not seen as stable and constant. Theoretical background lies on Stuart Hall s writings on national identity, which offer good practical methods to study national identity. According to Hall identity is based mainly on difference , difference to others . In practice this means how elite began to define themselves in contrast to Swedes and Russians. The Finnish national identity was constructed in contrast to Swedes due to the political reasons. In order to avoid Russians suspicions Finns had to diverge from Sweden. Sweden had also gone trough coup d état, which was disliked by the elite of Finland. However, the attitudes of the elite towards Sweden remained somewhat ambiguous. Even if it was politically and rationally thinking wisest to draw away from Sweden, emotionally it was difficult. Russia, on the other hand, had been for centuries the archenemy of the Finns as well as all the Swedes. The fear of the Russians was mainly imaginary. Russians were seen as cruel barbarians who hated and resented Finns. The Finnish national identity was constructed above all in contrast to the Russians, for the difference to Russia was seen as a precondition for the existence of Finland. Respectively, the new position of Finland also required approaching towards Russia, which was in its nature very pragmatic. The elite contrived to get rid off its prejudice against Russians on intellectual level, but not on emotional level. At the beginning of the autonomy the primary loyalty of the elite was directed into the Finnish fatherland and its habitants. This was a radical ideological change, because traditionally the loyalty of the elite had focused on monarch and monarch s realm. However, the role of Alexander I was crucial. According to the elite the emperor had granted them a new fatherland. The former native country (Finland) was seen as a new fatherland instead of Sweden. The loyalty of the elite to the emperor generated from the reciprocal gratitude; Alexander I had treated their native country so mercifully. The elite felt strong personal responsibility for Finland s existence. The elite believed that the future of Finland rested on their shoulders. Alexander I had given them fatherland, but it was in the hands of the elite to construct the Finnish state and national spirit. The study of the Finnish national identity brings forth also that the national identity was constructed by emphasizing Finns civic rights. The civic rights were essential part of the construction of the Finnish national identity, for the difference between Finns and Russians was based on Finns own laws and privileges, which the emperor of the Russia had ensured.

Graenum Berger papers, undated, (1825)-2002

Contains correspondence, minutes, reports, clippings, manuscripts, research materials, journal articles, photographs and publications; primarily relating to Berger's involvement with Ethiopian Jewry and his efforts to bring about their rescue through the organization he formed, the American Association for Ethiopian Jews. Also contains material from Berger's other interests- his writings, travels through the world and to Israel and Ethiopia, community affiliations, research in Black American Jews, profession as a Jewish social work executive, his commitment to Jewish causes and to Israel. There are also many personal and biographical materials from the numerous long-term friendships and associations he established.

Beatific Enjoyment in Scholastic Philosophy and Theology: 1240-1335

This dissertation examines the concept of beatific enjoyment (fruitio beatifica) in scholastic theology and philosophy in the thirteenth and early fourteenth century. The aim of the study is to explain what is enjoyment and to show why scholastic thinkers were interested in discussing it. The dissertation consists of five chapters. The first chapter deals with Aurelius Augustine's distinction between enjoyment and use and the place of enjoyment in the framework of Augustine's view of the passions and the human will. The first chapter also focuses upon the importance of Peter Lombard's Sentences for the transmission of Augustine's treatment of enjoyment in scholastic thought as well as upon Lombard's understanding of enjoyment. The second chapter treats thirteenth-century conceptions of the object and psychology of enjoyment. Material for this chapter is provided by the writings - mostly Sentences commentaries - of Alexander of Hales, Albert the Great, Bonaventure, Thomas Aquinas, Peter of Tarentaise, Robert Kilwardby, William de la Mare, Giles of Rome, and Richard of Middleton. The third chapter inspects early fourteenth-century views of the object and psychology of enjoyment. The fourth chapter focuses upon discussions of the enjoyment of the Holy Trinity. The fifth chapter discusses the contingency of beatific enjoyment. The main writers studied in the third, fourth and fifth chapters are John Duns Scotus, Peter Aureoli, Durandus of Saint Pourçain, William of Ockham, Walter Chatton, Robert Holcot, and Adam Wodeham. Historians of medieval intellectual history have emphasized the significance of the concept of beatific enjoyment for understanding the character and aims of scholastic theology and philosophy. The concept of beatific enjoyment was developed by Augustine on the basis of the insight that only God can satisfy our heart's desire. The possibility of satisfying this desire requires a right ordering of the human mind and a detachment of the will from the relative goals of earthly existence. Augustine placed this insight at the very foundation of the notion of Christian learning and education in his treatise On Christian Doctrine. Following Augustine, the twelfth-century scholastic theologian Peter Lombard made the concept of enjoyment the first topic in his plan of systematic theology. The official inclusion of Lombard's Sentences in the curriculum of theological studies in the early universities stimulated vigorous discussions of enjoyment. Enjoyment was understood as a volition and was analyzed in relation to cognition and other psychic features such as rest and pleasure. This study shows that early fourteenth-century authors deepened the analysis of enjoyment by concentrating upon the relationship between enjoyment and mental pleasure, the relationship between cognition and volition, and the relationship between the will and the beatific object (i.e., the Holy Trinity). The study also demonstrates the way in which the idea of enjoyment was affected by changes in the method of theological analysis - the application of Aristotelian logic in a Trinitarian context and the shift from virtue ethics to normative ethics.

Characterisation of the DNA-polymerase-alpha-primase complex from the silk glands of Bombyx mori

Silk gland cells ofBombyx mori undergo chromosomal endoduplication throughout larval development. The DNA content of both posterior and middle silk gland nuclei increased by 300000 times the haploid genomic content, amounting to 18 rounds of replication. The DNA doubling time is approximately 48 h and 24 h during the fourth and fifth instars of larval development. However, DNA content does not change during the interim moult. Concomitant with DNA content, DNA polymerase activity also increases as development progressed. Enzyme activity is predominantly due to DNA polymerase with no detectable level of polymerase . DNA polymerase from silk gland extracts was purified to homogeneity (using a series of columns involving ionexchange, gel-filtration and affintiy chromatography), resulting in a 4000-fold increase in specific activity. The enzyme is a heterogeneous multimer of high molecular mass, and the catalytic (polymerase) activity is resident in the 180-kDa subunit. The enzyme shows a PI of 6.2 and theKm values for the dNTP vary over 5-16 . The polymerase is tightly associated with primase activity and initiates primer synthesis in the presence of ribonucleoside triphosphates on a single-stranded DNA template. The primase activity is resident in the 45-kDa subunit. The enzyme is devoid of any detectable exonuclease activity. The abundance of DNA polymerase α in silk glands and its strong association with the nuclear matrix suggest a role in the DNA endoduplication process.

La teología pastoral de Evangelii Gaudium en el proyecto misionero de Francisco

Resumen: Este ensayo teológico comprende y expone el pensamiento pastoral del Papa Francisco, primer obispo de Roma y Papa latinoamericano, elegido desde las periferias del orbe para guiar al Pueblo de Dios en el corazón de la urbe. Francisco es un pastor misionero y un pastoralista lúcido, que ha enseñado teología pastoral y, lo sigue haciendo, de otra forma, desde el ministerio petrino. La exhortación Evangelii gaudium (2013) condensa de una forma orgánica su mirada a la evangelización en la huella de la exhortación Evangelii nuntiandi de Pablo VI (1975) y del Documento Conclusivo de Aparecida del Episcopado latinoamericano y caribeño (2007). La novedad de su pontificado reformador y misionero hunde sus raíces en la figura singular del jesuita argentino Jorge Mario Bergoglio; en su arraigo en la Iglesia latinoamericana y en el proyecto misionero de Aparecida; y en la incipiente pero promisoria teología argentina postconciliar. El autor hace un pormenorizado estudio sistemático y contextualizado de la exhortación La alegría del Evangelio desde el propio documento y en relación a otros textos de Jorge Bergoglio y, ahora, del Papa Francisco. Articula su discurso en dos momentos mostrando sus interrelaciones. El primero, breve, presenta al sucesor de Pedro como un icono de la fisonomía regional y la reflexión pastoral de la Iglesia latinoamericana. El segundo analiza nueve claves de la Evangelii gaudium: la alegría de evangelizar, síntesis de la mística misionera; la figura de la Iglesia centrada en la misión; la influencia del proyecto misionero de Aparecida; la conversión misionera para la reforma eclesial desde el Concilio Vaticano II; la Iglesia, Pueblo de Dios y Madre de los pueblos, como sujeto de la misión; la fuerza evangelizadora de la piedad católica popular; la revolución de la ternura comunicada en el Evangelio de la misericordia; la dimensión social del Evangelio y de la evangelización; la opción por los pobres desde el corazón de Dios.

Vetio Agorio Pretextato, visto por sus contemporáneos

Resumen: En fuentes epigráficas y literarias Vetio Agorio Pretextato es identificado como uno de los representantes más notables de la aristocracia senatorial pagana romana de la cuarta centuria. Dichos testimonios lo presentan como vívida encarnación y real custodio del mos maiorum, la imagen de los óptimos padres de Roma y símbolo de fidelidad a la misión arcana que hizo de los miembros de dicha elite, los legítimos depositarios de la divina tarea de conducir los destinos imperiales. Inferir el verdadero alcance de su figura, construida y trasmitida por sus contemporáneos, constituye el centro de interés de este estudio.